110 HR 2633 IH: Healthy Lifestyles and Prevention America Act or the HeLP America Act U.S. House of Representatives 2007-06-07 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
I 110th CONGRESS 1st Session H. R. 2633 IN THE HOUSE OF REPRESENTATIVES June 7, 2007 Mr. Udall of New Mexico (for himself, Mr. Moran of Virginia, and Mr. McGovern) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Labor, Oversight and Government Reform, House Administration, and Transportation and Infrastructure, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To improve the health of Americans and reduce health care costs by reorienting the Nation’s health care system toward prevention, wellness, and self care.
1.
Short title; table of contents
(a)
Short Title
This Act may be cited as the Healthy Lifestyles and Prevention America Act or the HeLP America Act. (b)
Table of Contents
The table of contents of this Act is as follows: Sec. 1. Short title; table of contents. Sec. 2. Findings. TITLE I—CHILDHOOD OBESITY Sec. 101. Federal Task Force on Childhood Obesity. TITLE II—HEALTHIER KIDS AND SCHOOLS Sec. 201. Fresh fruit and vegetable program. Sec. 202. Food of minimal nutritional value. Sec. 203. School nutrition environment enhancement grants. Sec. 204. Baby friendly hospital-center for breastfeeding excellence. Sec. 205. Intervention to strengthen families and build children’s resilience. Sec. 206. Grants for the integration of schools and mental health systems. Sec. 207. Grants for the promotion of university-community partnerships to increase youth competencies and reduce youth problem behaviors in communities. Sec. 208. Reservations for Early Head Start programs. TITLE III—HEALTHIER COMMUNITIES AND WORKPLACES Subtitle A—Incentives for a Healthy Workforce Sec. 301. Short title. Sec. 302. Tax credit to employers for costs of implementing wellness programs. Sec. 303. CDC and employer-based wellness programs. Sec. 304. Employer-provided off-premises health club services. Subtitle B—Healthy Communities Chapter 1—Provisions To Improve the Health of Communities Sec. 311. Healthy community grants. Sec. 312. Promoting the health and wellness of individuals with disabilities through community sports programs. Sec. 313. Safe and complete streets. Sec. 314. National assessment of mental health needs. Sec. 315. Preventive medicine and public health training grant program. Sec. 316. Task force for the Promotion of Breastfeeding in the Workplace. Sec. 317. Lactation accommodation and breastfeeding promotion at work. Chapter 2—Promoting Lifelong Active Communities Sec. 321. Short title. Sec. 322. Purpose. Sec. 323. Definition of Secretary. SUBCHAPTER A—NATIONAL PROGRAM PROMOTING LIFELONG ACTIVE COMMUNITIES Sec. 331. Development of community play index. Sec. 332. Sense of the House of Representatives regarding funding. SUBCHAPTER B—MODEL COMMUNITIES OF PLAY IMPLEMENTATION GRANTS Sec. 341. Model communities of play implementation grants. TITLE IV—RESPONSIBLE MARKETING AND CONSUMER AWARENESS Subtitle A—General Provisions Sec. 401. Nutrition labeling of restaurant foods. Sec. 402. Rulemaking authority for advertising to children. Sec. 403. Food advertising in schools. Sec. 404. Disallowance of deductions for advertising and marketing expenses relating to tobacco product use. Sec. 405. Federal-state tobacco counter-advertising programs. Subtitle B—Penalties for Failure To Reduce Teen Smoking Sec. 411. Child cigarette use surveys. Sec. 412. Cigarette use reduction goal and noncompliance. Sec. 413. Enforcement. Subtitle C—Food Guidance Sec. 421. Front-label food guidance systems. TITLE V—REIMBURSEMENT AND COVERAGE OF PREVENTIVE SERVICES Sec. 501. Coverage of substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling. Sec. 502. Medicare coverage of medical nutrition therapy services for people with pre-diabetes. Sec. 503. Preventive mental health screenings. Sec. 504. Encouragement of cessation of tobacco use. Sec. 505. Recognition of school-based health centers as model for delivery of primary care for children under the medicaid and State children’s health insurance programs. Sec. 506. Preventive health care demonstration program. Sec. 507. Preventive health services for women. Sec. 508. Promoting cessation of tobacco use by pregnant women under the medicaid program. TITLE VI—HELP (HEALTHY LIFESTYLES AND PREVENTION) AMERICA TRUST FUND Sec. 601. HELP (Healthy Lifestyles and Prevention) America Trust Fund. TITLE VII—RESEARCH Sec. 701. Expansion of research regarding obesity. Sec. 702. Incorporation of physical activity into Federal programs.
2.
Findings
Congress makes the following findings: (1)Health care costs in the United States are rising rapidly. Per capita health spending in the United States is 56 percent higher than the median country that is a member of the Organization for Economic Cooperation and Development. (2)According to the Centers for Medicare and Medicaid Services, total health care spending in the United States in 2004 was $1,800,000,000,000 and is expected to rise to $3,600,000,000,000 by 2014. Furthermore, chronic disease accounts for approximately 75 percent of health care costs annually. (3)The United States spends less than 2 percent of annual health care expenditures on prevention (4)Reducing and preventing the incidence of chronic disease is one means by which to reduce health care costs in the United States. (5)More than 1,700,000 Americans die of a chronic disease each year, accounting for nearly 70 percent of all deaths in the United States. (6)The economic impact of chronic disease can be seen in the annual costs associated with cardiovascular disease and stroke ($352,000,000,000), obesity ($117,000,000,000), cancer ($171,600,000,000), and diabetes ($132,000,000,000). (7)Obesity related health conditions cost employers nearly $13,000,000,000 in health care and other indirect costs. (8)Health promotion investments by employers on average yield a return of $3 for every $1 invested in a program. (9)Being overweight or obese increase the risk of diabetes, heart disease, stroke, several types of cancer and other health problems. (10)An estimated 65 percent of adults and 15 percent of children and adolescents in the United States are overweight or obese. (11)The rates of obesity have doubled in children and tripled in teens since the 1980’s. (12)Almost 40 percent of Americans are sedentary. More than 1/3 of young people in grades 9 through 12 do not regularly engage in vigorous-intensity physical activity. (13)Only 1 in 5 young people eat the recommended 5 daily servings of fruits and vegetables. (14)Food and beverage advertisers collectively spend $10,000,000,000 to $12,000,000,000 a year to reach children and youth. (15)Between 1977 and 1995, trips made by walking declined by 40 percent for adults while driving trips increased to almost 90 percent of the total. (16)Virtually all-new users of tobacco products are under the minimum legal age to purchase such products. Every day in America, more than 4,000 kids try their first cigarette. Another 2,000 children become new daily smokers. (17)In 2002, nearly a quarter of American adults, 46,000,000 people, smoked cigarettes, including almost 40 percent of college-aged students. (18)Research consistently shows that smoking cessation services offered as a combination of tobacco medication therapy and counseling can be one of the most cost-effective health interventions and can reduce smoking-related health care costs. (19)Physical and mental health are interconnected. Physical conditions often result in mental health complications and depression can manifest itself through physical symptoms. (20)The Surgeon General reported that mental disorders collectively account for over 15 percent of the overall burden of disease from all causes, slightly more than the burden associated with all forms of cancer. (21)One of every 2 people who need mental health treatment in the United States does not receive it. Of children and adolescents 6 to 17 years old who need mental health services, nearly 80 percent do not receive it. (22)Early screening and prevention programs in the schools can detect high risk children that are vulnerable to developing mental illness and assist in accessing appropriate services. (23)Children are at greater risk for mental health problems when they experience stressful family circumstances such as social or economic disadvantage, severe marital discord, divorce, family violence, parental substance abuse or other mental disorder or physical illness, and parental absence due to military service, imprisonment, or death. (24)The 2003 President’s New Freedom Commission on Mental Health urged a transformation of the approach to mental health in the United States, including improving the mental health of children and promoting resilience and prevention. (25)People with disabilities report substantial disparities in health compared with people without disabilities. These disparities are caused by a number of factors, including less access to health care than individuals without disabilities. People with disabilities report more days of pain, depression, and anxiety and they have higher rates of obesity. (26)Evidence shows that health promotion programs with exercise, nutrition, and wellness components targeting people with disabilities can significantly reduce the incidence of these conditions and lead to healthy outcomes for people with disabilities, as well as save money by reducing the frequency of medical visits.
<enum>I</enum><header>CHILDHOOD OBESITY</header> <section id="H88BE6F78E8A6499EB787BD6448BE358E"><enum>101.</enum><header>Federal Task Force on Childhood Obesity</header><text display-inline="no-display-inline">Part Q of title III of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/280h">42 U.S.C. 280h et seq.</external-xref>) is amended by adding at the end the following:</text> <quoted-block style="OLC" act-name="Public Health Service Act" id="HE38C3F340EBF4018A6395C5E09751111"> <section id="HE89FE0D3FC79486FA50029A641BABF51"><enum>399Z–1.</enum><header>Federal Task Force on Childhood Obesity</header> <subsection id="H094EFA31638E4DE7B3F50555BA004E74"><enum>(a)</enum><header>Establishment</header><text>The Secretary shall convene a Task Force on Childhood Obesity (referred to in this section as the <quote>Task Force</quote>) to—</text> <paragraph id="HBDC8A8F1800B421C876DD52D331C05BB"><enum>(1)</enum><text>establish a government-wide strategy for preventing and reducing childhood overweight and obesity;</text></paragraph> <paragraph id="HF448AA84972A4269BF19C56764CDD00"><enum>(2)</enum><text>coordinate effective inter-agency coordination and priorities for action among Federal agencies;</text></paragraph> <paragraph id="H55D161EBF93A4975A7BA4708522987B"><enum>(3)</enum><text>implement and evaluate the effectiveness of such strategy; and</text></paragraph> <paragraph id="H53A5129A44BE4752B8D896B13ED4363D"><enum>(4)</enum><text>direct the Secretary to designate a responsible agency to formally monitor and report, not later than January 1, 2008, to Congress on the progress of the various entities and activities related to the recommendations included in the report of Institute of Medicine entitled <quote>Food Marketing to Children and Youth</quote>.</text></paragraph></subsection> <subsection id="H56E785F8E7234EB0BC157368206369E0"><enum>(b)</enum><header>Membership</header> <paragraph id="H4F51125C4A1545DDA942736D583001B"><enum>(1)</enum><header>In general</header><text>The Task Force shall be composed of employees of—</text> <subparagraph id="H4A9D5349A32F43BD83EE05B94C40C6EB"><enum>(A)</enum><text>the Department of Health and Human Services;</text></subparagraph> <subparagraph id="HBDB37961B0324BB3B9EF1879004A2C2"><enum>(B)</enum><text>the Department of Agriculture;</text></subparagraph> <subparagraph id="HB73EA2D7E1094205A0089296E5E9EB16"><enum>(C)</enum><text>the Department of Education;</text></subparagraph> <subparagraph id="H7D99DFA3EB4945619C353CD6F5EA43AC"><enum>(D)</enum><text>the Federal Trade Commission;</text></subparagraph> <subparagraph id="H0E4DE96B21B4460183720855DFC07C28"><enum>(E)</enum><text>the Department of Transportation; and</text></subparagraph> <subparagraph id="HEAD06AF3BC514E549929C3E4DDE8FDB"><enum>(F)</enum><text>any other Federal agency that the Secretary determines appropriate.</text></subparagraph></paragraph> <paragraph id="HBFA82560B1FD4323B9AFCCA8A115E3C6"><enum>(2)</enum><header>Chairperson</header><text>The chairperson of the Task Force shall be—</text> <subparagraph id="H057624AA089844F1A0EBB04F0000ECED"><enum>(A)</enum><text>an individual appointed by the President; and</text></subparagraph> <subparagraph id="H06CE6FD9570D4C9DA1B5001581EA7729"><enum>(B)</enum><text>until the date that an individual is appointed under subparagraph (A), the Secretary.</text></subparagraph></paragraph></subsection> <subsection id="H47355B68C25D4B98B7B1FF676600B5C0"><enum>(c)</enum><header>Meetings</header><text>The Task Force shall meet at the call of the chairperson.</text></subsection> <subsection id="H92B0082B833B4B2C9335E0A37B2ED69"><enum>(d)</enum><header>Report</header><text>Not later than January 1, 2008, and on annual basis thereafter through January 1, 2013, the Task Force shall submit to the President and to the relevant committees of Congress, a report that—</text> <paragraph id="HFD929C44472B43F8AF4C652C67CFAB48"><enum>(1)</enum><text>describes the activities and efforts to prevent and reduce childhood overweight and obesity conducted by the Task Force during the year to which the report relates; and</text></paragraph> <paragraph id="HBF0CEAA64B284C5B9DA57F01CBE5AC00"><enum>(2)</enum><text>evaluates the effectiveness of such activities and efforts to prevent and reduce childhood overweight and obesity.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> <enum>II</enum><header>HEALTHIER KIDS AND SCHOOLS</header> <section id="HBD78366D4141465ABC84FF323F7D1D5C"><enum>201.</enum><header>Fresh Fruit and Vegetable Program</header><text display-inline="no-display-inline">Section 18(g)(6)(B) of the Richard B. Russell <act-name parsable-cite="NSLA">National School Lunch Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1769">42 U.S.C. 1769(g)(6)(B)</external-xref>) is amended—</text> <paragraph id="H775A6006BDEE48CAA7E58B4117475D38"><enum>(1)</enum><text>by redesignating clause (ii) as clause (iv); and</text></paragraph> <paragraph id="H72C279A6E7FF446FAA0452E8ED49A838"><enum>(2)</enum><text>by inserting after clause (i) the following:</text> <quoted-block style="OLC" id="HB748D44476A74A5B9DE6C4BA68AEA73C"> <clause id="H97DDCEFD090546FE8BCA4F415ED09168"><enum>(ii)</enum><header>Additional mandatory funding</header><text>Out of any funds in the Treasury not otherwise appropriated, the Secretary of the Treasury shall transfer to the Secretary of Agriculture to carry out and expand the program under this subsection, to remain available until expended—</text> <subclause id="HD97161B1F07648A69133B22DB4561531"><enum>(I)</enum><text>on October 1, 2007, $1,000,000,000; and</text></subclause> <subclause id="H9645375D31804742816BD36D7C5E6F89"><enum>(II)</enum><text>on October 1, 2007, and on each October 1 thereafter, the amount made available for the previous fiscal year, as adjusted under clause (iii).</text></subclause></clause> <clause id="H1BD932843E5C4C22ACC058690DC0065"><enum>(iii)</enum><header>Adjustment</header><text>On October 1, 2007, and on each October 1 thereafter of a fiscal year the amount made available under subclause (I) of clause (ii) shall be calculated by adjusting the amount made available for the previous fiscal year to reflect changes in the Consumer Price Index of the Bureau of Labor Statistics for fresh fruits and vegetables, with the adjustment—</text> <subclause id="H1A528980D67A4008AB069600B0FB07C5"><enum>(I)</enum><text>rounded down to the nearest dollar increment; and</text></subclause> <subclause id="H32FE9719714C4BCCBE15ADE817841B2B"><enum>(II)</enum><text>based on the unrounded amounts for the preceding 12-month period.</text></subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section> <section id="HE874E54D67044CE6A95298FA40A668B3"><enum>202.</enum><header>Food of minimal nutritional value</header><text display-inline="no-display-inline">Section 10 of the <act-name parsable-cite="CNA66">Child Nutrition Act of 1966</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1779">42 U.S.C. 1779</external-xref>) is amended—</text> <paragraph id="H24B25F34ED954A66BBB652BF76F382B"><enum>(1)</enum><text>by striking the section heading and all that follows through <quote>(a) The Secretary</quote> and inserting the following:</text> <quoted-block style="OLC" id="HF0A4DA58D91F4ABF9914F7273C8995D1"> <section id="HE735DEF77FB942B59037AC638B1C752E"><enum>10.</enum><header>Regulations</header> <subsection id="HDA7ADC492D0345FEBC52C3C1A528C007"><enum>(a)</enum><header>In General</header><text>The Secretary</text></subsection></section><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph> <paragraph id="H9759E84CC1534898A4116CA501C6EB00"><enum>(2)</enum><text>by striking subsections (b) and (c) and inserting the following:</text> <quoted-block style="OLC" id="HF15230B762464C4683A7A467CD44B33E"> <subsection id="H2B2E923250344A759BCD40D027CBCCF7"><enum>(b)</enum><header>Food of Minimal Nutritional Value</header> <paragraph id="H588C4F498AAC4B9BA5417EE63E267F5C"><enum>(1)</enum><header>Proposed regulations</header> <subparagraph id="HF92642C6321F40299B1B1D4293728280"><enum>(A)</enum><header>In general</header><text>Not later than 180 days after the date of enactment of this paragraph, the Secretary shall promulgate proposed regulations to revise the definition of <quote>food of minimal nutritional value</quote> that is used to carry out this Act and the Richard B. Russell <act-name parsable-cite="NSLA">National School Lunch Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1751">42 U.S.C. 1751 et seq.</external-xref>).</text></subparagraph> <subparagraph id="H83E7290B948E404698B46EB8650003B4"><enum>(B)</enum><header>Application</header><text>The revised definition of <quote>food of minimal nutritional value</quote> shall apply to all foods sold—</text> <clause id="HD89371C3E53B4DD18000C1B7335420AD"><enum>(i)</enum><text>outside the school meal programs;</text></clause> <clause id="H9D84C146344F4A5B9DAE8E10E5E42B59"><enum>(ii)</enum><text>on the school campus; and</text></clause> <clause id="HE0F88744AF1A4D72941D378EDA81DA7C"><enum>(iii)</enum><text>at any time during the school day.</text></clause></subparagraph> <subparagraph id="H1F44BB72B92E4B8B88E517233D6EE200"><enum>(C)</enum><header>Requirements</header><text>In revising the definition, the Secretary shall consider—</text> <clause id="HE98DC792F6E542B7825C03DF48F00B8"><enum>(i)</enum><text>both the positive and negative contributions of nutrients, ingredients, and foods (including calories, portion size, saturated fat, trans fat, sodium, and added sugars) to the diets of children;</text></clause> <clause id="HA915A396B7EA481F9B21647987C71939"><enum>(ii)</enum><text>evidence concerning the relationship between consumption of certain nutrients, ingredients, and foods to both preventing and promoting the development of overweight, obesity, and other chronic illnesses;</text></clause> <clause id="H197289120D994DD18DDADD5461B1CE4E"><enum>(iii)</enum><text>recommendations made by authoritative scientific organizations concerning appropriate nutritional standards for foods sold outside of the reimbursable meal programs in schools; and</text></clause> <clause id="H351EB55AA62E4910004E24F502D555FF"><enum>(iv)</enum><text>special exemptions for school-sponsored fundraisers (other than fundraising 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.</text></clause></subparagraph></paragraph> <paragraph id="H5F38FF7199474FBC8C974348B18F8C00"><enum>(2)</enum><header>Implementation</header> <subparagraph id="H038D8C0591E948D68F87813F7F2FEBA8"><enum>(A)</enum><header>Effective date</header> <clause id="H1EA93927B0494F4B97DDE6E693D738F"><enum>(i)</enum><header>In general</header><text>Except as provided in clause (ii), the proposed regulations shall take effect at the beginning of the school year following the date on which the regulations are finalized.</text></clause> <clause id="H523E6150071D489D82BFC8C34B6810C7"><enum>(ii)</enum><header>Exception</header><text>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 following school year.</text></clause></subparagraph> <subparagraph id="H69F30F0BCB5B43C992D50295659DB859"><enum>(B)</enum><header>Failure to promulgate</header><text>If, on the date that is 1 year after the date of enactment of this paragraph, the Secretary has not promulgated final regulations, the proposed regulations shall be considered to be final regulations.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section> <section id="HCF04F2F08A0E46439E30E6DA4F0600F5"><enum>203.</enum><header>School nutrition environment enhancement grants</header><text display-inline="no-display-inline">Section 18 of the Richard B. Russell <act-name parsable-cite="NSLA">National School Lunch Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1769">42 U.S.C. 1769</external-xref>) is amended by adding at the end the following:</text> <quoted-block style="OLC" act-name="National School Lunch Act" id="H92DDB1B92B8D4D5CA7638C484463E350"> <subsection id="HD12D4301051C440C8F052164F4A1CFD0"><enum>(l)</enum><header>Healthy School Nutrition Environment Incentive Grants</header> <paragraph id="HB93E14203D134EDB95F22C574EAEF63F"><enum>(1)</enum><header>In general</header><text>The Secretary may implement a grant program to follow the recommendations made by the Institute of Medicine report entitled <quote>Nutrition Standards for Foods in Schools-Leading the Way Toward Healthier Youth</quote> to—</text> <subparagraph id="H141F878F53D84C0A8FE4F50360256C8D"><enum>(A)</enum><text>provide schools with technical assistance in implementing the recommendations of the Institute of Medicine regarding appropriate school nutrition standards; and</text></subparagraph> <subparagraph id="H5F1B7B45D7524C1BA64813EF00CD6C57"><enum>(B)</enum><text>assess the impact of implementing the recommendations on the health and well-being of children enrolled in the schools.</text></subparagraph></paragraph> <paragraph id="H5862B14650B44597AF00F6156274468B"><enum>(2)</enum><header>Selection of schools</header><text>In selecting schools to receive incentive grants under this subsection, the Secretary shall—</text> <subparagraph id="HDED9553E68024555933D8FC7B0B654D2"><enum>(A)</enum><text>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;</text></subparagraph> <subparagraph id="H7E80AA05B1F7439EA528A977941BC6AE"><enum>(B)</enum><text>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;</text></subparagraph> <subparagraph id="H09E94406D7D444E1AC908874B4C3EE00"><enum>(C)</enum><text>ensure that, of the schools selected to participate in the program, there is appropriate representation of elementary, middle, and secondary schools, as determined by the Secretary;</text></subparagraph> <subparagraph id="H18F26642179248339C61C47D62CF4002"><enum>(D)</enum><text>ensure that schools selected to receive a grant under this subsection meet the requirements of paragraph (3);</text></subparagraph> <subparagraph id="H80EEC9FA4ADF46A0BFA3BF60952ECFE9"><enum>(E)</enum><text>give priority to schools that develop comprehensive plans that include the involvement of a broad range of community stakeholders in achieving healthy school nutrition environments; and</text></subparagraph> <subparagraph id="HCB26DFBC6AF4460CA202CD58FEDA6DA5"><enum>(F)</enum><text>give priority to schools that develop comprehensive plans that include a strategy for maintaining healthy school nutrition environments in the years following the fiscal years for which the schools receive grants under this subsection.</text></subparagraph></paragraph> <paragraph id="H6470EDFFA3B04F8C0036D981DBAA9284"><enum>(3)</enum><header>Requirements</header> <subparagraph id="HC841F596314B487EBBCDB92EDFEAD1F8"><enum>(A)</enum><header>Criteria for healthy school environments</header><text>The Secretary shall establish criteria, based upon the recommendations of the Institute of Medicine described in paragraph (1), under which schools may receive grants under this section.</text></subparagraph> <subparagraph id="HF9E48375310C478A85CA78CAD30016"><enum>(B)</enum><header>Plan</header><text>To be eligible to receive a grant under this subsection, a school shall—</text> <clause id="H61C429BCA3C146E1B776B6598B6F6892"><enum>(i)</enum><text>submit to the Secretary a healthy school nutrition environment plan that describes the actions the school will take to meet the criteria established under subparagraph (A); and</text></clause> <clause id="HDFD9DCEC09F14130835813922696FC8"><enum>(ii)</enum><text>take the actions described in the plan.</text></clause></subparagraph></paragraph> <paragraph id="HA73FE306F2A94314ABDFF514000646DA"><enum>(4)</enum><header>Grants</header><text>For each of 5-fiscal years following the establishment of criteria by the Secretary under paragraph (3), the Secretary shall award a grant to each school selected under paragraph (2).</text></paragraph> <paragraph id="HDC23BABB66AA4DFB9D6FD780C11B9713"><enum>(5)</enum><header>Evaluations</header> <subparagraph id="H01BA7765B6C34045AAC8008D29E2E63D"><enum>(A)</enum><header>In general</header><text>The Secretary, acting through the Administrator of the Food and Nutrition Service, shall conduct an evaluation of a representative sample of schools that receive grants under this subsection.</text></subparagraph> <subparagraph id="H5090A1B2FED243E2BD172DD1CC8460B0"><enum>(B)</enum><header>Content</header><text>The evaluation shall measure, at a minimum, the effects of a healthy school nutrition environment on—</text> <clause id="H9DBB379999534A518F50D71C423889DE"><enum>(i)</enum><text>overweight children and obesity;</text></clause> <clause id="H60A3FAB7AB3C4787B4362B105CC4C847"><enum>(ii)</enum><text>dietary intake;</text></clause> <clause id="HE6E5AECD4BF442F1B11316B9D9B58637"><enum>(iii)</enum><text>nutrition education and behavior;</text></clause> <clause id="H72E53C12B7CF4D219FB0BA35E7DDD4C"><enum>(iv)</enum><text>parental and student attitudes and participation; and</text></clause> <clause id="H2CAB67BE1F574BC4A2DFE7D4629F5D3F"><enum>(v)</enum><text>related funding issues, including the cost of maintaining a healthy school nutrition environment.</text></clause></subparagraph> <subparagraph id="H7A5D7E3991E64887AAE7CEB2169F11BB"><enum>(C)</enum><header>Reports</header><text>The Secretary shall submit to the Committee on Education and the Workforce of the House of Representatives and the Committee on Agriculture, Nutrition, and Forestry of the Senate—</text> <clause id="HD9FCEBA3D1324E65A8202E578EE6D6CD"><enum>(i)</enum><text>an interim report on the activities of schools evaluated under this subsection; and</text></clause> <clause id="H252D5453D66A47F5A6723016DC34D4D"><enum>(ii)</enum><text>a final report on the activities of schools evaluated under this subsection.</text></clause></subparagraph></paragraph> <paragraph id="H5076A15A88D949D2AA971B3DA987001F"><enum>(6)</enum><header>Authorization of appropriations</header> <subparagraph id="H93F7127247EA46C58E2D08000023E776"><enum>(A)</enum><header>In general</header><text>There are authorized to be appropriated such sums as are necessary to carry out this subsection for the 5-fiscal year following the establishment of criteria by the Secretary under paragraph (3), to remain available until expended.</text></subparagraph> <subparagraph id="H77DE71D5010141B89800643EA34717F5"><enum>(B)</enum><header>Evaluations</header><text>The Secretary may use not more than 10 percent of the total funds made available for a fiscal year under subparagraph (A) to carry out paragraph (5).</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="HFAAE404E98814693897CA0EC0EF23C6"><enum>204.</enum><header>Baby friendly hospital-center for breastfeeding excellence</header> <subsection id="H9B0A7594830648A88F00BE50884E13BC"><enum>(a)</enum><header>Establishment of Program</header><text>The Director of the Office on Women’s Health of the Department of Health and Human Services (referred to in this section as the <quote>Director</quote>) shall establish a program to be known as the <quote>Baby-Friendly Hospital Initiative</quote> (referred to in this section as the <quote>Initiative</quote>).</text></subsection> <subsection id="H94EEDBB03A9B4D169B90D0BACBC46805"><enum>(b)</enum><header>Certification Process</header><text>Under the Initiative, the Director shall establish a certification process under which a hospital can apply for a certification as a <quote>baby friendly hospital/center for breastfeeding excellence</quote>. Such certification process shall be based upon the international guidelines of the Baby-Friendly Hospital Initiative established by the World Health Organization and United Nations Children’s Fund.</text></subsection> <subsection id="H576B0E9FE8B0476AB62719D14DC8070"><enum>(c)</enum><header>Requirements</header> <paragraph id="H749BB70C004C4E4E81706E4BFA4CDFCD"><enum>(1)</enum><header>In general</header><text>To be certified as a baby friendly hospital/center for breastfeeding excellence, a hospital (as defined for purposes of this section by the Director, and which may include birth centers) shall carry out the following:</text> <subparagraph id="H521A444926734E8A86AD869E40BF6874"><enum>(A)</enum><text>The hospital shall maintain a written breastfeeding policy that is routinely communicated to all of the healthcare staff of the hospital.</text></subparagraph> <subparagraph id="H5EAFBA4CB42E498C80CF8F29DF10A816"><enum>(B)</enum><text>The hospital shall provide training for all healthcare staff in the skills necessary to implement the policy described in subparagraph (A).</text></subparagraph> <subparagraph id="H19E6AE2BC4EE4B4F89C0638D589F05C5"><enum>(C)</enum><text>The hospital shall ensure that all pregnant women who are patients at the hospital are informed about the benefits and management of breastfeeding.</text></subparagraph> <subparagraph id="H732D190A57124CDEB4F5AFC145CCBD8C"><enum>(D)</enum><text>The hospital shall help mothers initiate breastfeeding within one hour of birth.</text></subparagraph> <subparagraph id="H08303FB773F648D794A6A987BB72A25C"><enum>(E)</enum><text>The hospital shall demonstrate to mothers how to breastfeed and how to maintain lactation, even if the mother is separated from her infant.</text></subparagraph> <subparagraph id="H51E25C9E789A4CD5BC956E9423008B30"><enum>(F)</enum><text>The hospital shall give infants no food or drink other than breastmilk, unless medically indicated.</text></subparagraph> <subparagraph id="H8D4DA39DAF0048CA00A9E9838B9DDD7E"><enum>(G)</enum><text>The hospital shall implement a <quote>rooming in</quote> policy by allowing mothers and infants to remain together 24 hours a day in the same hospital room.</text></subparagraph> <subparagraph id="HE8D5F09D7B604310A5F130210051B958"><enum>(H)</enum><text>The hospital shall encourage unrestricted breastfeeding.</text></subparagraph> <subparagraph id="HE6282F6A1E654888B1D73F8F62D194EF"><enum>(I)</enum><text>The hospital shall provide no pacifiers or artificial nipples to breastfeeding infants.</text></subparagraph> <subparagraph id="HEBD1B2F2E0094D778D84DCE4B543C6DA"><enum>(J)</enum><text>The hospital shall foster the establishment of breastfeeding support groups and refer mothers to such groups on discharge from the hospital.</text></subparagraph></paragraph> <paragraph id="HA66A51C24E60474FA1A96FB94BFC5775"><enum>(2)</enum><header>Inspection</header><text>A hospital shall be certified as a baby friendly hospital/center for breastfeeding excellence only upon the completion of an on-site assessment by the Director through which the Director has determined that the hospital is in compliance with the guidelines used for certification under subsection (b).</text></paragraph> <paragraph id="H24B2B216215249C597C56266A53CF0C3"><enum>(3)</enum><header>Verification</header><text>Upon being certified as a baby friendly hospital/center for breastfeeding excellence, a hospital shall agree to permit the Director to conduct on-site assessments to verify the continued compliance of the hospital with the requirements of paragraph (1).</text></paragraph></subsection> <subsection id="HA12E46E7BD4A4356A1A36EB27C371237"><enum>(d)</enum><header>Authority for Automatic Certification</header><text>The Director may automatically certify a hospital as a baby friendly hospital/center of breastfeeding excellence if such hospital has been designated as a baby-friendly hospital under the Baby-Friendly USA program.</text></subsection> <subsection id="H06ABC51F1D94432DBD672B000346B86F"><enum>(e)</enum><header>Limitation</header><text>A hospital shall not make any claim that such hospital is a baby friendly hospital/center of breastfeeding excellence unless such hospital has been certified by the Director in accordance with this section.</text></subsection> <subsection id="HBCAF2F5F28094681BC9342EA632296EE"><enum>(f)</enum><header>Technical Assistance</header><text>The Director shall provide, at the request of a hospital seeking a certification as a baby friendly hospital/center of breastfeeding excellence, such technical assistance as appropriate to assist the requesting hospital to achieve such certification.</text></subsection> <subsection id="HDDB182F47BCE4960A91D3113676D80CF"><enum>(g)</enum><header>Certification Costs</header><text>Subject to the availability of appropriations, the Director may provide to a hospital that has successfully been certified as a baby friendly hospital/center of breastfeeding excellence under this Act, a one time award of up to $20,000 to offset the cost to such hospital of being certified as a baby friendly hospital/center of breastfeeding excellence.</text></subsection> <subsection id="H659CD9114B2C4F578C615D07CFF73F78"><enum>(h)</enum><header>Recommendations for Accrediting Entities</header><text>Not later than 12 months after certifying the first baby friendly hospital/center for breastfeeding excellence under this section, the Director shall provide to the appropriate organizations or entities that are engaged in the accreditation of healthcare organizations, recommendations concerning steps that such accrediting entities may take to integrate the baby friendly hospital requirements used in the Baby Friendly Hospital Initiative into healthcare organization accreditation procedures and requirements.</text></subsection> <subsection id="H671535FC81194F9DB773268055E209D"><enum>(i)</enum><header>Authorization of Appropriations</header><text>There are authorized to be appropriated such sums as may be necessary to carry out this section.</text></subsection></section> <section id="H1C99B9004B27463A9B3B787630D50046"><enum>205.</enum><header>Intervention to strengthen families and build children’s resilience</header><text display-inline="no-display-inline">Part B of title V of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 <external-xref legal-doc="usc" parsable-cite="usc/3/290bb">3 U.S.C. 290bb et seq.</external-xref>) is amended by adding at the end the following:</text> <quoted-block style="OLC" act-name="Public Health Service Act" id="H2F36E4DC8CE148EA931680A0C1C18447"> <section id="HFA4D29C1692C44ADBF154D89804D877C"><enum>520K.</enum><header>Interventions to strengthen families and build children’s resilience</header> <subsection id="H15BAF777F4D040C98184D638D055FA89"><enum>(a)</enum><header>In General</header><text>The Secretary shall award grants to eligible entities for the purpose of implementing programs that strengthen families of children at risk for emotional or behavioral problems due to family distress.</text></subsection> <subsection id="HBA12FCE4F4004004A434C4F045763ED3"><enum>(b)</enum><header>Eligible Entity</header><text>Entities eligible to receive funds under this section may include—</text> <paragraph id="H9C0B18B08A10456980BE74CB4B43506E"><enum>(1)</enum><text>a local public entity, including a health department or local education agency;</text></paragraph> <paragraph id="H670D869D69CB41679D5070C6AA9CDD16"><enum>(2)</enum><text>an Indian tribal organization or agency;</text></paragraph> <paragraph id="H935A688FBB35467692BCBC2D26CBC022"><enum>(3)</enum><text>a federally qualified health center;</text></paragraph> <paragraph id="H17AD38838E6A4E8B00387D7E155244ED"><enum>(4)</enum><text>a community-based organization; or</text></paragraph> <paragraph id="H04B4F5529FC34993A616F2162E0858E"><enum>(5)</enum><text>any other entity determined appropriate by the Secretary, including a consortia or partnership of entities eligible to receive funds under this section.</text></paragraph></subsection> <subsection id="H991EB91361CF4677BE7CD199547EBDD6"><enum>(c)</enum><header>Use of Funds</header> <paragraph id="H0A1A4D59373D4E9E8DB207795746F004"><enum>(1)</enum><header>In general</header><text>An eligible entity that receives a grant under this section shall use the funds made available through the grant to carry out home-based, school-based, and community-based activities that—</text> <subparagraph id="HB4439DFC2C034BC985A5111046A25FB8"><enum>(A)</enum><text>promote strong, supportive families and child resilience through parenting skills training and supports, or skill-building services with children, as well as provide other consultative services and support for family and other caregivers, such as child care providers, educators, and after-school program staff;</text></subparagraph> <subparagraph id="HF5D03FF265DF437596F2966D76AECD3"><enum>(B)</enum><text>enhance mental health promotion activities in domains where children live, play, and learn; and</text></subparagraph> <subparagraph id="H3B61DE5A9C9F43D4B330F061D9B1438"><enum>(C)</enum><text>enhance community wellness, and reduce the incidence of preventable mental health problems among children.</text></subparagraph></paragraph> <paragraph id="H7A6F5335BD914BB59E0444E662738838"><enum>(2)</enum><header>Intervention activities</header><text>Intervention activities funded under this section shall—</text> <subparagraph id="H29CB74839AF34CA691D4B75E63CE4EEB"><enum>(A)</enum><text>be consumer and family driven, and use strengths-based approaches;</text></subparagraph> <subparagraph id="H57E1CABBD3FE413ABD9597C7A0710004"><enum>(B)</enum><text>be designed to promote social and emotional competencies and increase children’s ability to successfully cope with stressful life circumstances;</text></subparagraph> <subparagraph id="HACE599BE67864D01BC642525BAA3A7AE"><enum>(C)</enum><text>be designed to strengthen children and their families by enhancing the knowledge, social, emotional, and other life or work skills, and support of, parents or other significant caregivers;</text></subparagraph> <subparagraph id="H8B656D2E27284F01BB2D41FE658958BF"><enum>(D)</enum><text>emphasize and model a positive, supportive approach to working with children;</text></subparagraph> <subparagraph id="HE8225FDB4EA947A79ED3E2047BA7D357"><enum>(E)</enum><text>be evidence-based and provide in-depth and ongoing training and consultation in the adoption and use of evidence-based interventions by schools, communities, and families;</text></subparagraph> <subparagraph id="H16F776ED2EF34A548B6D04EF5653F2C9"><enum>(F)</enum><text>include a rigorous evaluation component, including outcome measures suited to the intervention and the overall goals of the grant, as well as use of comparison groups and moderating and meditating process variables whenever possible;</text></subparagraph> <subparagraph id="HF7A5742B65004381B97EBBD26884C43E"><enum>(G)</enum><text>involve partnerships between communities or schools and universities where possible to support effective implementation and evaluation of the intervention activities;</text></subparagraph> <subparagraph id="H7F97AD5B89A3480F899B1C909EE74156"><enum>(H)</enum><text>provide facilitated referrals for parents and other family members who need mental health, substance abuse, or social work services, and coordinate a referral network of professionals with affordable fees; and</text></subparagraph> <subparagraph id="H4DCBFEA2C81944969B9B35985654BA00"><enum>(I)</enum><text>emphasize local capacity-building to use evidence-based intervention, promote linkages among individuals and groups that serve children and families, and develop community outreach to support coalition-building.</text></subparagraph></paragraph> <paragraph id="HD72E37A5C8EC4365805849230068D84"><enum>(3)</enum><header>Target populations</header><text>Families targeted by these activities shall include those with children at risk for increased mental health problems due to stressful family circumstances, including—</text> <subparagraph id="H7312A8D3EB7944C8BD8734EBADFEF930"><enum>(A)</enum><text>social or economic disadvantage;</text></subparagraph> <subparagraph id="H2D15B03FA5DE4549BAC6CAD626CE0095"><enum>(B)</enum><text>severe marital discord;</text></subparagraph> <subparagraph id="HC699800B0479420FB19B51775364E787"><enum>(C)</enum><text>divorce;</text></subparagraph> <subparagraph id="H9A7D8A0A2C03483F99717ECA5FAA35C7"><enum>(D)</enum><text>family violence;</text></subparagraph> <subparagraph id="H4892426D8FFD499AB9313F39750053B1"><enum>(E)</enum><text>parental substance abuse or other mental disorder or physical illness;</text></subparagraph> <subparagraph id="HF20CA5440C9748C4AB12F631FB72DD8"><enum>(F)</enum><text>parental death;</text></subparagraph> <subparagraph id="H928FF58CD5B344C7A3157D937BBD052B"><enum>(G)</enum><text>parental absence due to military service;</text></subparagraph> <subparagraph id="HBADDB70E82804FC4A9E06330EF69BC36"><enum>(H)</enum><text>parental absence due to imprisonment; and</text></subparagraph> <subparagraph id="H104229DF49CD4CBDB77F93F8214455B"><enum>(I)</enum><text>other family disruption determined appropriate by the Secretary.</text></subparagraph></paragraph></subsection> <subsection id="HABD24FFB977D40BD99A9E9BDA0AA3481"><enum>(d)</enum><header>Priority Funding</header><text>In awarding grants under subsection (a), the Secretary shall give priority to the following:</text> <paragraph id="H25B03F7FBE21449180608EBFC813FFED"><enum>(1)</enum><text>Entities that provide non-Federal contributions, either in cash or in kind.</text></paragraph> <paragraph id="H5FEBB214DFD944D3B16171C1394531A9"><enum>(2)</enum><text>Entities with demonstrated experience with community-based partnerships.</text></paragraph> <paragraph id="HBE4489AE49784823A9E2BBA51F4616A"><enum>(3)</enum><text>Entities with demonstrated experience and success with such interventions.</text></paragraph> <paragraph id="H6D224077EFDB4AD98986F44DEFF0C036"><enum>(4)</enum><text>Entities with demonstrated experience working with families.</text></paragraph> <paragraph id="HCA2A7D8B2E694072841DE1BAA5993225"><enum>(5)</enum><text>Entities that develop comprehensive plans that include a strategy for extending program activities developed under this section in the years following the fiscal years for which they receive grants under this section.</text></paragraph> <paragraph id="HB583145447794EDA85DEB7A238D31CE1"><enum>(6)</enum><text>Entities that submit plans that exhibit cooperative plans that include the involvement of a broad range of stakeholders, including the following:</text> <subparagraph id="H9A52DA24870146D5AFF8F5878EFBE394"><enum>(A)</enum><text>Community-based organizations.</text></subparagraph> <subparagraph id="HF292C77A93344DBD8F45C11E874FA2D6"><enum>(B)</enum><text>Local governments.</text></subparagraph> <subparagraph id="H396C1511B19F4FD299E075767155391C"><enum>(C)</enum><text>Local educational agencies.</text></subparagraph> <subparagraph id="H869642CA144F45E6842281F92B215E47"><enum>(D)</enum><text>Local business and community associations.</text></subparagraph> <subparagraph id="H81BB24BCEE704CB992752E452F8477DC"><enum>(E)</enum><text>Accredited colleges, universities, and community colleges.</text></subparagraph> <subparagraph id="H3607296A49734618BB534300A44CBEFE"><enum>(F)</enum><text>Other entities determined appropriate by the Secretary.</text></subparagraph></paragraph></subsection> <subsection id="HCF6E8A3814F14B08A0C6B68450A53BFC"><enum>(e)</enum><header>Evaluation</header><text>Of the funds appropriated to carry out this section, the Secretary may reserve up to 5 percent for each fiscal year for the purpose of carrying out evaluations of the activities carried out under this section, including a national cross-site evaluation. Within 90 days of the completion of any evaluations, they shall be provided to the relevant authorizing committees and to the Committees on Appropriations of the Senate and the House of Representatives.</text></subsection> <subsection id="H804B7474A45C41C6A3FD5CFE9D94F100"><enum>(f)</enum><header>Duration</header><text>The Secretary shall award grants under this section for a period of not more than 5 years.</text></subsection> <subsection id="H0F1887451E5B4500A7BCF7BCEA4E8973"><enum>(g)</enum><header>Authorization of Appropriations</header><text>There is authorized to be appropriated to carry out this section, $25,000,000 for fiscal year 2008, and such sums as may be necessary for each of fiscal years 2008 to 2012.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="H85563023CC044D1881BF5BE230F71BC9"><enum>206.</enum><header>Grants for the integration of schools and mental health systems</header><text display-inline="no-display-inline">Section 5541 of the <act-name parsable-cite="ESEA">Elementary and Secondary Education Act of 1965</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/20/7269">20 U.S.C. 7269</external-xref>) is amended—</text> <paragraph id="H2F507268BB6B4DF7842CCD74E9B8CC4C"><enum>(1)</enum><text>in subsection (c), by adding at the end the following:</text> <quoted-block style="OLC" id="HC4E96D1803D44757B3EB692B7CBF9426"> <paragraph id="H922F8332AE5C4B688E139F1EDFCDEDCA"><enum>(7)</enum><text>To support schools that work with families and appropriate community partners to implement school-wide prevention strategies, based on mental health research, that will support early and intensive interventions.</text></paragraph> <paragraph id="HB30672D68BCC4F579C6929AED5D72783"><enum>(8)</enum><text>To provide necessary training and support to school personnel on how to recognize and seek needed support for children exhibiting early warning signs of behavioral and academic problems.</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph> <paragraph id="H9008C424E778456F94C4D05187B6E9A"><enum>(2)</enum><text>in subsection (d)—</text> <subparagraph id="H3022441434B64B83B4C8ED8DA5FDE00"><enum>(A)</enum><text>in paragraph (4)—</text> <clause id="H0FD3AE973B8449BD97DC9505EBC269C9"><enum>(i)</enum><text>in subparagraph (C), by striking <quote>and</quote> after the semicolon;</text></clause> <clause id="H65F30AA835CE404D8907F3B2118EF0DF"><enum>(ii)</enum><text>in subparagraph (D), by striking the period and inserting <quote>; and</quote>; and</text></clause> <clause id="H24D68DE3D8D749AD82CEED861AB87A1"><enum>(iii)</enum><text>by adding at the end the following:</text> <quoted-block style="OLC" id="HBA3C2CA8999F473AAC8C621BEDA80073"> <subparagraph id="HF5DDBB830FE64580AF1CFE0007695358"><enum>(E)</enum><text>mental health services provided under this section by schools will be evidence-based or promising early interventions.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></clause></subparagraph> <subparagraph id="H4B89BF031D2B4EE8B769588680BFEFAC"><enum>(B)</enum><text>by adding at the end the following:</text> <quoted-block style="OLC" id="HD3CCA9BD9BF94026BAF95765CBB947F3"> <paragraph id="H90BB3979B7F4460AA335C9C69300A314"><enum>(7)</enum><text>An explanation of how the applicant will carry out public education programs in support of mental health promotion and prevention by collaborating with—</text> <subparagraph id="H0A2377E98FDA4567B19769576E900044"><enum>(A)</enum><text>an institution of higher education (including a graduate program in psychology, social work, or education at an institution of higher education); and</text></subparagraph> <subparagraph id="H89681D9825CE41B09E2FFA4400B0637B"><enum>(B)</enum><text>private nonprofit community-based organizations that have experience in public education programs relating to mental health promotion and prevention.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></section> <section id="H29DF212CA9CF4445B734352BADC08C61"><enum>207.</enum><header>Grants for the promotion of university-community partnerships to increase youth competencies and reduce youth problem behaviors in our communities</header> <subsection id="HAFD6EDBC5F8D4280A72400E1C9909E50"><enum>(a)</enum><header>In General</header><text>The Secretary of Health and Human Services shall award grants to eligible entities for the implementation of programs that promote university-community partnerships to implement community-based prevention strategies that will support youth competencies and prevent youth problem behaviors.</text></subsection> <subsection id="H30A09277DADD40029DDFDF00499729CA"><enum>(b)</enum><header>Eligibility</header><text>To be eligible to receive a grant under subsection (a), an entity shall be a partnership between—</text> <paragraph id="HC665A577C7C04FA400976BCC682BA055"><enum>(1)</enum><text>an institution of higher education (including a graduate program in psychology, social work, or education at an institution of higher education); and</text></paragraph> <paragraph id="H1D1656BF6B2243AA926EA1B552E166BC"><enum>(2)</enum><text>a private nonprofit community-based organization that has experience in prevention and interventions relating to mental health promotion and prevention.</text></paragraph></subsection> <subsection id="H3C0AF7885A094383B7B35D6FFF3E655F"><enum>(c)</enum><header>Use of Funds</header><text>An entity shall use amounts received under a grant under this section to carry out community-based activities that—</text> <paragraph id="H9C0DBA09834A47C4BCD6E9ACB37715C2"><enum>(1)</enum><text>are comprehensive and utilize evidence-based or promising early interventions; and</text></paragraph> <paragraph id="H51F092AEE15B4A4C8100A443A0FED22F"><enum>(2)</enum><text>include an evaluation component that includes outcomes measures related to prevention efforts as well as the overall goals of the grant.</text></paragraph></subsection> <subsection id="HABD3396D58A5497EAF24E14EAB1856E"><enum>(d)</enum><header>Authorization of Appropriations</header><text>There is to be authorized to be appropriated to carry out this section, $10,000,000 for fiscal year 2008, and such sums as may be necessary for each of fiscal years 2009 and 2010.</text></subsection></section> <section id="H1797F6A4B2DB43BDB516E28A76CD383"><enum>208.</enum><header>Reservations for Early Head Start programs</header><text display-inline="no-display-inline">Section 640(a)(6)(A) of the <act-name parsable-cite="HSA">Head Start Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/9835">42 U.S.C. 9835(a)(6)(A)</external-xref>) is amended by striking <quote>7.5 percent</quote> and all that follows and inserting <quote>12 percent for fiscal year 2008, 14 percent for fiscal year 2009, 16 percent for fiscal year 2010, 18 percent for fiscal year 2011, and 20 percent for fiscal year 2012, of the amount appropriated pursuant to section 639(a).</quote>.</text></section> <enum>III</enum><header>HEALTHIER COMMUNITIES AND WORKPLACES</header> <subtitle id="HF82B002DAA3B4C8E95239273A484ED4E"><enum>A</enum><header>Incentives for a Healthy Workforce</header> <section id="HFCBA931557224FCE8E0682DF1B369E64"><enum>301.</enum><header>Short title</header><text display-inline="no-display-inline">This subtitle may be cited as the <quote>Healthy Workforce Act of 2007</quote>.</text></section> <section id="HA430481C5780474488CCE1AAA2819628"><enum>302.</enum><header>Tax credit to employers for costs of implementing wellness programs</header> <subsection id="H9BC91CE779A1448F812168A15B20984E"><enum>(a)</enum><header>In General</header><text>Subpart D of part IV of subchapter A of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/26/1">chapter 1</external-xref> of the Internal Revenue Code of 1986 (relating to business related credits) is amended by adding at the end the following:</text> <quoted-block style="OLC" id="HE2ADB9CB46C64B67002800649B776F2D"> <section id="HEF0953EF7E61440AA32382BB33D2F852"><enum>45O.</enum><header>Wellness program credit</header> <subsection id="H57C21045A2E84079A40016E5AFFDEF9"><enum>(a)</enum><header>Allowance of Credit</header> <paragraph id="HC76FE778F2B24FE993CE3B1DBC2CF7"><enum>(1)</enum><header>In general</header><text>For purposes of section 38, the wellness program credit determined under this section for any taxable year during the credit period with respect to an employer is 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.</text></paragraph> <paragraph id="H3A78ECE10C794C75B5670072895EBD51"><enum>(2)</enum><header>Limitation</header><text>The amount of credit allowed under paragraph (1) for any taxable year shall not exceed the sum of—</text> <subparagraph id="H89BB4CA71C7D4C588DB088D10059C872"><enum>(A)</enum><text>the product of $200 and the number of employees of the employer not in excess of 200 employees, plus</text></subparagraph> <subparagraph id="HA483919266194E1D8E5738D76EB870DE"><enum>(B)</enum><text>the product of $100 and the number of employees of the employer in excess of 200 employees.</text></subparagraph></paragraph></subsection> <subsection id="HD21B487FBBD945E2999B1BFD61D21589"><enum>(b)</enum><header>Qualified Wellness Program</header><text>For purposes of this section—</text> <paragraph id="H672FE2BA3F0E4E5F8EDD200313C4C5C2"><enum>(1)</enum><header>Qualified wellness program</header><text>The term <term>qualified wellness program</term> means a program which—</text> <subparagraph id="H5F56EF7675934B279C732948A1450439"><enum>(A)</enum><text>consists of any 3 of the wellness program components described in subsection (c), and</text></subparagraph> <subparagraph id="HE185E41C1ECC40E598AC9DCA1C061C5B"><enum>(B)</enum><text>which is certified by the Secretary of Health and Human Services, in coordination with the Director of the Center for Disease Control and Prevention, as a qualified wellness program under this section.</text></subparagraph></paragraph> <paragraph id="H782A8636EDCA49D4A2DE8BE825F9FA87"><enum>(2)</enum><header>Programs must be consistent with research and best practices</header> <subparagraph id="HA02CA719B6F5493E9E36300080FF919E"><enum>(A)</enum><header>In general</header><text>The Secretary of Health and Human Services shall not certify a program as a qualified wellness program unless the program—</text> <clause id="HFA409C01E78046C5B470E0000131E481"><enum>(i)</enum><text>is consistent with evidence-based research and best practices, as identified by persons with expertise in employer health promotion and wellness programs,</text></clause> <clause id="H9F7D9A93868E415B80A556A351B1ECF3"><enum>(ii)</enum><text>includes multiple, evidence-based strategies which are based on the existing and emerging research and careful scientific reviews, including the Guide to Community Preventive Services, the Guide to Clinical Preventive Services, and the National Registry for Effective Programs, and</text></clause> <clause id="HD78D06503B0F4C0BB6B90E6101AD66"><enum>(iii)</enum><text>includes strategies which focus on employee populations with a disproportionate burden of health problems.</text></clause></subparagraph> <subparagraph id="H1A0DE3007352440AB4C76BD2234148A1"><enum>(B)</enum><header>Periodic updating and review</header><text>The Secretary of Health and Human Services shall establish procedures for periodic review and recertifications of programs under this subsection. Such procedures shall require revisions of programs if necessary to ensure compliance with the requirements of this section and require updating of the programs to the extent the Secretary, in coordination with the Director of the Centers for Disease Control and Prevention, determines necessary to reflect new scientific findings.</text></subparagraph></paragraph> <paragraph id="H9B50D81895BF44949E885D20C010AA4B"><enum>(3)</enum><header>Health literacy</header><text>The Secretary of Health and Human Services shall, as part of the certification process, encourage employees to make the programs culturally competent and to meet the health literacy needs of the employees covered by the programs.</text></paragraph></subsection> <subsection id="H853A44AC27DD4B7D9B40AA11F73F4EE0"><enum>(c)</enum><header>Wellness Program Components</header><text>For purposes of this section, the wellness program components described in this subsection are the following:</text> <paragraph id="H418405423EEB4730A1F6649EC730ECFD"><enum>(1)</enum><header>Health awareness component</header><text>A health awareness component which provides for the following:</text> <subparagraph id="HAC74F59FC42740F899CF8059AD1DD62C"><enum>(A)</enum><header>Health education</header><text>The dissemination of health information which addresses the specific needs and health risks of employees.</text></subparagraph> <subparagraph id="H2DEDB36696C24C778FCB40F335E0274C"><enum>(B)</enum><header>Health screenings</header><text>The opportunity for periodic screenings for health problems and referrals for appropriate follow up measures.</text></subparagraph></paragraph> <paragraph id="H7CD674726E6447629B53486BE9629DBD"><enum>(2)</enum><header>Employee engagement component</header><text>An employee engagement component which provides for—</text> <subparagraph id="HABCDE716CE874CF3B52863D7D1A4A2B6"><enum>(A)</enum><text>the establishment of a committee to actively engage employees in worksite wellness programs through worksite assessments and program planning, delivery, evaluation, and improvement efforts, and</text></subparagraph> <subparagraph id="HE921FAA686194F0D951DC3423DE0CB7C"><enum>(B)</enum><text>the tracking of employee participation.</text></subparagraph></paragraph> <paragraph id="H8F229BA8EE85412A81D3C81F54B105C4"><enum>(3)</enum><header>Behavioral change component</header><text>A behavioral change component which provides for altering employee lifestyles to encourage healthy living through counseling, seminars, on-line programs, or self-help materials which provide technical assistance and problem solving skills. Such component may include programs relating to—</text> <subparagraph id="H82B48AE1BAD4456AB8C568BA48B7009F"><enum>(A)</enum><text>tobacco use,</text></subparagraph> <subparagraph id="H353C5B5C77E9409BBD583B3F584690FF"><enum>(B)</enum><text>obesity,</text></subparagraph> <subparagraph id="H383452BA48FC4EC2B28F21946580E5F7"><enum>(C)</enum><text>stress management,</text></subparagraph> <subparagraph id="HC70129099B0C4563BC7CFF1BDB06C869"><enum>(D)</enum><text>physical fitness,</text></subparagraph> <subparagraph id="H990ED384FA0D4602BCA477B25B86201B"><enum>(E)</enum><text>nutrition,</text></subparagraph> <subparagraph id="H7A4290688C9E4AD89163DC9BD9049153"><enum>(F)</enum><text>substance abuse,</text></subparagraph> <subparagraph id="H065E980567D24FCAB76DC214E8A94C8E"><enum>(G)</enum><text>depression, and</text></subparagraph> <subparagraph id="HC0EBD796D997448B86CD0F39192D08"><enum>(H)</enum><text>mental health promotion (including anxiety).</text></subparagraph></paragraph> <paragraph id="H4AA4FC0500464F16A2181CB32CD06957"><enum>(4)</enum><header>Supportive environment component</header><text>A supportive environment component which includes the following:</text> <subparagraph id="H77F9B3CEE9444716B3358D1340EAC110"><enum>(A)</enum><header>On-site policies</header><text>Policies and services at the worksite which promote a healthy lifestyle, including policies relating to—</text> <clause id="H5CE5653C6DF14729BA069E57B57D7D9"><enum>(i)</enum><text>tobacco use at the worksite,</text></clause> <clause id="H3F1EDA7145714B39A27FC5F785789025"><enum>(ii)</enum><text>the nutrition of food available at the worksite through cafeterias and vending options,</text></clause> <clause id="H71FB2E33FFA1425D008FA88BE3204C16"><enum>(iii)</enum><text>minimizing stress and promoting positive mental health in the workplace,</text></clause> <clause id="H1CF649CF1EEE442DAE87A8BB21846DFF"><enum>(iv)</enum><text>where applicable, accessible and attractive stairs, and</text></clause> <clause id="H584D56E111554A5DAF437E2FF877A646"><enum>(v)</enum><text>the encouragement of physical activity before, during, and after work hours.</text></clause></subparagraph> <subparagraph id="H99ED66B3BDAE400B90A7E8C75D816D1B"><enum>(B)</enum><header>Participation incentives</header> <clause id="HD5849DEA61FD4198AD380472E88D26D1"><enum>(i)</enum><header>In general</header><text>Qualified incentive benefits for each employee who participates in the health screenings described in paragraph (1)(B) or the behavioral change programs described in paragraph (3).</text></clause> <clause id="H0C115B47D0B9497090F504002561E02B"><enum>(ii)</enum><header>Qualified incentive benefit</header><text>For purposes of clause (i), the term <term>qualified incentive benefit</term> means any benefit which is approved by the Secretary of Health and Human Services, in coordination with the Director of the Centers for Disease Control and Prevention. Such benefit may include an adjustment in health insurance premiums or co-pays.</text></clause></subparagraph> <subparagraph id="HE69EA5C472374102A3E33052892D9F75"><enum>(C)</enum><header>Employee input</header><text>The opportunity for employees to participate in the management of any qualified wellness program to which this section applies.</text></subparagraph></paragraph></subsection> <subsection id="H45A671CAEF964541821BBBF1D0385D93"><enum>(d)</enum><header>Participation Requirement</header> <paragraph id="H83F89ECA7B29402D94E276A200F96EE"><enum>(1)</enum><header>In general</header><text>No credit shall be allowed under subsection (a) unless the Secretary of Health and Human Services, in coordination with the Director of the Centers for Disease Control and Prevention, certifies, as a part of any certification described in subsection (b), that each wellness program component of the qualified wellness program applies to all qualified employees of the employer. The Secretary of Health and Human Services shall prescribe rules under which an employer shall not be treated as failing to meet the requirements of this subsection merely because the employer provides specialized programs for employees with specific health needs or unusual employment requirements or provides a pilot program to test new wellness strategies.</text></paragraph> <paragraph id="H176B3C78CBD14507903D7FA22F4FDB95"><enum>(2)</enum><header>Qualified employee</header><text>For purposes of paragraph (1), the term <term>qualified employee</term> means an employee who works an average of not less than 25 hours per week during the taxable year.</text></paragraph></subsection> <subsection id="HE4E50EE864DD49D18CF4DCD6FF570400"><enum>(e)</enum><header>Other Definitions and Special Rules</header><text>For purposes of this section—</text> <paragraph id="H0012AC4669FA481D9220E4304DD96C1"><enum>(1)</enum><header>Employee and employer</header> <subparagraph id="HE3CA1849B55F455D92324DE9FEBB8C81"><enum>(A)</enum><header>Partners and partnerships</header><text>The term <term>employee</term> includes a partner and the term <term>employer</term> includes a partnership.</text></subparagraph> <subparagraph id="HA54E670F0524481190EB7D1088EC0B4"><enum>(B)</enum><header>Certain rules to apply</header><text>Rules similar to the rules of section 52 shall apply.</text></subparagraph></paragraph> <paragraph id="H21795F4FF8464148A997B6385841FF01"><enum>(2)</enum><header>Certain costs not included</header><text>Costs paid or incurred by an employer for food or health insurance shall not be taken into account under subsection (a).</text></paragraph> <paragraph id="HF2CA4B82ED6E4E7083A1E700058D7042"><enum>(3)</enum><header>No credit where grant awarded</header><text>No credit shall be allowable under subsection (a) with respect to any qualified wellness program of any taxpayer (other than an eligible employer described in subsection (f)(2)(A)) who receives a grant provided by the United States, a State, or a political subdivision of a State for use in connection with such program. The Secretary shall prescribe rules providing for the waiver of this paragraph with respect to any grant which does not constitute a significant portion of the funding for the qualified wellness program.</text></paragraph> <paragraph id="H411589347FB14257BF00D4EFEC06CFF3"><enum>(4)</enum><header>Credit period</header> <subparagraph id="H841935039C424451B011797B5C70DB97"><enum>(A)</enum><header>In general</header><text>The term <term>credit period</term> means the period of 10 consecutive taxable years beginning with the taxable year in which the qualified wellness program is first certified under this section.</text></subparagraph> <subparagraph id="H1ADD6A9095214DE10030581EC33FD31"><enum>(B)</enum><header>Special rule for existing programs</header><text>In the case of an employer (or predecessor) which operates a wellness program for its employees on the date of the enactment of this section, subparagraph (A) shall be applied by substituting <quote>3 consecutive taxable years</quote> for <quote>10 consecutive taxable years</quote>. The Secretary shall prescribe rules under which this subsection shall not apply if an employer is required to make substantial modifications in the existing wellness program in order to qualify such program for certification as a qualified wellness program.</text></subparagraph> <subparagraph id="H6B54A9C5B99045D2BADB8B2E523855C0"><enum>(C)</enum><header>Controlled groups</header><text>For purposes of this paragraph, all persons treated as a single employer under subsection (b), (c), (m), or (o) of section 414 shall be treated as a single employer.</text></subparagraph></paragraph></subsection> <subsection id="HBC09DD7CA1024B89809653FC34799852"><enum>(f)</enum><header>Portion of Credit Made Refundable</header> <paragraph id="H517DD9AC1C0E45FB984727897C7BF654"><enum>(1)</enum><header>In general</header><text>In the case of an eligible employer of an employee, the aggregate credits allowed to a taxpayer under subpart C shall be increased by the lesser of—</text> <subparagraph id="HE67EB8FB864F45F498E8DBC84327544D"><enum>(A)</enum><text>the credit which would be allowed under this section without regard to this subsection and the limitation under section 38(c), or</text></subparagraph> <subparagraph id="HF843439CF582480D8D8E956CCEB941DE"><enum>(B)</enum><text>the amount by which the aggregate amount of credits allowed by this subpart (determined without regard to this subsection) would increase if the limitation imposed by section 38(c) for any taxable year were increased by the amount of employer payroll taxes imposed on the taxpayer during the calendar year in which the taxable year begins.</text></subparagraph><continuation-text continuation-text-level="paragraph">The amount of the credit allowed under this subsection shall not be treated as a credit allowed under this subpart and shall reduce the amount of the credit otherwise allowable under subsection (a) without regard to section 38(c).</continuation-text></paragraph> <paragraph id="H38840BAC6DA04FE7A73D00FF0546E915"><enum>(2)</enum><header>Eligible employer</header><text>For purposes of this subsection, the term <term>eligible employer</term> means an employer which is—</text> <subparagraph id="H4BA9DE8664E943E3A4BF9ECB8897DF66"><enum>(A)</enum><text>a State or political subdivision thereof, the District of Columbia, a possession of the United States, or an agency or instrumentality of any of the foregoing, or</text></subparagraph> <subparagraph id="HFA46D053FB864C95AC20891E2FFD41AC"><enum>(B)</enum><text>any organization described in <external-xref legal-doc="usc" parsable-cite="usc/26/501">section 501(c)</external-xref> of the Internal Revenue Code of 1986 which is exempt from taxation under section 501(a) of such Code.</text></subparagraph></paragraph> <paragraph id="HA4BF201E050D4E82B3C8B9EA739183D8"><enum>(3)</enum><header>Employer payroll taxes</header><text>For purposes of this subsection—</text> <subparagraph id="HA556D731EC104EE99C736717D53FCE83"><enum>(A)</enum><header>In general</header><text>The term <term>employer payroll taxes</term> means the taxes imposed by—</text> <clause id="H0C868C91EF6C4B778F83A20723BF1739"><enum>(i)</enum><text>section 3111(b), and</text></clause> <clause id="HC04AC0D97ACC482BBA3E4FB50033579F"><enum>(ii)</enum><text>sections 3211(a) and 3221(a) (determined at a rate equal to the rate under section 3111(b)).</text></clause></subparagraph> <subparagraph id="H72C511E95DE94E8DBCCDA28695898FDB"><enum>(B)</enum><header>Special rule</header><text>A rule similar to the rule of section 24(d)(2)(C) shall apply for purposes of subparagraph (A).</text></subparagraph></paragraph></subsection> <subsection id="H793967F5140440379500DEC460293B67"><enum>(g)</enum><header>Termination</header><text>This section shall not apply to any amount paid or incurred after December 31, 2017.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H412A548BFF9F4047896566E1A597793C"><enum>(b)</enum><header>Treatment as General Business Credit</header><text>Subsection (b) of <external-xref legal-doc="usc" parsable-cite="usc/26/38">section 38</external-xref> of the Internal Revenue Code of 1986 (relating to general business credit) is amended by striking <quote>plus</quote> at the end of paragraph (30), by striking the period at the end of paragraph (31) and inserting <quote>, plus</quote>, and by adding at the end the following:</text> <quoted-block style="OLC" id="H298E18B44D144229BA47AB1D90A954BF"> <paragraph id="H29C31DC441634D34ACF7E1754CE895BE"><enum>(32)</enum><text>the wellness program credit determined under section 45O.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H0596A2D7D99A4FF1A9D6DE9F3ED8DD50"><enum>(c)</enum><header>Denial of Double Benefit</header><text><external-xref legal-doc="usc" parsable-cite="usc/26/280C">Section 280C</external-xref> 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:</text> <quoted-block style="OLC" id="HA78D5ECBDF9C4BDDB83D44F73C7C346"> <subsection id="H744E16EFACD94188B530276200509B84"><enum>(f)</enum><header>Wellness Program Credit</header> <paragraph id="HE8587761D8DB453A897E98646E00B6F0"><enum>(1)</enum><header>In general</header><text>No deduction shall be allowed for that portion of the costs paid or incurred for a qualified wellness program (within the meaning of section 45O) allowable as a deduction for the taxable year which is equal to the amount of the credit allowable for the taxable year under section 45O.</text></paragraph> <paragraph id="H95711B6EC93648E8AD69F6BAC7C3A700"><enum>(2)</enum><header>Similar rule where taxpayer capitalizes rather than deducts expenses</header><text>If—</text> <subparagraph id="HDFF400EE98A349C8BA821C00F911C9D8"><enum>(A)</enum><text>the amount of the credit determined for the taxable year under section 45O, exceeds</text></subparagraph> <subparagraph id="HFEE279E3F7A040A4A1C30072B0D73900"><enum>(B)</enum><text>the amount allowable as a deduction for such taxable year for a qualified wellness program,</text></subparagraph><continuation-text continuation-text-level="paragraph">the amount chargeable to capital account for the taxable year for such expenses shall be reduced by the amount of such excess.</continuation-text></paragraph> <paragraph id="HCB4232900463458EBD297E5802CA6672"><enum>(3)</enum><header>Controlled groups</header><text>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 rules prescribed by the Secretary similar to the rules applicable under subparagraphs (A) and (B) of section 41(f)(1).</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H985F4DF7C2EC48768B7DA38E05DD85FD"><enum>(d)</enum><header>Clerical Amendment</header><text>The table of sections for subpart D of part IV of subchapter A of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/26/1">chapter 1</external-xref> of the Internal Revenue Code of 1986 is amended by adding at the end the following:</text> <quoted-block style="OLC" id="H3DD45A20FB614DC8B70019001550D828"> <toc regeneration="no-regeneration"> <toc-entry level="section">Sec. 45O. Wellness program credit.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="HA55094F042DD449BA5C8EB92B277653"><enum>(e)</enum><header>Effective Date</header><text>The amendments made by this section shall apply to taxable years beginning after December 31, 2007.</text></subsection> <subsection id="H9067BCD0EF954DE2B4217830C1AD9717"><enum>(f)</enum><header>Outreach</header> <paragraph id="H032A8D2AFBB6443C91FC00D9BC18EB35"><enum>(1)</enum><header>In general</header><text>The Secretary of the Treasury, 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 <external-xref legal-doc="usc" parsable-cite="usc/26/45O">section 45O</external-xref> of the Internal Revenue Code of 1986 as well as to educate businesses on how to develop programs according to recognized and promising practices and on how to measure the success of implemented programs.</text></paragraph> <paragraph id="H4B72013589E746E9804D6E26CAF60000"><enum>(2)</enum><header>Authorization of appropriations</header><text>There are authorized to be appropriated such sums as are necessary to carry out the outreach program described in paragraph (1).</text></paragraph></subsection></section> <section id="H0C9155FCF22C4DF8A9EE1D4950DA2FE9"><enum>303.</enum><header>CDC and employer-based wellness programs</header><text display-inline="no-display-inline">Title III of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/241">42 U.S.C. 241 et seq.</external-xref>) is amended by adding at the end the following:</text> <quoted-block style="OLC" act-name="Public Health Service Act" id="H08FDE4A33080406B990471ADD95C4D8C"> <part id="H18C5D891454B45C2AF56EDA0D9CD163B"><enum>R</enum><header>CDC AND EMPLOYER-BASED WELLNESS PROGRAMS</header> <section id="HF5EEAE654FD74B84A4F2D4A82288DCC"><enum>399Z–1.</enum><header>Motivating employers to implement Workplace wellness programs</header> <subsection id="HFBDDAF2588634B48926E8CF9CF6C6CE1"><enum>(a)</enum><header>Workplace Wellness Marketing Campaign for Employers</header><text>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.</text></subsection> <subsection id="H386AE8D99BE74F3D9F01A6CF00E1E2EE"><enum>(b)</enum><header>Employer Award Program</header><text>The Director of the Centers for Disease Control and Prevention shall develop an annual awards program for employers to encourage the development of creative and effective solutions to help employees maintain or improve their health. The awards program shall provide that small, medium, and large employers that are public or private shall be eligible for the awards</text></subsection></section> <section id="H692EE470F6C348DFAB869910C5161795"><enum>399Z–2.</enum><header>Evaluation of employer-based wellness programs</header><text display-inline="no-display-inline">The Director of the Centers for Disease Control and Prevention shall enter into contracts with entities to—</text> <paragraph id="H8FDC1EDC06D64EDCBC06889CA8383D79"><enum>(1)</enum><text>provide employers (including small, medium, and large employers, as determined by the Director) with technical assistance in evaluating such employers’ employer-based wellness programs, including—</text> <subparagraph id="H3677CA806F1D45CB8EF29F04BF055566"><enum>(A)</enum><text>measuring the participation of employees in such programs; and</text></subparagraph> <subparagraph id="H7A72169005A4426E8095EA8C17A16D9B"><enum>(B)</enum><text>evaluating such programs as they relate to changes in the health status of employees, the absenteeism of employees, the productivity of employees, and the medical costs incurred by employees; and</text></subparagraph></paragraph> <paragraph id="H572C6D60AC274627A141C8B8EC83A6BD"><enum>(2)</enum><text>train employers on how to evaluate such employers’ employer-based wellness programs.</text></paragraph></section> <section id="H103E301252EA4B2BA6BC863BB75D6FFA"><enum>399Z–3.</enum><header>National worksite health policies and programs study</header> <subsection id="H0708190EA23B4BF3005F287FAA1200FF"><enum>(a)</enum><header>In General</header><text>Not later than 1 year after the date of enactment of this section, and annually thereafter, the Director of the Centers for Disease Control and Prevention shall conduct a national worksite health policies and programs study to assess employer-based health policies and programs.</text></subsection> <subsection id="HE99A10B79B2D4BCFB2CFDC5CC414E330"><enum>(b)</enum><header>Report</header><text>After completing each study under subsection (a), the Director of the Centers for Disease Control and Prevention shall submit to Congress a report that includes the recommendations of the Director for the implementation of effective employer-based health policies and programs.</text></subsection></section> <section id="HB61A395DE6A340D5AA718F7F5E00D605"><enum>399Z–4.</enum><header>Miscellaneous provisions</header> <subsection id="HEBC3DE63DEFA47AEB4A300525171B4C8"><enum>(a)</enum><header>Behavioral Risk Factor Surveillance System</header><text>The Secretary shall expand the Behavioral Risk Factor Surveillance System to include a workforce component to enable employers, researchers, and health officials to assess employee health risks, identify emerging problems associated with general employee health, prevent disease within the employee population, and improve employer-based health programs and policies.</text></subsection> <subsection id="H986C89213B704AAAB8C2A49E2E1DFB32"><enum>(b)</enum><header>Demonstration Projects</header> <paragraph id="HE8672BA04602443FBA58001CAFAD9581"><enum>(1)</enum><header>In general</header><text>The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall award grants to entities to enable such entities to carry out research demonstration projects to study the effect of the application of new worksite-based health interventions and models.</text></paragraph> <paragraph id="H86BA030FC953406EACBFF8F259572000"><enum>(2)</enum><header>Eligibility</header><text>To be eligible to receive a grant under paragraph (1), an entity shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.</text></paragraph> <paragraph id="HADDE3B1DF2D84066B73074DBAED7DCD1"><enum>(3)</enum><header>Broad participation</header><text>In awarding grants under paragraph (1), the Secretary shall ensure that demonstration projects are conducted in both the public and private sectors and in small and large employer settings.</text></paragraph> <paragraph id="HFEAF9C00E3C64C1EB7693B6D97E9D719"><enum>(4)</enum><header>Submission of findings</header><text>An entity shall submit to the Secretary a report on the results of the research conducted under the grant within such period as the Secretary may prescribe. Such report shall include any guidelines or recommendations developed by the entity based on such research.</text></paragraph></subsection> <subsection id="H8CCD97182BC74A0B943EFAFAE2B03873"><enum>(c)</enum><header>Implementation of Research Results</header><text>The Secretary shall carry out activities to implement the guidelines or recommendations received by the Secretary under subsection (b)(4) if the Secretary determines that such guidelines of recommendations would result in improved employee health through worksite-based health programs or policies.</text></subsection></section></part><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="H9D32EFE5C63B4E59A800EF123B75816E"><enum>304.</enum><header>Employer-provided off-premises health club services</header> <subsection id="H6AF7C00A318B4750AEFFF30521B145A4"><enum>(a)</enum><header>Treatment as Fringe Benefit</header><text>Subparagraph (A) of <external-xref legal-doc="usc" parsable-cite="usc/26/132">section 132(j)(4)</external-xref> of the Internal Revenue Code of 1986 (relating to on-premises gyms and other athletic facilities) is amended to read as follows:</text> <quoted-block style="OLC" id="H7A0CE756477C42779F2050243E001F82"> <subparagraph id="H09A114552AEB4B0895B1A3B5AD341928"><enum>(A)</enum><header>In general</header><text>Gross income shall not include—</text> <clause id="H62AC4194D16940548732F1F502E1BA3E"><enum>(i)</enum><text>the value of any on-premises athletic facility provided by an employer to its employees, and</text></clause> <clause id="HE29F58B168D34C599C8C21D4DDF5FC9"><enum>(ii)</enum><text>so much of the fees, dues, or membership expenses paid by an employer to an athletic or fitness facility described in subparagraph (C) on behalf of its employees as does not exceed $900 per employee per year.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="HC28B6C7E06D8479CBAF7E3B6F654BB96"><enum>(b)</enum><header>Athletic Facilities Described</header><text>Paragraph (4) of <external-xref legal-doc="usc" parsable-cite="usc/26/132">section 132(j)</external-xref> of the Internal Revenue Code of 1986 (relating to special rules) is amended by adding at the end the following new subparagraph:</text> <quoted-block style="OLC" id="HA9F4BC8FEA3849B9A24E1E31D01579A5"> <subparagraph id="HE58AD60A0D06424C8D12619FB3043276"><enum>(C)</enum><header>Certain athletic or fitness facilities described</header><text>For purposes of subparagraph (A)(ii), an athletic or fitness facility described in this subparagraph is a facility—</text> <clause id="H9202769C8C5B460E93E86715E68F14"><enum>(i)</enum><text>which provides instruction in a program of physical exercise, offers facilities for the preservation, maintenance, encouragement, or development of physical fitness, or is the site of such a program of a State or local government,</text></clause> <clause id="H77AEB4970188409387899EA48061176E"><enum>(ii)</enum><text>which is not a private club owned and operated by its members,</text></clause> <clause id="H106E8311EC7E41A88BF21891BBC1B916"><enum>(iii)</enum><text>which does not offer golf, hunting, sailing, or riding facilities,</text></clause> <clause id="H98D5853CEAB14BAD8C22BDF57621963B"><enum>(iv)</enum><text>whose health or fitness facility is not incidental to its overall function and purpose, and</text></clause> <clause id="HA13D5891A6704A5400671DF9B9F8E300"><enum>(v)</enum><text>which is fully compliant with the State of jurisdiction and Federal anti-discrimination laws.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H0B377F8295B7416E94CEB633FA42A62D"><enum>(c)</enum><header>Exclusion Applies to Highly Compensated Employees Only if No Discrimination</header><text><external-xref legal-doc="usc" parsable-cite="usc/26/132">Section 132(j)(1)</external-xref> of the Internal Revenue Code of 1986 is amended—</text> <paragraph id="H5B5F4D70A96A49AD9CBF2302F5CAD859"><enum>(1)</enum><text>by striking <quote>Paragraphs (1) and (2) of subsection (a)</quote> and inserting <quote>Subsections (a)(1), (a)(2), and (j)(4)</quote>, and</text></paragraph> <paragraph id="HAC839D96105548DFACD4A589745B7769"><enum>(2)</enum><text>by striking the heading thereof through <quote><header-in-text>apply</header-in-text></quote> and inserting <quote><header-in-text>Certain exclusions apply</header-in-text></quote>.</text></paragraph></subsection> <subsection id="H668036A4BEC649FD975CF68BC4E4558F"><enum>(d)</enum><header>Employer Deduction for Dues to Certain Athletic Facilities</header> <paragraph id="H9501FD80BAD54D3BB7220889A1EB6B87"><enum>(1)</enum><header>In general</header><text>Paragraph (3) of <external-xref legal-doc="usc" parsable-cite="usc/26/274">section 274(a)</external-xref> of the Internal Revenue Code of 1986 (relating to denial of deduction for club dues) is amended by adding at the end the following new sentence: <quote>The preceding sentence shall not apply to so much of the fees, dues, or membership expenses paid to athletic or fitness facilities (within the meaning of section 132(j)(4)(C)) as does not exceed $900 per employee per year.</quote>.</text></paragraph> <paragraph id="H9BBB67FC26794A97996E5BA38C73591E"><enum>(2)</enum><header>Conforming amendment</header><text>The last sentence of section 274(e)(4) of such Code is amended by inserting <quote>the first sentence of</quote> before <quote>subsection (a)(3)</quote>.</text></paragraph></subsection> <subsection id="H04AC81F1827543A8A76FFAD0119E9E00"><enum>(e)</enum><header>Effective Date</header><text>The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.</text></subsection></section></subtitle> <subtitle id="H718636C8DF2F4136945E3FCBD7DAB088"><enum>B</enum><header>Healthy Communities</header> <chapter id="H17CDF128F8B5407D9154EAAB8BE49758"><enum>1</enum><header>PROVISIONS TO IMPROVE THE HEALTH OF COMMUNITIES</header> <section id="HFFABD6F63FB642A18CD26D0232270490"><enum>311.</enum><header>Healthy community grants</header><text display-inline="no-display-inline">Part P of title III of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/280g">42 U.S.C. 280g et seq.</external-xref>) is amended by adding at the end the following:</text> <quoted-block style="OLC" act-name="Public Health Service Act" id="H30D69D4255E547A99E2B9CF1095FDAE8"> <section id="H05B5335424D14995AE401CD0C6015584"><enum>399P.</enum><header>Healthy community grants</header> <subsection id="H086211E939304D33976B76FD80861484"><enum>(a)</enum><header>Establishment</header><text>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 competitive grants to eligible entities for the purpose of planning and implementing programs that seek to promote individual and community health and to prevent the incidence of chronic disease.</text></subsection> <subsection id="H642495342FC3406D8823AF6429A19B7D"><enum>(b)</enum><header>Eligibility</header> <paragraph id="HA0CFFDDBB70E481F9900AFE8B6DCCF42"><enum>(1)</enum><header>In general</header><text>To be eligible to receive a grant under this section an entity shall—</text> <subparagraph id="H2D1BF4B94B4343709D3117A5CB8800CC"><enum>(A)</enum><text>be—</text> <clause id="H0F26C3D2C5BC4102BEB7C6291569A08F"><enum>(i)</enum><text>a city, county, or Indian tribe;</text></clause> <clause id="HB4BB4C3A2B69459C8CB1965B9396DFF5"><enum>(ii)</enum><text>a local or tribal educational agency;</text></clause> <clause id="H5DB954C9B2B74341B71DB62E1FF10005"><enum>(iii)</enum><text>an accredited university, college, or community college;</text></clause> <clause id="H36122AD8C60342EAA200E1AF18917C14"><enum>(iv)</enum><text>a federally qualified health center;</text></clause> <clause id="HE12FAB251A8B4D4F86B447E896E72D68"><enum>(v)</enum><text>a local health department;</text></clause> <clause id="H0CEF0F09401F443B8217DE17EC1CDFC2"><enum>(vi)</enum><text>a health care provider;</text></clause> <clause id="HE25337F6911A4A418F01B3B434B4E9FE"><enum>(vii)</enum><text>a community-based organization; or</text></clause> <clause id="H38E9432B6C5F4F879754F7958B8515C9"><enum>(viii)</enum><text>any other entity determined appropriate by the Secretary, including a consortia or partnership of entities described in any of clauses (i) through (vii);</text></clause></subparagraph> <subparagraph id="HD4FF8636FDEA495980BA7954D47E0889"><enum>(B)</enum><text>prepare and submit an application in accordance with paragraph (2); and</text></subparagraph> <subparagraph id="H6899E427505140CA98DA8FA193FBCE35"><enum>(C)</enum><text>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.</text></subparagraph></paragraph> <paragraph id="H0A7B26C304FB43A98FE1FEF9C68C24D"><enum>(2)</enum><header>Application</header> <subparagraph id="H74DE2531AB13459098BCBFB93E17E4E"><enum>(A)</enum><header>In general</header><text>An entity desiring a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a plan that meets the requirements of subparagraph (B).</text></subparagraph> <subparagraph id="H13192BC32BF5461794B6CE001FEA5174"><enum>(B)</enum><header>Plan</header><text>A plan meets the requirements of this subparagraph if such plan, at a minimum, includes information regarding—</text> <clause id="H820177333CFB4571AB92507132827CC2"><enum>(i)</enum> <subclause display-inline="yes-display-inline" id="H2466EE6FFA264A829FB401C8C47269A9"><enum>(I)</enum><text>programs or community-based activities that the applicant proposes to carry out with funds received under this section and which seek to prevent and reduce the incidence of—</text> <item indent="up1" id="H0A5E529B00064B68BCA0C1EA2F7D45D"><enum>(aa)</enum><text>overweight and obesity, or chronic diseases associated with overweight and obesity;</text></item> <item indent="up1" id="HE3E764A47BA74F59B0A276C1F4EFF640"><enum>(bb)</enum><text>tobacco use; or</text></item> <item indent="up1" id="H6307EA19F7E0472B96AB4B7D19A03BE4"><enum>(cc)</enum><text>mental illness; or</text></item></subclause> <subclause indent="up1" id="HF354088EDB344E6384D25739FB511FCA"><enum>(II)</enum><text>other such activities, as determined appropriate by the Secretary, that are consistent with the goals of promoting individual and community health and preventing chronic disease; and</text></subclause></clause> <clause id="H506F3E7AA4A94B2E98F415B6EFD9001D"><enum>(ii)</enum><text>the manner in which the applicant will evaluate the effectiveness of the program or activities carried out under this section.</text></clause></subparagraph></paragraph> <paragraph id="H90392E05D0C145C381B30055C6CAA870"><enum>(3)</enum><header>Non-federal share</header><text>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.</text></paragraph></subsection> <subsection id="H05862DCA3F8C4807B2BDA6A15E7C59DF"><enum>(c)</enum><header>Use of Funds</header><text>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—</text> <paragraph id="HE22B02C9A3AD4E9391495B6FEF020052"><enum>(1)</enum><text>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—</text> <subparagraph id="H1DE36B8468A744C1BC40AE2E65D24CB8"><enum>(A)</enum><text>being overweight or obese;</text></subparagraph> <subparagraph id="H05BAB699D1E346ED9B475852A939CCF8"><enum>(B)</enum><text>tobacco use; or</text></subparagraph> <subparagraph id="HD47B198769944E5CBAA0CE0096879019"><enum>(C)</enum><text>mental illness; or</text></subparagraph></paragraph> <paragraph id="H204AB83D183C4B9CBD7D4C37C1BD57F1"><enum>(2)</enum><text>other activities undertaken with the goals of health promotion and chronic disease prevention, as determined appropriate by the Secretary.</text></paragraph></subsection> <subsection id="H4EB856857F8E4D14B4A510770011F560"><enum>(d)</enum><header>Priority</header><text>In awarding grants under subsection (a), the Secretary shall give priority to—</text> <paragraph id="H1EC0FFAA422A41C29EB300ADDB00C45E"><enum>(1)</enum><text>entities that demonstrate that they have previously applied successfully for funds to carry out activities that seek to promote individual and community health and to prevent the incidence of chronic disease and that can cite published and peer-reviewed research demonstrating that the activities that the entity proposes to carry out under this subsection are effective;</text></paragraph> <paragraph id="H4973A1FEB8294B259D96C0428BC0F867"><enum>(2)</enum><text>entities that will carry out programs or activities that seek to accomplish a goal or goals set by the State in the Healthy People 2010 plan of the State;</text></paragraph> <paragraph id="HF3E25925040E4D24B8B9DFE81FF377AC"><enum>(3)</enum><text>entities that provide non-Federal contributions, either in cash or in kind, to the costs of funding activities under the grant;</text></paragraph> <paragraph id="HE2827C56E0CB41C0A32114859D0398B5"><enum>(4)</enum><text>entities that develop comprehensive plans that include a strategy for extending program activities developed under this section in the years following the fiscal years for which they receive grants under this section;</text></paragraph> <paragraph id="H51B7C0574CE045B0A403672D2FE43600"><enum>(5)</enum><text>entities located in communities that are medically underserved, as determined by the Secretary;</text></paragraph> <paragraph id="HCA77B7D5F2C4430891484BBBD697B7A8"><enum>(6)</enum><text>entities located in areas where the average poverty rate is 150 or higher than the average poverty rate in the State involved, as determined by the Secretary; and</text></paragraph> <paragraph id="HF6C656D421F74771ADE7443D4C4428B9"><enum>(7)</enum><text>entities that submit plans that exhibit multisectoral, cooperative conduct that includes the involvement of a broad range of stakeholders, including—</text> <subparagraph id="H729D61DB0FF943E6B3CCA03307D0057B"><enum>(A)</enum><text>community-based organizations;</text></subparagraph> <subparagraph id="HB48FEF35BE654D9000DE35A8FCF9A298"><enum>(B)</enum><text>local governments;</text></subparagraph> <subparagraph id="HE173B9F086E74C72BC40F3CB3226FF0"><enum>(C)</enum><text>local educational agencies;</text></subparagraph> <subparagraph id="H0822538B7670497BA10480003874728F"><enum>(D)</enum><text>the private sector;</text></subparagraph> <subparagraph id="HC4040B7F61C74F9CAEDFB7B68C8400B5"><enum>(E)</enum><text>State or local departments of health;</text></subparagraph> <subparagraph id="H5F83C5FD42174ABD995628C8289DDBA"><enum>(F)</enum><text>accredited colleges, universities, and community colleges;</text></subparagraph> <subparagraph id="H8B9B0F99B156485981126E3F3C005570"><enum>(G)</enum><text>health care providers;</text></subparagraph> <subparagraph id="H41D457C1BA8F41228B8D4864106429EF"><enum>(H)</enum><text>State and local departments of transportation and city planning; and</text></subparagraph> <subparagraph id="H9A807FEBDEB848E48C3D9718B5F4DE8"><enum>(I)</enum><text>other entities determined appropriate by the Secretary.</text></subparagraph></paragraph></subsection> <subsection id="H260B0D646E87424CB9DFA9898FE9038"><enum>(e)</enum><header>Technical Assistance</header><text>From amounts appropriated to carry out this section, the Secretary may reserve not more than 10 percent for each fiscal year to provide entities receiving grants under this section with technical assistance in the implementation of the plans required under subsection (b)(2)(B).</text></subsection> <subsection id="H35D8A7D5532044BDB3E74E5C89598029"><enum>(f)</enum><header>Evaluation</header><text>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.</text></subsection> <subsection id="H03FAF0061F4E4F5DBFF8D044C8C1B2FF"><enum>(g)</enum><header>Limitation on Administrative Costs</header><text>An entity may not use more than 10 percent of amounts received under a grant under this section for administrative expenses.</text></subsection> <subsection id="HD78D33B2C0104D39B7931C670084EA1C"><enum>(h)</enum><header>Supplement Not Supplant</header><text>Amounts provided 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.</text></subsection> <subsection id="H59B6D3B72DC340908DA47E80A4DD00D5"><enum>(i)</enum><header>Authorization of Appropriations</header><text>There is authorized to be appropriated such sums as may be necessary to carry out this section.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="H5B653C01CC2449560044BC186E698B71"><enum>312.</enum><header>Promoting the health and wellness of Individuals with Disabilities through community sports programs</header><text display-inline="no-display-inline">Part P of title III of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/280g">42 U.S.C. 280g et seq.</external-xref>) is amended by adding at the end the following:</text> <quoted-block style="OLC" act-name="Public Health Service Act" id="H89A3BBF568EF4358B7359B6119C61EC8"> <section id="H90B1EE08DBDF47FEB5F482B9C4616836"><enum>399R.</enum><header>Community sports programs for Individuals with Disabilities</header> <subsection id="H56631F21F62F4984BF32003C1C8263E2"><enum>(a)</enum><header>In General</header> <paragraph id="HD60DDB09197A45468204577DE563072E"><enum>(1)</enum><header>Individual with a disability defined</header><text>For purposes of this section, the term <term>individual with a disability</term> has the meaning given such term in section 7(20) of the <act-name parsable-cite="REH">Rehabilitation Act of 1973</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/29/705">29 U.S.C. 705(20)</external-xref>, for the purpose of title V of such Act (<external-xref legal-doc="usc" parsable-cite="usc/29/791">29 U.S.C. 791 et seq.</external-xref>).</text></paragraph> <paragraph id="HF3A7B7C1CF7C451D9E4C856B89035FBB"><enum>(2)</enum><header>Community sports grants program</header><text>The Secretary, in collaboration with the National Advisory Committee on Community Sports Programs for Individuals with Disabilities, may award grants on a competitive basis to public and nonprofit private entities to implement community-based, sports and athletic programs for individuals with disabilities, including youth with disabilities.</text></paragraph></subsection> <subsection id="HE2170CE652A34288B495C2B7D57BF790"><enum>(b)</enum><header>Application</header><text>To be eligible to receive a grant under subsection (a)(2), a public or nonprofit private entity shall submit to the Secretary an application at such time, in such manner, and containing such agreements, assurances, and information as the Secretary determines to be necessary to carry out this section.</text></subsection> <subsection id="H28DE06E6C91F455193733D70A5B1A0C2"><enum>(c)</enum><header>Authorized Activities</header><text>Amounts awarded under a grant under subsection (a) shall be used for—</text> <paragraph id="H6826C5AEE75845EEAD72390719A90050"><enum>(1)</enum><text>community-based sports programs, leagues, or competitions in individual or team sports for individuals with physical disabilities;</text></paragraph> <paragraph id="H54FA2A98C6F74FED875C7BD9EFE57B91"><enum>(2)</enum><text>regional sports programs or competitions in individual or team sports for individuals with physical disabilities;</text></paragraph> <paragraph id="HFBB0F35E6C884340B96446F263C2974D"><enum>(3)</enum><text>the development of competitive team and individual sports programs for individuals with disabilities at the high school and collegiate level; or</text></paragraph> <paragraph id="H2F407A351C674B88AC559BD082C1632B"><enum>(4)</enum><text>the development of mentoring programs to encourage participation in sports programs for individuals who are newly disabled or with newly acquired physical limitations.</text></paragraph></subsection> <subsection id="H90CAE45F6E9443C1BFA000E64B721118"><enum>(d)</enum><header>Priorities</header> <paragraph id="H49B31819DC404F2C97F19F863963506F"><enum>(1)</enum><header>Advisory committee</header><text>The Secretary shall establish a National Advisory Committee on Community Sports Programs for Individuals with Disabilities that shall—</text> <subparagraph id="H8BFDB77EB6574C7D89B630F610995166"><enum>(A)</enum><text>establish priorities for the implementation of this section, review grant proposals;</text></subparagraph> <subparagraph id="HCFFC64DA1F1C4691A1B7460400313552"><enum>(B)</enum><text>make recommendations for funding under this section; and</text></subparagraph> <subparagraph id="HDF1E797022324301008C6E608E49D5D"><enum>(C)</enum><text>annually evaluate the progress of programs carried out under this section in implementing such priorities.</text></subparagraph></paragraph> <paragraph id="HF39E1449B4BF488781B9BCB5993900A0"><enum>(2)</enum><header>Representation</header><text>The Advisory Committee established under paragraph (1) shall include representatives of—</text> <subparagraph id="H8E8337ED630042D2A48F52ADD3EACB1"><enum>(A)</enum><text>the Department of Health and Human Services Office on Disability;</text></subparagraph> <subparagraph id="H5DD1E93CE868488795C69D6BAC63034C"><enum>(B)</enum><text>the United States Surgeon General;</text></subparagraph> <subparagraph id="HD600C2AA822043DB9E8497FE53A8D164"><enum>(C)</enum><text>the Centers for Disease Control and Prevention;</text></subparagraph> <subparagraph id="HDE94736E391745EA8D817FAEB100C24D"><enum>(D)</enum><text>the Paralympic division of the United States Olympic Committee;</text></subparagraph> <subparagraph id="HBEF10F88FA804C5FA194D700639762A2"><enum>(E)</enum><text>disabled sports organizations;</text></subparagraph> <subparagraph id="H7F0AA87985DF4BC788B6A25EA2304DDC"><enum>(F)</enum><text>organizations that represent the interests of individuals with disabilities; and</text></subparagraph> <subparagraph id="HFDAC6B151A124ED4B15E12A43CAE2ECD"><enum>(G)</enum><text>individuals with disabilities (including athletes with physical disabilities) or their family members.</text></subparagraph></paragraph></subsection> <subsection id="HFF91BA02D3DA4811AB650961E0E3D42B"><enum>(e)</enum><header>Dissemination of Information</header><text>The Secretary shall disseminate information about the availability of grants under this section in a manner that is designed to reach public entities and nonprofit private organizations that are dedicated to providing outreach, advocacy, or independent living services to individuals with disabilities.</text></subsection> <subsection id="H2982BEDF353B4199BAB00F133A278C"><enum>(f)</enum><header>Technical Assistance</header><text>The Secretary, in conjunction with the United States Olympic Committee and disabled sports organizations, shall establish a technical assistance center to provide training, support, and information to grantees under this section on establishing and operating community sports programs for individuals with disabilities.</text></subsection> <subsection id="HA5484FB10CFB4B78AA4C432E4B14A58F"><enum>(g)</enum><header>Report to Congress</header><text>Not later than 180 days after the date of the enactment of this section, and annually thereafter, the Secretary shall submit to Congress a report summarizing activities, findings, outcomes, and recommendations resulting from the grant projects funded under this section during the year for which the report is being prepared.</text></subsection> <subsection id="HD39295A08B3F4C8B85FC108ED03897D2"><enum>(h)</enum><header>Authorization of Appropriations</header> <paragraph id="H0AF49FEBFBD8413F87DE249FF8DB2ED"><enum>(1)</enum><header>In general</header><text>To carry out this section, there are authorized to be appropriated such sums as may be necessary.</text></paragraph> <paragraph id="HF6D4125C4D764ECB87524EC780E28C98"><enum>(2)</enum><header>Limitation</header><text>Not to exceed 10 percent of the amount appropriated in each fiscal year shall be used to carry out activities under subsection (c)(4).</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="HFA42AFCD929E4EDBB557802548AA4F22"><enum>313.</enum><header>Safe and complete streets</header><text display-inline="no-display-inline"><external-xref legal-doc="usc" parsable-cite="usc/23/133">Section 133</external-xref> of title 23, United States Code, is amended by adding at the end the following:</text> <quoted-block style="OLC" id="HE03EC4948F6140CEACC686A3E977C79E"> <subsection id="HC44EE5F047854DF7B7B2A5A947CF97AF"><enum>(g)</enum><header>Withholding of Funding</header> <paragraph id="H4EC7C1FF39CE4EF4B0922C630857714F"><enum>(1)</enum><header>In general</header><text>Beginning with the fiscal year that begins 2 years after the date of enactment of this subsection, the Secretary of Transportation shall withhold 2 percent of the amounts allocated in such fiscal year to the highway and planning funds allotted to a Metropolitan Planning Organization or State Transportation Improvement Program under the Safe, Accountable, Flexible, Efficient Transportation Equity Act unless the State or Metropolitan Planning Organization provides the Secretary with documentation—</text> <subparagraph id="HBDA342FE91AD4986BB17D9C5661DB361"><enum>(A)</enum><text>of the existence of an explicit statement of policy (that meets the requirements of subsection (b)) that the safety and convenience of all users of the transportation system shall be accommodated; and</text></subparagraph> <subparagraph id="H62D2BF8946134165BC4CDBA44C005609"><enum>(B)</enum><text>that such policy has been applied to the projects contained in the Transportation Improvement Plan.</text></subparagraph></paragraph> <paragraph id="HFDEC571DE17A4EE0AE93F1CB003FCD42"><enum>(2)</enum><header>Purpose</header><text>The purpose of the policy statement required under paragraph (1)(A) is to ensure that all users of the transportation system, including pedestrians, bicyclists, and transit users as well as children, older individuals, and individuals with disabilities, are able to travel safely and conveniently on streets and highways within the public right of way.</text></paragraph></subsection> <subsection id="HBDB2897F18FF499EA30516F727847194"><enum>(h)</enum><header>Policy Statement Requirements</header><text>A policy statement under subsection (g)(1)(A) shall include the following:</text> <paragraph id="H2E26DA7714714A30A910003C06411046"><enum>(1)</enum><text>An assurance that all users of the transportation system will include pedestrians (including individuals of all ages, and individuals with disabilities (including mobility, sensory, neurological or hidden disabilities)), bicyclists, transit vehicles and users, and motorists.</text></paragraph> <paragraph id="H625CF265B7AD4AE1A2FC8E15EF9477BD"><enum>(2)</enum><text>An assurance that the statement will apply to both new road construction and transportation improvement projects.</text></paragraph> <paragraph id="HC39B32DE8DE64D73AF67A722BF807919"><enum>(3)</enum><text>A clear procedure that requires approval by a senior manager of any specified exceptions from implementing the policy statement, including documentation with supporting data that indicates the basis for the exemption.</text></paragraph> <paragraph id="H3E889522AA2643AB8B4DD85013646FFD"><enum>(4)</enum><text>A statement directing the use of the current design standards, including those standards applying to access for individuals with disabilities.</text></paragraph> <paragraph id="H8C00D439B80C44948C1E55F2231E38EA"><enum>(5)</enum><text>A statement requiring that complete streets solutions be developed to fit in with the context of the community and that those solutions be flexible.</text></paragraph> <paragraph id="H100FB0F24A4642029C92FB452E32D00"><enum>(6)</enum><text>A description of the performance standards with measurable outcomes that will be developed.</text></paragraph> <paragraph id="H36059B104068492699958F053ED21B00"><enum>(7)</enum><text>A statement that accommodation shall be made for all users in all construction and improvement projects unless one or more of the following apply:</text> <subparagraph id="H08D2DD10FE1640A58F5BD405EBF8EE0"><enum>(A)</enum><text>The project involved a roadway on which non-motorized users are prohibited by law from using. In such case, a greater effort shall be made to accommodate bicyclists and pedestrians elsewhere.</text></subparagraph> <subparagraph id="HE9B727DB215B4E3689EEF5C0C651319F"><enum>(B)</enum><text>The cost of establishing complete facilities would be excessively disproportionate to the need or probable use.</text></subparagraph> <subparagraph id="H128CE49100034A93AA973ED82103155D"><enum>(C)</enum><text>With respect to a project area with a low population, a lack of transit service, or other documented factors indicate an absence of need now and in the future.</text></subparagraph> <subparagraph id="H35C24A08862649FC878F7FACDE5F0064"><enum>(D)</enum><text>The policy statement may be achieved through a State or local law or ordinance, or through an agency policy directive.</text> <clause indent="up3" id="H76BBEBE1F6EE4EDB8BFB74E7E79F733C"><enum>(i)</enum><header>Certifications</header><text>The Metropolitan Planning Organization and State Transportation Improvement Plan shall certify that each road project included in such plan has been reviewed for its compliance with any applicable policy statement under this section and that each project under such plan enhances the safety, convenience, and accessibility of the transportation system for all users to the extent that it is reasonably possible and that the project applicant addressed these concerns in the material prepared for public input with respect to such plan.</text></clause></subparagraph></paragraph></subsection> <subsection id="H6378B0136DFC4B6AB867F884D29F5900"><enum>(j)</enum><header>Accessibility Standards</header><text>Not later than 12 months after the date of enactment of this subsection, the United States Access Board shall issue final standards for accessibility of new construction and alterations of pedestrian facilities in the public right-of-way. Until such time as the Access Board completes a final Public Right of Way Accessibility rule, Department of Transportation Standards for Accessible Transportation Facilities (49 C.F.R. 37.9, as amended on 10/30/2006 (71 FR 63263)) shall serve as the minimum standard. If the Department Of Transportation standards are silent or inapplicable with respect to any issue, the 2005 draft Public Right Of Way Accessibility Guidelines provisions shall be consulted. A Metropolitan Planning Organization or State department of transportation that is adopting complete streets policies may consult existing Federal guidance, including the 2000 USDOT Guidance document, <quote>Accommodating Bicycle and Pedestrian Travel</quote>.</text></subsection> <subsection id="H727D4BA7BAB74D8F92F34D9796D97DFC"><enum>(k)</enum><header>Inclusion of All Users</header><text>Metropolitan planning organizations shall strongly encourage local jurisdictions that are served by such organizations to maximize their efforts to include all users in their transportation planning.</text></subsection> <subsection id="HCA1196768B1A42B5B46F59621058CBC1"><enum>(l)</enum><header>Additional Provisions</header> <paragraph id="H6C4EAAB070BB4691AEB8DD0927C3021"><enum>(1)</enum><header>Research</header> <subparagraph id="HE141663124B14A39A850B24A2161542"><enum>(A)</enum><header>In general</header><text>The Secretary of Transportation shall require the Federal Highway Administration to conduct complete streets research to assist States and Metropolitan Planning Organizations in developing, adopting, and implementing plans, projects, procedures, policies, and training that comply with the applicable statement of policy under subsection (g)(1)(A).</text></subparagraph> <subparagraph id="H8F232970667E40FA00CCFFA3AF8352B3"><enum>(B)</enum><header>Participation</header><text>Research under subparagraph (A) shall be conducted with the participation of the American Association of State Highway Transportation Officials, the Institute of Transportation Engineers, the American Public Transit Association, the American Planning Association, the National Association of Regional Councils, the Association of Metropolitan Planning Organizations, and representatives of the disability, motoring, bicycling, walking, transit user, aging, and other affected communities.</text></subparagraph> <subparagraph id="H7B63D5D9E89041A290C9DE9643AD5FB6"><enum>(C)</enum><header>Existing needs</header><text>Research under subparagraph (A) shall be based on the existing statement of complete streets research needs as outlined by the Transportation Research Board in TR Circular E110, and shall also develop new areas of inquiry.</text></subparagraph></paragraph> <paragraph id="HB956801E57B74CBE84F485368B4B2091"><enum>(2)</enum><header>Benchmarks and guidance</header><text>The research project conducted under paragraph (1) shall be designed to result in the establishment of benchmarks and the provision of practical guidance on how to effectively implement street procedures and designs that will accommodate all types of users along the same facility or corridor including, vehicles, pedestrians, bicycles, and transit use. Such benchmarks and guidance shall focus on changing scoping, design, and construction procedures to more effectively fit the individual modes together into integrated facilities that meet the needs of each in an appropriate balance. Such benchmarks and guidance shall indicate the expected operational and safety performance of alternative approaches to facility design.</text></paragraph> <paragraph id="H37932C8D7EB84A32BDD98DC3CE4C96CD"><enum>(3)</enum><header>Best practices report</header><text>Not later than 2 years after the date of enactment of this subsection, the Federal Highway Administration shall publish a best practices report showing how transportation agencies have changed their procedures to routinely design safe, effective multi-modal facilities. In establishing such best practices, consideration shall be given to the following areas:</text> <subparagraph id="HD6A19D5269D840B98D45FA8C001B1BEA"><enum>(A)</enum><text>Procedures for identifying the needs of the mix of users, including primary and secondary users that need to be served on various highway functional classes.</text></subparagraph> <subparagraph id="H96F9A306011B4934B969EA43CC091A1"><enum>(B)</enum><text>The identification of the types and designs of facilities needed to serve each of those types of users.</text></subparagraph> <subparagraph id="H70E8DDD32F2642E1AF293EDD6C1D4F38"><enum>(C)</enum><text>The identification of barriers to implementation and identification of costs associated with implementing complete streets policies.</text></subparagraph></paragraph> <paragraph id="HBB51BD77C1F54F0BB442CF042C728113"><enum>(4)</enum><header>Data collection</header><text>In addition to preparing the report under paragraph (3), the Federal Highway Administration shall work with the Bureau of Transportation Statistics and the Federal Transit Association and appropriate Transportation Research Board committees on data collection, including a baseline non-motorized and transit use survey that will be integrated into the National Highway Traffic Safety Administration and the development of a survey tool for use by State transportation departments in identifying the multi-modal capacity of State and local road networks.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="H5FA5E72889B54B21BA50D9A7339F6428"><enum>314.</enum><header>National assessment of mental health needs</header><text display-inline="no-display-inline">Title V of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa">42 U.S.C. 290aa et seq.</external-xref>) is amended by inserting after section 506B (<external-xref legal-doc="usc" parsable-cite="usc/42/290aa-5b">42 U.S.C. 290aa–5b</external-xref>) the following:</text> <quoted-block style="OLC" act-name="Public Health Service Act" id="HD1F0DD6375CA423D9867202BB1DA2FF"> <section id="H611CC21695FA49909241E9C9BE074B98"><enum>506C.</enum><header>National assessment of mental health needs</header> <subsection id="HA7FA12089764410D8C5441B4EBA74E2"><enum>(a)</enum><header>In General</header><text>The Secretary, acting through the Administrator, and in consultation with the Centers for Disease Control and Prevention and the Director of the National Institutes of Health, shall establish and implement public health monitoring measures to address the mental and behavioral health needs of the population of the United States and other populations served by the Administration, that include—</text> <paragraph id="H2D2793BC400A48ECBA9BC7102168E083"><enum>(1)</enum><text>monitoring the mental health status of the population, including incidence and prevalence rates of mental and behavioral health problems throughout the lifespan;</text></paragraph> <paragraph id="H4BC4A7977B894B3594FF8CC2E1D6647E"><enum>(2)</enum><text>monitoring mental and behavioral health risks;</text></paragraph> <paragraph id="H6F87F4C389EC4A95B668FCC6F9067E00"><enum>(3)</enum><text>enhancing existing public health monitoring systems to include data on mental and behavioral health status and risks; and</text></paragraph> <paragraph id="H637C081F11BF463C9D628C8FAFE66C76"><enum>(4)</enum><text>monitoring the immediate and long-term impact of environmental factors to collect data on the prevalence of mental and behavioral health problems throughout the lifespan with the aim of encouraging early intervention and treatment.</text></paragraph></subsection> <subsection id="H06D1FDEDAAA74545B0D497C8E3F79103"><enum>(b)</enum><header>Distinguishing Among Age Groups</header><text>In designing and implementing the measures described in subsection (a) the Secretary shall ensure that methods of monitoring and reporting data distinguish among different age groups, including when identifying groups of children, and very young children under age 3, together with their parents.</text></subsection> <subsection id="HD3601A2E547D447DBE8B12F1488CACD"><enum>(c)</enum><header>Report</header><text>Not later than 1 year after the date of enactment of this section, the Secretary shall submit a report to Congress that describes the progress on the implementation of the monitoring measures described in subsection (a).</text></subsection> <subsection id="HBDB327315B0449CD8517975FE8C4AE32"><enum>(d)</enum><header>Authorization of Appropriations</header><text>There is authorized to be appropriated to carry out this section $5,000,000 for fiscal year 2008 and such sums as may be necessary for each of the following fiscal years.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="H1F1BFFAF40744FB0893C5578919F2E11"><enum>315.</enum><header>Preventive medicine and public health training grant program</header><text display-inline="no-display-inline">Part D of title III of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/254b">42 U.S.C. 254b et seq.</external-xref>) is amended by adding at the end the following:</text> <quoted-block style="OLC" act-name="Public Health Service Act" id="HE31CE024B646439098517B2E12706EB"> <subpart id="HADA71A304E53425C8CF92E8523705932"><enum>XI</enum><header>Preventive Medicine Training</header> <section id="H1DC0921C11034C4E9D20A0A5764484E3"><enum>340H.</enum><header>Preventive medicine and public health training grant program</header> <subsection id="H834EF381F54542A8939437B60D0E6F0"><enum>(a)</enum><header>Grants</header><text>The Secretary, acting through the Director of the Centers for Disease Control and Prevention, may award grants to, or enter into contracts with, eligible entities to provide training to graduate medical residents in preventive medicine specialties.</text></subsection> <subsection id="H86ACCFF789C04E7982E8551600A7DE29"><enum>(b)</enum><header>Eligibility</header><text>To be eligible to receive a grant or contract under subsection (a), an entity shall—</text> <paragraph id="H2CD6FDAE4DC74CB8A5CAAD195E86ADDF"><enum>(1)</enum><text>be a school of public health, public health department, school of medicine or osteopathic medicine, public or private hospital, or public or private non-profit entity;</text></paragraph> <paragraph id="H4A7D78D41851456389F29D2CE361D9C0"><enum>(2)</enum><text>submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require; and</text></paragraph> <paragraph id="HC4BF904EAEC24025A83918620076C7CA"><enum>(3)</enum><text>maintain and adhere to a Letter of Agreement with a local community health center (if available in the local area involved) that supports practicum training of preventive medicine residents, if practicable.</text></paragraph></subsection> <subsection id="H2AD3E15C15E440988F8B96D01E510043"><enum>(c)</enum><header>Use of Funds</header><text>Amounts received under a grant or contract under this section shall be used to—</text> <paragraph id="HC9E37096B66D47F79BC88F317DB12E98"><enum>(1)</enum><text>to plan, develop, and operate residency programs for preventive medicine or public health;</text></paragraph> <paragraph id="HB069058F8B2E4EB8912247EAEF9484E"><enum>(2)</enum><text>provide financial assistance, including tuition and stipends, to resident physicians (MD or DO) who plan to specialize in preventive medicine or public health;</text></paragraph> <paragraph id="H59487ADBD08F41DEB7003D9C1F8538A"><enum>(3)</enum><text>defray the costs associated with the planning, development, and operation of preventive medicine or public health programs, including the development of curriculum to be used in such program; and</text></paragraph> <paragraph id="H592BC57328CB4A458D0017499513E46F"><enum>(4)</enum><text>provide for the improvement of academic administrative units.</text></paragraph></subsection> <subsection id="HECE624E28BA1473CB2B75944F163C1B"><enum>(d)</enum><header>Duration of Award</header><text>A grant or contract under this section shall be for a term of not to exceed 5 years.</text></subsection> <subsection id="H42C1E09194B74D808C3F7B56EBF4F3F2"><enum>(e)</enum><header>Authorization of Appropriations</header><text>There is authorized to be appropriated to carry out this section, $43,000,000 for fiscal year 2008, and such sums as may be necessary for each succeeding fiscal year.</text></subsection></section></subpart><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="H70FA7AF51B8B4104A3754E00C8F5849C"><enum>316.</enum><header>Task Force for the Promotion of Breastfeeding in the Workplace</header> <subsection id="H5FCB31022D80414DADDD177CEBA626E4"><enum>(a)</enum><header>Establishment</header><text>The Secretary of Health and Human Services and the Secretary of Labor, or their designees, shall convene a task force for the purpose of promoting breastfeeding among working mothers (referred to in this section as the <quote>Task Force</quote>).</text></subsection> <subsection id="H4655868BE6A84758AF73D94B72379897"><enum>(b)</enum><header>Membership</header><text>The Task Force shall be composed of members who are—</text> <paragraph id="H5B859510195B44929115A6E069FBDE3"><enum>(1)</enum><text>expert staff from the Department of Labor with expertise in workforce issues;</text></paragraph> <paragraph id="H2B3E94A8A96C49D3BA18F20000002D13"><enum>(2)</enum><text>expert staff from the Department of Health and Human Services with expertise in the areas of breastfeeding and breastfeeding promotion;</text></paragraph> <paragraph id="H8CF8D86555D742AEA700F121A967DCCD"><enum>(3)</enum><text>members of the United States Breastfeeding Committee;</text></paragraph> <paragraph id="H03D2EAA086724BE99DF650FC072FF122"><enum>(4)</enum><text>expert staff from the Department of Agriculture; and</text></paragraph> <paragraph id="H288A93872DEB4B08AC5F5009EC6DF6"><enum>(5)</enum><text>appointed by the Secretary of Health and Human Services and the Secretary of Labor, including—</text> <subparagraph id="H4AF9DA9B808643F0893541EC961249C3"><enum>(A)</enum><text>working mothers who have experience in working and breastfeeding; and</text></subparagraph> <subparagraph id="H29B093B2B06E49CEB97DA2E15646F1A1"><enum>(B)</enum><text>representatives of the human resource departments of both large and small employers that have successfully promoted breastfeeding and breastmilk pumping support at work.</text></subparagraph></paragraph></subsection> <subsection id="H490C3B247462440893A6D78BF7B89D6C"><enum>(c)</enum><header>Period of Appointment; Vacancies</header><text>Members shall be appointed for the life of the Task Force. Any vacancy in the Task Force shall not affects its powers, but shall be filled in the same manner as the original appointment.</text></subsection> <subsection id="HA2CAAF35D24349BDB3643C7DB29F0276"><enum>(d)</enum><header>Chair</header><text>The Task Force shall be chaired jointly by the Secretary of Health and Human Services and the Secretary of Labor, or their designees.</text></subsection> <subsection id="HAF4EB36DE45047C5B22989F8031DD1A3"><enum>(e)</enum><header>Duties of the Task Force</header> <paragraph id="H5C88B34365CF481EBFF3768B50285E61"><enum>(1)</enum><header>Examination</header><text>Consistent with the Department of Health and Human Services Blueprint for Action on Breastfeeding (2000), the Task Force shall examine the following issues:</text> <subparagraph id="HB532E9116A714117A631DC587BA1B1BB"><enum>(A)</enum><text>The challenges that mothers face with continuing breastfeeding when the mothers return to work after giving birth.</text></subparagraph> <subparagraph id="HEDF007E9EF76447EB1BA33B813F3018D"><enum>(B)</enum><text>The challenges that employers face in accommodating mothers who seek to continue to breastfeed or to express milk when the mothers re-enter the workforce, including different challenges that mothers of varying socio-economic status and in different professions may face.</text></subparagraph> <subparagraph id="H204760C98FF2424F84B5D498CA968E"><enum>(C)</enum><text>The benefits that accrue to mothers, babies, and to employers when mothers are able to continue to breastfeed or to express breastmilk at work after the mothers have re-entered the workforce.</text></subparagraph> <subparagraph id="HE1132ACCC94A43B8AB69E9C75E6751F0"><enum>(D)</enum><text>Federal and State statutes that may have the effect of reducing breastfeeding and breastfeeding retention rates among working mothers.</text></subparagraph></paragraph> <paragraph id="H9CC431F310D14BC693A3339C4D65D053"><enum>(2)</enum><header>Reports</header> <subparagraph id="H41CC04D455564D9184A9B8FC6DD4CAD4"><enum>(A)</enum><header>In general</header><text>Not later than 1 year after the date of enactment of this section, the Task Force shall issue a public report with recommendations on the following:</text> <clause id="HB19D553B026D4EDEAA2893E5B49E8458"><enum>(i)</enum><text>Steps that can be taken to promote breastfeeding among working mothers and to remove barriers to breastfeeding among working mothers.</text></clause> <clause id="H2D17A076ECA74D6B8517D4FD548026C"><enum>(ii)</enum><text>Potential ways in which the Federal Government can work with employers to promote breastfeeding among working mothers.</text></clause> <clause id="H304DF037A0504C84A72639F47E390010"><enum>(iii)</enum><text>Areas in which changes to existing Federal, State, or local laws would likely have the effect of making it easier for working mothers to breastfeed or would remove impediments to breastfeeding that currently exist in such laws.</text></clause> <clause id="HE92C033A9684494EAAF17DC3EE003709"><enum>(iv)</enum><text>Whether or not increased rates of breastfeeding among working mothers would likely have the result of reducing health care costs among such mothers and their children, and, in particular, whether increased rates of breastfeeding would be likely to result in lower Federal expenditures on health care for such mothers and their children.</text></clause> <clause id="HA273A954CBE04687B494D846EC9C2471"><enum>(v)</enum><text>Areas in which the Federal Government, through additional appropriations, increased efforts by Federal agencies, or changes to existing Federal law, can and should increase the Federal Government’s efforts to promote breastfeeding among working mothers.</text></clause></subparagraph> <subparagraph id="HDA98F854FCE64DA8B7F424B824382EE9"><enum>(B)</enum><header>Copy to congress</header><text>Upon completion of the report described in subparagraph (A), the Task Force shall submit a copy of the report to the Committee on Health, Education, Labor, and Pensions of the Senate, the Committee on Appropriations of the Senate, the Committee on Education and the Workforce of the House of Representatives, and the Committee on Appropriations of the House of Representatives.</text></subparagraph></paragraph></subsection> <subsection id="H2BE42F9083B845BABB2CFCDB6470F8CB"><enum>(f)</enum><header>Powers of the Task Force</header> <paragraph id="H54E7518108634ABEA1B35029B2D9C04F"><enum>(1)</enum><header>Hearings</header><text>The Task Force may hold such hearings, sit and act at such times and places, take such testimony, and receive such evidence as the Task Force considers advisable to carry out this section.</text></paragraph> <paragraph id="H4CA14EF74B3047ADB8D2F86ECB4E0084"><enum>(2)</enum><header>Information from federal agencies</header><text>The Task Force may secure directly from any Federal department or agency such information as the Task Force considers necessary to carry out this section. Upon request of the Chair of the Task Force, the head of such department or agency shall furnish such information to the task Force.</text></paragraph> <paragraph id="H745E31DA19324B48BD20A2C3326C647D"><enum>(3)</enum><header>Postal services</header><text>The Task Force may use the United States mails in the same manner and under the same conditions as other departments and agencies of the Federal Government.</text></paragraph> <paragraph id="HBEB151877F6E4C67BD3B00FC1D7556F8"><enum>(4)</enum><header>Gifts</header><text>The Task Force may accept, use, and dispose of gifts or donations of services or property.</text></paragraph></subsection> <subsection id="H188A4C22066E4095991E000977969DD9"><enum>(g)</enum><header>Operating Expenses</header><text>The operating expenses of the Task Force, including travel expenses for members of the Task Force, shall be paid for from the general operating expenses funds of the Secretary of Health and Human Services and the Secretary of Labor.</text></subsection></section> <section id="H02A6E65D43844491985C3E7D261480BC"><enum>317.</enum><header>Lactation accommodation and breastfeeding promotion at work</header> <subsection id="H1A976A9AB507440EBAA51E5EC47C30CC"><enum>(a)</enum><header>Breastfeeding at Work General Requirements</header><text>The Family and Medical Leave Act of 1993 (<external-xref legal-doc="usc" parsable-cite="usc/29/2611">29 U.S.C. 2611 et seq.</external-xref>) is amended by inserting after title IV the following:</text> <quoted-block style="OLC" id="HA883D3B353014917B654C8A5C914F294"> <title id="H687242427C1C42ADADB207D1F6BD1256"><enum>V</enum><header>LACTATION PERIODS AND FACILITIES</header> <section id="H865179D60EE245C584BDAB9367550267"><enum>501.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title:</text> <paragraph id="H604DED6D99B344C2B8B0C0BDC27D4120"><enum>(1)</enum><header>Eligible child</header><text>The term <term>eligible child</term>, used with respect to an eligible employee, means a son or daughter (as defined in section 101) who is a child of the employee.</text></paragraph> <paragraph id="H140205F086A74753004E5067109CA22C"><enum>(2)</enum><header>Eligible employee</header><text>The term <term>eligible employee</term> has the meaning given the term in section 101, except that the limitations established in clauses (i) and (ii) of section 101(2)(A) shall not apply. The term <term>eligible employee</term> does not include any Federal officer or employee covered under subchapter VII of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/63">chapter 63</external-xref> of title 5, United States Code, but does include a State employee described in section 304(a) of the Government Employee Rights Act of 1991 (42 U.S.C. 2000e–16c(a)).</text></paragraph> <paragraph id="H731BB652684F4C4B9DD7A817D808ECE8"><enum>(3)</enum><header>Employer</header><text>The term <term>employer</term> has the meaning given the term in section 101, and includes an entity employing a State employee described in section 304(a) of the Government Employee Rights Act of 1991.</text></paragraph> <paragraph id="HD2DB8B5E974F4130AF18958BCC8BA86F"><enum>(4)</enum><header>Undue hardship</header><text>The term <term>undue hardship</term> means an action requiring significant difficulty or expense.</text></paragraph></section> <section id="HCF7B1FB223664DA99B764BBD3291C469"><enum>502.</enum><header>Lactation periods</header> <subsection id="HF646BF86AD334B8A9BD240BE8CD6E576"><enum>(a)</enum><header>In General</header><text>An employer shall provide an appropriate number of lactation periods, of reasonable length, for an eligible employee during each workday, to permit the employee to express milk for, or breastfeed, an eligible child.</text></subsection> <subsection id="H447286FFC4C844939083C4AADFE1E1F5"><enum>(b)</enum><header>Break Time</header> <paragraph id="H6F2C6C1C4D1143E38971E5CFF4BC4170"><enum>(1)</enum><header>Unpaid break periods</header><text>Except as provided in paragraph (2), the lactation periods may consist of unpaid break periods.</text></paragraph> <paragraph id="HDFA4D3B5BFDD424CA3903221583C87CF"><enum>(2)</enum><header>Combined break periods</header><text>To the extent practicable, an employer shall combine break periods by providing the lactation periods for an eligible employee at the same time as the employer provides other break periods for the employee. If the employer combines the break periods, the employee shall receive the same compensation for a combined break period as the employee would have received for an original break period.</text></paragraph></subsection> <subsection id="HEC3E1C0DB24C46A2A19B6F643F459B00"><enum>(c)</enum><header>Limitation</header> <paragraph id="H4D22A57BB38E4540A1BB5000CB00AE6F"><enum>(1)</enum><header>Undue hardship</header><text>An employer shall not be required to provide a lactation period under this section if the employer demonstrates that providing the period would impose an undue hardship on the employer, subject to paragraph (2).</text></paragraph> <paragraph id="H6E4BE627534C4BE69F690033FCBA2177"><enum>(2)</enum><header>Reasonable efforts</header><text>An employer who maintains that an undue hardship would result from providing a lactation period to an eligible employee shall demonstrate that the employer made reasonable efforts to comply with subsections (a) and (b).</text></paragraph></subsection></section> <section id="H394CA820F20B43A7BE48F5AFF3F01B3"><enum>503.</enum><header>Lactation facilities</header> <subsection id="HF4B3ECAB0CC940839F67EED019B97057"><enum>(a)</enum><header>In General</header><text>An employer shall provide an appropriate lactation facility for an eligible employee, within a reasonable distance from the employee’s usual work location, to permit the employee to express milk for, or breastfeed, an eligible child.</text></subsection> <subsection id="H5B905B321C7D4E779868A3E1C2D7EC03"><enum>(b)</enum><header>Limitation</header> <paragraph id="H3AD6237DEC0D489E9000DE23098DFBD9"><enum>(1)</enum><header>Undue hardship</header><text>An employer shall not be required to provide a lactation facility under this section if the employer demonstrates that providing the facility would impose an undue hardship on the employer, subject to paragraph (2).</text></paragraph> <paragraph id="H1481742E91B64A9E841864009213003F"><enum>(2)</enum><header>Reasonable efforts</header><text>An employer who maintains that an undue hardship would result from providing a lactation facility to an eligible employee shall demonstrate that the employer made reasonable efforts to comply with subsection (a).</text></paragraph></subsection></section> <section id="H48C42921B3AB49C895ACC8F04602AFD1"><enum>504.</enum><header>Enforcement and remedies</header> <subsection id="H9110A07785974222AF2309461EB30040"><enum>(a)</enum><header>Enforcement Process</header><text>The Secretary of Labor shall establish or designate a process through which—</text> <paragraph id="HCA76E785C4004400BFFACAAEA1D949F4"><enum>(1)</enum><text>an individual may file a complaint regarding a violation of this title; and</text></paragraph> <paragraph id="H670ABC364A6B4923B26C00B17BDF9E59"><enum>(2)</enum><text>an office designated by the Secretary in the Department of Labor shall receive, investigate, make determinations regarding, and administer remedies with respect to such complaints.</text></paragraph></subsection> <subsection id="H08C07D1DB61144A9AE0511226190619D"><enum>(b)</enum><header>Remedies</header><text>The Secretary of Labor shall establish remedies for violations of this title.</text></subsection> <subsection id="HC8AFDBFA94F7475985F54815F1DADD03"><enum>(c)</enum><header>Government Accountability Office and Library of Congress</header><text>In the case of the Government Accountability Office and the Library of Congress, the authority of the Secretary of Labor under this title shall be exercised respectively by the Comptroller General of the United States and the Librarian of Congress.</text></subsection></section> <section id="HD532B0E622304EAE8034478233008740"><enum>505.</enum><header>Regulations</header><text display-inline="no-display-inline">The Secretary of Labor shall issue regulations to carry out this title, including provisions prescribing—</text> <paragraph id="H9B09B2373D0F4C8000200137DF67C532"><enum>(1)</enum><text>an appropriate number and reasonable length of lactation periods, for purposes of section 502;</text></paragraph> <paragraph id="HE9D8EC2416E549AFA56DAC7E121F9B8"><enum>(2)</enum><text>an appropriate lactation facility (which shall not be a restroom or a portion of a restroom) and a reasonable distance from a usual work location, for purposes of section 503; and</text></paragraph> <paragraph id="H17701689FA2648D4B913456018D4C6A"><enum>(3)</enum><text>the process and remedies described in section 504.</text></paragraph></section>. (b)
Breastfeeding at Work for Civil Service Employees
Chapter 63 of title 5, United States Code, is amended by adding at the end: VII
LACTATION PERIODS AND FACILITIES
6392.
Definitions
For the purpose of this subchapter— (1)the term eligible child, used with respect to an employee, means a son or daughter (as defined in section 6381) who is a child of the employee; (2)the term employee means any individual who is an employee, as defined by section 6301(2), including any individual employed in a position referred to in clause (v) or (ix) of section 6301(2), but excluding any individual employed by the government of the District of Columbia, any individual employed on a temporary or intermittent basis, and any employee of the General Accounting Office or the Library of Congress; and (3)the term undue hardship means an action requiring significant difficulty or expense.
6392A.
Lactation periods
(a)An employing agency shall provide an appropriate number of lactation periods, of reasonable length, for an employee during each workday, to permit the employee to express milk for, or breastfeed, an eligible child. (b) (1)Except as provided in paragraph (2), the lactation periods may consist of unpaid break periods. (2)To the extent practicable, an employing agency shall combine break periods by providing the lactation periods for an employee at the same time as the employing agency provides other break periods for the employee. If the employing agency combines the break periods, the employee shall receive the same compensation for a combined break period as the employee would have received for an original break period. (c) (1)An employing agency shall not be required to provide a lactation period under this section if the employing agency demonstrates that providing the period would impose an undue hardship on the employing agency, subject to paragraph (2). (2)An employing agency who maintains that an undue hardship would result from providing a lactation period to an employee shall demonstrate that the employing agency made reasonable efforts to comply with subsections (a) and (b).
6392B.
Lactation facilities
(a)An employing agency shall provide an appropriate lactation facility for an employee, within a reasonable distance from the employee’s usual work location, to permit the employee to express milk for, or breastfeed, an eligible child. (b) (1)An employing agency shall not be required to provide a lactation facility under this section if the employing agency demonstrates that providing the facility would impose an undue hardship on the employing agency, subject to paragraph (2). (2)An employing agency who maintains that an undue hardship would result from providing a lactation facility to an employee shall demonstrate that the employing agency made reasonable efforts to comply with subsection (a).
6392C.
Remedies
(a)The Office of Personnel Management shall establish or designate a process through which— (1)an individual may file a complaint regarding a violation of this subchapter; and (2)an office designated by the Director of the Office of Personnel Management shall receive, investigate, make determinations regarding, and administer remedies with respect to such complaints. (b)The Office of Personnel Management shall establish remedies for violations of this subchapter.
6392D.
Regulations
(a)The Office of Personnel Management shall issue regulations to carry out this subchapter, including provisions prescribing— (1)an appropriate number and reasonable length of lactation periods, for purposes of section 6392A; (2)an appropriate lactation facility (which shall not be a restroom or a portion of a restroom) and a reasonable distance from a usual work location, for purposes of section 6392B; and (3)the process and remedies described in section 6392C. (b)The regulations prescribed under this subchapter shall, to the extent appropriate, be consistent with the regulations prescribed by the Secretary of Labor to carry out title V of the Family and Medical Leave Act of 1993.
. (c)
Breastfeeding at Work for Congressional Employees
(1)
Application of laws
Section 102(a) of the Congressional Accountability Act of 1995 (2 U.S.C. 1302(a)) is amended— (A)in paragraph (5), by striking The and inserting Title I of the; and (B)by adding at the end the following: (12)Title V of the Family and Medical Leave Act of 1993.. (2)
Extension of rights and protections
Part A of title II of the Congressional Accountability Act of 1995 (2 U.S.C. 1311 et seq.) is amended— (A)in section 202 (2 U.S.C. 1312), by striking the title and inserting the following:
202.
Rights and protections under Title I of the Family and Medical Leave Act of 1993
; (B)by redesignating section 207 as section 208; and (C)by inserting after section 206 the following:
207.
Rights and protections under title V of the Family and Medical Leave Act of 1993
(a)
Breastfeeding Rights and Protections Provided
(1)
In general
The rights and protections established by sections 501 through 503 of the Family and Medical Leave Act of 1993 shall apply to covered employees. (2)
Definition
For purposes of the application described in paragraph (1)— (A)the term employer as used in the Family and Medical Leave Act of 1993 means any employing office; and (B)the term eligible employee as used in the Family and Medical Leave Act of 1993 means a covered employee who has been employed in any employing office. (b)
Remedy
The remedy for a violation of subsection (a) shall be such remedy as would be appropriate if awarded under section 504 of the Family and Medical Leave Act of 1993. (c)
Regulations
(1)
In general
The Board shall, pursuant to section 304, issue regulations to implement the rights and protections under this section. (2)
Agency regulations
The regulations issued under paragraph (1) shall be the same as substantive regulations promulgated by the Secretary of Labor to implement the statutory provisions referred to in subsections (a) and (b), except insofar as the Board may determine, for good cause shown and stated together with the issued regulations, that a modification of such promulgated regulations would be more effective for the implementation of the rights and protections under this section.
. (3)
Table of contents
The table of contents for the Congressional Accountability Act of 1995 is amended by striking the item relating to section 207 and inserting the following: Sec. 207. Rights and protections under title V of the Family and Medical Leave Act of 1993. Sec. 208. Prohibition of intimidation or reprisal.. (d)
Breastfeeding at Work for Employees in Presidential Offices
(1)
Application of laws
Section 402 of title 3, United States Code, is amended— (A)in paragraph (5), by striking The and inserting Title I of the; and (B)by adding at the end the following: (12)Title V of the Family and Medical Leave Act of 1993.. (2)
Extension of rights and protections
Subchapter II of chapter 5 of title 3, United States Code, is amended— (A)in section 412, by striking the title and inserting the following:
412.
Rights and protections under Title I of the Family and Medical Leave Act of 1993
; (B)by redesignating section 417 as section 418; and (C)by inserting after section 416 the following:
417.
Rights and protections under title V of the Family and Medical Leave Act of 1993
(a)
Breastfeeding Rights and Protections Provided
(1)
In general
The rights and protections established by sections 501 through 503 of the Family and Medical Leave Act of 1993 shall apply to covered employees. (2)
Definition
For purposes of the application described in paragraph (1)— (A)the term employer as used in the Family and Medical Leave Act of 1993 means any employing office; and (B)the term eligible employee as used in the Family and Medical Leave Act of 1993 means a covered employee. (b)
Remedy
The remedy for a violation of subsection (a) shall be such remedy as would be appropriate if awarded under section 504 of the Family and Medical Leave Act of 1993. (c)
Regulations
(1)
In general
The President, or the designee of the President, shall issue regulations to implement this section. (2)
Agency regulations
The regulations issued under paragraph (1) shall be the same as substantive regulations promulgated by the Secretary of Labor to implement the statutory provisions referred to in subsections (a) and (b)— (A)except to the extent that the President or designee may determine, for good cause shown and stated together with the issued regulations, that a modification of such promulgated regulations would be more effective for the implementation of the rights and protections under this section; and (B)except that the President or designee may, at the discretion of the President or designee, issue regulations to implement a provision of subchapter VII of chapter 63 of title 5, United States Code, that applies to employees in the executive branch of the Federal Government in lieu of an analogous statutory provision referred to in subsection (a) or (b), if the issuance of such regulations— (i)would be equally effective for the implementation of the rights and protections under this section; and (ii)would promote uniformity in the application of Federal law to employees in the executive branch of the Federal Government.
. (3)
Conforming amendment
Section 411(e) of title 3, United States Code, is amended by striking 417 and inserting 418. (4)
Table of contents
The table of contents for chapter 5 of title 3, United States Code, is amended by striking the item relating to section 417 and inserting the following: 417. Rights and protections under title V of the Family and Medical Leave Act of 1993. 418. Prohibition of intimidation or reprisal.. (e)
Effective Dates
(1)
In general
Except as provided in paragraph (2), this section and the amendments made by this section take effect 18 months after the date of enactment of this Act. (2)
Regulations
Section 505 of the Family and Medical Leave Act of 1993 (as added by subsection (a)), section 6392D of title 5, United States Code (as added by subsection (b)), section 207(c) of the Congressional Accountability Act of 1995 (as added by subsection (c)), and section 417(c) of title 3, United States Code (as added by subsection (d)) take effect on the date of enactment of this Act. 2
PROMOTING LIFELONG ACTIVE COMMUNITIES
321.
Short title
This chapter may be cited as the Promoting Lifelong Active Communities Every Day Act or the PLAY Every Day Act.
322.
Purpose
The purpose of this chapter is to help children, families and communities achieve the national recommendation of 60 minutes of physical activity every day.
323.
Definition of Secretary
In this chapter, the term Secretary means the Secretary of Health and Human Services.
A
National Program Promoting Lifelong Active Communities
331.
Development of Community Play Index
(a)
Community Play Index
The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall develop a well-validated community measurement tool, which shall be known as the Community Play Index, that can measure the policy, program, or environmental barriers in communities to participating in physical activity. The Community Play Index shall include— (1)cross-cutting measurements that— (A)examine barriers to physical activities across multiple settings, including homes, after school and child care sites, schools, the community at-large, and worksites; and (B)focus on the— (i)availability of adequate spaces and places for physical activity; (ii)availability of, and access to, quality physical activity and physical education programs; and (iii)the availability of programs, activities, and leaders to educate about the importance of physical activity for the community; and (2)additional measurements to assist economically and culturally diverse communities in examining the social determinants of health. (b)
Guidance and Training
The Secretary shall provide guidance and develop training on utilizing the Community Play Index.
332.
Sense of the House of Representatives regarding funding
It is the sense of the House of Representatives that the Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall carry out this subchapter using any additional and available funds provided to the Secretary for the steps to a healthier United States program carried out by the Centers for Disease Control and Prevention.
 B
Model Communities of Play Implementation Grants
341.
Model communities of PLAY implementation grants
(a)
Program Authorized
(1)
In general
The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall award 3 grants to State health departments to enable the State health departments to work in partnership with eligible community-based coalitions to plan and implement model communities of play that— (A)increase the physical spaces and places available for physical activity; (B)increase the opportunities for children and families to participate in quality play, and the number of children and families participating in quality play; and (C)increase knowledge and awareness about the importance of individuals achieving 60 minutes of recommended physical activity every day. (2)
Amount of grants
A grant awarded under this subsection shall be in the amount of $250,000. If the amounts appropriated under this title for a fiscal year are not sufficient to support 3 grants at such level, the Secretary shall ratably reduce the amount of all grants. (b)
Application
A State health department desiring a grant under subsection (a) shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require. (c)
Coordination
In awarding grants under subsection (a), the Secretary shall ensure that the proposed programs assisted under each grant are coordinated in substance and format with programs currently funded through other Federal departments and agencies, including— (1)State-based nutrition and physical activity programs, comprehensive school health education programs, and community-based health and wellness programs of the Centers for Disease Control and Prevention; (2)the physical education programs under subpart 10 of part D of title V of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7261 et seq.; (3)the safe routes to schools program under section 1404 of the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (23 U.S.C. 402 note; 119 Stat. 1228); and (4)other health and wellness programs operating within the community. (d)
Partnership With Community Coalitions
A State health department receiving a grant under subsection (a) shall use grant funds to carry out the activities described in subsection (e) in partnership with 1 or more community coalitions that meet all of the following requirements: (1)The community coalition is comprised of a representative sampling of community partners, including not less than half of the different types of individuals or entities described in subparagraphs (A) through (O): (A)A community-based organization that focuses on children and youth, preventive health, physical activity, or physical education. (B)A local parks and recreation department. (C)A local health department. (D)A local educational agency, as defined in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801). (E)A local city planning agency. (F)A local health care provider. (G)A 4-year institution of higher education, as defined in section 101 of the Higher Education Act of 1965 (20 U.S.C. 1001). (H)A tribal health facility, where applicable. (I)A tribal educational agency, where applicable. (J)A Federally qualified health center or rural health clinic, where applicable. (K)A hospital. (L)A faith-based organization. (M)A policymaker or elected official. (N)A community planning organization. (O)A business. (2)The community coalition completed and submitted to the State health department— (A)a Community Play Index developed under section 101 for the community that identifies the gaps and barriers to physical activity in the community to children and youth; and (B)a community action plan describing the programs, policy, and environmental change strategies that will be implemented with grant funds to help children and youth in the community reach the recommended 60 minutes of physical activity every day. (3)The community coalition provided— (A)documentation to the State health department on the manner in which the coalition will coordinate with appropriate State and local authorities, including— (i)State or local health departments; (ii)State educational agencies or local educational agencies, as defined in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801); (iii)State or local parks and recreation departments or associations; (iv)State or local departments of transportation or city planning; (v)community foundations; and (vi)any other entities determined to be appropriate by the Secretary; and (B)a description of the manner in which the coalition will evaluate the effectiveness of the programs carried out with grant funds. (e)
Authorized Activities
A State health department that receives a grant under subsection (a) shall use funds available through the grant to carry out the following activities: (1)Train community-based coalitions on how to utilize the Community Play Index to measure the program, policy, and environmental barriers to promoting lifelong physical activity for youth. (2)Work in partnership with community coalitions described in subsection (d) to enable the community coalitions to carry out the coalition’s community action plan and promote a model community of play, which may include the following: (A)Enabling the maximum use of, or the creation of spaces and places for, physical activity for children, families, and communities before, during, and after school or work, which may include increasing the number of— (i)programs that increase the number of safe streets and sidewalks in the community to walk and bike to school, work, or other community destinations, such as recreation sites, parks, or community centers; (ii)schools, faith-based organizations, and recreational facilities serving the community that provide programming on physical activity and physical education before, during, or after school; (iii)schools serving the community that provide recess, physical education, and physical activity for children and youth; (iv)day care, child care, and after school care sites in the community that provide physical activity for children and youth; (v)venues in the community that provide co-curricular physical activity programs, including sports fields and courts, especially venues for all-inclusive intramural programs and physical activity clubs; (vi)playgrounds and activity sites in the community for young children, including sites that offer programs that provide physical activity instruction that meet the various needs and interests of all students, including those with illness, injury, and physical and developmental disabilities, as well as those that live sedentary lifestyles or with a disinterest in traditional team sports; (vii)capital improvement projects that increase opportunities for physical activity in the community; and (viii)networks of walking and cycling trails where trails do not exist in the community, that offer both a functional alternative to automobile travel and an opportunity for exercise, recreation, and community connectedness. (B)Enhancing opportunities and access for children and youth in the community to participate in quality physical activity and physical education programs before, during, and after school, which may include increasing the number of— (i)school and after school care sites in the community that implement proven health curricula, physical education (including developing innovative approaches to teaching and staffing, physical education), and physical activity programming; (ii)children and youth in the community that are able to participate in physical education or activity during and after school, by ensuring that adequate equipment is available to such children and youth; (iii)scholarships to low-income children and youth for physical activity programs; (iv)education and training programs for education, recreation, leisure, child care, and coaching professionals regarding quality physical education and physical activity programs and policies; (v)training programs to assist physicians in— (I)carefully communicating the results of body mass index (BMI) tests to parents and, in an age-appropriate manner, to the children and youth themselves; (II)providing information to families so they may make informed decisions about physical activity and nutrition; and (III)explaining the benefits associated with physical activity and the risks associated with childhood overweight and obesity; (vi)assessment tools used to measure the quality of physical activity, sports, and intramural sports programs; (vii)guidelines and informational materials used by teachers, parents, caregivers, and health-care professionals who are interested in promoting physical activity for infants, toddlers, and preschoolers; and (viii)guidelines and informational materials used to promote physical activity with the intent of improving the current health, fitness, and wellness of preadolescent children (ages 6 through 12) as well as to promote lifelong physical activity. (C)Identifying, engaging and mobilizing community leaders, decision-makers, experts, and the media to raise awareness and educate the public about the importance of securing 60 minutes of physical activity every day, which may include increasing the number of— (i)school and after school care faculty and staff, including coaches, that serve as positive role models for students regarding regular physical activity; (ii)businesses that serve as role models by providing physical space and incentives for employees to participate in physical activity; (iii)businesses that serve as role models to communities by— (I)providing support to intramural teams, clubs, sports leagues, playgrounds, trails, biking and walking paths, and fields and venues for sports, play, and physical activity; (II)incorporating built environment strategies into new construction of facilities; (III)adopting safe routes to school programs; (IV)providing bike racks at the office; and (V)encouraging the use of the stairs; (iv)insurers that provide incentives for maintaining healthy body weight, including offering screening and obesity prevention services in routine clinical practice; (v)groups representing low-income individuals or individuals with disabilities, that can promote and secure safer and more accessible sites for activity; (vi)consumer research-driven marketing strategies for ongoing initiatives and interventions that enhance physical activity for children and youth; (vii)products and opportunities provided or offered by leisure, entertainment, and recreation industries that promote regular physical activity and reduce sedentary behaviors; (viii)media advocacy training programs for public health and exercise scientists so as to empower the scientists to disseminate their knowledge to a broad audience; and (ix)campaigns to foster awareness about the health benefits of regular physical activity of not less than 60 minutes a day for all children and youth. (3)To support the evaluation of the community action plans of the community coalitions and the activities carried out under this title. (f)
Authorization of Appropriations
There are authorized to be appropriated to carry out this subtitle $750,000 for fiscal year 2008.
 <enum>IV</enum><header>RESPONSIBLE MARKETING AND CONSUMER AWARENESS</header> <subtitle id="HC1EBE67AE3E843668C7FA6A0FB7575D9"><enum>A</enum><header>General Provisions</header> <section id="HD80DF78639FA4BBE8885BF2E00DA987E"><enum>401.</enum><header>Nutrition labeling of restaurant Foods</header><text display-inline="no-display-inline">Section 403(q)(5) of the <act-name parsable-cite="FFDCA">Federal Food, Drug, and Cosmetic Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/21/343">21 U.S.C. 343(q)(5)(A)(i)</external-xref>) is amended—</text> <paragraph id="HADFE56D665A14228A2E12746ABA100EC"><enum>(1)</enum><text>in clause (A)—</text> <subparagraph id="H448252ECD4614E2999D1315FA9B200D2"><enum>(A)</enum><text>in subclause (i), by inserting <quote>except as provided in clauses (H) and (I),</quote> before <quote>which</quote> the first place it appears; and</text></subparagraph> <subparagraph id="HA517B0AA3CEE4B0C9F9037B928992800"><enum>(B)</enum><text>in subclause (ii), by inserting <quote>except as provided in clauses (H) and (I),</quote> before <quote>which</quote> the first place it appears; and</text></subparagraph></paragraph> <paragraph id="HAD1D06F924D4461491A0B83000ED724C"><enum>(2)</enum><text>by adding at the end the following:</text> <quoted-block style="OLC" id="HB5BAC16FF8E44E16A83DB1D6E78DC48E"> <subparagraph indent="up2" id="HD3E23F77CE324FF5A9A3FB72B457D1DC"><enum>(H)</enum><header>Restaurants and Retail Food Establishments</header> <clause id="H1C4D459273654D77BE1F75BFCA56A500"><enum>(i)</enum><header>In general</header><text>Except for food described in subclause (iii), in the case of food that is served, processed, or prepared in a restaurant or similar retail food establishment that is part of a chain with 20 or more locations doing business under the same trade name (regardless of the type of ownership of the locations), the restaurant or establishment shall disclose the information described in subclause (ii).</text></clause> <clause id="HB47D61C809CC4502BBEB19FE0433ECC1"><enum>(ii)</enum><header>Information required to be disclosed</header><text>Except as provided in subclause (iii), the establishment shall disclose—</text> <subclause id="HD3ABE37F1B994D4DB3239252005EC849"><enum>(I)</enum> <item display-inline="yes-display-inline" id="HF0539978DB554D89AE88BB716BA36E39"><enum>(aa)</enum><text>in a statement adjacent to the name of the food on any menu listing the food for sale, or by any other means deemed equivalent by the Secretary, the number of calories, grams of saturated fat plus trans fat, and milligrams of sodium contained in a standard serving of the food, as usually offered for sale, in a clear and conspicuous manner; and</text></item> <item indent="up1" id="HF5225F016D3A4FD5B954B2C565F3F391"><enum>(bb)</enum><text>information, specified by the Secretary by regulation, designed to enable the public to understand, in the context of a total daily diet, the significance of the nutrition information that is provided; and</text></item></subclause> <subclause id="H1F4791160D464D3090A06E3D9111119D"><enum>(II)</enum><text>in a statement adjacent to the name of the food on any menu board or other sign listing the food for sale, or by any other means deemed equivalent by the Secretary—</text> <item id="HE51DD493897C4F1AB4FC5EC141B2D7D7"><enum>(aa)</enum><text>the number of calories contained in a serving of the food, as usually offered for sale, in a clear and conspicuous manner; and</text></item> <item id="HF3128F4DA03440CE9211872319D32943"><enum>(bb)</enum><text>notification that the information required by subitems (aa) and (bb) of item (I) shall be provided in writing at the request of a prospective purchaser.</text></item></subclause></clause> <clause id="H7BFE291E609A4E9C886C7EE26C6ED700"><enum>(iii)</enum><header>Nonapplicability to certain food</header><text>This clause does not apply to—</text> <subclause id="H0BF89AF60E4E44B2A019F9E6BC532129"><enum>(I)</enum><text>items that are not listed on a menu or menu board (such as condiments and other items placed on the table or counter for general use); or</text></subclause> <subclause id="HEC3AF1A9F1BD44DFAC4E4996CA005D7F"><enum>(II)</enum><text>daily specials, temporary menu items, or other irregular menu items, as specified by the Secretary by regulation.</text></subclause></clause> <clause id="HB26D10A5FD6C466EA6ACF0DB1F899200"><enum>(iv)</enum><header>Self-service facilities</header><text>In the case of food sold at a salad bar, buffet line, cafeteria line, or similar self-service facility, a restaurant or other establishment shall place a sign that lists calories per standard serving adjacent to each food offered.</text></clause> <clause id="HCEAEB18EF01646A8BED00D425D9DB05"><enum>(v)</enum><header>Voluntary provision of nutrition information; state regulation of nutrition information for restaurant food</header> <subclause id="H7663FEC3E8F14EAABCB9CE6F536E57DF"><enum>(I)</enum><header>Retail food establishments</header><text>Nothing in this clause precludes a restaurant or similar retail food establishment from providing additional nutrition information, voluntarily, if the information complies with the nutrition labeling requirements contained in this subparagraph.</text></subclause> <subclause id="H3A775394545D4B6C8500D16E6100BD2C"><enum>(II)</enum><header>State or local requirements</header><text>Nothing in this clause precludes a State or political subdivision of a State from requiring that a restaurant or similar food establishment provide nutrition information in addition to that required under this clause.</text></subclause></clause> <clause id="HBCB0737B48ED4098B5031C9BECC0B645"><enum>(vi)</enum><header>Regulations</header> <subclause id="H8FA8B3C02A7D4651956EAAF05B51175"><enum>(I)</enum><header>Proposed regulation</header><text>Not later than 1 year after the date of enactment of this clause, the Secretary shall promulgate proposed regulations to carry out this clause.</text></subclause> <subclause id="H7DDB2A0B721A46B7A563B6BBA5C44F9"><enum>(II)</enum><header>Contents</header><text>The regulations shall allow for the variations in serving sizes and in food preparation that can reasonably be expected to result from inadvertent human error, training of food service workers, and other factors.</text></subclause> <subclause id="HE0141EC6F87F4F288412B7E0032479D6"><enum>(III)</enum><header>Final regulations</header><text>Not later than 2 years after the date of enactment of this clause, the Secretary shall promulgate final regulations to implement this clause.</text></subclause> <subclause id="H64D2823590F74C638D004EC0B94C8C51"><enum>(IV)</enum><header>Failure to promulgate final regulations by required date</header><text>If the Secretary does not promulgate final regulations under item (III) by the date that is 2 years after the date of enactment of this clause—</text> <item id="HCBFA574BCEF44D2CBE49C1EDD009370"><enum>(aa)</enum><text>the proposed regulations issued in accordance with item (I) shall become effective as the final regulations on the day after that date; and</text></item> <item id="H006083F6E7BA45268FCB29EC0124E04D"><enum>(bb)</enum><text>the Secretary shall publish in the Federal Register notice of the final regulations.</text></item> <item indent="up3" id="HBF9315741FF248AE9455DF5F05FFB740"><enum>(I)</enum><header>Vending Machines</header></item></subclause></clause> <clause id="H55DEC6E7CD954D6A9D23D6075BC4456E"><enum>(i)</enum><header>In general</header><text>In the case of an article of food sold from a vending machine that—</text> <subclause id="HDE66EA2C24334E73B2ED39C00230E91E"><enum>(I)</enum><text>does not permit a prospective purchaser to examine the article so as to be able to read a statement affixed to the article before purchasing the article; and</text></subclause> <subclause id="H7F4324837D07456B9513BD28A99929F1"><enum>(II)</enum><text>is operated by a person that is engaged in the business of owning and operating 20 or more vending machines;</text><continuation-text continuation-text-level="paragraph">the vending machine operator shall provide a conspicuous sign in close proximity to the article that includes a statement disclosing the number of calories contained in the article.</continuation-text></subclause></clause> <clause id="HC360127A600F42E7BE7861A87C1CA398"><enum>(ii)</enum><header>Voluntary provision of nutrition information; state regulation of nutrition information for vending machines</header> <subclause id="H4322B9C3A0AD44CFA3E6FBC3DE3379B1"><enum>(I)</enum><header>Vending machine operators</header><text>Nothing in this clause precludes a vending machine operator from providing additional nutrition information, voluntarily, if the information complies with the nutrition labeling requirements contained in this subparagraph.</text></subclause> <subclause id="H9A5DAEF5FB474D5F866C20D6A752A737"><enum>(II)</enum><header>State or local requirements</header><text>Nothing in this title precludes a State or political subdivision of a State from requiring that a vending machine operator provide nutrition information in addition to that required under this clause.</text></subclause></clause> <clause id="HDF51C2B4F94E4F5980AE763CEF32516B"><enum>(iii)</enum><header>Regulations</header> <subclause id="HB377B7D32E9F4D31B673F5254CBF00A3"><enum>(I)</enum><header>Proposed regulations</header><text>Not later than 1 year after the date of enactment of this clause, the Secretary shall promulgate proposed regulations to carry out this clause.</text></subclause> <subclause id="H31F4F0DD6E85409CB5125335E5995B30"><enum>(II)</enum><header>Final regulations</header><text>Not later than 2 years after the date of enactment of this clause, the Secretary shall promulgate final regulations to implement this clause.</text></subclause> <subclause id="H14A9BA5406AC46F69182C7E261BBFA05"><enum>(III)</enum><header>Failure to promulgate final regulations by required date</header><text>If the Secretary does not promulgate final regulations under item (II) by the date that is 2 years after the date of enactment of this clause—</text> <item id="HB8E6B86C069C4680966B15DC893C4027"><enum>(aa)</enum><text>the proposed regulations issued in accordance with item (I) shall become effective as the final regulations on the day after that date; and</text></item> <item id="HE908F2ECC93641EDB76B62FCAC128C1F"><enum>(bb)</enum><text>the Secretary shall publish in the Federal Register notice of the final regulations.</text></item></subclause></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section> <section id="H401BAC0E739E43158E1F5CF8EB96296"><enum>402.</enum><header>Rulemaking authority for advertising to children</header> <subsection id="H47F76FC2E016414F9C1978653F52BD42"><enum>(a)</enum><header>Purpose</header><text>The purpose of this section is to restore the authority of the Federal Trade Commission to issue regulations that restrict the marketing or advertising of foods and beverages to children under the age of 18 years if the Federal Trade Commission determines that there is evidence that consumption of certain foods and beverages is detrimental to the health of children.</text></subsection> <subsection id="HF7D45A67AB794DE6969C677D382078F"><enum>(b)</enum><header>Authority</header><text>Section 18 of the <act-name parsable-cite="FTCA">Federal Trade Commission Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/15/57a">15 U.S.C. 57a</external-xref>) is amended by striking subsection (h).</text></subsection></section> <section id="H0DFC8A939B294D20A990E824F27142D"><enum>403.</enum><header>Food advertising in schools</header><text display-inline="no-display-inline">Section 10 of the <act-name parsable-cite="CNA66">Child Nutrition Act of 1966</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1779">42 U.S.C. 1779</external-xref>) is amended by adding at the end the following:</text> <quoted-block style="OLC" act-name="Child Nutrition Act of 1966" id="H94588B38D24C4B5DA036A474E764219F"> <subsection id="H15A8A62979FB4B68AE22AFC20092BF69"><enum>(d)</enum><header>Food Advertising</header><text>The Secretary may prohibit the advertising of food in participating schools if the Secretary determines that consumption of the advertised food has a detrimental effect on the diets or health of children.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="H0645FF0359EC4334A38BC43F588820E"><enum>404.</enum><header>Disallowance of deductions for advertising and marketing expenses relating to tobacco product use</header> <subsection id="H9EAE95FAC396497AAFE141AD408EB0E7"><enum>(a)</enum><header>In General</header><text>Part IX of subchapter B of chapter 1 of subtitle A of the Internal Revenue Code of 1986 (relating to items not deductible) is amended by adding at the end the following new section:</text> <quoted-block style="OLC" id="H3804ED4A559A4731A1D73DC6484EA00"> <section id="H8E51DA809BE544469500D03F81C9C727"><enum>280I.</enum><header>Disallowance of deduction for tobacco advertising and marketing expenses</header><text display-inline="no-display-inline">No deduction shall be allowed under this chapter for expenses relating to advertising or marketing cigars, cigarettes, smokeless tobacco, pipe tobacco, or any similar tobacco product. For purposes of this section, any term used in this section which is also used in section 5702 shall have the same meaning given such term by section 5702.</text></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H1AA48918FA5C4C51AAD4C745294FEE3B"><enum>(b)</enum><header>Conforming Amendment</header><text>The table of sections for such part IX is amended by adding after the item relating to section 280H the following new item:</text> <quoted-block style="OLC" id="HCD9F896CE08E4CFDB67C5E910054C038"> <toc regeneration="no-regeneration"> <toc-entry level="section">Sec. 280I. Disallowance of deduction for tobacco advertising and marketing expenses.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="HE99605914CC94209A4EDC8207236006F"><enum>(c)</enum><header>Effective Date</header><text>The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.</text></subsection></section> <section id="HCFA653EE4BEA4A71AD609E709C13498B"><enum>405.</enum><header>Federal-State tobacco counter-advertising programs</header><text display-inline="no-display-inline">Part P of title III of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/280g">42 U.S.C. 280g et seq.</external-xref>), as amended in section 312, is further amended by adding at the end the following:</text> <quoted-block style="OLC" act-name="Public Health Service Act" id="H456E941B415246DA95B355CCA5431259"> <section id="HD1622C3479E347F5B0745B58D40DCA2"><enum>399S.</enum><header>Federal-State tobacco counter-advertising programs</header> <subsection id="H3EBFC3C7BAFE4EDCB09F4622E9B0AAFC"><enum>(a)</enum><header>In General</header><text>The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall award grants to and enter into contracts with eligible entities for the implementation of national and local media (such as counter-advertising) and non-media campaigns designed to reduce the use of tobacco products.</text></subsection> <subsection id="HB3BC2E7B3CB045638B00A0B5BBCA6F36"><enum>(b)</enum><header>Eligibility</header><text>To be eligible to receive a grant under subsection (a), an entity shall be—</text> <paragraph id="H4C9E662933A94FD89600F3588F8C6355"><enum>(1)</enum><text>a public entity, including a State public health department; or</text></paragraph> <paragraph id="H307E15D29F6247B9B7507C6963B024BD"><enum>(2)</enum><text>a private, nonprofit entity that—</text> <subparagraph id="HD3500B9073C04E09B483FE5087306C"><enum>(A)</enum><text>is not affiliated with a manufacturer or importer of a tobacco product;</text></subparagraph> <subparagraph id="HEE8505804A2A49738FA32EDFD0848700"><enum>(B)</enum><text>has demonstrated a record of conducting a national antitobacco public education campaign to effectively reduce the use of tobacco products;</text></subparagraph> <subparagraph id="H7975F8D66F30445EB78D04F5E760000"><enum>(C)</enum><text>has expertise in conducting a multi-media communications campaign; and</text></subparagraph> <subparagraph id="H93A3E46CA671438C84BC21D51B382807"><enum>(D)</enum><text>has expertise in developing strategies that affect behavior changes in children and other targeted populations.</text></subparagraph></paragraph></subsection> <subsection id="H60AB0AD7776243588C1EE5E26E2BA1B8"><enum>(c)</enum><header>Application</header><text>An eligible entity shall submit an application to the Secretary for a grant under this section at such time, in such manner, and accompanied by such information as the Secretary may require.</text></subsection> <subsection id="HBAA6CA90765B4B7B96008E8599BB195D"><enum>(d)</enum><header>Use of Funds</header><text>An eligible entity shall use amounts received under a grant under this section to—</text> <paragraph id="H77DC5929CB07450099F5A5C41DB226A6"><enum>(1)</enum><text>design and implement multimedia public education and social marketing campaigns that—</text> <subparagraph id="H7635B169D3C64278B7D96E8C00D9D292"><enum>(A)</enum><text>discourage the use of tobacco products;</text></subparagraph> <subparagraph id="H787D33995BC046E993E73926A8EC62C"><enum>(B)</enum><text>encourage the use of products designed to enable tobacco use cessation; and</text></subparagraph> <subparagraph id="H0397A96629B142E281CD11F8175B9981"><enum>(C)</enum><text>educate the public about the hazards of environmental tobacco smoke exposure; or</text></subparagraph></paragraph> <paragraph id="HB67AF2F070E04511AFA9F646A97DF70"><enum>(2)</enum><text>conduct research related to the effectiveness of the campaigns described in paragraph (1).</text></paragraph></subsection> <subsection id="H8E81EF014AED4A7691C8BAA478D203DE"><enum>(e)</enum><header>Allocation of Grants</header><text>Of the amounts awarded under this section, the Secretary shall award—</text> <paragraph id="H847F2B8DED084BAEAD56DA4DC8803596"><enum>(1)</enum><text>50 percent of such amounts to eligible public entities; and</text></paragraph> <paragraph id="H1025F2CBC45F480A90D62FCAEF2B41E4"><enum>(2)</enum><text>50 percent of such amounts to eligible private, nonprofit entities.</text></paragraph></subsection> <subsection id="H2CD3FD7756194DA8A978806BC11840E4"><enum>(f)</enum><header>Authorization of Appropriations</header><text>There are authorized to be appropriated $200,000,000 to carry out this section.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section></subtitle> <subtitle id="H58F352872C42488CA505AF2EA241C700"><enum>B</enum><header>Penalties for Failure To Reduce Teen Smoking</header> <section id="H0AFF846B182945B8B282E900A3505DEB"><enum>411.</enum><header>Child cigarette use surveys</header> <subsection id="H6B04BDD615954D5F8169005D4167AFF6"><enum>(a)</enum><header>Annual Performance Survey</header> <paragraph id="H957898149B964EDC85C2BD5EE5B21FB"><enum>(1)</enum><header>In general</header><text>Not later than August 31, 2007, and annually thereafter, the Secretary of Health and Human Services (referred to in this section as the <quote>Secretary</quote>) shall publish the results of an annual cigarette survey, to be carried out after the date of enactment of this Act and completed prior to August 21, 2007, and prior to August 21 of each year thereafter, to determine—</text> <subparagraph id="HAF07CC5E36C94276837FDA3745E144A"><enum>(A)</enum><text>the percentage of all young individuals who used a type of cigarette within the 30-day period prior to the conduct of the survey involved; and</text></subparagraph> <subparagraph id="H92CF5661C5F443C29D89F026E6D06E85"><enum>(B)</enum><text>the percentage of young individuals who identify each brand of each type of cigarette as the usual brand smoked within such 30-day period.</text></subparagraph></paragraph> <paragraph id="H3036769FDF2B4C64969F56FEE619CA7"><enum>(2)</enum><header>Young individuals</header><text>For the purposes of this subtitle, the term <term>young individuals</term> means individuals who are under 18 years of age.</text></paragraph></subsection> <subsection id="H24F69F3001E8418087F2F396AF961618"><enum>(b)</enum><header>Size and Methodology</header> <paragraph id="H52D8337D619E418B93ABA7B02C312F00"><enum>(1)</enum><header>In general</header><text>The survey referred to in subsection (a) shall be comparable in size and methodology to the Monitoring the Future survey that was completed in 1999 to measure the use of cigarettes (by brand) by youths under 18 years of age within the 30-day period prior to the conduct of the study.</text></paragraph> <paragraph id="HAC9DE45D3B82403DB81EC04E059FB3B0"><enum>(2)</enum><header>Conclusive accurateness</header><text>A survey using the methodology described in paragraph (1) shall be deemed conclusively proper, correct, and accurate for purposes of this section.</text></paragraph> <paragraph id="H137FFE85F7F845949CED8844E35D3500"><enum>(3)</enum><header>Definition</header><text>In this subtitle, the term <term>Monitoring the Future survey</term> means the combined survey of 8th, 10th, and 12th grade students that was conducted at the Institute for Social Research at the University of Michigan.</text></paragraph></subsection> <subsection id="H0571C1641EF64596A0BFE9386BE0003"><enum>(c)</enum><header>Reduction</header><text>The Secretary, based on a comparison of the results of the first annual cigarette survey referred to in subsection (a) and the Monitoring the Future survey referred to in subsection (b)(1), shall determine the percentage reduction (if any) in youth cigarette use for each manufacturer of cigarettes.</text></subsection> <subsection id="H06A07C967B494D8C88F1006679AB439F"><enum>(d)</enum><header>Participation in Survey</header><text>Notwithstanding any other provision of law, the Secretary may conduct a survey under this section involving minors if the results of such survey with respect to such minors are kept confidential and not disclosed.</text></subsection> <subsection id="H72B032DCFD0E4FC5B05FA91DB903BFF0"><enum>(e)</enum><header>Nonapplicability</header><text><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/44/35">Chapter 35</external-xref> of title 44, United States Code, shall not apply to information required for the purposes of carrying out this section.</text></subsection> <subsection id="H69558B103E2C4371B461D6AA1DD333D5"><enum>(f)</enum><header>Definition</header><text>In this subtitle the term <term>cigarette</term> has the meaning given such term in section 3(1) of the Federal Cigarette Labeling and Advertising Act (<external-xref legal-doc="usc" parsable-cite="usc/15/1332">15 U.S.C. 1332(1)</external-xref>).</text></subsection></section> <section id="H6817E8A3680E43BD9E4088581C53B1A9"><enum>412.</enum><header>Cigarette use reduction goal and noncompliance</header> <subsection id="HF81CD164D6544CBEBA90CCBA26CBAACD"><enum>(a)</enum><header>Goal</header><text>It shall be the cigarette use reduction goal that each manufacturer reduce youth cigarette use by at least 15 percent during the period between the Monitoring the Future survey referred to in section 411(b)(1) and the completion of the first annual cigarette survey (and such subsequent surveys as compared to the previous year’s survey) referred to in section 411(a).</text></subsection> <subsection id="HFBDA717F3E984EBA83C2BF2358004E28"><enum>(b)</enum><header>Noncompliance</header> <paragraph id="H817AC646C9A8488900B902913B39EA00"><enum>(1)</enum><header>Industry-wide penalty</header><text>If the Secretary determines that the cigarette use reduction goal under subsection (a) has not been achieved, the Secretary shall, not later than September 10, 2007, and September 10 of each year thereafter, impose an industry-wide penalty on the manufacturers of cigarettes in an amount that is in the aggregate equal to—</text> <subparagraph id="H3F0386C97C254AAEB7F523EB6316FEC3"><enum>(A)</enum><text>if youth cigarette use has been reduced by 5 percent or less, $6,000,000,000;</text></subparagraph> <subparagraph id="HE80E5967323742F2A033707D1249FC57"><enum>(B)</enum><text>if youth cigarette use has been reduced by at least 6 percent but less than 10 percent, $4,000,000,000; and</text></subparagraph> <subparagraph id="HFFABA0DB61034C02B8049F46C712CA49"><enum>(C)</enum><text>if youth cigarette use has been reduced by at least 11 percent but less than 15 percent, $2,000,000,000.</text></subparagraph></paragraph> <paragraph id="HC3634A62E4504A6E96679449FDB38DD2"><enum>(2)</enum><header>Payment</header><text>The industry-wide penalty imposed under this subsection shall be paid by each manufacturer based on the percentage of cigarettes of each such manufacturer that are used by youth (as determined under the Monitoring the Future survey and compared to the cigarettes manufactured by all manufacturers) as such percentage relates to the total amount to be paid by all manufacturers.</text></paragraph> <paragraph id="H05047B185C404DBA879BBD459318612C"><enum>(3)</enum><header>Final determination</header><text>The determination of the Secretary as to the amount and allocation of a surcharge under this subtitle shall be final and the manufacturer shall pay such surcharge within 10 days of the date on which the manufacturer is assessed. Such payment shall be retained by the Secretary pending final judicial review of what, if any, change in the surcharge is appropriate.</text></paragraph> <paragraph id="H67F4156F006348BF9B72664D6FD51D70"><enum>(4)</enum><header>Compliance by certain manufacturers</header><text>A manufacturer that individually complies with the goal under subsection (a) shall not be liable for the payment of any portion of the penalty under this subsection.</text></paragraph> <paragraph id="H6446DDBD61974DC18DADBA056DB8A14E"><enum>(5)</enum><header>Limitation</header><text>With respect to cigarettes, a manufacturer with a market share of 1 percent or less of youth cigarette use shall not be liable for the payment of a surcharge under this section.</text></paragraph></subsection> <subsection id="HE19A0C5D4CB24E4EA2BDAB3800A146AD"><enum>(c)</enum><header>Penalties Nondeductible</header><text>The payment of penalties under this subtitle shall not be considered to be an ordinary and necessary expense in carrying on a trade or business for purposes of the Internal Revenue Code of 1986 and shall not be deductible.</text></subsection> <subsection id="H6EE0EBDACC6B4C80897C467312EFDE78"><enum>(d)</enum><header>Judicial Review</header> <paragraph id="HA1D18685355541AB88F7E9A6B64089D3"><enum>(1)</enum><header>After payment</header><text>A manufacturer of cigarettes may seek judicial review of any action under this subtitle only after the assessment involved has been paid by the manufacturer to the Department of the Treasury and only in the United States District Court for the District of Columbia.</text></paragraph> <paragraph id="H7543B4E2683C401689679EF11C5364B1"><enum>(2)</enum><header>Review by attorney general</header><text>Prior to the filing of an action by a manufacturer seeking judicial review of an action under this subtitle, the manufacturer shall notify the Attorney General of such intent to file and the Attorney General shall have 30 days in which to respond to the action.</text></paragraph> <paragraph id="H2532547AA7B64CC7995457F347E129C7"><enum>(3)</enum><header>Review</header><text>The amount of any surcharge paid under this subtitle shall be subject to judicial review by the United States Court of Appeals for the District of Columbia Circuit, based on the arbitrary and capricious standard of <external-xref legal-doc="usc" parsable-cite="usc/5/706">section 706</external-xref> of title 5, United States Code. Notwithstanding any other provision of law, no court shall have the authority to stay any surcharge payment due to the Secretary under this subtitle pending judicial review until the Secretary has made or failed to make a compliance determination, as described under this subtitle, that has adversely affected the person seeking the review.</text></paragraph></subsection></section> <section id="H49A3592900E4463EA2009E9337C8E093"><enum>413.</enum><header>Enforcement</header> <subsection id="HA1174A22FB7F4B06A08E0698CF005700"><enum>(a)</enum><header>Initial Penalty</header><text>There is hereby imposed an initial penalty on the failure of any manufacturer to make any payment required under this subtitle within 10 days after the date on which such payment is due.</text></subsection> <subsection id="H0745BBE487EF4DBE9E49FEF8C95BC9BE"><enum>(b)</enum><header>Amount of Penalty</header><text>The amount of the penalty imposed by subsection (a) on any failure with respect to a manufacturer shall be an amount equal to 2 percent of the penalty owed under section 412 for each day during the noncompliance period.</text></subsection> <subsection id="H1929F85D56FF4006A405CEA2F4F0C4F8"><enum>(c)</enum><header>Noncompliance Period</header><text>For purposes of this section, the term <term>noncompliance period</term> means, with respect to any failure to make the surcharge payment required under this subtitle, the period—</text> <paragraph id="H972CD7B4BED445739ECD23C121F347E2"><enum>(1)</enum><text>beginning on the due date for such payment; and</text></paragraph> <paragraph id="H65CBFBB3C4D64695B94541A397BA88A"><enum>(2)</enum><text>ending on the date on which such payment is paid in fall.</text></paragraph></subsection> <subsection id="H6E56BFEABF784A6DBA00B0C4904DD62"><enum>(d)</enum><header>Limitations</header><text>No penalty shall be imposed by subsection (a) on—</text> <paragraph id="H7FD87ADAE4D743DCA208B5AA54E054F"><enum>(1)</enum><text>any failure to make a surcharge payment under this subtitle during any period for which it is established to the satisfaction of the Secretary that none of the persons responsible for such failure knew or, exercising reasonable diligence, would have known, that such failure existed; or</text></paragraph> <paragraph id="H83AF94DD893B4553BFBD6D13A387E1F9"><enum>(2)</enum><text>any manufacturer that produces less than 1 percent of cigarettes used by youth in that year (as determined by the annual survey).</text></paragraph></subsection></section></subtitle> <subtitle id="H53C5ECB78AFD4DD1AC078069BA95EB7C"><enum>C</enum><header>Food Guidance</header> <section id="HBA4246C5A8FF4BF9A9FAA33F304D716F"><enum>421.</enum><header>Front-label food guidance systems</header> <subsection id="H66EA75C422E04BADB155E167629DB55E"><enum>(a)</enum><header>In General</header><text>Not later than March 1, 2008, the Secretary of Health and Human Services (referred to in this section as the <quote>Secretary</quote>) shall begin solicitation of public comments regarding—</text> <paragraph id="H5E9B38CEFD3A42C48D8EC8706C997900"><enum>(1)</enum><text>the use of retail front-label food guidance systems to convey nutrition information to the public using logos, symbols, signs, emblems, insignia, or other graphic representations on the labeling of food intended for human consumption that are intended to provide simple, standardized, and understandable nutrition information to the public in graphic form;</text></paragraph> <paragraph id="HA0A2A24DB1BE4958B4A3BBC2DC353B2B"><enum>(2)</enum><text>appropriate nutrition standards by which a retail front-label food guidance system may convey the relative nutritional value of different foods in simple graphic form; and</text></paragraph> <paragraph id="H51F85A82A86D41D09589DB3E89BCD0D4"><enum>(3)</enum><text>whether American consumers would be better served by establishing a single, standardized retail front-label food guidance system regulated by the Food and Drug Administration, or by allowing individual food companies, trade associations, nonprofit organizations, and others to continue to develop their own retail front-label food guidance systems.</text></paragraph></subsection> <subsection id="H8A49E43A02A643108D67008D6133D333"><enum>(b)</enum><header>Effect on Nutrition Facts Panel</header><text>In soliciting public comments under subsection (a), the Secretary shall inform the public that any retail front-label food guidance system is intended to supplement, not replace, the Nutrition Facts Panel that appears on food labels pursuant to section 403(q) of the <act-name parsable-cite="FFDCA">Federal Food, Drug, and Cosmetic Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/21/343">21 U.S.C. 343(q)</external-xref>).</text></subsection> <subsection id="H7BB53736C69A47E183868B50A7E9929F"><enum>(c)</enum><header>Proposed Regulation</header><text>Not later than 12 months following the closure of the public comment solicitation period under subsection (a), the Secretary shall—</text> <paragraph id="H9372A7729F3048DDAB4EB57FE8923973"><enum>(1)</enum><text>publish a notice in the Federal Register that summarizes the public comments and describes the suggested retail front-label food guidance systems received through such solicitation; and</text></paragraph> <paragraph id="H2D6A494E82B64077B3006696A5363E7"><enum>(2)</enum><text>publish proposed regulations that—</text> <subparagraph id="H1C7832E0BBAE49048512C547AD40ACF3"><enum>(A)</enum><text>establish a single, standardized retail front-label food guidance system; or</text></subparagraph> <subparagraph id="H165E78F9053541ACA6D75BB7013F3F6C"><enum>(B)</enum><text>establish the conditions under which individual food companies, trade associations, nonprofit organizations, and other persons may continue to develop their own retail front-label food guidance systems.</text></subparagraph></paragraph></subsection></section></subtitle> <enum>V</enum><header>REIMBURSEMENT AND COVERAGE OF PREVENTIVE SERVICES</header> <section id="H6CD7BC53556D4E0789A8B01FF91C58CA"><enum>501.</enum><header>Coverage of substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling</header> <subsection id="H59FAD6A1100D49E5AB838481C10619AB"><enum>(a)</enum><header>Coverage</header> <paragraph id="HF4D540CC1D484204A1CAC7FE72AC1F53"><enum>(1)</enum><header>In general</header><text>Section 1861(s)(2) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(s)(2)</external-xref>), as amended by section 642(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>; 117 Stat. 2322), is amended—</text> <subparagraph id="HA43B16E1A6E4471BBFD8FEA49B00AD10"><enum>(A)</enum><text>in subparagraph (Y), by striking <quote>and</quote> after the semicolon at the end;</text></subparagraph> <subparagraph id="H1E4DB8B69E314AE4008C72F8A7B2E369"><enum>(B)</enum><text>in subparagraph (Z), by adding <quote>and</quote> after the semicolon at the end; and</text></subparagraph> <subparagraph id="H631F23F34FFC41A38BEB71F0DE6AD7C"><enum>(C)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block style="OLC" id="H3B2590BB919B45178B8CE84207319830"> <subitem indent="up5" id="H2D8ABF8A0E1242F89DC696C2F2F84EC9"><enum>(AA)</enum><text>substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling (as defined in subsection (bbb)(1));</text></subitem><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="H4DAC9BFAADCF4319B2F4DC009DB5E15C"><enum>(2)</enum><header>Conforming amendments</header> <subparagraph display-inline="yes-display-inline" id="H7221B83735E64C21B0D800FBD5E3FC86"><enum>(A)</enum><text>Section 1862(a)(12) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395y">42 U.S.C. 1395y(a)(12)</external-xref>) is amended by inserting <quote>(except as otherwise allowed under subsection 1861(s)(2)(AA))</quote> after <quote>directly supporting teeth</quote>.</text></subparagraph> <subparagraph indent="up1" id="H7AEC88D7608149AF9946819EE0113E26"><enum>(B)</enum><text>Clauses (i) and (ii) of section 1861(s)(2)(K) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(s)(2)(K)</external-xref>), as amended by section 611(d)(2) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>; 117 Stat. 2304), are each amended by striking <quote>subsection (ww)(1)</quote> and inserting <quote>subsections (ww)(1) and (bbb)</quote>.</text></subparagraph></paragraph></subsection> <subsection id="H9FF62880B39E4A7DAAC27D755B39C9F"><enum>(b)</enum><header>Services Described</header><text>Section 1861 of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>), as amended by section 706(b) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>; 117 Stat. 2339), is amended by adding at the end the following new subsection:</text> <quoted-block style="traditional" act-name="Social Security Act" id="HBD8AD0DC298044B6A114D3CD473DC9A6"> <subsection id="H4752C37F48FE49BEA73E92E2EEBB6391"><enum>(bbb)</enum><header>Substance Use (Other Than Tobacco), Diet, Exercise, Injury Prevention, and Dental Health Counseling</header><text>The term <term>substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling</term> means therapy and counseling relating to substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling that is furnished—</text> <paragraph id="H1D7F7479A7654A03009947CD1777C1EF"><enum>(1)</enum><text>by or under the supervision of a physician; or</text></paragraph> <paragraph id="HA2BBAB097EC64EE9B6DFD7FECDADC6A2"><enum>(2)</enum><text>by any other health care professional who—</text> <subparagraph id="HC78EB1028E6849C0ABCE49CFF69DC6A6"><enum>(A)</enum><text>is legally authorized to furnish such services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished; and</text></subparagraph> <subparagraph id="H91A44DCCCA5A44D0BC0080BFE93754D9"><enum>(B)</enum><text>is authorized to receive payment for other services under this title or is designated by the Secretary for this purpose.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H0AC90D157B6849E684222E927F693402"><enum>(c)</enum><header>Payment and Elimination of Cost-Sharing</header> <paragraph id="H62AABD26F26D456C844993E287CF276B"><enum>(1)</enum><header>Payment and elimination of coinsurance</header><text>Section 1833(a)(1) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(a)(1)</external-xref>), as amended by section 302(b)(2) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>; 117 Stat. 2229), is amended—</text> <subparagraph id="H596FB3946D044A0B957F3948507571C8"><enum>(A)</enum><text>in subparagraph (N), by inserting <quote>or substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling (as defined in section 1861(bbb))</quote> after <quote>(as defined in section 1848(j)(3))</quote>;</text></subparagraph> <subparagraph id="H7A0014E43C7E4F299B39F6608332E622"><enum>(B)</enum><text>by striking <quote>and</quote> before <quote>(V)</quote>; and</text></subparagraph> <subparagraph id="HDFEE6B57795945E783CA99D1A1926124"><enum>(C)</enum><text>by inserting before the semicolon at the end the following: <quote>and (W) with respect to substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling (as defined in section 1861(bbb) the amount paid shall be the lesser of the actual charge for the services or the amount determined under the payment basis determined under section 1848</quote>.</text></subparagraph></paragraph> <paragraph id="H4DC54CDE083C4B2AA3ECA076E5B4FEB2"><enum>(2)</enum><header>Payment under physician fee schedule</header><text>Section 1848(j)(3) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4(j)(3)</external-xref>), as amended by section 611(c) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>; 117 Stat. 2304), is amended by inserting <quote>(2)(AA),</quote> after <quote>(2)(W),</quote>.</text></paragraph> <paragraph id="H61984362D9E349D3AE04C2BE1033E6C1"><enum>(3)</enum><header>Elimination of coinsurance in outpatient hospital settings</header> <subparagraph id="H0D77F2C941974C388E2CD97D661DD13"><enum>(A)</enum><header>Exclusion from opd fee schedule</header><text>Section 1833(t)(1)(B)(iv) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(t)(1)(B)(iv)</external-xref>), as amended by section 614(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>; 117 Stat. 2306), is amended by striking <quote>and diagnostic mammography</quote> and inserting <quote>, diagnostic mammography, or substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling (as defined in section 1861(bbb))</quote>.</text></subparagraph> <subparagraph id="H19C1C897090947B2B6497400E2D68DA4"><enum>(B)</enum><header>Conforming amendments</header><text>Section 1833(a)(2) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(a)(2)</external-xref>) is amended—</text> <clause id="HA76421C275DC4C6A0018481D14A6C4D4"><enum>(i)</enum><text>in subparagraph (F), by striking <quote>and</quote> after the semicolon at the end;</text></clause> <clause id="HE7E002841AC04064B1072BEFFA730476"><enum>(ii)</enum><text>in subparagraph (G)(ii), by striking the comma at the end and inserting <quote>; and</quote>; and</text></clause> <clause id="HED1D7D2C9A4F43158E8F3444C464B077"><enum>(iii)</enum><text>by inserting after subparagraph (G)(ii) the following new subparagraph:</text> <quoted-block style="OLC" id="H0D3375750F5246478F1464F0B3EAF715"> <subparagraph id="H9849D4E83D5E4F83A4B33010AE903E14"><enum>(H)</enum><text>with respect to substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling (as defined in section 1861(bbb)) furnished by an outpatient department of a hospital, the amount determined under paragraph (1)(W),</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></clause></subparagraph></paragraph> <paragraph id="HA7E30E93E61D463389FB2726DF36AE00"><enum>(4)</enum><header>Elimination of deductible</header><text>The first sentence of section 1833(b) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(b)</external-xref>) is amended—</text> <subparagraph id="HAEB6E45AB77943CD8F5E28D200A2F7A1"><enum>(A)</enum><text>by striking <quote>and</quote> before <quote>(6)</quote>; and</text></subparagraph> <subparagraph id="H202DC37B34FE487800FDE5E6A69F4265"><enum>(B)</enum><text>by inserting before the period at the end the following: <quote>, and (7) such deductible shall not apply with respect to substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling (as defined in section 1861(bbb))</quote>.</text></subparagraph></paragraph></subsection> <subsection id="H01C33EC01D994BE8B75F32EFCD3E1190"><enum>(d)</enum><header>Application of Limits on Billing</header><text>Section 1842(b)(18)(C) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395u">42 U.S.C. 1395u(b)(18)(C)</external-xref>) is amended by adding at the end the following new clause:</text> <quoted-block style="OLC" act-name="Social Security Act" id="HD7D172FA770A4B7DB1B185E235113C03"> <clause indent="up2" id="H0FCACDEB54B04C5788F284F276A514AB"><enum>(vii)</enum><text>Any health care professional designated under section 1861(bbb)(2)(B) to perform substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling that is not otherwise described in this subparagraph.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="HCE3092C5344A4855B8BD47CF56DE15A8"><enum>(e)</enum><header>Effective Date</header><text>The amendments made by this section shall take effect as if included in the enactment of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>; 117 Stat. 2066) and shall apply to services furnished on and after January 1, 2008.</text></subsection></section> <section id="HC696F032BE9F4D2A86B66800974F731F"><enum>502.</enum><header>Medicare coverage of medical nutrition therapy services for people with pre-diabetes</header> <subsection id="H368853523FD847B09785A127CA512995"><enum>(a)</enum><header>Coverage of Medical Nutrition Therapy Services</header><text>Section 1861(s)(2)(V) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(s)(2)(V)</external-xref>) is amended by inserting after <quote>beneficiary with diabetes</quote> the following <quote>, pre-diabetes or its risk factors, including hypertension, dyslipidemia, or obesity</quote>.</text></subsection> <subsection id="H0606921860094C23ADF6BFA4EEFDF222"><enum>(b)</enum><header>Effective Date</header><text>The amendment made by subsection (a) shall apply with respect to services furnished on or after the date of the enactment of this Act.</text></subsection></section> <section id="H57D0F18EB5BB45420011D48F876F76EE"><enum>503.</enum><header>Preventive mental health screenings</header> <subsection id="H5B4FE91A9D5E4C37A800C2FB627098F0"><enum>(a)</enum><header>Coverage</header> <paragraph id="HF1BF6B7F7A674BC59D58C472C8C200B3"><enum>(1)</enum><header>In general</header><text>Section 1861(s)(2) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(s)(2)</external-xref>), as amended by section 501(a)(1), is amended—</text> <subparagraph id="H90BE072D5C0F4B54B68BFBCDEF346DFE"><enum>(A)</enum><text>in subparagraph (Z), by striking <quote>and</quote> after the semicolon at the end;</text></subparagraph> <subparagraph id="HF771514B105A4BFFAE1DB931A8EC2EBB"><enum>(B)</enum><text>in subparagraph (AA), by adding <quote>and</quote> after the semicolon at the end; and</text></subparagraph> <subparagraph id="HD17C299C5B5E4B898C00E78B174042C0"><enum>(C)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block style="OLC" id="H63E091A685E349518C384B5126F736D9"> <subitem indent="up5" id="H36CE9506E2B34892A795FD2BCC008F03"><enum>(BB)</enum><text>screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in subsection (ccc)(1));</text></subitem><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="H89663A03DAD84D2490572366E94C2B74"><enum>(2)</enum><header>Conforming amendments</header><text>Clauses (i) and (ii) of section 1861(s)(2)(K) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(s)(2)(K)</external-xref>), as amended by section 501(a)(2)(B), are each amended by striking <quote>and (bbb)</quote> and inserting <quote>(bbb), and (ccc)</quote>.</text></paragraph></subsection> <subsection id="HD9DC40C280C84F8500B9675000548420"><enum>(b)</enum><header>Services Described</header><text>Section 1861 of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>), as amended by section 501(b), is amended by adding at the end the following new subsection:</text> <quoted-block style="traditional" act-name="Social Security Act" id="H65D3B57FC39A4605A06EA344E47B3486"> <subsection id="H3A962679445244D282B7317E7469E813"><enum>(ccc)</enum><header>Screenings for Clinical Depression, Anxiety, and Impaired Cognitive Functioning</header> <paragraph display-inline="yes-display-inline" id="HFF27D582B87D4EE2B276AE1FF73D531"><enum>(1)</enum><text>The term <term>screening for clinical depression, anxiety, and impaired cognitive functioning</term> means a consultation for the purpose of detecting clinical depression, anxiety, and impaired cognitive functioning during which a qualified health professional (as defined in paragraph (2))—</text> <subparagraph indent="up1" id="H27CE14D762054810A7C65183BF54000"><enum>(A)</enum><text>uses a screening on the list established or identified under paragraph (3);</text></subparagraph> <subparagraph indent="up1" id="H1DDAE7765844428A8F381596C8716549"><enum>(B)</enum><text>assesses the individual’s risk of clinical depression, anxiety, and impaired cognitive functioning; and</text></subparagraph> <subparagraph indent="up1" id="HECD1796550864EDB97B55F2F5210B61B"><enum>(C)</enum><text>if the qualified health professional determines that the individual is at high risk for clinical depression, anxiety, or impaired cognitive functioning, refers the individual for a full diagnostic evaluation and such additional treatment as may be required.</text></subparagraph></paragraph><continuation-text continuation-text-level="subsection">Nothing in subparagraph (C) shall be construed as prohibiting a qualified health professional performing the screening for clinical depression, anxiety, and impaired cognitive functioning with respect to an individual from directly providing the diagnostic evaluation and additional treatment described in such clause to such individual if such professional is legally authorized to provide such an evaluation and additional treatment under State law (or the State regulatory mechanism provided by State law) of the State in which the screening is performed.</continuation-text> <paragraph indent="up1" id="HF337BC768EA243BF9C007719258E1CB4"><enum>(2)</enum><text>For purposes of this subsection, the term <term>qualified health professional</term> means an individual who—</text> <subparagraph id="HA06638710307423E907C7E81E94989CA"><enum>(A)</enum><text>is—</text> <clause id="H67D06F65957049718C001D17B1534FAB"><enum>(i)</enum><text>a physician (as defined in subsection (r)(1));</text></clause> <clause id="HC13CE41E10BA483788F5C9736109B44D"><enum>(ii)</enum><text>a nurse practitioner (as defined in subsection (aa)(5)); or</text></clause> <clause id="H542F52F5070646FF94A75700FF2900E2"><enum>(iii)</enum><text>a mental health care professional (including clinical psychologists (as defined by the Secretary for purposes of section 1861(ii)) and clinical social workers (as defined in subsection 1861(hh))) that is licensed or certified to perform mental health services by the State in which the screenings are performed; and</text></clause></subparagraph> <subparagraph id="H20B2DF2563A646BE80030417F9FA0053"><enum>(B)</enum><text>has an agreement in effect with the Secretary to accept—</text> <clause id="H7F480295BAFB4B0297EF8D0039B1EBD5"><enum>(i)</enum><text>the amount determined under section 1833(a)(1)(W) as full payment for screenings for clinical depression, anxiety, and impaired cognitive functioning; and</text></clause> <clause id="H6086351FCA334B6CB5629E6C2D767BF1"><enum>(ii)</enum><text>an assignment described in section 1842(b)(3)(B)(ii) with respect to payment for each screening furnished by the professional to an individual enrolled under part B.</text></clause></subparagraph></paragraph> <paragraph indent="up1" id="H16F53F38DAE0485BB90000755304B00"><enum>(3)</enum><text>The Secretary shall, in consultation with mental health professionals and other stakeholders with experience in screening for clinical depression, anxiety, and impaired cognitive functioning, shall establish or identify a list of approved screenings to be used under this paragraph. The Secretary, in consultation with such professionals and stakeholders, shall review and update such list not less frequently than once every 5 years.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="HAF7F838601E14306808799C361AEE275"><enum>(c)</enum><header>Payment and Elimination of Cost-Sharing</header> <paragraph id="HAC9BAA492DB84C01A36D1EE9AA63FB75"><enum>(1)</enum><header>Payment and elimination of coinsurance</header><text>Section 1833(a)(1) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(a)(1)</external-xref>), as amended by section 501(c)(1), is amended—</text> <subparagraph id="HDDFA85001ACF47D7B59D21B2ED14BB"><enum>(A)</enum><text>in subparagraph (N), by striking <quote>or substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling (as defined in section 1861(bbb))</quote> and inserting <quote>substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling (as defined in section 1861(bbb)), or screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc))</quote>; and</text></subparagraph> <subparagraph id="H500A9FABBF924F1791631052EC7478F8"><enum>(B)</enum><text>in subparagraph (W), by inserting <quote>and screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc))</quote> after <quote>(as defined in section 1861(bbb))</quote>.</text></subparagraph></paragraph> <paragraph id="H6D3BED932F9D41BE94E63ABBE337F8E"><enum>(2)</enum><header>Payment under physician fee schedule</header><text>Section 1848(j)(3) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4(j)(3)</external-xref>), as amended by section 501(c)(2), is amended by inserting <quote>(2)(BB),</quote> after <quote>(2)(AA),</quote>.</text></paragraph> <paragraph id="H12DFFD0A0D3F4BA2A9694C20CF4DC7A8"><enum>(3)</enum><header>Elimination of coinsurance in outpatient hospital settings</header> <subparagraph id="HCFB7B2F14BFB44758F8259915E809B54"><enum>(A)</enum><header>Exclusion from opd fee schedule</header><text>Section 1833(t)(1)(B)(iv) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(t)(1)(B)(iv)</external-xref>), as amended by section 501(c)(3)(A), is amended by striking <quote>or substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling (as defined in section 1861(bbb))</quote> and inserting <quote>substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling (as defined in section 1861(bbb)), or screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc))</quote>.</text></subparagraph> <subparagraph id="H94EA733CC4BB4C609FF1F3CEAC90653E"><enum>(B)</enum><header>Conforming amendment</header><text>Section 1833(a)(2)(H) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(a)(2)(H)</external-xref>), as added by section 501(c)(3)(B)(iii), is amended by inserting <quote>and screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc))</quote> after <quote>(as defined in section 1861(bbb))</quote>.</text></subparagraph></paragraph> <paragraph id="H2E0A3AFED4E74FF39BB1EADA128588B"><enum>(4)</enum><header>Elimination of deductible</header><text>Section 1833(b)(7) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(b)(7)</external-xref>), as amended by section 501(c)(4), is amended by inserting <quote>or screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc))</quote> before the period at the end.</text></paragraph></subsection> <subsection id="HAF53351C508848DF83448DDA48C27E48"><enum>(d)</enum><header>Application of Limits on Billing</header><text>Section 1842(b)(18)(C) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395u">42 U.S.C. 1395u(b)(18)(C)</external-xref>), as amended by section 501(d), is amended by adding at the end the following new clause:</text> <quoted-block style="OLC" act-name="Social Security Act" id="HC1BB5AC12D8641DFBEC4388FF203291E"> <clause indent="up2" id="HDE77185263C04ED1A6CA329C5CEA732D"><enum>(viii)</enum><text>A mental health care professional described in section 1861(ccc)(2) that is authorized to perform screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc)(1)) that is not otherwise described in this subparagraph.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="HB2BDC0F9949C458BB2D5EBE2F15FF59D"><enum>(e)</enum><header>Frequency</header><text>Section 1862(a)(1) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395y">42 U.S.C. 1395y(a)(1)</external-xref>), as amended by section 613(c) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>; 117 Stat. 2306), is amended—</text> <paragraph id="H3B0B90CBA1004C14B66636097C7B0984"><enum>(1)</enum><text>in subparagraph (L), by striking <quote>and</quote> after the comma at the end;</text></paragraph> <paragraph id="H63F3A1B2AC1A48D585F21DA2A63E78B2"><enum>(2)</enum><text>in subparagraph (M), by striking the semicolon at the end and inserting <quote>, and</quote>; and</text></paragraph> <paragraph id="H93259A1C2B5549858F3341596F4601CB"><enum>(3)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block style="OLC" id="H2A2BC0A7CC6B4AEAB08900B8599D4F66"> <subparagraph indent="up1" id="H94AE8C77CC2C4F718F828342BEED7894"><enum>(N)</enum><text>in the case of screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc)(1)), which is performed more frequently than is covered under such section;</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H08A2095DC2084042A4C2BEA982A04400"><enum>(f)</enum><header>Effective Date</header><text>The amendments made by this section shall take effect as if included in the enactment of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>; 117 Stat. 2066) and shall apply to services furnished on and after January 1, 2008.</text></subsection></section> <section id="H260FD619473A4E869B99768748B60042"><enum>504.</enum><header>Encouragement of cessation of tobacco use</header> <subsection id="HB376C759B5C34BF387CD7F31B1BCEE99"><enum>(a)</enum><header>Medicare Coverage of Counseling and Pharmacotherapy for Cessation of Tobacco Use</header> <paragraph id="H2FEFB86A83CE4957867C70F624BB9871"><enum>(1)</enum><header>Coverage</header> <subparagraph id="HA6C3E0A1B26749AFA3BABC43006CE5C4"><enum>(A)</enum><header>In general</header><text>Section 1861(s)(2) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(s)(2)</external-xref>), as amended by section 502(a)(1), is amended—</text> <clause id="H461923CF3C024109A4940411D64C7651"><enum>(i)</enum><text>in subparagraph (AA), by striking <quote>and</quote> after the semicolon at the end;</text></clause> <clause id="H71B31FF2AC994F9CAB0346FEF8E0160"><enum>(ii)</enum><text>in subparagraph (BB), by adding <quote>and</quote> after the semicolon at the end; and</text></clause> <clause id="HEE6DA3F54051497A991070E68E81C3C4"><enum>(iii)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block style="OLC" id="H3FB040F4A16841848BDD89262ED04E8B"> <subclause indent="up3" id="H3E7582009A1449A381D6DACEDAEFE453"><enum>(CC)</enum><text>counseling and pharmacotherapy for cessation of tobacco use (as defined in subsection (ddd)(1));</text></subclause><after-quoted-block>.</after-quoted-block></quoted-block></clause></subparagraph> <subparagraph id="H44EE5D0782474A03A9736BB794DEF5E"><enum>(B)</enum><header>Conforming amendments</header><text>Clauses (i) and (ii) of section 1861(s)(2)(K) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(s)(2)(K)</external-xref>), as amended by section 502(a)(2), are each amended by striking <quote>and (ccc)</quote> and inserting <quote>(ccc), and (ddd)</quote>.</text></subparagraph></paragraph> <paragraph id="HD31A702FA54844FB87DD2CF0EB269CD5"><enum>(2)</enum><header>Services described</header><text>Section 1861 of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>), as amended by section 502(b), is amended by adding at the end the following new subsection:</text> <quoted-block style="traditional" act-name="Social Security Act" id="H61A80186BBAD4D9B8163CA2268ABDB8"> <subsection id="H5CF266D16DE04C23951BA64D9CA4524E"><enum>(ddd)</enum><header>Counseling and Pharmacotherapy for Cessation of Tobacco Use</header> <paragraph display-inline="yes-display-inline" id="H310D6C78EE7245398113FB1DA3A2F00"><enum>(1)</enum><text>Subject to paragraphs (2) and (3), the term <term>counseling and pharmacotherapy for cessation of tobacco use</term> means diagnostic, therapy, and counseling services and pharmacotherapy (including the coverage of prescription and nonprescription tobacco cessation agents approved by the Food and Drug Administration) for cessation of tobacco use for individuals who use tobacco products or who are being treated for tobacco use which are furnished—</text> <subparagraph indent="up1" id="H3A9E5C4DA55C483FB7F1462463345BF5"><enum>(A)</enum><text>by or under the supervision of a physician; or</text></subparagraph> <subparagraph indent="up1" id="H765319E42C1B47ABB41BA567D22457B5"><enum>(B)</enum><text>by any other health care professional who—</text> <clause id="H47490FF3DC9E41C2BD53142E4B3C9632"><enum>(i)</enum><text>is legally authorized to furnish such services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished; and</text></clause> <clause id="HF7383D75300E438EB43785BD3C36317D"><enum>(ii)</enum><text>is authorized to receive payment for other services under this title or is designated by the Secretary for this purpose.</text></clause></subparagraph></paragraph> <paragraph indent="up1" id="H86C0AFA5197B49A8A9717CC8ABBBFA7"><enum>(2)</enum><text>Such term is limited to—</text> <subparagraph id="HC38AE7DC31B049338F2CDE2DFF6F4240"><enum>(A)</enum><text>services recommended in <quote>Treating Tobacco Use and Dependence: A Clinical Practice Guideline</quote>, published by the Public Health Service in June 2000, or any subsequent modification of such Guideline; and</text></subparagraph> <subparagraph id="HABE00B93066C4088A9BA1DE2D90091CD"><enum>(B)</enum><text>such other services that the Secretary recognizes to be effective.</text></subparagraph></paragraph> <paragraph indent="up1" id="HB55C3D9FB4704F66B71CF2B9F1FADF6"><enum>(3)</enum><text>Each individual who is described in paragraph (1) and enrolled under part B shall be eligible for the services described in this subsection for up to 3 attempts to cease the use of tobacco.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph> <paragraph id="HEF37A024D4C1424B838C3B47825E81E0"><enum>(3)</enum><header>Payment and elimination of cost-sharing</header> <subparagraph id="H2B6A0E3FF8344ED1AECB6CCC806BECDA"><enum>(A)</enum><header>Payment and elimination of coinsurance</header><text>Section 1833(a)(1) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(a)(1)</external-xref>), as amended by section 502(c)(1), is amended—</text> <clause id="H033D15D5E3CA4FDD9C9E9ED0DB00ECF7"><enum>(i)</enum><text>in subparagraph (N) by striking <quote>or screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc))</quote> and inserting <quote>, screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc)), or counseling and pharmacotherapy for cessation of tobacco use (as defined in section 1861(ddd))</quote>; and</text></clause> <clause id="HFA34D08B194A47C8A0D298E900A811A6"><enum>(ii)</enum><text>in subparagraph (W), by striking <quote>and screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc))</quote> and inserting <quote>screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc)), and counseling and pharmacotherapy for cessation of tobacco use (as defined in section 1861(ddd))</quote>.</text></clause></subparagraph> <subparagraph id="H366992B109C64C4285D555947928FE73"><enum>(B)</enum><header>Payment under physician fee schedule</header><text>Section 1848(j)(3) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4(j)(3)</external-xref>), as amended by section 502(c)(2), is amended by inserting <quote>(2)(CC) (with separate payment amounts for pharmacotherapy, including prescription and nonprescription tobacco cessation agents approved by the Food and Drug Administration),</quote> after <quote>(2)(BB),</quote>.</text></subparagraph> <subparagraph id="H8CEA11DF65204479A66C92608B5B8157"><enum>(C)</enum><header>Elimination of coinsurance in outpatient hospital settings</header> <clause id="H1BEE62CA144345B89095896889F8C068"><enum>(i)</enum><header>Exclusion from opd fee schedule</header><text>Section 1833(t)(1)(B)(iv) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(t)(1)(B)(iv)</external-xref>), as amended by section 502(c)(3)(A), is amended by striking <quote>or screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc))</quote> and inserting <quote>screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc)), or counseling and pharmacotherapy for cessation of tobacco use (as defined in section 1861(ddd))</quote>.</text></clause> <clause id="HA9D19336018E4371B810D48F89B38644"><enum>(ii)</enum><header>Conforming amendment</header><text>Section 1833(a)(2)(H) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(a)(2)(H)</external-xref>), as added by section 502(c)(3)(B), is amended by striking <quote>and screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc))</quote> and inserting <quote>screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc)), and counseling and pharmacotherapy for cessation of tobacco use (as defined in section 1861(ddd))</quote>.</text></clause></subparagraph> <subparagraph id="HCD0EE486F5B04E18B62100F4F92D6913"><enum>(D)</enum><header>Elimination of deductible</header><text>Section 1833(b)(7) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(b)(7)</external-xref>), as added by section 502(c)(4), is amended by striking <quote>or screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc))</quote> and inserting <quote>screenings for clinical depression, anxiety, and impaired cognitive functioning (as defined in section 1861(ccc)), or counseling and pharmacotherapy for cessation of tobacco use (as defined in section 1861(ddd))</quote>.</text></subparagraph></paragraph> <paragraph id="HA1A8516C5490485F9E9CC9BE13F1A8E7"><enum>(4)</enum><header>Application of limits on billing</header><text>Section 1842(b)(18)(C) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395u">42 U.S.C. 1395u(b)(18)(C)</external-xref>), as amended by section 502(d), is amended by adding at the end the following new clause:</text> <quoted-block style="OLC" act-name="Social Security Act" id="H030971CE39BB49EFA717F80C11D6C00"> <clause indent="up2" id="H1A703E99C66147898D808200D4B77022"><enum>(ix)</enum><text>Any individual designated by the Secretary under section 1861(ddd)(1)(B)(ii).</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></paragraph> <paragraph id="H642DA7AEFCCB45C78096D3EF28EA2155"><enum>(5)</enum><header>Frequency</header><text>Section 1862(a)(1) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395y">42 U.S.C. 1395y(a)(1)</external-xref>), as amended by section 502(e), is amended—</text> <subparagraph id="H6A87E19569C14621ACB04DD112D0CFD5"><enum>(A)</enum><text>in subparagraph (M), by striking <quote>and</quote> after the comma at the end;</text></subparagraph> <subparagraph id="H6B47FB92ADAE43D6ADC5D0DE58CC6FEE"><enum>(B)</enum><text>in subparagraph (N), by striking the semicolon at the end and inserting <quote>, and</quote>; and</text></subparagraph> <subparagraph id="H15491E5DDEB94CFAAC2DDA0734A06551"><enum>(C)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block style="OLC" id="HE0C479E6E9034E2992CB24B149D4F325"> <subparagraph indent="up1" id="H68CF714281754E0AB6AA02CAC1F037BB"><enum>(O)</enum><text>in the case of counseling and pharmacotherapy for cessation of tobacco use (as defined in section 1861(ddd)), which is performed with respect to more attempts to cease tobacco use than is covered under such section;</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection> <subsection id="H7F0C7585AA4B4D699826A01626B56BCC"><enum>(b)</enum><header>Promoting Cessation of Tobacco Use Under the Medicaid Program</header> <paragraph id="H94DEE8295BFE49B5AE5F9437BB07C257"><enum>(1)</enum><header>Dropping exception from medicaid prescription drug coverage for tobacco cessation medications</header><text>Section 1927(d)(2) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-8">42 U.S.C. 1396r–8(d)(2)</external-xref>) is amended—</text> <subparagraph id="HD0D722C63A8D4A10BA002B7DADAA3FC7"><enum>(A)</enum><text>by striking subparagraph (E);</text></subparagraph> <subparagraph id="H7D66ACE3D98247898EA6E8D94939B8A4"><enum>(B)</enum><text>by redesignating subparagraphs (F) through (J) as subparagraphs (E) through (I), respectively; and</text></subparagraph> <subparagraph id="HF517D0B2DCC4423CB22001AE7BA30104"><enum>(C)</enum><text>in subparagraph (F) (as redesignated by paragraph (2)), by inserting before the period at the end the following: <quote>, except agents approved by the Food and Drug Administration for purposes of promoting, and when used to promote, tobacco cessation</quote>.</text></subparagraph></paragraph> <paragraph id="H232CB6CEFC4E40D1B3746DA0462516F"><enum>(2)</enum><header>Requiring coverage of tobacco cessation counseling and pharmacotherapy services for pregnant women</header><text>Section 1905(a)(4) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(a)(4)</external-xref>) is amended—</text> <subparagraph id="H38E388D5B2234C04B0A59FC30803FD28"><enum>(A)</enum><text>by striking <quote>and</quote> before <quote>(C)</quote>; and</text></subparagraph> <subparagraph id="H20A6F22C3DFB454D8D9E578CBC8685F9"><enum>(B)</enum><text>by inserting before the semicolon at the end the following: <quote>; and (D) counseling and pharmacotherapy for cessation of tobacco use (as defined in section 1861(ddd)) for pregnant women</quote>.</text></subparagraph></paragraph> <paragraph id="H6E519B813AE64F88B18D3C8981CB885B"><enum>(3)</enum><header>Removal of cost-sharing for tobacco cessation counseling and pharmacotherapy services for pregnant women</header><text>Section 1916 of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396o">42 U.S.C. 1396o</external-xref>) is amended in each of subsections (a)(2)(B) and (b)(2)(B), by inserting <quote>, and counseling for cessation of tobacco use (as defined in section 1861(ddd))</quote> after <quote>complicate the pregnancy</quote>.</text></paragraph></subsection> <subsection id="H50EB2A8757E042DF9E3F82CA46C6CEBE"><enum>(c)</enum><header>Coverage Under FEHBP</header><text>The last sentence of <external-xref legal-doc="usc" parsable-cite="usc/5/8904">section 8904(a)</external-xref> of title 5, United States Code, is amended by striking <quote>both for costs associated with care in a general hospital and for other health services of a catastrophic nature</quote> and inserting <quote>for costs associated with care in a general hospital, for other health services of a catastrophic nature, and for counseling and pharmacotherapy for cessation of tobacco use (as defined in section 1861(ddd)(1) of the <act-name parsable-cite="SSA">Social Security Act</act-name>)</quote>.</text></subsection> <subsection id="H1E0022468426450FBDE97595FFD30161"><enum>(d)</enum><header>Effective Date</header><text>The amendments made by this section shall take effect as if included in the enactment of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>; 117 Stat. 2066) and shall apply to services furnished on and after January 1, 2008.</text></subsection></section> <section id="H8F58371CB6934C82BCAB862FEBA49E4C"><enum>505.</enum><header>Recognition of school-based health Centers as model for delivery of primary care for children under the medicaid and State children’s health insurance programs</header> <subsection id="HA5FB41A4D10C4CBDA6255D6F8573A845"><enum>(a)</enum><header>In General</header><text>Title XIX of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) is amended by inserting after section 1911 the following:</text> <quoted-block style="traditional" act-name="Social Security Act" id="HE1FEF9E7EF7C47E0A9043F2CC608537"> <section id="H3E62EC47FF05402D83E4F4D1E55EC260"><enum>1911A.</enum><header>School-based health Centers</header><text>Not later than 12 months after the date of enactment of this section, the Secretary shall establish procedures to encourage a State program established under this title, title XXI, or both, to recognize school-based health centers as a model of delivery for primary care for children who are eligible for medical assistance under this title or child health assistance under title XXI. Such procedures shall include the following:</text> <paragraph id="H21CB8CB79FD24252BB882BCC26AC5AE"><enum>(1)</enum><header>Recognition of, and reimbursement for, services provided through school-based health centers</header><text>Procedures that encourage a State to recognize as primary care providers under this title and title XXI, providers who furnish physical or mental health services that are available as medical assistance under this title or child health assistance under title XXI to children who are eligible for such assistance through school-based health centers, and to reimburse such providers or centers (as appropriate) for furnishing such services to such children.</text></paragraph> <paragraph id="HC4BCA052BF11402DADF67444CDA4C710"><enum>(2)</enum><header>Exceptions to the <quote>free care</quote> rule</header><text>Procedures that allow a State the option to permit school-based health centers to bill the State for physical or mental health services that are available as medical assistance under this title or child health assistance under title XXI and that are furnished to children who are eligible for such assistance through such centers without billing all children who are provided such services.</text></paragraph> <paragraph id="HE22088B045424D65B3635D88B0C700E4"><enum>(3)</enum><header>Exceptions to the <quote>third party liability</quote> cost avoidance policy</header><text>Procedures that encourage a State to include physical or mental health services that are available as medical assistance under this title and that are provided through school-based health centers in the list of diagnosis billing codes for preventive pediatric care services that the State will pay for under this title and then seek reimbursement from any liable third party in accordance with the requirements of section 1902(a)(25).</text></paragraph> <paragraph id="HEA98E13284014F1CA8C2004C03F2B21"><enum>(4)</enum><header>Assurance of payment for services covered by a contract with a managed care entity</header><text>Procedures that encourage a State to include in any contract entered into with a managed care entity (as defined in section 1932(a)(1)(B)) under this title or title XXI provisions which ensure that the entity will make prompt payment to a school-based health center for furnishing physical or mental health services to a child who is eligible for medical assistance under this title or child health assistance under title XXI that are within the scope of items and services for which benefits are available with respect to the child under the contract between the entity and the State (or to a provider who furnishes such services to such a child through a school-based health center), regardless of whether the center (or provider) is a participating provider with respect to such entity, at a rate established by the entity for such services that is not less than the level and amount of payment which the entity would make for the services if the services were furnished by a participating provider.</text></paragraph></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H2A3189CB928140A98CDA832028ED2147"><enum>(b)</enum><header>Report to Congress</header><text>Not later than 36 months after the date of enactment of this section, the Secretary of Health and Human Services shall submit a report to Congress on the effectiveness of the procedures established in accordance with section 1911A of the <act-name parsable-cite="SSA">Social Security Act</act-name> (as added by subsection (a)) in encouraging the use of school-based health centers for the delivery of primary care physical and mental health services to children who are eligible for medical assistance under title XIX of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) or child health assistance under title XXI of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397aa">42 U.S.C. 1397aa et seq.</external-xref>), together with such recommendations for administrative or legislative action as the Secretary determines to be appropriate.</text></subsection></section> <section id="HA28B9BCBEF5840DC966937137FB1C4AA"><enum>506.</enum><header>Preventive health care demonstration program</header> <subsection id="H6B55A92614EF400DB173A0000E3DE73"><enum>(a)</enum><header>Establishment</header> <paragraph id="H3026082FB16448AB9B5160A207FEC58C"><enum>(1)</enum><header>In general</header><text>Not later than 18 months after the date of enactment of this Act, the Secretary of Health and Human Services (in this section referred to as the <quote>Secretary</quote>) shall conduct a 5-year demonstration program under part B of title XVIII of the <act-name parsable-cite="SSA">Social Security Act</act-name> under which the Secretary establishes demonstration projects to contract with appropriate entities to provide preventive health care to eligible beneficiaries through the development and implementation of a disease prevention plan (as described in subsection (b)).</text></paragraph> <paragraph id="H644948044E674311B22C9DF57BB33DE9"><enum>(2)</enum><header>Sites</header><text>The Secretary shall designate at least 2 sites at which to conduct the demonstration program under this section, of which—</text> <subparagraph id="H0D34AB046578484BAC8CB983522E7392"><enum>(A)</enum><text>1 shall be in an urban area; and</text></subparagraph> <subparagraph id="H348C665B74FF42BCB9085F8EC687D471"><enum>(B)</enum><text>1 shall be in a rural area.</text></subparagraph></paragraph> <paragraph id="H5C4B6294B7F84A4981EE3F16497E2E35"><enum>(3)</enum><header>Number of eligible beneficiaries</header><text>Each demonstration project site under this section shall consist of at least 1,000 eligible beneficiaries representative of the population of individuals entitled to benefits under part A of title XVIII of the <act-name parsable-cite="SSA">Social Security Act</act-name>, and enrolled under part B of such title. The Secretary may expand the population as needed to measure statistical significance.</text></paragraph> <paragraph id="HF25195E0A21B4C9BB95B695189EEF97F"><enum>(4)</enum><header>Identifying eligible beneficiaries</header><text>The Secretary shall develop a method for identifying eligible beneficiaries who may benefit from the demonstration program and communicate with them regarding their eligibility.</text></paragraph> <paragraph id="H1660C5EB34924ECEB393C4DF272FA4F"><enum>(5)</enum><header>Voluntary participation</header><text>Participation of health care providers, and individual beneficiaries, in the demonstration program shall be voluntary.</text></paragraph></subsection> <subsection id="HD83EAF1AB702423FBBFBDB64956308B7"><enum>(b)</enum><header>Disease Prevention Plan</header> <paragraph id="H45729C0B66984B11B432DAADBDB4EC6E"><enum>(1)</enum><header>In general</header><text>The disease prevention plan described in this subsection is a plan, developed in consultation with an eligible beneficiary participating in the demonstration program, to mitigate the risk factors associated with a particular disease.</text></paragraph> <paragraph id="H395C00858A3B459D93B0565BEBB32371"><enum>(2)</enum><header>Plan contents</header><text>The disease prevention plan should include the following:</text> <subparagraph id="H02508C954FF043D29BC5D1A0A3DF5D86"><enum>(A)</enum><header>Point of contact</header><text>The disease prevention plan shall provide for a point of contact responsible for communicating with the participating beneficiary and with other health care providers on behalf of such beneficiary.</text></subparagraph> <subparagraph id="H1045AFC51042465F8CA7356BB27B3E1"><enum>(B)</enum><header>Personal health care</header><text>The disease prevention plan shall provide for instruction on personal health care.</text></subparagraph> <subparagraph id="HFCB6781E94F24860A0ED43B27CB078D"><enum>(C)</enum><header>Physician and health care provider training</header><text>The disease prevention plan shall provide for the training of physicians or other health care providers in the communication of relevant clinical information.</text></subparagraph> <subparagraph id="HE0908723B7BA44C6A28BFCF8895736E6"><enum>(D)</enum><header>Monitoring technology</header><text>The disease prevention plan may provide for necessary monitoring technology to facilitate the exchange of information, including information such as vital signs, symptoms, and health self assessments.</text></subparagraph></paragraph></subsection> <subsection id="H8B60DFDD883149D184F96D4740925EAE"><enum>(c)</enum><header>Program Standards and Criteria</header><text>The Secretary shall establish performance standards for the demonstration program under this section, including best practices for the prevention of chronic diseases. Such practices shall be standardized to the greatest extent possible. The eligibility of entities or individuals to enter into a contract to provide preventive health care under the demonstration program shall be conditioned, at a minimum, on performance that meets or exceeds such standards.</text></subsection> <subsection id="HBFB167430925425288F8A64464E7E9AA"><enum>(d)</enum><header>Payment</header><text>The Secretary shall develop a method and level of payment for entities that participate in the program under this section based on best practices, as determined by the Secretary.</text></subsection> <subsection id="HDC8858A4F5BA4C1BBDD9DBDDDB6F00D"><enum>(e)</enum><header>Waiver Authority</header><text>The Secretary may waive such requirements of titles XI and XVIII of the <act-name parsable-cite="SSA">Social Security Act</act-name> as may be necessary to carry out the purposes of the demonstration program under this section.</text></subsection> <subsection id="H4FF0E2B758C04FE8A46F921496DDAA00"><enum>(f)</enum><header>Evaluation and Report</header> <paragraph id="HBD9EEC8338F5454D86C276C595D2D7FD"><enum>(1)</enum><header>Evaluation</header><text>The Secretary shall conduct evaluations of—</text> <subparagraph id="HD7EE77A0993D41D39D172131161CECCA"><enum>(A)</enum><text>the benefits due to a reduction, if any, in disease incidence for participants in the demonstration projects compared to the medicare population as a whole, as determined by the use of appropriate statistical techniques;</text></subparagraph> <subparagraph id="HE5B618AD04704D78AA4CB4A70020D540"><enum>(B)</enum><text>the long term cost effectiveness of the demonstration projects to the medicare program in terms of acute care costs avoided due to disease prevention; and</text></subparagraph> <subparagraph id="H0E09BF24703847C3BC899F7EAA6245F5"><enum>(C)</enum><text>patient satisfaction under the demonstration projects.</text></subparagraph></paragraph> <paragraph id="H09C6D4FBF8EF407B8E8714983F7CE960"><enum>(2)</enum><header>Report</header><text>Not later than 6 months after the date on which the demonstration program under this section ends, the Secretary shall prepare and submit to Congress a report on the demonstration program together with—</text> <subparagraph id="HD88E7BB8C9B9427FBB00B2D8006240CE"><enum>(A)</enum><text>recommendations on whether the demonstration program should be expanded in terms of its success in disease prevention and the cost effectiveness of the demonstration program; and</text></subparagraph> <subparagraph id="HAEA747C776F74A348C5BB263CD68B1A3"><enum>(B)</enum><text>such recommendations for legislation or administrative action as the Secretary determines appropriate.</text></subparagraph></paragraph></subsection> <subsection id="H2CB3FEAF61574049847DF32D96E0869"><enum>(g)</enum><header>Funding</header><text>The Secretary shall provide for the transfer from the Federal Supplementary Medical Insurance Trust Fund under section 1841 of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395t">42 U.S.C. 1395t</external-xref>) of such funds, not to exceed $50,000,000, as are necessary for the costs of carrying out the demonstration program under this Act.</text></subsection> <subsection id="HD7ABA6493EF74D0E837DFCF81DD8AC2E"><enum>(h)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="HEA8574846AA64DB59CEFF96F00B4D427"><enum>(1)</enum><header>Appropriate entity</header><text>The term <term>appropriate entity</term> means—</text> <subparagraph id="H23DB0F44213A4DDD91EA514600C5FEF4"><enum>(A)</enum><text>a chronic care improvement program;</text></subparagraph> <subparagraph id="HF8FB5C826BC64868BC08AD4CA6B4E3D1"><enum>(B)</enum><text>a hospital; and</text></subparagraph> <subparagraph id="H9FD1DDC0608A43409B879C96714053F9"><enum>(C)</enum><text>any other entity that the Secretary determines appropriate based on clinical, financial, or other requirements appropriate to carry out the purposes of the demonstration program under this section.</text></subparagraph></paragraph> <paragraph id="HA476655331484DB5B8CBBA45101C5F60"><enum>(2)</enum><header>Eligible beneficiary</header><text>The term <term>eligible beneficiary</term> means an individual who—</text> <subparagraph id="H989A3932A1204B1B972946FAA0A45D62"><enum>(A)</enum><text>is entitled to benefits under part A of title XVIII of the <act-name parsable-cite="SSA">Social Security Act</act-name> or enrolled under part B of such title; and</text></subparagraph> <subparagraph id="H72BB9BB499454D5EBB13C5F845EB69CE"><enum>(B)</enum><text>has 2 or more risk factors associated with—</text> <clause id="HDD3D8799A3204DC194008BEEEC1B52E3"><enum>(i)</enum><text>chronic obstructive pulmonary disease;</text></clause> <clause id="H8574D7B16B8F424EA8FB36F2B1AEFDE5"><enum>(ii)</enum><text>diabetes; or</text></clause> <clause id="H000D0ECC5F8445E0ADC5B8EA227DCD16"><enum>(iii)</enum><text>any other chronic condition that the Secretary determines would be appropriate for the purpose of providing significant potential cost benefits to the medicare program through the prevention of such condition.</text></clause></subparagraph></paragraph></subsection></section> <section id="HC14D9BABA4D4481E8BC37407E218F134"><enum>507.</enum><header>Preventive health services for women</header><text display-inline="no-display-inline">Section 1509 of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/300n-4a">42 U.S.C. 300n–4a</external-xref>) is amended to read as follows:</text> <quoted-block style="OLC" act-name="Public Health Service Act" id="H77A49D957E534B1EA98F79B9F0DD3DE8"> <section id="HD5FAB9180C454575003C070512ADB3DB"><enum>1509.</enum><header>Establishment of program for additional preventive health services</header> <subsection id="H0A027F779D684E98BE585B3E1E6D7427"><enum>(a)</enum><header>In General</header><text>The Secretary, acting through the Director of the Centers for Disease Control and Prevention, may, through a competitive review process, award grants to States that have received grants under section 1501 for a fiscal year, to enable such State to carry out programs—</text> <paragraph id="HD3CD92A8252B47F5BF4CC46CAD929D22"><enum>(1)</enum><text>to provide preventive health services, in addition to the services authorized in such section 1501, for diseases such as cardiovascular diseases, osteoporosis, and obesity;</text></paragraph> <paragraph id="H40409D0791C341DE9B4455DA99F93214"><enum>(2)</enum><text>to provide screenings, such as screening for blood pressure, cholesterol, and osteoporosis, and other services that the Secretary, acting through the Director of the Centers for Disease Control and Prevention, determines to be appropriate and feasible;</text></paragraph> <paragraph id="HB18803DE1B07442E9804EF5900D50087"><enum>(3)</enum><text>for health education, counseling, and interventions for behavioral risk factors, such as physical inactivity and poor nutrition, and diseases referred to in paragraph (1);</text></paragraph> <paragraph id="H83906C234DA34F349FE703CB006972F8"><enum>(4)</enum><text>to provide appropriate referrals for medical treatment of women receiving services pursuant to paragraph (1) through (3), and ensuring, to the extent practicable, the provision of appropriate follow-up services; and</text></paragraph> <paragraph id="HF088010AFED04D0EADAD666D12B7B95E"><enum>(5)</enum><text>to evaluate the activities conducted under paragraphs (1) through (4) through appropriate surveillance, research, or program monitoring activities.</text></paragraph></subsection> <subsection id="HD4B4900A0DD64FC0896CEC34C5F2F53B"><enum>(b)</enum><header>Status as Participant in Program Regarding Breast and Cervical Cancer</header><text>The Secretary may not make a grant to a State under subsection (a) unless the State involved agrees that services under the grant will be provided in conjunction with entities that are screening women for breast or cervical cancer pursuant to a grant under section 1501.</text></subsection> <subsection id="H3F151438A5FE43D0AECF64F7E9F996E8"><enum>(c)</enum><header>Applicability of Provisions</header><text>The provisions of this title shall apply to a grant under subsection (a) to the same extent and in the same manner as such provisions apply to a grant under section 1501.</text></subsection> <subsection id="HA94C4AF714864F94B17700FCD443CB14"><enum>(d)</enum><header>Funding</header> <paragraph id="HA127BDD72F2F483094B415EE3D93D087"><enum>(1)</enum><header>In general</header><text>There is authorized to be appropriated such sums as may be necessary to carry out this section for fiscal year 2008 and for each subsequent fiscal year.</text></paragraph> <paragraph id="H0D54E4618C9E40EAB47C8DA2820002A7"><enum>(2)</enum><header>Limitation regarding funding with respect to breast and cervical cancer</header><text>No additional resources shall be appropriated for a fiscal year under paragraph (1) unless the amount appropriated under section 1510(a) for such fiscal year is at least $173,920,000.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="HB3786665FAC1481DB6B1127F00BFF8E9"><enum>508.</enum><header>Promoting cessation of tobacco use by pregnant women under the medicaid program</header> <subsection id="H2599487BC3EA4C258B3FDB97F27CA62F"><enum>(a)</enum><header>Requiring Coverage of Counseling and Pharmacotherapy for Cessation of Tobacco Use by Pregnant Women</header><text>Section 1905 of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(a)(4)</external-xref>) is amended—</text> <paragraph id="HF1DEB59E54B74832BDD165E863F96D59"><enum>(1)</enum><text>in subsection (a)(4)—</text> <subparagraph id="H8513F3C0A07F4E8D9F44644B398470BF"><enum>(A)</enum><text>by striking <quote>and</quote> before <quote>(C)</quote>; and</text></subparagraph> <subparagraph id="HFADEBC0C21264A81B479FFEB2BF8D417"><enum>(B)</enum><text>by inserting before the semicolon at the end the following new subparagraph: <quote>; and (D) counseling and pharmacotherapy for cessation of tobacco use by pregnant women (as defined in subsection (y))</quote>; and</text></subparagraph></paragraph> <paragraph id="HA76022EB11614B559DFB52C23F35DED8"><enum>(2)</enum><text>by adding at the end the following:</text> <quoted-block style="OLC" id="H2422F3A312C44B7EA56D9CBF005B6E9C"> <subsection id="H6C7F6DC5EAE54C87A8AB0901D22FB52D"><enum>(y)</enum> <paragraph display-inline="yes-display-inline" id="HE0DCEC29D36F4599A3343B22409C2814"><enum>(1)</enum><text>For purposes of this title, the term <term>counseling and pharmacotherapy for cessation of tobacco use by pregnant women</term> means diagnostic, therapy, and counseling services and pharmacotherapy (including the coverage of prescription and nonprescription tobacco cessation agents approved by the Food and Drug Administration) for cessation of tobacco use by pregnant women who use tobacco products or who are being treated for tobacco use that is furnished—</text> <subparagraph indent="up1" id="H334EFE26F1844DFCAB692F84B07E62F6"><enum>(A)</enum><text>by or under the supervision of a physician; or</text></subparagraph> <subparagraph indent="up1" id="H98259A44900444C1AE29E88602A7726B"><enum>(B)</enum><text>by any other health care professional who—</text> <clause id="HA6473CC6199243358E698838A7238F14"><enum>(i)</enum><text>is legally authorized to furnish such services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished; and</text></clause> <clause id="HEAA15152ED804C55958E8B9B72203DB1"><enum>(ii)</enum><text>is authorized to receive payment for other services under this title or is designated by the Secretary for this purpose.</text></clause></subparagraph></paragraph> <paragraph indent="up1" id="HA7821A42F1F4491089EBC20326F8D71F"><enum>(2)</enum><text>Subject to paragraph (3), such term is limited to—</text> <subparagraph id="HB4696085069F445E836F08E7C2E48C91"><enum>(A)</enum><text>services recommended with respect to pregnant women in <quote>Treating Tobacco Use and Dependence: A Clinical Practice Guideline</quote>, published by the Public Health Service in June 2000, or any subsequent modification of such Guideline; and</text></subparagraph> <subparagraph id="H998EB9873A0742219B52009331163647"><enum>(B)</enum><text>such other services that the Secretary recognizes to be effective for cessation of tobacco use by pregnant women.</text></subparagraph></paragraph> <paragraph indent="up1" id="H75D56D5E9C8147A69CAEA29BB7B72B6"><enum>(3)</enum><text>Such term shall not include coverage for drugs or biologicals that are not otherwise covered under this title.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H20FCF794AD504121BE42172816AF4049"><enum>(b)</enum><header>Exception From Optional Restriction Under Medicaid Prescription Drug Coverage</header><text>Section 1927(d)(2) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-8">42 U.S.C. 1396r–8(d)(2)</external-xref>) is amended—</text> <paragraph id="H36C65CA7490C4B51895DC00D257CB80"><enum>(1)</enum><text>in subparagraph (E), by inserting before the period at the end the following: <quote>, except in the case of pregnant women when recommended in accordance with the Guideline referred to in section 1905(y)(2)(A)</quote>; and</text></paragraph> <paragraph id="H60F2F0031966496DA89C5C3300B9FD5"><enum>(2)</enum><text>in subparagraph (G), by inserting before the period at the end the following: <quote>, except, in the case of pregnant women when recommended in accordance with the Guideline referred to in section 1905(y)(2)(A), agents approved by the Food and Drug Administration for purposes of promoting, and when used to promote, tobacco cessation</quote>.</text></paragraph></subsection> <subsection id="H593854B85E8444279973FBAF0033AC54"><enum>(c)</enum><header>Removal of Cost-Sharing for Counseling and Pharmacotherapy for Cessation of Tobacco Use by Pregnant Women</header> <paragraph id="H91C9E8C1F4B84C5E8C0088CB5032D800"><enum>(1)</enum><header>General cost sharing limitations</header><text>Section 1916 of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396o">42 U.S.C. 1396o</external-xref>) is amended in each of subsections (a)(2)(B) and (b)(2)(B) by inserting <quote>, and counseling and pharmacotherapy for cessation of tobacco use by pregnant women (as defined in section 1905(y)) and covered outpatient drugs (as defined in subsection (k)(2) of section 1927 and including nonprescription drugs described in subsection (d)(2) of such section) that are prescribed for purposes of promoting, and when used to promote, tobacco cessation by pregnant women in accordance with the Guideline referred to in section 1905(y)(2)(A)</quote> after <quote>complicate the pregnancy</quote>.</text></paragraph> <paragraph id="HF307D23C355A47B082FB89CAFC9979CF"><enum>(2)</enum><header>Application to alternative cost sharing</header><text>Section 1916A(b)(3)(B)(iii) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396o-1">42 U.S.C. 1396o–1(b)(3)(B)(iii)</external-xref>) is amended by inserting <quote>, and counseling and pharmacotherapy for cessation of tobacco use by pregnant women (as defined in section 1905(y))</quote> after <quote>complicate the pregnancy</quote>.</text></paragraph></subsection> <subsection id="H626BE8FBE29E438BB3FDF28F6E9998D8"><enum>(d)</enum><header>Increased FMAP for Tobacco Cessation Counseling Services and Medications</header><text>The first sentence of section 1905(b) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(b)</external-xref>) is amended by inserting the following before the period: <quote>, and medical assistance provided for counseling and pharmacotherapy for cessation of tobacco use by pregnant women (as defined in subsection (y)) and for covered outpatient drugs (as defined in subsection (k)(2) of section 1927 and including nonprescription drugs described in subsection (d)(2) of such section) that are prescribed for purposes of promoting, and when used to promote, tobacco cessation by pregnant women in accordance with the Guideline referred to in subsection (y)(2)(A)</quote>.</text></subsection> <subsection id="HEF900BD52E6B4AA0A9D810D493FA60C5"><enum>(e)</enum><header>Effective Date</header><text>The amendments made by this section shall apply to services furnished on or after the first fiscal year quarter that begins after the date of enactment of this Act.</text></subsection></section> <enum>VI</enum><header>HELP (HEALTHY LIFESTYLES AND PREVENTION) AMERICA TRUST FUND</header> <section id="HB5937D3E627B41C69926229E3D2DBD65"><enum>601.</enum><header>HeLP (healthy lifestyles and prevention) America Trust Fund</header> <subsection id="H60FD6E6EF6CE40A9ACD33F789DCEC408"><enum>(a)</enum><header>Creation of Trust Fund</header><text>There is established in the Treasury of the United States a trust fund to be known as the <quote>HeLP (Healthy Lifestyles and Prevention) America Trust Fund</quote> (referred to in this section as the <quote>Trust Fund</quote>), consisting of such amounts as may be appropriated or credited to the Trust Fund as provided in this section.</text></subsection> <subsection id="HE44CDA8914AE4BA2B167BD8F6CFDB9"><enum>(b)</enum><header>Transfers to Trust Fund</header><text>There is hereby appropriated to the Trust Fund an amount equivalent to—</text> <paragraph id="H23B08F2ADFEE459E87E3EE802B4C0048"><enum>(1)</enum><text>the increase in revenues received in the Treasury as the result of the amendment made by section 405 of this Act,</text></paragraph> <paragraph id="HA6F8AC10A7D1448D8C48C85E25C00C3"><enum>(2)</enum><text>the increase in revenues received in the Treasury as the result of the amendments made by title II of this Act, and</text></paragraph> <paragraph id="HB0F4B79075064D1BA0E9DED437009888"><enum>(3)</enum><text>the receipts paid by tobacco companies under subtitle B of title III of this Act.</text></paragraph></subsection> <subsection id="H1BF190F5354645F1BB13E566B6181700"><enum>(c)</enum><header>Distribution of Amounts in Trust Fund</header> <paragraph id="H978BCF5CB1C84C8CB600C5D09996186"><enum>(1)</enum><header>Mandatory expenditures</header><text>On a fiscal year basis (beginning with fiscal year 2008) and without further appropriation the Secretary of the Treasury shall distribute from amounts in the Trust Fund such amounts as are necessary to provide for the Federal expenditures attributable to the following:</text> <subparagraph id="HF2C4DE01731C42EF88E77926410803AD"><enum>(A)</enum><text>The amendments made to the Fruit and Vegetable Program by section 201 of this Act.</text></subparagraph> <subparagraph id="H8E2F8F3952F249A394EDC077BE68C745"><enum>(B)</enum><text>Smoking cessation drugs under title XIX of the <act-name parsable-cite="SSA">Social Security Act</act-name> as identified by the Secretary of Health and Human Services.</text></subparagraph> <subparagraph id="H7F8C89C8A216421B8E66899313745D98"><enum>(C)</enum><text>Coverage of smoking cessation under the Federal Employee Health Benefits Program under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/89">chapter 89</external-xref> of title 5, United States Code (as amended by section 503).</text></subparagraph> <subparagraph id="H2B46ECCDF26D4FEFA69100DF6A69BA0"><enum>(D)</enum><text>The amendments made to the medicare program under title XVIII of the <act-name parsable-cite="SSA">Social Security Act</act-name> by sections 501 and 502 of this Act.</text></subparagraph> <subparagraph id="H5A0AC09C430540B68B6EDB909ECF1CD"><enum>(E)</enum><text>The preventive health care demonstration program carried out under section 505 of this Act.</text></subparagraph><continuation-text continuation-text-level="paragraph">Such amounts shall be in addition to any other amounts appropriated for such purposes.</continuation-text></paragraph> <paragraph id="H2C43F69B333A402EB8C939F300B158A7"><enum>(2)</enum><header>Discretionary expenditures</header><text>Amounts in the Trust Fund not to exceed $2,050,000,000 shall be available, as provided in appropriation Acts, for each fiscal year (beginning with fiscal year 2008) only for purposes of making expenditures to carry out the following:</text> <subparagraph id="H22333193ED7F4A39BE0942D6A0CBD026"><enum>(A)</enum><text>School nutrition environment enhancement grants under section 18(l) of the Richard B. Russell <act-name parsable-cite="NSLA">National School Lunch Act</act-name> (as added by section 203).</text></subparagraph> <subparagraph id="HD97398EA2BB0440D9FC194B7307FEE80"><enum>(B)</enum><text>Mental health services in schools under paragraphs (7) and (8) of section 5541(c) of the <act-name parsable-cite="ESEA">Elementary and Secondary Education Act of 1965</act-name> (as added by section 204).</text></subparagraph> <subparagraph id="HEA9A9047E49C473CB205522F2BD899DC"><enum>(C)</enum><text>The Baby-Friendly Hospital Initiative carried out under section 205 of this Act.</text></subparagraph> <subparagraph id="H3B53238603704B12B9854D52F4610727"><enum>(D)</enum><text>The grant program to strengthen families and build children’s resilience carried out under section 520K of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (as added by section 206).</text></subparagraph> <subparagraph id="HE96431141C0E47BA91938F7324AB79AE"><enum>(E)</enum><text>The reservation for early Head Start programs under section 640(a)(6)(A) of the <act-name parsable-cite="HSA">Head Start Act</act-name> (as amended by section 207).</text></subparagraph> <subparagraph id="HB5E27AAFEED644EDBD0033C1C98AD2"><enum>(F)</enum><text>Community grants to prevent and reduce the incidence of chronic disease under section 399P of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (as added by section 313).</text></subparagraph> <subparagraph id="H66F9D54DB4DB4C37B6438D54A138EFEF"><enum>(G)</enum><text>Living well with a disability and working well with a disability programs under sections 399Q and 399R of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (as added by section 312).</text></subparagraph> <subparagraph id="HCEF814BB2E774015A730DC4BFE88F2AB"><enum>(H)</enum><text>The amendments made to title 23, United States Code, by section 313 of this Act and the nonmotorized transportation pilot program carried out under section 313(d).</text></subparagraph> <subparagraph id="H2403FC88922D4057A37695ED94400049"><enum>(I)</enum><text>The national assessment of mental health needs program carried out under section 506C of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (as added by section 314).</text></subparagraph> <subparagraph id="H09E1A000CAA64F7F9420BD2F29B5CE83"><enum>(J)</enum><text>The preventive medicine and public health training grant program carried out under section 747A of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (as added by section 315).</text></subparagraph> <subparagraph id="H6766C906035846FE97F9F42D61936F01"><enum>(K)</enum><text>Federal-State tobacco counter-advertising programs under section 399S of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (as added by section 406).</text></subparagraph> <subparagraph id="HC1CFB0585AA2456DBCEE94C4AC5523E"><enum>(L)</enum><text>Preventive health services for women, including well-integrated screening and evaluation for women across the Nation, under section 1509 of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (as added by section 506).</text></subparagraph> <subparagraph id="HD04C1B1DDBFF4780B5951200DEC9013C"><enum>(M)</enum><text>Carol M. White Physical Education Program under subpart 10 of part D of title V of the <act-name parsable-cite="ESEA">Elementary and Secondary Education Act of 1965</act-name>.</text></subparagraph> <subparagraph id="HB937E851C02942168C90F7070042003F"><enum>(N)</enum><text>Research regarding obesity under section 101 of this Act.</text></subparagraph> <subparagraph id="H7AD14013F9FA4489AE795DB24D940014"><enum>(O)</enum><text>Expanded Food and Nutrition Education Program under <external-xref legal-doc="usc" parsable-cite="usc/23/3175">section 3175</external-xref> of title 23, United States Code.</text></subparagraph> <subparagraph id="H9AFB141F2B474823A184E8049000BB5F"><enum>(P)</enum><text>The following programs under the authority of the Secretary of Health and Human Services through the Centers for Disease Control and Prevention:</text> <clause id="H7C5FB3246B604D8F8414A75362E31028"><enum>(i)</enum><text>Nutrition and physical activity grants.</text></clause> <clause id="H07DC42060E7A4851B8DD797FC3283E8E"><enum>(ii)</enum><text>Division of Adolescent and School Health.</text></clause> <clause id="H43F4FD89AAAF487F8817A80761C8AD77"><enum>(iii)</enum><text>Verb Campaign.</text></clause> <clause id="H3C082033748C47888CB0A85982BF609"><enum>(iv)</enum><text>Prevention research centers.</text></clause> <clause id="H62C7BABA356C464D8BA4B8B0E65F1640"><enum>(v)</enum><text>5-a-day programs.</text></clause> <clause id="H7A6629A756424EC5A700143087B61EBB"><enum>(vi)</enum><text>Steps to a healthier United States.</text></clause></subparagraph> <subparagraph id="H90BF4A66306B4849B632ED459DDC31F"><enum>(Q)</enum><text>Access to local foods and school gardens, as authorized by section 122 of the Child Nutrition and WIC Reauthorization Act of 2004 (<external-xref legal-doc="public-law" parsable-cite="pl/108/265">Public Law 108–265</external-xref>).</text></subparagraph></paragraph></subsection> <subsection id="H673E0335C82C435EA37026A480F800B1"><enum>(d)</enum><header>Application of Certain Rules</header><text>For purposes of this section, rules similar to the rules of sections 9601 and 9602 of the Internal Revenue Code of 1986 shall apply.</text></subsection></section> <enum>VII</enum><header>RESEARCH</header> <section id="H825235004B2842F99EFA6E2D13F11587"><enum>701.</enum><header>Expansion of research regarding obesity</header><text display-inline="no-display-inline">The Secretary of Health and Human Services shall, based on the conclusions of the United States Preventive Services Task Force on Obesity, conduct research on obesity prevention, treatment, and control with regard to the following:</text> <paragraph id="H992D41B6631F4C61BB27AD89886916DD"><enum>(1)</enum><text>The effectiveness of physical activity and dietary counseling with children and adolescents in the primary care setting to prevent, treat, and control obesity.</text></paragraph> <paragraph id="H6EBB88C67A8946EDBDBC4E37BA1619F"><enum>(2)</enum><text>The cost-effectiveness of intensive dietary and physical activity counseling to prevent, treat, and control obesity in a variety of populations.</text></paragraph> <paragraph id="HC7C65251374B4138A77100CACA218BC4"><enum>(3)</enum><text>The effectiveness of dietary and physical activity counseling among children and adolescents, low income populations, and minority groups in the primary care setting to prevent, treat, and control obesity.</text></paragraph> <paragraph id="H1069307761A043ADAA09CD22FFFE5CEB"><enum>(4)</enum><text>The effectiveness of the assessment of obesity by a primary care physician and subsequent referral for obesity counseling to a nonaffiliated obesity expert or specialist.</text></paragraph></section> <section id="HFDB5B30BACFB4A2FB507DE49D9A98B66"><enum>702.</enum><header>Incorporation of physical activity into Federal programs</header> <subsection id="H7FFBB4DFD4E244AE9C86B3F0A7C8800"><enum>(a)</enum><header>Study</header><text>The Secretary of Health and Human Services, in collaborate with the Secretary of Education the Director of the Centers for Disease Control and Prevention, shall enter into a contract with the Institute of Medicine of the National Academy of Sciences for the conduct of a study to examine and make recommendations concerning the various means that could be employed to incorporate physical activity into Head Start and childcare settings, elementary, middle and high school settings, and before- and after-school programs. The Institute of Medicine shall submit to Congress a report concerning the results of such study.</text></subsection> <subsection id="HCF5F16B07B4E45EBA8A4DCEA82E1B4A7"><enum>(b)</enum><header>Classification</header><text>The Commissioner of Food and Drugs shall conduct a review of the classification of sodium and partially hydrogenated oil as a Generally Recognized as Safe (GRAS) ingredient based on new scientific developments.</text></subsection> <subsection id="HD2A75C8ADE9D4B3197B086D600B8E6EC"><enum>(c)</enum><header>Reducing Sodium Intake</header><text>The Secretary of Health and Human Services shall enter into a contract with the Institute of Medicine of the National Academy of Sciences for the conduct of a study and the development of recommendations on various means that could be employed to reduce dietary sodium intake to recommended levels and food reformulation approaches.</text></subsection></section>