1.This Act may be cited as the
Health Equity and Accountability Act
of 2011
.
2.The table of contents
of this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Findings.
Title I—Data Collection and Reporting
Sec. 101. Amendment to the Public Health Service Act.
Sec. 102. Elimination of prerequisite of direct appropriations
for data collection and analysis.
Sec. 103. Collection of race and ethnicity data by the Social
Security Administration.
Sec. 104. Revision of HIPAA claims standards.
Sec. 105. National Center for Health Statistics.
Sec. 106. Oversampling of Asian-Americans, Native Hawaiians, or
Pacific Islanders and other underrepresented groups in Federal health
surveys.
Sec. 107. Geo-access study.
Sec. 108. Racial, ethnic, and linguistic data collected by the
Federal Government.
Sec. 109. Data collection and analysis grants to
minority-serving institutions.
Sec. 110. Standards for measuring sexual orientation and gender
identity in collection of health data.
Sec. 111. Optional collection of health data on immigrants and
individuals in their households.
Sec. 112. Standards for measuring socioeconomic status in
collection of health data.
Sec. 113. Safety and effectiveness of drugs with respect to
racial and ethnic background.
Sec. 114. GAO study on compliance with existing FDA
requirements to present drug and device safety and effectiveness data by sex,
age, and racial and ethnic subgroups.
Sec. 115. Improving health data regarding Native Hawaiians and
other Pacific Islanders.
Title II—Culturally and Linguistically Appropriate Health
Care
Sec. 201. Definitions.
Sec. 202. Amendment to the Public Health Service
Act.
Sec. 203. Federal reimbursement for culturally and
linguistically appropriate services under the Medicare, Medicaid, and State
Children’s Health Insurance Programs.
Sec. 204. Increasing understanding of and improving health
literacy.
Sec. 205. Assurances for receiving Federal funds.
Sec. 206. Report on Federal efforts to provide culturally and
linguistically appropriate health care services.
Sec. 207. English for speakers of other languages.
Sec. 208. Implementation.
Sec. 209. Language access services.
Title III—Health Workforce Diversity
Sec. 301. Amendment to the Public Health Service Act.
Sec. 302. Hispanic-serving health professions
schools.
Sec. 303. Loan repayment program of Centers for Disease Control
and Prevention.
Sec. 304. Cooperative agreements for online degree programs at
schools of public health and schools of allied health.
Sec. 305. National report on the preparedness of health
professionals to care for diverse populations.
Sec. 306. Scholarship and fellowship programs.
Sec. 307. Advisory Committee on Health Professions Training for
Diversity.
Sec. 308. McNair Postbaccalaureate Achievement
Program.
Sec. 309. Rules for determination of full-time equivalent
residents for cost reporting periods.
Sec. 310. Developing and implementing strategies for local
health equity.
Sec. 311. Loan forgiveness for mental and behavioral health
social workers.
Title IV—Improvement of Health Care Services
Subtitle A—Health Empowerment Zones
Sec. 401. Short title.
Sec. 402. Findings.
Sec. 403. Designation of health empowerment zones.
Sec. 404. Assistance to those seeking designation.
Sec. 405. Benefits of designation.
Sec. 406. Definition.
Sec. 407. Authorization of appropriations.
Subtitle B—Other Improvements of Health Care
Services
Chapter 1—Expansion of Coverage
Sec. 411. Amendment to the Public Health Service Act.
Sec. 412. Removing barriers to unsubsidized purchase of private
insurance in American Health Benefit Exchanges.
Sec. 413. Study on the uninsured.
Sec. 414. Medicaid payment parity for the
territories.
Sec. 415. Clarification of Medicaid coverage for citizens of
Freely Associated States.
Sec. 416. Extension of Medicare secondary payer.
Sec. 417. Border health grants.
Sec. 418. Removing Medicare barrier to health care.
Sec. 419. 100 percent FMAP for medical assistance provided by
urban Indian health centers.
Sec. 420. 100 percent FMAP for medical assistance provided to a
Native Hawaiian through a federally qualified health center or a Native
Hawaiian health care system under the Medicaid program.
Chapter 2—Expansion of Access
Sec. 421. Grants for racial and ethnic approaches to community
health.
Sec. 422. Critical access hospital improvements.
Sec. 423. Establishment of Rural Community Hospital (RCH)
Program.
Sec. 424. Medicare remote monitoring pilot
projects.
Sec. 425. Rural health quality advisory commission and
demonstration projects.
Sec. 426. Rural health care services.
Sec. 427. Community health center collaborative access
expansion.
Sec. 428. Facilitating the provision of telehealth services
across State lines.
Sec. 429. Scoring of preventive health savings.
Sec. 430. Sense of Congress.
Sec. 431. Repeal of requirement for documentation evidencing
citizenship or nationality under the Medicaid program.
Sec. 432. Office of Minority Health in Veterans Health
Administration of Department of Veterans Affairs.
Sec. 433. Access for Native Americans under PPACA.
Title V—Improving Health Outcomes for Women, Children, and
Families
Sec. 501. Grants to promote positive health behaviors in women
and children.
Sec. 502. Removing barriers to health care and nutrition
assistance for children, pregnant women, and lawfully present
individuals.
Sec. 503. Repeal of denial of benefits.
Sec. 504. Birth defects prevention, risk reduction, and
awareness.
Sec. 505. Uniform State maternal mortality review committees on
pregnancy-related deaths.
Sec. 506. Eliminating disparities in maternity health
outcomes.
Sec. 507. Decreasing the risk factors for sudden unexpected
infant death and sudden unexplained death in childhood.
Sec. 508. Reducing teenage pregnancies.
Sec. 509. Gestational diabetes.
Sec. 510. Emergency contraception education and information
programs.
Sec. 511. Supporting healthy adolescent
development.
Title VI—Mental Health
Sec. 601. Coverage of marriage and family therapist services
and mental health counselor services under part
B of the Medicare program.
Sec. 602. Community Mental Health and Addiction Safety Net
Equity Act.
Sec. 603. Minority Fellowship Program.
Sec. 604. Integrated Health Care Demonstration
Program.
Sec. 605. Addressing racial and ethnic minority mental health
disparities research gaps.
Title VII—Addressing High Impact Minority Diseases
Subtitle A—Cancer
Sec. 701. Lung Cancer Mortality Reduction Program.
Sec. 702. Expanding prostate cancer research, outreach,
screening, testing, access, and treatment effectiveness.
Sec. 703. Improved Medicaid coverage for certain breast and
cervical cancer patients in the territories.
Sec. 704. Cancer prevention and treatment demonstration for
ethnic and racial minorities.
Sec. 705. Reducing cancer disparities within
Medicare.
Subtitle B—Viral Hepatitis and Liver Cancer Control and
Prevention
Sec. 711. Viral hepatitis and liver cancer control and
prevention.
Subtitle C—Acquired Bone Marrow Failure Diseases
Sec. 721. Acquired Bone Marrow Failure Diseases.
Subtitle D—Cardiovascular Disease, Chronic Disease, and Other
Disease Issues
Sec. 731. Guidelines for disease screening for minority
patients.
Sec. 732. Coverage of the shingles vaccine under the Medicare
program.
Sec. 733. CDC Wisewoman Screening Program.
Sec. 734. Report on cardiovascular care for women and
minorities.
Sec. 735. Coverage of comprehensive tobacco cessation services
in Medicaid.
Sec. 736. Clinical research funding for oral
health.
Subtitle E—HIV/AIDS
Sec. 741. Findings.
Sec. 742. Addressing HIV/AIDS in communities of
color.
Sec. 743. HIV/AIDS reduction in racial and ethnic minority
communities.
Sec. 744. Repealing ineffective and incomplete abstinence-only
education program.
Sec. 745. Dental Education Loan Repayment Program.
Sec. 746. Report on the implementation of the national HIV/AIDS
strategy.
Sec. 747. Addressing HIV/AIDS in the African-American
community.
Sec. 748. National Black Clergy for the Elimination of
HIV/AIDS.
Sec. 749. Reducing the spread of sexually transmitted
infections in correctional facilities.
Sec. 750. Stop AIDS in prison.
Sec. 751. Services to reduce HIV/AIDS in racial and ethnic
minority communities.
Sec. 752. Health care professionals treating individuals with
HIV/AIDS.
Sec. 753. Report on impact of HIV/AIDS in racial and ethnic
minority communities.
Sec. 754. Study on status of HIV/AIDS epidemic among
African-Americans.
Subtitle F—Diabetes
Sec. 755. Treatment of diabetes in minority
communities.
Sec. 756. Eliminating disparities in diabetes prevention access
and care.
Subtitle G—Lung Disease
Sec. 761. Expansion of the National Asthma Education and
Prevention Program.
Sec. 762. Asthma-related activities of the centers for disease
control and prevention.
Sec. 763. Influenza and pneumonia vaccination
campaign.
Sec. 764. Chronic obstructive pulmonary disease action
plan.
Title VIII—Health Information Technology
Subtitle A—Reducing Health Disparities through Health
IT
Sec. 801. HRSA assistance to health centers for promotion of
Health IT.
Sec. 802. Assessment of impact of Health IT on racial and
ethnic minority communities; outreach and adoption of Health IT in such
communities.
Subtitle B—Modifications to Achieve Parity in Existing
Programs
Sec. 811. Extending funding to strengthen the Health IT
infrastructure in racial and ethnic minority communities.
Sec. 812. Prioritizing regional extension center assistance to
racial and ethnic minority groups.
Sec. 813. Extending competitive grants for the development of
loan programs to facilitate adoption of certified EHR technology by providers
serving racial and ethnic minority groups.
Subtitle C—Additional Research and Studies
Sec. 831. Data collection and assessments conducted in
coordination with minority-serving institutions.
Sec. 832. IOM study and report on privacy concerns of certain
minority populations.
Sec. 833. Study of health information technology in medically
underserved communities.
Subtitle D—Closing Gaps in Funding To Adopt Certified
EHRs
Sec. 841. Application of Medicare HITECH payments to hospitals
in Puerto Rico.
Sec. 842. Extending Medicaid EHR incentive payments to
long-term care facilities and home health agencies.
Sec. 843. Extending physician assistant eligibility for
Medicaid electronic health record incentive payments.
Title IX—Accountability and Evaluation
Sec. 901. Prohibition on discrimination in Federal assisted
health care services and research programs on the basis of sex, race, color,
national origin, sexual orientation, gender identity, or disability
status.
Sec. 902. Treatment of Medicare payments under Title VI of the
Civil Rights Act of 1964.
Sec. 903. Accountability and transparency within the Department
of Health and Human Services.
Sec. 904. United States Commission on Civil Rights.
Sec. 905. Sense of Congress concerning full funding of
activities to eliminate racial and ethnic health disparities.
Sec. 906. GAO and NIH reports.
Title X—Addressing Social Determinants and Improving
Environmental Justice
Sec. 1001. Codification of Executive Order 12898.
Sec. 1002. Implementation of recommendations by Environmental
Protection Agency.
Sec. 1003. Grant program.
Sec. 1004. Additional research on the relationship between the
built environment and the health of community residents.
Sec. 1005. Environment and public health
restoration.
Sec. 1006. Healthy Food Financing Initiative.
Sec. 1007. GAO report on health effects of Deepwater Horizon
oil rig explosion in the Gulf Coast.
3.The Congress finds as follows:
(1)The population of
racial and ethnic minorities is expected to increase over the next few decades,
yet racial and ethnic minorities have the poorest health status and face
substantial cultural, social, and economic barriers to obtaining quality health
care.
(2)Health disparities
are a function of not only access to health care, but also the social
determinants of health—including the environment, the physical structure of
communities, nutrition and food options, educational attainment, employment,
race, ethnicity, sex, geography, language preference, immigrant or citizenship
status, sexual orientation, gender identity, socioeconomic status, or
disability status—that directly and indirectly affect the health, health care,
and wellness of individuals and communities.
(3)By 2020, the
Nation will face a shortage of health care providers and allied health workers
and this shortage disproportionately affects health professional shortage areas
where many racial and ethnic minority populations reside.
(4)All efforts to
reduce health disparities and barriers to quality health services require
better and more consistent data.
(5)A
full range of culturally and linguistically appropriate health care and public
health services must be available and accessible in every community.
(6)Racial and ethnic
minorities and underserved populations must be included early and equitably in
health reform innovations.
(7)Efforts to improve
minority health have been limited by inadequate resources in funding, staffing,
stewardship and accountability. Targeted investments that are focused on
disparities elimination must be made in providing care and services that are
community-based, including prevention and policies addressing social
determinants of health.
(8)In 2011, the
Department of Health and Human Services developed the HHS Action Plan to Reduce
Racial and Ethnic Health Disparities and the National Stakeholder Strategy for
Achieving Health Equity, two strategic plans that represent the country’s first
coordinated roadmap to reducing health disparities. Along with the National
Prevention Strategy and the National Health Care Quality Strategy, these
comprehensive plans will work to increase the number of Americans who are
healthy at every stage of life.
(9)The Department of
Health and Human Services also developed other strategic planning documents to
combat disease disparities with a high impact on minority populations including
the National HIV/AIDS Strategy, and the Action Plan for the Prevention, Care
and Treatment of Viral Hepatitis.
(10)The Patient
Protection and Affordable Care Act, as amended by the Health Care and Education
Reconciliation Act, represents the biggest advancement for minority health in
the last 40 years.
<enum>I</enum><header>Data
collection and reporting</header>
<section id="H555A9A025C024C1D945FCCEC7342BFB4"><enum>101.</enum><header>Amendment to
the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name></header>
<subsection id="H869C3F3FBBF54311BCB5A77D405907C0"><enum>(a)</enum><header>Purpose</header><text display-inline="yes-display-inline">It is the purpose of this section to
promote data collection, analysis, and reporting by race, ethnicity, sex,
primary language, sexual orientation, disability status, gender identity, and
socioeconomic status among federally supported health programs.</text>
</subsection><subsection id="H2B5E3B79CF7E47188754EAD50792915A"><enum>(b)</enum><header>Amendment</header><text>Title
XXXIV of the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name>, as amended by titles II and III of this Act, is further amended
by inserting after subtitle A the following:</text>
<quoted-block act-name="Public Health Service Act" id="HBDB3D7B124B245EDB1ED08D5394FB7C9">
<subtitle id="H86CD0E9EC6B1415CB87CC0D889C12285"><enum>B</enum><header>Strengthening data
collection, improving data analysis, and expanding data reporting</header>
<section id="HDF3886EA96AD4C2197768D3198EB87AD"><enum>3431.</enum><header>Health
disparity data</header>
<subsection id="H7CA52017931F480395E45D636066507E"><enum>(a)</enum><header>Requirements</header>
<paragraph id="H0A55A3FB26AD4BA3B454EE1F81A04472"><enum>(1)</enum><header>In
general</header><text>Each health-related program operated by or that receives
funding or reimbursement, in whole or in part, either directly or indirectly
from the Department of Health and Human Services shall—</text>
<subparagraph id="H1F60C68BC7214FDFB77ABD24C8FE0A19"><enum>(A)</enum><text display-inline="yes-display-inline">require the collection, by the agency or
program involved, of data on the race, ethnicity, sex, primary language, sexual
orientation, disability status, gender identity, and socioeconomic status of
each applicant for and recipient of health-related assistance under such
program—</text>
<clause id="H0604F254C90641F09195E557247EA1E5"><enum>(i)</enum><text>using, at a
minimum, the standards for data collection on race, ethnicity, sex, primary
language, sexual orientation, disability status, gender identity, and
socioeconomic status developed under section 3101;</text>
</clause><clause id="H1C63245730994B9E888EC6B72A0F9193"><enum>(ii)</enum><text>collecting data
for additional population groups if such groups can be aggregated into the
minimum race and ethnicity categories;</text>
</clause><clause id="HF8F47BAE43DD42B5AB1152BF3BEDF4BB"><enum>(iii)</enum><text>additionally
referring, where practicable, to the standards developed by the Institute of
Medicine in <quote>Race, Ethnicity, and Language Data: Standardization for
Health Care Quality Improvement</quote>; and</text>
</clause><clause id="H9B8ECF55DE344BADB9992858C59F0945"><enum>(iv)</enum><text>where
practicable, through self-reporting;</text>
</clause></subparagraph><subparagraph id="H0965D887D2224DDE9213090220C00F50"><enum>(B)</enum><text display-inline="yes-display-inline">with respect to the collection of the data
described in subparagraph (A), for applicants and recipients who are minors,
require communication assistance in speech or writing, and for applicants and
recipients who are otherwise legally incapacitated, require that—</text>
<clause id="H832EC5EAFD7B49FAA1CE177AD007D5B4"><enum>(i)</enum><text>such data be
collected from the parent or legal guardian of such an applicant or recipient;
and</text>
</clause><clause id="H3AA79FE976A649ACA935A0DB66FB10E9"><enum>(ii)</enum><text>the primary
language of the parent or legal guardian of such an applicant or recipient be
collected;</text>
</clause></subparagraph><subparagraph id="HC3899D45AF3D4E478AF24AFC13D86B75"><enum>(C)</enum><text display-inline="yes-display-inline">systematically analyze such data using the
smallest appropriate units of analysis feasible to detect racial and ethnic
disparities, as well as disparities along the lines of primary language, sex,
disability status, sexual orientation, gender identity, and socioeconomic
status in health and health care, and report the results of such analysis to
the Secretary, the Director of the Office for Civil Rights, each agency listed
in section 3101(c)(1), the Committee on Health, Education, Labor, and Pensions
and the Committee on Finance of the Senate, and the Committee on Energy and
Commerce and the Committee on Ways and Means of the House of
Representatives;</text>
</subparagraph><subparagraph id="HBB9B2CD7DB9645AE989F7C42943B7C4F"><enum>(D)</enum><text>provide such data
to the Secretary on at least an annual basis; and</text>
</subparagraph><subparagraph id="H2910B98C70EC41C7A22DB58D6AAEC832"><enum>(E)</enum><text display-inline="yes-display-inline">ensure that the provision of assistance to
an applicant or recipient of assistance is not denied or otherwise adversely
affected because of the failure of the applicant or recipient to provide race,
ethnicity, primary language, sex, sexual orientation, disability status, gender
identity, and socioeconomic status data.</text>
</subparagraph></paragraph><paragraph id="H5CAF8C48A64F47D6B6FC232322C6023A"><enum>(2)</enum><header>Rules of
construction</header><text>Nothing in this subsection shall be construed
to—</text>
<subparagraph id="HCEBFA7D6821B4E53B7B45535689F38EB"><enum>(A)</enum><text>permit the use of
information collected under this subsection in a manner that would adversely
affect any individual providing any such information; and</text>
</subparagraph><subparagraph id="H3CFF39E88CE24FA99DB0E49D21BA3019"><enum>(B)</enum><text>diminish existing
or future requirements on health care providers to collect data.</text>
</subparagraph></paragraph></subsection><subsection id="HFAA4FBAD469548D48F83F57EB1F84733"><enum>(b)</enum><header>Protection of
data</header><text>The Secretary shall ensure (through the promulgation of
regulations or otherwise) that all data collected pursuant to subsection (a)
are protected—</text>
<paragraph id="H5DEACC2587724384A1E34872E98863C3"><enum>(1)</enum><text>under the same
privacy protections as the Secretary applies to other health data under the
regulations promulgated under section 264(c) of the
<act-name parsable-cite="HIPAA">Health Insurance Portability and Accountability
Act of 1996</act-name> (Public Law 104–191; 110 Stat. 2033) relating to the
privacy of individually identifiable health information and other protections;
and</text>
</paragraph><paragraph id="HD3E080F1674146A8B96F28D9C4F9F74E"><enum>(2)</enum><text>from all
inappropriate internal use by any entity that collects, stores, or receives the
data, including use of such data in determinations of eligibility (or continued
eligibility) in health plans, and from other inappropriate uses, as defined by
the Secretary.</text>
</paragraph></subsection><subsection id="HCCCD2CA92DE4448B864CB7E4027346E7"><enum>(c)</enum><header>National plan of
the data Council</header><text display-inline="yes-display-inline">The
Secretary shall develop and implement a national plan to ensure the collection
of data in a culturally appropriate and competent manner, to improve the
collection, analysis, and reporting of racial, ethnic, sex, primary language,
sexual orientation, disability status, gender identity, and socioeconomic
status data at the Federal, State, territorial, tribal, and local levels,
including data to be collected under subsection (a), and to ensure that data
collection activities carried out under this section are in compliance with the
standards developed under section 3101. The Data Council of the Department of
Health and Human Services, in consultation with the National Committee on Vital
Health Statistics, the Office of Minority Health, Office on Women’s Health, and
other appropriate public and private entities, shall make recommendations to
the Secretary concerning the development, implementation, and revision of the
national plan. Such plan shall include recommendations on how to—</text>
<paragraph id="H2AAA0DF7554843DB8D084A03501CD5D9"><enum>(1)</enum><text>implement
subsection (a) while minimizing the cost and administrative burdens of data
collection and reporting;</text>
</paragraph><paragraph id="H4F37159FB3A947BEA9D959F14125E1C5"><enum>(2)</enum><text display-inline="yes-display-inline">expand awareness among Federal agencies,
States, territories, Indian tribes, health providers, health plans, health
insurance issuers, and the general public that data collection, analysis, and
reporting by race, ethnicity, primary language, sexual orientation, disability
status, gender identity, and socioeconomic status is legal and necessary to
assure equity and nondiscrimination in the quality of health care
services;</text>
</paragraph><paragraph id="H1A0770445133410B82E80208A806AB13"><enum>(3)</enum><text display-inline="yes-display-inline">ensure that future patient record systems
have data code sets for racial, ethnic, primary language, sexual orientation,
disability status, gender identity, and socioeconomic status identifiers and
that such identifiers can be retrieved from clinical records, including records
transmitted electronically;</text>
</paragraph><paragraph id="HA3F6F58B67FE4B12AF8116AF0B03EAE6"><enum>(4)</enum><text>improve health and
health care data collection and analysis for more population groups if such
groups can be aggregated into the minimum race and ethnicity categories,
including exploring the feasibility of enhancing collection efforts in States
for racial and ethnic groups that comprise a significant proportion of the
population of the State;</text>
</paragraph><paragraph id="H87FB595D257C4C9FA3AB7BB6FDF732D2"><enum>(5)</enum><text display-inline="yes-display-inline">provide researchers with greater access to
racial, ethnic, primary language, sexual orientation, disability status, gender
identity, and socioeconomic status data, subject to privacy and confidentiality
regulations; and</text>
</paragraph><paragraph id="HE4C9A36B859040EFADB214BE82AB15FC"><enum>(6)</enum><text>safeguard and
prevent the misuse of data collected under subsection (a).</text>
</paragraph></subsection><subsection id="H207A94D8D2B44115B079B613A1B2E638"><enum>(d)</enum><header>Compliance with
Standards</header><text>Data collected under subsection (a) shall be obtained,
maintained, and presented (including for reporting purposes) in accordance with
the 1997 Office of Management and Budget Standards for Maintaining, Collecting,
and Presenting Federal Data on Race and Ethnicity (at a minimum).</text>
</subsection><subsection id="HA8EF45DC1D93446AA36E6A40C6BCC384"><enum>(e)</enum><header>Technical
assistance for the collection and reporting of data</header>
<paragraph id="HCB2E26E7BCC74DFE9FA86C37E180BB9D"><enum>(1)</enum><header>In
general</header><text>The Secretary may, either directly or through grant or
contract, provide technical assistance to enable a health care program or an
entity operating under such program to comply with the requirements of this
section.</text>
</paragraph><paragraph id="H93F90A31EEF444C9A8949DE2ABC8ECF8"><enum>(2)</enum><header>Types of
assistance</header><text>Assistance provided under this subsection may include
assistance to—</text>
<subparagraph id="HEDD3AD897F15429DA0FBCF2BA9C75B48"><enum>(A)</enum><text display-inline="yes-display-inline">enhance or upgrade computer technology that
will facilitate racial, ethnic, primary language, sexual orientation,
disability status, gender identity, and socioeconomic status data collection
and analysis;</text>
</subparagraph><subparagraph id="HEA65ED4B1C464442BB566909B41C67FF"><enum>(B)</enum><text>improve methods
for health data collection and analysis including additional population groups
beyond the Office of Management and Budget categories if such groups can be
aggregated into the minimum race and ethnicity categories;</text>
</subparagraph><subparagraph id="HF3E4EBF2475B416DA3D40AA4C57B20FC"><enum>(C)</enum><text>develop mechanisms
for submitting collected data subject to existing privacy and confidentiality
regulations; and</text>
</subparagraph><subparagraph id="H676FC447849449CA8573DC47AB31E752"><enum>(D)</enum><text display-inline="yes-display-inline">develop educational programs to inform
health insurance issuers, health plans, health providers, health-related
agencies, and the general public that data collection and reporting by race,
ethnicity, primary language, sexual orientation, disability status, gender
identity, and socioeconomic status are legal and essential for eliminating
health and health care disparities.</text>
</subparagraph></paragraph></subsection><subsection id="H12343A27E70942FF83B7115C5E1198BC"><enum>(f)</enum><header>Analysis of
health disparity data</header><text>The Secretary, acting through the Director
of the Agency for Healthcare Research and Quality and in coordination with the
Administrator of the Centers for Medicare & Medicaid Services, shall
provide technical assistance to agencies of the Department of Health and Human
Services in meeting Federal standards for health disparity data collection and
for analysis of racial and ethnic disparities in health and health care in
public programs by—</text>
<paragraph id="HE32D719C03934C099A10803FC50FD78F"><enum>(1)</enum><text>identifying
appropriate quality assurance mechanisms to monitor for health
disparities;</text>
</paragraph><paragraph id="H260E797B0E8F4D888F7AD6D7173BF71A"><enum>(2)</enum><text>specifying the
clinical, diagnostic, or therapeutic measures which should be monitored;</text>
</paragraph><paragraph id="H72C818E3EA664133A8206CEFE4A07FB9"><enum>(3)</enum><text display-inline="yes-display-inline">developing new quality measures relating to
racial and ethnic disparities and their overlap with other disparity factors in
health and health care;</text>
</paragraph><paragraph id="H17F70F70D7BC4863A16A62BB2D2BD6BB"><enum>(4)</enum><text>identifying the
level at which data analysis should be conducted; and</text>
</paragraph><paragraph id="HE8857415882A497289F3B3468616EA55"><enum>(5)</enum><text>sharing data with
external organizations for research and quality improvement purposes.</text>
</paragraph></subsection><subsection id="H584CB799F5F44C6EB6BA302A52AC7B43"><enum>(g)</enum><header>Definition</header><text>In
this section, the term <term>health-related program</term> mean a
program—</text>
<paragraph id="HFECE15FBA1C742CEB1489DC10E18B32D"><enum>(1)</enum><text>under the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 301 et
seq.) that pays for health care and services; and</text>
</paragraph><paragraph id="H60EB629801ED4148A5006E633D045701"><enum>(2)</enum><text>under this Act
that provides Federal financial assistance for health care, biomedical
research, or health services research and or is designed to improve the
public’s health.</text>
</paragraph></subsection><subsection id="HB02C5FB65ADC4E95B2EA133A2E8F6C89"><enum>(h)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through 2017.</text>
</subsection></section><section commented="no" id="H31466ABA6A1745ABBDF72C77D99A2A82"><enum>3432.</enum><header>Provisions
relating to Native Americans</header>
<subsection commented="no" display-inline="no-display-inline" id="HF95F9BBB1DEE4839AF8CB7D90050F298"><enum>(a)</enum><header>Establishment of
epidemiology centers</header><text>The Secretary shall establish an
epidemiology center in each service area to carry out the functions described
in subsection (b). Any new center established after the date of the enactment
of the Health Equity and Accountability Act of 2011 may be operated under a
grant authorized by subsection (d), but funding under such a grant shall not be
divisible.</text>
</subsection><subsection commented="no" id="HB0C66AFD28084645ADADAD9C4217DE9D"><enum>(b)</enum><header>Functions of
centers</header><text>In consultation with and upon the request of Indian
tribes, tribal organizations, and urban indian organizations, each service area
epidemiology center established under this subsection shall, with respect to
such service area—</text>
<paragraph commented="no" id="H533D1ECCBED84D6D993B36158FF5DC35"><enum>(1)</enum><text>collect data
relating to, and monitor progress made toward meeting, each of the health
status objectives of the service, the Indian tribes, tribal organizations, and
urban indian organizations in the service area;</text>
</paragraph><paragraph commented="no" id="H3E6BBC491B074B6D94F07531D7AF2AF8"><enum>(2)</enum><text>evaluate existing
delivery systems, data systems, and other systems that impact the improvement
of Indian health;</text>
</paragraph><paragraph commented="no" id="H8489EEEFB69446DC8E4E029201951836"><enum>(3)</enum><text>assist Indian
tribes, tribal organizations, and urban indian organizations in identifying
their highest priority health status objectives and the services needed to
achieve such objectives, based on epidemiological data;</text>
</paragraph><paragraph commented="no" id="HB85D9E9165874BD4BF1C5564A2E0D88B"><enum>(4)</enum><text>make
recommendations for the targeting of services needed by the populations
served;</text>
</paragraph><paragraph commented="no" id="HB378E84C69754F729BC7C23143A94F60"><enum>(5)</enum><text>make
recommendations to improve health care delivery systems for Indians and urban
Indians;</text>
</paragraph><paragraph commented="no" id="HFC8A972AD443453895B9D3494A2556B2"><enum>(6)</enum><text>provide requested
technical assistance to Indian tribes, tribal organizations, and urban indian
organizations in the development of local health service priorities and
incidence and prevalence rates of disease and other illness in the community;
and</text>
</paragraph><paragraph commented="no" id="H20CA12CFDD8B4200B54259236BF60C15"><enum>(7)</enum><text>provide disease
surveillance and assist Indian tribes, tribal organizations, and urban Indian
organizations to promote public health.</text>
</paragraph></subsection><subsection commented="no" id="H96718C896C71435794C7E54A0954A4A7"><enum>(c)</enum><header>Technical
assistance</header><text>The Director of the Centers for Disease Control and
Prevention shall provide technical assistance to the centers in carrying out
the requirements of this subsection.</text>
</subsection><subsection commented="no" id="H57BFF2A5EED84077BEB90FA852020286"><enum>(d)</enum><header>Grants for
studies</header>
<paragraph commented="no" id="H2FF92E799DB946FD9DF8422E85DE7BFB"><enum>(1)</enum><header>In
general</header><text>The Secretary may make grants to Indian tribes, tribal
organizations, urban indian organizations, and eligible intertribal consortia
to conduct epidemiological studies of Indian communities.</text>
</paragraph><paragraph commented="no" id="H4C31A3514523498C94B414AD40585DBB"><enum>(2)</enum><header>Eligible
intertribal consortia</header><text>An intertribal consortium is eligible to
receive a grant under this subsection if—</text>
<subparagraph commented="no" id="H4889996F5B9D4CDFAABB28C8D77830D0"><enum>(A)</enum><text>the intertribal
consortium is incorporated for the primary purpose of improving Indian health;
and</text>
</subparagraph><subparagraph commented="no" id="H207672999A7A4252A2DFDBED1056A76C"><enum>(B)</enum><text>the intertribal
consortium is representative of the Indian tribes or urban Indian communities
in which the intertribal consortium is located.</text>
</subparagraph></paragraph><paragraph commented="no" id="HF5B9C191E5844A9098575D5394FCE413"><enum>(3)</enum><header>Applications</header><text>An
application for a grant under this subsection shall be submitted in such manner
and at such time as the Secretary shall prescribe.</text>
</paragraph><paragraph commented="no" id="HC6589E59B2DD4D6AAA31E8E50AB1C000"><enum>(4)</enum><header>Requirements</header><text>An
applicant for a grant under this subsection shall—</text>
<subparagraph commented="no" id="H31FE3C26C1664A5F9D6958FAF6C5CA94"><enum>(A)</enum><text>demonstrate the
technical, administrative, and financial expertise necessary to carry out the
functions described in paragraph (5);</text>
</subparagraph><subparagraph commented="no" id="HA7A054BE8EFB4A0AB731C802B7F3FE22"><enum>(B)</enum><text>consult and
cooperate with providers of related health and social services in order to
avoid duplication of existing services; and</text>
</subparagraph><subparagraph commented="no" id="H9A1C84A4535E4DCCAC0B9E873B04C538"><enum>(C)</enum><text>demonstrate
cooperation from Indian tribes or urban Indian organizations in the area to be
served.</text>
</subparagraph></paragraph><paragraph commented="no" id="H1641A6F1091C4A9DA60ADAA7A37AF578"><enum>(5)</enum><header>Use of
funds</header><text>A grant awarded under paragraph (1) may be used—</text>
<subparagraph commented="no" id="HEC0D38888E75430389C8FAAA3D169D44"><enum>(A)</enum><text>to carry out the
functions described in subsection (b);</text>
</subparagraph><subparagraph commented="no" id="H146C470E30724C12AAD65D8FBE9CE090"><enum>(B)</enum><text>to provide
information to and consult with tribal leaders, urban Indian community leaders,
and related health staff on health care and health service management issues;
and</text>
</subparagraph><subparagraph commented="no" id="H5CDCEDD0BF634357AA9ED9D7116D331A"><enum>(C)</enum><text>in collaboration
with Indian tribes, tribal organizations, and urban Indian communities, to
provide the service with information regarding ways to improve the health
status of Indians.</text>
</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H834E4A505B344FBB8DE741E2B39C3FDF"><enum>(e)</enum><header>Access to
information</header><text>An epidemiology center operated by a grantee pursuant
to a grant awarded under subsection (d) shall be treated as a public health
authority for purposes of the Health Insurance Portability and Accountability
Act of 1996 (Public Law 104–191; 110 Stat. 2033), as such entities are defined
in part 164.501 of title 45, Code of Federal Regulations (or a successor
regulation). The Secretary shall grant such grantees access to and use of data,
data sets, monitoring systems, delivery systems, and other protected health
information in the possession of the
Secretary.</text>
</subsection></section></subtitle><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section commented="no" id="H54A41D01C7B940F9AACC2740FFC3F310"><enum>102.</enum><header>Elimination of
prerequisite of direct appropriations for data collection and
analysis</header><text display-inline="no-display-inline">Section 3101 of the
Public Health Service Act (42 U.S.C. 300kk) is amended—</text>
<paragraph commented="no" id="HD19B86B5F6274F00A059B9837DEB9CDF"><enum>(1)</enum><text>by striking
subsection (h); and</text>
</paragraph><paragraph commented="no" id="H29543EADFD1B463B8DE11168A399FBCB"><enum>(2)</enum><text>by redesignating
subsection (i) as subsection (h).</text>
</paragraph></section><section id="HC0B632524F334C268CA257C724679313"><enum>103.</enum><header>Collection of
race and ethnicity data by the Social Security Administration</header><text display-inline="no-display-inline">Part A of title XI of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 1301 et
seq.) is amended by adding at the end the following:</text>
<quoted-block act-name="Social Security Act" id="H54A1BFD59CE94E9091481F2F02250781">
<section id="HD8C193B1721B4556A18481FDF1329C16"><enum>1150C.</enum><header>Collection of
race and ethnicity data by the Social Security Administration</header>
<subsection id="H99981B9495D247BE95D73BCBCD94237F"><enum>(a)</enum><header>Requirement</header><text>The
Commissioner of Social Security, in consultation with the Administrator of the
Centers for Medicare & Medicaid Services, shall—</text>
<paragraph id="HBE0C34162DE14039B05BF566C6329F89"><enum>(1)</enum><text>require the
collection of data on the race, ethnicity, primary language, and disability
status of all applicants for Social Security account numbers or benefits under
title II or part A of title XVIII and all individuals with respect to whom the
Commissioner maintains records of wages and self-employment income in
accordance with reports received by the Commissioner or the Secretary of the
Treasury—</text>
<subparagraph id="H122AE879033549E1A0A37C3316FDD1B2"><enum>(A)</enum><text>using, at a
minimum, the standards for data collection on race, ethnicity, primary
language, and disability status developed under section 3101 of the Public
Health Service Act;</text>
</subparagraph><subparagraph id="H2075E5BD455F45E1B04C4A83BB95C5E4"><enum>(B)</enum><text>where practicable,
collecting data for additional population groups if such groups can be
aggregated into the minimum race and ethnicity categories; and</text>
</subparagraph><subparagraph id="H2AF482076CAE41CE8CFBCB5517092B2C"><enum>(C)</enum><text>additionally
referring, where practicable, to the standards developed by the Institute of
Medicine in <quote>Race, Ethnicity, and Language Data: Standardization for
Health Care Quality Improvement</quote> (released August 31, 2009);</text>
</subparagraph></paragraph><paragraph id="HF327BC534CA94297B629C91A2CC323BC"><enum>(2)</enum><text>with respect to
the collection of the data described in paragraph (1) for applicants who are
under 18 years of age or otherwise legally incapacitated, require that—</text>
<subparagraph id="H89F38769858A429A83B6ADE701BB0440"><enum>(A)</enum><text>such data be
collected from the parent or legal guardian of such an applicant; and</text>
</subparagraph><subparagraph id="H4631AB64ABBC41F1B35329AF647A242A"><enum>(B)</enum><text>the primary
language of the parent or legal guardian of such an applicant or recipient be
used;</text>
</subparagraph></paragraph><paragraph id="H2B0859AC366947A2B3AA3A05F04C3BF1"><enum>(3)</enum><text>require that such
data be uniformly analyzed and reported at least annually to the Commissioner
of Social Security;</text>
</paragraph><paragraph id="H972BDF1667B64B7099EFBFCD71EED939"><enum>(4)</enum><text>be responsible for
storing the data reported under paragraph (3);</text>
</paragraph><paragraph id="H628C8093677744A8AE11FB4854C12DC7"><enum>(5)</enum><text>ensure
transmission to the Centers for Medicare & Medicaid Services and other
Federal health agencies;</text>
</paragraph><paragraph id="H9C31ADFFA37E4E12A6C808E11109E4E2"><enum>(6)</enum><text>provide such data
to the Secretary on at least an annual basis; and</text>
</paragraph><paragraph id="HD610096C83DA40E0A2EFBF8961651953"><enum>(7)</enum><text>ensure that the
provision of assistance to an applicant is not denied or otherwise adversely
affected because of the failure of the applicant to provide race, ethnicity,
primary language, and disability status data.</text>
</paragraph></subsection><subsection id="HD9C55AAA1DF446C486D3993E3C12170F"><enum>(b)</enum><header>Protection of
data</header><text>The Commissioner of Social Security shall ensure (through
the promulgation of regulations or otherwise) that all data collected pursuant
to subsection (a) are protected—</text>
<paragraph id="HC1847B0E6E524D669DC7B45F5444465E"><enum>(1)</enum><text>under the same
privacy protections as the Secretary applies to health data under the
regulations promulgated under section 264(c) of the
<act-name parsable-cite="HIPAA">Health Insurance Portability and Accountability
Act of 1996</act-name> (Public Law 104–191; 110 Stat. 2033) relating to the
privacy of individually identifiable health information and other protections;
and</text>
</paragraph><paragraph id="HA61802A9D5C047DFB0E36BB03936ECE2"><enum>(2)</enum><text>from all
inappropriate internal use by any entity that collects, stores, or receives the
data, including use of such data in determinations of eligibility (or continued
eligibility) in health plans, and from other inappropriate uses, as defined by
the Secretary.</text>
</paragraph></subsection><subsection id="HC8E994B4E8904C55A2D6D664E3E2290A"><enum>(c)</enum><header>Rule of
construction</header><text>Nothing in this section shall be construed to permit
the use of information collected under this section in a manner that would
adversely affect any individual providing any such information.</text>
</subsection><subsection id="H283816F1FBCF4814A334880CCB154F8D"><enum>(d)</enum><header>Technical
assistance</header><text>The Secretary may, either directly or by grant or
contract, provide technical assistance to enable any health entity to comply
with the requirements of this section.</text>
</subsection><subsection id="HCE4637AA42B74ADE8AF6376A2B59B012"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through
2017.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HA7C438D92C334FDDB2A5D4736492B44C"><enum>104.</enum><header>Revision of
HIPAA claims standards</header>
<subsection id="HB83FFA907B3C4AF1B75DA1B2B6C08471"><enum>(a)</enum><header>In
general</header><text>Not later than 1 year after the date of enactment of this
Act, the Secretary of Health and Human Services shall revise the regulations
promulgated under part C of title XI of the <act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 1320d et seq.),
relating to the collection of data on race, ethnicity, and primary language in
a health-related transaction, to require—</text>
<paragraph id="H7C6085C627DF4139B395B569514BCD5C"><enum>(1)</enum><text>the use, at a
minimum, of the standards for data collection on race, ethnicity, primary
language, disability, and sex developed under section 3101 of the Public Health
Service Act (42 U.S.C. 300kk); and</text>
</paragraph><paragraph id="HF0ED5554D5B84CE887150704F1ABFE44"><enum>(2)</enum><text>the designation of
the racial, ethnic, primary language, disability, and sex code sets as required
for claims and enrollment data.</text>
</paragraph></subsection><subsection id="H90D6A49E9DDB48A5A421A7F4F8F3DD21"><enum>(b)</enum><header>Dissemination</header><text>The
Secretary of Health and Human Services shall disseminate the new standards
developed under subsection (a) to all health entities that are subject to the
regulations described in such subsection and provide technical assistance with
respect to the collection of the data involved.</text>
</subsection><subsection id="H5E20E28EB150404AB5F9250B66C38EEA"><enum>(c)</enum><header>Compliance</header><text>The
Secretary of Health and Human Services shall require that health entities
comply with the new standards developed under subsection (a) not later than 2
years after the final promulgation of such standards.</text>
</subsection></section><section id="HA1FDE3705D174618B822E1311ED46856"><enum>105.</enum><header>National Center
for Health Statistics</header><text display-inline="no-display-inline">Section
306(n) of the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name> (42 U.S.C. 242k(n)) is amended—</text>
<paragraph id="HE2B8F3B9D62242B693C1264E152B2A2E"><enum>(1)</enum><text>in paragraph (1),
by striking <quote>2003</quote> and inserting <quote>2016</quote>;</text>
</paragraph><paragraph id="HE3A8ED3F0428476B84815027D2BDEC97"><enum>(2)</enum><text>in paragraph (2),
in the first sentence, by striking <quote>2003</quote> and inserting
<quote>2016</quote>; and</text>
</paragraph><paragraph id="H7ABBF69BF9DD42319A7E87DE332A72F4"><enum>(3)</enum><text>in paragraph (3),
by striking <quote>2002</quote> and inserting <quote>2016</quote>.</text>
</paragraph></section><section id="H7F47B972295A48999D7B18203D1CEEF6"><enum>106.</enum><header>Oversampling of
Asian-Americans, Native Hawaiians, or Pacific Islanders and other
underrepresented groups in Federal health surveys</header><text display-inline="no-display-inline">Part B of title III of the Public Health
Service Act (42 U.S.C. 243 et seq.) is amended by inserting after section 317T
the following:</text>
<quoted-block id="H398C2DDE344647D68D43A33EDF02FB0F" style="OLC">
<section id="HF4C723FB10794985AAE0EC19DB29CA27"><enum>317U.</enum><header>Oversampling
of Asian-Americans, Native Hawaiians, or Pacific Islanders and other
underrepresented groups in Federal health surveys</header>
<subsection id="H0DD98FB23CD940138FDB5B34847982EA"><enum>(a)</enum><header>National
strategy</header>
<paragraph id="HC06485BACC024413BA8F0DB45B3298CD"><enum>(1)</enum><header>In
general</header><text>The Secretary of Health and Human Services, acting
through the Director of the National Center for Health Statistics (referred to
in this section as <term>NCHS</term>) of the Centers for Disease Control and
Prevention, and other agencies within the Department of Health and Human
Services as the Secretary determines appropriate, shall develop and implement
an ongoing and sustainable national strategy for oversampling Asian-Americans,
Native Hawaiians, or Pacific Islanders, and other underrepresented populations
as determined appropriate by the Secretary in Federal health surveys.</text>
</paragraph><paragraph id="H177A8CDEEECF4963A39A1B5DBEA56D0A"><enum>(2)</enum><header>Consultation</header><text>In
developing and implementing a national strategy, as described in paragraph (1),
not later than 180 days after the date of the enactment of the this section,
the Secretary—</text>
<subparagraph id="H7587FFFFBECB4E56B6B7B75DCE96BDD6"><enum>(A)</enum><text>shall consult with
representatives of community groups, nonprofit organizations, nongovernmental
organizations, and government agencies working with Asian-Americans, Native
Hawaiians, or Pacific Islanders, and other underrepresented populations;
and</text>
</subparagraph><subparagraph id="HE853E762EC7A4DA199FA5A763897F894"><enum>(B)</enum><text>may solicit the
participation of representatives from other Federal departments and
agencies.</text>
</subparagraph></paragraph></subsection><subsection id="H734B67BA53E94D878E3C6C94480F9A3D"><enum>(b)</enum><header>Progress
report</header><text>Not later than 2 years after the date of the enactment of
this section, the Secretary shall submit to the Congress a progress report,
which shall include the national strategy described in subsection
(a)(1).</text>
</subsection><subsection id="H2C3BCD32C05D45AC8A071199DBEA2704"><enum>(c)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated such sums as may be necessary for fiscal years 2012 through
2017.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H1361AE31665A400FB6F9F43C5EA17D01"><enum>107.</enum><header>Geo-access
study</header><text display-inline="no-display-inline">The Administrator of the
Substance Abuse and Mental Health Services Administration shall—</text>
<paragraph id="HF15984649CEE45BE875FC14011A623E4"><enum>(1)</enum><text>conduct a study
to—</text>
<subparagraph id="H762E03F8203446A184E18DCDC7D76B3A"><enum>(A)</enum><text>determine which
geographic areas of the United States have shortages of specialty mental health
providers; and</text>
</subparagraph><subparagraph id="HD77DE0FB89A5446CBFFEA8C4851ED865"><enum>(B)</enum><text>assess the
preparedness of speciality mental health providers to deliver culturally and
linguistically appropriate, affordable, and accessible services; and</text>
</subparagraph></paragraph><paragraph id="H4721AD7E682348DB84CACEA1F4AB46C3"><enum>(2)</enum><text>submit a report to
the Congress on the results of such study.</text>
</paragraph></section><section id="H3FC34FB2E88E4527999BDF482A70DA2C"><enum>108.</enum><header>Racial, ethnic,
and linguistic data collected by the Federal Government</header>
<subsection id="H9363515B23C54549A71D3228E79D9544"><enum>(a)</enum><header>Collection;
submission</header><text>Not later than 90 days after the date of the enactment
of this Act, and January 31 of each year thereafter, each department, agency,
and office of the Federal Government that has collected racial, ethnic, or
linguistic data during the preceding calendar year shall submit such data to
the Secretary of Health and Human Services.</text>
</subsection><subsection id="H27E5CC46389C41829117ED9F5B805BB0"><enum>(b)</enum><header>Analysis; public
availability; reporting</header><text>Not later than April 30, 2012, and each
April 30 thereafter, the Secretary of Health and Human Services, acting through
the Director of the National Institute on Minority Health and Health
Disparities and the Deputy Assistant Secretary for Minority Health,
shall—</text>
<paragraph id="H36500FD918D54B2083BE45CCF0398CD3"><enum>(1)</enum><text>collect and
analyze the racial, ethnic, and linguistic data submitted under subsection (a)
for the preceding calendar year;</text>
</paragraph><paragraph id="H48B6849B0EC745EABF78FB084CD13EEA"><enum>(2)</enum><text>make publicly
available such data and the results of such analysis; and</text>
</paragraph><paragraph id="H707CAB1CEB6E4B858D695CE34171CBF7"><enum>(3)</enum><text>submit a report to
the Congress on such data and analysis.</text>
</paragraph></subsection></section><section commented="no" id="HB9A56C2ACF8E4D2DA1D8CFDB9A4EBC94"><enum>109.</enum><header>Data collection
and analysis grants to minority-serving institutions</header>
<subsection id="HCBF6859803564266AACC434A3CB5EC59"><enum>(a)</enum><header>Authority</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services,
acting through the National Institute on Minority Health and Health Disparities
and the Office of Minority Health, may award grants to access and analyze
racial and ethnic, and where possible other health disparity data, to monitor
and report on progress to reduce and eliminate disparities in health and health
care.</text>
</subsection><subsection id="H285A01B3201D4AC3A0B01E2AADD02BB7"><enum>(b)</enum><header>Eligible
entity</header><text>In this section, the term <term>eligible entity</term>
means a historically Black college or university, an Hispanic-serving
institution, a tribal college or university, or an Asian-American, Native
American, or Pacific Islander-serving institution with an accredited public
health, health policy, or health services research program.</text>
</subsection></section><section id="HF4238D49137B45EE8513E0611B101696"><enum>110.</enum><header>Standards for
measuring sexual orientation and gender identity in collection of health
data</header><text display-inline="no-display-inline">Section 3101(a) of the
Public Health Service Act (42 U.S.C. 300kk(a)) is amended—</text>
<paragraph id="HA2BDE66777FF451F826CABFC9289D073"><enum>(1)</enum><text>in paragraph
(1)(A), by inserting <quote>sexual orientation, gender identity,</quote> before
<quote>and disability status</quote>;</text>
</paragraph><paragraph id="HA62C7742A4F04B0791C33ED5FC27238D"><enum>(2)</enum><text>in paragraph
(1)(C), by inserting <quote>sexual orientation, gender identity,</quote> before
<quote>and disability status</quote>; and</text>
</paragraph><paragraph id="H4E2B4547BB6246579AC9BB7C634D007F"><enum>(3)</enum><text>in paragraph
(2)(B), by inserting <quote>sexual orientation, gender identity,</quote> before
<quote>and disability status</quote>.</text>
</paragraph></section><section commented="no" id="H45B22F16ED3D48F2BF70C29FBC8EF096"><enum>111.</enum><header>Optional
collection of health data on immigrants and individuals in their
households</header><text display-inline="no-display-inline">Section 3101(a) of
the Public Health Service Act (42 U.S.C. 300k(a)) is amended by adding at the
end the following:</text>
<quoted-block id="H21AB972AE84B40FCB7F583FEA6727EFE" style="OLC">
<paragraph id="H0267CCE3D4684AE0B71EC19688D2AB26"><enum>(4)</enum><header>Optional uniform
categories</header><text>Not later than 12 months after the date of the
enactment of this paragraph, the Secretary shall—</text>
<subparagraph id="H52F886EBD6AE4DAB92593587916BFCB6"><enum>(A)</enum><text>enter into an
arrangement with the Institute of Medicine of the National Academies (or, if
the Institute of Medicine declines to enter into such an arrangement, another
appropriate entity) to—</text>
<clause id="HF5A0DC23FA274C6391C89EAACD5DACA9"><enum>(i)</enum><text>conduct a study
and develop recommended standards for the optional collection of data on
immigrants, as well as citizens living within immigrant households
(mixed-status households), in order to measure disparities in health coverage,
health care access and quality, and health status among these populations,
and</text>
</clause><clause id="H2F9C229E39024539B15ABD5623ACCF39"><enum>(ii)</enum><text>include ensuing
recommendations and results in a report to the Secretary that includes best
practices to protect the privacy of respondents to the full extent of
applicable law;</text>
</clause></subparagraph><subparagraph id="HC296D9D5865F4AAE900470434C775F3B"><enum>(B)</enum><text>promulgate
standards based on the recommendations and results of subparagraph (A) for the
optional collection of data in major health surveys and research; and</text>
</subparagraph><subparagraph id="HFB2EF1C4B47E46B08C22F8DB1A48F42A"><enum>(C)</enum><text>provide clear
guidance that immigrant and mixed-status households are optional uniform
categories and data concerning such households shall—</text>
<clause id="HD151F0FE5CF0409EAB2EE864B58F909B"><enum>(i)</enum><text>not be required to
be collected by the standards under subparagraph (B);</text>
</clause><clause id="HBE46C337B8B54FEBBEE178C97EB450CD"><enum>(ii)</enum><text>be collected only
in accordance with—</text>
<subclause id="H7F8FC6E2549C4A448D320A1B7C49CD9E"><enum>(I)</enum><text>the
<term>Tri-Agency Guidance</term> issued by the Food and Nutrition Service of
the Department of Agriculture, the Centers for Medicare & Medicaid
Services, the Administration for Children and Families, and Office for Civil
Rights; and</text>
</subclause><subclause id="H6F571A96CFFA4FBAB78BA62F024E1346"><enum>(II)</enum><text>other applicable
law; and</text>
</subclause></clause><clause id="H9E0EF8775CB747FF9B1C574A96E5DF78"><enum>(iii)</enum><text>not be collected
for program application and enrollment processes beyond statutory
requirements.</text>
</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" id="HB454DAF3AF0B458489A9D5442EF34073"><enum>112.</enum><header>Standards for
measuring socioeconomic status in collection of health data</header><text display-inline="no-display-inline">Section 3101(a) of the Public Health Service
Act (42 U.S.C. 300kk(a)), as amended, is amended—</text>
<paragraph id="H6B27D7C1496343879CC59DF40BFFCFA2"><enum>(1)</enum><text>in paragraph
(1)(A), by inserting <quote>socioeconomic status,</quote> before <quote>and
disability status</quote>;</text>
</paragraph><paragraph id="H54B271DF9EE34C8AB86E8AAB893B9CF1"><enum>(2)</enum><text>in paragraph
(1)(C), by inserting <quote>socioeconomic status,</quote> before <quote>and
disability status</quote>; and</text>
</paragraph><paragraph id="H6934E717E9B24AA9B4920D936532C715"><enum>(3)</enum><text>in paragraph
(2)(B), by inserting <quote>socioeconomic status,</quote> before <quote>and
disability status</quote>.</text>
</paragraph></section><section id="H493EC05B93BC4607848782BFD351399E"><enum>113.</enum><header>Safety and
effectiveness of drugs with respect to racial and ethnic background</header>
<subsection id="H22096441FD5A46539F191D5763288A7D"><enum>(a)</enum><header>In
general</header><text>Chapter V of the <act-name parsable-cite="FFDCA">Federal
Food, Drug, and Cosmetic Act</act-name> (21 U.S.C. 351 et seq.) is amended by
adding after section 505D the following:</text>
<quoted-block act-name="Federal Food, Drug, and Cosmetic Act" id="H969A60356ED44F5481977C997816CB80">
<section id="H32BDF40F470A4259AA0A67EA7299F855"><enum>505E.</enum><header>Safety and
effectiveness of drugs with respect to racial and ethnic background</header>
<subsection id="H93CBB4B2B82F4423B6AFD5278FB57C09"><enum>(a)</enum><header>Preapproval
studies</header><text>If there is evidence that there may be a disparity on the
basis of racial or ethnic background as to the safety or effectiveness of a
drug, then—</text>
<paragraph id="HE352377C62BB4BF9B7BEE4D6BDD649C2"><enum>(1)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H4147DCC9DD434866B424CED073667705"><enum>(A)</enum><text>the investigations
required under section 505(b)(1)(A) shall include adequate and well-controlled
investigations of the disparity; or</text>
</subparagraph><subparagraph id="H42BF71B8030D4DA08705B8B945AE1CC2" indent="up1"><enum>(B)</enum><text>the evidence required under section
351(a) of the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name> for approval of a biologics license application for the drug
shall include adequate and well-controlled investigations of the disparity;
and</text>
</subparagraph></paragraph><paragraph id="H64BF263CE65E4C798177609CC8E2A355"><enum>(2)</enum><text>if the
investigations confirm that there is a disparity, the labeling of the drug
shall include appropriate information about the disparity.</text>
</paragraph></subsection><subsection id="H8EBE63A2B6244628A09DB6D9676DFFD1"><enum>(b)</enum><header>Postmarket
studies</header>
<paragraph id="H7A95B971167748F7A2185F973841C2D1"><enum>(1)</enum><header>In
general</header><text>If there is evidence that there may be a disparity on the
basis of racial or ethnic background as to the safety or effectiveness of a
drug for which there is an approved application under section 505 or a license
under section 351 of the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name>, the Secretary may by order require the holder of the approved
application or license to conduct, by a date specified by the Secretary,
postmarketing studies to investigate the disparity.</text>
</paragraph><paragraph id="HE77C0489F0014F1B80B271561E8A8988"><enum>(2)</enum><header>Labeling</header><text>If
the Secretary determines that the postmarket studies confirm that there is a
disparity described in paragraph (1), the labeling of the drug shall include
appropriate information about the disparity.</text>
</paragraph><paragraph id="HD4AC37818FA74CEBBCD83E08311218D3"><enum>(3)</enum><header>Study
design</header><text>The Secretary may specify all aspects of study design,
including the number of studies and study participants, and the other
demographic characteristics of study participants included, in the order
requiring postmarket studies of the drug.</text>
</paragraph><paragraph id="H197475E36E2A4062B8C41506507214B1"><enum>(4)</enum><header>Modifications of
study design</header><text>The Secretary may by order modify any aspect of the
study design as necessary after issuing an order under paragraph (1).</text>
</paragraph><paragraph id="H76B10CB5D90C485EA5E30909B5B96E02"><enum>(5)</enum><header>Study
results</header><text>The results from studies required under paragraph (1)
shall be submitted to the Secretary as supplements to the drug application or
biological license application.</text>
</paragraph></subsection><subsection id="HCE16823183BA49F7AE40ED1AB931F40A"><enum>(c)</enum><header>Disparity</header><text>The
term <term>evidence that there may be a disparity on the basis of racial or
ethnic background for adult and pediatric populations as to the safety or
effectiveness of a drug</term> includes—</text>
<paragraph id="H7E5CB1626CE14FCCBF4E9D749DCE66EE"><enum>(1)</enum><text>evidence that
there is a disparity on the basis of racial or ethnic background as to safety
or effectiveness of a drug in the same chemical class as the drug;</text>
</paragraph><paragraph id="H962EEC3445444C45A5C93372C0F5E124"><enum>(2)</enum><text>evidence that
there is a disparity on the basis of racial or ethnic background in the way the
drug is metabolized; and</text>
</paragraph><paragraph id="H72E7DF5D0AAB4D1681707BE4045F9A9C"><enum>(3)</enum><text>other evidence as
the Secretary may determine.</text>
</paragraph></subsection><subsection id="H10D3F2554A7847F1B47A2F6644C3BCFD"><enum>(d)</enum><header>Applications
under sections <enum-in-header>505(b)(2)</enum-in-header> and
<enum-in-header>505(j)</enum-in-header></header>
<paragraph id="HF3A32801C3EC49AD89AB38F5A4CE3F57"><enum>(1)</enum><header>In
general</header><text>A drug for which an application has been submitted or
approved under section 505(j) shall not be considered ineligible for approval
under that section or misbranded under section 502 on the basis that the
labeling of the drug omits information relating to a disparity on the basis of
racial or ethnic background as to the safety or effectiveness of the drug,
whether derived from investigations or studies required under this section or
derived from other sources, when the omitted information is protected by patent
or by exclusivity under clause (iii) or (iv) of section 505(j)(5)(B).</text>
</paragraph><paragraph id="HCCF52FB8818942F185E563043A1F7259"><enum>(2)</enum><header>Labeling</header><text>Notwithstanding
clauses (iii) and (iv) of section 505(j)(5)(B), the Secretary may require that
the labeling of a drug approved under section 505(j) that omits information
relating to a disparity on the basis of racial or ethnic background as to the
safety or effectiveness of the drug include a statement of any appropriate
contraindications, warnings, or precautions related to the disparity that the
Secretary considers
necessary.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HB9F5CAE5036B4B688CA03441A61DB42A"><enum>(b)</enum><header>Enforcement</header><text>Section
502 of the <act-name parsable-cite="FFDCA">Federal Food, Drug, and Cosmetic
Act</act-name> (21 U.S.C. 352) is amended by adding at the end the
following:</text>
<quoted-block act-name="Federal Food, Drug, and Cosmetic Act" id="H0F550B0448BF458A93D4A236E1BB14AD">
<subsection id="H8ED808B2ED02443296BA30CAF6037533"><enum>(aa)</enum><text display-inline="yes-display-inline">If it is a drug and the holder of the
approved application under section 505 or license under section 351 of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> for the
drug has failed to complete the investigations or studies, or comply with any
other requirement, of section
505E.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H321F65D62BE5460B8FBCC470FE444C71"><enum>(c)</enum><header>Drug
fees</header><text>Section 736(a)(1)(A)(ii) of the
<act-name parsable-cite="FFDCA">Federal Food, Drug, and Cosmetic Act</act-name>
(21 U.S.C. 379h) is amended by adding after <quote>are required</quote> the
following: <quote>, including supplements required under section
505E</quote>.</text>
</subsection></section><section commented="no" id="H9A02BA66BBAD433EB97F9274A559DC96"><enum>114.</enum><header>GAO study on
compliance with existing FDA requirements to present drug and device safety and
effectiveness data by sex, age, and racial and ethnic subgroups</header>
<subsection commented="no" id="H327ED02BED9340F3B8710637AF0C7BD2"><enum>(a)</enum><header>In
general</header><text>The Comptroller General of the United States shall
conduct a study investigating the extent to which sponsors of clinical studies
of investigational drugs, biologics, and devices and sponsors of applications
for approval or licensure of new drugs, biologics, and devices comply with Food
and Drug Administration requirements and follow guidance for presentation of
clinical study safety and effectiveness data by sex, age, and racial and ethnic
subgroups.</text>
</subsection><subsection commented="no" id="HBABF6C8487F641A486E9338625585D48"><enum>(b)</enum><header>Report by
GAO</header>
<paragraph commented="no" id="HA7A1FACF4BBB43238C4BDA588AFBACA5"><enum>(1)</enum><header>Submission</header><text>Not
later than 18 months after the date of the enactment of this Act, the
Comptroller General shall complete the study under subsection (a) and submit to
the Committee on Energy and Commerce of the House of Representatives and the
Committee on Health, Education, Labor, and Pensions of the Senate a report on
the results of such study.</text>
</paragraph><paragraph commented="no" id="H1F3E24E7DF3C4B9E86F96C1223C72226"><enum>(2)</enum><header>Contents</header><text>The
report required by paragraph (1) shall include each of the following:</text>
<subparagraph commented="no" id="H876791D020754450A47E079DD6B8A94F"><enum>(A)</enum><text>An assessment of
the extent to which the Food and Drug Administration assists sponsors in
complying with the requirements and following the guidance referred to in
subsection (a).</text>
</subparagraph><subparagraph commented="no" id="H42601D98C0944049B2783B72076B5A0A"><enum>(B)</enum><text>An assessment of
the effectiveness of the Food and Drug Administration’s enforcement of
compliance with such requirements.</text>
</subparagraph><subparagraph commented="no" id="HE957D19361514BBCB1C64F8EDE7E9DD6"><enum>(C)</enum><text>An analysis of the
extent to which females, racial and ethnic minorities, and adults of all ages
are adequately represented in Food and Drug Administration-approved clinical
studies (at all phases) so that product safety and effectiveness data can be
evaluated by sex, age, and racial and ethnic subgroup.</text>
</subparagraph><subparagraph commented="no" id="H820CBF4C79CE4F4D9040A5DB4B05318F"><enum>(D)</enum><text>An analysis of the
extent to which a summary of product safety and effectiveness data
disaggregated by sex, age, and racial and ethnic subgroup is readily available
to the public in a timely manner by means of the product label or the Food and
Drug Administration’s Web site.</text>
</subparagraph><subparagraph commented="no" id="H6113419799B9406DA553C8F5541C6378"><enum>(E)</enum><text>Recommendations
for—</text>
<clause commented="no" id="HE3E3D6361F2B487BB290B42BE5323C20"><enum>(i)</enum><text>modifications to
the requirements and guidance referred to in subsection (a); or</text>
</clause><clause commented="no" id="H4005F49179AB480FB856C3EC5BF55CE4"><enum>(ii)</enum><text>oversight by the
Food and Drug Administration of such requirements.</text>
</clause></subparagraph></paragraph></subsection><subsection commented="no" id="HD4C25923B4DF45B895C7B0B474EF0FEF"><enum>(c)</enum><header>Report by
HHS</header><text>Not later than 6 months after the submission by the
Comptroller General of the report required under subsection (b), the Secretary
of Health and Human Services shall submit to the Committee on Energy and
Commerce of the House of Representatives and the Committee on Health,
Education, Labor, and Pensions of the Senate a response to that report,
including a corrective action plan as needed to respond to the recommendations
in that report.</text>
</subsection><subsection commented="no" id="HFC0B905A88A848E590BD131B50C321CC"><enum>(d)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph commented="no" id="HA18477352AEF4B67A426144AD2D9A360"><enum>(1)</enum><text>The term
<term>biologic</term> has the meaning given to the term <term>biological
product</term> in section 351(i) of the Public Health Service Act (42 U.S.C.
262(i)).</text>
</paragraph><paragraph commented="no" id="H999B4B14594945139CB9EBAA840895AE"><enum>(2)</enum><text>The term
<term>device</term> has the meaning given to such term in section 201(h) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321(h)).</text>
</paragraph><paragraph commented="no" id="HFC3706A8CFBA492ABCB3838F0E79A2A9"><enum>(3)</enum><text>The term
<term>drug</term> has the meaning given to such term in section 201(g) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321(g)).</text>
</paragraph></subsection></section><section id="HD5DA79B8881B46F5A15ABF5BF274E116"><enum>115.</enum><header>Improving
health data regarding Native Hawaiians and other Pacific
Islanders</header><text display-inline="no-display-inline">Part B of title III
of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by
inserting after section 317U, as added, the following:</text>
<quoted-block display-inline="no-display-inline" id="HE9387FE65A0F4E91A1EF033E39ACE8C1" style="OLC">
<section id="HBBB90D3420034F479237724013FB332A"><enum>317V.</enum><header>Native
Hawaiian and other Pacific Islander health data</header>
<subsection id="HB00F8FDBE9724E3DA6243A6A4E91AD88"><enum>(a)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H921C3DD65B2E46EBB4D4B594FAF0D3EC"><enum>(1)</enum><header>Community
group</header><text>The term <term>community group</term> means a group of
NHOPI who are organized at the community level, and may include a church group,
social service group, national advocacy organization, or cultural group.</text>
</paragraph><paragraph id="H96C3F8B10FD644CA949533880DD2D5B3"><enum>(2)</enum><header>Nonprofit,
nongovernmental organization</header><text>The term <term>nonprofit,
nongovernmental organization</term> means a group of NHOPI with a demonstrated
history of addressing NHOPI issues, including a NHOPI coalition.</text>
</paragraph><paragraph id="H979314DB7E894C7F92043095C214F53E"><enum>(3)</enum><header>Designated
organization</header><text>The term <term>designated organization</term> means
an entity established to represent NHOPI populations and which has statutory
responsibilities to provide, or has community support for providing, health
care.</text>
</paragraph><paragraph id="HDDBF5315A3024F73A9547C8FF24DEE6D"><enum>(4)</enum><header>Government
representatives</header><text>The term <term>government representatives</term>
means representatives from Hawaii, American Samoa, the Commonwealth of the
Northern Mariana Islands, the Federated States of Micronesia, Guam, the
Republic of Palau, and the Republic of the Marshall Islands.</text>
</paragraph><paragraph id="H60DEBE292D39478F8664A09D0FA66FCD"><enum>(5)</enum><header>Native Hawaiians
and other Pacific Islanders (NHOPI)</header><text>The term <term>Native
Hawaiians and Other Pacific Islanders</term> or <term>NHOPI</term> means people
having origins in any of the original peoples of American Samoa, the
Commonwealth of the Northern Mariana Islands, the Federated States of
Micronesia, Guam, Hawaii, the Republic of the Marshall Islands, the Republic of
Palau, or any other Pacific island.</text>
</paragraph><paragraph id="H209E41C3EDA54B4C94F1B166E574DCC6"><enum>(6)</enum><header>Insular
area</header><text>The term <term>insular area</term> means Guam, the
Commonwealth of Northern Mariana Islands, American Samoa, the United States
Virgin Islands, the Federated States of Micronesia, the Republic of Palau, or
the Republic of the Marshall Islands.</text>
</paragraph></subsection><subsection id="HFFCFCB71CB2F41AD819553C14EFA44CD"><enum>(b)</enum><header>National
strategy</header>
<paragraph id="H2CEA2470FCF843F382774E209CFF9B8F"><enum>(1)</enum><header>In
general</header><text>The Secretary, acting through the Director of the
National Center for Health Statistics (referred to in this section as
<term>NCHS</term>) of the Centers for Disease Control and Prevention, and other
agencies within the Department of Health and Human Services as the Secretary
determines appropriate, shall develop and implement an ongoing and sustainable
national strategy for identifying and evaluating the health status and health
care needs of NHOPI populations living in the continental United States,
Hawaii, American Samoa, the Commonwealth of the Northern Mariana Islands, the
Federated States of Micronesia, Guam, the Republic of Palau, and the Republic
of the Marshall Islands.</text>
</paragraph><paragraph id="HBD9FEA947DDF47BCA7CF3846D64E1260"><enum>(2)</enum><header>Consultation</header><text>In
developing and implementing a national strategy, as described in paragraph (1),
not later than 180 days after the date of enactment of the
<short-title>Health Equity and Accountability Act of
2011</short-title>, the Secretary—</text>
<subparagraph id="HD159862BBC0941A9A6E14290658F0B67"><enum>(A)</enum><text>shall consult with
representatives of community groups, designated organizations, and nonprofit,
nongovernmental organizations and with government representatives of NHOPI
populations; and</text>
</subparagraph><subparagraph id="H1A3AB5181338456FB8C83CD85FF114B7"><enum>(B)</enum><text>may solicit the
participation of representatives from other Federal departments.</text>
</subparagraph></paragraph></subsection><subsection id="H353A1CC125254A39B2CDA1FA94E3EE76"><enum>(c)</enum><header>Preliminary
health survey</header>
<paragraph id="HEC5EC677033F4E8AB51597B235668488"><enum>(1)</enum><header>In
general</header><text>The Secretary, acting through the Director of NCHS, shall
conduct a preliminary health survey in order to identify the major areas and
regions in the continental United States, Hawaii, American Samoa, the
Commonwealth of the Northern Mariana Islands, the Federated States of
Micronesia, Guam, the Republic of Palau, and the Republic of the Marshall
Islands in which NHOPI people reside.</text>
</paragraph><paragraph id="HDCAE5D31740A494B998882AAF1B20AD8"><enum>(2)</enum><header>Contents</header><text>The
health survey described in paragraph (1) shall include health data and any
other data the Secretary determines to be—</text>
<subparagraph id="H9A465B22D86F4888A5941628B24E4615"><enum>(A)</enum><text>useful in
determining health status and health care needs; or</text>
</subparagraph><subparagraph id="HF04A0116AF444391B8DA1C456AFBE93D"><enum>(B)</enum><text>required for
developing or implementing a national strategy.</text>
</subparagraph></paragraph><paragraph id="H6DFA1D0B505D4A7E9249A13113948D33"><enum>(3)</enum><header>Methodology</header><text>Methodology
for the health survey described in paragraph (1), including plans for designing
questions, implementation, sampling, and analysis, shall be developed in
consultation with community groups, designated organizations, nonprofit,
nongovernmental organizations, and government representatives of NHOPI
populations, as determined by the Secretary.</text>
</paragraph><paragraph id="HCB6B7B9F2120470E9AF2F24BF4831661"><enum>(4)</enum><header>Timeframe</header><text>The
survey required under this subsection shall be completed not later than 18
months after the date of enactment of the <short-title>Health Equity and Accountability Act of
2011</short-title>.</text>
</paragraph></subsection><subsection id="H76FD8B08CB264D7099F43A0FA08B976B"><enum>(d)</enum><header>Progress
report</header><text>Not later than 2 years after the date of enactment of the
<short-title>Health Equity and Accountability Act of
2011</short-title>, the Secretary shall submit to Congress a progress report,
which shall include the national strategy described in subsection
(b)(1).</text>
</subsection><subsection id="H4192737F4B63497D8D8AC68C32F532D3"><enum>(e)</enum><header>Study and report
by the IOM</header>
<paragraph id="H36BF59AFB3B548CEAE239EDC13CEEA11"><enum>(1)</enum><header>In
general</header><text>The Secretary shall enter into an agreement with the
Institute of Medicine to conduct a study, with input from stakeholders in
insular areas, on the following:</text>
<subparagraph id="H9C271D54D26F435C96C9311A2F93284D"><enum>(A)</enum><text>The standards and
definitions of health care applied to health care systems in insular areas and
the appropriateness of such standards and definitions.</text>
</subparagraph><subparagraph id="H1E256929532944D8901978868C6E8F71"><enum>(B)</enum><text>The status and
performance of health care systems in insular areas, evaluated based upon
standards and definitions, as the Secretary determines.</text>
</subparagraph><subparagraph id="H02B6B7EF1310497AA99A45A812259B9C"><enum>(C)</enum><text>The effectiveness
of donor aid in addressing health care needs and priorities in insular
areas.</text>
</subparagraph><subparagraph id="H40EE71BFF8ED4CBAA5605782C81C72C3"><enum>(D)</enum><text>The progress
toward implementation of recommendations of the Committee on Health Care
Services in the United States—Associated Pacific Basin of the Institute of
Medicine that are set forth in the 1998 report, <term>Pacific Partnerships for
Health: Charting a New Course for the 21st Century</term>.</text>
</subparagraph></paragraph><paragraph id="H43ED72C1A60B4C399D6CDA9CB0B2561A"><enum>(2)</enum><header>Report</header><text>An
agreement described in paragraph (1) shall require the Institute of Medicine to
submit to the Secretary and to Congress, not later than 2 years after the date
of the enactment of the <short-title>Health Equity and
Accountability Act of 2011</short-title>, a report containing a description of
the results of the study conducted under paragraph (1), including the
conclusions and recommendations of the Institute of Medicine for each of the
items described in subparagraphs (A) through (D) of such paragraph.</text>
</paragraph></subsection><subsection id="H9825F74AEC014A17A5D7EB0880B424FF"><enum>(f)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated such sums as may be necessary for fiscal years 2012 through
2017.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><enum>II</enum><header>Culturally and
linguistically appropriate health care</header>
<section commented="no" id="H306E8CE2E3C847EEAA36185BE47A409E"><enum>201.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title, the definitions contained in
section 3400 of the Public Health Service Act, as added by section 202, shall
apply.</text>
</section><section id="H12C09F51E5BB4FEDB66B5BC4DC51552E"><enum>202.</enum><header>Amendment to
the Public Health Service Act</header>
<subsection id="H77CDC3B698754E4DB45FCC8FE63EA7FD"><enum>(a)</enum><header>Findings</header><text display-inline="yes-display-inline">Congress finds the following:</text>
<paragraph id="HCCDA0AB3EEC447F396639521A212BFDC"><enum>(1)</enum><text>Effective
communication is essential to meaningful access to quality physical and mental
health care.</text>
</paragraph><paragraph id="H82713D5F85CC41088CDF426605984C99"><enum>(2)</enum><text display-inline="yes-display-inline">Research indicates that the lack of
appropriate language services creates languages barriers that result in
increased risk of misdiagnosis, ineffective treatment plans and poor health
outcomes for limited-English-proficient individuals and individuals with
communication disabilities such as hearing, vision or print impairments.</text>
</paragraph><paragraph id="H670901EE96D943AA93E4DDECEC6EF3DD"><enum>(3)</enum><text>The number of
limited-English-speaking residents in the United States who speak English less
than very well and, therefore, cannot effectively communicate with health and
social service providers continues to increase significantly.</text>
</paragraph><paragraph id="HF1726D98403A4055A5734871477F8C2B"><enum>(4)</enum><text display-inline="yes-display-inline">The responsibility to fund language
services in the provision of health care and health care-related services to
limited-English-proficient individuals and individuals with communication
disabilities such as hearing, vision, or print impairments is a societal one
that cannot fairly be visited solely upon the health care, public health or
social services community.</text>
</paragraph><paragraph id="H5FF74EDBB9954A6DA7606237EB456C0D"><enum>(5)</enum><text display-inline="yes-display-inline">Title VI of the Civil Rights Act of 1964
prohibits discrimination based on the grounds of race, color or national origin
by any entity receiving Federal financial assistance. In order to avoid
discrimination on the grounds of national origin, all programs or activities
administered by the Department must take adequate steps to ensure that their
policies and procedures do not deny or have the effect of denying
limited-English-proficient individuals with equal access to benefits and
services for which such persons qualify.</text>
</paragraph><paragraph id="HF2A9AE50E6964D60A7DF2B78008E123D"><enum>(6)</enum><text>Linguistic
diversity in the healthcare and health-care-related-services workforce is
important for providing all patients the environment most conducive to positive
health outcomes.</text>
</paragraph><paragraph id="H082D1940C285415AAEB688191D7D44F1"><enum>(7)</enum><text display-inline="yes-display-inline">All members of the health care and
health-care-related-services community should continue to educate their staff
and constituents about limited-English proficient and disability communication
issues and help them identify resources to improve access to quality care for
limited-English-proficient individuals and individuals with communication
disabilities such as hearing, vision, or print impairments.</text>
</paragraph><paragraph id="H21530F3393E04BE1A829F5C8BBE2DB22"><enum>(8)</enum><text display-inline="yes-display-inline">Access to English as a second language and
sign language instructions is an important mechanism for ensuring effective
communication and eliminating the language barriers that impede access to
health care.</text>
</paragraph><paragraph id="HF6E422708BB048359BF70BB4BF267696"><enum>(9)</enum><text>Competent
languages services in health care settings should be available as a matter of
course.</text>
</paragraph></subsection><subsection id="HFD9AA4070B5946BB9DFF8175B17648D3"><enum>(b)</enum><header>Amendment</header><text>The
Public Health Service Act (42 U.S.C. 201 et seq.) is amended by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H872A66E8D6D346D6A993FB391E978611" style="OLC">
<title id="H71DC4F871FAB4C3F9BC7A2931B2B4B3D"><enum>XXXIV</enum><header>CULTURALLY AND
LINGUISTICALLY APPROPRIATE HEALTH CARE</header>
<section id="H96BD30052AC340729C91C8DE6BB81C96"><enum>3400.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title:</text>
<paragraph id="H91AA1D5C94AA4B6DBA78261DDC03B657"><enum>(1)</enum><header>Bilingual</header><text>The
term <term>bilingual</term> with respect to an individual means a person who
has sufficient degree of proficiency in two languages.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H64B9A7097CE64DCB93218B3F70C81DCB"><enum>(2)</enum><header>Community health
worker</header><text>The term <term>community health worker</term> includes a
community health advocate, a lay health educator, a community health
representative, a peer health promoter, a community health outreach worker, and
in Spanish, promotores de salud.</text>
</paragraph><paragraph id="H557E6DD97BDC4F7A94B4448DF759C6C7"><enum>(3)</enum><header>Competent
interpreter services</header><text>The term <term>competent interpreter
services</term> means a translanguage rendition of a spoken or signed message
in which the interpreter comprehends the source language and can communicate
comprehensively in the target language to convey the meaning intended in the
source language. The interpreter knows health and health-related terminology
and provides accurate interpretations by choosing equivalent expressions that
convey the best matching and meaning to the source language and captures, to
the greatest possible extent, all nuances intended in the source
message.</text>
</paragraph><paragraph id="H0478D07F6B954FE8A84DF784ACA0C684"><enum>(4)</enum><header>Competent
translation services</header><text>The term <term>competent translation
services</term> means a translanguage rendition of a written document in which
the translator comprehends the source language and can write or sign
comprehensively in the target language to convey the meaning intended in the
source language. The translator knows health and health-related terminology and
provides accurate translations by choosing equivalent expressions that convey
the best matching and meaning to the source language and captures, to the
greatest possible extent, all nuances intended in the source document.</text>
</paragraph><paragraph id="H6386AD0F62644B60857CB5DDD4238202"><enum>(5)</enum><header>Cultural
competence</header><text>The term <term>cultural competence</term> means a set
of congruent behaviors, attitudes, and policies that come together in a system,
agency, or among professionals that enables effective work in cross-cultural
situations. In the preceding sentence—</text>
<subparagraph id="H06D11DCDC1CE4EA7A3C98FFDCAB9452A"><enum>(A)</enum><text>the term
<term>cultural</term> refers to integrated patterns of human behavior that
include the language, thoughts, communications, actions, customs, beliefs,
values, and institutions of racial, ethnic, religious, or social groups,
including lesbian, gay, bisexual, transgender and intersex individuals, and
individuals with physical and mental disabilities; and</text>
</subparagraph><subparagraph id="HC3DCA736336546468BD34FA819A14A89"><enum>(B)</enum><text>the term
<term>competence</term> implies having the capacity to function effectively as
an individual and an organization within the context of the cultural beliefs,
behaviors, and needs presented by consumers and their communities.</text>
</subparagraph></paragraph><paragraph id="H042ED612C00C46A8A88B6AA5141DBC17"><enum>(6)</enum><header>Effective
communication</header><text>The term <term>effective communication</term> means
an exchange of information between the provider of health care or
health-care-related services and the recipient of such services who is limited
in English proficiency, or has a communication impairment such as a hearing,
vision, or learning impairment, that enables access, understanding, and benefit
from health care or health-care-related services, and full participation in the
development of their treatment plan.</text>
</paragraph><paragraph id="HD1C41B4471A94B42AE10F065493946B9"><enum>(7)</enum><header>Grievance
resolution process</header><text>The term <term>grievance resolution
process</term> means all aspects of dispute resolution including filing
complaints, grievance and appeal procedures, and court action.</text>
</paragraph><paragraph id="HDA6F06EE22134F8E9CAC0E96A6F3E1FB"><enum>(8)</enum><header>Health care
group</header><text>The term <term>health care group</term> means a group of
physicians organized, at least in part, for the purposes of providing
physicians’ services under the Medicaid, SCHIP, or Medicare programs and may
include a hospital and any other individual or entity furnishing services
covered under the Medicaid, SCHIP, or Medicare programs that is affiliated with
the health care group.</text>
</paragraph><paragraph id="H5B05B251AB5A4D2481814B383D561006"><enum>(9)</enum><header>Health-care
services</header><text>The term <term>health care services</term> means
services that address physical as well as mental health conditions in all care
settings.</text>
</paragraph><paragraph id="H4233C0BCAB854D4E899B9FD37DF9642A"><enum>(10)</enum><header>Health
care-related services</header><text display-inline="yes-display-inline">The
term <term>health-care-related services</term> means human or social services
programs or activities that provide access, referrals or links to health
care.</text>
</paragraph><paragraph id="H48B6FD66A4A14A80A4E38CEB269D0864"><enum>(11)</enum><header>Indian
tribe</header><text>The term <term>Indian tribe</term> means any Indian tribe,
band, nation, or other organized group or community, including any Alaska
Native village or group or regional or village corporation as defined in or
established pursuant to the Alaska Native Claims Settlement Act (85 Stat. 688)
(43 U.S.C. 1601 et seq.), which is recognized as eligible for the special
programs and services provided by the United States to Indians because of their
status as Indians.</text>
</paragraph><paragraph id="H98AF53B1609A465684DBB10E4A9DDF61"><enum>(12)</enum><header>Integrated
health care delivery system</header><text>The term <term>integrated health care
delivery system</term> means an interdisciplinary system that brings together
providers from the primary health, mental health, substance use and related
disciplines to improve the health outcomes of an individual. Providers may
include but are not limited to hospitals, health, mental health or substance
use clinics and providers, home health agencies, ambulatory surgery centers,
skilled nursing facilities, rehabilitation centers, and employed, independent
or contracted physicians.</text>
</paragraph><paragraph id="H7998916F8FB0432184B1124794969F42"><enum>(13)</enum><header>Interpreting/interpretation</header><text>The
terms <term>interpreting</term> and <term>interpretation</term> mean the
transmission of a spoken, written, or signed message from one language or
format into another, faithfully, accurately, and objectively.</text>
</paragraph><paragraph id="H0AFA19E7E5D04BAE96B4BD269616993B"><enum>(14)</enum><header>Language
access</header><text display-inline="yes-display-inline">The term
<term>language access</term> means the provision of language services to an LEP
individual or individual with communication disabilities designed to enhance
that individual’s access to, understanding of or benefit from health care or
health-care-related services.</text>
</paragraph><paragraph id="H33EB971FAE3C4D439F47F79BDBA81790"><enum>(15)</enum><header>Language or
language access services</header><text>The term <term>language or language
access services</term> means provision of health care services directly in a
non-English language, interpretation, translation, signage, video recording,
and English or non-English alternative formats.</text>
</paragraph><paragraph id="HEA35C161D6684A8BA53A7876A884B4D0"><enum>(16)</enum><header>LEP</header><text>The
term <term>LEP</term> means limited-English proficient.</text>
</paragraph><paragraph id="H0583BB3AEA7943CEA4CD9B8A33672BA5"><enum>(17)</enum><header>LEP related
data collection activities</header><text>The term <term>LEP related data
collection activities</term> includes identifying, collecting, storing,
tracking, and analyzing primary language data, and information on the methods
used to meet the language access needs of limited-English-proficient
individuals.</text>
</paragraph><paragraph id="H5B2E5B546F504549ACE943892FBB0B60"><enum>(18)</enum><header>Medicare,
Medicaid, and SCHIP</header><text>The terms <term>Medicare</term>,
<term>Medicaid</term>, and <term>SCHIP</term> means the respective programs
under titles XVIII, XIX, and XXI of the Social Security Act.</text>
</paragraph><paragraph id="H7B6F891BB68645C48CE39418937DB3BD"><enum>(19)</enum><header>Minority</header>
<subparagraph id="HC22F8538BA7748309360E764A96B5634"><enum>(A)</enum><header>In
general</header><text>The terms <term>minority</term> and
<term>minorities</term> refer to individuals from a minority group.</text>
</subparagraph><subparagraph id="H9B219ABA13D34F969837AD62AAF6009E"><enum>(B)</enum><header>Populations</header><text>The
term <term>minority</term>, with respect to populations, refers to racial and
ethnic minority groups.</text>
</subparagraph></paragraph><paragraph id="H3AF2CAAFED154402831860AA0AA8AB98"><enum>(20)</enum><header>Minority
group</header><text>The term <term>minority group</term> has the meaning given
the term <term>racial and ethnic minority group</term>.</text>
</paragraph><paragraph id="H0705D2DBB933469FBE96ACFC7C13A918"><enum>(21)</enum><header>Racial and
ethnic minority group</header><text>The term <term>racial and ethnic minority
group</term> means American Indians and Alaska Natives, African-Americans
(including Caribbean Blacks, Africans and other Blacks), Asian-Americans,
Hispanics (including Latinos), and Native Hawaiians and other Pacific
Islanders.</text>
</paragraph><paragraph id="H799AF973B3A54225A5CA405FC6431DCC"><enum>(22)</enum><header>On-site
interpreting/interpretation</header><text display-inline="yes-display-inline">The term <term>on-site
interpreting/interpretation</term> means a method of interpreting or
interpretation for which the interpreter is in the physical presence of the
provider of health care or health-care-related services and the recipient of
such services who is limited in English proficiency or has a communication
impairment such as hearing, vision, or learning.</text>
</paragraph><paragraph id="HFBEA2E21B8DC49A1BB8C157276D17E1D"><enum>(23)</enum><header>Secretary</header><text>The
term <term>Secretary</term> means the Secretary of Health and Human
Services.</text>
</paragraph><paragraph id="H6703432CA0514E1D8F21B080875423A7"><enum>(24)</enum><header>Sight
translation</header><text>The term <term>sight translation</term> means the
transmission of a written message in one language into a spoken or signed
message in another language, or an alternative format in English or another
language.</text>
</paragraph><paragraph id="H457304BDFB564F49B56DAE850EBE90D3"><enum>(25)</enum><header>State</header><text>The
term <term>State</term> means each of the several States, the District of
Columbia, the Commonwealth of Puerto Rico, the Indian tribes, the United States
Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern
Mariana Islands.</text>
</paragraph><paragraph id="H3C1B17E0715143CBAFBA23446E09AEA6"><enum>(26)</enum><header>Telephonic
interpretation</header><text>The term <term>telephonic interpretation</term>
(also known as over the phone interpretation or OPI) means a method of
interpreting/interpretation for which the interpreter is not in the physical
presence of the provider of health care or related services and the
limited-English-proficient recipient of such services but is connected via
telephone.</text>
</paragraph><paragraph id="H99DACDCA556B4C7085512FDA9D2002B8"><enum>(27)</enum><header>Translation</header><text>The
term <term>translation</term> means the transmission of a written message in
one language into a written or signed message in another language, and includes
translation into another language or alternative format, such as large print
font, Braille, audio recording, or CD.</text>
</paragraph><paragraph id="H0E1A0E21E56D4D2A95B2E9BD1AA7A55E"><enum>(28)</enum><header>Video
interpretation</header><text>The term <term>video interpretation</term> means a
method of interpreting/interpretation for which the interpreter is not in the
physical presence of the provider of health care or related services and the
limited-English-proficient recipient of such services but is connected via a
video hook-up that includes both audio and video transmission.</text>
</paragraph><paragraph id="HB90087929A664184911012B722519CCA"><enum>(29)</enum><header>Vital
document</header><text>The term <term>vital document</term> includes but is not
limited to applications for government programs that provide health care
services, medical or financial consent forms, financial assistance documents,
letters containing important information regarding patient instructions (such
as prescriptions, referrals to other providers, and discharge plans) and
participation in a program (such as a Medicaid managed care program), notices
pertaining to the reduction, denial, or termination of services or benefits,
notices of the right to appeal such actions, and notices advising
limited-English-proficient individuals and individuals with communication
disabilities of the availability of free language services, alternative
formats, and other outreach materials.</text>
</paragraph></section><section id="H17F29DC997F34779A54164FD57958C6B"><enum>3401.</enum><header>Improving
access to services for individuals with limited English proficiency</header>
<subsection id="HA0034E249E18419B99632F66EF03F2A3"><enum>(a)</enum><header>Purpose</header><text>As
provided in Executive Order 13166, it is the purpose of this section—</text>
<paragraph id="HE6B318CCF06C4EB7BA9D49610F2AF6BC"><enum>(1)</enum><text>to improve Federal
agency performance regarding access to federally conducted and federally
assisted programs and activities for individuals who are limited in their
English proficiency;</text>
</paragraph><paragraph id="HD6DA02AFA465421E8C1CD28F55A54896"><enum>(2)</enum><text display-inline="yes-display-inline">to require each Federal agency to examine
the services it provides and develop and implement a system by which
limited-English-proficient individuals can obtain cultural competence and
meaningful access to those services consistent with, and without substantially
burdening, the fundamental mission of the agency;</text>
</paragraph><paragraph id="HD2D614D969464759BAEB9297D8C162D3"><enum>(3)</enum><text display-inline="yes-display-inline">to require each Federal agency to ensure
that recipients of Federal financial assistance provide cultural competence and
meaningful access to their limited-English-proficient applicants and
beneficiaries;</text>
</paragraph><paragraph id="H45476CE4FBBC414E939AE7B73A400D21"><enum>(4)</enum><text display-inline="yes-display-inline">to ensure that recipients of Federal
financial assistance take reasonable steps, consistent with the guidelines set
forth in the Limited English Proficient Guidance of the Department of Justice
(as issued on June 12, 2002), to ensure cultural competence and meaningful
access to their programs and activities by limited-English-proficient
individuals; and</text>
</paragraph><paragraph id="H15CBDF9C657E4893A6C17B5403B1E328"><enum>(5)</enum><text>to ensure
compliance with title VI of the Civil Rights Act of 1964 and that health care
providers and organizations do not discriminate in the provision of
services.</text>
</paragraph></subsection><subsection id="H353A1B76F2B044569CC49652A8A3485C"><enum>(b)</enum><header>Federally
conducted programs and activities</header>
<paragraph id="H3C5B7BD104E24AD7BE0CADAABFDBC5C6"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">Not later than 120
days after the date of enactment of this title, each Federal agency that
carries out health-care-related activities shall prepare a plan to improve
access cultural competence to the federally conducted, health-are-related
programs and activities of the agency by limited-English-proficient
individuals. Each Federal agency must ensure that such plan is fully
implemented not later than one year after the date of enactment of this
Act.</text>
</paragraph><paragraph id="HFB50D864BFE241509BFA8A69C2E0203F"><enum>(2)</enum><header>Plan
requirement</header><text>Each plan under paragraph (1) shall include—</text>
<subparagraph id="H653DF5FF5BD547D08F7C9B6BEDB5AB1F"><enum>(A)</enum><text>the steps the
agency will take to ensure that limited-English-proficient individuals have
access to the agency’s federally conducted health care and health-care-related
programs and activities;</text>
</subparagraph><subparagraph id="H93D95D0A6D824F5DB1CB30FA837CADFE"><enum>(B)</enum><text display-inline="yes-display-inline">the policies and procedures for
identifying, assessing, and meeting the language needs and cultural competence
needs of its limited-English-proficient beneficiaries served by federally
conducted programs and activities;</text>
</subparagraph><subparagraph id="H6FD90344AEC44D728B89DED719B3FBE9"><enum>(C)</enum><text display-inline="yes-display-inline">the steps the agency will take for its
federally conducted programs and activities to improve cultural competence to
provide a range of language assistance options, notice to
limited-English-proficient individuals of the right to competent language
services, periodic training of staff, monitoring and quality assessment of the
language services and, in appropriate circumstances, the translation of written
materials;</text>
</subparagraph><subparagraph id="H20F37575ABFF4C7D99051527D5E31ECD"><enum>(D)</enum><text>the steps the
agency will take to ensure that applications, forms, and other relevant
documents for its federally conducted programs and activities are competently
translated into the primary language of a limited-English-proficient client
where such materials are needed to improve access to federally conducted and
federally assisted programs and activities for such a
limited-English-proficient individual; and</text>
</subparagraph><subparagraph id="H5ADBF40983664561917B99FF624CDDBB"><enum>(E)</enum><text display-inline="yes-display-inline">the resources the agency will provide to
improve cultural competence to assist recipients of Federal funds to improve
access to health care or health-care-related programs and activities for
limited-English-proficient individuals.</text>
</subparagraph><continuation-text continuation-text-level="paragraph">Each
agency shall send a copy of such plan to the Department of Justice, which shall
serve as the central repository of the Agency’s plans.</continuation-text></paragraph></subsection><subsection id="HBD50FE32E56847E38B6FA959FB42FE8B"><enum>(c)</enum><header>Federally
assisted programs and activities</header>
<paragraph id="H49E384F45A4E4F29ADE646BD3E4E6D8D"><enum>(1)</enum><header>In
general</header><text>Not later than 120 days after the date of enactment of
this title, each Federal agency providing health-care-related Federal financial
assistance shall ensure that the guidance for recipients of Federal financial
assistance developed by the agency to ensure compliance with title VI of the
Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.) is specifically tailored to
the recipients of such assistance. Each agency shall send a copy of such
guidance to the Department of Justice which shall serve as the central
repository of the Agency’s plans. After approval by the Department of Justice,
each agency shall publish its guidance document in the Federal Register for
public comment.</text>
</paragraph><paragraph id="HA06369E6583A4F66BACBA5F21FFE2A88"><enum>(2)</enum><header>Requirements</header><text>The
agency-specific guidance developed under paragraph (1) shall take into account
the types of health care services provided by the recipients, the individuals
served by the recipients, and other factors set out in such standards.</text>
</paragraph><paragraph id="HEC9DDF67FA1B4E9DBF332A66F9A5C77D"><enum>(3)</enum><header>Existing
guidances</header><text>A Federal agency that has developed a guidance for
purposes of title VI of the Civil Rights Act of 1964 shall examine such
existing guidance, as well as the programs and activities to which such
guidance applies, to determine if modification of such guidance is necessary to
comply with this subsection.</text>
</paragraph><paragraph id="H67E40840EABE4EFB8C50C8C718664FB2"><enum>(4)</enum><header>Consultation</header><text>Each
Federal agency shall consult with the Department of Justice in establishing the
guidances under this subsection.</text>
</paragraph></subsection><subsection id="HEC2186FD6212499CB32C126AF929236A"><enum>(d)</enum><header>Consultations</header>
<paragraph id="HCFCCCE56841E4288BA8077DCC2D8EF0B"><enum>(1)</enum><header>In
general</header><text>In carrying out this section, each Federal agency that
carriers out health care and health-care-related activities shall ensure that
stakeholders, such as limited-English-proficient individuals and their
representative organizations, recipients of Federal assistance, and other
appropriate individuals or entities, have an adequate opportunity to provide
input with respect to the actions of the agency.</text>
</paragraph><paragraph id="HD6194AA52180473696F96C2C003D80F3"><enum>(2)</enum><header>Evaluation</header><text>Each
Federal agency described in paragraph (1) shall evaluate the—</text>
<subparagraph id="HEE43027B33924110B0E5C0616C08DED6"><enum>(A)</enum><text>particular needs
of the limited-English-proficient individuals served by the agency;</text>
</subparagraph><subparagraph id="HD76F873DCA0E4FCD9F09713401713131"><enum>(B)</enum><text>particular needs
of the limited-English-proficient individuals served by the agency’s recipients
of Federal financial assistance; and</text>
</subparagraph><subparagraph id="HCCD1B1E96F3F4A02BAC5DB2BCF7EA3CC"><enum>(C)</enum><text>burdens of
compliance with the agency guidance and this section for the agency and its
recipients.</text>
</subparagraph></paragraph></subsection></section><section id="HAA0F1E1DD9B147608B818C57B1313C58"><enum>3402.</enum><header>National
standards for culturally and linguistically appropriate services in health
care</header><text display-inline="no-display-inline">Recipients of Federal
financial assistance from the Secretary shall, to the extent reasonable and
practicable after applying the 4-factor analysis described in title V of the
Guidance to Federal Financial Assistance Recipients Regarding Title VI
Prohibition Against National Origin Discrimination Affecting Limited-English
Proficient Persons (June 12, 2002)—</text>
<paragraph id="H2C891F780AA84B3F825FBB6BE82037B2"><enum>(1)</enum><text>implement
strategies to recruit, retain, and promote individuals at all levels of the
organization to maintain a diverse staff and leadership that can provide
culturally and linguistically appropriate health care to patient populations of
the service area of the organization;</text>
</paragraph><paragraph id="HD683D0F341FE42C79196F0B4DC85E356"><enum>(2)</enum><text>ensure that staff
at all levels and across all disciplines of the organization receive ongoing
education and training in culturally and linguistically appropriate service
delivery;</text>
</paragraph><paragraph id="H113D9600D563426688F3D5C958C6D674"><enum>(3)</enum><text>offer and provide
language assistance services, including trained bilingual staff and interpreter
services, at no cost to each patient with limited-English proficiency at all
points of contact, in a timely manner during all hours of operation;</text>
</paragraph><paragraph id="H31AD1BF1CA3D494FBE4CAE3E98E33F52"><enum>(4)</enum><text display-inline="yes-display-inline">notify patients, in a culturally
appropriate manner, of their right to receive language assistance services in
their primary language;</text>
</paragraph><paragraph id="H9B91738126694EB484766035B6FB5115"><enum>(5)</enum><text>ensure the
competence of language assistance provided to limited-English-proficient
patients by interpreters and bilingual staff, and ensure that family,
particularly minor children, and friends are not used to provide interpretation
services—</text>
<subparagraph id="H0F44313D629A47B79B856FD67E334DEB"><enum>(A)</enum><text>except in case of
emergency; or</text>
</subparagraph><subparagraph id="HE06B914BF980459ABA3F399130E508CA"><enum>(B)</enum><text>except on request
of the patient, who has been informed in his or her preferred language of the
availability of free interpretation services;</text>
</subparagraph></paragraph><paragraph id="H7D9860F9602B4CAFA064693AE215E7C8"><enum>(6)</enum><text>make available
easily understood patient-related materials, if such materials exist for
non-limited-English-proficient patients, including information or notices about
termination of benefits and post signage in the languages of the commonly
encountered groups or groups represented in the service area of the
organization;</text>
</paragraph><paragraph id="HB79835F23C3742239D797AD11D0C706B"><enum>(7)</enum><text>develop and
implement clear goals, policies, operational plans, and management
accountability and oversight mechanisms to provide culturally and
linguistically appropriate services;</text>
</paragraph><paragraph id="HCC85DC54A72E4136A90B7F76CEF3D1C7"><enum>(8)</enum><text>conduct initial
and ongoing organizational assessments of culturally and linguistically
appropriate services-related activities and integrate valid linguistic,
competence-related measures into the internal audits, performance improvement
programs, patient satisfaction assessments, and outcomes-based evaluations of
the organization;</text>
</paragraph><paragraph id="H05D22D1946AE4FB29765F9E26E014B3F"><enum>(9)</enum><text>ensure that,
consistent with the privacy protections provided for under the regulations
promulgated under section 264(c) of the Health Insurance Portability and
Accountability Act of 1996 (42 U.S.C. 1320d–2 note)—</text>
<subparagraph id="H2C807056301F40EF85AC5E81B9B6F528"><enum>(A)</enum><text display-inline="yes-display-inline">data on the individual patient’s race,
ethnicity, primary language, alternative format preferences, and policy
modification needs are collected in health records, integrated into the
organization’s management information systems, and periodically updated;
and</text>
</subparagraph><subparagraph id="HA8319F8696614B4BB5E850484DB874AF"><enum>(B)</enum><text>if the patient is
a minor or is incapacitated, the primary language of the parent or legal
guardian is collected;</text>
</subparagraph></paragraph><paragraph id="H9A1863664BE34BFD93328FBB8AD32598"><enum>(10)</enum><text>maintain a
current demographic, cultural, and epidemiological profile of the community as
well as a needs assessment to accurately plan for and implement services that
respond to the cultural and linguistic characteristics of the service area of
the organization;</text>
</paragraph><paragraph id="HD70ED2A653104F7C88DA52A85F32CAAA"><enum>(11)</enum><text>develop
participatory, collaborative partnerships with communities and utilize a
variety of formal and informal mechanisms to facilitate community and patient
involvement in designing and implementing culturally and linguistically
appropriate services-related activities;</text>
</paragraph><paragraph id="H24DD467FBED04BEE8D75AEF248162168"><enum>(12)</enum><text>ensure that
conflict and grievance resolution processes are culturally and linguistically
sensitive and capable of identifying, preventing, and resolving cross-cultural
conflicts or complaints by patients;</text>
</paragraph><paragraph id="HB473E0AA43934D6FBC8C241B24983B30"><enum>(13)</enum><text>regularly make
available to the public information about their progress and successful
innovations in implementing the standards under this section and provide public
notice in their communities about the availability of this information;
and</text>
</paragraph><paragraph id="H23364BB69E6046EC825DA084D75FAAC9"><enum>(14)</enum><text>if requested,
regularly make available to the head of each Federal entity from which Federal
funds are received, information about their progress and successful innovations
in implementing the standards under this section as required by the head of
such entity.</text>
</paragraph></section><section id="H5B5BE4CDD395409DA627C85DA45F933E"><enum>3403.</enum><header>Robert T.
Matsui Center for Cultural and Linguistic Competence in Health Care</header>
<subsection id="H5F62C6D6CAD5413DB468D7F29FF26E91"><enum>(a)</enum><header>Establishment</header><text>The
Secretary, acting through the Director of the Agency for Healthcare Research
and Quality, shall establish and support a center to be known as the
<term>Robert T. Matsui Center for Cultural and Linguistic Competence in Health
Care</term> (referred to in this section as the <term>Center</term>) to carry
out the following activities:</text>
<paragraph id="HBCF064FC1500460585C07D59DC1B21E0"><enum>(1)</enum><header>Interpretation
services</header><text>The Center shall provide resources via the Internet to
identify and link health care providers to competent interpreter and
translation services.</text>
</paragraph><paragraph id="H1DF5785707574661BE608696B590CCF3"><enum>(2)</enum><header>Translation of
written material</header>
<subparagraph id="HA0E1618811FA40F285C90F952E63404E"><enum>(A)</enum><text>The Center shall
provide, directly or through contract, vital documents from competent
translation services for providers of health care and health-care-related
services at no cost to such providers. Materials may be submitted for
translation into non-English languages. Translation services shall be provided
in a timely and reasonable manner and in accordance with the guidelines and
standards set forth in subsection (c) when such standards become available. The
quality of such translation services shall be monitored and reported
publicly.</text>
</subparagraph><subparagraph id="H5192974C201E46E1A394CEEA03B1E19D"><enum>(B)</enum><text>For each form
developed or revised by the Secretary that will be used by LEP individuals in
health care or health-care-related settings, the Center shall translate the
form, at a minimum, into the top 15 non-English languages in the United States
according to the most recent data from the American Community Survey or its
replacement. The translation must be completed within 45 days of the Secretary
receiving final approval of the form from the Office of Management and
Budget.</text>
</subparagraph></paragraph><paragraph id="HD38D65A14E2A413F84901A0F6C936C4C"><enum>(3)</enum><header>Toll-free
customer service telephone number</header><text display-inline="yes-display-inline">The Center shall provide, through a
toll-free number, a customer service line for LEP individuals—</text>
<subparagraph id="H319060FBBD8F408B8391413453DDBC3A"><enum>(A)</enum><text>to obtain
information about federally conducted or funded health programs, including
Medicare, Medicaid, and SCHIP;</text>
</subparagraph><subparagraph id="HFCF2BD42C88E41349CB6E76AB1E23F80"><enum>(B)</enum><text>to obtain
assistance with applying for or accessing these programs and understanding
Federal notices written in English; and</text>
</subparagraph><subparagraph id="H536D43D1D2454B919128FFD87B504AC4"><enum>(C)</enum><text>to learn how to
access language services.</text>
</subparagraph></paragraph><paragraph id="HD9165DA05D1E40A8A2A60BE7D737DE88"><enum>(4)</enum><header>Health
information clearinghouse</header>
<subparagraph id="H55832D882F354E999B33DB9FE0936020"><enum>(A)</enum><header>In
general</header><text>The Center shall develop and maintain an information
clearinghouse to facilitate the provision of language services by providers of
health care and health-care-related services to reduce medical errors, improve
medical outcomes, to improve cultural competence, reduce health care costs
caused by miscommunication with individuals with limited-English proficiency,
and reduce or eliminate the duplication of effort to translate materials. The
clearinghouse shall make such information available on the Internet and in
print. Such information shall include the information described in the
succeeding provisions of this paragraph.</text>
</subparagraph><subparagraph id="H0CB9D26B37804048A597A0D0D7347BEB"><enum>(B)</enum><header>Document
templates</header><text>The Center shall collect and evaluate for accuracy,
develop, and make available templates for standard documents that are necessary
for patients and consumers to access and make educated decisions about their
health care, including the following:</text>
<clause id="H1D692A99A14F4F6F9D155C60476743C6"><enum>(i)</enum><text>Administrative and
legal documents, including—</text>
<subclause id="HA5DBB25391844CC0882E97EF14F0DB72"><enum>(I)</enum><text>intake
forms;</text>
</subclause><subclause id="HF4B6636E11C247ADAEEC04B492A67DA5"><enum>(II)</enum><text>Medicare,
Medicaid, and SCHIP forms, including eligibility information;</text>
</subclause><subclause id="H9B029C3E003147208A24104190B14ED4"><enum>(III)</enum><text display-inline="yes-display-inline">forms informing patient of HIPAA compliance
and consent; and</text>
</subclause><subclause id="H7058F9CC874A490DB624127C634B72B2"><enum>(IV)</enum><text>documents
concerning informed consent, advanced directives, and waivers of rights.</text>
</subclause></clause><clause id="H1E089153431749CEBB833E600B587DF8"><enum>(ii)</enum><text>Clinical
information, such as how to take medications, how to prevent transmission of a
contagious disease, and other prevention and treatment instructions.</text>
</clause><clause id="H527E2D3868244872B733F32389996E89"><enum>(iii)</enum><text>Public health,
patient education, and outreach materials, such as immunization notices, health
warnings, or screening notices.</text>
</clause><clause id="H98649BC5E80B49189F9209256B8A3FF3"><enum>(iv)</enum><text>Additional health
or health-care-related materials as determined appropriate by the Director of
the Center.</text>
</clause></subparagraph><subparagraph id="HA00C5B2FA5C84FC7A9EFFD688F10DF85"><enum>(C)</enum><header>Structure of
forms</header><text>The operating the clearinghouse, the Center shall—</text>
<clause id="H9C66D93574D24C7990D6D857CF031861"><enum>(i)</enum><text>ensure that the
documents posted in English and non-English languages are culturally
appropriate;</text>
</clause><clause id="HAC6F6183441D47B0A8EF2144FA7C3D0E"><enum>(ii)</enum><text>allow public
review of the documents before dissemination in order to ensure that the
documents are understandable and culturally appropriate for the target
populations;</text>
</clause><clause id="H4DB1CCFA4B704A16B378EDAF3C512031"><enum>(iii)</enum><text>allow health
care providers to customize the documents for their use;</text>
</clause><clause id="H3E65A7054FF942D3AE32D3A13C9C9A89"><enum>(iv)</enum><text>facilitate access
to these documents;</text>
</clause><clause id="HD4B9F193CF9C4F158C54ACBD6E84FD58"><enum>(v)</enum><text>provide technical
assistance with respect to the access and use of such information; and</text>
</clause><clause id="HB4735C23E22049A09CA09761CA1C64F8"><enum>(vi)</enum><text>carry out any
other activities the Secretary determines to be useful to fulfill the purposes
of the clearinghouse.</text>
</clause></subparagraph><subparagraph id="HAF518B423A9E40DFA5B80BC9C69A3583"><enum>(D)</enum><header>Language
assistance programs</header><text>The Center shall provide for the collection
and dissemination of information on current examples of language assistance
programs and strategies to improve language services for LEP individuals,
including case studies using de-identified patient information, program
summaries, and program evaluations.</text>
</subparagraph><subparagraph id="H006C0257418D48E98028C2EA5726D651"><enum>(E)</enum><header>Cultural and
linguistic competence materials</header><text>The Center shall provide
information relating to culturally and linguistically competent health care for
minority populations residing in the United States to all health care providers
and health-care-related services at no cost. Such information shall
include—</text>
<clause id="H6BD1BFB841F24AF98B7F9036089338CE"><enum>(i)</enum><text>tenets of
culturally and linguistically competent care;</text>
</clause><clause id="HBEF09675DCDC4B6595EABF3815464339"><enum>(ii)</enum><text>cultural and
linguistic competence self-assessment tools;</text>
</clause><clause id="HA082A5210F56439BB2AC4E520E31F88D"><enum>(iii)</enum><text>cultural and
linguistic competence training tools;</text>
</clause><clause id="HB6775BC0D96D485BA4061B67B7A44628"><enum>(iv)</enum><text>strategic plans
to increase cultural and linguistic competence in different types of providers
of health care and health-care-related services, including regional
collaborations among health care organizations; and</text>
</clause><clause id="H77B85924F6CD4537BB90D5095A9F5131"><enum>(v)</enum><text>cultural and
linguistic competence information for educators, practitioners, and
researchers.</text>
</clause></subparagraph><subparagraph id="HAD42AD65AF49490E93C405CD5E7ABDAF"><enum>(F)</enum><header>Information
about progress</header><text>The Center shall regularly collect and make
publicly available information about the progress of entities receiving grants
under section 3404 regarding successful innovations in implementing the
obligations under this subsection and provide public notice in the entities’
communities about the availability of this information;</text>
</subparagraph></paragraph></subsection><subsection id="H668664EFC98F4AE0BAA0DB20EFF90AA2"><enum>(b)</enum><header>Director</header><text>The
Center shall be headed by a Director who shall be appointed by, and who shall
report to, the Director of the Agency for Healthcare Research and
Quality.</text>
</subsection><subsection id="H94EFB17ED45847DD8A687EC6C47743E8"><enum>(c)</enum><header>Interpretation
and translation guidelines and standards</header><text>The Center shall convene
a working group to develop and adopt interpretation and translation quality
guidelines and standards for use by the Center. The guidelines and standards
must be sufficient to ensure that LEP individuals have the equal opportunity to
benefit from health care services to the same extent as non-LEP individuals.
The guidelines and standards shall address the training, assessment, and
certification of individuals to provide competent interpreter and translator
services to work in health care and health-care-related settings and of
bilingual staff who provide services directly in non-English languages. The
working group may develop different guidelines and standards for bilingual
staff, interpreters, and translators.</text>
</subsection><subsection id="H586E45FD08B448168A244D66F19C27D1"><enum>(d)</enum><header>Membership</header>
<paragraph id="HF5552D318715430D97EAEC66726050EF"><enum>(1)</enum><header>Qualifications</header><text>The
Working Group shall consist of 14 members as follows:</text>
<subparagraph id="H6BA1BC4B773747D2BEDF585079158F04"><enum>(A)</enum><text>Four members from
organizations that advocate on behalf of LEP individuals.</text>
</subparagraph><subparagraph id="H0AC66A7FA5B047FC9832CCD233FADDDA"><enum>(B)</enum><text>One member who
represents a professional interpreter association (that is not the National
Council on Interpreting in Health Care) or translator association.</text>
</subparagraph><subparagraph id="H01622531B5C64DBCAEAE0038BC258C93"><enum>(C)</enum><text>One member from a
nonprofit community-based organization that provides language services.</text>
</subparagraph><subparagraph id="HB3C5CB14C9C842589EACC9BAD104B7E7"><enum>(D)</enum><text>Three members
recommended by the National Council on Interpreting in Health Care, including
one who individual who is a professional interpreter.</text>
</subparagraph><subparagraph id="H92C7343CF8204EE5B726380C2710605E"><enum>(E)</enum><text>Four members who
are health care or mental health providers or represent health care provider
associations, including one individual who represents a health care practice of
fewer than 5 clinicians.</text>
</subparagraph><subparagraph id="H87C11358050E442CBFF49E140ADD7C26"><enum>(F)</enum><text>One member who
works in or has extensive knowledge of issues related to health care risk
management.</text>
</subparagraph></paragraph><paragraph id="H136F9AEA114847EEAAEA3B9F265C4C43"><enum>(2)</enum><header>Geographic
representation</header><text>The membership of the Working Group shall reflect
a broad geographic representation including both urban and rural
representatives, including representatives of the United States
territories.</text>
</paragraph><paragraph id="HAB3748E42793449C8C1AE15E5ECC2689"><enum>(3)</enum><header>Prohibited
appointments</header><text>Members of the Working Group shall not include
Members of Congress or other elected Federal, State, or local government
officials.</text>
</paragraph><paragraph id="H2E9EF87A66E544449FE3F38DEB11B97E"><enum>(4)</enum><header>Vacancies</header><text>Any
vacancies in the Working Group shall not affect the power and duties of the
Working Group but shall be filled in the same manner as the original
appointment.</text>
</paragraph><paragraph id="H3B52E1DE056747E6B1D2996D0FEF9103"><enum>(5)</enum><header>Subcommittees</header><text>The
Working Group may establish subcommittees if doing so increases the efficiency
of the Working Group in completing its tasks, including subcommittees to
develop different guidelines and standards for interpreters, translators, and
bilingual staff.</text>
</paragraph><paragraph id="H1544EF7858874B73A11524146626BF23"><enum>(6)</enum><header>Advisory panel
to the working group</header><text>The Working Group shall consult with the
Advisory Panel in the development of the guidelines and standards. The Advisory
Panel shall include—</text>
<subparagraph id="H86F59B5F59D6451BBCFD0A4BBE796CA2"><enum>(A)</enum><text>representatives
from the American Translators Association, Association of Language Companies,
the National Center for State Courts, and States which have developed
interpreter standards such as California, Massachusetts, and Oregon who have
experience in the development or implementation of their organizations’
interpreter and translator certification programs;</text>
</subparagraph><subparagraph id="HB8CD6D8D71E141E1A5499970A21AD8AF"><enum>(B)</enum><text display-inline="yes-display-inline">Federal agencies including the Office for
Civil Rights, the Office of Minority Health, the Centers for Medicare &
Medicaid Services, and the National Institute on Minority Health and Health
Disparities; and</text>
</subparagraph><subparagraph id="H8E07D93557164E949E4C3BA0EC6EB7C1"><enum>(C)</enum><text>other individuals
or entities determined appropriate by the Secretary who have specific expertise
that will be useful to the Working Group.</text>
</subparagraph></paragraph><paragraph id="H6D12ADC261074027BCF856F2BEBAF773"><enum>(7)</enum><header>Publication</header>
<subparagraph id="HA15173133D8A4C939D1E6DCAB2FEE761"><enum>(A)</enum><header>Draft
standards</header><text>Not later than 18 months after the date of enactment of
this title, the Working Group shall—</text>
<clause id="H8EF85234720C4D58A79EBCF0763E5557"><enum>(i)</enum><text>prepare and make
available to the public through the Internet, the Federal Register, and other
appropriate public channels, a proposed set of interpretation and translation
guidelines and standards for training, assessment, and certification;
and</text>
</clause><clause id="HC408CFCEE67E41A1BD430F3B31A2376E"><enum>(ii)</enum><text>accept public
comment on such guidelines and standards for a period of not less than 90
days.</text>
</clause></subparagraph><subparagraph id="H3CA922F44CBD4D85AD82FFEA8A2681D4"><enum>(B)</enum><header>Final
standards</header><text>Not later than 120 days after the expiration of the
public comment period described in subparagraph (A), the Director of the Agency
for Healthcare Research and Quality shall publish, after consultation with and
the approval of the Working Group, final guidelines and standards in the
Federal Register and on the Internet.</text>
</subparagraph><subparagraph id="H2C2EBC7BC3E643FA9AE66B50AAEBE1DD"><enum>(C)</enum><header>Testing
development</header><text>Not later than 120 days after the publication of the
final recommendations described in subparagraph (B), the Director of the Agency
for Healthcare Research and Quality shall, if deemed necessary by the Working
Group, enter into a contract with an entity experienced in the development of
designing certification tests in language related fields to develop such tests
as may be necessary to implement the guidelines and standards.</text>
</subparagraph><subparagraph id="H05D94F6B06BF49FEA51EEA14B272FB5D"><enum>(D)</enum><header>Pilot
project</header>
<clause id="H9CDA1A89CCC24A5C8DF8B5E6E8BB0F75"><enum>(i)</enum><text>Not later than 120
days after completion of the test development described in subparagraph (C) or
after publication of the final guidelines and standards, whichever is later,
the Secretary shall design, fund, and implement a pilot project in up to 50
geographically and demographically diverse sites, two of which must be in the
United States territories, to test and evaluate implementation of the
recommendations.</text>
</clause><clause id="H2F3D301CF9654AC29C13C88D5F0BEE12"><enum>(ii)</enum><text>The Secretary
shall consult with the Working Group and the Advisory Panel in development of
the pilot project and report progress to the Working Group on an ongoing
basis.</text>
</clause><clause id="H2D98474A8E7F4A10B6D316EFE78DC187"><enum>(iii)</enum><text>The pilot
project shall include interpreters and translators working with various
provider types, including small group practices, hospitals, mental health and
substance use clinics, and community health clinics, and shall include broad
geographic representation including both urban and rural
representatives.</text>
</clause><clause id="H108DE91D14294AE4B4E86192E34306C5"><enum>(iv)</enum><text>The pilot project
shall operate for not less than 2 nor more than 4 years, as determined by the
Secretary.</text>
</clause><clause id="HC2D10365D51E4DED8285BC1C5C704CE5"><enum>(v)</enum><text>If
the Working Group determines that any revisions to guidelines and standards are
necessary as a result of the pilot project, it shall revise such guidelines and
standards and the Director of the Agency for Healthcare Research and Quality
shall publish the revisions in the Federal Register for notice and comment. Not
later than 120 days after the expiration of the public comment period on such
revisions, the Director of the Agency for Healthcare Research and Quality shall
publish, after consultation with and the approval of the Working Group, final
revisions to the guidelines and standards in the Federal Register and on the
Internet.</text>
</clause></subparagraph></paragraph><paragraph id="H9D34829453BE44D088DCA5CF16B7DE04"><enum>(8)</enum><header>Administration</header>
<subparagraph id="H5B38538F4F16417D959CCF48BB959982"><enum>(A)</enum><header>Chairperson</header><text>Not
later than 15 days after the date on which all members of the Working Group
have been appointed under subsection (d), the Working Group shall designate its
chairperson.</text>
</subparagraph><subparagraph id="H4052F545918A4042A0791C63E9717452"><enum>(B)</enum><header>Compensation</header><text>While
serving on the business of the Working Group (including travel time), a member
of the Working Group or the Advisory Panel shall be entitled to compensation at
the per diem equivalent of the rate provided for level IV of the Executive
Schedule under section 5315 of title 5, United States Code, and while so
serving away from home and the member’s regular place of business, a member may
be allowed travel expenses, as authorized by the chairperson of the Working
Group. For purposes of pay and employment benefits, rights, and privileges, all
personnel of the Working Group shall be treated as if they were employees of
the House of Representatives.</text>
</subparagraph><subparagraph id="H41F3C7CB61EF40B2A9A4E49317833B43"><enum>(C)</enum><header>Information from
Federal agencies</header><text>The Working Group may secure directly from any
Federal department or agency such information as the Working Group considers
necessary to carry out this section. Upon request of the Working Group, the
head of such department or agency shall furnish such information. Any
information that contains individually identifiable information received by the
Working Group shall not be disseminated or disclosed outside of the Working
Group and shall not be used except by the Working Group.</text>
</subparagraph><subparagraph id="H99B04B16571B4BE98B3E4FBA5849FCB6"><enum>(D)</enum><header>Detail</header><text>Not
more than 10 Federal Government employees employed by the Department of Health
and Human Services may be detailed to staff the Working Group under this
section without further reimbursement. Any detail of an employee shall be
without interruption or loss of civil service status or privilege.</text>
</subparagraph><subparagraph id="HDBE85A15726A4753873AB767404356F3"><enum>(E)</enum><header>Temporary and
intermittent services</header><text>The Working Group may procure temporary and
intermittent services under section 3109(b) of title 5, United States Code, at
rates for individuals which do not exceed the daily equivalent of the annual
rate of basic pay prescribed for level V of the Executive Schedule under
section 5316 of such title.</text>
</subparagraph><subparagraph id="H422A8C48E00B4D3AA50E564744D2B5A5"><enum>(F)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section such sums as may be necessary for the activities of the
Working Group and Advisory Panel for each of fiscal years 2012 through 2016,
and for the funding of the pilot project.</text>
</subparagraph></paragraph><paragraph id="HD49D8DEC008D4B2DA7F9C06DCB05DA3F"><enum>(9)</enum><header>Deemed
status</header>
<subparagraph id="HE948F3E6E34948398B9A3328F1B85CC7"><enum>(A)</enum><header>Certification by
private organization</header><text>If a private accreditation organization
establishes training, assessment, or certification standards for interpreters
or translators in health care which the Secretary determines are at least
equivalent to the training, assessment, or certification standards promulgated
by the Secretary as described in subsection (c), the Secretary shall find that
all organizations or individuals accredited by such organization comply also
with the standard described in subsection (c) if—</text>
<clause id="HADC89901352647CF86482DE05865A50B"><enum>(i)</enum><text>such organization
or individual authorizes the organization to release to the Secretary upon the
Secretary’s request (or such State agency as the Secretary may designate) a
copy of the most current accreditation survey of such organization or
individual made by the organization, together with any other information
directly related to the survey as the Secretary may require (including
corrective action plans); and</text>
</clause><clause id="HA0C45876C26D4FD7BD716DB81C42790C"><enum>(ii)</enum><text>such organization
releases such a copy and any such information to the Secretary.</text>
</clause></subparagraph><subparagraph id="H9278663C8E5347F590354A6D27AE93FF"><enum>(B)</enum><header>Certification by
a state or locality</header><text>If a State or locality has or establishes
training, assessment, or certification standards for interpreters or
translators in health care which the Secretary determines are at least
equivalent to the training, assessment, or certification standards promulgated
by the Secretary as described in subsection (c), the Secretary shall find that
all organizations or individuals accredited by such State or locality comply
also with the standard described in subsection (c) if—</text>
<clause id="H748EBD7DF8F042469220225822F066F9"><enum>(i)</enum><text>such organization
or individual authorizes the State or locality to release to the Secretary upon
his request (or such State agency as the Secretary may designate) a copy of the
most current accreditation survey of such organization or individual made by
such State or locality, together with any other information directly related to
the survey as the Secretary may require (including corrective action plans);
and</text>
</clause><clause id="HAF643E1A713D489992394EDFE9FCE6C1"><enum>(ii)</enum><text>such State or
locality releases such a copy and any such information to the Secretary.</text>
</clause></subparagraph><subparagraph id="HB31E46BCE4344E378770A11733ACA10F"><enum>(C)</enum><header>Timely action on
application</header><text display-inline="yes-display-inline">The Secretary
shall determine, within 210 days after the date the Secretary receives an
application by a private accrediting organization, State, or locality whether
the process of the private accrediting organization, State, or locality meets
the requirements with respect to training, assessment, or certification
standards for interpreters or translators with respect to which standards the
application is made. The Secretary may not deny an application on the basis
that it seeks to meet the requirements with respect to only one, or more than
one, training, assessment, or certification standards for interpreters or
translators.</text>
</subparagraph><subparagraph id="HE8BE9A2FE5AF493288ED6C33675C24B3"><enum>(D)</enum><header>Disclosure of
accreditation survey</header><text>The Secretary may not disclose any
accreditation survey made and released to him by the National Council on
Interpreting in Health Care or any State or locality of an accredited
organization or individual, except that the Secretary may disclose such a
survey and information related to such a survey to the extent such survey and
information relate to an enforcement action taken by the Secretary.</text>
</subparagraph><subparagraph id="H2079C0B24CE04968890DE7E1E6BD2E7E"><enum>(E)</enum><header>Deficiencies</header><text>If
the Secretary finds that an accredited organization or individual has
significant deficiencies (as defined in regulations pertaining to the training,
assessment, or certification standards), the organization or individual shall,
after the date of notice of such finding to the organization and for such
period as may be prescribed in regulations, be deemed not to meet the
conditions or requirements the organization or individual has been treated as
meeting pursuant to subparagraph (A).</text>
</subparagraph></paragraph></subsection><subsection id="H8660466D493F45389503F2146400A8C2"><enum>(e)</enum><header>Availability of
language access</header><text>The Director shall collaborate with the
Administrator of the Office of Minority Health, the Administrator of the
Centers for Medicare & Medicaid Services, and the Administrator of the
Health Resources and Services Administration to notify health care providers
and health care organizations about the availability of language access
services by the Center.</text>
</subsection><subsection id="H59F5758A777A4DB3A3C4E4D58EEB5601"><enum>(f)</enum><header>Education</header><text>The
Secretary, directly or through contract, shall undertake a national education
campaign to inform providers, LEP individuals, health professionals, graduate
schools, and community health centers about—</text>
<paragraph id="H0F1CABF3C95A4EF381B90A6C0B246145"><enum>(1)</enum><text>Federal and State
laws and guidelines governing access to language services;</text>
</paragraph><paragraph id="H672030526E0C429CAF8E343508D8E181"><enum>(2)</enum><text>the value of using
trained interpreters and the risks associated with using family members,
friends, minors, and untrained bilingual staff;</text>
</paragraph><paragraph id="HDF111EE1AEDD432CB5DD01B37C1E9CC1"><enum>(3)</enum><text>funding sources
for developing and implementing language services; and</text>
</paragraph><paragraph id="HF280CEB1D8DB4F1DAAB044D7138B2DD7"><enum>(4)</enum><text>promising
practices to effectively provide language services.</text>
</paragraph></subsection><subsection id="H68E02534D61A40B8BEE94FD411D67CEE"><enum>(g)</enum><header>Authorization of
appropriations</header><text>In addition to the amounts authorized under
subsection (e)(8)(F), there are authorized to be appropriated to carry out this
section such sums as may be necessary for each of fiscal years 2012 through
2016.</text>
</subsection></section><section id="HCA70B07D4AD244F39B2E62191477A2A9"><enum>3404.</enum><header>Innovations in
cultural and linguistic competence grants</header>
<subsection id="HBACA2C68A8F8480E8F8FEFB1070CC6C8"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Director of the Agency
for Healthcare Research and Quality, shall award grants to eligible entities to
enable such entities to design, implement, and evaluate innovative,
cost-effective programs to improve cultural competence and language access in
health care for individuals with limited-English proficiency. The Director of
the Agency for Healthcare Research and Quality shall coordinate with, and
ensure the participation of, other agencies including but not limited to the
Health Resources and Services Administration, the Center on Minority Health and
Health Disparities at the National Institutes of Health, and the Office of
Minority Health, regarding the design and evaluation of the grants
program.</text>
</subsection><subsection id="HA99B615B491D464A8DB5467DDC9483C3"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under subsection (a) an entity shall—</text>
<paragraph id="H2F90DDE3A94D4234AACA1AE73D7A00A6"><enum>(1)</enum><text>be—</text>
<subparagraph id="HDD2BD4190F0A4F53BC7B610268A0BD21"><enum>(A)</enum><text>a city, county,
Indian tribe, State, territory or subdivision thereof;</text>
</subparagraph><subparagraph id="H160DBCB2AE414F9B81CD3CAB1A29DA0D"><enum>(B)</enum><text>an organization
described in section 501(c)(3) of the Internal Revenue Code of 1986;</text>
</subparagraph><subparagraph id="H1512B695852841B8AF6B9871FFD56A9A"><enum>(C)</enum><text>a community
health, mental health, or substance use center or clinic;</text>
</subparagraph><subparagraph id="H48493141B0A54598AA81A9848826444A"><enum>(D)</enum><text>a solo or group
physician practice;</text>
</subparagraph><subparagraph id="H1D283A0DEA764724B19B170844A87DE7"><enum>(E)</enum><text>an integrated
health care delivery system;</text>
</subparagraph><subparagraph id="H9F242A516E65489F8C1FA044F6EF430E"><enum>(F)</enum><text>a public
hospital;</text>
</subparagraph><subparagraph id="HB40EE2653795453485BF5E63B5DA4F07"><enum>(G)</enum><text>a health care
group, university, or college; or</text>
</subparagraph><subparagraph id="H6247F149F21940B582D68AC95B2B82A4"><enum>(H)</enum><text>other entity
designated by the Secretary; and</text>
</subparagraph></paragraph><paragraph id="HB287F51B33BD4BC0BA89E0E4621AF945"><enum>(2)</enum><text>prepare and submit
to the Secretary an application, at such time, in such manner, and accompanied
by such additional information as the Secretary may require.</text>
</paragraph></subsection><subsection id="HE925303E75F0452B835831E4B58CEC10"><enum>(c)</enum><header>Use of
funds</header><text>An entity shall use funds received under a grant under this
section to—</text>
<paragraph id="H460ED005F92B49018669D4ECE1D7E9C9"><enum>(1)</enum><text>develop,
implement, and evaluate models of providing competent interpretation services
through on-site interpretation, telephonic interpretation, or video
interpretation;</text>
</paragraph><paragraph id="H02A9DAAE286B483AB2936A8F0EE6AD06"><enum>(2)</enum><text>implement
strategies to recruit, retain, and promote individuals at all levels of the
organization to maintain a diverse staff and leadership that can promote and
provide language services to patient populations of the service area of the
organization;</text>
</paragraph><paragraph id="H94A64997D97C4E88A7FC1BE237C29CA9"><enum>(3)</enum><text>develop and
maintain a needs assessment that identifies the current demographic, cultural,
and epidemiological profile of the community to accurately plan for and
implement language services needed in service area of the organization;</text>
</paragraph><paragraph id="HC0360B47C29C48E585D55B439D78BDDE"><enum>(4)</enum><text>develop a
strategic plan to implement language services;</text>
</paragraph><paragraph id="H8823D69A0C5F450881C4671E201C32B8"><enum>(5)</enum><text>develop
participatory, collaborative partnerships with communities encompassing the LEP
patient populations being served to gain input in designing and implementing
language services;</text>
</paragraph><paragraph id="H66AC926E17E247A1BCA694B7DF4236FB"><enum>(6)</enum><text>develop and
implement grievance resolution processes that are culturally and linguistically
sensitive and capable of identifying, preventing, and resolving complaints by
LEP individuals; or</text>
</paragraph><paragraph id="HB8B9FD699A5E4A45BE4C88AF498CE778"><enum>(7)</enum><text>develop short-term
medical mental health interpretation training courses and incentives for
bilingual health care staff who are asked to interpret in the workplace;</text>
</paragraph><paragraph id="H83B22305D72E4EAF82A2BAE99D1286D5"><enum>(8)</enum><text display-inline="yes-display-inline">develop formal training programs, including
continued professional development and education programs as well as
supervision, for individuals interested in becoming dedicated health care
interpreters and culturally competent providers;</text>
</paragraph><paragraph id="H1EDF90366AA749788620C203B7B99DD8"><enum>(9)</enum><text>provide staff
language training instruction, which shall include information on the practical
limitations of such instruction for non-native speakers;</text>
</paragraph><paragraph id="HDC08FA0CC5204909BD61B1396E2611CD"><enum>(10)</enum><text>develop policies
that address compensation in salary for staff who receive training to become
either a staff interpreter or bi-lingual provider;</text>
</paragraph><paragraph id="HB7B3EA5E864F4EABAE45D3DF4A2C6FD3"><enum>(11)</enum><text>develop other
language assistance services as determined appropriate by the Secretary;</text>
</paragraph><paragraph id="HE94B32A5A569490393B8601BF54C2B03"><enum>(12)</enum><text>develop,
implement, and evaluate models of improving cultural competence; and</text>
</paragraph><paragraph id="H8454609BE5204577B06A34701A335982"><enum>(13)</enum><text>ensure that,
consistent with the privacy protections provided for under the regulations
promulgated under section 264(c) of the Health Insurance Portability and
Accountability Act of 1996 (42 U.S.C. 1320d–2 note), and any applicable State
privacy laws, data on the individual patient or recipient’s race, ethnicity,
and primary language are collected (and periodically updated) in health records
and integrated into the organization’s information management systems or any
similar system used to store and retrieve data.</text>
</paragraph></subsection><subsection id="HA9E75AFE5C2B4328860E2E48065516DD"><enum>(d)</enum><header>Priority</header><text>In
awarding grants under this section, the Secretary shall give priority to
entities that primarily engage in providing direct care and that have developed
partnerships with community organizations or with agencies with experience
language access.</text>
</subsection><subsection id="HC6508B05FDC244CE81B0CB1417AE01C1"><enum>(e)</enum><header>Evaluation</header>
<paragraph id="HA2BD80F04C89453A91DC61EB7CF3C31E"><enum>(1)</enum><text>An entity that
receives a grant under this section shall submit to the Secretary an evaluation
that describes, in the manner and to the extent required by the Secretary, the
activities carried out with funds received under the grant, and how such
activities improved access to health and health-care-related services and the
quality of health care for individuals with limited-English proficiency. Such
evaluation shall be collected and disseminated through the Robert T. Matsui
Center for Cultural and Linguistic Competence in Health Care established under
section 3403. The Director of the Agency for Healthcare Research and Quality
shall notify grantees of the availability of technical assistance for the
evaluation and provide such assistance upon request.</text>
</paragraph><paragraph id="H5211FD6E058C4A6894F094F3B76925EB"><enum>(2)</enum><text>The Director of
the Agency for Healthcare Research and Quality shall evaluate or arrange with
other individuals or organizations to evaluate projects funded under this
section.</text>
</paragraph></subsection><subsection id="HDE8BCBDD9BE14B4C9260FBC97C1B8877"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, $5,000,000 for each of fiscal years 2012 through 2016.</text>
</subsection></section><section id="H4BE24AF206624366888F54277BB57198"><enum>3405.</enum><header>Research on
cultural and language competence</header>
<subsection id="H82AABD3A88EF40E7B4A3FB17C8A1A4B0"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Director of the Agency
for Healthcare Research and Quality, shall expand research concerning language
access in the provision of health care.</text>
</subsection><subsection id="H31BDFBB219D54C3F80F41AF6FC5B0DF0"><enum>(b)</enum><header>Eligibility</header><text>The
Director of the Agency for Healthcare Research and Quality may conduct the
research described in subsection (a) or enter into contracts with other
individuals or organizations to do so.</text>
</subsection><subsection id="HD1D7A8E09F5540D48BDAE918A48A96AB"><enum>(c)</enum><header>Use of
funds</header><text>Research under this section shall be designed to do one or
more of the following:</text>
<paragraph id="H28FC7931E5FD427C879850E22D1A1218"><enum>(1)</enum><text>To identify the
barriers to mental and behavioral services that are faced by LEP
individuals.</text>
</paragraph><paragraph id="H2BF373343DC642BF842FE5B1B9D34F22"><enum>(2)</enum><text>To identify health
care providers’ and health administrators’ attitudes, knowledge, and awareness
of the barriers to quality health care services that are faced by LEP
individuals.</text>
</paragraph><paragraph id="HC827E178C4B8457C959F45A32BA07890"><enum>(3)</enum><text>To identify
optimal approaches for delivering language access.</text>
</paragraph><paragraph id="HC59202E6B6A749E1918CFEF4C3F8A42B"><enum>(4)</enum><text>To identify best
practices for data collection, including—</text>
<subparagraph id="H76D61FF8162C470C9E56C1F9D300E05D"><enum>(A)</enum><text>the collection by
providers of health care and health-care-related services of data on the race,
ethnicity, and primary language of recipients of such services, taking into
account existing research conducted by the Government or private sector;</text>
</subparagraph><subparagraph id="H303DD391A2B446FE84CC12D2CD898E28"><enum>(B)</enum><text>the development
and implementation of data collection and reporting systems; and</text>
</subparagraph><subparagraph id="HEA8AFFD3CB974F088D674083E6AFF4A6"><enum>(C)</enum><text>effective privacy
safeguards for collected data.</text>
</subparagraph></paragraph><paragraph id="HEC32CBFA6E76479B9837964AED8441A4"><enum>(5)</enum><text>To develop a
minimum data collection set for primary language.</text>
</paragraph><paragraph id="H9E70C560DF5A40D4952D24460ABA0554"><enum>(6)</enum><text>To evaluate the
most effective ways in which the Department can create or coordinate, and then
subsidize or otherwise fund telephonic interpretation providers for health care
providers, taking into consideration, among other factors, the flexibility
necessary for such a system to accommodate variations in—</text>
<subparagraph id="H56BA20EF861C4B5DAD2EB12373F0E4E8"><enum>(A)</enum><text>provider
type;</text>
</subparagraph><subparagraph id="HB86ACAB54D664394AD02A1FE90905762"><enum>(B)</enum><text>languages needed
and their frequency of use;</text>
</subparagraph><subparagraph id="H028B2BF50BA2437D9A31D782E29C3B56"><enum>(C)</enum><text>type of
encounter;</text>
</subparagraph><subparagraph id="H0D8A7F18CC93401F80CFC649F291B608"><enum>(D)</enum><text>time of encounter,
including regular business hours and after hours; and</text>
</subparagraph><subparagraph id="H04637212F1994900B1C04FC8F676A53F"><enum>(E)</enum><text>location of
encounter.</text>
</subparagraph></paragraph></subsection><subsection id="HC72855189B94492C95BAC3E51A436D47"><enum>(d)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through
2016.</text>
</subsection></section>.
203.Federal
reimbursement for culturally and linguistically appropriate services under the
Medicare, Medicaid, and State Children’s Health Insurance Programs
(a)Language Access
grants for Medicare Providers
(1)
(A)Not later than 6 months after the date of the enactment
of this Act, the Secretary of Health and Human Services, acting through the
Centers for Medicare & Medicaid Services and in consultation with the
Center for Medicare and Medicaid Innovation, shall establish demonstration
program under which the Secretary shall award grants to eligible Medicare
service providers to improve communication between such providers and
limited-English-proficient Medicare beneficiaries, including beneficiaries who
live in diverse and underserved communities.
(B)Application of
innovation rulesThe demonstration project under
subparagraph (A) shall be conducted
in a manner that is consistent with the applicable provisions of subsections
(b), (c), and (d) of section 1115A of the Social Security Act.
(C)To the extent practicible, the Secretary shall award not
less than 24 grants under this subsection.
(D)Except as provided under
paragraph (2)(D), each grant awarded
under this subsection shall be for a 3-year period.
(2)To be eligible
for a grant under this subsection, an entity must meet the following
requirements:
(A)The entity must be—
(i)a provider of
services under part A of title XVIII of the Social Security Act;
(ii)a provider of
services under part B of such title;
(iii)a Medicare
Advantage organization offering a Medicare Advantage plan under part C of such
title; or
(iv)a PDP sponsor
offering a prescription drug plan under part D of such title.
(B)The entity must
serve a community that with respect to necessary langauge services for
improving access and utilization of health care amoung limited-English
proficienct individuals, is disproportinaly underserved.
(C)The
entity must prepare and submit to the Secretary an application, at such time,
in such manner, and accompanied by such additional information as the Secretary
may require.
(D)In
the case of a grantee that received a grant under this subsection in a previous
year, such grantee is only eligible for continued payments under a grant under
this subsection if the grantee met the reporting requirements under
paragraph (9) for such year. If a
grantee fails to meet the requirement of such paragraph for the first year of a
grant, the Secretary may terminate the grant and solicit applications from new
grantees to participate in the demonstration program.
(3)To
the extent feasible, the Secretary shall award—
(A)at least 6 grants
to providers of services described in
paragraph (2)(A)(i);
(B)at least 6 grants
to service providers described in
paragraph (2)(A)(ii);
(C)at least 6 grants
to organizations described in
paragraph (2)(A)(iii);
and
(D)at least 6 grants
to sponsors described in
paragraph (2)(A)(iv).
(4)Considerations
in awarding grants
(A)In awarding grants under this subsection, the Secretary
shall select grantees to ensure the following:
(i)The grantees
provide many different types of language services.
(ii)The grantees
serve Medicare beneficiaries who speak different languages, and who, as a
population, have differing needs for language services.
(iii)The grantees serve Medicare beneficiaries
in both urban and rural settings.
(iv)The grantees serve Medicare beneficiaries
in at least two geographic regions, as defined by the Secretary.
(v)The grantees serve Medicare beneficiaries
in at least two large metropolitan statistical areas with racial, ethnic, and
economicly diverse populations.
(B)Priority for
partnerships with community organizations and agenciesIn
awarding grants under this subsection, the Secretary shall give priority to
eligible entities that have a partnership with—
(i)a
community organization; or
(ii)a
consortia of community origanizations, state agecenices, and local
agencies,
that has
experience in providing language services.(5)Use of funds for
competent language services
(A)Subject to
subparagraph (E), a grantee may only
use grant funds received under this subsection to pay for the provision of
competent language services to Medicare beneficiaries who are limited-English
proficient.
(B)Competent
language services definedFor purposes of this subsection, the
term competent language services means—
(i)interpreter and
translation services that—
(I)subject to the
exceptions under
subparagraph (C)—
- (aa)if the grantee
operates in a State that has statewide health care interpreter standards, meet
the State standards currently in effect; or
- (bb)if the grantee
operates in a State that does not have statewide health care interpreter
standards, utilizes competent interpreters who follow the National Council on
Interpreting in Health Care’s Code of Ethics and Standards of Practice;
and
(II)that, in the case
of interpreter services, are provided through—
- (aa)on-site
interpretation;
- (bb)telephonic
interpretation; or
- (cc)video
interpretation; and
(ii)the direct
provision of health care or health-care-related services by a competent
bilingual health care provider.
(C)The
requirements of
subparagraph (B)(i)(I) do not
apply—
(i)to a Medicare
beneficiary who is limited-English-proficient who has been informed, in the
beneficiary’s primary language, of the availability of free interpreter and
translation services and who, instead, requests that a family member, friend,
or other person provide such services, if the grantee documents such request in
the beneficiary’s medical record; or
(ii)in the case of a
medical emergency where the delay directly associated with obtaining a
competent interpreter or translation services would jeopardize the health of
the patient.
Subparagraph (C)(ii) shall not
be construed to exempt emergency rooms or similar entities that regularly
provide health care services in medical emergencies to
limited-English-proficient patients from any applicable legal or regulatory
requirements related to providing competent interpreter and translation
services without undue delay.(D)MA organizations
and PDP sponsorsIf a grantee is a MA organization or a PDP
sponsor, such entity must provide at least 50 percent of the grant funds that
the entity receives under this subsection directly to the entity’s network
providers (including physicians and pharmacies) for the purpose of providing
support for such providers to provide competent language services to Medicare
beneficiaries who are limited-English proficient.
(E)Administrative
and reporting costsA grantee may use up to 10 percent of the
grant funds to pay for administrative costs associated with the provision of
competent language services and for reporting required under
paragraph (9).
(6)Determination of
amount of grant payments
(A)Payments to grantees under this subsection shall be
calculated based on the estimated numbers of limited-English-proficient
Medicare beneficiaries in a grantee’s service area utilizing—
(i)data on the
numbers of limited-English-proficient individuals who speak English less than
very well
from the most recently available data from the Bureau
of the Census or other State-based study the Secretary determines likely to
yield accurate data regarding the number of such individuals in such service
area; or
(ii)data provided by
the grantee, if the grantee routinely collects data on the primary language of
the Medicare beneficiaries that the grantee serves and the Secretary determines
that the data is accurate and shows a greater number of
limited-English-proficient individuals than would be estimated using the data
under
clause (i).
(B)Subject to
subparagraph (C), the amount of
payment made to a grantee under this subsection may be modified annually at the
discretion of the Secretary, based on changes in the data under
subparagraph (A) with respect to the
service area of a grantee for the year.
(C)The amount of a grant made under this subsection to a
grantee may not exceed $500,000 for the period under
paragraph (1)(D).
(7)Grantees under this subsection
shall—
(A)ensure that
clinical and support staff receive appropriate ongoing education and training
in linguistically appropriate service delivery;
(B)ensure the
linguistic competence of bilingual providers;
(C)offer and provide
appropriate language services at no additional charge to each patient with
limited-English proficiency for all points of contact between the patient and
the grantee, in a timely manner during all hours of operation;
(D)notify Medicare
beneficiaries of their right to receive language services in their primary
language;
(E)post signage in
the primary languages commonly used by the patient population in the service
area of the organization; and
(F)ensure
that—
(i)primary language
data is collected for recipients of language services and such data is
consistent with standards developed under title XXXIV of the Public Health
Service Act, as added by section 202 of this Act, to the extent such standards
are available upon the initiation of the demonstration program; and
(ii)consistent with
the privacy protections provided under the regulations promulgated pursuant to
section 264(c) of the Health Insurance Portability and Accountability Act of
1996 (42 U.S.C. 1320d–2 note), if the recipient of language services is a minor
or is incapacitated, primary language data is collected on the parent or legal
guardian of such recipient.
(8)Limited-English-proficient Medicare beneficiaries shall
not have to pay cost-sharing or co-payments for competent language services
provided under this demonstration program.
(9)Reporting
Requirements for granteesNot later than the end of each calendar
year, a grantee that receives funds under this subsection in such year shall
submit to the Secretary a report that includes the following
information:
(A)The number of
Medicare beneficiaries to whom competent language services are provided.
(B)The primary
languages of those Medicare beneficiaries.
(C)The types of
language services provided to such beneficiaries.
(D)Whether such
language services were provided by employees of the grantee or through a
contract with external contractors or agencies).
(E)The types of
interpretation services provided to such beneficiaries, and the approximate
length of time such service is provided to such beneficiaries.
(F)The costs of
providing competent language services.
(G)An account of the
training or accreditation of bilingual staff, interpreters, and translators
providing services funded by the grant under this subsection.
(10)Evaluation and
report to CongressNot later than 1 year after the completion of
a 3-year grant under this subsection, the Secretary shall conduct an evaluation
of the demonstration program under this subsection and shall submit to the
Congress a report that includes the following:
(A)An analysis of the
patient outcomes and the costs of furnishing care to the
limited-English-proficient Medicare beneficiaries participating in the project
as compared to such outcomes and costs for limited-English-proficient Medicare
beneficiaries not participating, based on the data provided under
paragraph (9) and any other information
available to the Secretary.
(B)The effect of
delivering langauge services on—
(i)Medicare
beneficiary access to care and utilization of services;
(ii)the
efficiency and cost effectiveness of health care delivery;
(iii)patient
satisfaction;
(iv)health outcomes;
and
(v)the
provision of culturally appropriate services provided to such
benificiaries.
(C)The extent to
which bilingual staff, interpreters, and translators providing services under
such demonstration were trained or accredited and the nature of accreditation
or training needed by type of provider, service, or other category as
determined by the Secretary to ensure the provision of high-quality
interpretation, translation, or other language services to Medicare
beneficiaries if such services are expanded pursuant to subsection (c) of
section 1907 of this Act.
(D)Recommendations,
if any, regarding the extension of such project to the entire Medicare program,
subject the to provision of section 1115A(c) of the Social Security Act.
(11)There
is appropriated to carry out this subsection, in equal parts from the Federal
Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance
Trust Fund, $16,000,000 for each fiscal year of the demonstration
program.
(b)Language
services under the Medicare program
(1)Subsection (aa)(1) of section 1861 of the
Social Security Act (42 U.S.C. 1395x) is amended—
(A)in subparagraph
(B), by striking the and
at the end;
(B)in subparagrpah
(C), by inserting and
after the comma at the end; and
(C)by inserting after
subparagraph (C) the following:
(D)language services as defined in subsection
(iii),
.
(2)Section 1833(a) of
the Social Security Act (42 U.S.C. 1395l(a)) is amended—payment
(A)by striking
and
at the end of paragraph (8);
(B)by edesignating
paragraph (9) as paragraph (10); and
(C)by inserting after
paragraph (8) the following new paragraph:
(9)in the case of language services described
in section 1861(iii), 100 percent of the reasonable charges for such services,
as determined in consultation with the Medicare Payment Advisory Commission;
and
.
(3)Section 1832(a)(2)
of such Act (42 U.S.C. 1395k(a)(2)) is amended—covered service
(A)by striking
and
at the end of subparagraph (I);
(B)by striking the
period at the end of subparagraph (J) and inserting ; and
;
and
(C)by adding at the
end of subparagraph (J) the following:
(K)language services
(as defined in section 1861(iii)) furnished by a interpreter or
translator.
.
(4)Section 1861 of
the Social Security Act (42 U.S.C. 1395x) is amended by adding at the end the
following new subsection:
(iii)Language services and related terms(1)Language services
definedThe term language services has the same
meaning given language or langauge access services
in section
3400 of the Public Health Service Act.
(2)Interpreter services
definedFor the purposes of this subsection, the term
interpreter services has the meaning given competent
interpreter services under section 3400(3) of the Public Health Service
Act.
(3)The term interpreter—
(A)means an individual—
(i)who faithfully, accurately, and
objectively transmits a spoken message from one language into another language;
and
(ii)who knows health and
health-related terminology in both languages; and
(B)includes individuals who provide
in-person, telephonic, and video interpretation.
(4)The term translation means the transmission
of a written message in one language into a written message in another language
that retains the intended meaning of the original message.
(5)Limited-English-proficient and LEP
definedThe terms Limited-English-proficient and
LEP have the meaning given the term limited english
proficient under section 9101(25) of the Elementary and Secondary
Education Act of 1965, except that subparagraphs (A), (B), and (D) of such
section not
apply.
.
(5)Waiver of budget
neutralityFor the 3-year period beginning on the date of
enactment of this section, the budget neutrality provision of section
1848(c)(2)(B)(ii) of the Social Security Act (42 U.S.C. 1395w–4(c)(2)(B)(ii))
shall not apply to language services (as such term is defined in section
1861(iii) of such Act).
(c)Medicare Part C
and Part D
(1)Medicare Advantage plans under part C of the Social
Security Act and Prescription Drug Plans under part D of such Act shall provide
effective language services to enrollees of such plans.
(2)Medicare Advantage and Prescription Drug plans shall
annually submit to the Secretary of Health and Human Services a report that
contains information on the plan’s internal policies and procedures related to
recruitment and retention efforts directed to workforce diversity and
linquistically and culturally appropriate provision of services in each of the
following contexts:
(A)The collection of data in a manner that
meets the requirements of title I of this Act, regarding the enrollee
population.
(B)Education of staff
and contractors who have routine contact with enrollees regarding the various
needs of the diverse enrollee population.
(C)Evaluation of the
health plan’s language services programs and services with respect to the
plan’s enrollee population, such as through analysis of complaints or
satisfaction survey results.
(D)Methods by which
the plan provides to the Secretary information regarding the ethnic diversity
of the plan’s enrollee population.
(E)The periodic
provision of educational information to plan enrollees on the plan’s language
services and programs.
(d)Improving
language services in Medicaid and SCHIP
(1)Section
1903(a)(2)(E) of the Social Security Act (42 U.S.C. 1396b(a)(2)(E)) is amended
by—
(A)striking 75
and inserting
90
;
(B)striking
translation or interpretation services
and inserting
language services
; and
(C)striking
children of families
and inserting
individuals
.
(2)Section
1902(a)(10)(A) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is
amended by striking and (28)
and inserting (28), and
(29)
.
(3)Section 1905(a) of
the Social Security Act (42 U.S.C. 1396d(a)) is amended by—
(A)in paragraph (28),
by striking and
at the end;
(B)by redesignating
paragraph (29) as paragraph (30); and
(C)by inserting after
paragraph (28) the following new paragraph:
(29)language
services, as such term is defined in section 1861(iii), provided in a timely
manner to limited-English-proficient individuals who need such services;
and
.
(4)Section 1916(a)(2)
of the Social Security Act (42 U.S.C. 1396o(2)) is amended by—
(A)by striking
or
at the end of subparagraph (D);
(B)by striking
; and
at the end of subparagraph (E) and inserting ,
or
; and
(C)by adding at the
end the following new subparagraph:
(F)language services
described in section 1905(a)(29);
and
.
(5)Section 2103 of
the Social Security Act (42 U.S.C. 1397cc) is amended—
(A)in subsection (a),
in the matter before paragraph (1), by striking and (7)
and
inserting (7), and (9)
; and
(B)in subsection (c),
by adding at the end the following new paragraph:
(9)The child health
assistance provided to a targeted low-income child shall include coverage of
language services, as such term is defined in section 1861(iii), provided in a
timely manner to limited-English-proficient individuals who need such
services.
;
and
(C)in subsection
(e)(2)—
(i)in the heading, by striking
Preventive
and inserting
Certain
; and
(ii)by inserting
, subsection (c)(9),
after subsection
(c)(1)(C)
.
(6)Section
2110(a)(27) of the Social Security Act (42 U.S.C. 1397jj) is amended by
striking translation
and inserting language services as
described in section 2103(c)(9)
.
(7)Pursuant to the
reporting requirement described in section 2107(b)(1) of the Social Security
Act (42 U.S.C. 1397gg(b)(1)), the Secretary of Health and Human Services shall
require that States collect data on—
(A)the primary
language of individuals receiving child health assistance under title XXI of
the Social Security Act; and
(B)in the case of
such individuals who are minors or incapacitated, the primary language of the
individual’s parent or guardian.
(8)Section 2105 of
the Social Security Act (42 U.S.C. 1397ee(c)) is amended—
(A)in subsection
(a)(1) by striking 75
and inserting 90
;
and
(B)in subsection
(c)(2)(A), by inserting before the period , except that expenditures
pursuant to clause (iv) of subparagraph (D) of such paragraph shall not count
towards this total
.
(e)Funding language
services furnished by providers of health care and health-Care-Related services
that serve high rates of uninsured LEP individuals
(1)
(A)Subject to subparagraph (B), the Secretary of Health and
Human Services shall make payments (on a quarterly basis) directly to eligible
entities to support the provision of language services to
limited-English-proficient individuals in an amount equal to an entity’s
eligible costs (as defined under
paragraph (3)) for such services for
the quarter.
(B)Out of any funds in the Treasury not
otherwise appropriated, there are appropriated to the Secretary of Health and
Human Services such sums as may be necessary for each of fiscal years 2012
through 2016.
(C)Payments under this subsection shall not offset or
reduce payments under section 1923 of the Social Security Act, nor shall
payments under such section be considered when determining uncompensated costs
associated with the provision of language services.
(2)In order to receive grants under this paragraph, an entity
must—
(A)be a Medicaid
provider that is—
(i)a
physician;
(ii)a hospital with a
low-income utilization rate (as defined in section 1923(b)(3) of the Social
Security Act (42 U.S.C. 1396r–4(b)(3))) of greater than 25 percent; or
(iii)a federally
qualified health center (as defined in section 1905(l)(2)(B) of the Social
Security Act (42 U.S.C. 1396d(l)(2)(B)));
(B)provide language
services to at least 8 percent of the entity’s total number of patients, not
later than 6 months after the date of the enactment of the Act; and
(C)prepare and submit
an application to the Secretary, at such time, in such manner, and accompanied
by such information as the Secretary may require to ascertain the entity’s
eligibility for funding under this subsection.
(3)
(A)In this subsection, the term eligible costs
means, with respect to an eligible entity that provides language services to
LEP individuals, the product of—
(i)the average per
person cost of language services, determined according to the methodology
devised under
subparagraph (B); and
(ii)the number of
limited-English-proficient individuals who are provided language services by
the entity and for whom no reimbursement is available for such services under
the amendments made by subsections (a), (b), (c), or (d) or by private health
insurance.
(B)
(i)The Secretary shall establish a methodology to determine
the average per person cost of language services.
(ii)In establishing such methodology, the Secretary may
establish different methodologies for different types of eligible
entities.
(iii)The Secretary may not require eligible entities to submit
individual claims for language services for individual patients as a
requirement for payment under this subsection.
(4)Data collection
instrumentFor purposes of this subsection, the Secretary shall
create a standard data collection instrument that is consistent with any
existing reporting requirements by the Secretary or relevant accrediting
organizations regarding the number of individuals to whom language access are
provided.
(5)Entities receiving payment under this subsection
shall provide the Secretary with a quarterly report on how the entity used such
funds. Such report shall contain aggregate (and may not contain individualized)
data collected using the instrument under
paragraph (4) and shall otherwise be in
a form and manner determined by the Secretary.
(6)For purposes of this
subsection, the term language services has the meaning given such
term in section 1861(iii) of the Social Security Act.
(7)
(A)Not
later than 6 months after the date of enactment of this Act, the Secretary of
Health and Human Services shall establish and distribute guidelines concerning
the implementation of this subsection.
(B)Not
later than 2 years after the date of enactment of this Act, and every 2 years
thereafter, the Secretary shall submit a report to Congress concerning the
implementation of this subsection.
(f)Application of
Civil Rights Act of 1964 and other lawsNothing in this section shall be construed
to limit otherwise existing obligations of recipients of Federal financial
assistance under title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000(d) et
seq.) or other laws that protect the civil rights of individuals.
(g)The amendments made by this section shall take effect on
October 1, 2011.
204.Increasing
understanding of and improving health literacy
(a)The Secretary, acting through the Director of the Agency
for Healthcare Research and Quality and the Administrator of the Health
Resources and Services Administration, in consultation with the Director of the
National Institute on Minority Health and Health Disparities and the Office of
Minority Health, shall award grants to eligible entities to improve health care
for patient populations that have low functional health literacy.
(b)To
be eligible to receive a grant under subsection (a), an entity shall—
(1)be a hospital,
health center or clinic, health plan, or other health entity (including a
nonprofit minority health organization or association); and
(2)prepare and submit
to the Secretary an application at such time, in such manner, and containing
such information as the Secretary may require.
(c)
(1)Agency for
healthcare research and qualityGrants awarded under subsection
(a) through the Agency for Healthcare Research and Quality shall be
used—
(A)to define and
increase the understanding of health literacy;
(B)to investigate the
correlation between low health literacy and health and health care;
(C)to clarify which
aspects of health literacy have an effect on health outcomes; and
(D)for any other
activity determined appropriate by the Director of the Agency.
(2)Health resources
and services administrationGrants awarded under subsection (a)
through the Health Resources and Services Administration shall be used to
conduct demonstration projects for interventions for patients with low health
literacy that may include—
(A)the development of
new disease management programs for patients with low health literacy;
(B)the tailoring of
existing disease management programs addressing mental, physical, oral, and
behavioral health conditions for patients with low health literacy;
(C)the translation of
written health materials for patients with low health literacy;
(D)the
identification, implementation, and testing of low health literacy screening
tools;
(E)the conduct of
educational campaigns for patients and providers about low health literacy;
and
(F)other activities
determined appropriate by the Administrator of the Health Resources and
Services Administration.
(d)In
this section, the term low health literacy means the inability of
an individual to obtain, process, and understand basic health information and
services needed to make appropriate health decisions.
(e)Authorization of
appropriationsThere are authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through 2016.
205.Assurances for
receiving Federal funds
(a)Entities that receive Federal funds under sections 201 or
202 (including under the amendments made by such section), in order to ensure
the right of LEP individuals to receive access to quality health care,
shall—
(1)ensure that
appropriate clinical and support staff receive ongoing education and training
in linguistically appropriate service delivery;
(2)offer and provide
appropriate language services at no additional charge to each patient with
limited-English proficiency at all points of contact, in a timely manner during
all hours of operation;
(3)notify patients of
their right to receive language services in their primary language; and
(4)utilize only
competent interpreter or translation services which—
(A)until adoption of
the Interpreter and Translator Guidelines and Standards described in section
3403(c) of the Public Health Service Act, are defined in section 3400 of the
Public Health Service Act; and
(B)after adoption of
the Interpreter and Translator Guidelines and Standards described in section
3403(c) of the Public Health Service Act, meet those guidelines and
standards;
(b)The
requirements of subsection (a)(4) shall not apply as follows:
(1)When a patient
(who has been informed in his or her primary language of the availability of
free interpreter and translation services) requests the use of family, friends,
or other persons untrained in interpretation or translation if the following
conditions are met:
(A)The interpreter
requested by the patient is over the age of 18.
(B)The recipient
informs the patient that he or she has the option of having the recipient
provide an interpreter for him/her without charge, or of using his/her own
interpreter.
(C)The recipient
informs the patient that the recipient may not require an LEP person to use a
family member or friend as an interpreter.
(D)The recipient
evaluates whether the person the patient wishes to use as an interpreter is
competent. If the recipient has reason to believe that the interpreter is not
competent, the recipient provides the recipient’s own interpreter to protect
the recipient from liability if the patient’s interpreter is later found not
competent.
(E)If the recipient
has reason to believe that there is a conflict of interest between the
interpreter and patient, the recipient may not use the patient’s
interpreter.
(F)The recipient has
the patient sign a waiver, witnessed by at least 1 individual not related to
the patient, that includes the information stated in subparagraphs (A) through
(E) and is translated into the patient’s language.
(2)When a medical
emergency exists and the delay directly associated with obtaining competent
interpreter or translation services would jeopardize the health of the patient
but only until a competent interpreter or translation service is available;
however, nothing in this subsection shall exempt emergency rooms or similar
entities that regularly provide health care services in medical emergencies
from having in place systems to provide competent interpreter and translation
services without undue delay.
206.Report on
Federal efforts to provide culturally and linguistically appropriate health
care services
(a)Not
later than 1 year after the date of enactment of this Act and annually
thereafter, the Secretary of Health and Human Services shall enter into a
contract with the Institute of Medicine for the preparation and publication of
a report that describes Federal efforts to ensure that all individuals with
limited-English proficiency have meaningful access culturally competent to
health care and health-care-related services. Such report shall include—
(1)a
description and evaluation of the activities carried out under this Act;
(2)a
description and analysis of best practices, model programs, guidelines, and
other effective strategies for providing access to culturally and
linguistically appropriate health care services;
(3)recommendations on
the development and implementation of policies and practices by providers of
health care and health-care-related services for limited-English-proficient
individuals;
(4)a
description of the effect of providing language services on quality of health
care and access to care; and
(5)a
description of the costs associated with or savings related to the provision of
language services.
(b)Authorization of
appropriationsThere are authorized to be appropriated to carry
out this section such sums as may be necessary for each of fiscal years 2012
through 2016.
207.English for
speakers of other languages
(a)The Secretary of Education is authorized to provide
grants to eligible entities for the provision of English as a second language
(hereafter referred to as ESL) instruction and shall determine,
after consultation with appropriate stakeholders, the mechanism for
administering and distributing such grants.
(b)For purposes of this section, the term eligible
entity means a State or community-based organization that employs, and
serves, minority populations.
(c)An
eligible entity may apply for a grant under this section by submitting such
information as the Secretary may require and in such form and manner as the
Secretary may require.
(d)As a condition of receiving a grant under this section, an
eligible entity shall—
(1)develop and
implement a plan for assuring the availability of ESL instruction that
effectively integrates information about the nature of the United States health
care system, how to access care, and any special language skills that may be
required for them to access and regularly negotiate the system
effectively;
(2)develop a plan, including, where
appropriate, public-private partnerships, for making ESL instruction
progressively available to all individuals seeking instruction; and
(3)maintain current
ESL instruction efforts by using the additional funds to supplement rather than
supplant any funds expended for ESL instruction in the State as of January 1,
2006.
(e)Additional
duties of the secretaryThe Secretary of Education shall—
(1)collect and
publicize annual data on how much Federal, State, and local governments spend
on ESL instruction;
(2)collect data from
State and local governments to identify the unmet needs of English language
learners for appropriate ESL instruction, including—
(A)the preferred
written and spoken language of such English language learners;
(B)the extent of
waiting lists including how many programs maintain waiting lists and, for
programs that do not have waiting lists, the reasons why not;
(C)the availability
of programs to geographically isolated communities;
(D)the impact of
course enrollment policies, including open enrollment, on the availability of
ESL instruction;
(E)the number
individuals in the State and each participating locality;
(F)the effectiveness
of the instruction in meeting the needs of individuals receiving instruction
and those needing instruction;
(G)as assessment of
the need for programs that integrate job training and ESL instruction, to
assist individuals to obtain better jobs; and
(H)the availability
of ESL slots by State and locality;
(3)determine the cost
and most appropriate methods of making ESL instruction available to all English
language learners seeking instruction; and
(4)within 1 year of
the date of enactment of this Act, issue a report to Congress that assesses the
information collected in paragraphs (1), (2), and (3) and makes recommendations
on steps that should be taken to progressively realize the goal of making ESL
instruction available to all English language learners seeking
instruction.
(f)Authorization of
AppropriationsThere are authorized to be appropriated to the
Secretary of Education for each of fiscal years 2012 through 2015 $250,000,000
to carry out this section.
208.
(a)
(1)A
State shall not be immune under the Eleventh Amendment of the Constitution of
the United States from suit in Federal court for failing to provide the
language access funded pursuant to this title.
(2)In a suit against
a State for a violation of this title, remedies (including remedies at both at
law and in equity) are available for such a violation to the same extent as
such remedies are available for such a violation in the suit against any public
or private entity other than a State.
(b)Nothing in this title shall be construed to limit
otherwise existing obligations of recipients of Federal financial assistance
under title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000(d) et seq.) or
any other statute.
209.
(a)Section 1302(b)(1)
of the Patient Protection and Affordable Care Act (42 U.S.C. 18022(b)(1)) is
amended by adding at the end the following:
(K)Language access services, including oral
interpretation and written
translations.
.
(b)Employer-Sponsored
minimum essential coverageSection 36B(c)(2)(C) of the Internal
Revenue Code of 1986 is amended by adding at the end the following:
(v)Coverage must
include language access and servicesExcept as provided in clause (iii), an
employee shall not be treated as eligible for minimum essential coverage if
such coverage consists of an eligible employer-sponsored plan (as defined in
section 5000A(f)(2)) and the plan does not provide coverage for language access
services, including oral interpretation and written
translations.
.
(c)Section 2717(a)(1) of the Public Health Service Act (42
U.S.C. 300gg–17(a)(1)) is amended—
(1)by striking
and
at the end of subparagraph (C);
(2)by striking the
period at the end of subparagraph (D) and inserting ; and
;
and
(3)by adding at the
end the following new subparagraph:
(E)reduce health disparities through the
provision of language access services, including oral interpretation and
written
translations.
.
<enum>III</enum><header>Health workforce
Diversity</header>
<section id="H7D7F654D18EF4226AFA9B7A3DBEDC709"><enum>301.</enum><header>Amendment to
the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name></header><text display-inline="no-display-inline">Title XXXIV of
the <act-name parsable-cite="PHSA">Public Health Service Act</act-name>, as
added by section 202, is amended by adding at the end the following:</text>
<quoted-block act-name="Public Health Service Act" id="H2A7965E9DA9047969EF09A5E89626DEB">
<subtitle id="H575173A2F77A41009FE1F8CB57732B81"><enum>A</enum><header>Diversifying the
Health care workplace</header>
<section id="H672BA2F8DA284B2AABF9C8ED14414B7B"><enum>3411.</enum><header>Report on
workforce Diversity</header>
<subsection id="H1EC7812B81914A6F94E24F458305EBA9"><enum>(a)</enum><header>In
general</header><text>Not later than July 1, 2012, and biannually thereafter,
the Secretary, acting through the director of each entity within the Department
of Health and Human Services, shall prepare and submit to the Committee on
Health, Education, Labor, and Pensions of the Senate and the Committee on
Energy and Commerce of the House of Representatives a report on health
workforce diversity.</text>
</subsection><subsection id="HD7A4A0CCB0E14A6891DEFB085A46A308"><enum>(b)</enum><header>Requirement</header><text>The
report under subsection (a) shall contain the following information:</text>
<paragraph id="H946B4766984642749AEE5BF9BE03AD3B"><enum>(1)</enum><text>A description of
any grant support that is provided by each entity for workforce diversity
initiatives with the following information—</text>
<subparagraph id="H09371B58CCAB4796AA3A1128BBBB8CA1"><enum>(A)</enum><text>the number of
grants made;</text>
</subparagraph><subparagraph id="HD04CE0434601456199A66522F59C445D"><enum>(B)</enum><text>the purpose of the
grants;</text>
</subparagraph><subparagraph id="H4044D380CF4C45569B4BAC15E74F2091"><enum>(C)</enum><text>the populations
served through the grants;</text>
</subparagraph><subparagraph id="HBB43B98553BB473989C42F8D106B36FD"><enum>(D)</enum><text>the organizations
and institutions receiving the grants; and</text>
</subparagraph><subparagraph id="H1B1DD18B024C41329DF406B74FD54E4F"><enum>(E)</enum><text>the tracking
efforts that were used to follow the progress of participants.</text>
</subparagraph></paragraph><paragraph id="H3F7E7F1B90CF4702A6A11AD77736974E"><enum>(2)</enum><text>A description of
the entity’s plan to achieve workforce diversity goals that includes, to the
extent relevant to such entity—</text>
<subparagraph id="HE0EC81B810924758A6A3D878BFEE69B4"><enum>(A)</enum><text>the number of
underrepresented minority health professionals that will be needed in various
disciplines over the next 10 years to achieve population parity;</text>
</subparagraph><subparagraph id="H3F22958E08574D34973DF43D966125A3"><enum>(B)</enum><text>the level of
funding needed to fully expand and adequately support health professions
pipeline programs;</text>
</subparagraph><subparagraph id="H903D6EAA8E804C62A71E1A1E047B4EF6"><enum>(C)</enum><text>the impact such
programs have had on the admissions practices and policies of health
professions schools;</text>
</subparagraph><subparagraph id="H1C35D24F75BB4985962843F89049ED78"><enum>(D)</enum><text>the management
strategy necessary to effectively administer and institutionalize health
profession pipeline programs; and</text>
</subparagraph><subparagraph id="H573826CA5E7A4519BC6106530090582D"><enum>(E)</enum><text>the impact that
the Government Performance and Results Act (GPRA) has had on evaluating the
performance of grantees and whether the GPRA is the best assessment tool for
programs under titles VII and VIII.</text>
</subparagraph></paragraph><paragraph id="HA74E15914DA144EF99F270FD0C89849B"><enum>(3)</enum><text>A description of
measurable objectives of each entity relating to workforce diversity
initiatives.</text>
</paragraph></subsection><subsection id="H2CEECAC502FD4C6F99901BBE26666394"><enum>(c)</enum><header>Public
availability</header><text>The report under subsection (a) shall be made
available for public review and comment.</text>
</subsection></section><section id="H29D8D244094F48589103ECBC61476DFF"><enum>3412.</enum><header>National
Working Group on Workforce Diversity</header>
<subsection id="HC30E940D5AC84A8C8CA6A0DEA99B366D"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Bureau of Health
Professions within the Health Resources and Services Administration, shall
award a grant to an entity determined appropriate by the Secretary for the
establishment of a national working group on workforce diversity.</text>
</subsection><subsection id="HAE74436E4A0345D9851DADA8EA2F7173"><enum>(b)</enum><header>Representation</header><text>In
establishing the national working group under subsection (a):</text>
<paragraph id="HD8B9ED8686CB4C5A8778396FD5047CF4"><enum>(1)</enum><text>The grantee shall
ensure that the group has representatives of the following:</text>
<subparagraph id="H5C522483CB0449C7A5C853C2514538E5"><enum>(A)</enum><text>The Health
Resources and Services Administration.</text>
</subparagraph><subparagraph id="H0E5A562B824645F7A6FCB6D0CDC0DCAD"><enum>(B)</enum><text>The Department of
Health and Human Services Data Council.</text>
</subparagraph><subparagraph id="H26B7C82D0E4F44A4955845EC7F160B52"><enum>(C)</enum><text>The Office of
Minority Health.</text>
</subparagraph><subparagraph id="HCDC9185BA2E145FA91E53420D9593554"><enum>(D)</enum><text>The Bureau of
Labor Statistics of the Department of Labor.</text>
</subparagraph><subparagraph id="HEE213913FDE44F018E1FD480A742901E"><enum>(E)</enum><text>The Public Health
Practice Program Office—Office of Workforce Policy and Planning.</text>
</subparagraph><subparagraph id="H8B37A62AE17E43FB8D692016CF1731C7"><enum>(F)</enum><text>The National
Institute on Minority Health and Health Disparities.</text>
</subparagraph><subparagraph id="HC4D8A3D437844B28A44657B7A675FD6F"><enum>(G)</enum><text>The Agency for
Healthcare Research and Quality.</text>
</subparagraph><subparagraph id="HA3C35C5A16F24D14BA5CF504521F86BB"><enum>(H)</enum><text>The Institute of
Medicine Study Committee for the 2004 workforce diversity report.</text>
</subparagraph><subparagraph id="H23906B0F53374362922C4CAE02899B88"><enum>(I)</enum><text>The Indian Health
Service.</text>
</subparagraph><subparagraph id="HAA2741F849244312B6ABBFACEA7448AA"><enum>(J)</enum><text>Minority-serving
academic institutions.</text>
</subparagraph><subparagraph id="H034C502A84E5482E9B2456359B4BB7DD"><enum>(K)</enum><text>Consumer
organizations.</text>
</subparagraph><subparagraph id="H7A90E2B9763340ADB74221EA223900E4"><enum>(L)</enum><text>Health
professional associations, including those that represent underrepresented
minority populations.</text>
</subparagraph><subparagraph id="HBFB70722C7A34A87BC009E08894B6902"><enum>(M)</enum><text>Researchers in the
area of health workforce.</text>
</subparagraph><subparagraph id="H080DCBD8CC2140B4807D2EF66D623436"><enum>(N)</enum><text>Health workforce
accreditation entities.</text>
</subparagraph><subparagraph id="HAC5FCF5AFF1A4FBDAC815602D497B643"><enum>(O)</enum><text>Private
foundations that have sponsored workforce diversity initiatives.</text>
</subparagraph></paragraph><paragraph id="HE214C2B02A6346408B49327B2AB9A9D8"><enum>(2)</enum><text display-inline="yes-display-inline">The grantee shall ensure that, in addition
to the representatives under paragraph (1), the group has not less than 5
health professions students representing various health profession fields and
levels of training.</text>
</paragraph></subsection><subsection id="H8CBBA46AC4E44020AD21F45859C06A12"><enum>(c)</enum><header>Activities</header><text>The
working group established under subsection (a) shall convene at least twice
each year to complete the following activities:</text>
<paragraph id="HC4CB3D8DA05D49CA92BCA8C5AE45DF63"><enum>(1)</enum><text>Review current
public and private health workforce diversity initiatives.</text>
</paragraph><paragraph id="H30A0CBF784C945AA9866A2F9B4E12016"><enum>(2)</enum><text>Identify
successful health workforce diversity programs and practices.</text>
</paragraph><paragraph id="H6228565B87D04E2FA3AC022B2EFA215F"><enum>(3)</enum><text>Examine challenges
relating to the development and implementation of health workforce diversity
initiatives.</text>
</paragraph><paragraph id="H51393D7CA2784634A724E9A729D67631"><enum>(4)</enum><text>Draft a national
strategic work plan for health workforce diversity, including recommendations
for public and private sector initiatives.</text>
</paragraph><paragraph id="HEEF2A8EB1B564416BDF691548AB431A6"><enum>(5)</enum><text>Develop a
framework and methods for the evaluation of current and future health workforce
diversity initiatives.</text>
</paragraph><paragraph id="H4141EF4C1AF44685A24D430A34AA0982"><enum>(6)</enum><text>Develop
recommended standards for workforce diversity that could be applicable to all
health professions programs and programs funded under this Act.</text>
</paragraph><paragraph id="H93FBF9C36F7049D9ACC7495E18B61AF9"><enum>(7)</enum><text>Develop curriculum
guidelines for diversity training.</text>
</paragraph><paragraph id="H76C6A1FA7E984B269C4B42F2E55AA2C5"><enum>(8)</enum><text>Develop a strategy
for the inclusion of community members on admissions committees for health
profession schools.</text>
</paragraph><paragraph id="HACA585CFB0FA474FAAFABBA044EA77FC"><enum>(9)</enum><text>Other activities
determined appropriate by the Secretary.</text>
</paragraph></subsection><subsection id="H24AE4BDC8C42438597CEAE4A26439AE6"><enum>(d)</enum><header>Annual
report</header><text>Not later than 1 year after the establishment of the
working group under subsection (a), and annually thereafter, the working group
shall prepare and make available to the general public for comment, an annual
report on the activities of the working group. Such report shall include the
recommendations of the working group for improving health workforce
diversity.</text>
</subsection><subsection id="HA19692C4D9A342C69490FF3A0BE8B07F"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section such sums as may be necessary for each of fiscal years 2012
through 2017.</text>
</subsection></section><section id="HC915A3BF7A404AD8B1605E48B0576EE4"><enum>3413.</enum><header>Technical
Clearinghouse for Health workforce Diversity</header>
<subsection id="H0F9166A56D45400BAAF0A0D427CA4D32"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, acting
through the Office of Minority Health, and in collaboration with the Bureau of
Health Professions within the Health Resources and Services Administration, the
National Institute on Minority Health and Health Disparities, shall establish a
technical clearinghouse on health workforce diversity within the Office of
Minority Health and coordinate current and future clearinghouses.</text>
</subsection><subsection id="H5D67B08BAF5B43C88476B53A71D88EA8"><enum>(b)</enum><header>Information and
services</header><text>The clearinghouse established under subsection (a) shall
offer the following information and services:</text>
<paragraph id="H44A24F1F6C9841FDAE1E902BB9E85150"><enum>(1)</enum><text>Information on the
importance of health workforce diversity.</text>
</paragraph><paragraph id="HFC24AAAE905A4333B9F47E6254198C93"><enum>(2)</enum><text>Statistical
information relating to underrepresented minority representation in health and
allied health professions and occupations.</text>
</paragraph><paragraph id="H0738A0F81A714E53A198E9F74983B43E"><enum>(3)</enum><text>Model health
workforce diversity practices and programs.</text>
</paragraph><paragraph id="H1625AC5D531A44B8BA816420787D3513"><enum>(4)</enum><text>Admissions
policies that promote health workforce diversity and are in compliance with
Federal and State laws.</text>
</paragraph><paragraph id="HD43C33CE583A453CB617152ACD12BE55"><enum>(5)</enum><text>Lists of
scholarship, loan repayment, and loan cancellation grants as well as fellowship
information for underserved populations for health professions schools.</text>
</paragraph><paragraph id="H0530A60F900C466293DAF3DBD6024CA7"><enum>(6)</enum><text>Foundation and
other large organizational initiatives relating to health workforce
diversity.</text>
</paragraph></subsection><subsection id="H4878943529CD492AABD2DA03372FDAAA"><enum>(c)</enum><header>Consultation</header><text>In
carrying out this section, the Secretary shall consult with non-Federal
entities which may include minority health professional associations to ensure
the adequacy and accuracy of information.</text>
</subsection><subsection id="H74FF653284E440CDB097A5FD5763F9B6"><enum>(d)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section such sums as may be necessary for each of fiscal years 2012
through 2017.</text>
</subsection></section><section id="HECCB42A38A894251B1076BDC253AF856"><enum>3414.</enum><header>Support for
Institutions committed to workforce Diversity</header>
<subsection id="HAC2D99F2A4904AC3AC8A44569423D258"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Administrator of the
Health Resources and Services Administration and the Centers for Disease
Control and Prevention, shall award grants to eligible entities that
demonstrate a commitment to health workforce diversity.</text>
</subsection><subsection id="HB9D00A1198F247728B05129597A794B4"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under subsection (a), an entity shall—</text>
<paragraph id="H8C7123AF3A684BFF804E348D17794C0D"><enum>(1)</enum><text>be an educational
institution or entity that historically produces or trains meaningful numbers
of underrepresented minority health professionals, including—</text>
<subparagraph id="HBBC78847580D4A8385282EC5FBD718DE"><enum>(A)</enum><text>historically Black
colleges and universities;</text>
</subparagraph><subparagraph id="HDCB6E85B16C4402EA6D596EEAB1FC580"><enum>(B)</enum><text>Hispanic-serving
health professions schools;</text>
</subparagraph><subparagraph id="H4666CB64CEA5492D9343B41C28ADBAC1"><enum>(C)</enum><text>Hispanic-serving
institutions;</text>
</subparagraph><subparagraph id="HF04D13A7A57345AAA66F516ECC62E826"><enum>(D)</enum><text>tribal colleges
and universities;</text>
</subparagraph><subparagraph id="H52924C94B74E444690807B980F301392"><enum>(E)</enum><text>Asian-American,
Native American, and Pacific Islander-serving institutions;</text>
</subparagraph><subparagraph id="H4A1E0364DCAE406CAF16C89F1215961F"><enum>(F)</enum><text>institutions that
have programs to recruit and retain underrepresented minority health
professionals, in which a significant number of the enrolled participants are
underrepresented minorities;</text>
</subparagraph><subparagraph id="H0F27A19B832645B8A3C9EF137A28B9B6"><enum>(G)</enum><text>health
professional associations, which may include underrepresented minority health
professional associations; and</text>
</subparagraph><subparagraph id="H7D001EB37C364E6BA78FAA3EAC050D97"><enum>(H)</enum><text>institutions—</text>
<clause id="HFBC3E703DA974DB39B9D04BD8BDE4F58"><enum>(i)</enum><text>located in
communities with predominantly underrepresented minority populations;</text>
</clause><clause id="H52EC2856081B4F0ABAF65D1A2090FB82"><enum>(ii)</enum><text>with whom
partnerships have been formed for the purpose of increasing workforce
diversity; and</text>
</clause><clause id="HA1B971CC07AE4F879D47BFD8688F3848"><enum>(iii)</enum><text>in which at
least 20 percent of the enrolled participants are underrepresented minorities;
and</text>
</clause></subparagraph></paragraph><paragraph id="HA2B7BBEB04374524AA2AC679063C8359"><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.</text>
</paragraph></subsection><subsection id="HD1FB4C46DE4D48F2A70C0C405D75C357"><enum>(c)</enum><header>Use of
funds</header><text>Amounts received under a grant under subsection (a) shall
be used to expand existing workforce diversity programs, implement new
workforce diversity programs, or evaluate existing or new workforce diversity
programs, including with respect to mental health care professions. Such
programs shall enhance diversity by considering minority status as part of an
individualized consideration of qualifications. Possible activities may
include—</text>
<paragraph id="HE6A9891500E54B6DB0405FD04CF047A8"><enum>(1)</enum><text>educational
outreach programs relating to opportunities in the health professions;</text>
</paragraph><paragraph id="HD6E6B516EA90494796B61212A963E3D0"><enum>(2)</enum><text>scholarship,
fellowship, grant, loan repayment, and loan cancellation programs;</text>
</paragraph><paragraph id="HFEAE68F239D643809120929F34BFA9AC"><enum>(3)</enum><text>postbaccalaureate
programs;</text>
</paragraph><paragraph id="H28C40DBD0DB04874B27B031DB88A3F10"><enum>(4)</enum><text>academic
enrichment programs, particularly targeting those who would not be competitive
for health professions schools;</text>
</paragraph><paragraph id="H0E1EBF925C9E43AB8BE638547FB2F64B"><enum>(5)</enum><text>kindergarten
through 12th grade and other health pipeline programs;</text>
</paragraph><paragraph id="H298BED0820954C5FB6B3A436B49C9A56"><enum>(6)</enum><text>mentoring
programs;</text>
</paragraph><paragraph id="HD678C66DFB804FA39FF9EB27B0EAB3B2"><enum>(7)</enum><text>internship or
rotation programs involving hospitals, health systems, health plans and other
health entities;</text>
</paragraph><paragraph id="HDE3FE4D4FAE24B319531C8998581141A"><enum>(8)</enum><text>community
partnership development for purposes relating to workforce diversity; or</text>
</paragraph><paragraph id="H95CD8AA187CD482AAEA7F9305148FF4A"><enum>(9)</enum><text>leadership
training.</text>
</paragraph></subsection><subsection id="HEDD3C971D9704C5E8A14DA98E40F6315"><enum>(d)</enum><header>Reports</header><text>Not
later than 1 year after receiving a grant under this section, and annually for
the term of the grant, a grantee shall submit to the Secretary a report that
summarizes and evaluates all activities conducted under the grant.</text>
</subsection><subsection id="H255C6180CF88490285940C7A1F409B12"><enum>(e)</enum><header>Definition</header><text display-inline="yes-display-inline">In this section, the term
<term>Asian-American, Native American, and Pacific Islander-serving
institutions</term> has the same meaning as the term <term>Asian American and
Native American Pacific Islander-serving institution</term> as defined in
section 371(c) of the Higher Education Act of 1965 (20 U.S.C. 1067q(c)).</text>
</subsection><subsection id="H04E02C7215254EF996A59F3025963828"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through 2017.</text>
</subsection></section><section id="H4E3AC40F76824A3A86FD5C9288EA8FB7"><enum>3415.</enum><header>Career
development for scientists and researchers</header>
<subsection id="H5792F19B133C40F9B81AFE571034F225"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Director of the
National Institutes of Health, the Director of the Centers for Disease Control
and Prevention, the Commissioner of Food and Drugs, and the Director of the
Agency for Healthcare Research and Quality, shall award grants that expand
existing opportunities for scientists and researchers and promote the inclusion
of underrepresented minorities in the health professions.</text>
</subsection><subsection id="H4AC5C125FE7C4582AFEA7B033FA95117"><enum>(b)</enum><header>Research
funding</header><text>The head of each entity within the Department of Health
and Human Services shall establish or expand existing programs to provide
research funding to scientists and researchers in training. Under such
programs, the head of each such entity shall give priority in allocating
research funding to support health research in traditionally underserved
communities, including underrepresented minority communities, and research
classified as community or participatory.</text>
</subsection><subsection id="HE8BB144E40224CF89B0E807F94BD6FBA"><enum>(c)</enum><header>Data
collection</header><text>The head of each entity within the Department of
Health and Human Services shall collect data on the number (expressed as an
absolute number and a percentage) of underrepresented minority and nonminority
applicants who receive and are denied agency funding at every stage of review.
Such data shall be reported annually to the Secretary and the appropriate
committees of Congress.</text>
</subsection><subsection id="HC1194E5557D94DEB9D7047EFC58EA5A0"><enum>(d)</enum><header>Student loan
reimbursement</header><text>The Secretary shall establish a student loan
reimbursement program to provide student loan reimbursement assistance to
researchers who focus on racial and ethnic disparities in health. The Secretary
shall promulgate regulations to define the scope and procedures for the program
under this subsection.</text>
</subsection><subsection id="HBDBDFC4DFD6748F3B0897AEEF42F0C51"><enum>(e)</enum><header>Student loan
cancellation</header><text>The Secretary shall establish a student loan
cancellation program to provide student loan cancellation assistance to
researchers who focus on racial and ethnic disparities in health. Students
participating in the program shall make a minimum 5-year commitment to work at
an accredited health profession school. The Secretary shall promulgate
additional regulations to define the scope and procedures for the program under
this subsection.</text>
</subsection><subsection id="HB0274FDE9E864B4181167DD2447C9423"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through 2017.</text>
</subsection></section><section id="H583D254601A541B18B3F65523575D793"><enum>3416.</enum><header>Career support
for non-research Health professionals</header>
<subsection id="H04CB1FEBE2FB4CB9A1D062F17A2C4D82"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, the Administrator of the Substance Abuse
and Mental Health Services Administration, the Administrator of the Health
Resources and Services Administration, and the Administrator of the Centers for
Medicare and Medicaid Services shall establish a program to award grants to
eligible individuals for career support in non-research-related health
care.</text>
</subsection><subsection id="H40C74F0389C642D497E5CCB998035769"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under subsection (a) an individual shall—</text>
<paragraph id="HBEF479076A064340AFAA2192B185CACD"><enum>(1)</enum><text>be a student in a
health professions school, a graduate of such a school who is working in a
health profession, or a faculty member of such a school; and</text>
</paragraph><paragraph id="HDE2B01DEB56F4456B52AE2310B961B82"><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.</text>
</paragraph></subsection><subsection id="HA8CD76A6A92342F78300ED0ECFFD6ECE"><enum>(c)</enum><header>Use of
funds</header><text>An individual shall use amounts received under a grant
under this section to—</text>
<paragraph id="H602D4378082F4263AD3DEEF1EC26C150"><enum>(1)</enum><text>support the
individual’s health activities or projects that involve underserved
communities, including racial and ethnic minority communities;</text>
</paragraph><paragraph id="H9F95D157B2574B54A2DC23925D42D533"><enum>(2)</enum><text>support
health-related career advancement activities;</text>
</paragraph><paragraph id="H36CB418B69A840DD88D6A35FE995E53E"><enum>(3)</enum><text>to pay, or as
reimbursement for payments of, student loans for individuals who are health
professionals and are focused on health issues affecting underserved
communities, including racial and ethnic minority communities; and</text>
</paragraph><paragraph id="HD686FF8A16EA427F93622957F52AFBC8"><enum>(4)</enum><text>to establish and
promote leadership training programs to decrease health disparities and to
increase cultural competence with the goal of increasing diversity in
leadership positions.</text>
</paragraph></subsection><subsection id="H2C4C60C5570D47C981BB27D4FC1CF78F"><enum>(d)</enum><header>Definition</header><text>In
this section, the term <term>career in non-research-related health care</term>
means employment or intended employment in the field of public health, health
policy, health management, health administration, medicine, nursing, pharmacy,
psychology, social work, psychiatry, other mental and behavioral health, allied
health, community health, social work, or other fields determined appropriate
by the Secretary, other than in a position that involves research.</text>
</subsection><subsection id="H0721003B7FD34900A1B79B7D7C7B51A8"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through 2017.</text>
</subsection></section><section id="HE316EC9FF69F4F37AE4F97AFAFA64B28"><enum>3417.</enum><header>Research on
the effect of workforce Diversity on quality</header>
<subsection id="H117F9B53EA214E2D80FC841C333A4197"><enum>(a)</enum><header>In
general</header><text>The Director of the Agency for Healthcare Research and
Quality, in collaboration with the Deputy Assistant Secretary for Minority
Health and the Director of the National Institute on Minority Health and Health
Disparities, shall award grants to eligible entities to expand research on the
link between health workforce diversity and quality health care.</text>
</subsection><subsection id="H4EF250555F974D908E32A85CD73B7F6F"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under subsection (a) an entity shall—</text>
<paragraph id="HEF8C4152418F42DEA19F685DA94128A0"><enum>(1)</enum><text>be a clinical,
public health, or health services research entity or other entity determined
appropriate by the Director; and</text>
</paragraph><paragraph id="H7F835D83306C42CD860F22EE80A02A23"><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.</text>
</paragraph></subsection><subsection id="H27A6E3ED410D44DA8C9DDB4EE4E4069F"><enum>(c)</enum><header>Use of
funds</header><text>Amounts received under a grant awarded under subsection (a)
shall be used to support research that investigates the effect of health
workforce diversity on—</text>
<paragraph id="HA7D99A902E114236A8216A436A18671B"><enum>(1)</enum><text>language
access;</text>
</paragraph><paragraph id="HB7E05304612A44DE8AD9D9EE2D1A60C1"><enum>(2)</enum><text>cultural
competence;</text>
</paragraph><paragraph id="H309FE742ECD24CB585EC0AE589105F92"><enum>(3)</enum><text>patient
satisfaction;</text>
</paragraph><paragraph id="H9E19AEEA894943BE83D37EB21B98924E"><enum>(4)</enum><text>timeliness of
care;</text>
</paragraph><paragraph id="H1AD1C552E37747929355D84F74619908"><enum>(5)</enum><text>safety of
care;</text>
</paragraph><paragraph id="H9ED9A2400E3544DFBAD71721ECFBD598"><enum>(6)</enum><text>effectiveness of
care;</text>
</paragraph><paragraph id="H0879C9C65B044FED87A4CC99C4EF9669"><enum>(7)</enum><text>efficiency of
care;</text>
</paragraph><paragraph id="H129CE52351F443B08A74DD9F329F0B93"><enum>(8)</enum><text>patient
outcomes;</text>
</paragraph><paragraph id="H681DC9587EF34FC0AD79B85F67BB441E"><enum>(9)</enum><text>community
engagement;</text>
</paragraph><paragraph id="H2BF6C338274943C3B51BB3618BEC8978"><enum>(10)</enum><text>resource
allocation;</text>
</paragraph><paragraph id="H2F2065922DDA44B69E6FD45F9036347A"><enum>(11)</enum><text>organizational
structure;</text>
</paragraph><paragraph id="H67DACDAA28C04B2A80EC9422FEEBFB32"><enum>(12)</enum><text>compliance of
care; or</text>
</paragraph><paragraph id="H21245B7256334D88AB26EA78A6870D8E"><enum>(13)</enum><text>other topics
determined appropriate by the Director.</text>
</paragraph></subsection><subsection id="HC51D659F573F437A865DD94D1437CA08"><enum>(d)</enum><header>Priority</header><text>In
awarding grants under subsection (a), the Director shall give individualized
consideration to all relevant aspects of the applicant’s background.
Consideration of prior research experience involving the health of underserved
communities shall be such a factor.</text>
</subsection><subsection id="H279AA509CBEF4B64911EF9C6A3E8758B"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through 2017.</text>
</subsection></section><section id="HE3AAA652D13B4B9FA1A153900DE02ECE"><enum>3418.</enum><header>Health
disparities education Program</header>
<subsection id="H36DB12F9C3B247AC86329D58AB800345"><enum>(a)</enum><header>Establishment</header><text>The
Secretary, acting through the National Institute on Minority Health and Health
Disparities and in collaboration with the Office of Minority Health, the Office
for Civil Rights, the Centers for Disease Control and Prevention, the Centers
for Medicare & Medicaid Services, the Health Resources and Services
Administration, and other appropriate public and private entities, shall
establish and coordinate a health and health care disparities education program
to support, develop, and implement educational initiatives and outreach
strategies that inform health care professionals and the public about the
existence of and methods to reduce racial and ethnic disparities in health and
health care.</text>
</subsection><subsection id="H74BC26F051064F039588CCFE6EC7E0B8"><enum>(b)</enum><header>Activities</header><text>The
Secretary, through the education program established under subsection (a)
shall, through the use of public awareness and outreach campaigns targeting the
general public and the medical community at large—</text>
<paragraph id="H751026F499ED441CB40B58AF911775D2"><enum>(1)</enum><text display-inline="yes-display-inline">disseminate scientific evidence for the
existence and extent of racial and ethnic disparities in health care, including
disparities that are not otherwise attributable to known factors such as access
to care, patient preferences, or appropriateness of intervention, as described
in the 2002 Institute of Medicine Report entitled <term>Unequal Treatment:
Confronting Racial and Ethnic Disparities in Health Care</term>, as well as the
impact of disparities related to age, disability status, socioeconomic status,
sex, gender identity, and sexual orientation on racial and ethnic
minorities;</text>
</paragraph><paragraph id="HFF281D850A4A4E7E8297FA13DDC6D933"><enum>(2)</enum><text>disseminate new
research findings to health care providers and patients to assist them in
understanding, reducing, and eliminating health and health care
disparities;</text>
</paragraph><paragraph id="HB19F5F60C87A46A3A2284440B13CC68B"><enum>(3)</enum><text>disseminate
information about the impact of linguistic and cultural barriers on health care
quality and the obligation of health providers who receive Federal financial
assistance to ensure that people with limited-English proficiency have access
to language access services;</text>
</paragraph><paragraph id="H7061E185C025439A8C06F9CDD63C1397"><enum>(4)</enum><text>disseminate
information about the importance and legality of racial, ethnic, disability
status, socioeconomic status, sex, gender identity, and sexual orientation, and
primary language data collection, analysis, and reporting;</text>
</paragraph><paragraph id="H5322199D95984443A9650A293CC6BA53"><enum>(5)</enum><text>design and
implement specific educational initiatives to health care providers relating to
health and health care disparities; and</text>
</paragraph><paragraph id="HA761C8259308413DAC45B0E56164D320"><enum>(6)</enum><text>assess the impact
of the programs established under this section in raising awareness of health
and health care disparities and providing information on available
resources.</text>
</paragraph></subsection><subsection id="HF171DD5F6B6148D699252C67C88DA04C"><enum>(c)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through
2017.</text>
</subsection></section></subtitle><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HA2BFA1F7825544A7AD41ACE279AC59DF"><enum>302.</enum><header>Hispanic-serving
health professions schools</header><text display-inline="no-display-inline">Part B of title VII of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
293 et seq.) is amended by adding at the end the following:</text>
<quoted-block act-name="Public Health Service Act" id="HB0A36C79CDA043C1826545380F076733">
<section id="H9BB99C0E75314455B3923362E4520B55"><enum>742.</enum><header>Hispanic-serving
health professions schools</header>
<subsection id="H0A5963ABD73E472C9448755C00336698"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Administrator of the
Health Resources and Services Administration, shall award grants to
Hispanic-serving health professions schools for the purpose of carrying out
programs to recruit Hispanic individuals to enroll in and graduate from such
schools, which may include providing scholarships and other financial
assistance as appropriate.</text>
</subsection><subsection id="H8F4B280DED5C40D4B638B493913601A0"><enum>(b)</enum><header>Eligibility</header><text>In
subsection (a), the term <term>Hispanic-serving health professions
school</term> means an entity that—</text>
<paragraph id="H4DEC78B369E04144842FF184FCA44B9D"><enum>(1)</enum><text display-inline="yes-display-inline">is a school or program under section
799B;</text>
</paragraph><paragraph id="HB86BCD539EB2486181B82DB35A03827D"><enum>(2)</enum><text>has an enrollment
of full-time equivalent students that is made up of at least 9 percent Hispanic
students;</text>
</paragraph><paragraph id="H12CB841C32064D358FB25D6DF5EDA621"><enum>(3)</enum><text>has been effective
in carrying out programs to recruit Hispanic individuals to enroll in and
graduate from the school;</text>
</paragraph><paragraph id="H79149EDEBB5944369C126C2FD1515D2D"><enum>(4)</enum><text>has been effective
in recruiting and retaining Hispanic faculty members;</text>
</paragraph><paragraph id="HCEF8F556DA5F48CC8AF77987C19C6585"><enum>(5)</enum><text>has a significant
number of graduates who are providing health services to medically underserved
populations or to individuals in health professional shortage areas; and</text>
</paragraph><paragraph id="H7AD1422D134E4552987B78F3E7EDD0BB"><enum>(6)</enum><text>Regional Hispanic
Centers of
Excellence.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H18991DD1037A4258B030DB2B6436D352"><enum>303.</enum><header>Loan repayment
program of Centers for Disease Control and Prevention</header><text display-inline="no-display-inline">Section 317F(c) of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
247b–7(c)) is amended—</text>
<paragraph id="H60AA6E27E90940DD8C831C72CBC867DD"><enum>(1)</enum><text>by striking
<quote>and</quote> after <quote>1994,</quote>; and</text>
</paragraph><paragraph id="H581D39FBDF2F462C9938610DE8F3AA54"><enum>(2)</enum><text>by inserting
before the period the following: <quote>$750,000 for fiscal year 2012, and such
sums as may be necessary for each of the fiscal years 2013 through
2017.</quote>.</text>
</paragraph></section><section id="H4EE1AB0E61784580865FC9A490CB85CD"><enum>304.</enum><header>Cooperative
agreements for online degree programs at schools of public health and schools
of allied health</header><text display-inline="no-display-inline">Part B of
title VII of the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name> (42 U.S.C. 293 et seq.), as amended by section 302, is further
amended by adding at the end the following:</text>
<quoted-block act-name="Public Health Service Act" id="H13021AF227D64D7085FBD31E447AC127">
<section id="HB24F4FAACF774E34A934B4686839814D"><enum>743.</enum><header>Cooperative
agreements for online degree programs</header>
<subsection id="H95320BCB27B74578AF88DFCD4EDAD0BF"><enum>(a)</enum><header>Cooperative
agreements</header><text>The Secretary, acting through the Administrator of the
Health Resources and Services Administration, in consultation with the Director
of the Centers for Disease Control and Prevention, the Director of the Agency
for Healthcare Research and Quality, and the Deputy Assistant Secretary for
Minority Health, shall award cooperative agreements to schools of public health
and schools of allied health to design and implement online degree
programs.</text>
</subsection><subsection id="HD1E595587CDE435CA754D93289441535"><enum>(b)</enum><header>Priority</header><text>In
awarding cooperative agreements under this section, the Secretary shall give
priority to any school of public health or school of allied health that has an
established track record of serving medically underserved communities.</text>
</subsection><subsection id="HEACDADFFAD094D71B13D1EEA12F1DFBD"><enum>(c)</enum><header>Requirements</header><text>Awardees
must design and implement an online degree program, that meet the following
restrictions:</text>
<paragraph id="HDD508CD766CB46108357080CAAC90DFA"><enum>(1)</enum><text>Enrollment of
individuals who have obtained a secondary school diploma or its recognized
equivalent.</text>
</paragraph><paragraph id="H6909C86BA6AC496997F0DF2B63819E52"><enum>(2)</enum><text>Maintaining a
significant enrollment of underrepresented minority or disadvantaged
students.</text>
</paragraph></subsection><subsection id="H60532500D6124EC89F35DCF7553DAFB7"><enum>(d)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through
2017.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H7FDBD9E03AA549D98E8BB3CFDEF225E2"><enum>305.</enum><header>National report
on the preparedness of health professionals to care for diverse
populations</header><text display-inline="no-display-inline">The Secretary of
Health and Human Services, in collaboration with the Bureau of Health
Professions, the Office of Minority Health and the National Institute on
Minority Health and Health Disparities, shall prepare and disseminate a report
that details and assesses the preparedness of health professionals to care for
racially and ethnically diverse populations. Such information, which shall be
collected by the Bureau of Health Professions, shall include—</text>
<paragraph id="HA4B117EF05F143F5B972FC2130FDB139"><enum>(1)</enum><text>with respect to
health professions education, the number and percentage of hours of classroom
discussion relating to minority health issues, including cultural
competence;</text>
</paragraph><paragraph id="H84AC275D6C3B4CC180343110F87AABE7"><enum>(2)</enum><text>a
description of the coursework involved in such education;</text>
</paragraph><paragraph id="HE37437F6EE74479DBA709E9FC4589E77"><enum>(3)</enum><text>a
description of the results of an evaluation of the preparedness of students in
such education;</text>
</paragraph><paragraph id="HB8E83640BF3C4E7EA033D25632C67D3F"><enum>(4)</enum><text>a
description of the types of exposure that students have during their education
to minority patient populations; and</text>
</paragraph><paragraph id="HECF59D0A768749D7808FAAC3646005C6"><enum>(5)</enum><text>a
description of model programs and practices.</text>
</paragraph></section><section id="HF2F15A5D471241839706CB8599B3DAFF"><enum>306.</enum><header>Scholarship and
fellowship programs</header><text display-inline="no-display-inline">Subtitle A
of title XXXIV of the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name>, as amended by section 301, is further amended by inserting
after section 3418 the following:</text>
<quoted-block act-name="Public Health Service Act" id="H1D327759A4D34961A0980D8B3F717508">
<section id="H953213479D584E2E87012886952662D7"><enum>3419.</enum><header>David Satcher
Public Health and Health Services Corps</header>
<subsection id="HA4C97F0F13E04D0691915354E9B7E51E"><enum>(a)</enum><header>In
general</header><text>The Administrator of the Health Resources and Services
Administration and the Director of the Centers for Disease Control and
Prevention, in collaboration with the Deputy Assistant Secretary for Minority
Health, shall award grants to eligible entities to increase awareness among
postprimary and postsecondary students of career opportunities in the health
professions.</text>
</subsection><subsection id="HAFA5D13CDDB9425CB631CA165F65EDB6"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under subsection (a) an entity shall—</text>
<paragraph id="H5DBA3C90904A49A78552D1F86556F439"><enum>(1)</enum><text>be a clinical,
public health or health services organization, community-based or nonprofit
entity, or other entity determined appropriate by the Director of the Centers
for Disease Control and Prevention;</text>
</paragraph><paragraph id="H8170BA4D1BDC42B1810A34BBDA9DD1BF"><enum>(2)</enum><text>serve a health
professional shortage area, as determined by the Secretary;</text>
</paragraph><paragraph id="H3E28789518564DDC9A6D017FC93E3027"><enum>(3)</enum><text>work with
students, including those from racial and ethnic minority backgrounds, that
have expressed an interest in the health professions; and</text>
</paragraph><paragraph id="H03C4724167CA4148981D8DF232FBF35C"><enum>(4)</enum><text>submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require.</text>
</paragraph></subsection><subsection id="HF90025C856D94EFE93AB9598F52B8554"><enum>(c)</enum><header>Use of
funds</header><text>Grant awards under subsection (a) shall be used to support
internships that will increase awareness among students of non-research-based
and career opportunities in the following health professions:</text>
<paragraph id="H543ADB74C157431C822DEFBE2C2861C3"><enum>(1)</enum><text>Medicine.</text>
</paragraph><paragraph id="HDBD304C72F5D4925B4E09A9E2C51314C"><enum>(2)</enum><text>Nursing.</text>
</paragraph><paragraph id="HA316FA6652394869B9E8784F3337753E"><enum>(3)</enum><text>Public
Health.</text>
</paragraph><paragraph id="HE85BD56E73214597B36A974F574AE459"><enum>(4)</enum><text>Pharmacy.</text>
</paragraph><paragraph id="H51F5BAA6AA7C421E8981CF66E8779FFA"><enum>(5)</enum><text>Health
administration and management.</text>
</paragraph><paragraph id="H7D9CCF34142C491A944C3DD119E7D543"><enum>(6)</enum><text>Health
policy.</text>
</paragraph><paragraph id="HC5CBC0A79C114789ABABA874D23EAD20"><enum>(7)</enum><text>Psychology.</text>
</paragraph><paragraph id="HEA7C90B1A41843138066A3A71666D35B"><enum>(8)</enum><text>Dentistry.</text>
</paragraph><paragraph id="HDC483E336ED84D23A0734C473342EA23"><enum>(9)</enum><text>International
health.</text>
</paragraph><paragraph id="H94E7126CE3AB4DB78789C2A0A555F91B"><enum>(10)</enum><text>Social
work.</text>
</paragraph><paragraph id="H9B1236E1FEBC43B2BA1834AB590C9817"><enum>(11)</enum><text>Allied
health.</text>
</paragraph><paragraph id="H0028A64E8F354DC98CC8771B0558983A"><enum>(12)</enum><text>Psychiatry.</text>
</paragraph><paragraph id="HE0B23308D28749A1906D7277406DA590"><enum>(13)</enum><text>Hospice
care.</text>
</paragraph><paragraph id="HDC2A954124B640CE8DC920DFF3C57A5F"><enum>(14)</enum><text>Other professions
deemed appropriate by the Director of the Centers for Disease Control and
Prevention.</text>
</paragraph></subsection><subsection id="HBB2E77338AF845FC9EADF6223BB1BB00"><enum>(d)</enum><header>Priority</header><text>In
awarding grants under subsection (a), the Director of the Centers for Disease
Control and Prevention shall give priority to those entities that—</text>
<paragraph id="H96A62D83F92944E494D209F8E835FCFA"><enum>(1)</enum><text>serve a high
proportion of individuals from disadvantaged backgrounds;</text>
</paragraph><paragraph id="HFBC79F81F0BC476FB40352493213AFE5"><enum>(2)</enum><text>have experience in
health disparity elimination programs;</text>
</paragraph><paragraph id="H13D75BA02683457EA27D71F1F272124A"><enum>(3)</enum><text>facilitate the
entry of disadvantaged individuals into institutions of higher education;
and</text>
</paragraph><paragraph id="HCD52DE1FA81348B5B95F47724F8C363A"><enum>(4)</enum><text>provide counseling
or other services designed to assist disadvantaged individuals in successfully
completing their education at the postsecondary level.</text>
</paragraph></subsection><subsection id="H206A0C04A2B24432821DEEB1BEAB264E"><enum>(e)</enum><header>Stipends</header><text>The
Secretary may approve stipends under this section for individuals for any
period of education in student-enhancement programs (other than regular
courses) at health professions schools, programs, or entities, except that such
a stipend may not be provided to an individual for more than 6 months, and such
a stipend may not exceed $20 per day (notwithstanding any other provision of
law regarding the amount of stipends).</text>
</subsection><subsection id="HF32E5AB942E14AF9BC9A62D9E222A22B"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through 2017.</text>
</subsection></section><section id="H77B079E2F646499E8E53D99031734AAB"><enum>3420.</enum><header>Louis Stokes
Public Health Scholars Program</header>
<subsection id="HD4E34B4A8CC04DC99CD09BD7D9D99290"><enum>(a)</enum><header>In
general</header><text>The Director of the Centers for Disease Control and
Prevention, in collaboration with the Deputy Assistant Secretary for Minority
Health, shall award scholarships to postsecondary students who seek a career in
public health.</text>
</subsection><subsection id="H1F98BE0D9B4A4709B98E1BE34FBCE697"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a scholarship under subsection (a) an individual
shall—</text>
<paragraph id="HD8908005D0EC4F738C3117AFFA873031"><enum>(1)</enum><text>have experience in
public health research or public health practice, or other health professions
as determined appropriate by the Director of the Centers for Disease Control
and Prevention;</text>
</paragraph><paragraph id="H6284BD5FF13248BCA0F04AEF5E8D616B"><enum>(2)</enum><text>reside in a health
professional shortage area as determined by the Secretary;</text>
</paragraph><paragraph id="H857AFB6D147A41D09C4133AC921632B2"><enum>(3)</enum><text>have expressed an
interest in public health;</text>
</paragraph><paragraph id="H59AAE9A9F9D04333B74D62B5167ABB1F"><enum>(4)</enum><text>demonstrate
promise for becoming a leader in public health;</text>
</paragraph><paragraph id="HA4604BEA4BC441C091AF204ED4BA8D92"><enum>(5)</enum><text>secure admission
to a 4-year institution of higher education;</text>
</paragraph><paragraph id="HC5985A5DBBDD4CE88FD4B73F586DBB81"><enum>(6)</enum><text>comply with
subsection (f); and</text>
</paragraph><paragraph id="H94D53C1B0A1243B699EBC3736D585861"><enum>(7)</enum><text>submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require.</text>
</paragraph></subsection><subsection id="H3473298EFF2948B4874B25BD9E568A52"><enum>(c)</enum><header>Use of
funds</header><text>Amounts received under an award under subsection (a) shall
be used to support opportunities for students to become public health
professionals.</text>
</subsection><subsection id="H6EE05A15070D43A49955413DC306C408"><enum>(d)</enum><header>Priority</header><text>In
awarding grants under subsection (a), the Director shall give priority to those
students that—</text>
<paragraph id="H715736D3D11E47D7AC909129CF6120AA"><enum>(1)</enum><text>are from
disadvantaged backgrounds;</text>
</paragraph><paragraph id="H9391A56FFA08464699CCE372D75C8699"><enum>(2)</enum><text>have secured
admissions to a minority-serving institution; and</text>
</paragraph><paragraph id="H96876FECFE534B428E346A80E128FC49"><enum>(3)</enum><text>have identified a
health professional as a mentor at their school or institution and an academic
advisor to assist in the completion of their baccalaureate degree.</text>
</paragraph></subsection><subsection id="HCD85C8E2ABBF4EF194F16375B67580C2"><enum>(e)</enum><header>Scholarships</header><text>The
Secretary may approve payment of scholarships under this section for such
individuals for any period of education in student undergraduate tenure, except
that such a scholarship may not be provided to an individual for more than 4
years, and such scholarships may not exceed $10,000 per academic year
(notwithstanding any other provision of law regarding the amount of
scholarship).</text>
</subsection><subsection id="H9DD56DBB87EB46A69038AB9D091E4398"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through 2017.</text>
</subsection></section><section id="HD80C8323539D474F95AD46A8B8A676E9"><enum>3420A.</enum><header>Patsy Mink
Health and Gender Research Fellowship Program</header>
<subsection id="HBF51E32858F643E68563210556B1DF1C"><enum>(a)</enum><header>In
general</header><text>The Director of the Centers for Disease Control and
Prevention, in collaboration with the Deputy Assistant Secretary for Minority
Health, the Administrator of the Substance Abuse and Mental Health Services
Administration, and the Director of the Indian Health Services, shall award
research fellowships to post-baccalaureate students to conduct research that
will examine gender and health disparities and to pursue a career in the health
professions.</text>
</subsection><subsection id="H56FFB065DDA3441CA0ABF0F01115007E"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a fellowship under subsection (a) an individual
shall—</text>
<paragraph id="H652EC76A519640FF9A297CCDDFDE0B0E"><enum>(1)</enum><text>have experience in
health research or public health practice;</text>
</paragraph><paragraph id="H7BF18389F2284CA89214F8D9FB6FA881"><enum>(2)</enum><text>reside in a health
professional shortage area as determined by the Secretary;</text>
</paragraph><paragraph id="H8C00A5E44CDB4B4A9C06266E852A51BC"><enum>(3)</enum><text>have expressed an
interest in the health professions;</text>
</paragraph><paragraph id="H708D80F0385A4A5697E0074D5C835162"><enum>(4)</enum><text>demonstrate
promise for becoming a leader in the field of women’s health;</text>
</paragraph><paragraph id="H7BAD33480A7A47A8A44BB00998ED028D"><enum>(5)</enum><text>secure admission
to a health professions school or graduate program with an emphasis in gender
studies;</text>
</paragraph><paragraph id="HB17960997ABE4BE8855B67FC4A76B37C"><enum>(6)</enum><text>comply with
subsection (f); and</text>
</paragraph><paragraph id="H2B3E019D31F44CB8A65AF7949FC1810E"><enum>(7)</enum><text>submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require.</text>
</paragraph></subsection><subsection id="H8DDC9AA5975D4269A4A5434F8EF602C1"><enum>(c)</enum><header>Use of
funds</header><text>Amounts received under an award under subsection (a) shall
be used to support opportunities for students to become researchers and advance
the research base on the intersection between gender and health.</text>
</subsection><subsection id="HD4DB8E69FA9F4EDDA758D8989C387C5C"><enum>(d)</enum><header>Priority</header><text>In
awarding grants under subsection (a), the Director of the Centers for Disease
Control and Prevention shall give priority to those applicants that—</text>
<paragraph id="H1FE3A7D5E4BB4EE5A3D8689530A02036"><enum>(1)</enum><text>are from
disadvantaged backgrounds; and</text>
</paragraph><paragraph id="H1061BA62077D4E38A42265D83519A9D3"><enum>(2)</enum><text>have identified a
mentor and academic advisor who will assist in the completion of their graduate
or professional degree and have secured a research assistant position with a
researcher working in the area of gender and health.</text>
</paragraph></subsection><subsection id="H09ABDC99FC6049B8A69164D4EBE31A21"><enum>(e)</enum><header>Fellowships</header><text>The
Director of the Centers for Disease Control and Prevention may approve
fellowships for individuals under this section for any period of education in
the student’s graduate or health profession tenure, except that such a
fellowship may not be provided to an individual for more than 3 years, and such
a fellowship may not exceed $18,000 per academic year (notwithstanding any
other provision of law regarding the amount of fellowship).</text>
</subsection><subsection id="H568936C1025A45FBA5781011B4A70746"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through 2017.</text>
</subsection></section><section id="H9D2982FE1D704C719EC4E217E12D57B8"><enum>3420B.</enum><header>Paul David
Wellstone International Health Fellowship Program</header>
<subsection id="H58E0D0322FA4497CB8C6D092307B6671"><enum>(a)</enum><header>In
general</header><text>The Director of the Agency for Healthcare Research and
Quality, in collaboration with the Deputy Assistant Secretary for Minority
Health, shall award research fellowships to college students or recent
graduates to advance their understanding of international health.</text>
</subsection><subsection id="HDC8CD0759DD8435F8EDD726A63913CDF"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a fellowship under subsection (a) an individual
shall—</text>
<paragraph id="HBBF639FB995449AFAB7F4570D980BBB7"><enum>(1)</enum><text>have educational
experience in the field of international health;</text>
</paragraph><paragraph id="HE1772AAD005F456C85F4DC5566A53B94"><enum>(2)</enum><text>reside in a health
professional shortage area as determined by the Secretary;</text>
</paragraph><paragraph id="HF67707D886B7412FB3209FC5AB45A55C"><enum>(3)</enum><text>demonstrate
promise for becoming a leader in the field of international health;</text>
</paragraph><paragraph id="HA6A63D6D387445759893F228C131FC12"><enum>(4)</enum><text>be a college
senior or recent graduate of a four-year higher education institution;</text>
</paragraph><paragraph id="H53C08975F01546C6882D549F26F0AF59"><enum>(5)</enum><text>comply with
subsection (f); and</text>
</paragraph><paragraph id="H205260F8692949A3B8075974B35E409F"><enum>(6)</enum><text>submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require.</text>
</paragraph></subsection><subsection id="HECC50ED22F7B4FD8A1C84F30EA1577A5"><enum>(c)</enum><header>Use of
funds</header><text>Amounts received under an award under subsection (a) shall
be used to support opportunities for students to become health professionals
and to advance their knowledge about international issues relating to health
care access and quality.</text>
</subsection><subsection id="H7A2A55A62B7B4C6F9269BF8A1D212614"><enum>(d)</enum><header>Priority</header><text>In
awarding grants under subsection (a), the Director shall give priority to those
applicants that—</text>
<paragraph id="H083492ECE3394364A71F2EE84D336BD7"><enum>(1)</enum><text>are from a
disadvantaged background; and</text>
</paragraph><paragraph id="H8EBC08FF108746F3A513B57BD36B2743"><enum>(2)</enum><text>have identified a
mentor at a health professions school or institution, an academic advisor to
assist in the completion of their graduate or professional degree, and an
advisor from an international health non-governmental organization, private
volunteer organization, or other international institution or program that
focuses on increasing health care access and quality for residents in
developing countries.</text>
</paragraph></subsection><subsection id="HF37621FEE44A4EB0B6AD7E706894C9B3"><enum>(e)</enum><header>Fellowships</header><text>The
Secretary shall approve fellowships for college seniors or recent graduates,
except that such a fellowship may not be provided to an individual for more
than 6 months, may not be awarded to a graduate that has not been enrolled in
school for more than 1 year, and may not exceed $4,000 per academic year
(notwithstanding any other provision of law regarding the amount of
fellowship).</text>
</subsection><subsection id="HDFEAC73CEC904E6A81FC9E68906651A1"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through 2017.</text>
</subsection></section><section id="H775F0C818A124816A9246B37D16603AA"><enum>3420C.</enum><header>Edward R.
Roybal Health Care Scholar Program</header>
<subsection id="H6A31F3BE12B947B19D5ACCAD26730A70"><enum>(a)</enum><header>In
general</header><text>The Director of the Agency for Healthcare Research and
Quality, the Director of the Centers for Medicaid & Medicare, and the
Administrator for Health Resources and Services Administration, in
collaboration with the Deputy Assistant Secretary for Minority Health, shall
award grants to eligible entities to expose entering graduate students to the
health professions.</text>
</subsection><subsection id="H79C6508CB49842E493D037503F12C654"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under subsection (a) an entity shall—</text>
<paragraph id="H1E85DAA3359146678EF7DEE5E698D4B0"><enum>(1)</enum><text>be a clinical,
public health or health services organization, community-based or nonprofit
entity, or other entity determined appropriate by the Director of the Agency
for Healthcare Research and Quality;</text>
</paragraph><paragraph id="H7B6F9925D5E44690BDBA0781A78AEBBA"><enum>(2)</enum><text>serve in a health
professional shortage area as determined by the Secretary;</text>
</paragraph><paragraph id="H508B6FB0FAD94EEE92AA061BAC194A4F"><enum>(3)</enum><text>work with students
obtaining a degree in the health professions; and</text>
</paragraph><paragraph id="H76F9AD0D0EBD4F0B983301B585D4765E"><enum>(4)</enum><text>submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require.</text>
</paragraph></subsection><subsection id="H4CB84A5574A743D6AFC58A099F5C14F0"><enum>(c)</enum><header>Use of
funds</header><text>Amounts received under a grant awarded under subsection (a)
shall be used to support opportunities that expose students to
non-research-based health professions, including—</text>
<paragraph id="H389571238D1142A1851CAA04DF68AAA0"><enum>(1)</enum><text>public health
policy;</text>
</paragraph><paragraph id="H915A376D3064466FB863724986187704"><enum>(2)</enum><text>health care and
pharmaceutical policy;</text>
</paragraph><paragraph id="HAE73D848698749C5AFB3F0ABA635A943"><enum>(3)</enum><text>health care
administration and management;</text>
</paragraph><paragraph id="HCA6BA0930C6C4F29AB4EEC65744A832F"><enum>(4)</enum><text>health economics;
and</text>
</paragraph><paragraph id="HA8C634609058471EB1B358C646CD6D25"><enum>(5)</enum><text>other professions
determined appropriate by the Director of the Agency for Healthcare Research
and Quality.</text>
</paragraph></subsection><subsection id="H9853F7781B134F7B909CEDE9388FE953"><enum>(d)</enum><header>Priority</header><text>In
awarding grants under subsection (a), the Director of the Agency for Healthcare
Research and Quality shall give priority to those entities that—</text>
<paragraph id="H0DB02769137C4E4689F38AAABCB0E54A"><enum>(1)</enum><text>have experience
with health disparity elimination programs;</text>
</paragraph><paragraph id="HFE4B8906050A4D13A09ECCBAD5E978D5"><enum>(2)</enum><text>facilitate
training in the fields described in subsection (c); and</text>
</paragraph><paragraph id="H64FB039AB90041D4A3605D559551C157"><enum>(3)</enum><text>provide counseling
or other services designed to assist such individuals in successfully
completing their education at the postsecondary level.</text>
</paragraph></subsection><subsection id="H9830240E9171478D937AB603F114DC71"><enum>(e)</enum><header>Stipends</header><text>The
Secretary may approve the payment of stipends for individuals under this
section for any period of education in student-enhancement programs (other than
regular courses) at health professions schools or entities, except that such a
stipend may not be provided to an individual for more than 2 months, and such a
stipend may not exceed $100 per day (notwithstanding any other provision of law
regarding the amount of stipends).</text>
</subsection><subsection id="H67F5A7A1DE20428BA792F535D99B7630"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section such sums as may be necessary for each of fiscal years 2012
through
2017.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HD3019E64BF4E48CA9BDEE255D5551376"><enum>307.</enum><header>Advisory
Committee on Health Professions Training for Diversity</header>
<subsection id="H4BD6EB73350742B8A23DF45D58143EBB"><enum>(a)</enum><header>Establishment</header><text>The
Secretary of Health and Human Services (referred to in this section as the
<term>Secretary</term>) shall establish an advisory committee to be known as
the Advisory Committee on Health Professions Training for Diversity (in this
section referred to as the <term>Advisory Committee</term>).</text>
</subsection><subsection id="HA7FA778F24D846FC8D0D3D456A99242B"><enum>(b)</enum><header>Composition</header>
<paragraph id="HCD5D53AFB7B94B4494A4AFA3F6492D0C"><enum>(1)</enum><header>In
general</header><text>The Secretary shall determine the appropriate number of
individuals to serve on the Advisory Committee. Such individuals shall not be
officers or employees of the Federal Government.</text>
</paragraph><paragraph id="HC8857B263F7944EDB2E454DEA9890372"><enum>(2)</enum><header>Appointment</header><text>Not
later than 60 days after the date of enactment of this section, the Secretary
shall appoint the members of the Advisory Committee from among individuals who
are health professionals. In making such appointments, the Secretary shall
ensure a fair balance between the health professions, that at least 75 percent
of the members of the Advisory Committee are health professionals, a broad
geographic representation of members and a balance between urban and rural
members. Members shall be appointed based on their competence, interest, and
knowledge of the mission of the profession involved.</text>
</paragraph><paragraph id="H34FF636CAEB7425F8CF14706D8857752"><enum>(3)</enum><header>Minority
representation</header><text>In appointing the members of the Advisory
Committee under paragraph (2), the Secretary shall ensure the adequate
representation of women and minorities.</text>
</paragraph></subsection><subsection id="HB4CBF60C8E3D4C589849C0FC02DE6A11"><enum>(c)</enum><header>Terms</header>
<paragraph id="H0ED722CAEB964DDDB4A7839763ED7439"><enum>(1)</enum><header>In
general</header><text>A member of the Advisory Committee shall be appointed for
a term of 3 years, except that of the members first appointed—</text>
<subparagraph id="HF4C4A3F7B0024B429BB671B67797948F"><enum>(A)</enum><text><fraction>1/3</fraction>
of such members shall serve for a term of 1 year;</text>
</subparagraph><subparagraph id="HD5B5D28606D84B7DBDC25BCD4A337653"><enum>(B)</enum><text><fraction>1/3</fraction>
of such members shall serve for a term of 2 years; and</text>
</subparagraph><subparagraph id="HA0424C0B19DF46398AF6398F0850308E"><enum>(C)</enum><text><fraction>1/3</fraction>
of such members shall serve for a term of 3 years.</text>
</subparagraph></paragraph><paragraph id="HEFD5FCF26C9B42B1A8D6D6580168B627"><enum>(2)</enum><header>Vacancies</header>
<subparagraph id="HD1D762F87EDA4378A30A777373608BEA"><enum>(A)</enum><header>In
general</header><text>A vacancy on the Advisory Committee shall be filled in
the manner in which the original appointment was made and shall be subject to
any conditions which applied with respect to the original appointment.</text>
</subparagraph><subparagraph id="HFE5CA65403364846BDFE02EBCB92739F"><enum>(B)</enum><header>Filling
unexpired term</header><text>An individual chosen to fill a vacancy shall be
appointed for the unexpired term of the member replaced.</text>
</subparagraph></paragraph></subsection><subsection id="H1F9C41B754CB4D85AE6A44C33296BAE5"><enum>(d)</enum><header>Duties</header>
<paragraph id="H4B30254FAF3045248C562F1D9C463294"><enum>(1)</enum><header>In
general</header><text>The Advisory Committee shall—</text>
<subparagraph id="HD5A48A8F064D49EDBCD5E30D0943AA34"><enum>(A)</enum><text>provide advice and
recommendations to the Secretary concerning policy and program development and
other matters of significance concerning activities under this part; and</text>
</subparagraph><subparagraph id="H72DE4845330A4BDBA4E6E6B699AD1BAD"><enum>(B)</enum><text>not later than 2
years after the date of enactment of this section, and annually thereafter,
prepare and submit to the Secretary, and the Committee on Health, Education,
Labor, and Pensions of the Senate, and the Committee on Energy and Commerce of
the House of Representatives, a report describing the activities of the
Committee.</text>
</subparagraph></paragraph><paragraph id="HC6864518E3BA423681BEA8BC84479216"><enum>(2)</enum><header>Consultation
with students</header><text>In carrying out duties under paragraph (1), the
Advisory Committee shall consult with individuals who are attending health
professions schools with which this part is concerned.</text>
</paragraph></subsection><subsection id="H8D328CE3B4034128AB84B341C707B3F3"><enum>(e)</enum><header>Meetings and
documents</header>
<paragraph id="H3548AFD399624F32A7A8DD7BD19DC3E4"><enum>(1)</enum><header>Meetings</header><text>The
Advisory Committee shall meet not less than 2 times each year. Such meetings
shall be held jointly with other related entities established under this title
where appropriate.</text>
</paragraph><paragraph id="HAD529C1DA0734A66B62A6642FAB10446"><enum>(2)</enum><header>Documents</header><text>Not
later than 14 days prior to the convening of a meeting under paragraph (1), the
Advisory Committee shall prepare and make available an agenda of the matters to
be considered by the Advisory Committee at such meeting. At any such meeting,
the Advisory Committee shall distribute materials with respect to the issues to
be addressed at the meeting. Not later than 30 days after the adjourning of
such a meeting, the Advisory Committee shall prepare and make available a
summary of the meeting and any actions taken by the Committee based upon the
meeting.</text>
</paragraph></subsection><subsection id="HE554BF5FCF24485894205C0A70DCB979"><enum>(f)</enum><header>Compensation and
expenses</header>
<paragraph id="H31909CF55D46465AA35263A5AED92BDB"><enum>(1)</enum><header>Compensation</header><text>Each
member of the Advisory Committee shall be compensated at a rate equal to the
daily equivalent of the annual rate of basic pay prescribed for level IV of the
Executive Schedule under section 5315 of title 5, United States Code, for each
day (including travel time) during which such member is engaged in the
performance of the duties of the Committee.</text>
</paragraph><paragraph id="H7FE6F64121E546239CB49E2DF5ABDB15"><enum>(2)</enum><header>Expenses</header><text>The
members of the Advisory Committee shall be allowed travel expenses, including
per diem in lieu of subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States Code, while away
from their homes or regular places of business in the performance of services
for the Committee.</text>
</paragraph></subsection><subsection id="HF1F7A3D191BE41B59546F510C6D35426"><enum>(g)</enum><header>FACA</header><text>The
<act-name parsable-cite="FACA">Federal Advisory Committee Act</act-name> shall
apply to the Advisory Committee under this section only to the extent that the
provisions of such Act do not conflict with the requirements of this
section.</text>
</subsection></section><section id="HFB6596BD481F46069A004C0D8685FBE4"><enum>308.</enum><header>McNair
Postbaccalaureate Achievement Program</header><text display-inline="no-display-inline">Section 402E of the
<act-name parsable-cite="HEA65">Higher Education Act of 1965</act-name> (20
U.S.C. 1070a–15) is amended by striking subsection (g) and inserting the
following:</text>
<quoted-block act-name="Higher Education Act of 1965" id="HADBACB6E1EA04A10B9B87A05C20AEBAC">
<subsection id="H128E305C3D1240F19D73D1E1A41F71BF"><enum>(g)</enum><header>Collaboration in
Health profession Diversity training programs</header><text>The Secretary shall
coordinate with the Secretary of Health and Human Services to ensure that there
is collaboration between the goals of the program under this section and
programs of the Health Resources and Services Administration that promote
health workforce diversity. The Secretary of Education shall take such measures
as may be necessary to encourage participants in programs under this section to
consider health profession careers.</text>
</subsection><subsection id="H43BC946FE63C42DFB8148811C61F3C0A"><enum>(h)</enum><header>Funding</header><text>From
amounts appropriated pursuant to the authority of section 402A(g), the
Secretary shall, to the extent practicable, allocate funds for projects
authorized by this section in an amount which is not less than $31,000,000 for
each of the fiscal years 2012 through
2018.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H482A61D781C945E688C108EC07AA6324"><enum>309.</enum><header>Rules for
determination of full-time equivalent residents for cost reporting
periods</header>
<subsection id="H8E9C3557F3D546DF8104501C74F5E4D7"><enum>(a)</enum><header>DGME
determinations</header><text>Section 1886(h)(4) of the Social Security Act (42
U.S.C. 1395ww(d)(5)(B)) is amended—</text>
<paragraph id="H2B69838A4A8041F8A624330E44623A3A"><enum>(1)</enum><text>in subparagraph
(E), by striking <quote>Subject to subparagraphs (J) and (K), such
rules</quote> and inserting <quote>Subject to subparagraphs (J), (K), and (L),
such rules</quote>;</text>
</paragraph><paragraph id="H9C90BB8EDCF14EE9B74096E525F5EA21"><enum>(2)</enum><text>in subparagraph
(J), by striking <quote>Such rules</quote> and inserting <quote>Subject to
subparagraph (L), such rules</quote>;</text>
</paragraph><paragraph id="H2A93D4E3F8F64B63A4768AA3F6FD824A"><enum>(3)</enum><text>in subparagraph
(K), by striking <quote>In determining</quote> and inserting <quote>Subject to
subparagraph (L), in determining</quote>; and</text>
</paragraph><paragraph id="HBFF20E41C5A44907B538B646E7BDFB17"><enum>(4)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block id="H5DA0B59158814FCA8B1619CEB05A2CB3" style="OLC">
<subparagraph id="HF4A589024AFE4863938A824869AAF614"><enum>(L)</enum><text>For purposes of
cost-reporting periods beginning on or after October 1, 2011, in determining
the hospital’s number of full-time equivalent residents for purposes of this
subparagraph, all the time spent by an intern or resident in an approved
medical residency training program shall be counted toward the determination of
full-time equivalency if the hospital—</text>
<clause id="HB25CFDBD591640F8ACE29EFE73FBD5E3"><enum>(i)</enum><text>is
recognized as a subsection (d) hospital;</text>
</clause><clause id="HE8E8ADB6475742E487A89C98D3BBB212"><enum>(ii)</enum><text>is recognized as
a subsection (d) Puerto Rico hospital;</text>
</clause><clause id="HA0C5B28ADACA415A8619F37F6294F866"><enum>(iii)</enum><text>is reimbursed
under a reimbursement system authorized under section 1814(b)(3); or</text>
</clause><clause id="H8EA3DA40D00A4152951066B98E2FE547"><enum>(iv)</enum><text>is a
provider-based hospital outpatient
department.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H5229AD2BB0FE46BFADAB436565DEDD85"><enum>(b)</enum><header>IME
determinations</header><text>Section 1886(d)(5)(B) of such Act (42 U.S.C.
1395ww(d)(5)(B)) is amended—</text>
<paragraph id="HF6726DA391FD415E95C0DB3C0908DA02"><enum>(1)</enum><text>in clause (x)(II),
by striking <quote>In determining</quote> and inserting <quote>Subject to
subclause (x)(IV), in determining</quote>;</text>
</paragraph><paragraph id="H047524349F8245C39313B424CA28078D"><enum>(2)</enum><text>in clause
(x)(III), by striking <quote>In determining</quote> and inserting
<quote>Subject to subclause (x)(IV), in determining</quote>; and</text>
</paragraph><paragraph id="H923BB146BAD349168C34182AEEA92BA6"><enum>(3)</enum><text>by adding at the
end the following new subclause:</text>
<quoted-block display-inline="no-display-inline" id="H8588D1E13D424243965E6F8F9C92622F" style="OLC">
<subclause id="H8AF27E4991CF46E090D4C0DDD5BE0111"><enum>(IV)</enum><text display-inline="yes-display-inline">The provisions of subparagraph (L) of
subsection (h)(4) shall apply under this subparagraph in the same manner as
they apply under such
subsection.</text>
</subclause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="H15378FAF4EBD40C3871F18CC69775E71"><enum>310.</enum><header>Developing and
implementing strategies for local health equity</header>
<subsection id="H6FF8416D624F49BFA752104347F2CACF"><enum>(a)</enum><header>Grants</header><text display-inline="yes-display-inline">The Secretaries of Health and Human
Services, Education, and Labor, acting jointly, shall make grants to academic
institutions for the purposes of—</text>
<paragraph id="H0701ADB369A446269B5CA5150005790F"><enum>(1)</enum><text>in accordance with
subsection (b), developing capacity—</text>
<subparagraph id="HCC198D42C0D64BB8BDCFDF51CF045434"><enum>(A)</enum><text>to build an
evidence base for successful strategies for increasing local health equity;
and</text>
</subparagraph><subparagraph id="H0F1C6E69938F41F09C17DDF578F56939"><enum>(B)</enum><text>to serve as
national models of driving local health equity;</text>
</subparagraph></paragraph><paragraph id="H194A8F86991A4691B4BA2D982D50169E"><enum>(2)</enum><text display-inline="yes-display-inline">in accordance with subsection (c),
developing a strategic partnership with the community in which the academic
institution is located; and</text>
</paragraph><paragraph id="H8B5190C0CB7E4E769C75489DB10D3CF7"><enum>(3)</enum><text display-inline="yes-display-inline">collecting data on, and periodically
evaluating, the effectiveness of the institution’s programs funded through this
section to enable the institution to adapt accordingly for maximum efficiency
and success.</text>
</paragraph></subsection><subsection id="H1182CD4710164B8EBD56C9BF4042A2E5"><enum>(b)</enum><header>Developing
capacity for increasing local health equity</header><text display-inline="yes-display-inline">As a condition on receipt of a grant under
subsection (a), an academic institution shall agree to use the grant to build
an evidence base for successful strategies for increasing local health equity,
and to serve as a national model of driving local health equity, by
supporting—</text>
<paragraph id="HD4B945189D3241EDBD0B869A05A02125"><enum>(1)</enum><text>resources to
strengthen institutional metrics and capacity to execute institutionwide health
workforce goals that can serve as models for increasing health equity in
communities across the country ;</text>
</paragraph><paragraph id="H805FCC229D5F46469A0C05BC885E9B6D"><enum>(2)</enum><text>collaborations
among a cohort of institutions in implementing systemic change, partnership
development, and programmatic efforts supportive of health equity goals across
disciplines and populations; and</text>
</paragraph><paragraph id="H654B7CEBBCC44FB4A0374CDAE9D9B09C"><enum>(3)</enum><text>enhanced or newly
developed data systems and research infrastructure capable of informing current
and future workforce efforts and building a foundation for a broader research
agenda targeting urban health disparities.</text>
</paragraph></subsection><subsection id="H6D1BA1E9C3E74E799B02F94849AA8BB7"><enum>(c)</enum><header>Strategic
partnerships</header><text>As a condition on receipt of a grant under
subsection (a), an academic institution shall agree to use the grant to develop
a strategic partnership with the community in which the institution is located
for the purposes of—</text>
<paragraph id="HF1732F77A1B84738A7FDCF758E2EF025"><enum>(1)</enum><text>strengthening
connections between the institution and the community—</text>
<subparagraph id="H2FB4255B665E4054B91CD900782CAD0A"><enum>(A)</enum><text>to improve
evaluation of and address the community’s health and health workforce needs;
and</text>
</subparagraph><subparagraph id="H5D6D15B970BA40F582A79D7172BF8DA2"><enum>(B)</enum><text>to engage the
community in health workforce development;</text>
</subparagraph></paragraph><paragraph id="HAA9A22A80F244D5B814A0A2FBFD1D1EC"><enum>(2)</enum><text>developing,
enhancing, or accelerating innovative undergraduate and graduate programs in
the biomedical sciences and health professions; and</text>
</paragraph><paragraph id="H43D7EFC6BAC14738A6B5F50D69A2AD88"><enum>(3)</enum><text display-inline="yes-display-inline">strengthening the <term>birth to
career</term> pipeline in the biomedical sciences and health professions,
including by developing partnerships between institutions of higher education
and elementary and secondary schools to recruit the next generation of health
professionals earlier in the pipeline to a health care career.</text>
</paragraph></subsection></section><section commented="no" id="HA93D05DF3EDD4BDEBB3A37153ABE8C36"><enum>311.</enum><header>Loan
forgiveness for mental and behavioral health social workers</header><text display-inline="no-display-inline">Section 455 of the Higher Education Act of
1965 (20 U.S.C. 1087e) is amended by adding at the end the following new
subsection:</text>
<quoted-block display-inline="no-display-inline" id="H44530E048964403FA18D86DF6175C101" style="OLC">
<subsection commented="no" id="H063E2BA0CDAF4ED3A2324426E715C60B"><enum>(q)</enum><header>Repayment plan
for mental and behavioral health social workers</header>
<paragraph commented="no" id="HD971C84DCB48493CA50F8A4E868ADB1D"><enum>(1)</enum><header>In
general</header><text>The Secretary shall cancel the balance of interest and
principal due on any eligible Federal Direct Loan not in default for a borrower
who—</text>
<subparagraph commented="no" id="HC285470CC2434DD2AFF14786BAB80B7A"><enum>(A)</enum><text>has made 120
monthly payments on the eligible Federal Direct Loan after October 1, 2012,
pursuant to any one or a combination of the following—</text>
<clause display-inline="no-display-inline" id="H60B6BCBDBB3F40D8B7CF89429536732A"><enum>(i)</enum><text>payments under an
income-based repayment plan under section 493C;</text>
</clause><clause id="H05B11EB0E5324EE0869A37A5D27FF7C5"><enum>(ii)</enum><text>payments under a
standard repayment plan under subsection (d)(1)(A), based on a 10-year
repayment period;</text>
</clause><clause id="HC1DD4177D54F4B17BA04D546E67F5948"><enum>(iii)</enum><text>monthly payments
under a repayment plan under subsection (d)(1) or (g) of not less than the
monthly amount calculated under subsection (d)(1)(A), based on a 10-year
repayment period; or</text>
</clause><clause id="HE04D9A267D6541329826941646AD49B5"><enum>(iv)</enum><text>payments under an
income contingent repayment plan under subsection (d)(1)(D); and</text>
</clause></subparagraph><subparagraph commented="no" id="H685EB67CD3F041BE843AC821F2A8512E"><enum>(B)</enum><clause commented="no" display-inline="yes-display-inline" id="HE0D44EA149D544408077BA1212E4707B"><enum>(i)</enum><text>is employed as a mental
health or behavioral health social worker, as defined by the Secretary by
regulation, at the time of such forgiveness; and</text>
</clause><clause commented="no" id="H4D714EF96EA647068BDC79A415848B76" indent="up1"><enum>(ii)</enum><text>has been employed as such a mental
health or behavioral health social worker during the period in which the
borrower makes each of the 120 payments as described in subparagraph
(A).</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="H7911B884A9F444D8AD26736339DE00CE"><enum>(2)</enum><header>Loan
cancellation amount</header><text>After the conclusion of the employment period
described in paragraph (1), the Secretary shall cancel the obligation to repay
the balance of principal and interest due as of the time of such cancellation,
on the eligible Federal Direct Loans made to the borrower under this
part.</text>
</paragraph><paragraph commented="no" id="HAF821E989C86420698BF692D1F9A92B3"><enum>(3)</enum><header>Definition of
eligible Federal Direct Loan</header><text>In this subsection, the term
<term>eligible Federal Direct Loan</term> means a Federal Direct Stafford Loan,
Federal Direct PLUS Loan, Federal Direct Unsubsidized Stafford Loan, or a
Federal Direct Consolidation
Loan.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><enum>IV</enum><header>Improvement of
Health Care Services</header>
<subtitle id="HE7FF86553E3F4122AE0ED6AC19AC7D9B"><enum>A</enum><header>Health Empowerment
Zones</header>
<section id="HD0C97E93795E45719BAF858DECF2792B" section-type="subsequent-section"><enum>401.</enum><header>Short
title</header><text display-inline="no-display-inline">This subtitle may be
cited as the <quote><short-title>Health Empowerment Zone
Act of 2011</short-title></quote>.</text>
</section><section id="H23B1363970DF4EAD921712BA3CC0CAA2"><enum>402.</enum><header>Findings</header><text display-inline="no-display-inline">The Congress finds the following:</text>
<paragraph id="H56A0F4E4FD944145ACBC8DB1F80DD953"><enum>(1)</enum><text>Numerous studies
and reports, including the National Healthcare Disparities Report and Unequal
Treatment, the 2002 Institute of Medicine Report, document the extensiveness to
which health disparities exist across the country.</text>
</paragraph><paragraph id="H43040F11AE5845DBB9F8A81C9AC1EB37"><enum>(2)</enum><text display-inline="yes-display-inline">These studies have found that, on average,
racial and ethnic minorities are disproportionately afflicted with chronic and
acute conditions—such as cancer, diabetes, and hypertension—and suffer worse
health outcomes, worse health status, and higher mortality rates than their
White counterparts.</text>
</paragraph><paragraph id="H8AA5BAF45D5C4E93971A5B0B83A049A6"><enum>(3)</enum><text display-inline="yes-display-inline">Several recent studies also show that
health disparities are a function of not only access to health care, but also
the social determinants of health—including the environment, the physical
structure of communities, nutrition and food options, educational attainment,
employment, race, ethnicity, geography, and language preference—that directly
and indirectly affect the health, health care, and wellness of individuals and
communities.</text>
</paragraph><paragraph id="HD18D0B87986A4BDCA94BB85D4D6C0BDE"><enum>(4)</enum><text>Integrally
involving and fully supporting the communities most affected by health
inequities in the assessment, planning, launch, and evaluation of health
disparity elimination efforts is among the leading recommendations made to
adequately address and ultimately reduce health disparities.</text>
</paragraph><paragraph id="HB67ABB8E9A7A49829F62DEA686B19C81"><enum>(5)</enum><text display-inline="yes-display-inline">Recommendations also include supporting the
efforts of community stakeholders from a broad crosssection—including, but not
limited to local businesses, local departments of commerce, education, labor,
urban planning, and transportation, and community-based and other nonprofit
organizations—to find areas of common ground around health disparity
elimination and collaborate to improve the overall health and wellness of a
community and its residents.</text>
</paragraph></section><section id="HC72438D6398B48D98882405C24274BC5"><enum>403.</enum><header>Designation of
health empowerment zones</header>
<subsection id="H0863CC8F31CA4C8EB1848B19A9FFB208"><enum>(a)</enum><header>In
general</header><text>At the request of an eligible community partnership, the
Secretary may designate an eligible area as a health empowerment zone.</text>
</subsection><subsection id="H6A456268A4D34AA7A1CB8CEF1B3AE683"><enum>(b)</enum><header>Eligibility
criteria</header>
<paragraph id="HC89CE4189ADE4A40A640CCC7FB93C709"><enum>(1)</enum><header>Eligible
community partnership</header><text display-inline="yes-display-inline">A
community partnership is eligible to submit a request under this section if the
partnership—</text>
<subparagraph id="H7B67F8F1939E407CB636FE970E1A0707"><enum>(A)</enum><text>demonstrates
widespread public support from key individuals and entities in the eligible
area, including State and local governments, nonprofit organizations, and
community and industry leaders, for designation of the eligible area as a
health empowerment zone; and</text>
</subparagraph><subparagraph id="H2BA054075E6C4FAFB02F1BFE417295F2"><enum>(B)</enum><text>includes
representatives of—</text>
<clause id="HBA62F3F254DF418896E96EA7F05F12FB"><enum>(i)</enum><text>a
broad cross section of stakeholders and residents from communities in the
eligible area experiencing disproportionate disparities in health status and
health care; and</text>
</clause><clause id="HD51611C8A6284711BFCA6D412DA0C6FC"><enum>(ii)</enum><text>organizations,
facilities, and institutions that have a history of working within and serving
such communities.</text>
</clause></subparagraph></paragraph><paragraph id="H683DA654E97446198F2A45075CBCE9D2"><enum>(2)</enum><header>Eligible
area</header><text>An area is eligible to be designated as a health empowerment
zone under this section if one or more communities in the area experience
disproportionate disparities in health status and health care. In determining
whether a community experiences such disparities, the Secretary shall consider
the data collected by the Department of Health and Human Services focusing on
the following areas:</text>
<subparagraph id="HB5693FF57E5F427990A5A8BCC4085E60"><enum>(A)</enum><text>Access to
affordable high-quality health services.</text>
</subparagraph><subparagraph id="HC60F78DE4A09499CAEEFABC7E40EA52E"><enum>(B)</enum><text display-inline="yes-display-inline">Arthritis, osteoporosis, and chronic back
conditions.</text>
</subparagraph><subparagraph id="HC4E25882627D494F87827AFD25A38009"><enum>(C)</enum><text>Cancer.</text>
</subparagraph><subparagraph id="H3CA87C6794DD42C2AB81078793355AB2"><enum>(D)</enum><text>Chronic kidney
disease.</text>
</subparagraph><subparagraph id="HCC1F6445CEF842B8885841DF930F3EE2"><enum>(E)</enum><text display-inline="yes-display-inline">Diabetes.</text>
</subparagraph><subparagraph id="HB76D9FF29800442FBC90E14415E99C82"><enum>(F)</enum><text>Injury and
violence prevention.</text>
</subparagraph><subparagraph id="HD5F7DCEC78564485AA605FEE9C691218"><enum>(G)</enum><text>Maternal, infant,
and child health.</text>
</subparagraph><subparagraph id="H18D63289935041A1AD3E2AA269DE53F4"><enum>(H)</enum><text>Medical product
safety.</text>
</subparagraph><subparagraph id="H4E71FBD299F04D32891323A54C7C4AA5"><enum>(I)</enum><text>Mental health and
mental disorders.</text>
</subparagraph><subparagraph id="H982D27C57942449681499E366B1B819D"><enum>(J)</enum><text>Nutrition and
overweight.</text>
</subparagraph><subparagraph id="H72A9127A4D8944508343D56ED1930F54"><enum>(K)</enum><text>Disability and
secondary conditions.</text>
</subparagraph><subparagraph id="H78253FA507524A738E2E6BFDF9A81A8F"><enum>(L)</enum><text>Educational and
community-based health programs.</text>
</subparagraph><subparagraph id="H95382B6444524BC9B9C548AE3D179C03"><enum>(M)</enum><text>Environmental
health.</text>
</subparagraph><subparagraph id="H36D3B88B305049FBA0D0D9BC939715B2"><enum>(N)</enum><text>Family
planning.</text>
</subparagraph><subparagraph id="HB93DAAAB2F61477CA933B0769BC14349"><enum>(O)</enum><text>Food
safety.</text>
</subparagraph><subparagraph id="HC289630BF7F74001A67711E035D7C9FE"><enum>(P)</enum><text>Health
communication.</text>
</subparagraph><subparagraph id="HB89C14A5DDC4469F912D88AF2B09FBB2"><enum>(Q)</enum><text>Health disease and
stroke.</text>
</subparagraph><subparagraph id="H98CAA915E7F942D4BF3A3E451337DD07"><enum>(R)</enum><text>HIV/AIDS.</text>
</subparagraph><subparagraph id="HB810B56EB733419680AD17549470D689"><enum>(S)</enum><text>Immunization and
infectious diseases.</text>
</subparagraph><subparagraph id="H555752230E7545AE9FE454D81457E974"><enum>(T)</enum><text>Occupational
safety and health.</text>
</subparagraph><subparagraph id="H8EDAD6DEC26645A1AD0A852162FDBC57"><enum>(U)</enum><text>Oral
health.</text>
</subparagraph><subparagraph id="H7B853B535F684CA58B97992585A31291"><enum>(V)</enum><text>Physical activity
and fitness.</text>
</subparagraph><subparagraph id="HA3192EC7D38F41CEB9E6B335BD60E617"><enum>(W)</enum><text>Public health
infrastructure.</text>
</subparagraph><subparagraph id="H84C4CE72516443248163485536D13BF4"><enum>(X)</enum><text>Respiratory
diseases.</text>
</subparagraph><subparagraph id="H00F12A33E49940F2AF20CDCE4D77116A"><enum>(Y)</enum><text>Sexually
transmitted diseases.</text>
</subparagraph><subparagraph id="HB739A0A4A3DE412385B2E7295FCE366F"><enum>(Z)</enum><text>Substance
abuse.</text>
</subparagraph><subparagraph id="H82E850F22B214A29880DA9C228EDD50C"><enum>(AA)</enum><text>Tobacco
use.</text>
</subparagraph><subparagraph id="HF7513B84CA8044DB8E78FBE634F7E12C"><enum>(BB)</enum><text>Vision and
hearing.</text>
</subparagraph><subparagraph id="H1FB48389D4C24A558D2BDD3544ED18F7"><enum>(CC)</enum><text>The degree to
which those who have disabilities have access to health services, including
physical activity and fitness, including the ability to physically access the
locations where such services are provided.</text>
</subparagraph></paragraph></subsection><subsection id="HD58CAF01D6A74F788854CD0E7E063145"><enum>(c)</enum><header>Procedure</header>
<paragraph id="HE70660B9062141FF8B83FD735625CBA4"><enum>(1)</enum><header>Request</header><text>A
request under subsection (a) shall—</text>
<subparagraph id="HF5F4F94037A04A7882DD3B400AF49EDE"><enum>(A)</enum><text>describe the
bounds of the area to be designated as a health empowerment zone and the
process used to select those bounds;</text>
</subparagraph><subparagraph id="H42A711AA57EA4956BF33E27571AFE448"><enum>(B)</enum><text>demonstrate that
the partnership submitting the request is an eligible community partnership
described in subsection (b)(1);</text>
</subparagraph><subparagraph id="HF267005D640644CD81673D5B41C1BEC5"><enum>(C)</enum><text>demonstrate that
the area is an eligible area described in subsection (b)(2);</text>
</subparagraph><subparagraph id="HB073D6DBBD4145AD849AF8A64DEF5098"><enum>(D)</enum><text>include a
comprehensive assessment of disparities in health status and health care
experience by one or more communities in the area;</text>
</subparagraph><subparagraph id="HE924BE3D86D8400D9A1B5F5616FC7B1F"><enum>(E)</enum><text display-inline="yes-display-inline">set forth—</text>
<clause id="H11C0747B7CB94BF39DF9B15B1DD04A44"><enum>(i)</enum><text>a
vision and a set of values for the area; and</text>
</clause><clause id="H2BC307734B9F4C148124403FA3F5B24D"><enum>(ii)</enum><text>a
comprehensive and holistic set of goals to be achieved in the area through
designation as a health empowerment zone; and</text>
</clause></subparagraph><subparagraph id="HC5463AA789E6466F941BE3EAA58B111E"><enum>(F)</enum><text>include a
strategic plan for achieving the goals described in subparagraph
(E)(ii).</text>
</subparagraph></paragraph><paragraph id="H7E20924E13EC45ED9BF7498259902BED"><enum>(2)</enum><header>Approval</header><text>Not
later than 60 days after the receipt of a request for designation of an area as
a health empowerment zone under this section, the Secretary shall approve or
disapprove the request.</text>
</paragraph></subsection><subsection commented="no" id="H1305508673A044DE9C27A23103F637ED"><enum>(d)</enum><header>Minimum
number</header><text>The Secretary—</text>
<paragraph commented="no" id="HF99DE56B2E72491695CD14E3178E18F4"><enum>(1)</enum><text>shall designate
not more than 110 health empowerment zones under this section; and</text>
</paragraph><paragraph commented="no" id="HA8F272A0B4CB48B5A6D6BF8815F74573"><enum>(2)</enum><text>shall designate at
least one health empowerment zone in each of the several States, the District
of Columbia, and each territory or possession of the United States.</text>
</paragraph></subsection></section><section id="H7A0881EA61E6481FAA04371C0954480E"><enum>404.</enum><header>Assistance to
those seeking designation</header><text display-inline="no-display-inline">At
the request of any organization or entity seeking to submit a request under
section 403(a), the Secretary shall provide technical assistance, and may award
a grant, to assist such organization or entity—</text>
<paragraph id="H267267C1D6BD445B839B9AFCE72A8FC2"><enum>(1)</enum><text>to form an
eligible community partnership described in section 403(b)(1);</text>
</paragraph><paragraph id="HC5BCC35F5F124C0DA1B926E3ED80E33F"><enum>(2)</enum><text>to complete a
health assessment, including an assessment of health disparities under section
403(c)(1)(D); or</text>
</paragraph><paragraph id="HD8B7109519424F76B9ED428DCB8E47DF"><enum>(3)</enum><text>to prepare and
submit a request, including a strategic plan, in accordance with section
403.</text>
</paragraph></section><section id="HE99749A53EFD4F04BEA0A6FF14934182"><enum>405.</enum><header>Benefits of
designation</header>
<subsection id="HBE332D4762C94E868DCAA1DA6C6ABF13"><enum>(a)</enum><header>Priority</header><text display-inline="yes-display-inline">In awarding any competitive grant, a
Federal official shall give priority to any applicant that—</text>
<paragraph id="H90A35F093E0E4250BB2847619FD89A11"><enum>(1)</enum><text>meets the
eligibility criteria for the grant;</text>
</paragraph><paragraph id="H878F24B8A83D44728843562A2AB16661"><enum>(2)</enum><text>proposes to use
the grant for activities in a health empowerment zone; and</text>
</paragraph><paragraph id="HBE56B1DB3F234308BC3ACCCC25594FE2"><enum>(3)</enum><text>demonstrates that
such activities will directly and significantly further the goals of the
strategic plan approved for such zone under section 403.</text>
</paragraph></subsection><subsection id="HBDCA8BDEBE864E2CAFDD5F544E9D5839"><enum>(b)</enum><header>Grants for
initial implementation of strategic plan</header>
<paragraph id="H75558E6AE2994C4AB81BEABE75D935D8"><enum>(1)</enum><header>In
general</header><text>Upon designating an eligible area as a health empowerment
zone at the request of an eligible community partnership, the Secretary shall,
subject to the availability of appropriations, make a grant to the community
partnership for implementation of the strategic plan for such zone.</text>
</paragraph><paragraph id="HEFC9B711DCD84C10ADDDFF7305DBE173"><enum>(2)</enum><header>Grant
period</header><text>A grant under paragraph (1) for a health empowerment zone
shall be for a period of 2 years and may be renewed, except that the total
period of grants under paragraph (1) for such zone may not exceed 10
years.</text>
</paragraph><paragraph id="H3C96915716244B109591D4AD8EC36CEF"><enum>(3)</enum><header>Limitation</header><text display-inline="yes-display-inline">In awarding grants under this subsection,
the Secretary shall not give less priority to an applicant or reduce the amount
of a grant because the Secretary rendered technical assistance or made a grant
to the same applicant under section 404.</text>
</paragraph><paragraph id="H729901B44EAA4852BF157890EF8CBE85"><enum>(4)</enum><header>Reporting</header><text>The
Secretary shall require each recipient of a grant under this subsection to
report to the Secretary not less than every 6 months on the progress in
implementing the strategic plan for the health empowerment zone.</text>
</paragraph></subsection></section><section id="H85104F3CB0FA4D8E9F6846931DFC6EDB"><enum>406.</enum><header>Definition</header><text display-inline="no-display-inline">In this subtitle, the term
<term>Secretary</term> means the Secretary of Health and Human Services, acting
through the Administrator of the Health Resources and Services Administration
and the Deputy Assistant Secretary for Minority Health, and in cooperation with
the Director of the Office of Community Services and the Director of the
National Institute for Minority Health and Health Disparities.</text>
</section><section id="HE50B9142514D4930ACDF419D866CA210"><enum>407.</enum><header>Authorization
of appropriations</header><text display-inline="no-display-inline">To carry out
this subtitle, there is authorized to be appropriated $100,000,000 for fiscal
year 2012.</text>
</section></subtitle><subtitle id="H64F7563563B5459D92D62EBBCA0351F8"><enum>B</enum><header>Other Improvements
of Health Care Services</header>
<chapter commented="no" id="H2A4C6855456A4F11B9FA6C22D1B4BB76"><enum>1</enum><header>Expansion of
Coverage</header>
<section commented="no" display-inline="no-display-inline" id="H3B665E22E63341A49EB03B2470894BC3" section-type="subsequent-section"><enum>411.</enum><header>Amendment to the
<act-name parsable-cite="PHSA">Public Health Service
Act</act-name></header><text display-inline="no-display-inline">Title XXXIV of
the <act-name parsable-cite="PHSA">Public Health Service Act</act-name>, as
amended by titles I, II, III, and IX of this Act, is further amended by
inserting after subtitle C the following:</text>
<quoted-block act-name="Public" id="HA67335A0B08E4497B5B73D2CD02CA295">
<subtitle commented="no" id="H3A2E0A7F6F9841928183C528E06801A2"><enum>D</enum><header>Reconstruction and
Improvement Grants for Public Health Care Facilities Serving Pacific Islanders
and the Insular Areas</header>
<section commented="no" id="H649DA70E9CF04C0AA56BEE4996D68BA3"><enum>3451.</enum><header>Grant support
for quality improvement initiatives</header>
<subsection commented="no" id="H9A4C9B64F89A463782343BE2A87CC291"><enum>(a)</enum><header>In
general</header><text>The Secretary, in collaboration with the Administrator of
the Health Resources and Services Administration, the Director of the Agency
for Healthcare Research and Quality, and the Administrator of the Centers for
Medicare & Medicaid Services, shall award grants to eligible entities for
the conduct of demonstration projects to improve the quality of and access to
health care.</text>
</subsection><subsection commented="no" id="H0B2F6BC6D2404838B3F12C0C663237F6"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under subsection (a), an entity shall—</text>
<paragraph commented="no" id="H3FA9CF4B7C1D4DEF8474C1CAFE67FB2B"><enum>(1)</enum><text>be a health
center, hospital, health plan, health system, community clinic. or other health
entity determined appropriate by the Secretary—</text>
<subparagraph commented="no" id="H3083B4FF3E794F809B09F374501AB66E"><enum>(A)</enum><text>that, by legal
mandate or explicitly adopted mission, provides patients with access to
services regardless of their ability to pay;</text>
</subparagraph><subparagraph commented="no" id="H0558C9B404B04C03B1C1F9F907A016DD"><enum>(B)</enum><text>that provides care
or treatment for a substantial number of patients who are uninsured, are
receiving assistance under a State program under title XIX of the
<act-name parsable-cite="SSA">Social Security Act</act-name>, or are members of
vulnerable populations, as determined by the Secretary; and</text>
</subparagraph><subparagraph commented="no" id="HA89EB1550F8D495D8F2400DBCE7539A3"><enum>(C)</enum><clause commented="no" display-inline="yes-display-inline" id="H5B2B2A0412294C83B71BB5F721F3A49B"><enum>(i)</enum><text>with respect to which,
not less than 50 percent of the entity’s patient population is made up of
racial and ethnic minorities; or</text>
</clause><clause commented="no" id="H3E46B7D22C7C4254BDBE180D979D6078" indent="up1"><enum>(ii)</enum><text>that—</text>
<subclause commented="no" id="H5714AC16D0AC413DAD6BFED28457F62C"><enum>(I)</enum><text>serves a disproportionate percentage of
local, minority racial and ethnic patients, or that has a patient population,
at least 50 percent of which is limited-English proficient; and</text>
</subclause><subclause commented="no" id="H960F8B95399E481497C0CDBA25EC45E8"><enum>(II)</enum><text>provides an assurance that amounts
received under the grant will be used only to support quality improvement
activities in the racial and ethnic population served; and</text>
</subclause></clause></subparagraph></paragraph><paragraph commented="no" id="H45FC30F56B6A4060A20D94D39007F4E9"><enum>(2)</enum><text>prepare and submit
to the Secretary an application at such time, in such manner, and containing
such information as the Secretary may require.</text>
</paragraph></subsection><subsection commented="no" id="HD198729465D1427EB38BEB400CE98D75"><enum>(c)</enum><header>Priority</header><text>In
awarding grants under subsection (a), the Secretary shall give priority to
applicants under subsection (b)(2) that—</text>
<paragraph commented="no" id="H31BFFEDD188D436990FA41A40642618E"><enum>(1)</enum><text>demonstrate an
intent to operate as part of a health care partnership, network, collaborative,
coalition, or alliance where each member entity contributes to the design,
implementation, and evaluation of the proposed intervention; or</text>
</paragraph><paragraph commented="no" id="HC7DB810C74E2430A910355473B909496"><enum>(2)</enum><text>intend to use
funds to carry out systemwide changes with respect to health care quality
improvement, including—</text>
<subparagraph commented="no" id="HC68B5B861C3E46F6A5428B66B28A5240"><enum>(A)</enum><text>improved systems
for data collection and reporting;</text>
</subparagraph><subparagraph commented="no" id="H40DBDFA9DF594D71B6B6E15C3A62AA23"><enum>(B)</enum><text>innovative
collaborative or similar processes;</text>
</subparagraph><subparagraph commented="no" id="H864BA4861D3C4D78BCEFD88A5C9286CF"><enum>(C)</enum><text>group programs
with behavioral or self-management interventions;</text>
</subparagraph><subparagraph commented="no" id="H5BBD0CBDFA8D4A059F408BAA32D1A8D6"><enum>(D)</enum><text>case management
services;</text>
</subparagraph><subparagraph commented="no" id="HB9A42317117546D28F9F9723E741A152"><enum>(E)</enum><text>physician or
patient reminder systems;</text>
</subparagraph><subparagraph commented="no" id="HC766F7F0F5E04DECA8FA3F70E7DB5615"><enum>(F)</enum><text>educational
interventions; or</text>
</subparagraph><subparagraph commented="no" id="HF5248964BE3642C99C0582815608F1F2"><enum>(G)</enum><text>other activities
determined appropriate by the Secretary.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H6943232839E74B74B07E20B5CA41BA31"><enum>(d)</enum><header>Use of
funds</header><text>An entity shall use amounts received under a grant under
subsection (a) to support the implementation and evaluation of health care
quality improvement activities or minority health and health care disparity
reduction activities that include—</text>
<paragraph commented="no" id="HE8C46EE3E5914E5C98A9350BB2ACFBCF"><enum>(1)</enum><text>with respect to
health care systems, activities relating to improving—</text>
<subparagraph commented="no" id="H2BE864E4FB4E44EE82E1B99F649220C8"><enum>(A)</enum><text>patient
safety;</text>
</subparagraph><subparagraph commented="no" id="HC8CE409C02FD4834ADEB304328747CC5"><enum>(B)</enum><text>timeliness of
care;</text>
</subparagraph><subparagraph commented="no" id="H934A724CFE13497A8794336B2A42C035"><enum>(C)</enum><text>effectiveness of
care;</text>
</subparagraph><subparagraph commented="no" id="HEE85CDC08B2F44BBA24E0A18D587D7F1"><enum>(D)</enum><text>efficiency of
care;</text>
</subparagraph><subparagraph commented="no" id="H3DDBA1C25E274473B990D94B1DDDB730"><enum>(E)</enum><text>patient
centeredness; and</text>
</subparagraph><subparagraph commented="no" id="H639EF82B0619459685C9782BC902B4BA"><enum>(F)</enum><text>health information
technology; and</text>
</subparagraph></paragraph><paragraph commented="no" id="HF8B46CCFA244486394C74CCCAE894F60"><enum>(2)</enum><text>with respect to
patients, activities relating to—</text>
<subparagraph commented="no" id="HA81AB46AC7EA450ABC027A9D9717AF30"><enum>(A)</enum><text>staying
healthy;</text>
</subparagraph><subparagraph commented="no" id="HDA21A9482920497BAC1BF2FA114FCCA1"><enum>(B)</enum><text>getting
well;</text>
</subparagraph><subparagraph commented="no" id="H56EECC5573FE4B9E939EEF2F21357BA5"><enum>(C)</enum><text>living with
illness or disability; and</text>
</subparagraph><subparagraph commented="no" id="HB07128AB3D914BF19D0EE16ED73979D7"><enum>(D)</enum><text>coping with
end-of-life issues.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="HE3015BAE04CE41B1A0BC6AB10D761701"><enum>(e)</enum><header>Common data
systems</header><text>The Secretary shall provide financial and other technical
assistance to grantees under this section for the development of common data
systems.</text>
</subsection><subsection commented="no" id="H36391BDE238C40A3A400845B1F9FF8C8"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2010
through 2015.</text>
</subsection></section><section commented="no" id="H3C5A4E758F8C4568AD25D5466E5F5BE1"><enum>3452.</enum><header>Centers of
excellence</header>
<subsection commented="no" id="H82EADC8E70F044629B50FE72E55CD1A6"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Administrator of the
Health Resources and Services Administration, shall designate centers of
excellence at public hospitals, and other health systems serving large numbers
of minority patients, that—</text>
<paragraph commented="no" id="H5A0456386C3D4D80806239CA45A142D2"><enum>(1)</enum><text>meet the
requirements of section 3451(b)(1);</text>
</paragraph><paragraph commented="no" id="H9CD52F17C98D4498B0C42FE7D29CF5F0"><enum>(2)</enum><text>demonstrate
excellence in providing care to minority populations; and</text>
</paragraph><paragraph commented="no" id="H008E5552249D453EBA21029FF72FA557"><enum>(3)</enum><text>demonstrate
excellence in reducing disparities in health and health care.</text>
</paragraph></subsection><subsection commented="no" id="HE3FD24880E4F46C7AEEB6BFAE882E8A6"><enum>(b)</enum><header>Requirements</header><text>A
hospital or health system that serves as a Center of Excellence under
subsection (a) shall—</text>
<paragraph commented="no" id="HBB2A568FF9F4469991F1FA695B5AD1BF"><enum>(1)</enum><text>design, implement,
and evaluate programs and policies relating to the delivery of care in
racially, ethnically, and linguistically diverse populations;</text>
</paragraph><paragraph commented="no" id="H14B696254FEB474EA41794F830B42059"><enum>(2)</enum><text>provide training
and technical assistance to other hospitals and health systems relating to the
provision of quality health care to minority populations; and</text>
</paragraph><paragraph commented="no" id="H36C0612129214E2B8F273E8149EB0EC8"><enum>(3)</enum><text>develop activities
for graduate or continuing medical education that institutionalize a focus on
cultural competence training for health care providers.</text>
</paragraph></subsection><subsection commented="no" id="H254D7D47EF1D4C07AACDEA8D4D12351D"><enum>(c)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2010
through 2015.</text>
</subsection></section><section commented="no" id="H39139B6D00AE4078ABC212A915DF4E15"><enum>3453.</enum><header>Reconstruction
and improvement grants for Public Health care facilities serving Pacific
Islanders and the insular areas</header>
<subsection commented="no" id="H40E2F965C3254DB893A902B3E676941E"><enum>(a)</enum><header>In
general</header><text>The Secretary shall provide direct financial assistance
to designated health care providers and community health centers in American
Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the United
States Virgin Islands, Puerto Rico, and Hawaii for the purposes of
reconstructing and improving health care facilities and services.</text>
</subsection><subsection commented="no" id="H7ABB190EBD494E29A4139B757191D376"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive direct financial assistance under subsection (a), an
entity shall be a public health facility or community health center located in
American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the
United States Virgin Islands, Puerto Rico, or Hawaii that—</text>
<paragraph commented="no" id="H744B2169C80E451DB89F7FBC9822BE47"><enum>(1)</enum><text>is owned or
operated by—</text>
<subparagraph commented="no" id="H2BFBEF745E59495381B384D9985609F9"><enum>(A)</enum><text>the Government of
American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the
United States Virgin Islands, Puerto Rico, or Hawaii or a unit of local
government; or</text>
</subparagraph><subparagraph commented="no" id="H4283F99AAB24446C857BFB1F6080166B"><enum>(B)</enum><text>a nonprofit
organization; and</text>
</subparagraph></paragraph><paragraph commented="no" id="H0F921873FA0F4852A0B8B593EBCE3FC4"><enum>(2)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H6CF0E8F403194693A54411D7337CABC7"><enum>(A)</enum><text>provides care or
treatment for a substantial number of patients who are uninsured, receiving
assistance under a State program under a title XVIII of the
<act-name parsable-cite="SSA">Social Security Act</act-name>, or a State
program under title XIX of such Act, or who are members of a vulnerable
population, as determined by the Secretary; or</text>
</subparagraph><subparagraph commented="no" id="H1A6291E00AD541BDA71F904E53F33701" indent="up1"><enum>(B)</enum><text>serves a disproportionate percentage
of local, minority racial and ethnic patients.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="HC1A913C6FA1742818F3E23F36D815FEB"><enum>(c)</enum><header>Report</header><text>Not
later than 180 days after the date of enactment of this title and annually
thereafter, the Secretary shall submit to the Congress and the President a
report that includes an assessment of health resources and facilities serving
populations in American Samoa, Guam, the Commonwealth of the Northern Mariana
Islands, the United States Virgin Islands, Puerto Rico, and Hawaii. In
preparing such report, the Secretary shall—</text>
<paragraph commented="no" id="H94A34407F7C84E2185FE4DF72871D22D"><enum>(1)</enum><text>consult with and
obtain information on all health care facilities needs from the entities
described in subsection (b);</text>
</paragraph><paragraph commented="no" id="H2A2F4FEBBFDB4099A18A17E52E41A07B"><enum>(2)</enum><text>include all
amounts of Federal assistance received by each entity in the preceding fiscal
year;</text>
</paragraph><paragraph commented="no" id="H58E5128C358E40A28FDE7CACCE0A1ABA"><enum>(3)</enum><text>review the total
unmet needs of each jurisdiction for health care facilities, including needs
for renovation and expansion of existing facilities; and</text>
</paragraph><paragraph commented="no" id="HEC9DE0418ACC49C89D5364DACCB8BCB6"><enum>(4)</enum><text>include a
strategic plan for addressing the needs of each jurisdiction identified in the
report.</text>
</paragraph></subsection><subsection commented="no" id="H741F0FCA498C49C98AFAF29FE3A7A527"><enum>(d)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated such sums
as necessary to carry out this
section.</text>
</subsection></section></subtitle><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" display-inline="no-display-inline" id="H6EA6300C46EE43A58650AA3A2405554F" section-type="subsequent-section"><enum>412.</enum><header>Removing barriers to
unsubsidized purchase of private insurance in American Health Benefit
Exchanges</header>
<subsection id="H38CA632676EF4F0CB93D9ABE72216DDF"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 1312(f) of
the Patient Protection and Affordable Care Act (42 U.S.C.18032(f)) is
amended—</text>
<paragraph commented="no" id="HC50FFE9689444ED7BFDFE9BEBBB7809A"><enum>(1)</enum><text>in the subsection
heading, by striking the semicolon and all that follows through
<quote><header-in-text level="subsection" style="OLC">Residents</header-in-text></quote>; and</text>
</paragraph><paragraph commented="no" id="H900A9409429249A98AF6785DD216B483"><enum>(2)</enum><text>by striking
paragraph (3).</text>
</paragraph></subsection><subsection id="H57EB4283E47A487D9E913F0C2C5F4EE6"><enum>(b)</enum><header>Conforming
amendment</header><text display-inline="yes-display-inline">Section 1411(a)(1)
of such Act (42 U.S.C. 18081(a)(1)) is amended by striking
<quote>1312(f)(3),</quote>.</text>
</subsection></section><section commented="no" id="H856B69A818F246C587C2D7E8998BA099"><enum>413.</enum><header>Study on the
uninsured</header>
<subsection id="H495C08AF69AC4CE7B2930AA5C987B10E"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary of
Health and Human Services shall—</text>
<paragraph id="HC26BF64DB32241E787A3E0309CF5059B"><enum>(1)</enum><text>conduct a study on
the demographic characteristics of the population of individuals who do not
have health insurance coverage; and</text>
</paragraph><paragraph id="H079DBA13E5924B0C9CA704095282EFA6"><enum>(2)</enum><text>predict, based on
such study, the demographic characteristics of the population of individuals
who will not have health insurance coverage after January 1, 2014.</text>
</paragraph></subsection><subsection id="H0AD978D19CA24C2EBD0E4FCF34D9F14C"><enum>(b)</enum><header>Reporting
requirements</header>
<paragraph id="H3633A4B95AC846BF91AE55473C74AFEB"><enum>(1)</enum><header>In
general</header><text>Not later than 12 months after the date of the enactment
of this Act, the Secretary shall submit to the Congress the results of the
study under
<internal-xref idref="HC26BF64DB32241E787A3E0309CF5059B" legis-path="413.(a)(1)">subsection (a)(1)</internal-xref> and the prediction
made under
<internal-xref idref="H079DBA13E5924B0C9CA704095282EFA6" legis-path="413.(a)(2)">subsection (a)(2)</internal-xref>.</text>
</paragraph><paragraph id="HA55353C162824ACCB0FD3F522874CAE9"><enum>(2)</enum><header>Reporting of
demographic characteristics</header><text display-inline="yes-display-inline">The Secretary shall report the demographic
characteristics under paragraphs (1) and (2) of
<internal-xref idref="H495C08AF69AC4CE7B2930AA5C987B10E" legis-path="413.(a)">subsection (a)</internal-xref> on the basis of racial and
ethnic group, and shall stratify the reporting on each racial and ethnic group
by other demographic characteristics that can impact access to health insurance
coverage, such as sexual orientation, gender identity, primary language,
disability status, sex, socioeconomic status, and citizenship and immigration
status, in a manner consistent with title I of this Act.</text>
</paragraph></subsection></section><section commented="no" id="H28B20CD2CBD547F882E608F7504627E1"><enum>414.</enum><header>Medicaid
payment parity for the territories</header>
<subsection commented="no" id="HA81CBF044B534256AFCED24D03BA336D"><enum>(a)</enum><header>Elimination of
funding limitations for Puerto Rico, the United States Virgin Islands, Guam,
the Commonwealth of the Northern Mariana Islands, and American Samoa</header>
<paragraph commented="no" id="HFACA2009451B45B486A73CF20830F2CD"><enum>(1)</enum><header>In
general</header><text>Section 1108 of the Social Security Act (42 U.S.C. 1308)
is amended—</text>
<subparagraph commented="no" id="H7C4AE0D2B74B46499880454427191622"><enum>(A)</enum><text display-inline="yes-display-inline">in subsection (f), in the matter before
paragraph (1), by striking <quote>subsection (g)</quote> and inserting
<quote>subsections (g) and (h)</quote>;</text>
</subparagraph><subparagraph commented="no" id="H887420BF75464C019D7B71D8FBD52CA8"><enum>(B)</enum><text>in subsection
(g)(2), in the matter before subparagraph (A), by inserting <quote>and
subsection (h)</quote> after <quote>paragraphs (3) and (5)</quote>; and</text>
</subparagraph><subparagraph commented="no" id="HC5BAB06207DC41E39742E95CBEDBA743"><enum>(C)</enum><text>by adding at the
end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H35D5068105D44F9FA6371C9F8FDE731F" style="OLC">
<subsection commented="no" id="H364F44FD8D9548BEA10CFE863012658C"><enum>(h)</enum><header>Sunset of
funding limitations for Puerto Rico, the United States Virgin Islands, Guam,
the Commonwealth of the Northern Mariana Islands, and American
Samoa</header><text display-inline="yes-display-inline">Subsections (f) and (g)
shall not apply to Puerto Rico, the United States Virgin Islands, Guam, the
Commonwealth of the Northern Mariana Islands, and American Samoa for any fiscal
year after fiscal year
2011.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph commented="no" id="HCDE67F34F6F74B6B98B70F626DF530CD"><enum>(2)</enum><header>Conforming
amendment</header><text display-inline="yes-display-inline">Section 1903(u) of
such Act (42 U.S.C. 1396c(u)) is amended by striking paragraph (4).</text>
</paragraph><paragraph commented="no" id="HE2702A25E08B4773866E2C5E44101DB8"><enum>(3)</enum><header>Effective
date</header><text>The amendments made by this subsection shall apply beginning
with fiscal year 2012.</text>
</paragraph></subsection><subsection commented="no" id="H5CA49ADA7CDE47C0B70995563F6BC5DB"><enum>(b)</enum><header>Parity in
FMAP</header>
<paragraph commented="no" id="H20C7E9D2BCD94FF296F8B1ADBE523D3C"><enum>(1)</enum><header>In
general</header><text>Section 1905(b)(2) of such Act (42 U.S.C. 1396d(b)(2)) is
amended by inserting after <quote>50 per centum</quote> the following:
<quote>(except that, beginning with fiscal year 2014, the Federal medical
assistance percentage for Puerto Rico, the United States Virgin Islands, Guam,
the Commonwealth of the Northern Mariana Islands, and American Samoa shall be
the Federal medical assistance percentage determined by the Secretary in
consultation (for the United States Virgin Islands, Guam, the Commonwealth of
the Northern Mariana Islands, and American Samoa) with the Secretary of the
Interior)</quote>.</text>
</paragraph><paragraph commented="no" id="H171F38FAF1514725921FF700ACF1AF96"><enum>(2)</enum><header>2-fiscal-year
transition</header><text display-inline="yes-display-inline">Notwithstanding
any other provision of law, during fiscal years 2012 and 2013, the Federal
medical assistance percentage established under section 1905(b) of the Social
Security Act (42 U.S.C. 1396d(b)) for Puerto Rico, the United States Virgin
Islands, Guam, the Commonwealth of the Northern Mariana Islands, and American
Samoa shall be the highest such Federal medical assistance percentage
applicable to any of the 50 States or the District of Columbia for the fiscal
year involved, taking into account the application of subsections (a) and
(b)(1) of 5001 of division B of the American Recovery and Reinvestment Act of
2009 (Public Law 111–5) to such States and District of Columbia for calendar
quarters during such fiscal years for which such subsections apply
respectively.</text>
</paragraph><paragraph commented="no" id="H8B18FB8871754798A1F3BDF9BC684C9E"><enum>(3)</enum><header>Per capita
income data</header>
<subparagraph commented="no" id="H56270BCF1FB844388905574AF24888C2"><enum>(A)</enum><header>Report to
Congress</header><text display-inline="yes-display-inline">Not later than
October 1, 2012, the Secretary of Health and Human Services shall submit to
Congress a report that describes the per capita income data used to promulgate
the Federal medical assistance percentage in the territories and how such data
differ from the per capita income data used to promulgate Federal medical
assistance percentages for the 50 States and the District of Columbia. The
report should include recommendations on how the Federal medical assistance
percentages can be calculated for the territories to ensure parity with the 50
States and the District of Columbia.</text>
</subparagraph><subparagraph commented="no" id="H1C894202D9DD42E0823D9A0C18B830AA"><enum>(B)</enum><header>Application</header><text>Section
1101(a)(8)(B) of the Social Security Act (42 U.S.C. 1308(a)(8)(B)) is
amended—</text>
<clause commented="no" id="H84A90F682463432DA6706CB607661BCC"><enum>(i)</enum><text>by striking
<quote>(other than Puerto Rico, the United States Virgin Islands, and
Guam)</quote> and inserting <quote>(including Puerto Rico, the United States
Virgin Islands, Guam, the Commonwealth of the Northern Mariana Islands, and
American Samoa)</quote>; and</text>
</clause><clause commented="no" id="H5B94296143D3417C9C48DADBC23BA11C"><enum>(ii)</enum><text>by inserting
<quote>(or, if such satisfactory data are not available in the case of the
Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa,
satisfactory data available from the Department of the Interior for the same
period, or if such satisfactory data are not available in the case of Puerto
Rico, satisfactory data available from the government of the Commonwealth of
Puerto Rico for the same period)</quote> after <quote>Department of
Commerce</quote>.</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="HBC9323AF44B347BB894D49DDA5E73D5A"><enum>(4)</enum><header>Relation to
American Recovery and Reinvestment Act of 2009</header><text>For any period and
territory in which the provisions of this subsection apply to a territory, the
provisions of section 5001(b)(2) of division B of the American Recovery and
Reinvestment Act of 2009 (Public Law 111–5) shall not apply (except as
otherwise specifically provided in paragraph (2)).</text>
</paragraph></subsection></section><section commented="no" id="HFDE5E268DAF441C1A5142B7449F9FF39"><enum>415.</enum><header>Clarification
of Medicaid coverage for citizens of Freely Associated States</header>
<subsection commented="no" id="H90DD76BB50904910B5C9FB13E5FFFA1E"><enum>(a)</enum><header>In
general</header><text>Section 402(b)(2) of the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996 (8 U.S.C. 1612(b)(2)) is amended by
adding at the end the following:</text>
<quoted-block id="H59E1F2D7355849308C16D7A6FCA29802" style="OLC">
<subparagraph commented="no" id="HCA06E62903F34A4FBAFDE00C52482604"><enum>(G)</enum><header>Medicaid
exception for citizens of Freely Associated States</header><text display-inline="yes-display-inline">With
respect to eligibility for benefits for the program defined in paragraph (3)(C)
(relating to the Medicaid program), paragraph (1) shall not apply to any
individual who lawfully resides in the United States (including territories and
possessions of the United States) in accordance with the Compacts of Free
Association between the Government of the United States and the Governments of
the Federated States of Micronesia, the Republic of the Marshall Islands, and
the Republic of
Palau.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" id="HD41499B29D904E88B980C2B7B959B94C"><enum>(b)</enum><header>Conforming
definition of qualified alien</header><text>Section 431(b) of such Act (8
U.S.C. 1641(b)) is amended—</text>
<paragraph commented="no" id="HED33C8B1652944A39D1EC3D4E8AA8471"><enum>(1)</enum><text>in paragraph (6),
by striking <quote>or</quote> at the end;</text>
</paragraph><paragraph commented="no" id="H57D2B52F150D4C6487137E0EC4417733"><enum>(2)</enum><text>in paragraph (7),
by striking the period at the end and inserting <quote>; or</quote>; and</text>
</paragraph><paragraph commented="no" id="H46B7A08C9E354F0E89DAE76CAF826280"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block id="HBD5F61F3DBB04BE798D85CAA17AF5F96" style="OLC">
<paragraph commented="no" id="HD4A933BA10014A189B64D1E7C9E0EAF7"><enum>(8)</enum><text>an individual who
lawfully resides in the United States (including territories and possessions of
the United States) in accordance with a Compact of Free Association referred to
in section 402(b)(2)(G), but only with respect to the program defined in
section 402(b)(3)(C) (relating to the Medicaid
program).</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="H06494718495243249A5C763B06E5ADB8"><enum>(c)</enum><header>Setting FMAP at
100 percent</header><text>The third sentence of section 1905(b) of the Social
Security Act (42 U.S.C. 1396d(b)) is amended by inserting before the period at
the end the following: <quote>; with respect to medical assistance for
individuals described in section 402(b)(2)(G) of the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996</quote>.</text>
</subsection><subsection commented="no" id="H6669C9A3CB8947838665DE6CC5687CE6"><enum>(d)</enum><header>Effective
date</header><text>The amendments made by this Act take effect on October 1,
2011, and apply to benefits and assistance provided on or after that
date.</text>
</subsection></section><section commented="no" id="H825006B512B34CCA973BAB348D5FBB3D"><enum>416.</enum><header>Extension of
Medicare secondary payer</header>
<subsection commented="no" id="H0D3EC607D1674F58AF796C90FEAED9D2"><enum>(a)</enum><header>In
general</header><text>Section 1862(b)(1)(C) of the Social Security Act (42
U.S.C. 1395y(b)(1)(C)) is amended—</text>
<paragraph commented="no" id="HE44BB83C9855455AA01AE7EE823B3EE8"><enum>(1)</enum><text>in the last
sentence, by inserting <quote>, and before January 1, 2012</quote> after
<quote>prior to such date)</quote>; and</text>
</paragraph><paragraph commented="no" id="H550BBC629133443EB7B919798285F670"><enum>(2)</enum><text>by adding at the
end the following new sentence: <quote>Effective for items and services
furnished on or after January 1, 2012 (with respect to periods beginning on or
after the date that is 42 months prior to such date), clauses (i) and (ii)
shall be applied by substituting <quote>42-month</quote> for
<quote>12-month</quote> each place it appears in the first
sentence.</quote>.</text>
</paragraph></subsection><subsection commented="no" id="H08E2011375E646EA906D0C3BBBA5CFD6"><enum>(b)</enum><header>Effective
date</header><text>The amendments made by this subsection shall take effect on
the date of enactment of this Act. For purposes of determining an individual’s
status under section 1862(b)(1)(C) of the Social Security Act (42 U.S.C.
1395y(b)(1)(C)), as amended by paragraph (1), an individual who is within the
coordinating period as of the date of enactment of this Act shall have that
period extended to the full 42 months described in the last sentence of such
section, as added by the amendment made by paragraph (1)(B).</text>
</subsection></section><section commented="no" display-inline="no-display-inline" id="H13CB5934C7AD431FB42E6B224A47C878" section-type="subsequent-section"><enum>417.</enum><header>Border health
grants</header>
<subsection commented="no" id="H5AF261B72BB84D7B8DA6FAAD99E6F755"><enum>(a)</enum><header>Eligible entity
defined</header><text>In this section, the term <term>eligible entity</term>
means a State, public institution of higher education, local government, tribal
government, nonprofit health organization, community health center, or
community clinic receiving assistance under section 330 of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
254b), that is located in the border area.</text>
</subsection><subsection commented="no" id="H57B49031B5A841138031A19BAF8BE933"><enum>(b)</enum><header>Authorization</header><text>From
funds appropriated under subsection (f), the Secretary of Health and Human
Services (in this section referred to as the <term>Secretary</term>), acting
through the United States members of the United States-Mexico Border Health
Commission, shall award grants to eligible entities to address priorities and
recommendations to improve the health of border area residents that are
established by—</text>
<paragraph commented="no" id="H8F48F38E576346629999E80FABC10A80"><enum>(1)</enum><text>the United States
members of the United States-Mexico Border Health Commission;</text>
</paragraph><paragraph commented="no" id="H4AB8C7690CA846CC9377E71AA4BFB712"><enum>(2)</enum><text>the State border
health offices; and</text>
</paragraph><paragraph commented="no" id="H5D9E85D2DEDF4048BFDDF3F258E20C4E"><enum>(3)</enum><text>the
Secretary.</text>
</paragraph></subsection><subsection commented="no" id="H903372EC6C3A4C08A186CE53B3181C4D"><enum>(c)</enum><header>Application</header><text>An
eligible entity that desires a grant under subsection (b) shall submit an
application to the Secretary at such time, in such manner, and containing such
information as the Secretary may require.</text>
</subsection><subsection commented="no" id="HF225DE9F873C489BADD3B1A1BA0996E6"><enum>(d)</enum><header>Use of
funds</header><text>An eligible entity that receives a grant under subsection
(b) shall use the grant funds for—</text>
<paragraph commented="no" id="HF79A64B43D7441A78C9E8EE897476AAF"><enum>(1)</enum><text>programs relating
to—</text>
<subparagraph commented="no" id="HB74284AF7E9640F485FB24F8FC4C6263"><enum>(A)</enum><text>maternal and child
health;</text>
</subparagraph><subparagraph commented="no" id="HC82770672E17401F8FAEB5155E3507D5"><enum>(B)</enum><text>primary care and
preventative health;</text>
</subparagraph><subparagraph commented="no" id="HA429BA03DFB94316892D5EDFC29CF6E7"><enum>(C)</enum><text>public health and
public health infrastructure;</text>
</subparagraph><subparagraph commented="no" id="H6B8FB4B2923D4A64B2D4CD94C09CECE6"><enum>(D)</enum><text>health education
and promotion;</text>
</subparagraph><subparagraph commented="no" id="HF0F4B9533C384F37BDD47A43BD836D38"><enum>(E)</enum><text>oral
health;</text>
</subparagraph><subparagraph commented="no" id="HF950044FBBEF42119CC04F64E3C7D5C8"><enum>(F)</enum><text>mental and
behavioral health;</text>
</subparagraph><subparagraph commented="no" id="H5CE3474F46DE47B195C01B4B1153BFEE"><enum>(G)</enum><text>substance
abuse;</text>
</subparagraph><subparagraph commented="no" id="HB510DDB7FD2B43A68AE6C97933D2B82D"><enum>(H)</enum><text>health conditions
that have a high prevalence in the border area;</text>
</subparagraph><subparagraph commented="no" id="HBBD2B47DB36945DEBFF201FF80B7FC48"><enum>(I)</enum><text>medical and health
services research;</text>
</subparagraph><subparagraph commented="no" id="HA2BE88AEAE5949CF82096489A91DB1EA"><enum>(J)</enum><text>workforce training
and development;</text>
</subparagraph><subparagraph commented="no" id="HD632A6284DDB4589B45C6A1461CA27FC"><enum>(K)</enum><text>community health
workers or promotoras;</text>
</subparagraph><subparagraph commented="no" id="H7A5AE15437E044CE829CC8EEA61583C4"><enum>(L)</enum><text>health care
infrastructure problems in the border area (including planning and construction
grants);</text>
</subparagraph><subparagraph commented="no" id="H7BBE1502E3C644D7AFA6AD8FB31A8245"><enum>(M)</enum><text>health disparities
in the border area;</text>
</subparagraph><subparagraph commented="no" id="HF8888FD6E5D049098B4191B70F7006AC"><enum>(N)</enum><text>environmental
health; and</text>
</subparagraph><subparagraph commented="no" id="H6C9F1E1842B345A5B84BE40BE666D325"><enum>(O)</enum><text>outreach and
enrollment services with respect to Federal programs (including programs
authorized under titles XIX and XXI of the <act-name parsable-cite="SSA">Social
Security Act</act-name> (42 U.S.C. 1396 and 1397aa)); and</text>
</subparagraph></paragraph><paragraph commented="no" id="H7F02B7FCFF0F49DAB95203B3AAED83D4"><enum>(2)</enum><text>other programs
determined appropriate by the Secretary.</text>
</paragraph></subsection><subsection commented="no" id="HCB6BD7F7D634451F8C8AF2628718B4FC"><enum>(e)</enum><header>Supplement, not
supplant</header><text>Amounts provided to an eligible entity awarded a grant
under subsection (b) shall be used to supplement and not supplant other funds
available to the eligible entity to carry out the activities described in
subsection (d).</text>
</subsection><subsection commented="no" id="HEED8B8DB2AC749E3979278B4D695A2D9"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section, $200,000,000 for fiscal year 2012, and such sums as may be
necessary for each succeeding fiscal year.</text>
</subsection></section><section id="H6903A22CC02F4DA8BB0EF882D055D61F"><enum>418.</enum><header>Removing
Medicare barrier to health care</header><text display-inline="no-display-inline">Section 1818(a)(3) of the Social Security
Act (42 U.S.C. 1395i–2(a)(3)) is amended by amending subparagraph (B) to read
as follows: <quote>(B) an individual who is lawfully present in the United
States</quote>.</text>
</section><section id="HA80C7AE02CF94296A579D0DF87274E91"><enum>419.</enum><header>100 percent
FMAP for medical assistance provided by urban Indian health centers</header>
<subsection id="H27C5CB265DF7407B8C73E285EEC6B24A"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 1905(b) of
the Social Security Act (42 U.S.C. 1396(b)), as amended by section 415(c), is
amended by inserting <quote>or are received through a program operated by an
urban Indian organization through a grant or contract under title V of such
Act</quote>.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HE4C542EEF5904E9B99457266CB0FF1E0"><enum>(b)</enum><header display-inline="yes-display-inline">Effective
date</header><text display-inline="yes-display-inline">The amendment made by
this section shall apply to medical assistance provided on or after the date of
enactment of this Act.</text>
</subsection></section><section commented="no" display-inline="no-display-inline" id="H57133F3245C04C94A81674FDCB2ACA17" section-type="subsequent-section"><enum>420.</enum><header display-inline="yes-display-inline">100 percent FMAP for medical assistance
provided to a Native Hawaiian through a federally qualified health center or a
Native Hawaiian health care system under the Medicaid program</header>
<subsection commented="no" display-inline="no-display-inline" id="H4601E739203B4CFB9C2464CFBA2165B1"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The third sentence of section 1905(b) of
the <act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1396d(b)), as amended by section 419, is amended by inserting <quote>; and,
with respect to medical assistance provided to a Native Hawaiian (as defined in
section 12(2) of the Native Hawaiian Health Care Improvement Act) through a
federally qualified health center or a Native Hawaiian health care system (as
defined in section 12(6) of such Act), whether directly, by referral, or under
contract or other arrangement between such federally qualified health center or
Native Hawaiian health care system and another health care provider</quote>
before the period.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HF4899ED44E3C497CBBEDA7E71002F498"><enum>(b)</enum><header display-inline="yes-display-inline">Effective
date</header><text display-inline="yes-display-inline">The amendment made by
this section shall apply to medical assistance provided on or after the date of
enactment of this Act.</text>
</subsection></section></chapter><chapter id="HD929CE5505484656BAAEDBD989B3AFC9"><enum>2</enum><header>Expansion of
Access</header>
<section commented="no" id="HAE7310FCD0064E559E7BF7EA49603A93"><enum>421.</enum><header>Grants for
racial and ethnic approaches to community health</header>
<subsection commented="no" id="H4FCD11568CF2475C89946DD857315C83"><enum>(a)</enum><header>Purpose</header><text>It
is the purpose of this section to provide for the awarding of grants to assist
communities in mobilizing and organizing resources in support of effective and
sustainable programs that will reduce or eliminate disparities in health and
health care experienced by racial and ethnic minority individuals.</text>
</subsection><subsection commented="no" id="H867DD36C37BF4E33B8FC46E7EDE1FC9D"><enum>(b)</enum><header>Authority To
Award Grants</header><text>The Secretary, acting through the Centers for
Disease Control and Prevention, shall award grants to eligible entities to
assist in designing, implementing, and evaluating culturally and linguistically
appropriate, science-based, and community-driven sustainable strategies to
eliminate racial and ethnic health and health care disparities.</text>
</subsection><subsection commented="no" id="H94035EA8D0B54A9BB5CEC767A2ACF932"><enum>(c)</enum><header>Eligible
Entities</header><text>To be eligible to receive a grant under this section, an
entity shall—</text>
<paragraph commented="no" id="H5AE62855097F4AFA8C0D62B057470DC7"><enum>(1)</enum><text>represent a
coalition—</text>
<subparagraph commented="no" id="H7E243F721443407FAD0E90D0F051A35F"><enum>(A)</enum><text>whose principal
purpose is to develop and implement interventions to reduce or eliminate a
health or health care disparity in a targeted racial or ethnic minority group
in the community served by the coalition; and</text>
</subparagraph><subparagraph commented="no" id="H1577D87119A64B2B9C8FD8188B42091E"><enum>(B)</enum><text>that
includes—</text>
<clause commented="no" id="H5F4438723AD64A8F9CC38CDF26731CCC"><enum>(i)</enum><text>members selected
from among—</text>
<subclause commented="no" id="H22E090911F3D414E8129D66BC2FFB7DD"><enum>(I)</enum><text>public health
departments;</text>
</subclause><subclause commented="no" id="HA475C91A2CD149F7BE92C6DBE4EA9007"><enum>(II)</enum><text>community-based
organizations;</text>
</subclause><subclause commented="no" id="HC022D8FC8EC24D2DB488954854529EA1"><enum>(III)</enum><text>university and
research organizations;</text>
</subclause><subclause commented="no" id="HDE7406C2F15A48DE9D2A9DF3C21DEDC6"><enum>(IV)</enum><text>American Indian
tribal organizations, national American Indian organizations, Indian Health
Service, or organizations serving Alaska Natives; and</text>
</subclause><subclause commented="no" id="HECE81E719BA343BFA3AF4C7D2E62120E"><enum>(V)</enum><text>interested public
or private health care providers or organizations as deemed appropriate by the
Secretary; and</text>
</subclause></clause><clause commented="no" id="H3309A7E0AB6D438FBE22EF0EFE0B9D40"><enum>(ii)</enum><text>at least 1 member
from a community-based organization that represents the targeted racial or
ethnic minority group; and</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="H863BEFB6670E4032AB135C2515DDE6D7"><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, which shall include—</text>
<subparagraph commented="no" id="H154AE0F49EB44EC28260F3777B2AE9CD"><enum>(A)</enum><text>a description of
the targeted racial or ethnic populations in the community to be served under
the grant;</text>
</subparagraph><subparagraph commented="no" id="H84FCA4958217494491E50A426FE1B54E"><enum>(B)</enum><text>a description of
at least 1 health disparity that exists in the racial or ethnic targeted
populations, including health issues such as infant mortality, breast and
cervical cancer screening and management, cardiovascular disease, diabetes,
child and adult immunization levels, or other health priority areas as
designated by the Secretary; and</text>
</subparagraph><subparagraph commented="no" id="HEB7BA6886E8949E59E6F972DB86923C5"><enum>(C)</enum><text>a demonstration of
a proven record of accomplishment of the coalition members in serving and
working with the targeted community.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H39D47E0593D24703BAA77EDB49088314"><enum>(d)</enum><header>Sustainability</header><text>The
Secretary shall give priority to an eligible entity under this section if the
entity agrees that, with respect to the costs to be incurred by the entity in
carrying out the activities for which the grant was awarded, the entity (and
each of the participating partners in the coalition represented by the entity)
will maintain its expenditures of non-Federal funds for such activities at a
level that is not less than the level of such expenditures during the fiscal
year immediately preceding the first fiscal year for which the grant is
awarded.</text>
</subsection><subsection commented="no" id="H978096F0B61244D782F7ECAC191F87BE"><enum>(e)</enum><header>Nonduplication</header><text>Funds
provided through this grant program should supplement, not supplant, existing
Federal funding, and the funds should not be used to duplicate the activities
of the other health disparity grant programs in this Act.</text>
</subsection><subsection commented="no" id="H45901A7126664764BF28F0E66798D5FB"><enum>(f)</enum><header>Technical
Assistance</header><text>The Secretary may, either directly or by grant or
contract, provide any entity that receives a grant under this section with
technical and other nonfinancial assistance necessary to meet the requirements
of this section.</text>
</subsection><subsection commented="no" id="H5368A4A1ADF04E21969A0B8E3A19133F"><enum>(g)</enum><header>Dissemination</header><text>The
Secretary shall encourage and enable grantees to share best practices,
evaluation results, and reports with communities not affiliated with grantees
using the Internet, conferences, and other pertinent information regarding the
projects funded by this section, including the outreach efforts of the Office
of Minority Health and Health Disparity Elimination and the Centers for Disease
Control and Prevention.</text>
</subsection><subsection commented="no" id="HFBA4D0E1707848F3B21E75063AC8765F"><enum>(h)</enum><header>Administrative
Burdens</header><text>The Secretary shall make every effort to minimize
duplicative or unnecessary administrative burdens on grantees.</text>
</subsection><subsection commented="no" id="HDDAC76FA889645259AF7EAEB564C26CF"><enum>(i)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">There are
authorized to be appropriated such sums as may be necessary to carry out this
section.</text>
</subsection></section><section commented="no" display-inline="no-display-inline" id="H6650B402AD88408EB670A250A9AEC7C1" section-type="subsequent-section"><enum>422.</enum><header>Critical access
hospital improvements</header>
<subsection commented="no" id="HD21F5BEFD21E4ABC96B6BD1BC26F4C63"><enum>(a)</enum><header>Elimination of
isolation Test for cost-based ambulance reimbursement</header>
<paragraph commented="no" id="H63F02C96B5C042D189AEB6EF1D1463CF"><enum>(1)</enum><header>In
general</header><text>Section 1834(l)(8) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 1395m(l)(8)) is
amended—</text>
<subparagraph commented="no" id="H60C07BD66535432F988B4968108D0223"><enum>(A)</enum><text>in subparagraph
(B)—</text>
<clause commented="no" id="HE6DDEA0ECB874198B663991EBB3D6099"><enum>(i)</enum><text>by striking
<quote>owned and</quote>; and</text>
</clause><clause commented="no" id="HD3773AB851A24D0AA88F5BDB56A6CF20"><enum>(ii)</enum><text>by inserting
<quote>(including when such services are provided by the entity under an
arrangement with the hospital)</quote> after <quote>hospital</quote>;
and</text>
</clause></subparagraph><subparagraph commented="no" id="H65D9DDB26F8B478D98D5790334F440A7"><enum>(B)</enum><text>by striking the
comma at the end of subparagraph (B) and all that follows and inserting a
period.</text>
</subparagraph></paragraph><paragraph commented="no" id="H19010E9367AC43C88E3151200D3993C9"><enum>(2)</enum><header>Effective
date</header><text>The amendments made by this subsection shall apply to
services furnished on or after January 1, 2012.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H306D0B1D9F3543B59A2198C936FD9766"><enum>(b)</enum><header>Provision of a
more flexible alternative to the CAH designation 25 inpatient bed limit
requirement</header>
<paragraph commented="no" id="HDC0607394270424E8D97C05AEE637986"><enum>(1)</enum><header>In
general</header><text>Section 1820(c)(2) of the Social Security Act (42 U.S.C.
1395i–4(c)(2)) is amended—</text>
<subparagraph commented="no" id="H499DA9CE37CA4DD0B8D9C8A7F1065A7B"><enum>(A)</enum><text>in subparagraph
(B)(iii), by striking <quote>provides not more than</quote> and inserting
<quote>subject to subparagraph (F), provides not more than</quote>; and</text>
</subparagraph><subparagraph commented="no" id="H0F9426F1EFFF4753A91847EE3C897ECC"><enum>(B)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H8B1C6BB8A5194AC481CFDAF24472B351" style="OLC">
<subparagraph commented="no" id="H53A7127CBC694831BDF82732FA045C91"><enum>(F)</enum><header>Alternative to
25 inpatient bed limit requirement</header>
<clause commented="no" id="H379DCE4AFBFA46F98E55493F5C4A2229"><enum>(i)</enum><header>In
general</header><text display-inline="yes-display-inline">A State may elect to
treat a facility, with respect to the designation of the facility for a cost
reporting period, as satisfying the requirement of subparagraph (B)(iii)
relating to a maximum number of acute care inpatient beds if the facility
elects, in accordance with a method specified by the Secretary and before the
beginning of the cost reporting period, to meet the requirement under clause
(ii).</text>
</clause><clause commented="no" id="H6D6F16724E0A4479961D49AD58EA4A1D"><enum>(ii)</enum><header>Alternate
requirement</header><text>The requirement under this clause, with respect to a
facility and a cost reporting period, is that the total number of inpatient bed
days described in subparagraph (B)(iii) during such period will not exceed
7,300. For purposes of this subparagraph, an individual who is an inpatient in
a bed in the facility for a single day shall be counted as one inpatient bed
day.</text>
</clause><clause commented="no" id="H4625CCAD623A46788F50A50021FD2FEA"><enum>(iii)</enum><header>Withdrawal of
election</header><text>The option described in clause (i) shall not apply to a
facility for a cost reporting period if the facility (for any two consecutive
cost-reporting periods during the previous 5 cost-reporting periods) was
treated under such option and had a total number of inpatient bed days for each
of such two cost-reporting periods that exceeded the number specified in such
clause.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph commented="no" id="H7B6B5A0FFDB2424EA821DD1E2622E829"><enum>(2)</enum><header>Effective
date</header><text>The amendments made by paragraph (1) shall apply to
cost-reporting periods beginning on or after the date of the enactment of this
Act.</text>
</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H034E9FF85EC04AFAB851DC38F3301C22" section-type="subsequent-section"><enum>423.</enum><header>Establishment of
Rural Community Hospital (RCH) Program</header>
<subsection commented="no" id="H5028246A0C344D47B15670C8787F5C10"><enum>(a)</enum><header>In
general</header><text>Section 1861 of the Social Security Act (42 U.S.C.
1395x), as amended by section 203(b)(1)(A), is amended by adding at the end of
the following new subsection:</text>
<quoted-block act-name="" display-inline="no-display-inline" id="H13367290E6E546A6937E93D25176D841" other-style="archaic" style="other">
<subsection commented="no" id="H18691D9F983F4AA1B60FE4EE6D65F0C2"><enum>(jjj)</enum><header>Rural Community Hospital; Rural Community Hospital
Services</header><paragraph commented="no" display-inline="yes-display-inline" id="H19747FEDA0934C558CFAAE95410FD70E"><enum>(1)</enum><text>The term <term>rural
community hospital</term> means a hospital (as defined in subsection (e))
that—</text>
<subparagraph commented="no" id="HB7BE382611A444EFBC23624E2FE12F7F" indent="up1"><enum>(A)</enum><text>is located in a rural area (as defined
in section 1886(d)(2)(D)) or treated as being so located pursuant to section
1886(d)(8)(E);</text>
</subparagraph><subparagraph commented="no" id="H0508FE0227064AAFB49E39D7B3375B4A" indent="up1"><enum>(B)</enum><text>subject to paragraph (2), has less
than 51 acute care inpatient beds, as reported in its most recent cost
report;</text>
</subparagraph><subparagraph commented="no" id="H15194F1DFBAE45418E1113A4C293FBCF" indent="up1"><enum>(C)</enum><text>makes available 24-hour emergency care
services;</text>
</subparagraph><subparagraph commented="no" id="H769D77C275314968838AA198431DB1DA" indent="up1"><enum>(D)</enum><text>subject to paragraph (3), has a
provider agreement in effect with the Secretary and is open to the public as of
January 1, 2010; and</text>
</subparagraph><subparagraph commented="no" id="H1A4F4CCA9AFD4E9196405A4BEBEB12DF" indent="up1"><enum>(E)</enum><text>applies to the Secretary for such
designation.</text>
</subparagraph></paragraph><paragraph commented="no" id="H5510FEB0A11B4BACBC11B8AA3FCEBFBA" indent="up1"><enum>(2)</enum><text>For purposes of paragraph (1)(B),
beds in a psychiatric or rehabilitation unit of the hospital which is a
distinct part of the hospital shall not be counted.</text>
</paragraph><paragraph commented="no" id="H16856BAC3BDD4A17AE6552684526D4EA" indent="up1"><enum>(3)</enum><text>Paragraph (1)(D) shall not be
construed to prohibit any of the following from qualifying as a rural community
hospital:</text>
<subparagraph commented="no" id="HC9AA32D3E4B24707A4973EE8F5F0D8EA"><enum>(A)</enum><text>A replacement facility (as defined by
the Secretary in regulations in effect on January 1, 2012) with the same
service area (as defined by the Secretary in regulations in effect on such
date).</text>
</subparagraph><subparagraph commented="no" id="HDD93ECBA304A4542AD77D3DFF800D0B7"><enum>(B)</enum><text>A facility obtaining a new provider
number pursuant to a change of ownership.</text>
</subparagraph><subparagraph commented="no" id="H624C262F48BB4B1693B510DDCDAAB295"><enum>(C)</enum><text>A facility which has a binding written
agreement with an outside, unrelated party for the construction,
reconstruction, lease, rental, or financing of a building as of January 1,
2012.</text>
</subparagraph></paragraph><paragraph commented="no" id="HE0244698F9364F74B2FD2855CB22E43A" indent="up1"><enum>(4)</enum><text>Nothing in this subsection shall be
construed as prohibiting a critical access hospital from qualifying as a rural
community hospital if the critical access hospital meets the conditions
otherwise applicable to hospitals under subsection (e) and section 1866.</text>
</paragraph><paragraph commented="no" id="H6C19A8F9865F42ADAF887470122AD9FD" indent="up1"><enum>(5)</enum><text>Nothing in this subsection shall be
construed as prohibiting a rural community hospital participating in the
demonstration program under section 410A of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2313)
from qualifying as a rural community hospital if the rural community hospital
meets the conditions otherwise applicable to hospitals under subsection (e) and
section
1866.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" id="H7123561297C94130BC6D39EB07B4F7B1"><enum>(b)</enum><header>Payment</header>
<paragraph commented="no" id="HB8C2FAF3BB414E9FBD5FD3CC232CDB5C"><enum>(1)</enum><header>Inpatient
hospital services</header><text>Section 1814 of the Social Security Act (42
U.S.C. 1395f) is amended by adding at the end the following new
subsection:</text>
<quoted-block act-name="" display-inline="no-display-inline" id="HA1C36D6DC5AD48FBABC3B432B21BCBFA" other-style="archaic" style="other">
<subsection commented="no" id="H9CDBE0DF949E42E2874AC0409A19C256"><enum>(m)</enum><header>Payment for Inpatient Services Furnished in Rural Community
Hospitals</header><text>The amount of
payment under this part for inpatient hospital services furnished in a rural
community hospital, other than such services furnished in a psychiatric or
rehabilitation unit of the hospital which is a distinct part, is, at the
election of the hospital in the application referred to in section
1861(jjj)(1)(E)—</text>
<paragraph commented="no" id="H7DEC5B3E94244B7FB7D81932C6385F32"><enum>(1)</enum><text>101 percent of the
reasonable costs of providing such services, without regard to the amount of
the customary or other charge, or</text>
</paragraph><paragraph commented="no" id="H06F8A8A855AA49E2B377189E4387A750"><enum>(2)</enum><text>the amount of
payment provided for under the prospective payment system for inpatient
hospital services under section
1886(d).</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" id="HE3343EC18A694D568E8B3F3B60D25C51"><enum>(2)</enum><header>Outpatient
services</header><text>Section 1834 of such Act (42 U.S.C. 1395m) is amended by
adding at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="HF8AFB58FE0694079BE92C5D5CBFEDD78" style="OLC">
<subsection commented="no" id="HF728D325D1044A608F8640B7D72329F0"><enum>(p)</enum><header>Payment for
outpatient services furnished in rural community hospitals</header><text>The
amount of payment under this part for outpatient services furnished in a rural
community hospital is, at the election of the hospital in the application
referred to in section 1861(jjj)(1)(E)—</text>
<paragraph commented="no" id="HF9D75F4DAD974718AFA981787BFEB27C"><enum>(1)</enum><text>101 percent of the
reasonable costs of providing such services, without regard to the amount of
the customary or other charge and any limitation under section 1861(v)(1)(U),
or</text>
</paragraph><paragraph commented="no" id="H31BE3E3F3CAE479399D838C440ADFA96"><enum>(2)</enum><text>the amount of
payment provided for under the prospective payment system for covered OPD
services under section
1833(t).</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" id="H0C8B4E59A9784C1DBF4D37D3BD17F6C2"><enum>(3)</enum><header>Exemption from
30-percent reduction in reimbursement for bad debt</header><text>Section
1861(v)(1)(T) of such Act (42 U.S.C. 1395x(v)(1)(T)) is amended by inserting
<quote>(other than for a rural community hospital)</quote> after <quote>In
determining such reasonable costs for hospitals</quote>.</text>
</paragraph></subsection><subsection commented="no" id="H44E10ED2214E463F88A2F9674F6B0869"><enum>(c)</enum><header>Beneficiary
cost-Sharing for outpatient services</header><text>Section 1834(p) of such Act
(as added by subsection (b)(2)) is amended—</text>
<paragraph commented="no" id="HA98351E3D3284E44BB547A0CC49A3D9A"><enum>(1)</enum><text>by redesignating
paragraphs (1) and (2) as subparagraphs (A) and (B), respectively;</text>
</paragraph><paragraph commented="no" id="HA1578AAEFFB043FDA1D9D2ADB3581E38"><enum>(2)</enum><text>by inserting
<quote>(1)</quote> after <quote>(p)</quote>; and</text>
</paragraph><paragraph commented="no" id="HBF298A04043A43ACACB7E093D7F4C90D"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H50526D4BCA744161A55DDFCCC7E9B15F" style="OLC">
<paragraph commented="no" id="H6C4635A8A9AD45CC89166D462B558B48" indent="up1"><enum>(2)</enum><text>The amounts of beneficiary
costsharing for outpatient services furnished in a rural community hospital
under this part shall be as follows:</text>
<subparagraph commented="no" id="H0149C450451F4E11A7FFD6D5CB203A15"><enum>(A)</enum><text>For items and services that would have
been paid under section 1833(t) if provided by a hospital, the amount of
costsharing determined under paragraph (8) of such section.</text>
</subparagraph><subparagraph commented="no" id="HFAD61F9975FF4B5EACBF0E89BAEE2827"><enum>(B)</enum><text>For items and services that would have
been paid under section 1833(h) if furnished by a provider or supplier, no
costsharing shall apply.</text>
</subparagraph><subparagraph commented="no" id="H2B80A98ECABD42DEADE0A9B5F4FA7569"><enum>(C)</enum><text>For all other items and services, the
amount of costsharing that would apply to the item or service under the
methodology that would be used to determine payment for such item or service if
provided by a physician, provider, or supplier, as the case may
be.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="HC23640699A1D4786A0CFB250C4B1D681"><enum>(d)</enum><header>Conforming
amendments</header>
<paragraph commented="no" id="H74CD1710F8AC45BDADD4A58AF6CAD184"><enum>(1)</enum><header>Part A
payment</header><text>Section 1814(b) of such Act (42 U.S.C. 1395f(b)) is
amended in the matter preceding paragraph (1) by inserting <quote>other than
inpatient hospital services furnished by a rural community hospital,</quote>
after <quote>critical access hospital services,</quote>.</text>
</paragraph><paragraph commented="no" id="H2513926806464F73BCB427C07B55724F"><enum>(2)</enum><header>Part B
payment</header><text>Section 1833(a) of such Act (42 U.S.C. 1395l(a)), as
amended by section 203(b)(2), is amended—</text>
<subparagraph commented="no" id="HBB58240192F34EBCAAC2D4F49FAF6777"><enum>(A)</enum><text>in paragraph (2),
in the matter before subparagraph (A), by striking <quote>and (I)</quote> and
inserting <quote>(I), and (K)</quote>;</text>
</subparagraph><subparagraph commented="no" id="H173547094ABF481C84B0AA9EEBA92907"><enum>(B)</enum><text>by striking
<quote>and</quote> at the end of paragraph (9);</text>
</subparagraph><subparagraph commented="no" id="H939355AFE5C844979C4F5C28058218CF"><enum>(C)</enum><text>by striking the
period at the end of paragraph (10) and inserting <quote>; and</quote>;
and</text>
</subparagraph><subparagraph commented="no" id="H2A3854FD733B45DCBD4D9AA136D3094C"><enum>(D)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H9831EA80B27D4D8B831A3807B072D58C" style="OLC">
<paragraph commented="no" id="H8C4CEFA090F14845B9B76010972BAA12"><enum>(11)</enum><text>in the case of
outpatient services furnished by a rural community hospital, the amounts
described in section
1834(p).</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph commented="no" id="H6E341FB0C766454293AA0691C7C2116B"><enum>(3)</enum><header>Technical
amendments</header>
<subparagraph commented="no" id="HDFDF77255C354B3DAF5D1E1C06029C2C"><enum>(A)</enum><header>Consultation
with state agencies</header><text>Section 1863 of such Act (42 U.S.C. 1395z) is
amended by striking <quote>and (dd)(2)</quote> and inserting <quote>(dd)(2),
(mm)(1), and (jjj)(1)</quote>.</text>
</subparagraph><subparagraph commented="no" id="H80FF8B595E9A42E484CAB6187099B2BD"><enum>(B)</enum><header>Provider
agreements</header><text>Section 1866(a)(2)(A) of such Act (42 U.S.C.
1395cc(a)(2)(A)) is amended by inserting <quote>section 1834(p)(2),</quote>
after <quote>section 1833(b),</quote>.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="HA1E753D4614C480EA44344B8DCF904DC"><enum>(e)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to items and
services furnished on or after October 1, 2011.</text>
</subsection></section><section commented="no" id="H3A83D181F5D944FD988CC418AC970C40"><enum>424.</enum><header>Medicare remote
monitoring pilot projects</header>
<subsection commented="no" id="H7B452301555A4208BCA3C4AAA7FF239A"><enum>(a)</enum><header>Pilot
projects</header>
<paragraph commented="no" id="HCA5CFDBD98A04812A1761D71EABED780"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">Not later than 9
months after the date of enactment of this Act, the Secretary of Health and
Human Services (in this section referred to as the <term>Secretary</term>)
shall conduct pilot projects under title XVIII of the Social Security Act for
the purpose of providing incentives to home health agencies to utilize home
monitoring and communications technologies that—</text>
<subparagraph commented="no" id="H212BF766530040D4863CC93A8FE3D11F"><enum>(A)</enum><text>enhance health
outcomes for Medicare beneficiaries; and</text>
</subparagraph><subparagraph commented="no" id="H4805BE3C9A014147A90AE4FA95F31AF3"><enum>(B)</enum><text>reduce
expenditures under such title.</text>
</subparagraph></paragraph><paragraph commented="no" id="H42572D6720124ACEB2C9409E3786089B"><enum>(2)</enum><header>Site
requirements</header>
<subparagraph commented="no" id="HD7DCC9F3EC9148748D6A64E4E5B935BB"><enum>(A)</enum><header>Urban and
Rural</header><text>The Secretary shall conduct the pilot projects under this
section in both urban and rural areas.</text>
</subparagraph><subparagraph commented="no" id="H8428E109CA8A4C8AA09ED1787DC93225"><enum>(B)</enum><header>Site in a small
state</header><text>The Secretary shall conduct at least 3 of the pilot
projects in a State with a population of less than 1,000,000.</text>
</subparagraph></paragraph><paragraph commented="no" id="H825A6D6A8A934250B73520368E41DF7C"><enum>(3)</enum><header>Definition of
home health agency</header><text>In this section, the term <term>home health
agency</term> has the meaning given that term in section 1861(o) of the Social
Security Act (42 U.S.C. 1395x(o)).</text>
</paragraph></subsection><subsection commented="no" id="H916C958FD8154A27AAE59893CD3B7508"><enum>(b)</enum><header>Medicare
beneficiaries within the scope of projects</header><text>The Secretary shall
specify the criteria for identifying those Medicare beneficiaries who shall be
considered within the scope of the pilot projects under this section for
purposes of the application of subsection (c) and for the assessment of the
effectiveness of the home health agency in achieving the objectives of this
section. Such criteria may provide for the inclusion in the projects of
Medicare beneficiaries who begin receiving home health services under title
XVIII of the Social Security Act after the date of the implementation of the
projects.</text>
</subsection><subsection commented="no" id="H6B9D9E4CD92448D8B293C787F0759692"><enum>(c)</enum><header>Incentives</header>
<paragraph commented="no" id="HCCCF75B7E8A24B3AB16000EA3CE442CD"><enum>(1)</enum><header>Performance
targets</header><text>The Secretary shall establish for each home health agency
participating in a pilot project under this section a performance target using
one of the following methodologies, as determined appropriate by the
Secretary:</text>
<subparagraph commented="no" id="H2CE8E85161534204948B2E3F19CA484E"><enum>(A)</enum><header>Adjusted
historical performance target</header><text>The Secretary shall establish for
the agency—</text>
<clause commented="no" id="H69FB79F22E004481B74F006D2A8033FB"><enum>(i)</enum><text>a base expenditure
amount equal to the average total payments made to the agency under parts A and
B of title XVIII of the Social Security Act for Medicare beneficiaries
determined to be within the scope of the pilot project in a base period
determined by the Secretary; and</text>
</clause><clause commented="no" id="HAC4061E785EC478B8F87A274EB51B080"><enum>(ii)</enum><text>an annual per
capita expenditure target for such beneficiaries, reflecting the base
expenditure amount adjusted for risk and adjusted growth rates.</text>
</clause></subparagraph><subparagraph commented="no" id="H885BE502CC0D414684B7037DDFAE8BD6"><enum>(B)</enum><header>Comparative
performance target</header><text>The Secretary shall establish for the agency a
comparative performance target equal to the average total payments under such
parts A and B during the pilot project for comparable individuals in the same
geographic area that are not determined to be within the scope of the pilot
project.</text>
</subparagraph></paragraph><paragraph commented="no" id="HE254C81B21404B1A9C97A92B6730BAE6"><enum>(2)</enum><header>Incentive</header><text>Subject
to paragraph (3), the Secretary shall pay to each participating home care
agency an incentive payment for each year under the pilot project equal to a
portion of the Medicare savings realized for such year relative to the
performance target under paragraph (1).</text>
</paragraph><paragraph commented="no" id="H6FC99471C801469890A232D73689A62B"><enum>(3)</enum><header>Limitation on
expenditures</header><text>The Secretary shall limit incentive payments under
this section in order to ensure that the aggregate expenditures under title
XVIII of the Social Security Act (including incentive payments under this
subsection) do not exceed the amount that the Secretary estimates would have
been expended if the pilot projects under this section had not been
implemented.</text>
</paragraph></subsection><subsection commented="no" id="HDF185982F2834C88ADCF6820D4B95F82"><enum>(d)</enum><header>Waiver
authority</header><text>The Secretary may waive such provisions of titles XI
and XVIII of the Social Security Act as the Secretary determines to be
appropriate for the conduct of the pilot projects under this section.</text>
</subsection><subsection commented="no" id="H8F5F65FE903640EB90E8C2CC3E5D678D"><enum>(e)</enum><header>Report to
Congress</header><text>Not later than 5 years after the date that the first
pilot project under this section is implemented, the Secretary shall submit to
Congress a report on the pilot projects. Such report shall contain a detailed
description of issues related to the expansion of the projects under subsection
(f) and recommendations for such legislation and administrative actions as the
Secretary considers appropriate.</text>
</subsection><subsection commented="no" id="H0F4FCAF99B5445C7A73E426237A03571"><enum>(f)</enum><header>Expansion</header><text>If
the Secretary determines that any of the pilot projects under this section
enhance health outcomes for Medicare beneficiaries and reduce expenditures
under title XVIII of the Social Security Act, the Secretary may initiate
comparable projects in additional areas.</text>
</subsection><subsection commented="no" id="HF2CBD7BD60E246099DAA8AD15B9DF693"><enum>(g)</enum><header>Incentive
payments have no effect on other Medicare payments to agencies</header><text>An
incentive payment under this section—</text>
<paragraph commented="no" id="H890EBB4C103E4A558AC38F7437630612"><enum>(1)</enum><text>shall be in
addition to the payments that a home health agency would otherwise receive
under title XVIII of the Social Security Act for the provision of home health
services; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HC8D8A23DB17E46E889B4291CF763778D"><enum>(2)</enum><text>shall have no
effect on the amount of such payments.</text>
</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H9511276E927F418DAF5D298CA852A573" section-type="subsequent-section"><enum>425.</enum><header>Rural health quality
advisory commission and demonstration projects</header>
<subsection commented="no" id="HF68272AB3A9B4A7387D4277716805459"><enum>(a)</enum><header>Rural Health
Quality Advisory Commission</header>
<paragraph commented="no" id="H995BC96416614BEAB0AC24DB42E55D33"><enum>(1)</enum><header>Establishment</header><text>Not
later than 6 months after the date of the enactment of this section, the
Secretary of Health and Human Services (in this section referred to as the
<term>Secretary</term>) shall establish a commission to be known as the Rural
Health Quality Advisory Commission (in this section referred to as the
<term>Commission</term>).</text>
</paragraph><paragraph commented="no" id="H45561FE2C4994543AA793CDB4C1C705D"><enum>(2)</enum><header>Duties of
commission</header>
<subparagraph commented="no" id="H0D217F21501B4EBFB62655496D0AB749"><enum>(A)</enum><header>National
plan</header><text>The Commission shall develop, coordinate, and facilitate
implementation of a national plan for rural health quality improvement. The
national plan shall—</text>
<clause commented="no" id="HA84F46B609CA4FA4879CA6B4730E5ED1"><enum>(i)</enum><text>identify
objectives for rural health quality improvement;</text>
</clause><clause commented="no" id="H814AAD3C91014AEDAFF918B040E6BB51"><enum>(ii)</enum><text>identify
strategies to eliminate known gaps in rural health system capacity and improve
rural health quality; and</text>
</clause><clause commented="no" id="HF18A7F45197549F491813254FABCD42F"><enum>(iii)</enum><text>provide for
Federal programs to identify opportunities for strengthening and aligning
policies and programs to improve rural health quality.</text>
</clause></subparagraph><subparagraph commented="no" id="H4AAB797600494A0094FD4C01C1AE1D28"><enum>(B)</enum><header>Demonstration
projects</header><text>The Commission shall design demonstration projects to
test alternative models for rural health quality improvement, including with
respect to both personal and population health.</text>
</subparagraph><subparagraph commented="no" id="HF034780F64B6412EA6E1C27D2E98848E"><enum>(C)</enum><header>Monitoring</header><text>The
Commission shall monitor progress toward the objectives identified pursuant to
paragraph (1)(A).</text>
</subparagraph></paragraph><paragraph commented="no" id="H4F3EDCCA4B314AC9B84BCC3036C5C735"><enum>(3)</enum><header>Membership</header>
<subparagraph commented="no" id="HC39A2A6A440D4FF9B4652D22E61AC408"><enum>(A)</enum><header>Number</header><text>The
Commission shall be composed of 11 members appointed by the Secretary.</text>
</subparagraph><subparagraph commented="no" id="HEA210F9F5B5642BCA9C11598FB788FAD"><enum>(B)</enum><header>Selection</header><text>The
Secretary shall select the members of the Commission from among individuals
with significant rural health care and health care quality expertise, including
expertise in clinical health care, health care quality research, population or
public health, or purchaser organizations.</text>
</subparagraph></paragraph><paragraph commented="no" id="HA3C0FB991C934353954B7143DBBB51A7"><enum>(4)</enum><header>Contracting
authority</header><text>Subject to the availability of funds, the Commission
may enter into contracts and make other arrangements, as may be necessary to
carry out the duties described in paragraph (2).</text>
</paragraph><paragraph commented="no" id="H5532A172F07640E19718F60E5E85BB99"><enum>(5)</enum><header>Staff</header><text>Upon
the request of the Commission, the Secretary may detail, on a reimbursable
basis, any of the personnel of the Office of Rural Health Policy of the Health
Resources and Services Administration, the Agency for Health care Quality and
Research, or the Centers for Medicare & Medicaid Services to the Commission
to assist in carrying out this subsection.</text>
</paragraph><paragraph commented="no" id="HB734686F83FB498F8A0E7EBE540CC6B2"><enum>(6)</enum><header>Reports to
congress</header><text>Not later than 1 year after the establishment of the
Commission, and annually thereafter, the Commission shall submit a report to
the Congress on rural health quality. Each such report shall include the
following:</text>
<subparagraph commented="no" id="HAE1B3F4405E940EEB21B647493341D96"><enum>(A)</enum><text>An inventory of
relevant programs and recommendations for improved coordination and integration
of policy and programs.</text>
</subparagraph><subparagraph commented="no" id="H958CD0DEA25B474EB4D6C7B48567A240"><enum>(B)</enum><text>An assessment of
achievement of the objectives identified in the national plan developed under
paragraph (2) and recommendations for realizing such objectives.</text>
</subparagraph><subparagraph commented="no" id="H0ACC1C53B5124942AD9D4C1405A503AD"><enum>(C)</enum><text>Recommendations on
Federal legislation, regulations, or administrative policies to enhance rural
health quality and outcomes.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H7753493490824C45BC3D3E628296080E"><enum>(b)</enum><header>Rural Health
Quality Demonstration Projects</header>
<paragraph commented="no" id="H77192E8C8C8A426DB0661253A257B97B"><enum>(1)</enum><header>In
general</header><text>Not later than 270 days after the date of the enactment
of this section, the Secretary, in consultation with the Rural Health Quality
Advisory Commission, the Office of Rural Health Policy of the Health Resources
and Services Administration, the Agency for Healthcare Research and Quality,
and the Centers for Medicare & Medicaid Services, shall make grants to
eligible entities for 5 demonstration projects to implement and evaluate
methods for improving the quality of health care in rural communities. Each
such demonstration project shall include—</text>
<subparagraph commented="no" id="H6F276DAAA2E34FB78AE1253BFCA04A82"><enum>(A)</enum><text>alternative
community models that—</text>
<clause commented="no" id="H37EE920991F44DF89E2E4FBE7788D6B8"><enum>(i)</enum><text>will achieve
greater integration of personal and population health services; and</text>
</clause><clause commented="no" id="HA4EBE6E7162747058A7A574D1616CEEA"><enum>(ii)</enum><text>address safety,
effectiveness, patient- or community-centeredness, timeliness, efficiency, and
equity (the 6 aims identified by the Institute of Medicine of the National
Academies in its report entitled <term>Crossing the Quality Chasm: A New Health
System for the 21st Century</term> released on March 1, 2001);</text>
</clause></subparagraph><subparagraph commented="no" id="HFEA95B6F4DBE44398761EB8BC6DD12C8"><enum>(B)</enum><text>innovative
approaches to the financing and delivery of health services to achieve rural
health quality goals; and</text>
</subparagraph><subparagraph commented="no" id="H1350B3DA13334EF38C5DC1FF1C650582"><enum>(C)</enum><text>development of
quality improvement support structures to assist rural health systems and
professionals (such as workforce support structures, quality monitoring and
reporting, clinical care protocols, and information technology
applications).</text>
</subparagraph></paragraph><paragraph commented="no" id="H72B9A9B830034422A05C2D1C84523110"><enum>(2)</enum><header>Eligible
entities</header><text>In this subsection, the term <term>eligible
entity</term> means a consortium that—</text>
<subparagraph commented="no" id="HD199641347054764998123E9AEA4B69F"><enum>(A)</enum><text>shall
include—</text>
<clause commented="no" id="H5FC4B56445BC4DEABAE7EB941317BD76"><enum>(i)</enum><text>at least one
health care provider or health care delivery system located in a rural area;
and</text>
</clause><clause commented="no" id="H772EB377431F46B096076A47DDE8CB14"><enum>(ii)</enum><text>at least one
organization representing multiple community stakeholders; and</text>
</clause></subparagraph><subparagraph commented="no" id="H3D9B27CD25454E0AA18222C75EE614F9"><enum>(B)</enum><text>may include other
partners such as rural research centers.</text>
</subparagraph></paragraph><paragraph commented="no" id="H40007FB034E246039291060E604CFF75"><enum>(3)</enum><header>Consultation</header><text>In
developing the program for awarding grants under this subsection, the Secretary
shall consult with the Administrator of the Agency for Healthcare Research and
Quality, rural health care providers, rural health care researchers, and
private and nonprofit groups (including national associations) which are
undertaking similar efforts.</text>
</paragraph><paragraph commented="no" id="H43047B26D5C847ED966840AEF78819A3"><enum>(4)</enum><header>Expedited
waivers</header><text>The Secretary shall expedite the processing of any waiver
that—</text>
<subparagraph commented="no" id="H0EBA6A3BE0304DB781451F7453200A6E"><enum>(A)</enum><text>is authorized
under title XVIII or XIX of the Social Security Act (42 U.S.C. 1395 et seq.);
and</text>
</subparagraph><subparagraph commented="no" id="H4E6A9C2F59484359BB6FDACBE90BCA82"><enum>(B)</enum><text>is necessary to
carry out a demonstration project under this subsection.</text>
</subparagraph></paragraph><paragraph commented="no" id="H5CD3BB2BF5D94AB6BF6B39D305BCECF8"><enum>(5)</enum><header>Demonstration
project sites</header><text>The Secretary shall ensure that the 5 demonstration
projects funded under this subsection are conducted at a variety of sites
representing the diversity of rural communities in the Nation.</text>
</paragraph><paragraph commented="no" id="H15ABE93F280D459F87B9D5D55EB30BAD"><enum>(6)</enum><header>Duration</header><text>Each
demonstration project under this subsection shall be for a period of 4
years.</text>
</paragraph><paragraph commented="no" id="H455D20CFCE7144A3BD502BABD90529C5"><enum>(7)</enum><header>Independent
evaluation</header><text>The Secretary shall enter into an arrangement with an
entity that has experience working directly with rural health systems for the
conduct of an independent evaluation of the program carried out under this
subsection.</text>
</paragraph><paragraph commented="no" id="H445031FCB8054B98AB2101CCF2AC0799"><enum>(8)</enum><header>Report</header><text>Not
later than 1 year after the conclusion of all of the demonstration projects
funded under this subsection, the Secretary shall submit a report to the
Congress on the results of such projects. The report shall include—</text>
<subparagraph commented="no" id="HAE3ADA96029D412880D9641DAED31647"><enum>(A)</enum><text>an evaluation of
patient access to care, patient outcomes, and an analysis of the cost
effectiveness of each such project; and</text>
</subparagraph><subparagraph commented="no" id="H6A0685785ADB45449E00A2AB45686682"><enum>(B)</enum><text>recommendations on
Federal legislation, regulations, or administrative policies to enhance rural
health quality and outcomes.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H30BEA4B0BC604180A1AE4F4288F565DF"><enum>(c)</enum><header>Appropriation</header>
<paragraph commented="no" id="HD7C33F09DE1443E9A56C8447ADCFEF53"><enum>(1)</enum><header>In
general</header><text>Out of funds in the Treasury not otherwise appropriated,
there are appropriated to the Secretary to carry out this section $30,000,000
for the period of fiscal years 2012 through 2016.</text>
</paragraph><paragraph commented="no" id="H342A5784B26342AA8DAB926CB24E9175"><enum>(2)</enum><header>Availability</header>
<subparagraph commented="no" id="H4E9A0EBA0FB04565833BB558DD441EC7"><enum>(A)</enum><header>In
general</header><text>Funds appropriated under paragraph (1) shall remain
available for expenditure through fiscal year 2016.</text>
</subparagraph><subparagraph commented="no" id="H105B70575B8D4868AB913821967FB8F0"><enum>(B)</enum><header>Report</header><text>For
purposes of carrying out subsection (b)(8), funds appropriated under paragraph
(1) shall remain available for expenditure through fiscal year 2017.</text>
</subparagraph></paragraph><paragraph commented="no" id="H411724CCDB9A4ED0B15C3535225FD95E"><enum>(3)</enum><header>Reservation</header><text>Of
the amount appropriated under paragraph (1), the Secretary shall
reserve—</text>
<subparagraph commented="no" id="H3D5927721D444E7B8ED32D925B9DD092"><enum>(A)</enum><text>$5,000,000 to
carry out subsection (a); and</text>
</subparagraph><subparagraph commented="no" id="HE8BB70CB0B0E4A6786861FD30DD17233"><enum>(B)</enum><text>$25,000,000 to
carry out subsection (b), of which—</text>
<clause commented="no" id="H1ED2763FA946403E981127628B60E7EB"><enum>(i)</enum><text>2 percent shall be
for the provision of technical assistance to grant recipients; and</text>
</clause><clause commented="no" id="H0398ED776CB541A2AF98F76520C895D6"><enum>(ii)</enum><text>5 percent shall
be for independent evaluation under subsection (b)(7).</text>
</clause></subparagraph></paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="HBA8EA89458C4485FB92DBA46262E36F7" section-type="subsequent-section"><enum>426.</enum><header>Rural health care
services</header><text display-inline="no-display-inline">Section 330A of the
Public Health Service Act (42 U.S.C. 254c) is amended to read as
follows:</text>
<quoted-block display-inline="no-display-inline" id="HA15D5CC775EB41C5BC84DD0279328A22" style="OLC">
<section commented="no" id="HFE1EDE77741F41B5884471F9FA414786"><enum>330A.</enum><header>Rural health
care services outreach, rural health network development, Delta rural
disparities and health systems development, and small rural health care
provider quality improvement grant programs</header>
<subsection commented="no" id="H082AFD2EE91948D899D9E3C56E1CC0EF"><enum>(a)</enum><header>Purpose</header><text>The
purpose of this section is to provide for grants—</text>
<paragraph commented="no" id="H9A2F649046DA459D96CBEF405F984C11"><enum>(1)</enum><text>under subsection
(b), to promote rural health care services outreach;</text>
</paragraph><paragraph commented="no" id="H35713F664EE0483588481C80E6B0A881"><enum>(2)</enum><text display-inline="yes-display-inline">under subsection (c), to provide for the
planning and implementation of integrated health care networks in rural
areas;</text>
</paragraph><paragraph commented="no" id="HC8CB85C9ABCB457BA2CA02EAEA5AAD2E"><enum>(3)</enum><text display-inline="yes-display-inline">under subsection (d), to assist rural
communities in the Delta Region to reduce health disparities and to promote and
enhance health system development; and</text>
</paragraph><paragraph commented="no" id="H009791AE3F4D4920A31F577B7FDF4CE4"><enum>(4)</enum><text display-inline="yes-display-inline">under subsection (e), to provide for the
planning and implementation of small rural health care provider quality
improvement activities.</text>
</paragraph></subsection><subsection commented="no" id="H01307321E8634175A554F27A11864ACD"><enum>(b)</enum><header>Rural health
care services outreach grants</header>
<paragraph commented="no" id="HC7B589513A4E48FAB84D89A96531A5FB"><enum>(1)</enum><header>Grants</header><text display-inline="yes-display-inline">The Director of the Office of Rural Health
Policy of the Health Resources and Services Administration may award grants to
eligible entities to promote rural health care services outreach by expanding
the delivery of health care services to include new and enhanced services in
rural areas. The Director may award the grants for periods of not more than 3
years.</text>
</paragraph><paragraph commented="no" id="H7AD0E1F1152346B4AB4849FF16385368"><enum>(2)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under this subsection for a project, an
entity—</text>
<subparagraph commented="no" id="HB5D9260CBA1449D4B72B3650F6F25EA4"><enum>(A)</enum><text display-inline="yes-display-inline">shall be a rural public or rural nonprofit
private entity, a facility that qualifies as a rural health clinic under title
XVIII of the Social Security Act, a public or nonprofit entity existing
exclusively to provide services to migrant and seasonal farm workers in rural
areas, or a tribal government whose grant-funded activities will be conducted
within federally recognized tribal areas;</text>
</subparagraph><subparagraph commented="no" id="HB97608A9C7D64DE4935CCCD386E7FD09"><enum>(B)</enum><text>shall represent a
consortium composed of members—</text>
<clause commented="no" id="H30F20824CCBF432DB635EBB10A557C92"><enum>(i)</enum><text>that include 3 or
more independently owned health care entities; and</text>
</clause><clause commented="no" id="H3F6F8A7BEA874C90AF7DE89EAC280665"><enum>(ii)</enum><text>that may be
nonprofit or for-profit entities; and</text>
</clause></subparagraph><subparagraph commented="no" id="H1F7F4BABC0674C63A0E9956331364510"><enum>(C)</enum><text>shall not
previously have received a grant under this subsection for the same or a
similar project, unless the entity is proposing to expand the scope of the
project or the area that will be served through the project.</text>
</subparagraph></paragraph><paragraph commented="no" id="H623087E6CAF046E0AFA5F2F2B424AA60"><enum>(3)</enum><header>Applications</header><text>To
be eligible to receive a grant under this subsection, an eligible entity shall
prepare and submit to the Director an application at such time, in such manner,
and containing such information as the Director may require, including—</text>
<subparagraph commented="no" id="HF54923E656D547218396F3C0B2D2D01E"><enum>(A)</enum><text>a description of
the project that the eligible entity will carry out using the funds provided
under the grant;</text>
</subparagraph><subparagraph commented="no" id="H615EDA7160CA4AFDB35ACC5758C4699A"><enum>(B)</enum><text>a description of
the manner in which the project funded under the grant will meet the health
care needs of rural populations in the local community or region to be
served;</text>
</subparagraph><subparagraph commented="no" id="H50D2986068E5451C90294189961D28A7"><enum>(C)</enum><text>a plan for
quantifying how health care needs will be met through identification of the
target population and benchmarks of service delivery or health status, such
as—</text>
<clause commented="no" id="H260EA15534DA434D9B4BAD509EC895E1"><enum>(i)</enum><text>quantifiable
measurements of health status improvement for projects focusing on health
promotion; or</text>
</clause><clause commented="no" id="H96B438A2B9834F739E634A3F4837FB31"><enum>(ii)</enum><text>benchmarks of
increased access to primary care, including tracking factors such as the number
and type of primary care visits, identification of a medical home, or other
general measures of such access;</text>
</clause></subparagraph><subparagraph commented="no" id="H0D2BC7BD06B64D839EF5A544C62F71F2"><enum>(D)</enum><text>a description of
how the local community or region to be served will be involved in the
development and ongoing operations of the project;</text>
</subparagraph><subparagraph commented="no" id="H874670888EEA4A27AB8A98160E0D536A"><enum>(E)</enum><text>a plan for
sustaining the project after Federal support for the project has ended;</text>
</subparagraph><subparagraph commented="no" id="HD91E61D571B5412CA3DF2DDC09307A68"><enum>(F)</enum><text>a description of
how the project will be evaluated;</text>
</subparagraph><subparagraph commented="no" id="H57FF6BC0960143F08E58DFABF284F88F"><enum>(G)</enum><text>the administrative
capacity to submit annual performance data electronically as specified by the
Director; and</text>
</subparagraph><subparagraph commented="no" id="HBC93DF20418649759C99678095C8987F"><enum>(H)</enum><text>other such
information as the Director determines to be appropriate.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H9EBFFBCEFF8544EB9588607BAFC7A2E6"><enum>(c)</enum><header>Rural health
network development grants</header>
<paragraph commented="no" id="H725D512F1C5C44C1B3426458BC3290ED"><enum>(1)</enum><header>Grants</header>
<subparagraph commented="no" id="H72DE569F72104E769CAF7209750D109C"><enum>(A)</enum><header>In
general</header><text>The Director may award rural health network development
grants to eligible entities to promote, through planning and implementation,
the development of integrated health care networks that have combined the
functions of the entities participating in the networks in order to—</text>
<clause commented="no" id="H089397C21FCA462B86ECB58BC2500FC2"><enum>(i)</enum><text>achieve
efficiencies and economies of scale;</text>
</clause><clause commented="no" id="H7B2093BE799E482C943EFEF6E9C9CB3F"><enum>(ii)</enum><text>expand access to,
coordinate, and improve the quality of the health care delivery system through
development of organizational efficiencies;</text>
</clause><clause commented="no" id="HA6794D957B5D4B56A22F2E435C240782"><enum>(iii)</enum><text>implement health
information technology to achieve efficiencies, reduce medical errors, and
improve quality;</text>
</clause><clause commented="no" id="HDC4E8B4B3FE143D7AD4DCC03A938163F"><enum>(iv)</enum><text>coordinate care
and manage chronic illness; and</text>
</clause><clause commented="no" id="H24C2FD207D044C838748007DAC61E817"><enum>(v)</enum><text>strengthen the
rural health care system as a whole in such a manner as to show a quantifiable
return on investment to the participants in the network.</text>
</clause></subparagraph><subparagraph commented="no" id="H2F8567B6AD4A41759885BFDEE1C3ACD7"><enum>(B)</enum><header>Grant
periods</header><text>The Director may award such a rural health network
development grant—</text>
<clause commented="no" id="HC7F62ED6B4484B0F9029EB782BFEE8DC"><enum>(i)</enum><text>for a period of 3
years for implementation activities; or</text>
</clause><clause commented="no" id="H5E17D091214F4594A58FE967E70ADCDB"><enum>(ii)</enum><text display-inline="yes-display-inline">for a period of 1 year for planning
activities to assist in the initial development of an integrated health care
network, if the proposed participants in the network do not have a history of
collaborative efforts and a 3-year grant would be inappropriate.</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="H68CB78F637C64C31B8EB28EB540D58F0"><enum>(2)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under this subsection, an entity—</text>
<subparagraph commented="no" id="HEAD8942048964DEDB879409E57FFA29B"><enum>(A)</enum><text display-inline="yes-display-inline">shall be a rural public or rural nonprofit
private entity, a facility that qualifies as a rural health clinic under title
XVIII of the Social Security Act, a public or nonprofit entity existing
exclusively to provide services to migrant and seasonal farm workers in rural
areas, or a tribal government whose grant-funded activities will be conducted
within federally recognized tribal areas;</text>
</subparagraph><subparagraph commented="no" id="HF72BC751DE514EB1961EFAE9D270C3EE"><enum>(B)</enum><text>shall represent a
network composed of participants—</text>
<clause commented="no" id="H91F23CC014D64E9A86F96C9BAC96CB60"><enum>(i)</enum><text>that include 3 or
more independently owned health care entities; and</text>
</clause><clause commented="no" id="HA9202B3852A2413A9740B09A3A424BD0"><enum>(ii)</enum><text>that may be
nonprofit or for-profit entities; and</text>
</clause></subparagraph><subparagraph commented="no" id="HF12AEB174A904C5CBBD93AB7B6C2F5F0"><enum>(C)</enum><text>shall not
previously have received a grant under this subsection (other than a 1-year
grant for planning activities) for the same or a similar project.</text>
</subparagraph></paragraph><paragraph commented="no" id="HEB81B6DECD034B40B0E3C27D23E81793"><enum>(3)</enum><header>Applications</header><text>To
be eligible to receive a grant under this subsection, an eligible entity, in
consultation with the appropriate State office of rural health or another
appropriate State entity, shall prepare and submit to the Director an
application at such time, in such manner, and containing such information as
the Director may require, including—</text>
<subparagraph commented="no" id="HD02DB76BDC1F472787A55C2346FDE16A"><enum>(A)</enum><text>a description of
the project that the eligible entity will carry out using the funds provided
under the grant;</text>
</subparagraph><subparagraph commented="no" id="H1EE4BEB1C7BD487284AE867A05072E33"><enum>(B)</enum><text>an explanation of
the reasons why Federal assistance is required to carry out the project;</text>
</subparagraph><subparagraph commented="no" id="H20C86F02B7CE465296E694CD114FB92A"><enum>(C)</enum><text>a description
of—</text>
<clause commented="no" id="H34AA6BB551B64FEBBF05A822CD8CDCB3"><enum>(i)</enum><text>the history of
collaborative activities carried out by the participants in the network;</text>
</clause><clause commented="no" id="H1B93047F240A4096A072014FF1B5409F"><enum>(ii)</enum><text>the degree to
which the participants are ready to integrate their functions; and</text>
</clause><clause commented="no" id="H0EB1896507B24CA4AA16FF32277CB7E6"><enum>(iii)</enum><text>how the local
community or region to be served will benefit from and be involved in the
activities carried out by the network;</text>
</clause></subparagraph><subparagraph commented="no" id="HF78A84052B1A42578D27454D458C98AF"><enum>(D)</enum><text>a description of
how the local community or region to be served will experience increased access
to quality health care services across the continuum of care as a result of the
integration activities carried out by the network, including a description
of—</text>
<clause commented="no" id="HED8014FE13BF453C8913BB98836D476E"><enum>(i)</enum><text>return on
investment for the community and the network members; and</text>
</clause><clause commented="no" id="H51A455F6305F4D6EA3D693F698DF737E"><enum>(ii)</enum><text>other
quantifiable performance measures that show the benefit of the network
activities;</text>
</clause></subparagraph><subparagraph commented="no" id="H7C01BD771EFC4182B1C0C09570096926"><enum>(E)</enum><text>a plan for
sustaining the project after Federal support for the project has ended;</text>
</subparagraph><subparagraph commented="no" id="H2EC8D4AE9EDE4E4D8063326B1E7DD28C"><enum>(F)</enum><text>a description of
how the project will be evaluated;</text>
</subparagraph><subparagraph commented="no" id="H3D22EF48CC0443E4B64F7F1E90AFAB3A"><enum>(G)</enum><text>the administrative
capacity to submit annual performance data electronically as specified by the
Director; and</text>
</subparagraph><subparagraph commented="no" id="HA6D2141584E8469FBB84A2276C4A3192"><enum>(H)</enum><text>other such
information as the Director determines to be appropriate.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="HC044A8A6A8624B8DB246D8DFA971D70C"><enum>(d)</enum><header>Delta rural
disparities and health systems development grants</header>
<paragraph commented="no" id="H826C95D2A3E4422B9B956235A80553B7"><enum>(1)</enum><header>Grants</header><text>The
Director may award grants to eligible entities to support reduction of health
disparities, improve access to health care, and enhance rural health system
development in the Delta Region.</text>
</paragraph><paragraph commented="no" id="H669B4C6F9B58450DAC9657B2EA3249EA"><enum>(2)</enum><header>Eligibility</header><text display-inline="yes-display-inline">To be eligible to receive a grant under
this subsection, an entity shall be a rural public or rural nonprofit private
entity, a facility that qualifies as a rural health clinic under title XVIII of
the Social Security Act, a public or nonprofit entity existing exclusively to
provide services to migrant and seasonal farm workers in rural areas, or a
tribal government whose grant-funded activities will be conducted within
federally recognized tribal areas.</text>
</paragraph><paragraph commented="no" id="HB8D46D58B6664749AB035786AB76C596"><enum>(3)</enum><header>Applications</header><text>To
be eligible to receive a grant under this subsection, an eligible entity shall
prepare and submit to the Director an application at such time, in such manner,
and containing such information as the Director may require, including—</text>
<subparagraph commented="no" id="HFA6B2E5BCE094A40A1FAC71DB2042668"><enum>(A)</enum><text>a description of
the project that the eligible entity will carry out using the funds provided
under the grant;</text>
</subparagraph><subparagraph commented="no" id="HD57884A26E8E40E69497F4CCB587D60E"><enum>(B)</enum><text>an explanation of
the reasons why Federal assistance is required to carry out the project;</text>
</subparagraph><subparagraph commented="no" id="HBC67E923A43E402982CE430FB59C929A"><enum>(C)</enum><text>a description of
the manner in which the project funded under the grant will meet the health
care needs of the Delta Region;</text>
</subparagraph><subparagraph commented="no" id="H81BBFDD9D52F49BFA0545A3B98BA5ED1"><enum>(D)</enum><text>a description of
how the local community or region to be served will experience increased access
to quality health care services as a result of the activities carried out by
the entity;</text>
</subparagraph><subparagraph commented="no" id="H67ADC55CDF8A4751980FA49F515D337F"><enum>(E)</enum><text>a description of
how health disparities will be reduced or the health system will be
improved;</text>
</subparagraph><subparagraph commented="no" id="H391021BEDC554973A4A38EC77DF12B61"><enum>(F)</enum><text>a plan for
sustaining the project after Federal support for the project has ended;</text>
</subparagraph><subparagraph commented="no" id="HF85D5192ADC84E9B81840E033EE13F29"><enum>(G)</enum><text>a description of
how the project will be evaluated including process and outcome measures
related to the quality of care provided or how the health care system improves
its performance;</text>
</subparagraph><subparagraph commented="no" id="H9F134E0AE68E4D1397D5191C2B85E3C9"><enum>(H)</enum><text>a description of
how the grantee will develop an advisory group made up of representatives of
the communities to be served to provide guidance to the grantee to best meet
community need; and</text>
</subparagraph><subparagraph commented="no" id="H30E92E533C08464899B85D272908B431"><enum>(I)</enum><text>other such
information as the Director determines to be appropriate.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H866655C53B654A4E9DEB76C61DD40778"><enum>(e)</enum><header>Small rural
health care provider quality improvement grants</header>
<paragraph commented="no" id="H48DC1CCA81964AA5823F58CB8CFF2B00"><enum>(1)</enum><header>Grants</header><text>The
Director may award grants to provide for the planning and implementation of
small rural health care provider quality improvement activities. The Director
may award the grants for periods of 1 to 3 years.</text>
</paragraph><paragraph commented="no" id="HAEF9F578D16841698C4CBD3F80881D15"><enum>(2)</enum><header>Eligibility</header><text>To
be eligible for a grant under this subsection, an entity—</text>
<subparagraph commented="no" id="H75E46E7758D84FABAD25BB021CC1A403"><enum>(A)</enum><text>shall be—</text>
<clause commented="no" id="H480D45F3C9B84810BEBF7B95EED764FB"><enum>(i)</enum><text display-inline="yes-display-inline">a rural public or rural nonprofit private
health care provider or provider of health care services, such as a rural
health clinic; or</text>
</clause><clause commented="no" id="H9E7B6A7193A64D5C9B509C7221A1F65B"><enum>(ii)</enum><text display-inline="yes-display-inline">another rural provider or network of small
rural providers identified by the Director as a key source of local care;
and</text>
</clause></subparagraph><subparagraph commented="no" id="HAD1783AD352E486DBFB6265A6C858D2B"><enum>(B)</enum><text>shall not
previously have received a grant under this subsection for the same or a
similar project.</text>
</subparagraph></paragraph><paragraph commented="no" id="H4DBFACEB136A4AE58DE189308565726F"><enum>(3)</enum><header>Preference</header><text display-inline="yes-display-inline">In awarding grants under this subsection,
the Director shall give preference to facilities that qualify as rural health
clinics under title XVIII of the Social Security Act.</text>
</paragraph><paragraph commented="no" id="HE266FDE7CEF84DC786F2FC5AAD4B9B36"><enum>(4)</enum><header>Applications</header><text>To
be eligible to receive a grant under this subsection, an eligible entity shall
prepare and submit to the Director an application at such time, in such manner,
and containing such information as the Director may require, including—</text>
<subparagraph commented="no" id="H681D7BA65FE7422D90DB231A2B652B64"><enum>(A)</enum><text>a description of
the project that the eligible entity will carry out using the funds provided
under the grant;</text>
</subparagraph><subparagraph commented="no" id="H128AFA1B3E614ED1A3B6C633573C1D69"><enum>(B)</enum><text>an explanation of
the reasons why Federal assistance is required to carry out the project;</text>
</subparagraph><subparagraph commented="no" id="H0F78C0FBBE31482A896986C392496EA8"><enum>(C)</enum><text>a description of
the manner in which the project funded under the grant will assure continuous
quality improvement in the provision of services by the entity;</text>
</subparagraph><subparagraph commented="no" id="H49608D6EFF60449797B4E2D90BC94913"><enum>(D)</enum><text>a description of
how the local community or region to be served will experience increased access
to quality health care services as a result of the activities carried out by
the entity;</text>
</subparagraph><subparagraph commented="no" id="HE54347E1978448C491DBF56B8E1000FA"><enum>(E)</enum><text>a plan for
sustaining the project after Federal support for the project has ended;</text>
</subparagraph><subparagraph commented="no" id="H163E98ABC6BC4F4A8FF3B0CC85D9A8C3"><enum>(F)</enum><text>a description of
how the project will be evaluated including process and outcome measures
related to the quality of care provided; and</text>
</subparagraph><subparagraph commented="no" id="HC52FB34503B74388B07596F941A6AF30"><enum>(G)</enum><text>other such
information as the Director determines to be appropriate.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="HE16F023C7AED463FB942E9D31B4DC29D"><enum>(f)</enum><header>General
requirements</header>
<paragraph commented="no" id="H4C9DB1FB4E434E81B831243FAA40F5A1"><enum>(1)</enum><header>Prohibited uses
of funds</header><text>An entity that receives a grant under this section may
not use funds provided through the grant—</text>
<subparagraph commented="no" id="H3093C9CA153F412B9A3F97B6C95AD165"><enum>(A)</enum><text>to build or
acquire real property; or</text>
</subparagraph><subparagraph commented="no" id="H5071FA38F5D94C3BBCE3BC647A441F79"><enum>(B)</enum><text>for
construction.</text>
</subparagraph></paragraph><paragraph commented="no" id="H29BAB10DEF634E498D4472B68EB472B5"><enum>(2)</enum><header>Coordination
with other agencies</header><text>The Director shall coordinate activities
carried out under grant programs described in this section, to the extent
practicable, with Federal and State agencies and nonprofit organizations that
are operating similar grant programs, to maximize the effect of public dollars
in funding meritorious proposals.</text>
</paragraph></subsection><subsection commented="no" id="H62866C3B93F646CE8477E44E28F94120"><enum>(g)</enum><header>Report</header><text>Not
later than September 30, 2014, the Secretary shall prepare and submit to the
appropriate committees of Congress a report on the progress and accomplishments
of the grant programs described in subsections (b), (c), (d), and (e).</text>
</subsection><subsection commented="no" id="H4AEEA927E4584380895D13BD466EDBF5"><enum>(h)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph commented="no" id="HD2FD753D8F544AACBCFCE923219A81F2"><enum>(1)</enum><text display-inline="yes-display-inline">The term <term>Delta Region</term> has the
meaning given to the term <term>region</term> in section 382A of the
Consolidated Farm and Rural Development Act (7 U.S.C. 2009aa).</text>
</paragraph><paragraph commented="no" id="H8AF9D29A4E5D495BA6F54F51AE71CDA3"><enum>(2)</enum><text>The term
<term>Director</term> means the Director of the Office of Rural Health Policy
of the Health Resources and Services Administration.</text>
</paragraph></subsection><subsection commented="no" id="H789B84618C0345DD815CA853B220CCCF"><enum>(i)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section $40,000,000 for fiscal year 2012, and such sums as may be
necessary for each of fiscal years 2013 through
2016.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" id="H967DAA28305C4737A7D5E937CC018C40"><enum>427.</enum><header>Community
health center collaborative access expansion</header><text display-inline="no-display-inline">Section 330 of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
254b) is amended by adding at the end the following:</text>
<quoted-block act-name="Public" display-inline="no-display-inline" id="HEC121C624EDB4F6DAF882C79E00B8649" style="OLC">
<subsection commented="no" id="H33825138D88048BEA82F6BEE096215A3"><enum>(t)</enum><header>Miscellaneous
Provisions</header>
<paragraph commented="no" id="HEC0944D14B4949AB82F1F24B5897E996"><enum>(1)</enum><header>Rule of
construction with respect to rural health clinics</header>
<subparagraph commented="no" id="HD06295D5AD744012954FE9033E036B54"><enum>(A)</enum><header>In
general</header><text>Nothing in this section shall be construed to prevent a
community health center from contracting with a federally certified rural
health clinic (as defined by section 1861(aa)(2) of the
<act-name parsable-cite="SSA">Social Security Act</act-name>) for the delivery
of primary health care services that are available at the rural health clinic
to individuals who would otherwise be eligible for free or reduced cost care if
that individual were able to obtain that care at the community health center.
Such services may be limited in scope to those primary health care services
available in that rural health clinic.</text>
</subparagraph><subparagraph commented="no" id="H30F019777B6B41DA88BFC6166669DFC1"><enum>(B)</enum><header>Assurances</header><text>In
order for a rural health clinic to receive funds under this section through a
contract with a community health center under paragraph (1), such rural health
clinic shall establish policies to ensure—</text>
<clause commented="no" id="H0A46CED8814E4078ABBCF4A701378273"><enum>(i)</enum><text>nondiscrimination
based upon the ability of a patient to pay; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="HABC08AE50F5E43AD8C6466F2590A7D8F"><enum>(ii)</enum><text>the establishment
of a sliding fee scale for low-income
patients.</text>
</clause></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" id="H2AC5F06492F14DD98C56B262E2F74EA5"><enum>428.</enum><header>Facilitating
the provision of telehealth services across State lines</header>
<subsection commented="no" id="H4EAD83F6A1D2437EA9021FE3BDAA0667"><enum>(a)</enum><header>In
general</header><text>For purposes of expediting the provision of telehealth
services, for which payment is made under the Medicare program, across State
lines, the Secretary of Health and Human Services shall, in consultation with
representatives of States, physicians, health care practitioners, and patient
advocates, encourage and facilitate the adoption of provisions allowing for
multistate practitioner practice across State lines.</text>
</subsection><subsection commented="no" id="H57140B75CE2B43FEAC2DDF37972D3ECE"><enum>(b)</enum><header>Definitions</header><text>In
subsection (a):</text>
<paragraph commented="no" id="H8BE75F6168204F44BC1AA2C2CE6050EA"><enum>(1)</enum><header>Telehealth
service</header><text>The term <term>telehealth service</term> has the meaning
given that term in subparagraph (F) of section 1834(m)(4) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1395m(m)(4)).</text>
</paragraph><paragraph commented="no" id="HC3A77A1D89274A58B44033B2017A01B5"><enum>(2)</enum><header>Physician,
practitioner</header><text>The terms <term>physician</term> and
<term>practitioner</term> have the meaning given those terms in subparagraphs
(D) and (E), respectively, of such section.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3D0FD1A762F940AF9AAB02D1328E1D07"><enum>(3)</enum><header>Medicare
program</header><text>The term <term>Medicare program</term> means the program
of health insurance administered by the Secretary of Health and Human Services
under title XVIII of the <act-name parsable-cite="SSA">Social Security
Act</act-name> (42 U.S.C. 1395 et seq.).</text>
</paragraph></subsection></section><section id="HFC4422387D6C4167943E2E6EEBFCE4DB" section-type="subsequent-section"><enum>429.</enum><header>Scoring of
preventive health savings</header><text display-inline="no-display-inline">Section 202 of the Congressional Budget and
Impoundment Control Act of 1974 (2 U.S.C. 602) is amended by adding at the end
the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H090AFD7ACF6D4582B8E27F234A095A4F" style="OLC">
<subsection id="HB3CF53646331478F9F5858B641210A6E"><enum>(h)</enum><header>Scoring of
preventive health savings</header>
<paragraph id="HD7F6535566514D748657EA2FF6FB4E6A"><enum>(1)</enum><header>Determination by
the Director</header><text>Upon a request by the chairman or ranking minority
member of the Committee on the Budget of the Senate, or by the chairman or
ranking minority member of the Committee on the Budget of the House of
Representatives, the Director shall determine if a proposed measure would
result in reductions in budget outlays in budgetary outyears through the use of
preventive health and preventive health services.</text>
</paragraph><paragraph id="H0342207F47F743BBBF073ACC18AEF0EA"><enum>(2)</enum><header>Projections</header><text>If
the Director determines that a measure would result in substantial reductions
in budget outlays as described in paragraph (1), the Director—</text>
<subparagraph id="HD57E485FE1734FF28B540E5F03E4DAB7"><enum>(A)</enum><text>shall include, in
any projection prepared by the Director, a description and estimate of the
reductions in budget outlays in the budgetary outyears and a description of the
basis for such conclusions; and</text>
</subparagraph><subparagraph id="HF9D951BBB42D4524AE35E636DBC59963"><enum>(B)</enum><text>may prepare a
budget projection that includes some or all of the budgetary outyears,
notwithstanding the time periods for projections described in subsection (e)
and sections 308, 402, and 424.</text>
</subparagraph></paragraph><paragraph id="HFA71CF7FD4604B418FDF9576C99BCEC8"><enum>(3)</enum><header>Definitions</header><text>As
used in this subsection—</text>
<subparagraph id="HA3BD69CB64CD46C5AEE8B2596D924A5F"><enum>(A)</enum><text>the term
<term>preventive health</term> means an action that focuses on the health of
the public, individuals, and defined populations in order to protect, promote,
and maintain health, wellness, and functional ability, and prevent disease,
disability, and premature death that is demonstrated by credible and publicly
available epidemiological projection models, incorporating clinical trials or
observational studies in humans, to avoid future health care costs; and</text>
</subparagraph><subparagraph id="HC4DD70AF472B4A47ABD6053CA01D72DC"><enum>(B)</enum><text>the term
<term>budgetary outyears</term> means the 2 consecutive 10-year periods
beginning with the first fiscal year that is 10 years after the budget year
provided for in the most recently agreed to concurrent resolution on the
budget.</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" display-inline="no-display-inline" id="H359413516B4A4930AFAA55145C904A45"><enum>430.</enum><header>Sense of
Congress</header><text display-inline="no-display-inline">It is the sense of
the Congress that—</text>
<paragraph commented="no" id="H9513523C420B472DAA462FC58C9DD3FA"><enum>(1)</enum><text display-inline="yes-display-inline">the maintenance of effort (MOE) provisions
added to sections 1902 and 2105(d) of the Social Security Act by sections
2001(b) and 2101(b) of the Patient Protection and Affordable Care Act were
written to maintain the eligibility standards for the Medicaid program and
Children’s Health Insurance Program until the American Health Benefit Exchanges
in the States are fully operational;</text>
</paragraph><paragraph commented="no" id="H71FDC9524C034AB686D9A93F7F069FDB"><enum>(2)</enum><text>it is imperative
that the MOE provisions are enforced to the strict standard intended by the
Congress;</text>
</paragraph><paragraph id="H3DCE233755C84DCFB10B2C3E675B8F8B"><enum>(3)</enum><text>waiving the MOE
provisions should not be permitted, except in the case of a request for a
waiver that meets the explicit nonapplication requirements;</text>
</paragraph><paragraph commented="no" id="H75334AEB53FB4FF795DED45F920A6A38"><enum>(4)</enum><text>the MOE provisions
ensure the continued success of the Medicaid program and CHIP and were written
deliberately to specifically protect vulnerable and disabled individuals,
children, and senior citizens, many of whom are also members of communities of
color; and</text>
</paragraph><paragraph commented="no" id="HD0675B47900A4FC4B67D8EFBB38E77B8"><enum>(5)</enum><text>the MOE provisions
must be strictly enforced and proposals to weaken the MOE provisions must not
be considered in this time of recession.</text>
</paragraph></section><section id="H7094BAD1774540C39CA0A525074D4896"><enum>431.</enum><header>Repeal of
requirement for documentation evidencing citizenship or nationality under the
Medicaid program</header>
<subsection id="HEEDB705F45F94A9584FA86AAE39B8827"><enum>(a)</enum><header>Repeal</header><text>Subsections
(i)(22) and (x) of section 1903 of the Social Security Act (42 U.S.C. 1396b),
as added by section 6036 of the Deficit Reduction Act of 2005, are each
repealed.</text>
</subsection><subsection id="H5580D49FF74343D58BE058247B66E99F"><enum>(b)</enum><header>Conforming
amendments</header>
<paragraph id="HBF656576A62148B2AFD4F78713AF7612"><enum>(1)</enum><text>Section 1903 of
the Social Security Act (42 U.S.C. 1396b) is amended—</text>
<subparagraph id="H5AD47B3BC1DF4DCF8CB73FF836A85A7B"><enum>(A)</enum><text>in subsection
(i)—</text>
<clause id="H87B1BE25431B426B839AFE206A845998"><enum>(i)</enum><text>in
paragraph (20), by adding <quote>or</quote> after the semicolon at the end;
and</text>
</clause><clause id="H0033A720A93B4561ABAAFC8E598E6F4F"><enum>(ii)</enum><text>in
paragraph (21), by striking <quote>; or</quote> and inserting a period;</text>
</clause></subparagraph><subparagraph id="H715A6B9C976B4B1E97444194149420D8"><enum>(B)</enum><text>by redesignating
subsection (y), as added by section 6043(b) of the Deficit Reduction Act of
2005, as subsection (x); and</text>
</subparagraph><subparagraph id="H48F4FDC43F0443498123B8FFB427846F"><enum>(C)</enum><text>by redesignating
subsection (z), as added by section 6081(a) of the Deficit Reduction Act of
2005, as subsection (y).</text>
</subparagraph></paragraph><paragraph id="HF056BBA0418E454DA27A56B204E3A840"><enum>(2)</enum><text>Subsection (c) of
section 6036 of the Deficit Reduction Act of 2005 is repealed.</text>
</paragraph></subsection><subsection id="H1BB403633D27492C88B437B5790DD26E"><enum>(c)</enum><header>Effective
date</header><text>The repeals and amendments made by this section shall take
effect as if included in the enactment of the Deficit Reduction Act of
2005.</text>
</subsection></section><section id="HDB701924C9F74A719CD6F7B843859392"><enum>432.</enum><header>Office of
Minority Health in Veterans Health Administration of Department of Veterans
Affairs</header>
<subsection id="H5DB0ADB0B4564D9BAD2E630348BAB4D1"><enum>(a)</enum><header>Establishment
and functions</header><text>Subchapter I of chapter 73 of title 38, United
States Code, is amended by adding at the end the following new section:</text>
<quoted-block id="HD7A75C04881542CC9AE2A99F2E6878FA" style="USC">
<section id="HFEC8C4D95D14422FB29B304087D8EB7A"><enum>7309.</enum><header>Office of
Minority Health</header>
<subsection display-inline="no-display-inline" id="H27480277B1D24976B0E9E4DC88CA03AE"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">There is established in the Department
within the Office of the Under Secretary for Health an office to be known as
the <quote>Office of Minority Health</quote> (in this section referred to as
the <term>Office</term>).</text>
</subsection><subsection id="H60EC4832EBC14B3BBD2DBA1AC90ADE95"><enum>(b)</enum><header>Head</header><text>The
Director of the Office of Minority Health shall be the head of the Office. The
Director of the Office of Minority Health shall be appointed by the Under
Secretary of Health from among individuals qualified to perform the duties of
the position.</text>
</subsection><subsection id="HBB5193B2A3114E50AE77EE18CC487710"><enum>(c)</enum><header>Functions</header><text>The
functions of the Office are as follows:</text>
<paragraph id="H4BD9F0FC100B4D8BA05DA4DFEDE72872"><enum>(1)</enum><text>To establish
short-range and long-range goals and objectives and coordinate all other
activities within the Veterans Health Administration that relate to disease
prevention, health promotion, health care services delivery, and health care
research concerning veterans who are members of a racial or ethnic minority
group.</text>
</paragraph><paragraph id="H8E2B373E6368430E9665D9FF0EF01967"><enum>(2)</enum><text>To support
research, demonstrations, and evaluations to test new and innovative models for
the discharge of activities described in paragraph (1).</text>
</paragraph><paragraph id="H9F9609E16F494AFFA484F3E1156B8966"><enum>(3)</enum><text>To increase
knowledge and understanding of health risk factors for veterans who are members
of a racial or ethnic minority group.</text>
</paragraph><paragraph id="H83394B7FCCEB4BE7A9BCD89FC1B97EDF"><enum>(4)</enum><text>To develop
mechanisms that support better health care information dissemination,
education, prevention, and services delivery to veterans from disadvantaged
backgrounds, including veterans who are members of a racial or ethnic minority
group.</text>
</paragraph><paragraph id="H373744A3860A4521BF68CF61377CC246"><enum>(5)</enum><text>To enter into
contracts or agreements with appropriate public and nonprofit private entities
to develop and carry out programs to provide bilingual or interpretive services
to assist veterans who are members of a racial or ethnic minority group and who
lack proficiency in speaking the English language in accessing and receiving
health care services through the Veterans Health Administration.</text>
</paragraph><paragraph id="H46F80672B1284669BF91DCA58988CE63"><enum>(6)</enum><text>To carry out
programs to improve access to health care services through the Veterans Health
Administration for veterans with limited proficiency in speaking the English
language, including the development and evaluation of demonstration and pilot
projects for that purpose.</text>
</paragraph><paragraph id="H0A03B58359E04A41A22F1FFC51353321"><enum>(7)</enum><text>To advise the
Under Secretary of Health on matters relating to the development,
implementation, and evaluation of health professions education in decreasing
disparities in health care outcomes between veterans who are members of a
racial or ethnic minority group and other veterans, including cutural
competency as a method of eliminating such health disparities.</text>
</paragraph><paragraph id="H40071BECB740483F87D93D6C17D71DB4"><enum>(8)</enum><text>To perform such
other functions and duties as the Secretary or the Under Secretary for Health
considers appropriate.</text>
</paragraph></subsection><subsection id="H1560B7C7D352492382308841C4BD014F"><enum>(d)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H5B1C0A63E376439B91C5C6012E001CDA"><enum>(1)</enum><text>The term
<term>racial or ethnic minority group</term> means the following:</text>
<subparagraph id="H65406835A25149E899F06A204FD3BFD4"><enum>(A)</enum><text>American Indians
(including Alaska Natives, Eskimos, and Aleuts).</text>
</subparagraph><subparagraph id="H8E2D69EEC064498E88ACA594F71CCFAF"><enum>(B)</enum><text>Asian
Americans.</text>
</subparagraph><subparagraph id="H9051443BC1A748C295A2CBAC3366E8A6"><enum>(C)</enum><text>Native Hawaiians
and other Pacific Islanders.</text>
</subparagraph><subparagraph id="H4058ED82E08A4F7CAE3D466FA64D82B9"><enum>(D)</enum><text>Blacks.</text>
</subparagraph><subparagraph id="HC4C23F50BCF24F16888932FDAC2FA723"><enum>(E)</enum><text>Hispanics.</text>
</subparagraph></paragraph><paragraph id="H4C443721303045EFA8DBAF4068ED784F"><enum>(2)</enum><text>The term
<term>Hispanic</term> means individuals whose origin is Mexican, Puerto Rican,
Cuban, Central or South American, or any other Spanish-speaking
country.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="HE0FA603E10324027A21160BCC7E295A0"><enum>433.</enum><header>Access for
Native Americans under PPACA</header>
<subsection display-inline="no-display-inline" id="HF2A97D4BFE3141A38B1CD610E5D6DC70"><enum>(a)</enum><header>In
general</header><text>Title I of the Patient Protection and Affordable Care Act
is amended—</text>
<paragraph id="H29B05C44E3004D37B0EF5B0D361AB245"><enum>(1)</enum><text>in section
1311(c)(6)(D), by striking <quote>(as defined in section 4 of the Indian Health
Care Improvement Act)</quote> and inserting <quote>(as defined in section
447.50(b)(1) of title 42 of the Code of Federal Regulations, as in effect on
July 1, 2010)</quote>; and</text>
</paragraph><paragraph id="H3713D6D1536C4F09985036A765E174B5"><enum>(2)</enum><text display-inline="yes-display-inline">in section 1402(d)(1), by striking
<quote>(as defined in section 4(d) of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450b(d)))</quote> and inserting (f)
<quote>(as defined in section 447.50(b)(1) of title 42 of the Code of Federal
Regulations, as in effect on July 1, 2010)</quote>.</text>
</paragraph></subsection><subsection commented="no" id="H30F5E307C42842EC9EDDBFF272B97606"><enum>(b)</enum><header>Individual
mandate</header><text display-inline="yes-display-inline">In section
5000A(e)(3) of the Internal Revenue Code of 1986, by striking <quote>(as
defined in section 45A(c)(6))</quote> and inserting <quote>(as defined in
section 447.50(b)(1) of title 42 of the Code of Federal Regulations, as in
effect on July 1, 2010)</quote>.</text>
</subsection></section></chapter></subtitle><enum>V</enum><header>IMPROVING HEALTH
OUTCOMES FOR WOMEN, CHILDREN, AND FAMILIES</header>
<section commented="no" display-inline="no-display-inline" id="H744B3B8DFAE04DF68CE22B8EA49D3B60"><enum>501.</enum><header>Grants to
promote positive health behaviors in women and children</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> (42 U.S.C.
280g et seq.) is amended by adding at the end the following:</text>
<quoted-block act-name="Public" id="HC1BC459FD1DE461FAAB1CDED6FC7F09E" style="OLC">
<section commented="no" id="H9547DAE2517D4C1AACE1E73C6446FB0D"><enum>399Z–2.</enum><header>Grants to
promote positive health behaviors in women and children</header>
<subsection commented="no" id="H9BE4F53528824E5E8C4E49D8DB98AC5F"><enum>(a)</enum><header>Grants
Authorized</header><text>The Secretary, in collaboration with the Director of
the Centers for Disease Control and Prevention and other Federal officials
determined appropriate by the Secretary, is authorized to award grants to
eligible entities to promote positive health behaviors for women and children
in target populations, especially racial and ethnic minority women and children
in medically underserved communities.</text>
</subsection><subsection commented="no" id="H007A29F261B84717AB193EC31652E1FB"><enum>(b)</enum><header>Use of
Funds</header><text>Grants awarded pursuant to subsection (a) may be used to
support community health workers—</text>
<paragraph commented="no" id="H50C4FF23FA084530943D6CC670559289"><enum>(1)</enum><text>to educate and
provide outreach regarding enrollment in health insurance including the State
Children’s Health Insurance Program under title XXI of the
<act-name parsable-cite="SSA">Social Security Act</act-name>, Medicare under
title XVIII of such Act, and Medicaid under title XIX of such Act;</text>
</paragraph><paragraph commented="no" id="HB4897D4F4848401894F2D3B3C99D3DC4"><enum>(2)</enum><text>to educate, guide,
and provide outreach in a community setting regarding health problems prevalent
among women and children and especially among racial and ethnic minority women
and children;</text>
</paragraph><paragraph commented="no" id="HA74F2A8F0E1D4125BE74E13667E6EBE2"><enum>(3)</enum><text>to educate, guide,
and provide experiential learning opportunities that target behavioral risk
factors including—</text>
<subparagraph commented="no" id="H0DE23EACFCF745A08E671392D2574F8F"><enum>(A)</enum><text>poor
nutrition;</text>
</subparagraph><subparagraph commented="no" id="H62F78C32A24D4ED6A889DDB386C94A78"><enum>(B)</enum><text>physical
inactivity;</text>
</subparagraph><subparagraph commented="no" id="H1C91BD47FB674AA2AFAD6AC2906CBB81"><enum>(C)</enum><text>being overweight
or obese;</text>
</subparagraph><subparagraph commented="no" id="H836FA3304760443293F0F569EAC4ED9A"><enum>(D)</enum><text>tobacco
use;</text>
</subparagraph><subparagraph commented="no" id="H039C6CAC0E014E1BAB9115175D141AD0"><enum>(E)</enum><text>alcohol and
substance use;</text>
</subparagraph><subparagraph commented="no" id="H74EC63895F484200BFD4DD8403DB0988"><enum>(F)</enum><text>injury and
violence;</text>
</subparagraph><subparagraph commented="no" id="HA405E0282D06438BB021742C3AB49097"><enum>(G)</enum><text>risky sexual
behavior;</text>
</subparagraph><subparagraph commented="no" id="H13A20EBC6A644904AA9A390339E6FA62"><enum>(H)</enum><text>mental health
problems;</text>
</subparagraph><subparagraph id="H1F66E518CBA2418CB4192E706F4E477A"><enum>(I)</enum><text>musculoskeletal
health;</text>
</subparagraph><subparagraph commented="no" id="H668EA4665D15432085687684567BD348"><enum>(J)</enum><text>dental and oral
health problems; and</text>
</subparagraph><subparagraph commented="no" id="H0F38CD8E03BD4E3CAD122D044C32B62C"><enum>(K)</enum><text>understanding
informed consent;</text>
</subparagraph></paragraph><paragraph commented="no" id="HB214FCC0BCA542B9838558F97404D617"><enum>(4)</enum><text>to educate and
guide regarding effective strategies to promote positive health behaviors
within the family;</text>
</paragraph><paragraph commented="no" id="H02954F1A806D424B9B78FE6A4D55439D"><enum>(5)</enum><text>to promote
community wellness and awareness; and</text>
</paragraph><paragraph commented="no" id="H6DD690D3F5ED4500A8E168C67BB2F2C9"><enum>(6)</enum><text>to educate and
refer target populations to appropriate health care agencies and
community-based programs and organizations in order to increase access to
quality health care services, including preventive health services.</text>
</paragraph></subsection><subsection commented="no" id="HF14DB449665848338F43BADF122E640A"><enum>(c)</enum><header>Application</header>
<paragraph commented="no" id="H81D2C3373E6A476BA6DC2050E50B124E"><enum>(1)</enum><header>In
general</header><text>Each eligible entity that desires to receive a grant
under subsection (a) shall submit an application to the Secretary, at such
time, in such manner, and accompanied by such additional information as the
Secretary may require.</text>
</paragraph><paragraph commented="no" id="HCBB722B8CC1A4246901EB22E1D27D4A9"><enum>(2)</enum><header>Contents</header><text>Each
application submitted pursuant to paragraph (1) shall—</text>
<subparagraph commented="no" id="HED2819809AF843308E7C3C86C1716218"><enum>(A)</enum><text>describe the
activities for which assistance under this section is sought;</text>
</subparagraph><subparagraph commented="no" id="H52E758FC67F043ADA76AA8F5D9FE0456"><enum>(B)</enum><text>contain an
assurance that with respect to each community health worker program receiving
funds under the grant awarded, such program provides training and supervision
to community health workers to enable such workers to provide authorized
program services;</text>
</subparagraph><subparagraph commented="no" id="H250963E75E534073B35BCBA70A1EFCFB"><enum>(C)</enum><text>contain an
assurance that the applicant will evaluate the effectiveness of community
health worker programs receiving funds under the grant;</text>
</subparagraph><subparagraph commented="no" id="HFF24DC23625340B2B4AEDAF0E7302357"><enum>(D)</enum><text>contain an
assurance that each community health worker program receiving funds under the
grant will provide services in the cultural context most appropriate for the
individuals served by the program;</text>
</subparagraph><subparagraph commented="no" id="H3DA27E441FFC43A7B7703D4ACB283A17"><enum>(E)</enum><text>contain a plan to
document and disseminate project description and results to other States and
organizations as identified by the Secretary; and</text>
</subparagraph><subparagraph commented="no" id="H3EAF5A9FEF5F42FD8381E786B9A2102D"><enum>(F)</enum><text>describe plans to
enhance the capacity of individuals to utilize health services and
health-related social services under Federal, State, and local programs
by—</text>
<clause commented="no" id="HB8D80F4ACC494F1FB4BDC9F723A51B74"><enum>(i)</enum><text>assisting
individuals in establishing eligibility under the programs and in receiving the
services or other benefits of the programs; and</text>
</clause><clause commented="no" id="H9B37D7FABDD34C73B8CEC240E6FADCE0"><enum>(ii)</enum><text>providing other
services as the Secretary determines to be appropriate, that may include
transportation and translation services.</text>
</clause></subparagraph></paragraph></subsection><subsection commented="no" id="H7277B8845C5A489F831CD2F27AF303EA"><enum>(d)</enum><header>Priority</header><text>In
awarding grants under subsection (a), the Secretary shall give priority to
those applicants—</text>
<paragraph commented="no" id="H854BE936FACA44A398878BEDEE1E8B17"><enum>(1)</enum><text>who propose to
target geographic areas—</text>
<subparagraph commented="no" id="H235E32E2CB7C414CB112A9ACAC26B612"><enum>(A)</enum><text>with a high
percentage of residents who are eligible for health insurance but are uninsured
or underinsured; and</text>
</subparagraph><subparagraph commented="no" id="HCF63BC577A564CBDB8C84DE9785BCA38"><enum>(B)</enum><text>with a high
percentage of families for whom English is not their primary language;</text>
</subparagraph></paragraph><paragraph commented="no" id="HE10899D4A5DE471FAC6DA7CF88491E33"><enum>(2)</enum><text>with experience in
providing health or health-related social services to individuals who are
underserved with respect to such services; and</text>
</paragraph><paragraph commented="no" id="H50DFEED28B324BEDB644175138308799"><enum>(3)</enum><text>with documented
community activity and experience with community health workers.</text>
</paragraph></subsection><subsection commented="no" id="HB7715FB166D74FC597301B6C4355B2A0"><enum>(e)</enum><header>Collaboration
With Academic Institutions</header><text display-inline="yes-display-inline">The Secretary shall encourage community
health worker programs receiving funds under this section to collaborate with
academic institutions, including minority-serving institutions. Nothing in this
section shall be construed to require such collaboration.</text>
</subsection><subsection commented="no" id="H19C43980A18043E8B9810D475BD620E3"><enum>(f)</enum><header>Quality
Assurance and Costeffectiveness</header><text>The Secretary shall establish
guidelines for assuring the quality of the training and supervision of
community health workers under the programs funded under this section and for
assuring the costeffectiveness of such programs.</text>
</subsection><subsection commented="no" id="H51646235554146B8951200BD79D401EF"><enum>(g)</enum><header>Monitoring</header><text>The
Secretary shall monitor community health worker programs identified in approved
applications and shall determine whether such programs are in compliance with
the guidelines established under subsection (f).</text>
</subsection><subsection commented="no" id="H286C9FB167B044788DF5305CEB3AC01B"><enum>(h)</enum><header>Technical
Assistance</header><text>The Secretary may provide technical assistance to
community health worker programs identified in approved applications with
respect to planning, developing, and operating programs under the grant.</text>
</subsection><subsection commented="no" id="H47591335AB4A4357B6ED20B016B6A401"><enum>(i)</enum><header>Report to
Congress</header>
<paragraph commented="no" id="H701F8F7AB7CD4835B5EF7432986CF26C"><enum>(1)</enum><header>In
general</header><text>Not later than 4 years after the date on which the
Secretary first awards grants under subsection (a), the Secretary shall submit
to Congress a report regarding the grant project.</text>
</paragraph><paragraph commented="no" id="H283A1CB3F4E94939A589120E593E255D"><enum>(2)</enum><header>Contents</header><text>The
report required under paragraph (1) shall include the following:</text>
<subparagraph commented="no" id="H9C66A52660794B2E8C23440479FD61E0"><enum>(A)</enum><text>A description of
the programs for which grant funds were used.</text>
</subparagraph><subparagraph commented="no" id="HA37936F3329D4AF58D75D0C66570CBBE"><enum>(B)</enum><text>The number of
individuals served.</text>
</subparagraph><subparagraph commented="no" id="H624CAABBC07A4AFA8EB13234C1EC2313"><enum>(C)</enum><text>An evaluation
of—</text>
<clause commented="no" id="HD9B372D9E3EA4BD68B4BDF9AC571A3BB"><enum>(i)</enum><text>the effectiveness
of these programs;</text>
</clause><clause commented="no" id="HCA0AF8A1E77247B5AD2896734C5B187E"><enum>(ii)</enum><text>the cost of these
programs; and</text>
</clause><clause commented="no" id="H6D6B9EEA16A54C3786D2AAA2FBB4A267"><enum>(iii)</enum><text>the impact of
the project on the health outcomes of the community residents.</text>
</clause></subparagraph><subparagraph commented="no" id="H28896739F1F7410E9FA748EA675E3959"><enum>(D)</enum><text>Recommendations
for sustaining the community health worker programs developed or assisted under
this section.</text>
</subparagraph><subparagraph commented="no" id="H5AFD17B9C1854458897101C963547541"><enum>(E)</enum><text>Recommendations
regarding training to enhance career opportunities for community health
workers.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="HE6435FCEC40344318A11ADEA2919F1F6"><enum>(j)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph commented="no" id="HEAA49A924D0441B69490328EBFC6515A"><enum>(1)</enum><header>Community health
worker</header><text>The term <term>community health worker</term> means an
individual who promotes health or nutrition within the community in which the
individual resides—</text>
<subparagraph commented="no" id="H75906AAA21E44BEDA22DEB11E670CCFE"><enum>(A)</enum><text>by serving as a
liaison between communities and health care agencies;</text>
</subparagraph><subparagraph commented="no" id="H413B2E03CDDE4BDAAEE11CD86331A0B5"><enum>(B)</enum><text>by providing
guidance and social assistance to community residents;</text>
</subparagraph><subparagraph commented="no" id="H0FEA76E7BE6246B0A30CC7CB1F7A1FD5"><enum>(C)</enum><text>by enhancing
community residents’ ability to effectively communicate with health care
providers;</text>
</subparagraph><subparagraph commented="no" id="H5826CDB97CB74507AAA6F65B691293C4"><enum>(D)</enum><text>by providing
culturally and linguistically appropriate health or nutrition education;</text>
</subparagraph><subparagraph commented="no" id="H8C7AF381763E47129E2DE603A1477FF2"><enum>(E)</enum><text>by advocating for
individual and community health, including dental, oral, mental, and
environmental health, or nutrition needs; and</text>
</subparagraph><subparagraph commented="no" id="HEE4C77BB091C4C9EA11C1314818DAD15"><enum>(F)</enum><text>by providing
referral and followup services.</text>
</subparagraph></paragraph><paragraph commented="no" id="HE3164B5228ED4B08A6CC3E6A7EB96E5F"><enum>(2)</enum><header>Community
setting</header><text>The term <term>community setting</term> means a home or a
community organization located in the neighborhood in which a participant
resides.</text>
</paragraph><paragraph commented="no" id="HAF263ED8AC364ADBA76E802D651AE7FB"><enum>(3)</enum><header>Eligible
entity</header><text>The term <term>eligible entity</term> means—</text>
<subparagraph commented="no" id="H86631AD3515B4B33AB1D6190A9C77FAD"><enum>(A)</enum><text display-inline="yes-display-inline">a unit of State, territorial, local, or
tribal government (including a federally recognized tribe or Alaska Native
village); or</text>
</subparagraph><subparagraph commented="no" id="HB30D897D5A6E46AF88088895D35EBF3E"><enum>(B)</enum><text>a community-based
organization.</text>
</subparagraph></paragraph><paragraph commented="no" id="H10C167FBC12A40788F50125FA498FD61"><enum>(4)</enum><header>Medically
underserved community</header><text>The term <term>medically underserved
community</term> means a community—</text>
<subparagraph commented="no" id="HF1BE8ED3213E43D7B263EFBD97F9EAAD"><enum>(A)</enum><text>that has a
substantial number of individuals who are members of a medically underserved
population, as defined by section 330(b)(3); and</text>
</subparagraph><subparagraph commented="no" id="H0965E99F55CD456D98F0A3BEDBA6F723"><enum>(B)</enum><text>a significant
portion of which is a health professional shortage area as designated under
section 332.</text>
</subparagraph></paragraph><paragraph commented="no" id="H5DED0EADF09644A382502FEE9494D4F4"><enum>(5)</enum><header>Support</header><text>The
term <term>support</term> means the provision of training, supervision, and
materials needed to effectively deliver the services described in subsection
(b), reimbursement for services, and other benefits.</text>
</paragraph><paragraph commented="no" id="HAA922FB6FC1E469691FE9D0898A0EFA8"><enum>(6)</enum><header>Target
population</header><text>The term <term>target population</term> means women of
reproductive age, regardless of their current childbearing status and children
under 21 years of age.</text>
</paragraph></subsection><subsection commented="no" id="H9DFCAC1B0F9E4B74B0A75735479BEA8B"><enum>(k)</enum><header>Authorization of
Appropriations</header><text>There are authorized to be appropriated to carry
out this section $15,000,000 for each of fiscal years 2012 through
2016.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" display-inline="no-display-inline" id="H21FD39296B7E43D2AD4548EFB811CD25"><enum>502.</enum><header>Removing
barriers to health care and nutrition assistance for children, pregnant women,
and lawfully present individuals</header>
<subsection commented="no" id="H4CF2E93332C24A08B8210B35F946F58B"><enum>(a)</enum><header>Medicaid</header><text>Section
1903(v) of the Social Security Act (42 U.S.C. 1396b(v)) is amended by striking
paragraph (4) and inserting the following new paragraph:</text>
<quoted-block id="HBAE4168F229B431CBA3D438957601D22" style="OLC">
<paragraph commented="no" id="HA31EFEFF7C8A44B6A2C3EB9A4AFD72F4"><enum>(4)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="HB217767ABE704215B71D29419BD05D1A"><enum>(A)</enum><text>Notwithstanding sections
401(a), 402(b), 403, and 421 of the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996, payment shall be made under this
section for care and services that are furnished to aliens, including those
described in paragraph (1), if they otherwise meet the eligibility requirements
for medical assistance under the State plan approved under this subchapter
(other than the requirement of the receipt of aid or assistance under title IV,
supplemental security income benefits under title XVI, or a State supplementary
payment), and are—</text>
<clause commented="no" id="H8164B2612EB3487F879FD09A3E7A1C19"><enum>(i)</enum><text>lawfully present
in the United States;</text>
</clause><clause commented="no" id="HD7FB7C9A8D834E72A25C5655B9826FB8"><enum>(ii)</enum><text>children under 21
years of age, including any optional targeted low-income child (as such term is
defined in section 1905(u)(2)(B)); or</text>
</clause><clause commented="no" id="HBFB996015B144A8DACB46BBBDFD5193C"><enum>(iii)</enum><text>pregnant women
during pregnancy and during the 60-day period beginning on the last day of the
pregnancy.</text>
</clause></subparagraph><subparagraph commented="no" id="H8214F539C88E4A5F87451804C3A00368" indent="up1"><enum>(B)</enum><text>No debt shall accrue under an
affidavit of support against any sponsor of such an alien on the basis of
provision of assistance to such alien under this paragraph and the cost of such
assistance shall not be considered as an unreimbursed
cost.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" id="H667812F67A2F43D680D784DC2F3F0152"><enum>(b)</enum><header>SCHIP</header><text>Section
2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1)) is amended by
amending subparagraph (J) to read as follows:</text>
<quoted-block id="H76C9354C8EEA400886BBC964C6D3725E" style="OLC">
<subparagraph commented="no" id="H1F96354E7500496BB983A20EDF807D16"><enum>(J)</enum><text>Paragraph (4) of
section 1903(v) (relating to individuals who, but for sections 401(a), 403, and
421 of the Personal Responsibility and Work Opportunity Reconciliation Act of
1996, would be eligible for medical assistance under title
XXI).</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" id="H1784EBEAA0044B80AC2FA6F3DD3C31B4"><enum>(c)</enum><header>Supplemental
nutrition assistance</header><text display-inline="yes-display-inline">Notwithstanding sections 401(a), 402(a),
and 403(a) of the Personal Responsibility and Work Opportunity Reconciliation
Act of 1996 (8 U.S.C. 1611(a); 1612(a); 1613(a)) and section 6(f) of the Food
and Nutrition Act of 2008 (7 U.S.C. 2015(f)), persons who are lawfully present
in the United States shall be not be ineligible for benefits under the
supplemental nutrition assistance program on the basis of their immigration
status or date of entry into the United States.</text>
</subsection><subsection commented="no" id="HC480302C699C416BA73FA0C0B8B641CC"><enum>(d)</enum><header>Eligibility for
families with children</header><text display-inline="yes-display-inline">Section of the 421(d)(3) of the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C.
1631(d)(3)) is amended by striking <quote>to the extent that a qualified alien
is eligible under section 402(a)(2)(J)</quote> and inserting, <quote>to the
extent that a child is a member of a household under the supplemental nutrition
assistance program</quote>.</text>
</subsection><subsection commented="no" id="H59BAB422370C471086D320284C6342CF"><enum>(e)</enum><header>Ensuring proper
screening</header><text display-inline="yes-display-inline">Section 11(e)(2)(B)
of the Food and Nutrition Act of 2008 (7 U.S.C. 2020(e)(2)(B)) is
amended—</text>
<paragraph commented="no" id="H17A44A18762F498781532D65EF13394B"><enum>(1)</enum><text>by redesignating
clauses (vi) and (vii) as clauses (vii) and (viii); and</text>
</paragraph><paragraph commented="no" id="H0226E121AAA54026811730EE5CC116AB"><enum>(2)</enum><text>by inserting after
clause (v) the following:</text>
<quoted-block display-inline="no-display-inline" id="H70296074288F4643AE9566BBA16A211A" style="OLC">
<clause commented="no" id="HE7954BEB3D69434197AB95452A10F428"><enum>(vi)</enum><text display-inline="yes-display-inline">shall provide a method for implementing
section 421 of the Personal Responsibility and Work Opportunity Reconciliation
Act of 1996 (8 U.S.C. 1631) that does not require any unnecessary information
from persons who may be exempt from that
provision;</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section commented="no" id="H914E361F9D844B048CC2C10850CCAF09"><enum>503.</enum><header> Repeal of
denial of benefits</header><text display-inline="no-display-inline">Section 115
of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996
(21 U.S.C. 862a) is amended—</text>
<paragraph commented="no" id="HACA20B6EC55F45E583F01C0357BAD9C6"><enum>(1)</enum><text>in subsection (a)
by striking paragraph (2);</text>
</paragraph><paragraph commented="no" id="HB41631983CFF427AB98F7165970AAF18"><enum>(2)</enum><text>in subsection (b)
by striking paragraph (2); and</text>
</paragraph><paragraph commented="no" id="H05E9456859024C1A8B52AB5815DE743B"><enum>(3)</enum><text>in subsection (e)
by striking paragraph (2).</text>
</paragraph></section><section commented="no" id="HFAF9D1106A9547A0B62822FC5D841F13"><enum>504.</enum><header>Birth defects
prevention, risk reduction, and awareness</header>
<subsection id="HA5C9485E58D041A5AA0B56B6F68DEB5A"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary shall
establish and implement a birth defects prevention and public awareness
program, consisting of the activities described in subsections (c) and
(d).</text>
</subsection><subsection id="H29FC3BE2581F43C587813A7E3E60B615"><enum>(b)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H644781B322024BA0A784498917553141"><enum>(1)</enum><text>The term
<term>pregnancy and breastfeeding information services</term> includes
only—</text>
<subparagraph id="H0DF6357D86434B8A89554C0A27A08BAA"><enum>(A)</enum><text>information
services to provide accurate, evidence-based, clinical information regarding
maternal exposures during pregnancy that may be associated with birth defects
or other health risks, such as exposures to medications, chemicals, infections,
foodborne pathogens, illnesses, nutrition, or lifestyle factors;</text>
</subparagraph><subparagraph id="H259F709DAC2F4953A0A35982890CE7FF"><enum>(B)</enum><text>information
services to provide accurate, evidence-based, clinical information regarding
maternal exposures during breastfeeding that may be associated with health
risks to a breast-fed infant, such as exposures to medications, chemicals,
infections, foodborne pathogens, illnesses, nutrition, or lifestyle
factors;</text>
</subparagraph><subparagraph id="HACF47ACF10A64A6CBE9078F8612AD4F4"><enum>(C)</enum><text>the provision of
accurate, evidence-based information weighing risks of exposures during
breastfeeding against the benefits of breastfeeding; and</text>
</subparagraph><subparagraph id="HBE2C20D56E444A2EA252334EB097050E"><enum>(D)</enum><text>the provision of
information described in subparagraph (A), (B), or (C) through counselors, Web
sites, fact sheets, telephonic or electronic communication, community outreach
efforts, or other appropriate means.</text>
</subparagraph></paragraph><paragraph id="H3E5B1E0517484C2FA47ABAE90D0BD611"><enum>(2)</enum><text>The term
<term>Secretary</term> means the Secretary of Health and Human Services, acting
through the Director of the Centers for Disease Control and Prevention.</text>
</paragraph></subsection><subsection commented="no" id="H4A0252190F8B4575BFFB1D883A62FA8F"><enum>(c)</enum><header>Nationwide media
campaign</header><text>In carrying out subsection (a), the Secretary shall
conduct or support a nationwide media campaign to increase awareness among
health care providers and at-risk populations about pregnancy and breastfeeding
information services.</text>
</subsection><subsection commented="no" id="H9B4AE921E4214D4CA976E06FDA6FEED0"><enum>(d)</enum><header>Grants for
pregnancy and breastfeeding information services</header>
<paragraph id="H808D580EA292461692A0F952017F3CA3"><enum>(1)</enum><header>In
general</header><text>In carrying out subsection (a), the Secretary shall award
grants to State or regional agencies or organizations for any of the
following:</text>
<subparagraph commented="no" id="HD257A08E15244B78A33852C1702844E8"><enum>(A)</enum><header>Information
services</header><text>The provision of, or campaigns to increase awareness
about, pregnancy and breastfeeding information services.</text>
</subparagraph><subparagraph commented="no" id="H2DF28A7DF1F44E069C7F59B7224F52A7"><enum>(B)</enum><header>Surveillance and
research</header><text>The conduct or support of—</text>
<clause id="H01C457AA31284E46A2EF52F14545E15B"><enum>(i)</enum><text>surveillance of or
research on—</text>
<subclause id="H2CD96D1DD4B3485AB58A963967E96D50"><enum>(I)</enum><text>maternal exposures
and maternal health conditions that may influence the risk of birth defects,
prematurity, or other adverse pregnancy outcomes; and</text>
</subclause><subclause id="HF21E4886D82D46058BCDEE37DB478AAD"><enum>(II)</enum><text>maternal
exposures that may influence health risks to a breastfed infant; or</text>
</subclause></clause><clause id="H24992311C58E4E26ACAEA2408DDCF9A7"><enum>(ii)</enum><text>networking to
facilitate surveillance or research described in this subparagraph.</text>
</clause></subparagraph></paragraph><paragraph id="HB80BE2382EA544D4A10AFA970930F904"><enum>(2)</enum><header>Preference for
certain States</header><text display-inline="yes-display-inline">The Secretary,
in making any grant under this subsection, shall give preference to States,
otherwise equally qualified, that have or had a pregnancy and breastfeeding
information service in place on or after January 1, 2006.</text>
</paragraph><paragraph id="H750F759C0E834ACFBE8A80BDC58800B2"><enum>(3)</enum><header>Matching
funds</header><text>The Secretary may only award a grant under this subsection
to a State or regional agency or organization that agrees, with respect to the
costs to be incurred in carrying out the grant activities, to make available
(directly or through donations from public or private entities) non-Federal
funds toward such costs in an amount equal to not less than 25 percent of the
amount of the grant.</text>
</paragraph><paragraph id="HF5AD7847DF3C4F41B1AFF7AD7DD90795"><enum>(4)</enum><header>Coordination</header><text>The
Secretary shall ensure that activities funded through a grant under this
subsection are coordinated, to the maximum extent practicable, with other birth
defects prevention and environmental health activities of the Federal
Government, including with respect to pediatric environmental health specialty
units and children’s environmental health centers.</text>
</paragraph></subsection><subsection id="H1A8F82DEC74F4A4CA928CBEC493326CD"><enum>(e)</enum><header>Evaluation</header><text display-inline="yes-display-inline">In furtherance of the program under
subsection (a), the Secretary shall provide for an evaluation of pregnancy and
breastfeeding information services to identify efficient and effective models
of—</text>
<paragraph id="H66BC03525FE1455EB124CDFD61109345"><enum>(1)</enum><text>providing
information;</text>
</paragraph><paragraph id="H03824D083742480EA2B4F60612256E66"><enum>(2)</enum><text>raising awareness
and increasing knowledge about birth defects prevention measures;</text>
</paragraph><paragraph id="H9504C702729C45B98A2312B53EEFD655"><enum>(3)</enum><text>modifying risk
behaviors; or</text>
</paragraph><paragraph id="HDBB3D614079E4ADB81302F58FA7A0BCD"><enum>(4)</enum><text>other outcome
measures as determined appropriate by the Secretary.</text>
</paragraph></subsection><subsection commented="no" id="H8985A36B3D1D455B8CCCA4B9FCCDB0F8"><enum>(f)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated $5,000,000 for fiscal year 2012, $6,000,000 for fiscal year
2013, $7,000,000 for fiscal year 2014, $8,000,000 for fiscal year 2015, and
$9,000,000 for fiscal year 2016.</text>
</subsection></section><section id="H750AFD3AD1C9453588FDDF57088B0532"><enum>505.</enum><header>Uniform State
maternal mortality review committees on pregnancy-related deaths</header>
<subsection id="HA8ADBCF6653C4716B5F0303D64DE3EED"><enum>(a)</enum><header>Condition of
receipt of payments from allotment under Maternal and Child Health Service
Block Grant</header><text display-inline="yes-display-inline">Title V of the
Social Security Act (42 U.S.C. 701 et seq.) is amended by adding at the end the
following new section:</text>
<quoted-block display-inline="no-display-inline" id="HE6BE2126D3BC47DAA972F69C28B91189" style="OLC">
<section id="HF2E76FBB4FB14F22B506AE1D06F79D40"><enum>514.</enum><header>Uniform State
maternal mortality review committees on pregnancy-related deaths</header>
<subsection id="H64C9FB3AD0334FF1903209163A32C190"><enum>(a)</enum><header>Grants</header>
<paragraph id="H64A26E643C57467CBDD2C1978EF41D45"><enum>(1)</enum><header>In
general</header><text>Notwithstanding any other provision of this title, for
each of fiscal years 2012 through 2018, in addition to payments from allotments
for States under section 502 for such year, the Secretary shall, subject to
paragraph (3) and in accordance with the criteria established under paragraph
(2), award grants to States to—</text>
<subparagraph commented="no" id="H6516B72C438C47E39FA9814FAAAB8EB8"><enum>(A)</enum><text>carry out the
activities described in subsection (b)(1);</text>
</subparagraph><subparagraph id="HF3B2BF665CAB4371841CFF076163306C"><enum>(B)</enum><text>establish a State
maternal mortality review committee, in accordance with subsection (b)(2), to
carry out the activities described in subsection (b)(2)(A), and to establish
the processes described in subsection (b)(1);</text>
</subparagraph><subparagraph commented="no" id="H0E0AD8F3B7B547618DFD4504D8CAB938"><enum>(C)</enum><text>ensure the State
department of health carries out the applicable activities described in
subsection (b)(3), with respect to pregnancy-related deaths occurring within
the State during such fiscal year;</text>
</subparagraph><subparagraph id="H6C412CEBD4FB49FB90ACAB5535A50E5C"><enum>(D)</enum><text>implement and use
the comprehensive case abstraction form developed under subsection (c), in
accordance with such subsection; and</text>
</subparagraph><subparagraph id="H28D57BA632424635906C2FA96313ED57"><enum>(E)</enum><text>provide for public
disclosure of information, in accordance with subsection (e).</text>
</subparagraph></paragraph><paragraph display-inline="no-display-inline" id="HD44C74B918A5404891BC2F9B19F0086A"><enum>(2)</enum><header>Criteria</header><text>The
Secretary shall establish criteria for determining eligibility for and the
amount of a grant awarded to a State under paragraph (1). Such criteria shall
provide that in the case of a State that receives such a grant for a fiscal
year and is determined by the Secretary to have not used such grant in
accordance with this section, such State shall not be eligible for such a grant
for any subsequent fiscal year.</text>
</paragraph><paragraph id="H7D33482FF9644E52B0FFEF65105370CA"><enum>(3)</enum><header>Authorization of
appropriations</header><text>For purposes of carrying out the grant program
under this section, including for administrative purposes, there is authorized
to be appropriated $10,000,000 for each of fiscal years 2012 through
2018.</text>
</paragraph></subsection><subsection id="H419999DA3718454595F4D19CCAD343B6"><enum>(b)</enum><header>Pregnancy-Related
death review</header>
<paragraph id="H770B000B993844998F542533444F37BE"><enum>(1)</enum><header>Review of
pregnancy-related death and pregnancy-associated death cases</header><text>For
purposes of subsection (a), with respect to a State that receives a grant under
subsection (a), the following shall apply:</text>
<subparagraph id="H06826DEE0F6140608DBAF0CC3D7160B7"><enum>(A)</enum><header>Mandatory
reporting of pregnancy-related deaths</header>
<clause id="HC25E33DF18D54C4AA5DDF2E76BF11595"><enum>(i)</enum><header>In
general</header><text>The State shall, through the State maternal mortality
review committee, develop a process, separate from any reporting process
established by the State department of health prior to the date of the
enactment of this section, that provides for mandatory and confidential case
reporting by individuals and entities described in clause (ii) of
pregnancy-related deaths to the State department of health.</text>
</clause><clause id="HF3D98A6F26CD47059B0B07CBF0E471DF"><enum>(ii)</enum><header>Individuals and
Entities described</header><text>Individuals and entities described in this
clause include each of the following:</text>
<subclause id="HEB3DB4253A1A4A32A4CEA345847C2A38"><enum>(I)</enum><text>Health care
providers.</text>
</subclause><subclause id="HABDE6A939DBB4B46BDF0F36B87E1137D"><enum>(II)</enum><text>Medical
examiners.</text>
</subclause><subclause id="H60B1E14149B847A7B9C7E6D42E6F2662"><enum>(III)</enum><text>Medical
coroners.</text>
</subclause><subclause id="H23049390185C40FB91C1183A8C45119D"><enum>(IV)</enum><text>Hospitals.</text>
</subclause><subclause id="HB21989722DBF4599AFD5C2DEB3396DF3"><enum>(V)</enum><text>Free-standing
birth centers.</text>
</subclause><subclause id="H3AEC5D0C5ECD495EBF6CDFBA37AC8737"><enum>(VI)</enum><text>Other health care
facilities.</text>
</subclause><subclause id="H8EFE22BE685D4E1D8DAE468326B29D14"><enum>(VII)</enum><text>Any other
individuals responsible for completing death certificates.</text>
</subclause><subclause commented="no" id="H54FF3909CBDE4573AB351A506A6FB495"><enum>(VIII)</enum><text>Any other
appropriate individuals or entities specified by the Secretary.</text>
</subclause></clause></subparagraph><subparagraph id="H8ACD17CBD521433E9C6E7DDFEDE7FAE2"><enum>(B)</enum><header>Voluntary
reporting of pregnancy-related and pregnancy-associated deaths</header>
<clause id="HEB1E223899574E20B7799D3D588971A0"><enum>(i)</enum><text display-inline="yes-display-inline">The State shall, through the State maternal
mortality review committee, develop a process for and encourage, separate from
any reporting process established by the State department of health prior to
the date of the enactment of this section, voluntary and confidential case
reporting by individuals described in clause (ii) of pregnancy-associated
deaths to the State department of health.</text>
</clause><clause id="H30DFF7BF18E243B885F2820B3E0E7E9B"><enum>(ii)</enum><text display-inline="yes-display-inline">The State shall, through the State maternal
mortality review committee, develop a process for voluntary and confidential
reporting by family members of the deceased and by other individuals on
possible pregnancy-related and pregnancy-associated deaths to the State
department of health. Such process shall include—</text>
<subclause id="H0C73521AD8CC43F1A50035843E64BEBE"><enum>(I)</enum><text>making publicly
available on the Internet Web site of the State department of health a
telephone number, Internet Web link, and email address for such reporting;
and</text>
</subclause><subclause id="HED2A2914D4744E82A69250AF8EE823D2"><enum>(II)</enum><text>publicizing to
local professional organizations, community organizations, and social services
agencies the availability of the telephone number, Internet Web link, and email
address made available under subclause (I).</text>
</subclause></clause></subparagraph><subparagraph id="HC3A34132B86549BF94BB5E272CA76C9F"><enum>(C)</enum><header>Development of
case-finding</header><text>The State, through the vital statistics unit of the
State, shall annually identify pregnancy-related and pregnancy-associated
deaths occurring in such State during the year involved by—</text>
<clause id="H928448F8512940C3B9F0327189024109"><enum>(i)</enum><text>matching all death
records, with respect to such year, for women of childbearing age to live birth
certificates and infant death certificates to identify deaths of women that
occurred during pregnancy and within one year after the end of a
pregnancy;</text>
</clause><clause id="HDA622FE5984942248B288E7771288EE9"><enum>(ii)</enum><text>identifying
deaths reported during such year as having an underlying or contributing cause
of death related to pregnancy, regardless of the time that has passed between
the end of the pregnancy and the death;</text>
</clause><clause id="H9BC03756195C415E968712BA2AD36D6A"><enum>(iii)</enum><text>collecting data
from medical examiner and coroner reports; and</text>
</clause><clause id="HA52624CF32C24A61A8B24D7963856C3E"><enum>(iv)</enum><text>any other methods
the States may devise to identify maternal deaths, such as through review of a
random sample of reported deaths of women of childbearing age to ascertain
cases of pregnancy-related and pregnancy-associated deaths that are not
discernable from a review of death certificates alone.</text>
</clause><continuation-text continuation-text-level="subparagraph">When
feasible and for purposes of effectively collecting and obtaining data on
pregnancy-related and pregnancy-associated deaths, the State shall adopt the
most recent standardized birth and death certificates, as issued by the
National Center for Vital Health Statistics, including the recommended checkbox
section for pregnancy on the death certificates.</continuation-text></subparagraph><subparagraph id="H4C96C56D625C46FBB7442992CCB34661"><enum>(D)</enum><header>Case
investigation and development of case summaries</header><text>Following receipt
of reports by the State department of health pursuant to subparagraph (A) or
(B) and collection by the vital statistics unit of the State of possible cases
of pregnancy-related and pregnancy-associated deaths pursuant to subparagraph
(C), the State, through the State maternal mortality review committee
established under subsection (a), shall investigate each case, utilizing the
case abstraction form described in subsection (c), and prepare de-identified
case summaries, which shall be reviewed by the committee and included in
applicable reports. For purposes of subsection (a), under the processes
established under subparagraphs (A), (B), and (C), a State department of health
or vital statistics unit of a State shall provide to the State maternal
mortality review committee access to information collected pursuant to such
subparagraphs as necessary to carry out this subparagraph. Data and information
collected for the case summary and review are for purposes of public health
activities, in accordance with HIPAA privacy and security law (as defined in
section 3009(a)(2) of the Public Health Service Act). Such case investigations
shall include data and information obtained through—</text>
<clause id="HBF24334DC5AE4937AC7595EB85E35D0F"><enum>(i)</enum><text>medical examiner
and autopsy reports of the woman involved;</text>
</clause><clause id="H1D024D96DD8441A59F3B69B85C36320B"><enum>(ii)</enum><text>medical records
of the woman, including such records related to health care prior to pregnancy,
prenatal and postnatal care, labor and delivery care, emergency room care,
hospital discharge records, and any care delivered up until the time of death
of the woman for purposes of public health activities, in accordance with HIPAA
privacy and security law (as defined in section 3009(a)(2) of the Public Health
Service Act);</text>
</clause><clause id="H2366D299843A4DB98632CF92D2140BD9"><enum>(iii)</enum><text>oral and written
interviews of individuals directly involved in the maternal care of the woman
during and immediately following the pregnancy of the woman, including health
care, mental health, and social service providers, as applicable;</text>
</clause><clause id="HBD134BD8C7844971A94F4BAA2BE0D1F0"><enum>(iv)</enum><text>optional oral or
written interviews of the family of the woman;</text>
</clause><clause id="HE1343D7E935A41B2A2CF31F77A33C40F"><enum>(v)</enum><text>socioeconomic and
other relevant background information about the woman;</text>
</clause><clause id="H2875042C94AA4E1B872CF9053F56CD7F"><enum>(vi)</enum><text>information
collected in subparagraph (C)(i); and</text>
</clause><clause id="H130AC35C61634BB685E1EEC262D37A43"><enum>(vii)</enum><text>other
information on the cause of death of the woman, such as social services and
child welfare reports.</text>
</clause></subparagraph></paragraph><paragraph id="HB46445951A9B449A8216B29ADAF099A4"><enum>(2)</enum><header>State maternal
mortality review committees</header>
<subparagraph id="H2D71974DBA644F538AD4EF221E778071"><enum>(A)</enum><header>Duties</header>
<clause id="HFD20EF97C0CF46EA8B9469DE23AADD4B"><enum>(i)</enum><header>Required
committee activities</header><text>For purposes of subsection (a), a maternal
mortality review committee established by a State pursuant to a grant under
such subsection shall carry out the following pregnancy-related death and
pregnancy-associated death review activities and shall include all information
relevant to the death involved on the case abstraction form developed under
subsection (d):</text>
<subclause id="H954455D591974371A6274BA43E035D71"><enum>(I)</enum><text>With respect to a
case of pregnancy-related or pregnancy-associated death of a woman, review the
case summaries prepared under subparagraphs (A), (B), (C), and (D) of paragraph
(1).</text>
</subclause><subclause id="HB64728B2A78C4D319FC34EBDAFDAAF18"><enum>(II)</enum><text>Review aggregate
statistical reports developed by the vital statistics unit of the State under
paragraph (1)(C) regarding pregnancy-related and pregnancy-associated deaths to
identify trends, patterns, and disparities in adverse outcomes and address
medical, non-medical, and system-related factors that may have contributed to
such pregnancy-related and pregnancy-associated deaths and disparities.</text>
</subclause><subclause id="H0C9BAAAF8F7E49208B1B2668D7695379"><enum>(III)</enum><text>Develop
recommendations, based on the review of the case summaries under paragraph
(1)(D) and aggregate statistical reports under subclause (II), to improve
maternal care, social and health services, and public health policy and
institutions, including with respect to improving access to maternal care,
improving the availability of social services, and eliminating disparities in
maternal care and outcomes.</text>
</subclause></clause><clause id="HADDF78E3708E4788B269AB24071B5562"><enum>(ii)</enum><header>Optional
committee activities</header><text display-inline="yes-display-inline">For
purposes of subsection (a), a maternal mortality review committee established
by a State under such subsection may present findings and recommendations
regarding a specific case or set of circumstances directly to a health care
facility or its local or State professional organization for the purpose of
instituting policy changes, educational activities, or otherwise improving the
quality of care provided by the facilities.</text>
</clause></subparagraph><subparagraph id="HF2D486A36BDE44E4AA5B759302C11C66"><enum>(B)</enum><header>Composition of
maternal mortality review committees</header>
<clause id="HBC92847D0EB44F718C133489F26CBEF1"><enum>(i)</enum><header>In
General</header><text>Each State maternal mortality review committee
established pursuant to a grant under subsection (a) shall be
multi-disciplinary, consisting of health care and social service providers,
public health officials, other persons with professional expertise on maternal
health and mortality, and patient and community advocates who represent those
communities within such State that are the most affected by maternal mortality.
Membership on such a committee of a State shall be reviewed annually by the
State department of health to ensure that membership representation
requirements are being fulfilled in accordance with this paragraph.</text>
</clause><clause id="H5C7B832EEC124B908DD61D690C5E45B1"><enum>(ii)</enum><header>Required
membership</header><text>Each such review committee shall include—</text>
<subclause id="HEA28E4701612471A99DA148F8F9FD6BC"><enum>(I)</enum><text>representatives
from medical specialities providing care to pregnant and postpartum patients,
including obstetricians (including generalists and maternal fetal medicine
specialists), and family practice physicians;</text>
</subclause><subclause id="H88794CE41C8E4208A0BF15C355B9CEE1"><enum>(II)</enum><text>certified nurse
midwives, certified midwives, and advanced practice nurses;</text>
</subclause><subclause id="H17328362A1354FC69CEDB94C7886854B"><enum>(III)</enum><text>hospital-based
nurses;</text>
</subclause><subclause id="H05FACF9F0CE2490593D06DCCBA5E16AE"><enum>(IV)</enum><text>representatives
of the State department of health maternal and child health department;</text>
</subclause><subclause id="HDF77906B81CA497599D91BB5E89071D2"><enum>(V)</enum><text>social service
providers or social workers;</text>
</subclause><subclause id="H700BD1AC7DA84B62B99E3A8136A80990"><enum>(VI)</enum><text>the chief medical
examiners or designees;</text>
</subclause><subclause id="H1CF05A823A4741E98A372CB3252686F6"><enum>(VII)</enum><text>facility
representatives, such as from hospitals or free-standing birth centers;
and</text>
</subclause><subclause id="H6169139DF5D54B48BDC0ADAAF4F3F34C"><enum>(VIII)</enum><text display-inline="yes-display-inline">community or patient advocates who
represent those communities within the State that are the most affected by
maternal mortality.</text>
</subclause></clause><clause id="H134B356DD67744FEB219677F0A27311E"><enum>(iii)</enum><header>Additional
members</header><text>Each such review committee may also include
representatives from other relevant academic, health, social service, or policy
professions, or community organizations, on an ongoing basis, or as needed, as
determined beneficial by the review committee, including—</text>
<subclause id="HB78F8F4E16FD42E9A8F112E9CEF57846"><enum>(I)</enum><text>anesthesiologists;</text>
</subclause><subclause id="H93FC7E85CB5545C7AB7B459187625D6C"><enum>(II)</enum><text>emergency
physicians;</text>
</subclause><subclause id="H174683C177354308BE3BFCBFB4B77343"><enum>(III)</enum><text>pathologists;</text>
</subclause><subclause id="H4BD39F4BBBB548E0B2296AE0D2C428DB"><enum>(IV)</enum><text>epidemiologists
or biostatisticians;</text>
</subclause><subclause id="H53E900A814574B03A2DC552AED3BDCF5"><enum>(V)</enum><text>intensivists;</text>
</subclause><subclause id="H142EC836A2F047C1B73DBE16B103797B"><enum>(VI)</enum><text>vital statistics
officers;</text>
</subclause><subclause id="HACF008012ED04A2690F2426E691D7FFD"><enum>(VII)</enum><text>nutritionists;</text>
</subclause><subclause id="H9599A16ED05F46F6AC5ECB7AF155FB2F"><enum>(VIII)</enum><text>mental health
professionals;</text>
</subclause><subclause id="H6BD47A8F36084BE8A227BABAA521EB50"><enum>(IX)</enum><text>substance abuse
treatment specialists;</text>
</subclause><subclause id="H0E8287B9FEA041A685341DD85E02B0BE"><enum>(X)</enum><text>representatives of
relevant advocacy groups;</text>
</subclause><subclause id="HA6687DE47B6B4E34B8BD92C0A350A7F9"><enum>(XI)</enum><text>academics;</text>
</subclause><subclause id="H7733C8956203446C9AFF8F8CC8C887EC"><enum>(XII)</enum><text>representatives
of beneficiaries of the State plan under the Medicaid program under title
XIX;</text>
</subclause><subclause id="H022316DBF6024544BC1F701DB582B781"><enum>(XIII)</enum><text>paramedics;</text>
</subclause><subclause id="HB762E4E68CFE42CC8B3EE3DAEB4FA16C"><enum>(XIV)</enum><text>lawyers;</text>
</subclause><subclause id="H512A009B80C54CC8B8EF8C7CD5374CEF"><enum>(XV)</enum><text>risk management
specialists;</text>
</subclause><subclause id="H7A4F9D2E6B6249F2A9E3B01CE458BD4D"><enum>(XVI)</enum><text>representatives
of the departments of health or public health of major cities in the State
involved; and</text>
</subclause><subclause id="HF19C23C6A0E34BB49F1CC89A1AEF1774"><enum>(XVII)</enum><text>policy
makers.</text>
</subclause></clause><clause id="HB4BEEE2689D747AFB07EE61FCB3EE2D0"><enum>(iv)</enum><header>Diverse
community membership</header><text>The composition of such a committee, with
respect to a State, shall include—</text>
<subclause id="HFAA7AE4CF6694CD1ABFD3A9EF1A21878"><enum>(I)</enum><text>representatives
from diverse communities, particularly those communities within such State most
severely affected by pregnancy-related deaths or pregnancy-associated deaths
and by a lack of access to relevant maternal care services, from community
maternal child health organizations, and from minority advocacy groups;</text>
</subclause><subclause id="H943C4E44EB224EDDA8DC094E0C1664BA"><enum>(II)</enum><text>members,
including health care providers, from different geographic regions in the
State, including any rural, urban, and tribal areas; and</text>
</subclause><subclause id="H3CF601F1EF1049E397C72D4E3A079563"><enum>(III)</enum><text>health care and
social service providers who work in communities that are diverse with regard
to race, ethnicity, immigration status, Indigenous status, and English
proficiency.</text>
</subclause></clause><clause id="H1F5B50E38FBC4951A0E6BB0B7BC245CE"><enum>(v)</enum><header>Maternal
mortality review staff</header><text>Staff of each such review committee shall
include—</text>
<subclause id="H35BC7718EC3543628C575D9B234DFA12"><enum>(I)</enum><text>vital health
statisticians, maternal child health statisticians, or epidemiologists;</text>
</subclause><subclause id="HAA53D5E4261647C396254E7801E0EC22"><enum>(II)</enum><text>a coordinator of
the State maternal mortality review committee, to be designated by the State;
and</text>
</subclause><subclause id="H7D1ADD4CA3CB4B38A03211E027592745"><enum>(III)</enum><text>administrative
staff.</text>
</subclause></clause></subparagraph><subparagraph id="H50B0437D76054EA5938CE4D87B27F464"><enum>(C)</enum><header>Option for
States to form regional maternal mortality reviews</header><text>States with a
low rate of occurrence of pregnancy-associated or pregnancy-related deaths may
choose to partner with one or more neighboring States to fulfill the activities
described in paragraph (1)(C). In such a case, with respect to States in such a
partnership, any requirement under this section relating to the reporting of
information related to such activities shall be deemed to be fulfilled by each
such State if a single such report is submitted for the partnership.</text>
</subparagraph></paragraph><paragraph id="H1C9213568C774037A78BDD6FD5536CC4"><enum>(3)</enum><header>State Department
of Health Activities</header><text>For purposes of subsection (a), a State
department of health of a State receiving a grant under such subsection
shall—</text>
<subparagraph id="H766954362D654494A1A3D8EE8F632FD8"><enum>(A)</enum><text>in consultation
with the maternal mortality review committee of the State and in conjunction
with relevant professional organizations, develop a plan for ongoing health
care provider education, based on the findings and recommendations of the
committee, in order to improve the quality of maternal care; and</text>
</subparagraph><subparagraph id="HE9E25F7656A747E484F3C8D65576F2CC"><enum>(B)</enum><text>take steps to
widely disseminate the findings and recommendations of the State maternal
mortality review committees of the State and to implement the recommendations
of such committee.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H909F020C6AA048DDAE5EACC1470164F9"><enum>(c)</enum><header>Case abstraction
form</header>
<paragraph commented="no" id="H8453A2D8AB884DC58D274208D6F2C9B3"><enum>(1)</enum><header>Development</header><text display-inline="yes-display-inline">The Director of the Centers for Disease
Control and Prevention shall develop a uniform, comprehensive case abstraction
form and make such form available to States for State maternal mortality review
committees for use by such committees in order to—</text>
<subparagraph commented="no" id="H6B669B47FA13424FB5898D33A7A07276"><enum>(A)</enum><text>ensure that the
cases and information collected and reviewed by such committees can be pooled
for review by the Department of Health and Human Services and its agencies;
and</text>
</subparagraph><subparagraph commented="no" id="H425AF1B1CE1E41F88315CD264BA10BA5"><enum>(B)</enum><text>preserve the
uniformity of the information and its use for Federal public health
purposes.</text>
</subparagraph></paragraph><paragraph commented="no" id="HEC4C4B74363047358FAE48438C021A4B"><enum>(2)</enum><header>Permissible
State modification</header><text display-inline="yes-display-inline">Each State
may modify the form developed under paragraph (1) for implementation and use by
such State or by the State maternal mortality review committee of such State by
including on such form additional information to be collected, but may not
alter the standard questions on such form, in order to ensure that the
information can be collected and reviewed centrally at the Federal
level.</text>
</paragraph></subsection><subsection id="H61B7A61FA07E42B0AFB2B7932E90AEF0"><enum>(d)</enum><header>Treatment as
public health authority for purposes of HIPAA</header><text display-inline="yes-display-inline">For purposes of applying HIPAA privacy and
security law (as defined in section 3009(a)(2) of the Public Health Service
Act), a State maternal mortality review committee of a State established
pursuant to this section to carry out activities described in subsection
(b)(2)(A) shall be deemed to be a public health authority described in section
164.501 (and referenced in section 164.512(b)(1)(i)) of title 45, Code of
Federal Regulations (or any successor regulation), carrying out public health
activities and purposes described in such section 164.512(b)(1)(i) (or any such
successor regulation).</text>
</subsection><subsection id="HDE6980A137E746F486B245D062FE7BC1"><enum>(e)</enum><header>Public
disclosure of information</header>
<paragraph id="H24677305F5A74C8D948FA34EDB8256BA"><enum>(1)</enum><header>In
general</header><text>For fiscal year 2012 or a subsequent fiscal year, each
State receiving a grant under this section for such year shall, subject to
paragraph (3), provide for the public disclosure, and submission to the
information clearinghouse established under paragraph (2), of the information
included in the report of the State under section 506(a)(2)(F) for such year
(relating to the findings for such year of the State maternal mortality review
committee established by the State under this section).</text>
</paragraph><paragraph id="H65E357D9682344CDBAD8B1658BBED7B0"><enum>(2)</enum><header>Information
clearinghouse</header><text display-inline="yes-display-inline">The Secretary
of Health and Human Services shall establish an information clearinghouse, that
shall be administered by the Director of the Centers for Disease Control and
Prevention, that will maintain findings and recommendations submitted pursuant
to paragraph (1) and provide such findings and recommendations for public
review and research purposes by State health departments, maternal mortality
review committees, and health providers and institutions.</text>
</paragraph><paragraph id="H30A05932C4DF42DBB5EC23703B41534F"><enum>(3)</enum><header>Confidentiality
of information</header><text>In no case shall any individually identifiable
health information be provided to the public, or submitted to the information
clearinghouse, under paragraph (1).</text>
</paragraph></subsection><subsection id="H2EF85D5159504B60AF912CF8394A360A"><enum>(f)</enum><header>Confidentiality
of review committee proceedings</header>
<paragraph display-inline="no-display-inline" id="HB3C1CDC32F084E79AF3F760E40249A77"><enum>(1)</enum><header>In
general</header><text>All proceedings and activities of a State maternal
mortality review committee under this section, opinions of members of such a
committee formed as a result of such proceedings and activities, and records
obtained, created, or maintained pursuant to this section, including records of
interviews, written reports, and statements procured by the Department of
Health and Human Services or by any other person, agency, or organization
acting jointly with the Department, in connection with morbidity and mortality
reviews under this section, shall be confidential, and not subject to
discovery, subpoena, or introduction into evidence in any civil, criminal,
legislative, or other proceeding. Such records shall not be open to public
inspection.</text>
</paragraph><paragraph id="H8D214301EF28447083A5F77940A577E2"><enum>(2)</enum><header>Testimony of
members of committee</header>
<subparagraph id="HE654B756DE40465AA7A3E140D5B41150"><enum>(A)</enum><header>In
general</header><text>Members of a State maternal mortality review committee
under this section may not be questioned in any civil, criminal, legislative,
or other proceeding regarding information presented in, or opinions formed as a
result of, a meeting or communication of the committee.</text>
</subparagraph><subparagraph id="H4DEE5FDBCA044A21AFF30950CD61694D"><enum>(B)</enum><header>Clarification</header><text>Nothing
in this subsection shall be construed to prevent a member of such a committee
from testifying regarding information that was obtained independent of such
member’s participation on the committee, or that is public information.</text>
</subparagraph></paragraph><paragraph id="HCB62870960DF4EA2B9F59914153C2642"><enum>(3)</enum><header>Availability of
information for research purposes</header><text display-inline="yes-display-inline">Nothing in this subsection shall prohibit
the publishing by such a committee or the Department of Health and Human
Services of statistical compilations and research reports that—</text>
<subparagraph id="HB1C9DC9085F64DD6A6068C7DFD478AD5"><enum>(A)</enum><text>are based on
confidential information, relating to morbidity and mortality review;
and</text>
</subparagraph><subparagraph id="HF0CF3E20FC114915AF7F2D8803F0DFB2"><enum>(B)</enum><text>do not contain
identifying information or any other information that could be used to
ultimately identify the individuals concerned.</text>
</subparagraph></paragraph></subsection><subsection id="HE916D01C85D0458FADDE08365FF55BF2"><enum>(g)</enum><header>Definitions</header><text>For
purposes of this section:</text>
<paragraph id="H9B522F4F952D4C9BA8FF049AB4D28E27"><enum>(1)</enum><text display-inline="yes-display-inline">The term <term>pregnancy-associated
death</term> means the death of a woman while pregnant or during the one-year
period following the date of the end of pregnancy, irrespective of the cause of
such death.</text>
</paragraph><paragraph commented="no" id="HDC3E5066E63F4E04B919EEBA0695FF48"><enum>(2)</enum><text display-inline="yes-display-inline">The term <term>pregnancy-related
death</term> means the death of a woman while pregnant or during the one-year
period following the date of the end of pregnancy, irrespective of the duration
or site of the pregnancy, from any cause related to or aggravated by the
pregnancy or its management, but not from any accidental or incidental
cause.</text>
</paragraph><paragraph id="HF65D2BBAA216489BBB68C7E29E376A0B"><enum>(3)</enum><text display-inline="yes-display-inline">The term <term>woman of childbearing
age</term> means a woman who is at least 10 years of age and not more than 54
years of
age.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H3A308C8B2EC84D8D85917263E865E3CC"><enum>(b)</enum><header>Inclusion of
findings of review committees in required reports</header>
<paragraph id="H42676CF41C194849A20C838DFD9A0CC4"><enum>(1)</enum><header>State triennial
reports</header><text display-inline="yes-display-inline">Paragraph (2) of
section 506(a) of such Act (42 U.S.C. 706(a)) is amended by inserting after
subparagraph (E) the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H8D1A088957A84834A5EA14B349794DEE" style="OLC">
<subparagraph id="H907438E878D24501A74B1C7C2436241D"><enum>(F)</enum><text display-inline="yes-display-inline">In the case of a State receiving a grant
under section 514, beginning for the first fiscal year beginning after 3 years
after the date of establishment of the State maternal mortality review
committee established by the State pursuant to such grant and once every 3
years thereafter, information containing the findings and recommendations of
such committee and information on the implementation of such recommendations
during the period
involved.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H330BD318A13140B5B9C87104BCF101AE"><enum>(2)</enum><header>Annual reports
to Congress</header><text>Paragraph (3) of such section is amended—</text>
<subparagraph id="HEFB0A4442F474BD6AC4A5CD99267CD88"><enum>(A)</enum><text>in subparagraph
(D), at the end, by striking <quote>and</quote>;</text>
</subparagraph><subparagraph id="H928BBCF3C5F944FAA12E40FAE9D8E3E0"><enum>(B)</enum><text display-inline="yes-display-inline">in subparagraph (E), at the end, by
striking the period and inserting <quote>; and</quote>; and</text>
</subparagraph><subparagraph id="H7133741F763E4CBB85B06C07222CE423"><enum>(C)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="HE52D5EB0B1CB44AC941FC689D352421B" style="OLC">
<subparagraph id="HC80B4544226D48E181BB3D7DB532F998"><enum>(F)</enum><text display-inline="yes-display-inline">For fiscal year 2012 and each subsequent
fiscal year, taking into account the findings, recommendations, and
implementation information submitted by States pursuant to paragraph (2)(F), on
the status of pregnancy-related deaths and pregnancy-associated deaths in the
United States and including recommendations on methods to prevent such deaths
in the United
States.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection></section><section id="HF45EDEE64D1C407EB9CF8ACAE2FCE0AB"><enum>506.</enum><header>Eliminating
disparities in maternity health outcomes</header><text display-inline="no-display-inline">Part B of title III of the Public Health
Service Act is amended by inserting after section 317V, as added, the following
new section:</text>
<quoted-block display-inline="no-display-inline" id="H6C909F62B17E4E4A926D8B1E77FC7D06" style="OLC">
<section id="H1C9A67501D784DFA9BB232F05AF5B7E0"><enum>317W.</enum><header>Eliminating
disparities in maternity health outcomes</header>
<subsection id="H69D5D2E2C58E45F58064B6F8D993B9A5"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary shall,
in consultation with relevant national stakeholder organizations, such as
national medical specialty organizations, national maternal child health
organizations, and national health disparity organizations, carry out the
following activities to eliminate disparities in maternal health
outcomes:</text>
<paragraph id="HCAA46AEBFA654DF5AEA224C79CD80FE2"><enum>(1)</enum><text display-inline="yes-display-inline">Conduct research into the determinants and
the distribution of disparities in maternal care, health risks, and health
outcomes, and improve the capacity of the performance measurement
infrastructure to measure such disparities.</text>
</paragraph><paragraph id="HD02D737EB2E44F019CDE6CA447A2E7AF"><enum>(2)</enum><text display-inline="yes-display-inline">Expand access to services that have been
demonstrated to improve the quality and outcomes of maternity care for
vulnerable populations.</text>
</paragraph><paragraph id="H33052C0BE2504E72BEBFCC8B6D525254"><enum>(3)</enum><text display-inline="yes-display-inline">Establish a demonstration project to
compare the effectiveness of interventions to reduce disparities in maternity
services and outcomes, and implement and assess effective interventions.</text>
</paragraph></subsection><subsection id="H89622B2734A74808BFC64C7AE544FBFB"><enum>(b)</enum><header>Scope and
selection of States for demonstration project</header><text display-inline="yes-display-inline">The demonstration project under subsection
(a)(3) shall be conducted in no more than 8 States, which shall be selected by
the Secretary based on—</text>
<paragraph id="H058F95BA3FD9454691B1A67E7B05BB6C"><enum>(1)</enum><text>applications
submitted by States, which specify which regions and populations the State
involved will serve under the demonstration project;</text>
</paragraph><paragraph id="H675ABC2FC2294709B4DCCA612FC49574"><enum>(2)</enum><text>criteria designed
by the Secretary to ensure that, as a whole, the demonstration project is, to
the greatest extent possible, representative of the demographic and geographic
composition of communities most affected by disparities;</text>
</paragraph><paragraph id="H1008A2B59ADE4FE8A4131FE6ED40A815"><enum>(3)</enum><text>criteria designed
by the Secretary to ensure that a variety of type of models are tested through
the demonstration project and that such models include interventions that have
an existing evidence base for effectiveness; and</text>
</paragraph><paragraph commented="no" id="H3D46BCECD9234228944CF3452993CA1C"><enum>(4)</enum><text>criteria designed
by the Secretary to assure that the demonstration projects and models will be
carried out in consultation with local and regional provider organizations,
such as community health centers, hospital systems, and medical societies
representing providers of maternity services.</text>
</paragraph></subsection><subsection id="H12F7D1CA9BCE44AAA1A7F2018A1C8B9D"><enum>(c)</enum><header>Duration of
demonstration project</header><text>The demonstration project under subsection
(a)(3) shall begin on January 1, 2012, and end on December 31, 2016.</text>
</subsection><subsection id="H216F6C16E98A4036A3A8D55314B6AFE5"><enum>(d)</enum><header>Grants for
evaluation and monitoring</header><text display-inline="yes-display-inline">The
Secretary may make grants to States and health care providers participating in
the demonstration project under subsection (a)(3) for the purpose of collecting
data necessary for the evaluation and monitoring of such project.</text>
</subsection><subsection id="H094CE8311F244E428BA651F3CB805DD5"><enum>(e)</enum><header>Reports</header>
<paragraph id="HC08E5010C1F44F9A911FA62691EF67A9"><enum>(1)</enum><header>State
reports</header><text display-inline="yes-display-inline">Each State that
participates in the demonstration project under subsection (a)(3) shall report
to the Secretary, in a time, form, and manner specified by the Secretary, the
data necessary to—</text>
<subparagraph id="H4222531DDFBB44F88A0E6194D7005974"><enum>(A)</enum><text>monitor
the—</text>
<clause id="HE5CCA6DF3E1E4299A9804FA898F581BB"><enum>(i)</enum><text>outcomes of the
project;</text>
</clause><clause id="H9512C2DBB938428084F064CF0387222E"><enum>(ii)</enum><text>costs of the
project; and</text>
</clause><clause id="H4FBA85CBBEF54DFBA026CA10FFD6D7B9"><enum>(iii)</enum><text>quality of
maternity care provided under the project; and</text>
</clause></subparagraph><subparagraph id="H9E25152D180E43DB8E2A2459F1AC5DBF"><enum>(B)</enum><text>evaluate the
rationale for the selection of the items and services included in any bundled
payment made by the State under the project.</text>
</subparagraph></paragraph><paragraph id="HBCAFE09D349A4B6BB68B1C0B0F011FF1"><enum>(2)</enum><header>Final
report</header><text display-inline="yes-display-inline">Not later than
December 31, 2017, the Secretary shall submit to Congress a report on the
results of the demonstration project under subsection
(a)(3).</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" id="H1DB697BC40A24B2BA94B2ED208E5992D"><enum>507.</enum><header>Decreasing the
risk factors for sudden unexpected infant death and sudden unexplained death in
childhood</header>
<subsection id="H3324D65D0FF544E5B37DF9F69670CE6F"><enum>(a)</enum><header>Establishment</header><text>The
Secretary of Health and Human Services acting through the Administrator of the
Health Resources and Services Administration and in consultation with the
Director of the Centers for Disease Control and Prevention and the Director of
the National Institutes of Health (in this section referred to as the
<term>Secretary</term>) shall establish and implement a culturally competent
public health awareness and education campaign to provide information that is
focused on decreasing the risk factors for sudden unexpected infant death and
sudden unexplained death in childhood, including educating individuals about
safe sleep environments, sleep positions, and reducing exposure to smoking
during pregnancy and after birth.</text>
</subsection><subsection id="H4CDAC7B157DE4207A12B6071B04824B5"><enum>(b)</enum><header>Targeted
Populations</header><text>The campaign under subsection (a) shall be designed
to reduce health disparities through the targeting of populations with high
rates of sudden unexpected infant death and sudden unexplained death in
childhood.</text>
</subsection><subsection id="HC087D493DB234255962B5BC375C308CC"><enum>(c)</enum><header>Consultation</header><text>In
establishing and implementing the campaign under subsection (a), the Secretary
shall consult with national organizations representing health care providers,
including nurses and physicians, parents, child care providers, children's
advocacy and safety organizations, maternal and child health programs and
women’s, infants, and children nutrition professionals, and other individuals
and groups determined necessary by the Secretary for such establishment and
implementation.</text>
</subsection><subsection id="H4ED68EE0C7CF4E07AFD73255EB0FB6D1"><enum>(d)</enum><header>Grants</header>
<paragraph id="H25641FF5F02E48BDB7E91496C902725E"><enum>(1)</enum><header>In
general</header><text>In carrying out the campaign under subsection (a), the
Secretary shall award grants to national organizations, State and local health
departments, and community-based organizations for the conduct of education and
outreach programs for nurses, parents, child care providers, public health
agencies, and community organizations.</text>
</paragraph><paragraph id="H66BEBC0D7932426F8E1BF077FA07E895"><enum>(2)</enum><header>Application</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></subsection><subsection id="H0BE864F26B16442DA0AE6E9FBD17C145"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section such sums as may be necessary for each of fiscal years 2012
through 2016.</text>
</subsection></section><section id="H4E3D2BFC943C45948EF1AE4E28664576"><enum>508.</enum><header>Reducing
teenage pregnancies</header><text display-inline="no-display-inline">Title III
of the Public Health Service Act (42 U.S.C. 241 et seq.) is amended by adding
at the end the following new part:</text>
<quoted-block display-inline="no-display-inline" id="H9A318841A68045F08738142463B7C364" style="OLC">
<part id="HB6284193C232488995EF1F97BCC24247"><enum>W</enum><header>Youth Pregnancy
Prevention Programs</header>
<section id="HD36F2E0063914764A3AE064A135FA3B5"><enum>399OO.</enum><header>Purpose</header><text display-inline="no-display-inline">It is the purpose of this part to develop
and carry out research and demonstration projects on new and existing program
interventions to provide youth in racial or ethnic minority or immigrant
communities the information and skills needed to reduce teenage pregnancies,
build healthy relationships, and improve overall health and well-being.</text>
</section><section id="H93292E7512014E7F8C4FE905119BB133"><enum>399OO–1.</enum><header>Demonstration
grants to reduce teenage pregnancies</header>
<subsection id="H3BA8571A8FFC4FC2A8773D1940A0ED06"><enum>(a)</enum><header>In
general</header><text>The Secretary shall award competitive grants to eligible
entities for establishing or expanding programs to provide youth in racial or
ethnic minority or immigrant communities the information and skills needed to
avoid teenage pregnancy and develop healthy relationships.</text>
</subsection><subsection id="HBDC10511F7C041B3AA9166C1EEE58D50"><enum>(b)</enum><header>Priority</header><text>In
awarding grants under this section, the Secretary shall give priority to
applicants—</text>
<paragraph id="HEB8C77751CE24153BC443EF85D044A37"><enum>(1)</enum><text>proposing to carry
out projects in racial or ethnic minority or immigrant communities;</text>
</paragraph><paragraph id="H6BD9615E04D1474BBBEAD3875104AA0B"><enum>(2)</enum><text>that have a
demonstrated history of effectively working with such targeted communities;
or</text>
</paragraph><paragraph id="H781D733ADE5B4114A3DF3DB78C9F0EE2"><enum>(3)</enum><text>that have a
demonstrated history of engaging in a meaningful and significant partnership
with such targeted communities.</text>
</paragraph></subsection><subsection commented="no" id="H5240835B9C034676814E47B11059DC71"><enum>(c)</enum><header>Program
settings</header><text>Programs funded through a grant under subsection (a)
shall be provided—</text>
<paragraph commented="no" id="H2B6E1583E4AE443DB1667DB42661DBF1"><enum>(1)</enum><text>through
classroom-based settings, such as school health education, humanities, language
arts, or family and consumer science education; after-school programs;
community-based programs; workforce development programs; and health care
settings; or</text>
</paragraph><paragraph commented="no" id="H4C08817C916D4E91AEE742E64CD3D50F"><enum>(2)</enum><text>in collaboration
with systems that serve large numbers of at-risk youth such as juvenile justice
or foster care systems.</text>
</paragraph></subsection><subsection id="HA340CA9B316C4AC8A05B89F34FD44D57"><enum>(d)</enum><header>Project
requirements</header><text>As a condition of receipt of a grant under this
section, an entity shall agree that, with respect to information and skills
provided through the grant—</text>
<paragraph id="HC3E5966869C243E6A9C3F7E0B1ABD2EA"><enum>(1)</enum><text>such information
and skills will be—</text>
<subparagraph id="H09D0F7CDADE2479180BD3BFB8CAE819F"><enum>(A)</enum><text>age-appropriate;</text>
</subparagraph><subparagraph id="H5BC549BD1D1A41979453C015D3E4107E"><enum>(B)</enum><text>evidence-based or
evidence-informed;</text>
</subparagraph><subparagraph commented="no" id="HDB8E3BB1CCE0471C83DA5F831C436B14"><enum>(C)</enum><text>provided in
accordance with section 399OO–5(b); and</text>
</subparagraph><subparagraph id="HCDF7B21F99C1491A93E24DD7C446FB0C"><enum>(D)</enum><text>culturally
sensitive and relevant to the target populations; and</text>
</subparagraph></paragraph><paragraph id="H1E28D65CAFB740B883084DCFC7A3C5B7"><enum>(2)</enum><text display-inline="yes-display-inline">any information provided about
contraceptives shall include the health benefits and side effects of all
contraceptives and barrier methods.</text>
</paragraph></subsection><subsection id="HE99F435BE0CC48DAA895B411BFA498CE"><enum>(e)</enum><header>Evaluation</header><text>Of
the total amount made available to carry out this section for a fiscal year,
the Secretary, acting through the Director of the Centers for Disease Control
and Prevention and other agencies as appropriate, shall allot up to 10 percent
of such amount to carry out a rigorous, independent evaluation to determine the
extent and the effectiveness of activities funded through this section during
such fiscal year in changing attitudes and behavior of teenagers with respect
to healthy relationships and childbearing.</text>
</subsection><subsection id="HFF889411DAA2475095FA44FDE1FE3D91"><enum>(f)</enum><header>Grants for
Indian tribes or tribal organizations</header><text>Of the total amount made
available to carry out this section for a fiscal year, the Secretary shall
reserve 5 percent of such amount to award grants under this section to Indian
tribes and tribal organizations in such manner, and subject to such
requirements, as the Secretary, in consultation with Indian tribes and tribal
organizations, determines appropriate.</text>
</subsection><subsection id="H3053C1A9E81E4DFAB03FE26AFC8933E6"><enum>(g)</enum><header>Eligible entity
defined</header>
<paragraph id="HAE01D043F07C452DA4A83AA201FCD796"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">In this section, the
term <term>eligible entity</term> means a State, local, or tribal agency; a
school or postsecondary institution; an after-school program; a nonprofit
organization; or a community or faith-based organization.</text>
</paragraph><paragraph id="H36F86026162B42FFA56D39977EF46A47"><enum>(2)</enum><header>Preventing
exclusion of smaller community-based organizations</header><text>In carrying
out this section, the Secretary shall ensure that the amounts and requirements
of grants provided under this section do not preclude receipt of such grants by
community-based organizations with a demonstrated history of effectively
working with adolescents in racial or ethnic minority or immigrant communities
or engaged in meaningful and significant partnership with such
communities.</text>
</paragraph></subsection></section><section id="H1F09E751EFE6407294C4286986008AAF"><enum>399OO–2.</enum><header>Multimedia
campaigns to reduce teenage pregnancies</header>
<subsection id="H9DE44ACE992F463195BAC9331E056D63"><enum>(a)</enum><header>In
general</header><text>The Secretary shall award competitive grants to public
and private entities to carry out multimedia campaigns to provide public
education and increase public awareness regarding teenage pregnancy and related
social and emotional issues, such as violence prevention.</text>
</subsection><subsection id="H8CA9AD404457436B8FCAEA8D488CB547"><enum>(b)</enum><header>Priority</header><text>In
awarding grants under this section, the Secretary shall give priority to
applicants proposing to carry out campaigns developed for racial or ethnic
minority or immigrant communities.</text>
</subsection><subsection id="H48464657650D4C24A2B18305C9BAA429"><enum>(c)</enum><header>Information To
be provided</header><text>As a condition of receipt of a grant under this
section, an entity shall agree to use the grant to carry out multimedia
campaigns described in subsection (a) that—</text>
<paragraph id="H95277D70170F4349BAD7DFDBD3CFD8A1"><enum>(1)</enum><text>at a minimum,
shall provide information on—</text>
<subparagraph id="H2C9040C46FFA436DA51206D9583A38A1"><enum>(A)</enum><text>the prevention of
teenage pregnancy; and</text>
</subparagraph><subparagraph id="HB58B176528D04EE5A3DBEC92609ACC0B"><enum>(B)</enum><text>healthy
relationship development; and</text>
</subparagraph></paragraph><paragraph id="HD9EF7ED100CE4853867B7AA6F063A0E2"><enum>(2)</enum><text>may provide
information on the prevention of dating violence.</text>
</paragraph></subsection></section><section id="HE1D929DC4D7849A0A28B18DE32772A77"><enum>399OO–3.</enum><header>Research on
reducing teenage pregnancies and teenage dating violence and improving healthy
relationships</header>
<subsection id="HE665A37069CD484A8C35D2D6128B8571"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, shall make grants to public and private
entities to conduct, support, or coordinate research on teenage pregnancy,
dating violence, and healthy relationships among racial or ethnic minority or
immigrant communities that—</text>
<paragraph id="H9F756C609C744C8FADF9BE971FFD9F99"><enum>(1)</enum><text>improves data
collection on—</text>
<subparagraph id="HD39CAA881AC74B8C86EE156F63EF5FB6"><enum>(A)</enum><text>sexual and
reproductive health, including teenage pregnancies and births, among all
minority communities and subpopulations in which such data are not collected,
including American Indian and Alaska Native youth;</text>
</subparagraph><subparagraph id="H50FF49EEE25C47AB96221BEDC19FCDFE"><enum>(B)</enum><text>sexual behavior,
sexual or reproductive coercion, and teenage contraceptive use patterns at the
State level, as appropriate; and</text>
</subparagraph><subparagraph id="HBEDF48A0E6214EFC897F0ABE91A272AF"><enum>(C)</enum><text>teenage
pregnancies among youth in and aging out of foster care or juvenile justice
systems and the underlying factors that lead to teenage pregnancy among youth
in foster care or juvenile justice systems;</text>
</subparagraph></paragraph><paragraph id="H6107D9F88DA44EEBA860115CEE47BEF4"><enum>(2)</enum><text>investigates—</text>
<subparagraph id="H1B7B723A51B74E39A88236875E90FD5B"><enum>(A)</enum><text>the variance in
the rates of teenage pregnancy by—</text>
<clause id="HA56AE6B3D6D545AF90F9FBFC7BFF45AD"><enum>(i)</enum><text display-inline="yes-display-inline">racial and ethnic group (such as Hispanic,
Asian-American, African-American, Pacific Islander, American Indian, and Alaska
Native); and</text>
</clause><clause id="HB5AC060B4FE94991BC6B52F764E2466C"><enum>(ii)</enum><text display-inline="yes-display-inline">socioeconomic status, including as based on
the income of the family and education attainment;</text>
</clause></subparagraph><subparagraph id="HDC9897287CB744F991C800631683CADD"><enum>(B)</enum><text display-inline="yes-display-inline">factors affecting the risk for youth of
teenage pregnancy or dating abuse, including the physical and social
environment, level of acculturation, access to health care, aspirations for the
future, and history of physical or sexual violence or abuse;</text>
</subparagraph><subparagraph id="H0486C380771B4936BE3CFC76DDF4727D"><enum>(C)</enum><text display-inline="yes-display-inline">the role that violence and abuse play in
teenage sex, pregnancy, and childbearing;</text>
</subparagraph><subparagraph id="H5FBB8878076B4D9C8B22C9F26C56BE7E"><enum>(D)</enum><text>strategies to
address the disproportionate rates of teenage pregnancies and dating violence
in racial or ethnic minority or immigrant communities;</text>
</subparagraph><subparagraph id="H801722551168474AB35FCEC729F5021C"><enum>(E)</enum><text>how effective
interventions can be replicated or adapted in other settings to serve racial or
ethnic minority or immigrant communities; and</text>
</subparagraph><subparagraph id="HBBF9E6C269634AA7A4E81769C67B9D15"><enum>(F)</enum><text display-inline="yes-display-inline">the effectiveness of media campaigns in
addressing healthy relationship development, dating violence prevention, and
teenage pregnancy; and</text>
</subparagraph></paragraph><paragraph id="H9C0F075D19674DD6BF513D7C340DFF68"><enum>(3)</enum><text display-inline="yes-display-inline">tests research-based strategies for
addressing high rates of unintended teenage pregnancy through programs that
emphasize healthy relationships and violence prevention.</text>
</paragraph></subsection><subsection id="H049EA8B63B4C40B09E6E8BFF805E6E55"><enum>(b)</enum><header>Priority</header><text>In
carrying out this section, the Secretary shall give priority to research that
incorporates—</text>
<paragraph id="HF00A149C8F434899827BD47089D6DB9E"><enum>(1)</enum><text>interdisciplinary
approaches;</text>
</paragraph><paragraph id="HC2106B7D9AFE4E8F8D8182AC52B72001"><enum>(2)</enum><text>a strong emphasis
on community-based participatory research; or</text>
</paragraph><paragraph id="H8AE9FB6724434C10A7A3C971403E2FD1"><enum>(3)</enum><text>translational
research.</text>
</paragraph></subsection></section><section commented="no" id="HDBA7710A080A4D75BBDFD53DF70EF9FE"><enum>399OO–4.</enum><header>HHS
adolescent health work group</header>
<subsection commented="no" id="HDF76FC376B4743979610E65D8E3CB520"><enum>(a)</enum><header>Purpose</header><text display-inline="yes-display-inline">Not later than 30 days after the date of
the enactment of this part, the Secretary shall direct the interagency
adolescent health workgroup within the Office of Adolescent Health of the
Department of Health and Human Services to—</text>
<paragraph commented="no" id="H62BB68B73DB24007ADFEEA95EE191700"><enum>(1)</enum><text>include in the
work of the group strategies for teenage dating violence prevention and healthy
teenage relationships with a particular focus among racial or ethnic minority
or immigrant communities; and</text>
</paragraph><paragraph commented="no" id="H2D139DA3228F4507ACD7996A82303C78"><enum>(2)</enum><text display-inline="yes-display-inline">with respect to including such strategies,
consult, to the greatest extent possible, with the Federal Interagency
Workgroup on Teen Dating Violence formed under the leadership of the National
Institute of Justice of the Department of Justice.</text>
</paragraph></subsection><subsection commented="no" id="HB0E331B3E991400A8946475424F49E52"><enum>(b)</enum><header>Report
Requirement</header><text display-inline="yes-display-inline">The Secretary,
through the Office of Adolescent Health, shall periodically submit to Congress
a report that—</text>
<paragraph commented="no" id="H3A82F71EA9FE4C61B2CBF26C66FCB796"><enum>(1)</enum><text>includes a review
of the evidence-based programs on preventing teenage pregnancy, which are
carried out and identified by the Office; and</text>
</paragraph><paragraph commented="no" id="H1709D17C1C6E4FD4AB375CD7CED854D2"><enum>(2)</enum><text>identifies the
programs of the Department of Health and Human Services that include teenage
dating violence prevention and the promotion of healthy teenage relationships
as part of a strategy to prevent teenage pregnancy.</text>
</paragraph></subsection></section><section id="HA6BD1F3EBDB944B09BCD5036BD42A784"><enum>399OO–5.</enum><header>General
grant provisions</header>
<subsection id="H0E9BA27C5ACC4A4D88DD9D34FB72184F"><enum>(a)</enum><header>Applications</header><text>To
seek a grant under this part, an entity shall submit an application to the
Secretary in such form, in such manner, and containing such agreements,
assurances, and information as the Secretary may require.</text>
</subsection><subsection id="HB5676E2B77484B10881EB0FAD7B3E411"><enum>(b)</enum><header>Additional
requirements</header><text>A grant may be made under this part only if the
applicant involved agrees that information, activities, and services provided
under the grant—</text>
<paragraph id="H4BC75A8553D848A59C1ED0763B6E2CDF"><enum>(1)</enum><text>will be
evidence-based or evidence informed;</text>
</paragraph><paragraph id="H1050D35631CD4921A852533CAC5D82EA"><enum>(2)</enum><text>will be factually
and medically accurate and complete; and</text>
</paragraph><paragraph id="H8B20EF59BE264BA9ABF23B7A4C273751"><enum>(3)</enum><text>if directed to a
particular population group, will be provided in an appropriate language and
cultural context.</text>
</paragraph></subsection><subsection id="H22169272C1CD439BBBCAA1270B7E3D25"><enum>(c)</enum><header>Training and
technical assistance</header>
<paragraph id="HA96756489ADA496F8B496C959891E7DD"><enum>(1)</enum><header>In
general</header><text>Of the total amount made available to carry out this part
for a fiscal year, the Secretary shall use 10 percent to provide, directly or
through a competitive grant process, training and technical assistance to the
grant recipients under this part, including by disseminating research and
information regarding effective and promising practices, providing consultation
and resources on a broad array of teenage and unintended pregnancy and violence
prevention strategies, and developing resources and materials.</text>
</paragraph><paragraph id="H2FDF2E1B933944A8A4FFCC5B68872021"><enum>(2)</enum><header>Collaboration</header><text>In
carrying out this subsection, the Secretary shall collaborate with entities
that have expertise in the prevention of teenage pregnancy, healthy
relationship development, minority health and health disparities, and violence
prevention.</text>
</paragraph></subsection></section><section id="HC5998E905E2442DA87AFAF8F29838445"><enum>399OO–6.</enum><header>Definitions</header><text display-inline="no-display-inline">In this part:</text>
<paragraph id="HC72E16450BCB4FF8BA5AA28F8BD4559D"><enum>(1)</enum><header>Medically
accurate and complete</header><text>The term <term>medically accurate and
complete</term> means, with respect to information, activities, or services,
verified or supported by the weight of research conducted in compliance with
accepted scientific methods and—</text>
<subparagraph id="H3025D6EE69EA4F80935C1F0B56002453"><enum>(A)</enum><text>published in
peer-reviewed journals, where applicable; or</text>
</subparagraph><subparagraph id="H49C3B1353B694332A3AF53D658CF84C5"><enum>(B)</enum><text>comprising
information that leading professional organizations and agencies with relevant
expertise in the field recognize as accurate, objective, and complete.</text>
</subparagraph></paragraph><paragraph id="H22D2C35EC1614B69950DA207691A5D84"><enum>(2)</enum><header>Racial or ethnic
minority or immigrant communities</header><text>The term <term>racial or ethnic
minority or immigrant communities</term> means communities with a substantial
number of residents who are members of racial or ethnic minority groups or who
are immigrants.</text>
</paragraph><paragraph id="H0D97817F8E6B411EAA4010F45F214B8F"><enum>(3)</enum><header>Reproductive
coercion</header><text>The term <term>reproductive coercion</term> means, with
respect to a person, coercive behavior that interferes with the ability of such
person to control the reproductive decisionmaking of such person, such as
intentionally exposing such person to sexually transmitted infections; in the
case such person is a female, attempting to impregnate such person against her
will; intentionally interfering with the person’s birth control; or threatening
or acting violent if the person does not comply with the perpetrator’s wishes
regarding contraception or the decision whether to terminate or continue a
pregnancy.</text>
</paragraph><paragraph id="H47BAD01286954890BD10D9BA137D747E"><enum>(4)</enum><header>Youth</header><text>The
term <term>youth</term> means individuals who are 11 to 19 years of age.</text>
</paragraph></section><section id="H5804FF090D634BF3A40D08E97B7B9350"><enum>399OO–7.</enum><header>Reports</header>
<subsection id="H1225173D64A84873AB0D42C2EA4777D6"><enum>(a)</enum><header>Report on use of
funds</header><text>Not later than 1 year after the date of the enactment of
this part, the Secretary shall submit to Congress a report on the use of funds
provided pursuant to this part.</text>
</subsection><subsection id="HF101BBF3517540FEAFAC24D4219712D1"><enum>(b)</enum><header>Report on impact
of programs</header><text display-inline="yes-display-inline">Not later than
March 1, 2016, the Secretary shall submit to Congress a report on the impact
that the programs under this part had on reducing teenage pregnancies.</text>
</subsection></section><section id="H8E65063606F94E91ABF7C4D9D1983C1C"><enum>399OO–8.</enum><header>Authorization
of appropriations</header>
<subsection id="H37DA89E2E1D04DD1A4A376AB512EE784"><enum>(a)</enum><header>In
general</header><text>There are authorized to be appropriated to carry out this
part such sums as may be necessary for each of the fiscal years 2012 through
2016.</text>
</subsection><subsection id="H0E6E23B01D8649EA906C8CF6130050D3"><enum>(b)</enum><header>Availability</header><text>Amounts
appropriated pursuant to subsection (a)—</text>
<paragraph id="H972748DB5FEC437EAF9BB8017EFD0525"><enum>(1)</enum><text>are authorized to
remain available until expended; and</text>
</paragraph><paragraph id="HD859E4F334C045CBB9AB9E88DFFE185E"><enum>(2)</enum><text>are in addition to
amounts otherwise made available for such
purposes.</text>
</paragraph></subsection></section></part><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H3C5A372481324B25983A57EA33B89046"><enum>509.</enum><header>Gestational
diabetes</header><text display-inline="no-display-inline">Part B of title III
of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by adding
after section 317H the following:</text>
<quoted-block display-inline="no-display-inline" id="HC95263BC29D8483BAA7BB5D32712D482" style="OLC">
<section id="H35508075F1D8418C948A71FEFF4AADC3"><enum>317H–1.</enum><header>Gestational
diabetes</header>
<subsection id="H7D3E7AD7EF224EFF8B412166887A9F41"><enum>(a)</enum><header>Understanding
and monitoring gestational diabetes</header>
<paragraph id="H6A7AC97E884D4090897344F3191B96DB"><enum>(1)</enum><header>In
general</header><text>The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, in consultation with the Diabetes Mellitus
Interagency Coordinating Committee established under section 429 and
representatives of appropriate national health organizations, shall develop a
multisite gestational diabetes research project within the diabetes program of
the Centers for Disease Control and Prevention to expand and enhance
surveillance data and public health research on gestational diabetes.</text>
</paragraph><paragraph id="H35496A430AA543F4BC61AA36183B0DC5"><enum>(2)</enum><header>Areas to be
addressed</header><text>The research project developed under paragraph (1)
shall address—</text>
<subparagraph id="H4E2ACAF6E2F04F98AE7062AFBA1A2D7B"><enum>(A)</enum><text>procedures to
establish accurate and efficient systems for the collection of gestational
diabetes data within each State and commonwealth, territory, or possession of
the United States;</text>
</subparagraph><subparagraph id="H4937D1F21112490DBCCB6BD852C94C85"><enum>(B)</enum><text>the progress of
collaborative activities with the National Vital Statistics System, the
National Center for Health Statistics, and State health departments with
respect to the standard birth certificate, in order to improve surveillance of
gestational diabetes;</text>
</subparagraph><subparagraph id="H952F460C51DD4BD7B2F66E9A79543105"><enum>(C)</enum><text display-inline="yes-display-inline">postpartum methods of tracking women with
gestational diabetes after delivery as well as targeted interventions proven to
lower the incidence of type 2 diabetes in that population;</text>
</subparagraph><subparagraph id="HDE37985C77AE4465B1C459F83FFD4749"><enum>(D)</enum><text>variations in the
distribution of diagnosed and undiagnosed gestational diabetes, and of impaired
fasting glucose tolerance and impaired fasting glucose, within and among groups
of women; and</text>
</subparagraph><subparagraph id="HC3D093151BAD49F0AD8B45FD1BC4D4AC"><enum>(E)</enum><text>factors and
culturally sensitive interventions that influence risks and reduce the
incidence of gestational diabetes and related complications during childbirth,
including cultural, behavioral, racial, ethnic, geographic, demographic,
socioeconomic, and genetic factors.</text>
</subparagraph></paragraph><paragraph id="H1CB5E3EA637947E79965E754B613CD0C"><enum>(3)</enum><header>Report</header><text>Not
later than 2 years after the date of the enactment of this section, and
annually thereafter, the Secretary shall generate a report on the findings and
recommendations of the research project including prevalence of gestational
diabetes in the multisite area and disseminate the report to the appropriate
Federal and non-Federal agencies.</text>
</paragraph></subsection><subsection id="H96353E2430EE4449B2CC1768CA2E6C79"><enum>(b)</enum><header>Expansion of
gestational diabetes research</header>
<paragraph id="H2D5C3B5705B343C1BA631743677D32F1"><enum>(1)</enum><header>In
General</header><text display-inline="yes-display-inline">The Secretary shall
expand and intensify public health research regarding gestational diabetes.
Such research may include—</text>
<subparagraph id="H2AFD1DD9873C48E1AD57720CC9782737"><enum>(A)</enum><text>developing and
testing novel approaches for improving postpartum diabetes testing or screening
and for preventing type 2 diabetes in women with a history of gestational
diabetes; and</text>
</subparagraph><subparagraph id="H12BAD380465B48918C32462AAECBE58E"><enum>(B)</enum><text>conducting public
health research to further understanding of the epidemiologic,
socioenvironmental, behavioral, translation, and biomedical factors and health
systems that influence the risk of gestational diabetes and the development of
type 2 diabetes in women with a history of gestational diabetes.</text>
</subparagraph></paragraph><paragraph id="H7CDF2CC1F3904C32BB91CE8F12672E45"><enum>(2)</enum><header>Authorization of
Appropriations</header><text>There is authorized to be appropriated to carry
out this subsection $5,000,000 for each of fiscal years 2012 through
2016.</text>
</paragraph></subsection><subsection id="H20B889BF3F9A4B1E976440486DC11AA9"><enum>(c)</enum><header>Demonstration
grants To lower the rate of gestational diabetes</header>
<paragraph id="HE19369566A8D4E3597B4928344FB0F6A"><enum>(1)</enum><header>In
General</header><text display-inline="yes-display-inline">The Secretary, acting
through the Director of the Centers for Disease Control and Prevention, shall
award grants, on a competitive basis, to eligible entities for demonstration
projects that implement evidence-based interventions to reduce the incidence of
gestational diabetes, the recurrence of gestational diabetes in subsequent
pregnancies, and the development of type 2 diabetes in women with a history of
gestational diabetes.</text>
</paragraph><paragraph id="H5A9956AE388F4B93B40FF68B068B90D8"><enum>(2)</enum><header>Priority</header><text>In
making grants under this subsection, the Secretary shall give priority to
projects focusing on—</text>
<subparagraph id="H73CBB8EE253143E68A233D823C696662"><enum>(A)</enum><text display-inline="yes-display-inline">helping women who have 1 or more risk
factors for developing gestational diabetes;</text>
</subparagraph><subparagraph id="HC9C72583B8034E1FA10F592C1B3293B7"><enum>(B)</enum><text display-inline="yes-display-inline">working with women with a history of
gestational diabetes during a previous pregnancy;</text>
</subparagraph><subparagraph id="HCDBBE2F3E87542D88180EF3750DAB8AE"><enum>(C)</enum><text display-inline="yes-display-inline">providing postpartum care for women with
gestational diabetes;</text>
</subparagraph><subparagraph id="HC7B82BD8E4AB410C80E1081212D674AB"><enum>(D)</enum><text display-inline="yes-display-inline">tracking cases where women with a history
of gestational diabetes developed type 2 diabetes;</text>
</subparagraph><subparagraph id="H5C918F8388574358A106896927786F06"><enum>(E)</enum><text display-inline="yes-display-inline">educating mothers with a history of
gestational diabetes about the increased risk of their child developing
diabetes;</text>
</subparagraph><subparagraph id="HEC824CE1B2564E0CB28139A10E6602A2"><enum>(F)</enum><text display-inline="yes-display-inline">working to prevent gestational diabetes and
prevent or delay the development of type 2 diabetes in women with a history of
gestational diabetes; and</text>
</subparagraph><subparagraph id="HE5E52D7DBF0E40D98B3989747B5BAF21"><enum>(G)</enum><text display-inline="yes-display-inline">achieving outcomes designed to assess the
efficacy and cost-effectiveness of interventions that can inform decisions on
long-term sustainability, including third-party reimbursement.</text>
</subparagraph></paragraph><paragraph id="H53B858EE02174399A9AF319121255067"><enum>(3)</enum><header>Application</header><text>An
eligible entity desiring to receive a grant under this subsection shall submit
to the Secretary—</text>
<subparagraph id="HEB23AC6F6FE0425DA1FF751356E8089A"><enum>(A)</enum><text>an application at
such time, in such manner, and containing such information as the Secretary may
require; and</text>
</subparagraph><subparagraph id="H63CF621B53FE40BCBAE67D34FADFADCE"><enum>(B)</enum><text>a plan to—</text>
<clause id="H06A9F80046A948269A2BF7A76AF20C50"><enum>(i)</enum><text>lower the rate of
gestational diabetes during pregnancy; or</text>
</clause><clause id="HDE65E9D58A434AB58D48C8FFB5EB9FE6"><enum>(ii)</enum><text display-inline="yes-display-inline">develop methods of tracking women with a
history of gestational diabetes and develop effective interventions to lower
the incidence of the recurrence of gestational diabetes in subsequent
pregnancies and the development of type 2 diabetes.</text>
</clause></subparagraph></paragraph><paragraph id="H0C4085CF8630436385AD0C1A1B19E088"><enum>(4)</enum><header>Uses of
Funds</header><text>An eligible entity receiving a grant under this subsection
shall use the grant funds to carry out demonstration projects described in
paragraph (1), including—</text>
<subparagraph id="HE1AAE31D05CE4F3B9B45BC93834B9526"><enum>(A)</enum><text>expanding
community-based health promotion education, activities, and incentives focused
on the prevention of gestational diabetes and development of type 2 diabetes in
women with a history of gestational diabetes;</text>
</subparagraph><subparagraph id="H428DE1ED49D044DA89868E44858F9E66"><enum>(B)</enum><text display-inline="yes-display-inline">aiding State- and tribal-based diabetes
prevention and control programs to collect, analyze, disseminate, and report
surveillance data on women with, and at risk for, gestational diabetes, the
recurrence of gestational diabetes in subsequent pregnancies, and, for women
with a history of gestational diabetes, the development of type 2 diabetes;
and</text>
</subparagraph><subparagraph id="HC2368E6EAD2C455682295165E2695261"><enum>(C)</enum><text>training and
encouraging health care providers—</text>
<clause id="H3DA3C18F6BB1443498B0EBC9DCF96D91"><enum>(i)</enum><text>to
promote risk assessment, high-quality care, and self-management for gestational
diabetes and the recurrence of gestational diabetes in subsequent pregnancies;
and</text>
</clause><clause id="H080C0683B87B4165A28835E4A60CE2C7"><enum>(ii)</enum><text>to prevent the
development of type 2 diabetes in women with a history of gestational diabetes,
and its complications in the practice settings of the health care
providers.</text>
</clause></subparagraph></paragraph><paragraph id="H44695CE2E12A4DE4BE14E19B5B0A4DF9"><enum>(5)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 4 years after the date of
the enactment of this section, the Secretary shall prepare and submit to the
Congress a report concerning the results of the demonstration projects
conducted through the grants awarded under this subsection.</text>
</paragraph><paragraph id="HEFA4F3636C654DAA9780F5B268D64B35"><enum>(6)</enum><header>Definition of
Eligible Entity</header><text>In this subsection, the term <term>eligible
entity</term> means a nonprofit organization (such as a nonprofit academic
center or community health center) or a State, tribal, or local health
agency.</text>
</paragraph><paragraph id="HA6B165806E0F498A86950BE0A69C28ED"><enum>(7)</enum><header>Authorization of
Appropriations</header><text>There is authorized to be appropriated to carry
out this subsection $5,000,000 for each of fiscal years 2012 through
2016.</text>
</paragraph></subsection><subsection id="HBF15729936734FA2AD1E9747D8C40E71"><enum>(d)</enum><header>Postpartum
follow-Up regarding gestational diabetes</header><text>The Secretary, acting
through the Director of the Centers for Disease Control and Prevention, shall
work with the State- and tribal-based diabetes prevention and control programs
assisted by the Centers to encourage postpartum follow-up after gestational
diabetes, as medically appropriate, for the purpose of reducing the incidence
of gestational diabetes, the recurrence of gestational diabetes in subsequent
pregnancies, the development of type 2 diabetes in women with a history of
gestational diabetes, and related
complications.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" id="HFE3FC13C62814E45AC7961D159B9DD8A"><enum>510.</enum><header>Emergency
contraception education and information programs</header>
<subsection commented="no" id="HA076E83440BF4CD5B5359AE60271ADE9"><enum>(a)</enum><header>Emergency
Contraception Public Education Program</header>
<paragraph commented="no" id="HDA4B8021DE4F4F3B874117ECF800E881"><enum>(1)</enum><header>In
general</header><text>The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, shall develop and disseminate to the public
information on emergency contraception.</text>
</paragraph><paragraph commented="no" id="H771E2FDF240440078279CCB2679FBED0"><enum>(2)</enum><header>Dissemination</header><text>The
Secretary may disseminate information under paragraph (1) directly or through
arrangements with nonprofit organizations, consumer groups, institutions of
higher education, clinics, the media, and Federal, State, and local
agencies.</text>
</paragraph><paragraph commented="no" id="H2338C3DC34A94969A4CE299C4AAA97A2"><enum>(3)</enum><header>Information</header><text>The
information disseminated under paragraph (1) shall include, at a minimum, a
description of emergency contraception and an explanation of the use, safety,
efficacy, and availability of such contraception.</text>
</paragraph></subsection><subsection commented="no" id="H3184B9EBB16C49F6932EF9C46546F106"><enum>(b)</enum><header>Emergency
Contraception Information Program for Health Care Providers</header>
<paragraph commented="no" id="H6B0E86B1AED84128A749FF4511F6EEF1"><enum>(1)</enum><header>In
general</header><text>The Secretary, acting through the Administrator of the
Health Resources and Services Administration and in consultation with major
medical and public health organizations, shall develop and disseminate to
health care providers information on emergency contraception.</text>
</paragraph><paragraph commented="no" id="H0B1DF55A4BB94E3B8E1AF4D556FDB8EE"><enum>(2)</enum><header>Information</header><text>The
information disseminated under paragraph (1) shall include, at a
minimum—</text>
<subparagraph commented="no" id="HB97F8A8FB94B4B528064A3E95D3D6EAC"><enum>(A)</enum><text>information
describing the use, safety, efficacy, and availability of emergency
contraception;</text>
</subparagraph><subparagraph commented="no" id="H470A84A7D17B497795A42BD6C1517AFC"><enum>(B)</enum><text>a recommendation
regarding the use of such contraception in appropriate cases; and</text>
</subparagraph><subparagraph commented="no" id="H2AFE68EC1E854596BB5899E4DF8DBD42"><enum>(C)</enum><text>information
explaining how to obtain copies of the information developed under subsection
(a) for distribution to the patients of the providers.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="HFF74E44029A74A968863EDE89AA7851B"><enum>(c)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph commented="no" id="H2815BDA8A82F44D3825EC5C417F0EBB6"><enum>(1)</enum><header>Emergency
contraception</header><text>The term <term>emergency contraception</term> means
a drug or device (as the terms are defined in section 201 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 321)) or a drug regimen that—</text>
<subparagraph commented="no" id="H96A5332E362D438E8F84643EE45A1D06"><enum>(A)</enum><text>is used
postcoitally;</text>
</subparagraph><subparagraph commented="no" id="H74D54D93D9334F6EBF022756AD4A9ECB"><enum>(B)</enum><text>prevents pregnancy
primarily by preventing or delaying ovulation, and does not terminate an
established pregnancy; and</text>
</subparagraph><subparagraph commented="no" id="HDFAD3E76D5004E859ACC116863D88CFA"><enum>(C)</enum><text>is approved by the
Food and Drug Administration.</text>
</subparagraph></paragraph><paragraph commented="no" id="H35AEBBA8ACCC4F8F9A56A1065748C113"><enum>(2)</enum><header>Health care
provider</header><text>The term <term>health care provider</term> means an
individual who is licensed or certified under State law to provide health care
services and who is operating within the scope of such license. Such term shall
include a pharmacist.</text>
</paragraph><paragraph commented="no" id="HC94F2C1729CE4D0CA8A80A98D060BE69"><enum>(3)</enum><header>Institution of
higher education</header><text>The term <term>institution of higher
education</term> has the same meaning given such term in section 101(a) of the
Higher Education Act of 1965 (20 U.S.C. 1001(a)).</text>
</paragraph><paragraph commented="no" id="HA8ED4DDE9A5D4885908E6DE5BED6C393"><enum>(4)</enum><header>Secretary</header><text>The
term <term>Secretary</term> means the Secretary of Health and Human
Services.</text>
</paragraph></subsection><subsection commented="no" id="HB0F602BA3031477C885EBF25A45FB2C7"><enum>(d)</enum><header>Authorization of
Appropriations</header><text>There are authorized to be appropriated to carry
out this section such sums as may be necessary for each of the fiscal years
2012 through 2016.</text>
</subsection></section><section id="H762E020A31E2461293E0D68D5BF74D94"><enum>511.</enum><header>Supporting
healthy adolescent development</header>
<subsection id="HD4D637F4C7A24C7EBB93FB1C9968FAA5"><enum>(a)</enum><header>In
General</header><text>The Secretary may award a grant to each eligible State to
conduct programs of sex education described in subsection (b), including
education on both abstinence and contraception for the prevention of teenage
pregnancy and sexually transmitted diseases, including HIV/AIDS.</text>
</subsection><subsection id="H6635EA3BE30744B189632724C04CC2B4"><enum>(b)</enum><header>Requirements for
Sex Education Programs</header><text>A program of sex education described in
this subsection is a program that—</text>
<paragraph id="H46D208A9EC6B47C5AFA0FE6BC3FB0A79"><enum>(1)</enum><text>is age appropriate
and medically accurate;</text>
</paragraph><paragraph id="H9B67C2C7B6E345F8B13190AC67F33849"><enum>(2)</enum><text>stresses the value
of abstinence while not ignoring those young people who have been or are
sexually active;</text>
</paragraph><paragraph id="H88ADB7B375A84613A5278486C32D56EC"><enum>(3)</enum><text>provides
information about the health benefits and side effects of contraceptive and
barrier methods used—</text>
<subparagraph id="H315A48A0837948EFA2BAABA26DE1AAF6"><enum>(A)</enum><text>as a means to
prevent pregnancy; and</text>
</subparagraph><subparagraph id="H0ACF515516854347A8E8F0D284092B0E"><enum>(B)</enum><text>to reduce the risk
of contracting sexually transmitted disease, including HIV/AIDS;</text>
</subparagraph></paragraph><paragraph id="HBB1A4547B44346DCB3BB9C7B37BF7353"><enum>(4)</enum><text>encourages family
communication between parent and child about sexuality;</text>
</paragraph><paragraph id="HB1D4573B5CEB45D2A1F0BB687B0EF5CD"><enum>(5)</enum><text>cultivates a
respectful dialogue about sexuality, including sexual orientation and gender
identity, and embraces the principles of nondiscrimination based on sexual
orientation and gender identity;</text>
</paragraph><paragraph id="H66394A1EDACA415DAE41CBA7BD0FBC44"><enum>(6)</enum><text>counters the
perpetuation of narrow gender roles, including the sexualization of female
children, adolescents, and adults;</text>
</paragraph><paragraph id="H06F995AA660E4B5CB4B7F5C9E8CA1937"><enum>(7)</enum><text>teaches young
people the skills to make responsible decisions about sexuality, including how
to avoid unwanted verbal, physical, and sexual advances and how to avoid making
verbal, physical, and sexual advances that are not wanted by the other
party;</text>
</paragraph><paragraph id="HA38A5534E93149C2A001CDA110FDD80A"><enum>(8)</enum><text>develops healthy
relationships, including the prevention of dating and sexual violence;</text>
</paragraph><paragraph id="H6FDE885A99C448338C5EC1D037F78D85"><enum>(9)</enum><text>teaches young
people how alcohol and drug use can affect responsible decisionmaking;
and</text>
</paragraph><paragraph id="H69F9068D102D45A38668DE5699D2329C"><enum>(10)</enum><text>does not teach or
promote religion.</text>
</paragraph></subsection><subsection id="H7F03FE324CC041389155F93CFC6CDD9D"><enum>(c)</enum><header>Additional
Activities</header><text>In carrying out a program of sex education, a State
may expend grant funds awarded under subsection (a) to carry out educational
and motivational activities that help young people—</text>
<paragraph id="H7B9CD0251A444631A7C9BF968F8A00CD"><enum>(1)</enum><text>gain knowledge
about the physical, emotional, biological, and hormonal changes of adolescence
and subsequent stages of human maturation;</text>
</paragraph><paragraph id="H8BF1795C85594A88B93A9FDE9A138643"><enum>(2)</enum><text>develop the
knowledge and skills necessary to ensure and protect their sexual and
reproductive health from unintended pregnancy and sexually transmitted disease,
including HIV/AIDS, throughout their lifespan;</text>
</paragraph><paragraph id="HFEBC965F9553432392EFC35EEB7083D9"><enum>(3)</enum><text>gain knowledge
about the specific involvement and responsibility of each individual in sexual
decisionmaking;</text>
</paragraph><paragraph id="HAE100BCD2CB3411DA7361D5E4C3A27E3"><enum>(4)</enum><text>develop healthy
attitudes and values about adolescent growth and development, body image,
gender roles, racial and ethnic diversity, sexual orientation and gender
identity, and other subjects;</text>
</paragraph><paragraph id="H90C5462099144771B07F4CD8CC87AD69"><enum>(5)</enum><text>develop and
practice healthy life skills including goal-setting, decisionmaking,
negotiation, communication, and stress management; and</text>
</paragraph><paragraph id="HD77A03BE42774426A1884F8D3A0677DA"><enum>(6)</enum><text>promote
self-esteem and positive interpersonal skills focusing on relationship
dynamics, including friendships, dating, romantic involvement, marriage, and
family interactions.</text>
</paragraph></subsection><subsection commented="no" id="HD5694412243349D2B349E9665BCE71B9"><enum>(d)</enum><header>Matching
funds</header><text display-inline="yes-display-inline">The Secretary may not
make payments to a State under this section in an amount exceeding Federal
medical assistance percentage for such State (as such term is defined in
section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b))) of the costs
of the programs conducted by the State under this section.</text>
</subsection><subsection id="HC8CEF139EA644BFBA3CFE9ACC4DFF45D"><enum>(e)</enum><header>Evaluation of
programs</header>
<paragraph id="H5BDB914F41FF46F5AEDC41BF575A054B"><enum>(1)</enum><header>In
General</header><text>For the purpose of evaluating the effectiveness of
programs of sex education carried out with a grant under this section,
evaluations shall be carried out in accordance with paragraphs (2) and
(3).</text>
</paragraph><paragraph id="H08599B5C76704F21BDA134F86BE15286"><enum>(2)</enum><header>National
Evaluation</header>
<subparagraph id="H7CDE1DA5245D43A69C914B66771ABB57"><enum>(A)</enum><header>Method</header><text>The
Secretary shall provide for a national evaluation of a representative sample of
programs of sex education carried out with grants under this section to
determine—</text>
<clause id="HA66647975BDA43A7A4C1BAF6AA2041C6"><enum>(i)</enum><text>the
effectiveness of such programs in helping to delay the initiation of sexual
intercourse and other high-risk behaviors;</text>
</clause><clause id="H4C1F6CC3C6AA4564B64AA626D2B537BF"><enum>(ii)</enum><text>the
effectiveness of such programs in preventing adolescent pregnancy;</text>
</clause><clause id="HE617BCC1D24046F2875014F53C93ADCE"><enum>(iii)</enum><text>the
effectiveness of such programs in preventing sexually transmitted disease,
including HIV/AIDS;</text>
</clause><clause id="H7554461566FA48AE8D14164A38922249"><enum>(iv)</enum><text>the
effectiveness of such programs in increasing contraceptive knowledge and
contraceptive behaviors when sexual intercourse occurs; and</text>
</clause><clause id="H89B73016CBDE4C02812A54ED3560A561"><enum>(v)</enum><text>a
list of best practices based upon essential programmatic components of
evaluated programs that have led to success described in clauses (i) through
(iv).</text>
</clause></subparagraph><subparagraph id="HB44567E03DAD45798C48EF396BFCABE9"><enum>(B)</enum><header>Grant
condition</header><text>A condition for the receipt of a grant to a State under
this section is that the State cooperate with the evaluation under subparagraph
(A).</text>
</subparagraph><subparagraph id="HDA12C1ACEE5247E9B4D125F840A64D7E"><enum>(C)</enum><header>Report</header><text>The
Secretary shall submit to the Congress—</text>
<clause id="H0EA25642D26F47309E8586E3CDFEA6AC"><enum>(i)</enum><text>not
later than the end of each fiscal year during the 5-year period beginning with
fiscal year 2012, an interim report on the national evaluation under
subparagraph (A); and</text>
</clause><clause id="HF1C5F58FDA1549FE9B456A56FC1FCB94"><enum>(ii)</enum><text>not
later than March 31, 2017, a final report providing the results of such
national evaluation.</text>
</clause></subparagraph></paragraph><paragraph id="H455EC87A03A542AD9842B774C87E6D29"><enum>(3)</enum><header>Individual State
Evaluations</header><text display-inline="yes-display-inline">A condition for
the receipt of a grant under this section is that the State evaluate of the
programs of sex education funded through such grant in accordance with the
following requirements:</text>
<subparagraph id="HB8CD5DAD99474FDD99662EB8C4CE6A5F"><enum>(A)</enum><text>The evaluation
will be conducted by an external, independent entity.</text>
</subparagraph><subparagraph id="H59708C3E86C64AE1A68AB02D375C2FCD"><enum>(B)</enum><text>The purposes of
the evaluation will be the determination of—</text>
<clause id="H523F151156074CC1BAF6FE1A3A2A4C5F"><enum>(i)</enum><text>the
effectiveness of such programs in helping to delay the initiation of sexual
intercourse and other high-risk behaviors;</text>
</clause><clause id="HE527534929E54BB5873FB4F2F930DBB8"><enum>(ii)</enum><text>the
effectiveness of such programs in preventing adolescent pregnancy;</text>
</clause><clause id="H4541443301704129BE61C151A057D3E0"><enum>(iii)</enum><text>the
effectiveness of such programs in preventing sexually transmitted disease,
including HIV/AIDS; and</text>
</clause><clause id="HC5CF8F246756454C87F3A40383569F71"><enum>(iv)</enum><text display-inline="yes-display-inline">the effectiveness of such programs in
increasing contraceptive and barrier method knowledge and contraceptive
behaviors when sexual intercourse occurs.</text>
</clause></subparagraph></paragraph></subsection><subsection id="H33577075EC834C4C8FF60822FA98DBE7"><enum>(f)</enum><header>Limitations on
use of funds</header>
<paragraph id="H3EDC68A6268D480D8FB4E62634A046C2"><enum>(1)</enum><header>Limitations on
Secretary</header><text>Of the amounts appropriated for a fiscal year for
purposes of this section, the Secretary may not use more than—</text>
<subparagraph id="H8079DE6577B441A5B1C34F1C3FDFDA38"><enum>(A)</enum><text>7 percent of such
amounts for administrative expenses related to carrying out this section for
that fiscal year; and</text>
</subparagraph><subparagraph id="HD0634705B4A7402AAF11B5F32FD63317"><enum>(B)</enum><text>10 percent of such
amounts for the national evaluation under subsection (e)(2).</text>
</subparagraph></paragraph><paragraph id="H4D5E5C3E631D46178887B33693F6261E"><enum>(2)</enum><header>Limitations to
states</header><text>Of amounts provided to an eligible State under this
subsection, the State may not use more than 10 percent of the grant to conduct
any evaluation under subsection (e)(3).</text>
</paragraph></subsection><subsection id="H6288BCEC129F426AB4EAE954ECD75AF6"><enum>(g)</enum><header>Nondiscrimination
required</header><text>Programs funded under this section shall not
discriminate on the basis of sex, race, ethnicity, national origin, disability,
religion, marital status, familial status, sexual orientation, or gender
identity. Nothing in this section shall be construed to invalidate or limit
rights, remedies, procedures, or legal standards available to victims of
discrimination under any other Federal law or any law of a State or a political
subdivision of a State, including title VI of the Civil Rights Act of 1964 (42
U.S.C. 2000d et seq.), title IX of the Education Amendments of 1972 (20 U.S.C.
1681 et seq.), section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794),
and the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et
seq.).</text>
</subsection><subsection id="H61AA1EB8E8AB449F8B34AF2BA0E03456"><enum>(h)</enum><header>Definitions</header><text>For
purposes of this section:</text>
<paragraph id="H5C1B2877218B451EB692B54B72B4539D"><enum>(1)</enum><text>The term <term>age
appropriate</term> means, with respect to topics, messages, and teaching
methods, those suitable to particular ages or age groups of children,
adolescents, and adults, based on developing cognitive, emotional, and
behavioral capacity typical for the age or age group.</text>
</paragraph><paragraph id="HBA2E3B0C06604C9A994BFB7FFF783B84"><enum>(2)</enum><text>The term
<term>eligible State</term> means a State that submits to the Secretary an
application for a grant under this section that is in such form, is made in
such manner, and contains such agreements, assurances, and information as the
Secretary determines to be necessary to carry out this section.</text>
</paragraph><paragraph id="H1F335F848D8448748433F68483C87934"><enum>(3)</enum><text>The term
<term>HIV/AIDS</term> means the human immunodeficiency virus, and includes
acquired immune deficiency syndrome.</text>
</paragraph><paragraph id="H29E83A88E51445F78B644B57E3EBC3BD"><enum>(4)</enum><text display-inline="yes-display-inline">The term <term>medically accurate</term>,
with respect to information, means information that is supported by research,
recognized as accurate and objective by leading medical, psychological,
psychiatric, and public health organizations and agencies, and, published in
journals that are peer reviewed.</text>
</paragraph><paragraph id="H92B7618167594C558C39A0851AEE32DD"><enum>(5)</enum><text>The term
<term>State</term> means the 50 States, the District of Columbia, the
Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana Islands,
American Samoa, Guam, the United States Virgin Islands, and any other territory
or possession of the United States.</text>
</paragraph></subsection><subsection id="HEE4808C9EC39400AAE32BD4D47E41F6D"><enum>(i)</enum><header>Authorization of
appropriations</header><text>For the purpose of carrying out this section,
there is authorized to be appropriated $50,000,000 for each of the fiscal years
2012 through 2016.</text>
</subsection></section><enum>VI</enum><header>MENTAL HEALTH
</header>
<section commented="no" display-inline="no-display-inline" id="HA990440DD68F48CB9E4D97A503A3F84C" section-type="subsequent-section"><enum>601.</enum><header>Coverage of marriage
and family therapist services and mental health counselor services under part
<enum-in-header>B</enum-in-header> of the Medicare program</header>
<subsection commented="no" id="H68FA6081DE444B76A13A3D858A503CFF"><enum>(a)</enum><header>Coverage of
Services</header>
<paragraph commented="no" id="HB4106AC96B894ABDACAF5E1C01BD1F65"><enum>(1)</enum><header>In
general</header><text>Section 1861(s)(2) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 1395x(s)(2)) is
amended—</text>
<subparagraph commented="no" id="H713A8FBF562F42588F0CED6D60D2A803"><enum>(A)</enum><text>in subparagraph
(EE), by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph commented="no" id="H5A2700F1A35E41C3BB58ED92D3C3B582"><enum>(B)</enum><text>in subparagraph
(FF), by inserting <quote>and</quote> at the end; and</text>
</subparagraph><subparagraph commented="no" id="H1AE891EA4DED4BDDADE40076687E8AA3"><enum>(C)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block id="H05DB4E56CF174A59B7917BD9C8767576" style="OLC">
<subitem commented="no" id="H952FC507572A4F2E8E01E6C9D9FF238E" indent="up5"><enum>(GG)</enum><text>marriage and family therapist
services (as defined in subsection (kkk)(1)) and mental health counselor
services (as defined in subsection
(kkk)(3));</text>
</subitem><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph commented="no" id="H2F62C880FD214F6E9D8C260DBFED82EB"><enum>(2)</enum><header>Definitions</header><text>Section
1861 of such Act (42 U.S.C. 1395x), as amended by sections 202(b)(1)(A) and
423(a), is amended by adding at the end the following new subsection:</text>
<quoted-block act-name="Social" id="H1438BEA5C7604263A3050462D8F13571" other-style="archaic" style="other"><subsection commented="no" id="HCAE1FE6BFBE14C1B9FB065DCCCDDF5D0"><enum>(kkk)</enum><header>Marriage and Family
Therapist Services; Marriage and Family Therapist; Mental Health Counselor
Services; Mental Health Counselor</header><paragraph commented="no" display-inline="yes-display-inline" id="H1FB9DAD39E274EF6B41C33F7B5EFFD9C"><enum>(1)</enum><text>The term <term>marriage
and family therapist services</term> means services performed by a marriage and
family therapist (as defined in paragraph (2)) for the diagnosis and treatment
of mental illnesses, which the marriage and family therapist is legally
authorized to perform under State law (or the State regulatory mechanism
provided by State law) of the State in which such services are performed, as
would otherwise be covered if furnished by a physician or as an incident to a
physician’s professional service, but only if no facility or other provider
charges or is paid any amounts with respect to the furnishing of such
services.</text>
</paragraph><paragraph commented="no" id="HF2F91962BA8243B499B85AC282814DFB" indent="up1"><enum>(2)</enum><text>The term <term>marriage and family
therapist</term> means an individual who—</text>
<subparagraph commented="no" id="H1290DF1F5FB84B7AB920297A1C59BBDE"><enum>(A)</enum><text>possesses a master’s or doctoral
degree which qualifies for licensure or certification as a marriage and family
therapist pursuant to State law;</text>
</subparagraph><subparagraph commented="no" id="H38454399DBBA472DAF06BBEAE329B057"><enum>(B)</enum><text>after obtaining such degree has
performed at least 2 years of clinical supervised experience in marriage and
family therapy; and</text>
</subparagraph><subparagraph commented="no" id="HD3575A074304415FBAF96C6B6D22E05B"><enum>(C)</enum><text>in the case of an individual
performing services in a State that provides for licensure or certification of
marriage and family therapists, is licensed or certified as a marriage and
family therapist in such State.</text>
</subparagraph></paragraph><paragraph commented="no" id="HA8AAEDC62ED24538A5229F8809756799" indent="up1"><enum>(3)</enum><text>The term <term>mental health
counselor services</term> means services performed by a mental health counselor
(as defined in paragraph (4)) for the diagnosis and treatment of mental
illnesses which the mental health counselor is legally authorized to perform
under State law (or the State regulatory mechanism provided by the State law)
of the State in which such services are performed, as would otherwise be
covered if furnished by a physician or as incident to a physician’s
professional service, but only if no facility or other provider charges or is
paid any amounts with respect to the furnishing of such services.</text>
</paragraph><paragraph commented="no" id="H25805A75F7C94081BAFCCF507AEFBCE8" indent="up1"><enum>(4)</enum><text>The term <term>mental health
counselor</term> means an individual who—</text>
<subparagraph commented="no" id="HC7D46F1B1D294A00A5ED2DC1909A8407"><enum>(A)</enum><text>possesses a master’s or doctor’s
degree in mental health counseling or a related field;</text>
</subparagraph><subparagraph commented="no" id="HA8EE1618426C4F4A851824C778B28330"><enum>(B)</enum><text>after obtaining such a degree has
performed at least 2 years of supervised mental health counselor practice;
and</text>
</subparagraph><subparagraph commented="no" id="H5332FA7E3F15460DB90BD150B3B730BE"><enum>(C)</enum><text>in the case of an individual
performing services in a State that provides for licensure or certification of
mental health counselors or professional counselors, is licensed or certified
as a mental health counselor or professional counselor in such
State.</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" id="H8572C7BA7212488BBF82EF08141BB39D"><enum>(3)</enum><header>Provision for
payment under part B</header><text>Section 1832(a)(2)(B) of such Act (42 U.S.C.
1395k(a)(2)(B)) is amended by adding at the end the following new
clause:</text>
<quoted-block act-name="Social" id="HDA6EC15688E94534968BE059EA52D941" style="OLC">
<clause commented="no" id="H4D79F362C05E413295ACECF2CC848ACA"><enum>(v)</enum><text>marriage and
family therapist services and mental health counselor
services;</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" id="HEF71F0982B844184B323725B64901237"><enum>(4)</enum><header>Amount of
payment</header><text>Section 1833(a)(1) of such Act (42 U.S.C. 1395l(a)(1)) is
amended—</text>
<subparagraph commented="no" id="HDE89347219124CF09EBE5A031644694D"><enum>(A)</enum><text>by striking
<quote>and (Z)</quote> and inserting <quote>(Z)</quote>; and</text>
</subparagraph><subparagraph commented="no" id="H6CCDC1AD57B2460297934EB79A8284A7"><enum>(B)</enum><text>by inserting
before the semicolon at the end the following: <quote>, and (AA) with respect
to marriage and family therapist services and mental health counselor services
under section 1861(s)(2)(GG), the amounts paid shall be 80 percent of the
lesser of the actual charge for the services or 75 percent of the amount
determined for payment of a psychologist under subparagraph (L)</quote>.</text>
</subparagraph></paragraph><paragraph commented="no" id="HDF4D6B388C3C4AC5B4AE67EA774EE4BD"><enum>(5)</enum><header>Exclusion of
marriage and family therapist services and mental health counselor services
from skilled nursing facility prospective payment system</header><text>Section
1888(e)(2)(A)(ii) of such Act (42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended by
inserting <quote>marriage and family therapist services (as defined in section
1861(kkk)(1)), mental health counselor services (as defined in section
1861(kkk)(3)),</quote> after <quote>qualified psychologist
services,</quote>.</text>
</paragraph><paragraph commented="no" id="H8C559692C6684EB7875CAFC7285C6AC4"><enum>(6)</enum><header>Inclusion of
marriage and family therapists and mental health counselors as practitioners
for assignment of claims</header><text>Section 1842(b)(18)(C) of such Act (42
U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following new
clauses:</text>
<quoted-block act-name="Social" id="H2FD66F3238A14806AFA243151DDB1104" style="OLC">
<clause commented="no" id="HAC5253037CC3417C9F1FC3D0C1F01C7E" indent="up2"><enum>(vii)</enum><text>A marriage and family therapist (as
defined in section 1861(kkk)(2)).</text>
</clause><clause commented="no" id="H00872B6C6B254A788770BABCF0B14792" indent="up2"><enum>(viii)</enum><text>A mental health counselor (as
defined in section
1861(kkk)(4)).</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="HD94BD5FC90394873833FEA127CDCCE1B"><enum>(b)</enum><header>Coverage of
Certain Mental Health Services Provided in Certain Settings</header>
<paragraph commented="no" id="H8A9CDA9136CA439EA19C9E9CE640499B"><enum>(1)</enum><header>Rural health
clinics and federally qualified health centers</header><text>Section
1861(aa)(1)(B) of the <act-name parsable-cite="SSA">Social Security
Act</act-name> (42 U.S.C. 1395x(aa)(1)(B)) is amended by striking <quote>or by
a clinical social worker (as defined in subsection (hh)(1)),</quote> and
inserting <quote>, by a clinical social worker (as defined in subsection
(hh)(1)), by a marriage and family therapist (as defined in subsection
(kkk)(2)), or by a mental health counselor (as defined in subsection
(kkk)(4)),</quote>.</text>
</paragraph><paragraph commented="no" id="HE1DF01BED5E449869149529C41CCB9F0"><enum>(2)</enum><header>Hospice
programs</header><text>Section 1861(dd)(2)(B)(i)(III) of such Act (42 U.S.C.
1395x(dd)(2)(B)(i)(III)) is amended by inserting <quote>or one marriage and
family therapist (as defined in subsection (kkk)(2))</quote> after
<quote>social worker</quote>.</text>
</paragraph></subsection><subsection commented="no" id="H72576ABD86EC4BE8993AFF3952A210BF"><enum>(c)</enum><header>Authorization of
Marriage and Family Therapists To Develop Discharge Plans for Post-Hospital
Services</header><text>Section 1861(ee)(2)(G) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1395x(ee)(2)(G)) is amended by inserting <quote>marriage and family therapist
(as defined in subsection (kkk)(2)),</quote> after <quote>social
worker,</quote>.</text>
</subsection><subsection commented="no" id="H2834AC3D161141E489FF3B24CB8C1E93"><enum>(d)</enum><header>Effective
Date</header><text>The amendments made by this section shall apply with respect
to services furnished on or after January 1, 2012.</text>
</subsection></section><section commented="no" id="H309D0816822B46398145144B05DA76B3"><enum>602.</enum><header>Community
Mental Health and Addiction Safety Net Equity Act</header>
<subsection commented="no" id="H7AF3D399EE4347C1855694EAF0A12C05"><enum>(a)</enum><header>Federally
Qualified Behavioral Health Centers</header><text>Section 1913 of the Public
Health Service Act (42 U.S.C. 300x–3) is amended—</text>
<paragraph commented="no" id="H372FE79B485D463B9A3DFF9E0BCA6C9E"><enum>(1)</enum><text>in subsection
(a)(2)(A), by striking <quote>community mental health services</quote> and
inserting <quote>behavioral health services (of the type offered by federally
qualified behavioral health centers consistent with subsection
(c)(3))</quote>;</text>
</paragraph><paragraph commented="no" id="H7ED3C559C0C2442A8056680C931E2D76"><enum>(2)</enum><text>in subsection
(b)—</text>
<subparagraph commented="no" id="H284AB3D923DF4A9D8DD8CF732BC06A5F"><enum>(A)</enum><text>by striking
paragraph (1) and inserting the following:</text>
<quoted-block id="H28DD3AF49FBD473F9182B91226A17603" style="OLC">
<paragraph commented="no" id="HFC4D41C4D76743C39CBE086F57545507"><enum>(1)</enum><text>services under the
plan will be provided only through appropriate, qualified community programs
(which may include federally qualified behavioral health centers, child mental
health programs, psychosocial rehabilitation programs, mental health
peer-support programs, and mental health primary consumer-directed programs);
and</text>
</paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph><subparagraph commented="no" id="HF98A606BC7714D6CB775D94F337D1A48"><enum>(B)</enum><text>in paragraph (2),
by striking <quote>community mental health centers</quote> and inserting
<quote>federally qualified behavioral health centers</quote>; and</text>
</subparagraph></paragraph><paragraph commented="no" id="HE308DB34796E48E19E898D3B2E308550"><enum>(3)</enum><text>by striking
subsection (c) and inserting the following:</text>
<quoted-block id="HF61422C601574F54A6EC2816A96EDEC1" style="OLC">
<subsection commented="no" id="HFD12B99ECDAB49D0B9CECF954CCCFBAD"><enum>(c)</enum><header>Criteria for
Federally Qualified Behavioral Health Centers</header>
<paragraph commented="no" id="H538D5E47266547E699746F21AFA33CB1"><enum>(1)</enum><header>In
general</header><text>The Administrator shall certify, and recertify at least
every 5 years, federally qualified behavioral health centers as meeting the
criteria specified in this subsection.</text>
</paragraph><paragraph commented="no" id="HEAD9EC642858423C963AA1C4915BEA34"><enum>(2)</enum><header>Regulations</header><text display-inline="yes-display-inline">Not later than 18 months after the date of
the enactment of this section, the Administrator shall issue final regulations
for certifying nonprofit or local government centers as centers under paragraph
(1).</text>
</paragraph><paragraph commented="no" id="H675B17BF73C44546AD48411C57648701"><enum>(3)</enum><header>Criteria</header><text>The
criteria referred to in subsection (b)(2) are that the center performs each of
the following:</text>
<subparagraph commented="no" id="H646185A1EF5B4DB99BC2FB59CD9D5253"><enum>(A)</enum><text display-inline="yes-display-inline">Provide services in locations that ensure
services will be promptly available, be physically accessible, provide
reasonable policy modifications, and be provided in a manner which preserves
human dignity and assures continuity of care.</text>
</subparagraph><subparagraph commented="no" id="HEE17BBB83C0545E887B037D1C1E954F0"><enum>(B)</enum><text>Provide services
in a mode of service delivery appropriate for the target population.</text>
</subparagraph><subparagraph commented="no" id="HC903A3E07C8740558A5BCFFC759E7AEB"><enum>(C)</enum><text>Provide
individuals with a choice of service options where there is more than one
efficacious treatment.</text>
</subparagraph><subparagraph commented="no" id="H3C9E8BB550EC41089FA7B8C20EA2FAA7"><enum>(D)</enum><text>Employ a core
staff of clinical staff that is multidisciplinary and culturally and
linguistically competent.</text>
</subparagraph><subparagraph commented="no" id="H8976D0976C0343109D19EAAB83B6C331"><enum>(E)</enum><text>Provide services,
within the limits of the capacities of the center, to any individual residing
or employed in the service area of the center, regardless of the ability of the
individual to pay.</text>
</subparagraph><subparagraph commented="no" id="H42060A488AF5443D9E413A4E46D85474"><enum>(F)</enum><text>Provide, directly
or through contract, to the extent covered for adults in the State Medicaid
plan under title XIX of the Social Security Act and for children in accordance
with section 1905(r) of such Act regarding early and periodic screening,
diagnosis, and treatment, each of the following services:</text>
<clause commented="no" id="HE1F784B74D8B43B99505F812162E391D"><enum>(i)</enum><text>Screening,
assessment, and diagnosis, including risk assessment.</text>
</clause><clause commented="no" id="H3FD23B35361746D8A985B8B6D642F202"><enum>(ii)</enum><text>Person-centered
treatment planning or similar processes, including risk assessment and crisis
planning.</text>
</clause><clause commented="no" id="H1A28EC00168240539FBDD5FDBB6EDED0"><enum>(iii)</enum><text>Outpatient
clinic mental health services, including screening, assessment, diagnosis,
psychotherapy, substance abuse counseling, medication management, and
integrated treatment for mental illness and substance abuse which shall be
evidence-based (including cognitive behavioral therapy and other such therapies
which are evidence-based).</text>
</clause><clause commented="no" id="H6D9DA179B79F4FD2A12EFA0A1EE1CC1A"><enum>(iv)</enum><text>Outpatient clinic
primary care services, including screening and monitoring of key health
indicators and health risk (including screening for diabetes, hypertension, and
cardiovascular disease and monitoring of weight, height, body mass index (BMI),
blood pressure, blood glucose or HbA1C, and lipid profile).</text>
</clause><clause commented="no" id="H631638B78CED48A2838EE9D35849EC30"><enum>(v)</enum><text>Crisis mental
health services, including 24-hour mobile crisis teams, emergency crisis
intervention services, and crisis stabilization.</text>
</clause><clause commented="no" id="H3F0F8BB8447E4BE5BBBA06BEFE4A3A50"><enum>(vi)</enum><text display-inline="yes-display-inline">Targeted case management (services to
assist individuals gaining access to needed medical, social, educational, and
other home- and community-based services and applying for income security and
other benefits to which they may be entitled).</text>
</clause><clause commented="no" id="H2723EDBAEE1F48BF8900512676C84861"><enum>(vii)</enum><text>Psychiatric
rehabilitation services including skills training, assertive community
treatment, family psychoeducation, disability self-management, supported
employment, supported housing services, therapeutic foster care services, and
such other evidence-based practices as the Secretary may require.</text>
</clause><clause commented="no" id="H24E0D0A964634EE0BBF5F425AB93882E"><enum>(viii)</enum><text>Peer support
and counselor services and family supports.</text>
</clause></subparagraph><subparagraph commented="no" id="H5FB28BFF5DD04483A0EF444B9BAFBFD2"><enum>(G)</enum><text>Maintain linkages,
and where possible enter into formal contracts with the following:</text>
<clause commented="no" id="HE86D96AD9A8D4ACFAA4E38ED095222EF"><enum>(i)</enum><text>Inpatient
psychiatric facilities and substance abuse detoxification and residential
programs.</text>
</clause><clause commented="no" id="HE80D3E701F8341D398FBF9AAEA515FFB"><enum>(ii)</enum><text>Adult and youth
peer support and counselor services.</text>
</clause><clause commented="no" id="H5456B61E7BC5441D984E2B5C4C72F2BB"><enum>(iii)</enum><text>Family support
services for families of children with serious mental disorders.</text>
</clause><clause commented="no" id="H7CFBFB1F7E15467FAAAEF2CB6D9535C3"><enum>(iv)</enum><text display-inline="yes-display-inline">Other home- and community-based or regional
services, supports, and providers, including schools, child welfare agencies,
juvenile and criminal justice agencies and facilities, housing agencies and
programs, employers, and other social services.</text>
</clause><clause commented="no" id="HF110611ADF5F47558E4AC0A8B1017AD1"><enum>(v)</enum><text>Onsite or offsite
access to primary care services.</text>
</clause><clause commented="no" id="H222C93DE3FFC4336AA6CBFF79C90E3DA"><enum>(vi)</enum><text>Enabling
services, including outreach, transportation, and translation.</text>
</clause><clause commented="no" id="HBD594B8008834277B0E84744E92F65C8"><enum>(vii)</enum><text>Health and
wellness services, including services for tobacco
cessation.</text>
</clause></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="H27B72668185E4D00B720A29FD12B9D5F"><enum>(b)</enum><header>Medicaid
coverage and payment for federally qualified behavioral health center
services</header>
<paragraph commented="no" id="H6A1D28F406CF49AFAC483CF22291761B"><enum>(1)</enum><header>Payment for
services provided by federally qualified behavioral health
centers</header><text>Section 1902(bb) of the Social Security Act (42 U.S.C.
1396a(bb)) is amended—</text>
<subparagraph commented="no" id="H5C3F1C78A37640B6919FF0E50714AF57"><enum>(A)</enum><text>in the heading, by
striking <quote><header-in-text level="subsection" style="OLC">and Rural Health
Clinics</header-in-text></quote> and inserting <quote><header-in-text level="subsection" style="OLC">, federally qualified behavioral health centers,
and Rural Health Clinics</header-in-text></quote>;</text>
</subparagraph><subparagraph commented="no" id="H2658DCCEC6D947D182A6AFDA38E3639F"><enum>(B)</enum><text>in paragraph (1),
by inserting <quote>(and beginning with fiscal year 2012 with respect to
services furnished on or after January 1, 2012, and each succeeding fiscal
year, for services described in section 1905(a)(2)(D) furnished by a federally
qualified behavioral health center)</quote> after <quote>by a rural health
clinic</quote>;</text>
</subparagraph><subparagraph commented="no" id="H18F40D8EDCCD4C0E8A583B067346B41F"><enum>(C)</enum><text>in paragraph
(2)—</text>
<clause commented="no" id="H965108D0BD0647B48DC06C600E8B9015"><enum>(i)</enum><text>by striking the
heading and inserting <quote><header-in-text level="paragraph" style="OLC">Initial fiscal year</header-in-text></quote>;</text>
</clause><clause commented="no" id="H921F38168B224AB58703FD7942E5CD08"><enum>(ii)</enum><text>by inserting
<quote>(or, in the case of services described in section 1905(a)(2)(D)
furnished by a federally qualified behavioral health center, for services
furnished on and after January 1, 2012, during fiscal year 2012)</quote> after
<quote>January 1, 2001, during fiscal year 2001</quote>;</text>
</clause><clause commented="no" id="HCB522AB3E2154C0D8A980D27967E6652"><enum>(iii)</enum><text>by inserting
<quote>(or, in the case of services described in section 1905(a)(2)(D)
furnished by a federally qualified behavioral health center, during fiscal
years 2010 and 2011)</quote> after <quote>1999 and 2000</quote>; and</text>
</clause><clause commented="no" id="HC9BA20960C92425BB572ACB979BAD30E"><enum>(iv)</enum><text>by inserting
<quote>(or, in the case of services described in section 1905(a)(2)(D)
furnished by a federally qualified behavioral health center, during fiscal year
2012)</quote> before the period;</text>
</clause></subparagraph><subparagraph commented="no" id="HA3618299592744798F2544F949051E11"><enum>(D)</enum><text>in paragraph
(3)—</text>
<clause commented="no" id="H69786C59B6324599A0520A115ADF73ED"><enum>(i)</enum><text>in the heading, by
striking <quote><header-in-text level="paragraph" style="OLC">Fiscal year 2002
and succeeding</header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">Succeeding</header-in-text></quote>; and</text>
</clause><clause commented="no" id="H6D7F253F9D1C4332A5DD34A2985A6234"><enum>(ii)</enum><text display-inline="yes-display-inline">by inserting <quote>(or, in the case of
services described in section 1905(a)(2)(D) furnished by a federally qualified
behavioral health center, for services furnished during fiscal year 2013 or a
succeeding fiscal year)</quote> after <quote>2002 or a succeeding fiscal
year</quote>;</text>
</clause></subparagraph><subparagraph commented="no" id="H6082872868724D3692BE23DFF4017EBC"><enum>(E)</enum><text>in paragraph
(4)—</text>
<clause commented="no" id="H842DC1DF0F904CCD98FE21CFC1CC7ABF"><enum>(i)</enum><text>by inserting
<quote>(or as a federally qualified behavioral health center after fiscal year
2011</quote> after <quote>or rural health clinic after fiscal year
2000</quote>;</text>
</clause><clause commented="no" id="H09AF3A57792A42AE8E663B5DABE2AA50"><enum>(ii)</enum><text>by striking
<quote>furnished by the center or</quote> and inserting <quote>furnished by the
federally qualified health center, services described in section 1905(a)(2)(D)
furnished by the federally qualified behavioral health center,
or</quote>;</text>
</clause><clause commented="no" id="H9B34F36FAB524D84A125631DD0C14BD0"><enum>(iii)</enum><text display-inline="yes-display-inline">in the second sentence, by striking
<quote>or rural health clinic</quote> and inserting <quote>, federally
qualified behavioral health center, or rural health clinic</quote>;</text>
</clause></subparagraph><subparagraph commented="no" id="H016B256075634A45AF43ED438C2E8D26"><enum>(F)</enum><text>in paragraph (5),
in each of subparagraphs (A) and (B), by striking <quote>or rural health
clinic</quote> and inserting <quote>, federally qualified behavioral health
center, or rural health clinic</quote>; and</text>
</subparagraph><subparagraph commented="no" id="HF33322627C79458FBCB8C7AD19B1A30F"><enum>(G)</enum><text>in paragraph (6),
by striking <quote>or to a rural health clinic</quote> and inserting <quote>,
to a federally qualified behavioral health center for services described in
section 1905(a)(2)(D), or to a rural health clinic</quote>.</text>
</subparagraph></paragraph><paragraph commented="no" id="HF4571E7DCCA54A52B412141C5C8C5B9D"><enum>(2)</enum><header>Inclusion of
federally qualified behavioral health center services in the term medical
assistance</header><text>Section 1905(a)(2) of the Social Security Act (42
U.S.C. 1396d(a)(2)) is amended—</text>
<subparagraph commented="no" id="HD8A49BFEF15246A09B1230299EA5F445"><enum>(A)</enum><text>by striking
<quote>and</quote> before <quote>(C)</quote>; and</text>
</subparagraph><subparagraph commented="no" id="HEE783131213C4037B03234EB0ECD08DF"><enum>(B)</enum><text>by inserting
before the semicolon at the end the following: <quote>, and (D) federally
qualified behavioral health center services (as defined in subsection
(l)(4))</quote>.</text>
</subparagraph></paragraph><paragraph commented="no" id="H63BC450B9C244A0F84F4A2E9AE6243F8"><enum>(3)</enum><header>Definition of
federally qualified behavioral health center services</header><text>Section
1905(l) of the Social Security Act (42 U.S.C. 1396d(l)) is amended by adding at
the end the following paragraph:</text>
<quoted-block id="HC052934A3E644217BDEF30980F8296F9" style="OLC">
<paragraph commented="no" id="HE1617DD2278A43CC83E9A0DA3E7A0E53"><enum>(4)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H3CDC794B6A1D4FEE8BDF8E40F8112E50"><enum>(A)</enum><text>The term <term>federally
qualified behavioral health center services</term> means services furnished to
an individual at a federally qualified behavioral health center (as defined by
subparagraph (B)).</text>
</subparagraph><subparagraph commented="no" id="H8557888DF9C54203B0AB8C151FBEC177" indent="up1"><enum>(B)</enum><text>The term <term>federally qualified
behavioral health center</term> means an entity that is certified under section
1913(c) of the Public Health Service Act as meeting the criteria described in
paragraph (3) of such
section.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="H393FF87FA1444C398F0C3D33A1F74D12"><enum>(c)</enum><header>Mental health
and addiction safety net studies</header>
<paragraph commented="no" id="HFCFCD7E7EDCB4D8291D712AAC43C14A6"><enum>(1)</enum><header>Paperwork
reduction study</header>
<subparagraph commented="no" id="HB7F43C22F7D14A9BAF71F47A85820468"><enum>(A)</enum><header>In
general</header><text>Not later than 12 months after the date of the enactment
of this Act, the Institute of Medicine shall submit to the appropriate
committees of Congress a report that evaluates the combined paperwork burden of
federally qualified behavioral health centers certified section 1913(c) of the
Public Health Service Act, as inserted by subsection (a).</text>
</subparagraph><subparagraph commented="no" id="H8FFF4AFCB2B0481BAB6A1889EABC6D95"><enum>(B)</enum><header>Scope</header><text>In
preparing the report under subparagraph (A), the Institute of Medicine shall
examine licensing, certification, service definitions, claims payment, billing
codes, and financial auditing requirements utilized by the Office of Management
and Budget, the Centers for Medicare & Medicaid Services, the Health
Resources and Services Administration, the Substance Abuse and Mental Health
Services Administration, the Office of the Inspector General, State Medicaid
agencies, State departments of health, State departments of education, and
State and local juvenile justice and social services agencies to—</text>
<clause commented="no" id="H77E7A989C50040FBBA0457D0A8A05930"><enum>(i)</enum><text>establish an
estimate of the combined nationwide cost of complying with the requirements
described in this subparagraph, in terms of both administrative funding and
staff time;</text>
</clause><clause commented="no" id="H7171A2527D7741F68E4622F019F72C13"><enum>(ii)</enum><text>establish an
estimate of the per capita cost to each federally qualified behavioral health
center certified under section 1913(c) of the Public Health Service Act to
comply with the requirements described in this subparagraph, in terms of both
administrative funding and staff time; and</text>
</clause><clause commented="no" id="HF10F0A2C32D4410DBEFCCF865E242CCC"><enum>(iii)</enum><text>make
administrative and statutory recommendations to Congress, which may include a
uniform methodology, to reduce the paperwork burden experienced by such
federally qualified behavioral health centers.</text>
</clause></subparagraph><subparagraph commented="no" id="H16832F7226FE4712926A7CF1410490F8"><enum>(C)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this subsection $550,000 for each of the fiscal years 2012 and 2013.</text>
</subparagraph></paragraph><paragraph commented="no" id="H8E32E7CC6DBD4B51AAB6139692907B60"><enum>(2)</enum><header>Wage
study</header>
<subparagraph commented="no" id="H2838A5C8D4D948D5B6A787B7CAF5CF6E"><enum>(A)</enum><header>In
general</header><text>Not later than 12 months after the date of the enactment
of this Act, the Institute of Medicine shall conduct a nationwide analysis, and
submit a report to the appropriate committees of Congress, concerning the
compensation structure of professional and paraprofessional personnel employed
by federally qualified behavioral health centers certified under section
1913(c) of the Public Health Service Act, as inserted by subsection (a), as
compared with the compensation structure of comparable health safety net
providers and relevant private sector health care employers.</text>
</subparagraph><subparagraph commented="no" id="H61344790BE434554B92ED9059C2CF03F"><enum>(B)</enum><header>Scope</header><text>In
preparing the report under subparagraph (A), the Institute of Medicine shall
examine compensation disparities, if such disparities are determined to exist,
by type of personnel, type of provider or private sector employer, and by
geographic region.</text>
</subparagraph><subparagraph commented="no" id="HD599C4B5A56B4C038B5ACFE12717B08B"><enum>(C)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this paragraph, $550,000 for each of the fiscal years 2012 and 2013.</text>
</subparagraph></paragraph></subsection></section><section commented="no" id="H8062B6A8375C4E8E8C321FEB92AC4FA4"><enum>603.</enum><header>Minority
Fellowship Program</header><text display-inline="no-display-inline">Title V of
the Public Health Service Act is amended by inserting after section 506B of
such Act (42 U.S.C. 290aa–5b) the following:</text>
<quoted-block display-inline="no-display-inline" id="H55875D510F404F9BB3BC2AB7A60E9DD7" style="OLC">
<section id="H16F1879A0611432492EA0A79C71D2D0C"><enum>506C.</enum><header>Minority
Fellowship Program</header>
<subsection id="H9D105AB1D96047319C252D227BD24B7A"><enum>(a)</enum><header>Fellowships</header><text display-inline="yes-display-inline">The Administrator shall maintain a program,
to be known as the Minority Fellowship Program, under which the Administrator
awards grants or contracts to national associations or other appropriate
entities for the financial support of graduate students, postdoctoral fellows,
and residents in the professions of psychology, psychiatry, social work,
psychiatric advance-practice nursing, and marriage and family therapy to
students who demonstrate a commitment to clinical or research careers focused
on racial and ethnic minority populations.</text>
</subsection><subsection id="H0146F9D7AB044438B99ADC0374EF88D5"><enum>(b)</enum><header>Term of
financial support</header><text>Financial support provided to an individual
pursuant to subsection (a) shall be for a term of not more than 12 months and
may be renewed thereafter.</text>
</subsection><subsection id="HC529D9F1217840A782AD00087D894546"><enum>(c)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there is authorized to
be appropriated $10,000,000 for each of fiscal years 2012 through
2016</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" id="HF8B262C3CEBB4ED2A8FF33EF82A1A2F0"><enum>604.</enum><header>Integrated
Health Care Demonstration Program</header><text display-inline="no-display-inline">Part D of title V of the Public Health
Service Act (42 U.S.C. 290dd et seq.) is amended by adding at the end the
following:</text>
<quoted-block display-inline="no-display-inline" id="H0E5E526CDD2E495FA4FD5618EB75485A" style="OLC">
<section commented="no" id="H454DA3655BBA434B95D4ED74F4191569"><enum>544.</enum><header>Interprofessional
health care teams for provision of behavioral health care in primary care
settings</header>
<subsection commented="no" id="H1D686F99343D4CD5A5D61B29826409B8"><enum>(a)</enum><header>Grants</header><text display-inline="yes-display-inline">The Secretary, acting through the Director
of the Office of Minority Health of the Administration, shall award grants to
eligible entities for the purpose of providing technical assistance and
training regarding the effective development and implementation of integrated
interprofessional health care teams that provide behavioral health care.</text>
</subsection><subsection commented="no" id="HC3F0ED5AA54C48BE809E13681EE9A44F"><enum>(b)</enum><header>Eligible
entities</header><text display-inline="yes-display-inline">To be eligible to
receive a grant under this section, an entity shall be a federally qualified
health center (as defined in section 1861(aa) of the Social Security Act)
serving a high proportion of individuals from racial and ethnic minority groups
(as defined in section 1707(g)).</text>
</subsection><subsection commented="no" id="HB55F041FD514499DA5A62A82EB933B37"><enum>(c)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there is authorized to
be appropriated $20,000,000 for each of fiscal years 2012 through
2014.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" id="H87F93AB5A39649619A3530D67E504960"><enum>605.</enum><header>Addressing
racial and ethnic minority mental health disparities research
gaps</header><text display-inline="no-display-inline">Not later than 6 months
after the date of the enactment of this Act, the Director of the National
Institute on Minority Health and Health Disparities shall enter into an
arrangement with the Institute of Medicine (or, if the Institute declines to
enter into such an arrangement, another appropriate entity)—</text>
<paragraph id="H23359268091A4DEE8B966E7602FB8336"><enum>(1)</enum><text>to conduct a study
with respect to mental and behavioral health disparities in racial and ethnic
minority groups (as defined in section 1707(g) of the Public Health Service Act
(42 U.S.C. 300u–6(g)); and</text>
</paragraph><paragraph id="H8F5832C3BB364CFC8D9A83429E2C790F"><enum>(2)</enum><text>to submit to the
Congress a report on the results of such study, including—</text>
<subparagraph id="H23F0A2C1CEE843CEB58A8C4343BBF396"><enum>(A)</enum><text>a compilation of
information on the dynamics of mental disorders in such racial and ethnic
minority groups;</text>
</subparagraph><subparagraph id="H00590C37D1184EAC89CF440C9754EF22"><enum>(B)</enum><text>an identification
of gaps in knowledge and research needs; and</text>
</subparagraph><subparagraph id="HAA5DA4BC39ED43AABCFDA99B5F888AFA"><enum>(C)</enum><text>recommendations
for an interprofessional research agenda at the National Institutes of Health
aimed at reducing and ultimately eliminating mental and behavioral health
disparities in such racial and ethnic minority groups.</text>
</subparagraph></paragraph></section><enum>VII</enum><header>ADDRESSING HIGH
IMPACT MINORITY DISEASES </header>
<subtitle id="HDC0BFA5FFBEE43F39209EFD97AAB09E5"><enum>A</enum><header>Cancer</header>
<section id="HF8C50536D9B04BEBAEA3026784EE7D7F"><enum>701.</enum><header>Lung Cancer
Mortality Reduction</header>
<subsection id="HC617C81A5A67422F89D59FB857F4A110"><enum>(a)</enum><header>Short
title</header><text>This section may be cited as the <quote><short-title>Lung Cancer Mortality Reduction Act of
2011</short-title></quote>.</text>
</subsection><subsection id="HE39A489E4E9D497B8169737175B4C471"><enum>(b)</enum><header>Findings</header><text>Congress
makes the following findings:</text>
<paragraph id="H6AEDC942452C4CA9B920AE0FED457BFC"><enum>(1)</enum><text>Lung cancer is the
leading cause of cancer death for both men and women, accounting for 28 percent
of all cancer deaths.</text>
</paragraph><paragraph id="H34CAE64B7A3648898E988EC742408470"><enum>(2)</enum><text>Lung cancer kills
more people annually than breast cancer, prostate cancer, colon cancer, liver
cancer, melanoma, and kidney cancer combined.</text>
</paragraph><paragraph id="H3188E383631F4D4C9EC66972E6A69A87"><enum>(3)</enum><text>Since the National
Cancer Act of 1971 (Public Law 92–218; 85 Stat. 778), coordinated and
comprehensive research has raised the 5-year survival rates for breast cancer
to 88 percent, for prostate cancer to 99 percent, and for colon cancer to 64
percent.</text>
</paragraph><paragraph id="HD3286712BC2F4640935DE8FF07D1B879"><enum>(4)</enum><text>However, the
5-year survival rate for lung cancer is still only 15 percent and a similar
coordinated and comprehensive research effort is required to achieve increases
in lung cancer survivability rates.</text>
</paragraph><paragraph id="H7213348A986941F1A8864F814E19B84A"><enum>(5)</enum><text>Sixty percent of
lung cancer cases are now diagnosed nonsmokers or former smokers.</text>
</paragraph><paragraph id="H5F9399C557FF47EBBA7D334D61717CB6"><enum>(6)</enum><text>Two-thirds of
nonsmokers diagnosed with lung cancer are women.</text>
</paragraph><paragraph id="HDA9FBD3834414D14B73D6837F79925CB"><enum>(7)</enum><text>Certain minority
populations, such as African-American males, have disproportionately high rates
of lung cancer incidence and mortality, notwithstanding their similar smoking
rate.</text>
</paragraph><paragraph id="H641A42111E854B5C8E00B7A4B00C0632"><enum>(8)</enum><text>Members of the
baby boomer generation are entering their sixties, the most common age at which
people develop lung cancer.</text>
</paragraph><paragraph id="H26CA6C627B4D41A1A27239010C7448BB"><enum>(9)</enum><text>Tobacco addiction
and exposure to other lung cancer carcinogens such as Agent Orange and other
herbicides and battlefield emissions are serious problems among military
personnel and war veterans.</text>
</paragraph><paragraph id="HDA576C8B7C1A4285929AF3CC7F173EAC"><enum>(10)</enum><text>Significant and
rapid improvements in lung cancer mortality can be expected through greater use
and access to lung cancer screening tests for at-risk individuals.</text>
</paragraph><paragraph id="HEFF073526B52489A946C0335E75213EA"><enum>(11)</enum><text>Additional
strategies are necessary to further enhance the existing tests and therapies
available to diagnose and treat lung cancer in the future.</text>
</paragraph><paragraph id="H2B71886490BB4A2BB370F8431AB56D66"><enum>(12)</enum><text>The August 2001
Report of the Lung Cancer Progress Review Group of the National Cancer
Institute stated that funding for lung cancer research was <quote>far below the
levels characterized for other common malignancies and far out of proportion to
its massive health impact</quote>.</text>
</paragraph><paragraph id="HF8BF4AFE8E8A4344B913CB50ABB589C5"><enum>(13)</enum><text>The Report of the
Lung Cancer Progress Review Group identified as its <quote>highest
priority</quote> the creation of integrated, multidisciplinary,
multi-institutional research consortia organized around the problem of lung
cancer rather than around specific research disciplines.</text>
</paragraph><paragraph id="H6C309441D67644C2A960A5FE1BD89454"><enum>(14)</enum><text>The United States
must enhance its response to the issues raised in the Report of the Lung Cancer
Progress Review Group, and this can be accomplished through the establishment
of a coordinated effort designed to reduce the lung cancer mortality rate by 50
percent by 2015 and targeted funding to support this coordinated effort.</text>
</paragraph></subsection><subsection id="H733B0FED9D574D30A9CFC669C560A787"><enum>(c)</enum><header>Sense of
Congress concerning investment in lung cancer research</header><text>It is the
sense of the Congress that—</text>
<paragraph id="HF27F9182A89F4B69B8A95FE37F23534F"><enum>(1)</enum><text>lung cancer
mortality reduction should be made a national public health priority;
and</text>
</paragraph><paragraph id="H13ED455ED552437DA8F756586426F62B"><enum>(2)</enum><text>a
comprehensive mortality reduction program coordinated by the Secretary of
Health and Human Services is justified and necessary to adequately address and
reduce lung cancer mortality.</text>
</paragraph></subsection><subsection id="H7A3AE854A8184E5F836A1B5A96405038"><enum>(d)</enum><header>Lung Cancer
Mortality Reduction Program</header>
<paragraph id="H7D4CCF15BE7B4A13998E1A02210C16D3"><enum>(1)</enum><header>In
General</header><text>Subpart 1 of part C of title IV of the Public Health
Service Act (42 U.S.C. 285 et seq.) is amended by adding at the end the
following:</text>
<quoted-block id="H40BFABFD3B394117B5E3E38A353D2178" style="OLC">
<section id="H25B0062E96974861AFF817D670DB2182"><enum>417H.</enum><header>Lung Cancer
Mortality Reduction Program</header>
<subsection id="H788F79796BC2463BA7C22EB0582511F9"><enum>(a)</enum><header>In
General</header><text>Not later than 6 months after the date of the enactment
of this section, the Secretary, in consultation with the Secretary of Defense,
the Secretary of Veterans Affairs, the Director of the National Institutes of
Health, the Director of the Centers for Disease Control and Prevention, the
Commissioner of Food and Drugs, the Administrator of the Centers for Medicare
& Medicaid Services, the Director of the National Institute on Minority
Health and Health Disparities, and other members of the Lung Cancer Advisory
Board established under section 546 of the Lung Cancer Mortality Reduction Act
of 2011, shall implement a comprehensive program, to be known as the Lung
Cancer Mortality Reduction Program, to achieve a reduction of at least 25
percent in the mortality rate of lung cancer by 2017.</text>
</subsection><subsection id="HFCB19B07EEE7474886147E56D640EDDE"><enum>(b)</enum><header>Requirements</header><text>The
Program shall include at least the following:</text>
<paragraph id="H1F4953064545441A96C45428AFF93786"><enum>(1)</enum><text>With respect to
the National Institutes of Health—</text>
<subparagraph id="H55D187EBCD3643F09B97A635227F5099"><enum>(A)</enum><text>a strategic review
and prioritization by the National Cancer Institute of research grants to
achieve the goal of the Lung Cancer Mortality Reduction Program in reducing
lung cancer mortality;</text>
</subparagraph><subparagraph id="H01FF8BE761E64CA98A831A130DF546CE"><enum>(B)</enum><text>the provision of
funds to enable the Airway Biology and Disease Branch of the National Heart,
Lung, and Blood Institute to expand its research programs to include
predispositions to lung cancer, the interrelationship between lung cancer and
other pulmonary and cardiac disease, and the diagnosis and treatment of these
interrelationships;</text>
</subparagraph><subparagraph id="HBA78D24917464B49B7E9658F65CA40C2"><enum>(C)</enum><text display-inline="yes-display-inline">the provision of funds to enable the
National Institute of Biomedical Imaging and Bioengineering to expedite the
development of computer assisted diagnostic, surgical, treatment, and
drug-testing innovations to reduce lung cancer mortality, such as through
expansion of the Institute’s Quantum Grant Program and Image-Guided
Interventions programs; and</text>
</subparagraph><subparagraph id="H218A1D5E7D554CBC99AEE53240477525"><enum>(D)</enum><text>the provision of
funds to enable the National Institute of Environmental Health Sciences to
implement research programs relative to the lung cancer incidence.</text>
</subparagraph></paragraph><paragraph id="H85550F7837824419B54F1D2C8C7F2443"><enum>(2)</enum><text>With respect to
the Food and Drug Administration—</text>
<subparagraph id="H2D4F5C861B6449A3AA4A8AAE4F007B19"><enum>(A)</enum><text>activities under
section 529 of the Federal Food, Drug, and Cosmetic Act; and</text>
</subparagraph><subparagraph id="HF4D93B0EC9284709B39D495518F23CB9"><enum>(B)</enum><text>activities under
section 561 of the Federal Food, Drug, and Cosmetic Act to expand access to
investigational drugs and devices for the diagnosis, monitoring, or treatment
of lung cancer.</text>
</subparagraph></paragraph><paragraph id="H3D1D734C12EB437EBAD6C1FF95385690"><enum>(3)</enum><text display-inline="yes-display-inline">With respect to the Centers for Disease
Control and Prevention, the establishment of an early disease research and
management program under section 1511.</text>
</paragraph><paragraph id="H3D46EE1219D244A8BA425940984D8E47"><enum>(4)</enum><text>With respect to
the Agency for Healthcare Research and Quality, the conduct of a biannual
review of lung cancer screening, diagnostic, and treatment protocols, and the
issuance of updated guidelines.</text>
</paragraph><paragraph id="H2EF171BE25894EE7822E35870318C8E7"><enum>(5)</enum><text>The cooperation
and coordination of all minority and health disparity programs within the
Department of Health and Human Services to ensure that all aspects of the Lung
Cancer Mortality Reduction Program under this section adequately address the
burden of lung cancer on minority and rural populations.</text>
</paragraph><paragraph id="HE04C1E6F5FF94832BB7899C9FEDFA93D"><enum>(6)</enum><text>The cooperation
and coordination of all tobacco control and cessation programs within agencies
of the Department of Health and Human Services to achieve the goals of the Lung
Cancer Mortality Reduction Program under this section with particular emphasis
on the coordination of drug and other cessation treatments with early detection
protocols.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HF1B2BB3546684D48BD314C169F0D6AD3"><enum>(2)</enum><header>Federal Food,
Drug, and Cosmetic Act</header><text>Subchapter B of chapter V of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 360aaa et seq.) is amended by adding at
the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HEBFF97B3DFAF4FD48CB50561679AD02C" style="traditional">
<section id="HF7BF2673725640F2BEECF979FF17B966"><enum>529.</enum><header>Drugs relating to lung cancer</header><subsection commented="no" display-inline="yes-display-inline" id="H4A4C7E6FC8A64BCEA3F6D7BACC45AC22"><enum>(a)</enum><header>In
general</header><text>The provisions of this subchapter shall apply to a drug
described in subsection (b) to the same extent and in the same manner as such
provisions apply to a drug for a rare disease or condition.</text>
</subsection><subsection id="H5509A160BBE542949FBF5E15BFF92EB4"><enum>(b)</enum><header>Qualified
drugs</header><text display-inline="yes-display-inline">A drug described in
this subsection is—</text>
<paragraph id="H240798E702E84CB18E10F994BCD7C2D1"><enum>(1)</enum><text>a chemoprevention
drug for precancerous conditions of the lung;</text>
</paragraph><paragraph id="HDAAA0159C386495493FB88A1AE87194B"><enum>(2)</enum><text>a drug for
targeted therapeutic treatments, including any vaccine, for lung cancer;
and</text>
</paragraph><paragraph id="HC0DB2C1C67D44C959D505721D6F5B420"><enum>(3)</enum><text>a drug to curtail
or prevent nicotine addiction.</text>
</paragraph></subsection><subsection commented="no" id="HF9DD808E8711437AA2D2470C2D2A1E9D"><enum>(c)</enum><header>Board</header><text>The
Board established under the Lung Cancer Mortality Reduction Act of 2011 shall
monitor the program implemented under this
section.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" id="HF2664E3C2256416D999666F7FDC4E898"><enum>(3)</enum><header>Access to
Unapproved Therapies</header><text>Section 561(e) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 360bbb(e)) is amended by inserting before the
period the following: <quote>and shall include expanding access to drugs under
section 529, with substantial consideration being given to whether the totality
of information available to the Secretary regarding the safety and
effectiveness of an investigational drug, as compared to the risk of morbidity
and death from the disease, indicates that a patient may obtain more benefit
than risk if treated with the drug</quote>.</text>
</paragraph><paragraph id="H1A937AD69E234B04857CD64E56C851C4"><enum>(4)</enum><header>CDC</header><text>Title
XV of the Public Health Service Act (42 U.S.C. 300k et seq.) is amended by
adding at the end the following:</text>
<quoted-block id="H818FC1C6E87A408EABF6A30D10D31764" style="OLC">
<section id="H3051D9999EEB4809970ADF2D6173E62A"><enum>1511.</enum><header>Early disease
research and management program</header><text display-inline="no-display-inline">The Secretary shall establish and implement
an early disease research and management program targeted at the high incidence
and mortality rates of lung cancer among minority and low-income
populations.</text>
</section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HC296D60720C64EEA97CAEDCE03A0ADB7"><enum>(e)</enum><header>Department of
defense and the department of veterans affairs</header><text>The Secretary of
Defense and the Secretary of Veterans Affairs shall coordinate with the
Secretary of Health and Human Services—</text>
<paragraph id="H7F5F5436F5AA4902B1AE0BB7A78515A9"><enum>(1)</enum><text>in the development
of the Lung Cancer Mortality Reduction Program under section 417H;</text>
</paragraph><paragraph id="H88E6FBF785244DD2BE191B8124DA7211"><enum>(2)</enum><text>in the
implementation within the Department of Defense and the Department of Veterans
Affairs of an early detection and disease management research program for
military personnel and veterans whose smoking history and exposure to
carcinogens during active duty service has increased their risk for lung
cancer; and</text>
</paragraph><paragraph id="HB20689CCBB1546238E204D8769BC645B"><enum>(3)</enum><text>in the
implementation of coordinated care programs for military personnel and veterans
diagnosed with lung cancer.</text>
</paragraph></subsection><subsection id="H8107ADCF5DA54676A5C2038380312EDF"><enum>(f)</enum><header>Lung cancer
advisory board</header>
<paragraph id="HFFED837AC2074B9C9E4467EDA5E0B3C1"><enum>(1)</enum><header>In
General</header><text>The Secretary of Health and Human Services shall convene
a Lung Cancer Advisory Board (referred to in this section as the
<term>Board</term>)—</text>
<subparagraph id="H81529CA166224ED1B6192BDBF0749DAC"><enum>(A)</enum><text>to monitor the
programs established under this section (and the amendments made by this
section); and</text>
</subparagraph><subparagraph id="H7DAC76B469DB44C79728BB2DCA7CBB67"><enum>(B)</enum><text>to provide annual
reports to the Congress concerning benchmarks, expenditures, lung cancer
statistics, and the public health impact of such programs.</text>
</subparagraph></paragraph><paragraph id="H8842821515E74E268B2AD1E907497452"><enum>(2)</enum><header>Composition</header><text>The
Board shall be composed of—</text>
<subparagraph id="HC20C8DDA569345CF86BE8AFDE4D38ECE"><enum>(A)</enum><text>the Secretary of
Health and Human Services;</text>
</subparagraph><subparagraph id="H18CAFF74814B42FFAD01530ECF9B62E2"><enum>(B)</enum><text>the Secretary of
Defense;</text>
</subparagraph><subparagraph id="HF89BFDB081634703B41E1CF11D5603FD"><enum>(C)</enum><text>the Secretary of
Veterans Affairs; and</text>
</subparagraph><subparagraph id="HB3B164927538417D83C0782FA8B23B1A"><enum>(D)</enum><text>two
representatives each from the fields of clinical medicine focused on lung
cancer, lung cancer research, imaging, drug development, and lung cancer
advocacy, to be appointed by the Secretary of Health and Human Services.</text>
</subparagraph></paragraph></subsection><subsection id="HFD1DAEB1DB704ECF910849F1C8F547A7"><enum>(g)</enum><header>Authorization of
appropriations</header>
<paragraph id="H98D9BDC026874CCBBAB895C136C4110D"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">To carry out this
section (and the amendments made by this section), there are authorized to be
appropriated such sums as may be necessary for each of fiscal years 2012
through 2016.</text>
</paragraph><paragraph id="H028DADE934204FBAB26AEE79B848F09D"><enum>(2)</enum><header>Lung Cancer
Mortality Reduction Program</header><text>Of the amounts authorized to be
appropriated by subsection (a), there are authorized to be appropriated—</text>
<subparagraph id="H257F82B6E23E4D92B89F7B990612CFA8"><enum>(A)</enum><text display-inline="yes-display-inline">$25,000,000 for fiscal year 2012, and such
sums as may be necessary for each of fiscal years 2013 through 2016, for the
activities described in section 417H(b)(1)(B) of the Public Health Service Act,
as added by subsection (d)(1);</text>
</subparagraph><subparagraph id="H8EA4A7788E0D443E8C8540A0DCE50378"><enum>(B)</enum><text display-inline="yes-display-inline">$25,000,000 for fiscal year 2012, and such
sums as may be necessary for each of fiscal years 2013 through 2016, for the
activities described in section 417H(b)(1)(C) of such Act;</text>
</subparagraph><subparagraph id="HF7F8635BC5414AE386BE1280C6B351DF"><enum>(C)</enum><text display-inline="yes-display-inline">$10,000,000 for fiscal year 2012, and such
sums as may be necessary for each of fiscal years 2013 through 2016, for the
activities described in section 417H(b)(1)(D) of such Act; and</text>
</subparagraph><subparagraph id="H7A197A63A18343A09B306913901D4EFA"><enum>(D)</enum><text display-inline="yes-display-inline">$15,000,000 for fiscal year 2012, and such
sums as may be necessary for each of fiscal years 2013 through 2016, for the
activities described in section 417H(b)(3) of such Act.</text>
</subparagraph></paragraph></subsection></section><section id="H1A2A137C274F40FEA56084B86D08FCDD"><enum>702.</enum><header>Expanding
Prostate Cancer Research, Outreach, Screening, Testing, Access, and Treatment
Effectiveness</header>
<subsection id="HA001B9EA9EB146B48ADA56362811BAB2"><enum>(a)</enum><header>Short
Title</header><text>This section may be cited as the <quote><short-title>Prostate Research, Outreach, Screening, Testing, Access,
and Treatment Effectiveness Act of 2011</short-title></quote> or the
<quote><short-title>PROSTATE
Act</short-title></quote>.</text>
</subsection><subsection id="H1E96BE65B5564A37A1AFD44D26292D89"><enum>(b)</enum><header>Findings</header><text>Congress
makes the following findings:</text>
<paragraph id="HA8F50C0A353A40B7B06677CC46D085C0"><enum>(1)</enum><text>Prostate cancer is
the second leading cause of cancer death among men.</text>
</paragraph><paragraph id="HD8E507C468754C4191657CE2ABE5BBA3"><enum>(2)</enum><text>In 2010, more than
217,730 new patients were diagnosed with prostate cancer and more than 32,000
men died from this disease.</text>
</paragraph><paragraph id="HAE559536A11645A382715A8E3FA0BE7B"><enum>(3)</enum><text>Roughly 2,000,000
Americans are living with a diagnosis of prostate cancer and its
consequences.</text>
</paragraph><paragraph id="H35740D8DF9044085A113F8A12CC4A0C9"><enum>(4)</enum><text>While prostate
cancer generally affects older individuals, younger men are also at risk for
the disease, and when prostate cancer appears in early middle age it frequently
takes on a more aggressive form.</text>
</paragraph><paragraph id="H45B09182339B462993000A50F3AACC73"><enum>(5)</enum><text>There are
significant racial and ethnic disparities that demand attention, namely
African-Americans have prostate cancer mortality rates that are more than
double those in the White population.</text>
</paragraph><paragraph id="H1432E710028746738457506EBD3D9EBA"><enum>(6)</enum><text>Underserved rural
populations have higher rates of mortality compared to their urban
counterparts, and innovative and cost-efficient methods to improve rural access
to high quality care should take advantage of advances in telehealth to
diagnose and treat prostate cancer when appropriate.</text>
</paragraph><paragraph id="HA90E4F2F9F83401AA01905380E179381"><enum>(7)</enum><text>Certain veterans
populations may have nearly twice the incidence of prostate cancer as the
general population of the United States.</text>
</paragraph><paragraph id="H2DF940320B444239831C0B92EACF7E43"><enum>(8)</enum><text>Urologists may
constitute the specialists who diagnose and treat the vast majority of prostate
cancer patients.</text>
</paragraph><paragraph id="HCF0676474C7C4268B3304066A9CE933F"><enum>(9)</enum><text>Although much
basic and translational research has been completed and much is currently
known, there are still many unanswered questions. For example, it is not fully
understood how much of known disparities are attributable to disease etiology,
access to care, or education and awareness in the community.</text>
</paragraph><paragraph id="H51D8844046724A1480878FF171D2A011"><enum>(10)</enum><text>Causes of
prostate cancer are not known. There is not good information regarding how to
differentiate accurately, early on, between aggressive and indolent forms of
the disease. As a result, there is significant overtreatment in prostate
cancer. There are no treatments that can durably arrest growth or cure prostate
cancer once it has metastasized.</text>
</paragraph><paragraph id="H2626703083F949ABA9BAD870A05C6B5F"><enum>(11)</enum><text>A significant
proportion (roughly 23 to 54 percent) of cases may be clinically indolent and
<quote>overdiagnosed</quote>, resulting in significant overtreatment. More
accurate tests will allow men and their families to face less physical,
psychological, financial, and emotional trauma and billions of dollars could be
saved in private and public health care systems in an area that has been
identified by the Medicare program as one of eight high-volume, high-cost areas
in the Resource Utilization Report program authorized by Congress under the
Medicare Improvements for Patients and Providers Act of 2008.</text>
</paragraph><paragraph id="H620A0D07228749BE8F8D302F879D5EF4"><enum>(12)</enum><text>Prostate cancer
research and health care programs across Federal agencies should be coordinated
to improve accountability and actively encourage the translation of research
into practice, to identify and implement best practices, in order to foster an
integrated and consistent focus on effective prevention, diagnosis, and
treatment of this disease.</text>
</paragraph></subsection><subsection id="H7EE250D8C1604222A8DA54871F5D1CFB"><enum>(c)</enum><header>Prostate cancer
coordination and education</header>
<paragraph id="H3E4B88C84A1D4B75B0C4A27ED0BF7EC4"><enum>(1)</enum><header>Interagency
prostate cancer coordination and education task force</header><text display-inline="yes-display-inline">Not later than 180 days after the date of
the enactment of this section, the Secretary of Veterans Affairs, in
cooperation with the Secretary of Defense and the Secretary of Health and Human
Services, shall establish an Interagency Prostate Cancer Coordination and
Education Task Force (in this section referred to as the <term>Prostate Cancer
Task Force</term>).</text>
</paragraph><paragraph id="H10CDC63BA3724B80AF2D9B6FEC1C1D0A"><enum>(2)</enum><header>Duties</header><text>The
Prostate Cancer Task Force shall—</text>
<subparagraph id="HC222409C5D7A472A9A232E5109E15FF9"><enum>(A)</enum><text display-inline="yes-display-inline">develop a summary of advances in prostate
cancer research supported or conducted by Federal agencies relevant to the
diagnosis, prevention, and treatment of prostate cancer, including psychosocial
impairments related to prostate cancer treatment, and compile a list of best
practices that warrant broader adoption in health care programs;</text>
</subparagraph><subparagraph id="HB665CF133A93459193FBAA60EAD980B7"><enum>(B)</enum><text display-inline="yes-display-inline">consider establishing, and advocating for,
a guidance to enable physicians to allow screening of men who are over age 74,
on a case-by-case basis, taking into account quality of life and family history
of prostate cancer;</text>
</subparagraph><subparagraph id="HE3EE7EFD912047BDA51B9A63A3A26B98"><enum>(C)</enum><text>share and
coordinate information on Federal research and health care program activities,
including activities related to—</text>
<clause id="HD4D529C738A84168A3FECB1B1D0B2000"><enum>(i)</enum><text display-inline="yes-display-inline">determining how to improve research and
health care programs, including psychosocial impairments related to prostate
cancer treatment;</text>
</clause><clause id="HEE49FAF1D05A47D89571264A4030D4A3"><enum>(ii)</enum><text>identifying any
gaps in the overall research inventory and in health care programs;</text>
</clause><clause id="H4753395A60FF4B8B82896928736FF7F8"><enum>(iii)</enum><text>identifying
opportunities to promote translation of research into practice; and</text>
</clause><clause id="H1D50F34B4CE341AEBC07E2B2E36266D0"><enum>(iv)</enum><text>maximizing the
effects of Federal efforts by identifying opportunities for collaboration and
leveraging of resources in research and health care programs that serve those
susceptible to or diagnosed with prostate cancer;</text>
</clause></subparagraph><subparagraph id="H27B0C6F6656C45CF9D5949436B3AB093"><enum>(D)</enum><text>develop a
comprehensive interagency strategy and advise relevant Federal agencies in the
solicitation of proposals for collaborative, multidisciplinary research and
health care programs, including proposals to evaluate factors that may be
related to the etiology of prostate cancer, that would—</text>
<clause id="H875DC4707B0A4374A340155A2C6A4748"><enum>(i)</enum><text>result in
innovative approaches to study emerging scientific opportunities or eliminate
knowledge gaps in research to improve the prostate cancer research portfolio of
the Federal Government;</text>
</clause><clause id="H12876E5D47A1419FB055D21D09979537"><enum>(ii)</enum><text>outline key
research questions, methodologies, and knowledge gaps; and</text>
</clause><clause id="H3F7CC3638154477B805F90F71D09C265"><enum>(iii)</enum><text display-inline="yes-display-inline">ensure consistent action, as outlined by
section 402(b) of the Public Health Service Act;</text>
</clause></subparagraph><subparagraph id="H504A652BDCA44C58BB8F8686C62B5A9A"><enum>(E)</enum><text>develop a
coordinated message related to screening and treatment for prostate cancer to
be reflected in educational and beneficiary materials for Federal health
programs as such documents are updated; and</text>
</subparagraph><subparagraph id="H1D1AD3E81DA041DAA75192996C2D6804"><enum>(F)</enum><text display-inline="yes-display-inline">not later than 2 years after the date of
the establishment of the Prostate Cancer Task Force, submit to the Expert
Advisory Panel to be reviewed and returned within 30 days, and then within 90
days submitted to Congress recommendations—</text>
<clause id="H2A213D7219B34C3681957462532728DC"><enum>(i)</enum><text>regarding any
appropriate changes to research and health care programs, including
recommendations to improve the research portfolio of the Department of Veterans
Affairs, Department of Defense, National Institutes of Health, and other
Federal agencies to ensure that scientifically based strategic planning is
implemented in support of research and health care program priorities;</text>
</clause><clause id="H7017D7526B294B5EB3BB8E09F0658C4F"><enum>(ii)</enum><text>designed to
ensure that the research and health care programs and activities of the
Department of Veterans Affairs, the Department of Defense, the Department of
Health and Human Services, and other Federal agencies are free of unnecessary
duplication;</text>
</clause><clause id="HAB6C4AAE79134BB28535349D5892CF48"><enum>(iii)</enum><text>regarding public
participation in decisions relating to prostate cancer research and health care
programs to increase the involvement of patient advocates, community
organizations, and medical associations representing a broad geographical
area;</text>
</clause><clause id="H9C47E79F92904F87A7EF74E5279D69BB"><enum>(iv)</enum><text>on
how to best disseminate information on prostate cancer research and progress
achieved by health care programs;</text>
</clause><clause id="HB1382C550BE54177926BF2C602BE39B7"><enum>(v)</enum><text>about how to
expand partnerships between public entities, including Federal agencies, and
private entities to encourage collaborative, cross-cutting research and health
care delivery;</text>
</clause><clause id="H346C9900BFD4467C972F6B0F95ECB641"><enum>(vi)</enum><text>assessing any
cost savings and efficiencies realized through the efforts identified and
supported in this section and recommending expansion of those efforts that have
proved most promising while also ensuring against any conflicts in directives
from other congressional or statutory mandates or enabling statutes;</text>
</clause><clause id="H06E87E21B28346A4ACF22C4707235BAE"><enum>(vii)</enum><text>identifying key
priority action items from among the recommendations; and</text>
</clause><clause id="HEAE05EA51972454DB833F98C8103EF83"><enum>(viii)</enum><text>with respect to
the level of funding needed by each agency to implement the recommendations
contained in the report.</text>
</clause></subparagraph></paragraph><paragraph id="HC030A07105844C1AA2EF830BA955AB01"><enum>(3)</enum><header>Members of the
Prostate Cancer Task Force</header><text>The Prostate Cancer Task Force
described in subsection (a) shall be composed of representatives from such
Federal agencies, as each Secretary determines necessary, to coordinate a
uniform message relating to prostate cancer screening and treatment where
appropriate, including representatives of the following:</text>
<subparagraph id="H7905AEB843E04786A5BBAC8A4E8C6EBC"><enum>(A)</enum><text>The Department of
Veterans Affairs, including representatives of each relevant program areas of
the Department of Veterans Affairs.</text>
</subparagraph><subparagraph id="HDA6953A5D6504F9E8642B24D847E622F"><enum>(B)</enum><text display-inline="yes-display-inline">The Prostate Cancer Research Program of the
Congressionally Directed Medical Research Program of the Department of
Defense.</text>
</subparagraph><subparagraph id="H6BF146ED263C4510B1BF882B4EAD60A7"><enum>(C)</enum><text>The Department of
Health and Human Services, including at a minimum representatives of the
following:</text>
<clause id="HFF7A78B832A0452EBD3C53BA247031A3"><enum>(i)</enum><text>The
National Institutes of Health.</text>
</clause><clause id="HE4CC962C74334BBCA13217B0F1617E6E"><enum>(ii)</enum><text>National research
institutes and centers, including the National Cancer Institute, the National
Institute of Allergy and Infectious Diseases, and the Office of Minority
Health.</text>
</clause><clause id="HB09B6A616B84465F980B92A3CC35D17B"><enum>(iii)</enum><text>The Centers for
Medicare & Medicaid Services.</text>
</clause><clause id="H717203C9A24C49BB8B72F1EF77108BA1"><enum>(iv)</enum><text>The
Food and Drug Administration.</text>
</clause><clause id="HF0DC5F7EE87240E6AFE5CF8760FE5329"><enum>(v)</enum><text>The
Centers for Disease Control and Prevention.</text>
</clause><clause id="HCD426BDC21CF4D38997267E08567216C"><enum>(vi)</enum><text>The
Agency for Healthcare Research and Quality.</text>
</clause><clause id="HD9117E668A5149DFA384F65E3284073B"><enum>(vii)</enum><text>The Health
Resources and Services Administration.</text>
</clause></subparagraph></paragraph><paragraph id="H94A59DD0447444F688D423540CC94BF2"><enum>(4)</enum><header>Appointing
expert advisory panels</header><text>The Prostate Cancer Task Force shall
appoint expert advisory panels, as determined appropriate, to provide input and
concurrence from individuals and organizations from the medical, prostate
cancer patient and advocate, research, and delivery communities with expertise
in prostate cancer diagnosis, treatment, and research, including practicing
urologists, primary care providers, and others and individuals with expertise
in education and outreach to underserved populations affected by prostate
cancer.</text>
</paragraph><paragraph id="H280C8E58A0404E54A3735C9D5D8B2AC9"><enum>(5)</enum><header>Meetings</header><text>The
Prostate Cancer Task Force shall convene not less than twice a year, or more
frequently as the Secretary determines to be appropriate.</text>
</paragraph><paragraph id="HFB15ADF0FF494BFBA4E53B69CDCA9EB2"><enum>(6)</enum><header>Submission of
recommendations to Congress</header><text>The Secretary of Veterans Affairs
shall submit to Congress any recommendations submitted to the Secretary under
paragraph (2)(E).</text>
</paragraph><paragraph id="H8C770A9EB0904518BDC4ACFD4820E1C5"><enum>(7)</enum><header>Federal Advisory
Committee Act</header>
<subparagraph id="H5040D9BABD3741A19B6B4723E66BC497"><enum>(A)</enum><header>In
general</header><text>Except as provided in subparagraph (B), the Federal
Advisory Committee Act (5 U.S.C. App.) shall apply to the Prostate Cancer Task
Force.</text>
</subparagraph><subparagraph id="HE803A7EEBC82427F8D43B09777154F5A"><enum>(B)</enum><header>Exception</header><text>Section
14(a)(2)(B) of such Act (relating to the termination of advisory committees)
shall not apply to the Prostate Cancer Task Force.</text>
</subparagraph></paragraph><paragraph commented="no" id="H6F8111E8640C4D198E69F484E2E44D7D"><enum>(8)</enum><header>Sunset
Date</header><text display-inline="yes-display-inline">The Prostate Cancer Task
Force shall terminate at the end of fiscal year 2016.</text>
</paragraph></subsection><subsection id="H0277448365F84BB0BF8C98DBF75869D4"><enum>(d)</enum><header>Prostate cancer
research</header>
<paragraph id="H0329EFCC6C4843B6B8E19037E143CCAB"><enum>(1)</enum><header>Research
coordination</header><text>The Secretary of Veterans Affairs, in coordination
with the Secretaries of Defense and of Health and Human Services, shall
establish and carry out a program to coordinate and intensify prostate cancer
research as needed. Specifically, such research program shall—</text>
<subparagraph id="HF1404E84885B4316B94018D09EF6AD18"><enum>(A)</enum><text>develop advances
in diagnostic and prognostic methods and tests, including biomarkers and an
improved prostate cancer screening blood test, including improvements or
alternatives to the prostate specific antigen test and additional tests to
distinguish indolent from aggressive disease;</text>
</subparagraph><subparagraph id="H18C6B3B7FBCA4CAE909708DE8C740EAF"><enum>(B)</enum><text>better understand
the etiology of the disease (including an analysis of lifestyle factors proven
to be involved in higher rates of prostate cancer, such as obesity and diet,
and in different ethnic, racial, and socioeconomic groups, such as the
African-American, Latin-American, and American Indian populations and men with
a family history of prostate cancer) to improve prevention efforts;</text>
</subparagraph><subparagraph id="HDB0FA65F168F480ABD63C8603E36985E"><enum>(C)</enum><text>expand basic
research into prostate cancer, including studies of fundamental molecular and
cellular mechanisms;</text>
</subparagraph><subparagraph id="H1C1313017B44402EBB08C45A2464CBC8"><enum>(D)</enum><text>identify and
provide clinical testing of novel agents for the prevention and treatment of
prostate cancer;</text>
</subparagraph><subparagraph id="H1A7798FEA2D44E71946B3FCE9F448A28"><enum>(E)</enum><text>establish clinical
registries for prostate cancer;</text>
</subparagraph><subparagraph id="H8FED142C862F4363907738A8D52C90CC"><enum>(F)</enum><text display-inline="yes-display-inline">use the National Institute of Biomedical
Imaging and Bioengineering and the National Cancer Institute for assessment of
appropriate imaging modalities; and</text>
</subparagraph><subparagraph id="H0CCB1861C7F94C5381779854C907EA2A"><enum>(G)</enum><text>address such other
matters relating to prostate cancer research as may be identified by the
Federal agencies participating in the program under this section.</text>
</subparagraph></paragraph><paragraph id="H9E17D0028FCF4EB3985227B755860FEE"><enum>(2)</enum><header>Prostate Cancer
Advisory Board</header><text>There is established in the Office of the Chief
Scientist of the Food and Drug Administration a Prostate Cancer Scientific
Advisory Board. Such board shall be responsible for accelerating real-time
sharing of the latest research data and accelerating movement of new medicines
to patients.</text>
</paragraph><paragraph id="H5E40755B04D448098B3AB14B159A61C2"><enum>(3)</enum><header>Underserved
minority grant program</header><text>In carrying out such program, the
Secretary shall—</text>
<subparagraph id="HA67741D7CDBD473BB995EC1A7BC4612F"><enum>(A)</enum><text>award grants to
eligible entities to carry out components of the research outlined in paragraph
(1);</text>
</subparagraph><subparagraph id="HAF74FF3EE6FC470EA5AD2586A02AA901"><enum>(B)</enum><text>integrate and
build upon existing knowledge gained from comparative effectiveness research;
and</text>
</subparagraph><subparagraph id="H73186DCF49B24C2485FF638AF1D0831F"><enum>(C)</enum><text>recognize and
address—</text>
<clause id="H432F74C12B564D5184BE90B9FFE6FAB1"><enum>(i)</enum><text>the
racial and ethnic disparities in the incidence and mortality rates of prostate
cancer and men with a family history of prostate cancer;</text>
</clause><clause id="HB6DBADCAEE464F00B50B9860F4914335"><enum>(ii)</enum><text display-inline="yes-display-inline">any barriers in access to care and
participation in clinical trials that are specific to racial, ethnic, and other
underserved minorities and men with a family history of prostate cancer;</text>
</clause><clause id="H86075AEDBD244B05BF7DB39B3D4BE6D7"><enum>(iii)</enum><text>needed outreach
and educational efforts to raise awareness in these communities; and</text>
</clause><clause id="HA4F9F61182184BEFAC16E8D601B280E0"><enum>(iv)</enum><text>appropriate
access and utilization of imaging modalities.</text>
</clause></subparagraph></paragraph></subsection><subsection id="H122034E2319C4C6286A9A649A4F94326"><enum>(e)</enum><header>Telehealth and
rural access pilot project</header>
<paragraph id="H336D0A8961784C59BC9AAEEE50D330D0"><enum>(1)</enum><header>In
general</header><text>The Secretary of Veterans Affairs, the Secretary of
Defense, and the Secretary of Health and Human Services (in this section
referred to as the <term>Secretaries</term>) shall establish 4-year telehealth
pilot projects for the purpose of analyzing the clinical outcomes and cost
effectiveness associated with telehealth services in a variety of geographic
areas that contain high proportions of medically underserved populations,
including African-Americans, Latin-Americans, American Indians, and those in
rural areas. Such projects shall promote efficient use of specialist care
through better coordination of primary care and physician extender teams in
underserved areas and more effectively employ tumor boards to better counsel
patients.</text>
</paragraph><paragraph id="HB846461F13714D0E84891E35C6EF2C51"><enum>(2)</enum><header>Eligible
entities</header>
<subparagraph id="H7C13485C8ACD47F194941BF87880ABE3"><enum>(A)</enum><header>In
general</header><text>The Secretaries shall select eligible entities to
participate in the pilot projects under this section.</text>
</subparagraph><subparagraph id="H52BE5EFE6CB14E0A902EB5A23A34922B"><enum>(B)</enum><header>Priority</header><text>In
selecting eligible entities to participate in the pilot projects under this
section, the Secretaries shall give priority to such entities located in
medically underserved areas, particularly those that include African-Americans,
Latin-Americans, and facilities of the Indian Health Service, and those in
rural areas.</text>
</subparagraph></paragraph><paragraph id="H40541F7086624DB6831575190286F5A5"><enum>(3)</enum><header>Evaluation</header><text>The
Secretaries shall, through the pilot projects, evaluate—</text>
<subparagraph id="HB08DA2DAE2A44C3092C870F2F4D9B360"><enum>(A)</enum><text>the effective and
economic delivery of care in diagnosing and treating prostate cancer with the
use of telehealth services in medically underserved and tribal areas including
collaborative uses of health professionals and integration of the range of
telehealth and other technologies;</text>
</subparagraph><subparagraph id="H0271B77A154D474FA39263CDB9B56E66"><enum>(B)</enum><text>the effectiveness
of improving the capacity of nonmedical providers and nonspecialized medical
providers to provide health services for prostate cancer in medically
underserved and tribal areas, including the exploration of innovative medical
home models with collaboration between urologists, other relevant medical
specialists, including oncologists, radiologists, and primary care teams and
coordination of care through the efficient use of primary care teams and
physician extenders; and</text>
</subparagraph><subparagraph id="HD70CDE8ABC25499FA95990F7BBDBB6B6"><enum>(C)</enum><text>the effectiveness
of using telehealth services to provide prostate cancer treatment in medically
underserved areas, including the use of tumor boards to facilitate better
patient counseling.</text>
</subparagraph></paragraph><paragraph id="HD63D3963074B4BFC827A5AC4F6F5652F"><enum>(4)</enum><header>Report</header><text>Not
later than 12 months after the completion of the pilot projects under this
subsection, the Secretaries shall submit to Congress a report describing the
outcomes of such pilot projects, including any cost savings and efficiencies
realized, and providing recommendations, if any, for expanding the use of
telehealth services.</text>
</paragraph></subsection><subsection id="HEF16F41F40D249169B1A4B0517135B1A"><enum>(f)</enum><header>Education and
awareness</header>
<paragraph id="H9FC5C46A51C64A27B7B1A665CEEFA885"><enum>(1)</enum><header>In
general</header><text>The Secretary of Veterans Affairs shall develop a
national education campaign for prostate cancer. Such campaign shall involve
the use of written educational materials and public service announcements
consistent with the findings of the Prostate Cancer Task Force under subsection
(c), that are intended to encourage men to seek prostate cancer screening when
appropriate.</text>
</paragraph><paragraph id="HF160A2BF37E14B56862D90908263C20E"><enum>(2)</enum><header>Racial
disparities and the population of men with a family history of prostate
cancer</header><text>In developing the national campaign under paragraph (1),
the Secretary shall ensure that such educational materials and public service
announcements are more readily available in communities experiencing racial
disparities in the incidence and mortality rates of prostate cancer and by men
of any race classification with a family history of prostate cancer.</text>
</paragraph><paragraph id="H9449662C70C94F769BACE71ED9B43EBE"><enum>(3)</enum><header>Grants</header><text>In
carrying out the national campaign under this section, the Secretary shall
award grants to nonprofit private entities to enable such entities to test
alternative outreach and education strategies.</text>
</paragraph></subsection><subsection id="H4CF559D045DF4355A099F8595ECE6ED5"><enum>(g)</enum><header>Authorization of
appropriations</header>
<paragraph id="H122FF1BE54F74AC09D919DC51E1D6997"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">There is authorized
to be appropriated to carry out this section for the period of fiscal years
2012 through 2016 an amount equal to the savings described in paragraph
(2).</text>
</paragraph><paragraph id="HAACA74B2DCD842F88944C37445F81914"><enum>(2)</enum><header>Corresponding
reduction</header><text>The amount authorized to be appropriated by provisions
of law other than this section for the period of fiscal years 2012 through 2016
for Federal research and health care program activities related to prostate
cancer is reduced by the amount of Federal savings projected to be achieved
over such period by implementation of subsection (c)(2)(C) of this
section.</text>
</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H952BB46A97EF44DCAA7F6EEAA2D114DB" section-type="subsequent-section"><enum>703.</enum><header>Improved Medicaid
coverage for certain breast and cervical cancer patients in the
territories</header>
<subsection commented="no" id="H71D96738A84242E6B24A0C8403298D0D"><enum>(a)</enum><header>Elimination of
funding limitations</header>
<paragraph id="H00C7A56FD9404C70AE9D04015B0675B9"><enum>(1)</enum><header>In
general</header><text>Section 1108(g)(4) of the Social Security Act (42 U.S.C.
1308(g)(4)) is amended by adding at the end the following: <quote>With respect
to fiscal years beginning with fiscal year 2012, payment for medical assistance
for individuals who are eligible for such assistance only on the basis of
section 1902(a)(10)(A)(ii)(XVIII) shall not be taken into account in applying
subsection (f) (as increased in accordance with paragraphs (1), (2), and (3) of
this subsection) to such commonwealth or territory for such fiscal
year.</quote>.</text>
</paragraph><paragraph id="H6C9782CDE629485A8E04EDA4C8E1C8C3"><enum>(2)</enum><header>Technical
amendment</header><text>Such section is further amended by striking <quote>(3),
and (4)</quote> and inserting <quote>and (3)</quote>.</text>
</paragraph></subsection><subsection commented="no" id="HA9FD6514459E405ABD944BA57B4A44FD"><enum>(b)</enum><header>Application of
enhanced FMAP for highest State</header><text>Section 1905(b) of such Act (42
U.S.C. 1396d(b)) is amended by adding at the end the following:
<quote>Notwithstanding the first sentence of this subsection, with respect to
medical assistance described in clause (4) of such sentence that is furnished
in Puerto Rico, the United States Virgin Islands, Guam, the Commonwealth of the
Northern Mariana Islands, or American Samoa in a fiscal year, the Federal
medical assistance percentage is equal to the highest such percentage applied
under such clause for such fiscal year for any of the 50 States or the District
of Columbia that provides such medical assistance for any portion of such
fiscal year.</quote></text>
</subsection><subsection commented="no" id="HD14E1E95103B45BEA8296532BDE9096C"><enum>(c)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to payment
for medical assistance for items and services furnished on or after October 1,
2011.</text>
</subsection></section><section commented="no" id="H4F165ABC88274E9DAF75AC164579E249"><enum>704.</enum><header>Cancer
prevention and treatment demonstration for ethnic and racial
minorities</header>
<subsection commented="no" id="HA841B33302844066A37192BF47B78441"><enum>(a)</enum><header>Demonstration</header>
<paragraph commented="no" id="H725DD52FBBC04300A069C9A8253053D3"><enum>(1)</enum><header>In
general</header><text>The Secretary of Health and Human Services (in this
section referred to as the <term>Secretary</term>) shall conduct demonstration
projects (in this section referred to as <term>demonstration projects</term>)
for the purpose of developing models and evaluating methods that—</text>
<subparagraph commented="no" id="H68B48F34FC2944BF95C53BCB3F18AD79"><enum>(A)</enum><text>improve the
quality of items and services provided to target individuals in order to
facilitate reduced disparities in early detection and treatment of
cancer;</text>
</subparagraph><subparagraph commented="no" id="H3714743744D946E09A52004396D306E7"><enum>(B)</enum><text>improve clinical
outcomes, satisfaction, quality of life, and appropriate use of
Medicare-covered services and referral patterns among those target individuals
with cancer;</text>
</subparagraph><subparagraph commented="no" id="H2607331A31004B469E918FDD1A78B245"><enum>(C)</enum><text>eliminate
disparities in the rate of preventive cancer screening measures, such as Pap
smears, prostate cancer screenings, and CT scans for lung cancer among target
individuals;</text>
</subparagraph><subparagraph commented="no" id="H056CFC425CC64C23AE9DE2D02CAAC89D"><enum>(D)</enum><text>promote
collaboration with community-based organizations to ensure cultural competency
of health care professionals and linguistic access for persons with
limited-English proficiency; and</text>
</subparagraph><subparagraph id="H50965D4C65234DA880CE78A0FFDE8FE4"><enum>(E)</enum><text>encourage the
incorporation of community health workers to increase the efficiency and
appropriateness of cervical cancer programs.</text>
</subparagraph></paragraph><paragraph commented="no" id="H0834CFCF3CF4435D824A636A4BA270F5"><enum>(2)</enum><header>Community health
worker defined</header><text>In this section, the term <term>community health
worker</term> includes a community health advocate, a lay health worker, a
community health representative, a peer health promotor, a community health
outreach workers, and promotores de salud, who promotes health or nutrition
within the community in which the individual resides.</text>
</paragraph><paragraph commented="no" id="H9CB3E8ECFE02412E8DEA4BB41F757B3F"><enum>(3)</enum><header>Target
individual defined</header><text>In this section, the term <term>target
individual</term> means an individual of a racial and ethnic minority group, as
defined in section 1707(g)(1) of the Public Health Service Act (42 U.S.C.
300u–6(g)(1)), who is entitled to benefits under part A, and enrolled under
part B, of title XVIII of the Social Security Act.</text>
</paragraph></subsection><subsection commented="no" id="H86696B501DB549278084E2D84FD89CDB"><enum>(b)</enum><header>Program
design</header>
<paragraph commented="no" id="H54EE191FA4D441A886E09098443A0D67"><enum>(1)</enum><header>Initial
design</header><text>Not later than 1 year after the date of the enactment of
this Act, the Secretary shall evaluate best practices in the private sector,
community programs, and academic research of methods that reduce disparities
among individuals of racial and ethnic minority groups in the prevention and
treatment of cancer and shall design the demonstration projects based on such
evaluation.</text>
</paragraph><paragraph commented="no" id="H9F8C05DE58154B82BF721839A2B46996"><enum>(2)</enum><header>Number and
project areas</header><text>Not later than 2 years after the date of the
enactment of this Act, the Secretary shall implement at least nine
demonstration projects, including the following:</text>
<subparagraph commented="no" id="HFCAB90F8DD2E42549CF9F8AC8A76AB10"><enum>(A)</enum><text>Two projects for
each of the four following major racial and ethnic minority groups:</text>
<clause commented="no" id="H6CE1591ED37C433FB53D96766A6191CD"><enum>(i)</enum><text>American Indians
and Alaska Natives, Eskimos and Aleuts.</text>
</clause><clause commented="no" id="HB9658A8E25CC496F9E8DA64F053821FF"><enum>(ii)</enum><text>Asian-Americans.</text>
</clause><clause commented="no" id="H9FCE4E96BD614B7C9AC415C82AAEE44A"><enum>(iii)</enum><text>Blacks/African-Americans.</text>
</clause><clause commented="no" id="H808A916B57854DAE821573A9B1B01DAD"><enum>(iv)</enum><text>Hispanic/Latin-Americans.</text>
</clause><clause commented="no" id="HA921BA0645AE471A81E811609D647231"><enum>(v)</enum><text>Native Hawaiians
and other Pacific Islanders.</text>
</clause><continuation-text commented="no" continuation-text-level="subparagraph">The two projects must target
different ethnic subpopulations.</continuation-text></subparagraph><subparagraph commented="no" id="HF9AF3A542F894012A8E20E06AD07EFFD"><enum>(B)</enum><text>One project within
the Pacific Islands or United States insular areas.</text>
</subparagraph><subparagraph commented="no" id="HFD7A99D46A5B483FA0A86EBD08AED08A"><enum>(C)</enum><text>At least one
project each in a rural area and inner-city area.</text>
</subparagraph></paragraph><paragraph commented="no" id="H7313343CA9ED4347A6FF6337010F2BD4"><enum>(3)</enum><header>Expansion of
projects; implementation of demonstration project results</header><text>If the
initial report under subsection (c) contains an evaluation that demonstration
projects—</text>
<subparagraph commented="no" id="H06DB7DC2410C481D9665DBD8C0F38F51"><enum>(A)</enum><text>reduce
expenditures under the Medicare program under title XVIII of the Social
Security Act; or</text>
</subparagraph><subparagraph commented="no" id="H8BC5704B68994E76952C83CBEEC12240"><enum>(B)</enum><text>do not increase
expenditures under the Medicare program and reduce racial and ethnic health
disparities in the quality of health care services provided to target
individuals and increase satisfaction of beneficiaries and health care
providers;</text>
</subparagraph><continuation-text commented="no" continuation-text-level="paragraph">the Secretary shall continue the
existing demonstration projects and may expand the number of demonstration
projects.</continuation-text></paragraph></subsection><subsection commented="no" id="H5A33837E937045B5B791377B90061D65"><enum>(c)</enum><header>Report to
congress</header>
<paragraph commented="no" id="H395211236C0A4A6F9EFCBFC00306CB78"><enum>(1)</enum><header>In
general</header><text>Not later than 2 years after the date the Secretary
implements the initial demonstration projects, and biannually thereafter, the
Secretary shall submit to Congress a report regarding the demonstration
projects.</text>
</paragraph><paragraph commented="no" id="HE7B7BD2372374E87A692C89FAB3FAABA"><enum>(2)</enum><header>Contents of
report</header><text>Each report under paragraph (1) shall include the
following:</text>
<subparagraph commented="no" id="HFCB40F3C25B34A53AFBA9DCED1447241"><enum>(A)</enum><text>A description of
the demonstration projects.</text>
</subparagraph><subparagraph commented="no" id="HFDB6ED5E84134644A3875797439631BF"><enum>(B)</enum><text>An evaluation
of—</text>
<clause commented="no" id="H57D751D458E346FABECEAFD6A857941F"><enum>(i)</enum><text>the cost
effectiveness of the demonstration projects;</text>
</clause><clause commented="no" id="H4307FDB181ED495687231E15346F2CB6"><enum>(ii)</enum><text>the quality of
the health care services provided to target individuals under the demonstration
projects; and</text>
</clause><clause commented="no" id="HDE5682514A89409D8DD41E9391177C3B"><enum>(iii)</enum><text>beneficiary and
health care provider satisfaction under the demonstration projects.</text>
</clause></subparagraph><subparagraph commented="no" id="H3FAFCD122A5743D1892A8B1DAD062D44"><enum>(C)</enum><text>Any other
information regarding the demonstration projects that the Secretary determines
to be appropriate.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="HD145E0A399924930BE6E479CFBF0745E"><enum>(d)</enum><header>Waiver
authority</header><text>The Secretary shall waive compliance with the
requirements of title XVIII of the Social Security Act to such extent and for
such period as the Secretary determines is necessary to conduct demonstration
projects.</text>
</subsection></section><section id="H54FA5EDA9B1446F385ECD9D268BB9E29"><enum>705.</enum><header>Reducing cancer
disparities within Medicare</header>
<subsection commented="no" id="H23C889B3B54A47EE8CD217AC7783BBF6"><enum>(a)</enum><header>Development of
measures of disparities in quality of cancer care</header>
<paragraph commented="no" id="H517F8DCD79E948EC800E33D03266A2ED"><enum>(1)</enum><header>Development of
measures</header><text>The Secretary of Health and Human Services (in this
section referred to as the <term>Secretary</term>) shall enter into an
agreement with the National Quality Forum <inline-comment display="no">(operating as a voluntary consensus standards body as defined for
purposes of section 12(d) of the National Technology Transfer and Advancement
Act of 1995 (Public Law 104–113) and Office of Management and Budget Revised
Circular A–119 (published in the Federal Register on February 10,
1998))</inline-comment> under which the National Quality Forum shall develop a
uniform set of measures to evaluate disparities in the quality of cancer care,
endorse such set of measures through its multistakeholder consensus development
process, and annually update such set of measures.</text>
</paragraph><paragraph commented="no" id="H2078FF2A47CE40C09F4EB3F620EC4841"><enum>(2)</enum><header>Measures to be
included</header><text>Such set of measures shall include, with respect to the
treatment of cancer, measures of patient outcomes, the process for delivering
medical care related to such treatment, patient counseling and engagement in
decisionmaking, patient experience of care, resource use, and practice
capabilities, such as care coordination.</text>
</paragraph></subsection><subsection commented="no" id="H8953EF9728F247B587A731BA46FDE75A"><enum>(b)</enum><header>Establishment of
reporting process</header>
<paragraph commented="no" id="H29D7A0B30CDA49C59504AE8FC8248401"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary shall
establish a reporting process that provides for a method for health care
providers specified under paragraph (2) to submit to the Secretary and make
public data on the performance of such providers during each reporting period
through use of the measures developed pursuant to subsection (a). Such data
shall be submitted in a form and manner and at a time specified by the
Secretary.</text>
</paragraph><paragraph commented="no" id="H4A31C14BD6384E33846EA9027D58126F"><enum>(2)</enum><header>Specification of
providers to report on measures</header><text display-inline="yes-display-inline">The Secretary shall specify the classes of
Medicare providers of services and suppliers, including hospitals, cancer
centers, physicians, primary care providers, and specialty providers, that will
be required under such process to publicly report on the measures specified
under subsection (a).</text>
</paragraph><paragraph commented="no" id="HB9B63FCD7A144F779EC242C933270419"><enum>(3)</enum><header>Assessment of
changes</header><text>Within this reporting process, the Secretary shall also
establish a format that assesses changes in both the absolute and relative
disparities over time. These measures shall be presented in an easily
comprehensible format, such as those presented in the final publications
relating to Healthy People 2010 or the National Healthcare Disparities
Report.</text>
</paragraph><paragraph id="H3113EC8629E04413A2E28D9E4D714C69"><enum>(4)</enum><header>Initial
implementation</header><text>The Secretary shall implement the reporting
process under this subsection for reporting periods beginning not later than 6
months after the date that measures are first established under subsection
(a).</text>
</paragraph></subsection></section></subtitle><subtitle id="H3FDAFDC51BCA4561AC6F80DF46ED44D6"><enum>B</enum><header>Viral Hepatitis
and Liver Cancer Control and Prevention</header>
<section id="H5DA7DE3F6AD04FC38A4407EBE3B0F203"><enum>711.</enum><header>Viral Hepatitis
and Liver Cancer Control and Prevention</header>
<subsection id="HA16BB2D3493C43EE8281C0C4FB074A15"><enum>(a)</enum><header>Short
title</header><text>This subtitle may be cited as the <quote><short-title>Viral Hepatitis and Liver Cancer Control and Prevention
Act of 2011</short-title></quote>.</text>
</subsection><subsection id="HEE15225183E0495C91FE55470F363623"><enum>(b)</enum><header>Findings</header><text>Congress
finds the following:</text>
<paragraph id="HEBCE32E615CE45F08EA8EC6FED962A77"><enum>(1)</enum><text>Approximately
5,300,000 Americans are chronically infected with the hepatitis B virus
(referred to in this section as <term>HBV</term>), the hepatitis C virus
(referred to in this section as <term>HCV</term>), or both.</text>
</paragraph><paragraph id="HD118F18D44F147C897EDE786AE204672"><enum>(2)</enum><text>In the United
States, chronic HBV and HCV are the most common cause of liver cancer, one of
the most lethal and fastest growing cancers in this country. It is the most
common cause of chronic liver disease, liver cirrhosis, and the most common
indication for liver transplantation. It is also a leading cause of death in
Americans living with HIV/AIDS, many of whom are coinfected with chronic HBV,
chronic HCV, or both. At least 15,000 deaths per year in the United States can
be attributed to chronic HBV and HCV.</text>
</paragraph><paragraph id="H14526B4B0EB7454A89233AB22BAF064A"><enum>(3)</enum><text>According to the
Centers for Disease Control and Prevention (referred to in this section as the
<term>CDC</term><quote></quote>), approximately 2 percent of the population of
the United States is living with chronic HBV, chronic HCV, or both. The CDC has
recognized HCV as the Nation’s most common chronic bloodborne virus infection
and HBV as the deadliest vaccine-preventable disease.</text>
</paragraph><paragraph id="HA0C625B99D4246F68ACBEFAA1B6CB0F8"><enum>(4)</enum><text>HBV is easily
transmitted and is 100 times more infectious than HIV. According to the CDC,
HBV is transmitted through percutaneous (i.e., puncture through the skin) or
mucosal contact with infectious blood or body fluids. HCV is transmitted by
percutaneous exposures to infectious blood.</text>
</paragraph><paragraph id="H5C3BCC49964E4DB3B10FC87C2FA2F609"><enum>(5)</enum><text>The CDC
conservatively estimates that in 2008 approximately 18,000 Americans were newly
infected with HCV and more than 38,000 Americans were newly infected with
HBV.</text>
</paragraph><paragraph id="HEBF25506FDE84EA3807C1C84BF42262D"><enum>(6)</enum><text>There were 6
outbreaks reported to CDC for investigation in 2008 related to health care
acquired infection of HBV and HCV, potentially exposing more than 52,000
Americans to the viruses, in 2009–2010 there were 15 outbreaks in which more
than 30,000 people were potentially exposed.</text>
</paragraph><paragraph id="HE327CE9F4A4F4A41AB60D388A2812A0B"><enum>(7)</enum><text>Chronic HBV and
chronic HCV usually do not cause symptoms early in the course of the disease,
but after many years of a clinically <term>silent</term> phase, more than 50
percent of infected individuals will develop cirrhosis, end-stage liver
disease, or liver cancer. Since most of those with chronic HBV and HCV are
unaware of their infection, they do not know to take precautions to prevent the
spread of their infection and can unknowingly exacerbate their own disease
progression.</text>
</paragraph><paragraph id="H0C40229C76474A4E80C57D8781DF30E5"><enum>(8)</enum><text>HBV and HCV
disproportionately affect certain populations in the United States. Although
representing only 5 percent of the population, Asian-Americans and Pacific
Islanders account for over half of the 1,400,000 domestic chronic HBV cases.
Baby boomers (those born between 1946 and 1964) account for more than half of
domestic chronic hepatitis C cases. In addition, African-Americans,
Latin-Americans, and American Indian/Alaskan Natives are among the groups which
have disproportionately high rates of HBV and/or HCV infections in the United
States.</text>
</paragraph><paragraph id="HD896A29F228A4B9A836C6C9B30E230CD"><enum>(9)</enum><text>For both chronic
HBV and chronic HCV, behavioral changes can slow disease progression if
diagnosis is made early. Early diagnosis, which is determined through simple
blood tests, can reduce the risk of transmission and disease progression
through education and vaccination of household members and other susceptible
persons at risk.</text>
</paragraph><paragraph id="H4484B2A7E3E1455FADCEB3A3FD5E37E0"><enum>(10)</enum><text>For those
chronically infected with HBV or HCV, regular monitoring can lead to the early
detection of liver cancer at a stage where cure is still possible. Liver cancer
is the third deadliest cancer in the United States however, liver cancer has
received little funding for research, prevention, or treatment.</text>
</paragraph><paragraph id="HA9907B10E4614ECBA1CC418024784C29"><enum>(11)</enum><text>Treatment for
chronic HCV can eradicate the disease in approximately 75 percent of those
currently treated. The treatment of chronic HBV can effectively suppress viral
replication in the overwhelming majority (>80%) of those treated thereby
reducing the risk of transmission and progression to liver scarring or liver
cancer even though a complete cure is much less common than for HCV.</text>
</paragraph><paragraph id="H3D017408AC204A27B8AB33AA7369F07A"><enum>(12)</enum><text>To combat the HBV
and HCV epidemics in the United States, in May 2011, the Department of Health
and Human Services released Combating the Silent Epidemic of Viral Hepatitis:
Action Plan for the Prevention, Care & Treatment of Viral Hepatitis
(hereafter referred to as the HHS Action Plan). The Institute of Medicine (IOM)
of the National Academies 2010 reported on the Federal response to HBV and HCV
titled: Hepatitis and Liver Cancer: A National Strategy for Prevention and
Control of Hepatitis B and C. These recommendations and guidelines provide a
framework for HBV and HCV prevention, education, control, research, and medical
management programs.</text>
</paragraph><paragraph id="HF7E66D7940CD414FAD07A08D272F124B"><enum>(13)</enum><text>The annual health
care costs attributable to HBV and HCV in the United States are significant.
For HBV, it is estimated to be approximately $1,000,000,000 to 2,000,000,000
($1,000 to $2,000 per infected person). More than $1,000,000,000 is spent each
year for HBV-related hospitalizations. The indirect costs of chronic HBV
infection are harder to measure, but include reduced physical and emotional
quality of life, reduced economic productivity, long-term disability, and
premature death. For HCV, medical costs for patients are expected to increase
from $30,000,000,000 in 2009 to over $85,000,000,000 in 2024. Avoiding these
costs by screening and diagnosing individuals earlier—and connecting them to
appropriate treatment and care will save lives and critical health care
dollars. Currently, without a comprehensive screening, testing and diagnosis
program, most patients are diagnosed too late when they need a liver transplant
costing at least $314,000 for uncomplicated cases or when they have liver
cancer or end stage liver disease which costs $30,980 to $110,576 per hospital
admission. As health care costs continue to grow, it is critical that the
Federal Government invests in effective mechanisms to avoid documented cost
drivers.</text>
</paragraph><paragraph id="HD3186F1C19F04009AE56431C3B1C3F99"><enum>(14)</enum><text>According to the
IOM report in 2010, chronic HBV and HCV infections cause substantial morbidity
and mortality despite being preventable and treatable. Deficiencies in the
implementation of established guidelines for the prevention, diagnosis, and
medical management of chronic HBV and HCV infections perpetuate personal and
economic burdens. Existing grants are not sufficient for the scale of the
health burden presented by HBV and HCV.</text>
</paragraph><paragraph id="HDE419739D1884116836D2B522A2EA49E"><enum>(15)</enum><text>Screening and
testing for HBV and HCV is aligned with the Healthy People 2020 goal; Increase
immunization rates and reduce preventable infectious diseases. Awareness of
disease and access to prevention and treatment remain essential components for
reducing infectious disease transmission.</text>
</paragraph><paragraph id="HB0FB9DF9CCB24A4E8B61ACC937237852"><enum>(16)</enum><text>Federal support
is necessary to increase knowledge and awareness of HBV and HCV and to assist
State and local prevention and control efforts in reducing the morbidity and
mortality of these epidemics.</text>
</paragraph></subsection><subsection commented="no" id="HAE1671E562D8445EBA151D696651EC1C"><enum>(c)</enum><header>Biennial
assessment of HHS hepatitis B and hepatitis C prevention, education, research,
and medical management plan</header><text>Title III of the Public Health
Service Act (42 U.S.C. 241 et seq.) is amended—</text>
<paragraph commented="no" id="HF47DA6AFB16D4C1BB9B737406C87BD14"><enum>(1)</enum><text>by striking
section 317N (42 U.S.C. 247b–15); and</text>
</paragraph><paragraph commented="no" id="H51CDBBF1F474433FA559124EF7FD7570"><enum>(2)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H8587D8741A9F4F80966C0D0AE44B910B" style="OLC">
<part commented="no" id="H7F8FDDB364014F619762E3CE0C97BA7F"><enum>X</enum><header>Biennial
assessment of HHS Hepatitis B and Hepatitis C prevention, education, research,
and medical management plan</header>
<section commented="no" id="H8F9CC51CD33949D4A43CCA87C4360104"><enum>399NN.</enum><header>Biennial
Update of the Plan</header>
<subsection commented="no" id="H34650B3E3328442485EAB12E67E059B0"><enum>(a)</enum><header>In
general</header><text>The Secretary shall conduct a biennial assessment of the
Secretary’s plan for the prevention, control, and medical management of, and
education and research relating to, hepatitis B and hepatitis C, for the
purposes of—</text>
<paragraph commented="no" id="H7A55E1D4A1D945659CAD2EC3C1C70843"><enum>(1)</enum><text>incorporating into
such plan new knowledge or observations relating to hepatitis B and hepatitis C
(such as knowledge and observations that may be derived from clinical,
laboratory, and epidemiological research and disease detection, prevention, and
surveillance outcomes);</text>
</paragraph><paragraph commented="no" id="H868847EBAA9749A5AA021D4FA5F5E04B"><enum>(2)</enum><text display-inline="yes-display-inline">addressing gaps in the coverage or
effectiveness of the plan; and</text>
</paragraph><paragraph commented="no" id="HDF352D6142164A3FA7A40CF8D80AB372"><enum>(3)</enum><text>evaluating and, if
appropriate, updating recommendations, guidelines, or educational materials of
the Centers for Disease Control and Prevention or the National Institutes of
Health for health care providers or the public on viral hepatitis in order to
be consistent with the plan.</text>
</paragraph></subsection><subsection commented="no" id="H77F8405A18CD429EB557D7BD5F272464"><enum>(b)</enum><header>Publication of
notice of assessments</header><text>Not later than October 1 of the first
even-numbered year beginning after the date of the enactment of this part, and
October 1 of each even-numbered year thereafter, the Secretary shall publish in
the Federal Register a notice of the results of the assessments conducted under
paragraph (1). Such notice shall include—</text>
<paragraph commented="no" id="H9D5605B804794E50BF0F2ADE7EDAFFA3"><enum>(1)</enum><text>a description of
any revisions to the plan referred to in subsection (a) as a result of the
assessment;</text>
</paragraph><paragraph commented="no" id="HDFA69893D88147C1B3856D3C54AC7933"><enum>(2)</enum><text>an explanation of
the basis for any such revisions, including the ways in which such revisions
can reasonably be expected to further promote the original goals and objectives
of the plan; and</text>
</paragraph><paragraph commented="no" id="H42F0467BD820414EBE929674EB3323F2"><enum>(3)</enum><text>in the case of a
determination by the Secretary that the plan does not need revision, an
explanation of the basis for such determination.</text>
</paragraph></subsection></section><section commented="no" id="H0C63C335268648BB81E70F9444A5C1C4"><enum>399NN–1.</enum><header>Elements of
program</header>
<subsection commented="no" id="H12201B922E9A4726A711CE45154AA790"><enum>(a)</enum><header>Education and
awareness programs</header><text>The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, the Administrator of the Health
Resources and Services Administration, and the Administrator of the Substance
Abuse and Mental Health Services Administration, and in accordance with the
plan referred to in section 399NN(a), shall implement programs to increase
awareness and enhance knowledge and understanding of hepatitis B and hepatitis
C. Such programs shall include—</text>
<paragraph commented="no" id="H7568DDBC243B4D1787872BF1B69B6205"><enum>(1)</enum><text>the conduct of
culturally and language appropriate health education in primary and secondary
schools, college campuses, public awareness campaigns, and community outreach
activities (especially to the ethnic communities with high rates of chronic
hepatitis B and chronic hepatitis C and other high-risk groups) to promote
public awareness and knowledge about the value of hepatitis A and hepatitis B
immunization, risk factors, the transmission and prevention of hepatitis B and
hepatitis C, the value of screening for the early detection of hepatitis B and
hepatitis C, and options available for the treatment of chronic hepatitis B and
chronic hepatitis C;</text>
</paragraph><paragraph commented="no" id="H1724AD14CC804CE5BAC7A27040A91B69"><enum>(2)</enum><text display-inline="yes-display-inline">the promotion of immunization programs that
increase awareness and access to hepatitis A and hepatitis B vaccines for
susceptible adults and children;</text>
</paragraph><paragraph commented="no" id="H1DE52A64168D4F739DDB8769E0F50B5A"><enum>(3)</enum><text display-inline="yes-display-inline">the training of health care professionals
regarding the importance of vaccinating individuals infected with hepatitis C
and individuals who are at risk for hepatitis C infection against hepatitis A
and hepatitis B;</text>
</paragraph><paragraph commented="no" id="H1515A4FD615346B5803D817E15AA5675"><enum>(4)</enum><text>the training of
health care professionals regarding the importance of vaccinating individuals
chronically infected with hepatitis B and individuals who are at risk for
chronic hepatitis B infection against the hepatitis A virus;</text>
</paragraph><paragraph commented="no" id="H37E8DD9A399D4B62B678922CC1186D5B"><enum>(5)</enum><text>the training of
health care professionals and health educators to make them aware of the high
rates of chronic hepatitis B and chronic hepatitis C in certain adult ethnic
populations, and the importance of prevention, detection, and medical
management of hepatitis B and hepatitis C and of liver cancer screening;</text>
</paragraph><paragraph commented="no" id="HA6459E1801904F238EAABECEF1EA008F"><enum>(6)</enum><text>the development
and distribution of health education curricula (including information relating
to the special needs of individuals infected with hepatitis B and hepatitis C,
such as the importance of prevention and early intervention, regular
monitoring, the recognition of psychosocial needs, appropriate treatment, and
liver cancer screening) for individuals providing hepatitis B and hepatitis C
counseling; and</text>
</paragraph><paragraph commented="no" id="H1EAC86CBCBDE47358715DB329C04FFF5"><enum>(7)</enum><text>support for the
implementation curricula described in paragraph (6) by State and local public
health agencies.</text>
</paragraph></subsection><subsection commented="no" id="H79C867754D9F4ED79BBB39B2DA3108D2"><enum>(b)</enum><header>Immunization,
prevention, and control programs</header>
<paragraph commented="no" id="H90DEEC4106054B228F6DD17E35FE5583"><enum>(1)</enum><header>In
general</header><text>The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, shall support the integration of activities
described in paragraph (2) into existing clinical and public health programs at
State, local, territorial, and tribal levels (including community health
clinics, programs for the prevention and treatment of HIV/AIDS, sexually
transmitted diseases, and substance abuse, and programs for individuals in
correctional settings).</text>
</paragraph><paragraph commented="no" id="HC0BC91E1F5874C6F9A044874A3583685"><enum>(2)</enum><header>Activities</header>
<subparagraph commented="no" id="HBE073619062D4D01B914CB87B494D996"><enum>(A)</enum><header>Voluntary
testing programs</header>
<clause commented="no" id="H7D06088A83734CD2AEA04E8ACE163B2E"><enum>(i)</enum><header>In
general</header><text>The Secretary shall establish a mechanism by which to
support and promote the development of State, local, territorial, and tribal
voluntary hepatitis B and hepatitis C testing programs to screen the
high-prevalence populations to aid in the early identification of chronically
infected individuals.</text>
</clause><clause commented="no" id="H7A8FDE5AACF849DB9E64D0F334F02087"><enum>(ii)</enum><header>Confidentiality
of the test results</header><text>The Secretary shall prohibit the use of the
results of a hepatitis B or hepatitis C test conducted by a testing program
developed or supported under this subparagraph for any of the following:</text>
<subclause commented="no" id="H1965876173904D42A54005BF8DC2FABE"><enum>(I)</enum><text>Issues relating to
health insurance.</text>
</subclause><subclause commented="no" id="H6F4C7C6CF06846298904300491675712"><enum>(II)</enum><text>To screen or
determine suitability for employment.</text>
</subclause><subclause commented="no" id="HA9FD936FE0EF437E894925A3784F2EF0"><enum>(III)</enum><text>To discharge a
person from employment.</text>
</subclause></clause></subparagraph><subparagraph commented="no" id="HC59F0D4B7E3C4D79B005025400A97347"><enum>(B)</enum><header>Counseling
regarding viral hepatitis</header><text>The Secretary shall support State,
local, territorial, and tribal programs in a wide variety of settings,
including those providing primary and specialty health care services in
nonprofit private and public sectors, to—</text>
<clause commented="no" id="HCEFBB4B8694F465AA4598A49BD7272B0"><enum>(i)</enum><text>provide
individuals with ongoing risk factors for hepatitis B and hepatitis C infection
with client-centered education and counseling which concentrates on—</text>
<subclause commented="no" id="H3E819480E39048D7BFBE124443F7E408"><enum>(I)</enum><text>promoting testing
of individuals that have been exposed to their blood, family members, and their
sexual partners; and</text>
</subclause><subclause commented="no" id="HF14175DBC8434E039D37C963475A414E"><enum>(II)</enum><text>changing
behaviors that place individuals at risk for infection;</text>
</subclause></clause><clause commented="no" id="H2BD52406A29B4F0B84A632AFAE954BE0"><enum>(ii)</enum><text>provide
individuals chronically infected with hepatitis B or hepatitis C with
education, health information, and counseling to reduce their risk of—</text>
<subclause commented="no" id="H45811B72108B41238501CEA489C99F61"><enum>(I)</enum><text>dying from
end-stage liver disease and liver cancer; and</text>
</subclause><subclause commented="no" id="HEA9CC1CF2D2849C593F0C83DE6B5F2E8"><enum>(II)</enum><text>transmitting
viral hepatitis to others; and</text>
</subclause></clause><clause commented="no" id="HA38897CC3C854632AB4E72C16BD895CE"><enum>(iii)</enum><text>provide women
chronically infected with hepatitis B or hepatitis C who are pregnant or of
childbearing age with culturally and language appropriate health information,
such as how to prevent hepatitis B perinatal infection, and to alleviate fears
associated with pregnancy or raising a family.</text>
</clause></subparagraph><subparagraph commented="no" id="H1500A36CB8A9493BB57826CBC61F7EF4"><enum>(C)</enum><header>Immunization</header><text>The
Secretary shall support State, local, territorial, and tribal efforts to expand
the current vaccination programs to protect every child in the country and all
susceptible adults, particularly those infected with hepatitis C and
high-prevalence ethnic populations and other high-risk groups, from the risks
of acute and chronic hepatitis B infection by—</text>
<clause commented="no" id="HA93270CFCD104246B9CDC881EF107A33"><enum>(i)</enum><text>ensuring continued
funding for hepatitis B vaccination for all children 19 years of age or younger
through the Vaccines for Children Program;</text>
</clause><clause commented="no" id="H393196A3F5A64B34BDC2D67D44B40503"><enum>(ii)</enum><text>ensuring that the
recommendations of the Advisory Committee on Immunization Practices are
followed regarding the birth dose of hepatitis B vaccinations for
newborns;</text>
</clause><clause commented="no" id="HD917CB0385864C0AACE2EC4158C862E3"><enum>(iii)</enum><text>requiring proof
of hepatitis B vaccination for entry into public or private daycare, preschool,
elementary school, secondary school, and institutions of higher
education;</text>
</clause><clause commented="no" id="HD86EA739433A44E1BAB12925C184CDDC"><enum>(iv)</enum><text>expanding the
availability of hepatitis B vaccination for all susceptible adults to protect
them from becoming acutely or chronically infected, including ethnic and other
populations with high prevalence rates of chronic hepatitis B infection;</text>
</clause><clause commented="no" id="HF9989B5413FB4C76A7CB05970E7CA144"><enum>(v)</enum><text>expanding the
availability of hepatitis B vaccination for all susceptible adults,
particularly those in their reproductive age (women and men less than 45 years
of age), to protect them from the risk of hepatitis B infection;</text>
</clause><clause commented="no" id="H97F6B091D0684A528544FF2DE0FDBB61"><enum>(vi)</enum><text>ensuring the
vaccination of individuals infected, or at risk for infection, with hepatitis C
against hepatitis A, hepatitis B, and other infectious diseases, as
appropriate, for which such individuals may be at increased risk; and</text>
</clause><clause commented="no" id="H6D2175ED72E246A5865ABAAED400B8DB"><enum>(vii)</enum><text>ensuring the
vaccination of individuals infected, or at risk for infection, with hepatitis B
against hepatitis A virus and other infectious diseases, as appropriate, for
which such individuals may be at increased risk.</text>
</clause></subparagraph><subparagraph commented="no" id="H1AA8A53F6BDA44E1BB9ED5DDB274135F"><enum>(D)</enum><header>Medical
referral</header><text>The Secretary shall support State, local, territorial,
and tribal programs that support—</text>
<clause commented="no" id="HA2D7DCF44CB4427CA1299333A3521814"><enum>(i)</enum><text>referral of
persons chronically infected with hepatitis B or hepatitis C—</text>
<subclause commented="no" id="HC99F8659D96C4C51AB0A6D3104230636"><enum>(I)</enum><text>for medical
evaluation to determine the appropriateness for antiviral treatment to reduce
the risk of progression to cirrhosis and liver cancer; and</text>
</subclause><subclause commented="no" id="HEF72BDD53FA14D248F75FBF0148EC43E"><enum>(II)</enum><text>for ongoing
medical management including regular monitoring of liver function and screening
for liver cancer; and</text>
</subclause></clause><clause commented="no" id="H4FA515728FC54C27B3A80379E6098105"><enum>(ii)</enum><text>referral of
persons infected with acute or chronic hepatitis B infection or acute or
chronic hepatitis C infection for drug and alcohol abuse treatment where
appropriate.</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="H899FCAAACF464EB9911C64074EB86576"><enum>(3)</enum><header>Increased
support for adult viral hepatitis coordinators</header><text>The Secretary,
acting through the Director of the Centers for Disease Control and Prevention,
shall provide increased support to Adult Viral Hepatitis Coordinators in State,
local, territorial, and tribal health departments in order to enhance the
additional management, networking, and technical expertise needed to ensure
successful integration of hepatitis B and hepatitis C prevention and control
activities into existing public health programs.</text>
</paragraph></subsection><subsection commented="no" id="HE66693B89B0C4F47B2D6BA3FB31DB5FC"><enum>(c)</enum><header>Epidemiological
surveillance</header>
<paragraph commented="no" id="H947C34A4BFBE4A86AFA3484635BE54B9"><enum>(1)</enum><header>In
general</header><text>The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, shall support the establishment and
maintenance of a national chronic and acute hepatitis B and hepatitis C
surveillance program, in order to identify—</text>
<subparagraph commented="no" id="H92D2A54A5177404CBD5EB3E1AD13663F"><enum>(A)</enum><text>trends in the
incidence of acute and chronic hepatitis B and acute and chronic hepatitis
C;</text>
</subparagraph><subparagraph commented="no" id="H443D30FBE87A4EC493DF37D54433CACF"><enum>(B)</enum><text>trends in the
prevalence of acute and chronic hepatitis B and acute and chronic hepatitis C
infection among groups that may be disproportionately affected; and</text>
</subparagraph><subparagraph commented="no" id="H3B8329F11EE84043A7619806055A0009"><enum>(C)</enum><text>trends in liver
cancer and end-stage liver disease incidence and deaths, caused by chronic
hepatitis B and chronic hepatitis C in the high-risk ethnic populations.</text>
</subparagraph></paragraph><paragraph commented="no" id="H82CA35A62A504932925A6F3EA6770EA9"><enum>(2)</enum><header>Seroprevalence
and liver cancer studies</header><text>The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, shall prepare a
report outlining the population-based seroprevalence studies currently
underway, future planned studies, the criteria involved in determining which
seroprevalence studies to conduct, defer, or suspend, and the scope of those
studies, the economic and clinical impact of hepatitis B and hepatitis C, and
the impact of chronic hepatitis B and chronic hepatitis C infections on the
quality of life. Not later than one year after the date of the enactment of
this part, the Secretary shall submit the report to the Committee on Energy and
Commerce of the House of Representatives and the Committee on Health,
Education, Labor, and Pensions of the Senate.</text>
</paragraph><paragraph commented="no" id="HB9F71CFDF0E941439252AA4909BB863F"><enum>(3)</enum><header>Confidentiality</header><text>The
Secretary shall not disclose any individually identifiable information
identified under paragraph (1) or derived through studies under paragraph
(2).</text>
</paragraph></subsection><subsection commented="no" id="H97959AE75FD0459D9075A7DA3C99E1EF"><enum>(d)</enum><header>Research</header><text>The
Secretary, acting through the Director of the Centers for Disease Control and
Prevention, the Director of the National Cancer Institute, and the Director of
the National Institutes of Health, shall—</text>
<paragraph commented="no" id="H8406FCF83EB4488A877BCF65578C82F4"><enum>(1)</enum><text>conduct
epidemiologic and community-based research to develop, implement, and evaluate
best practices for hepatitis B and hepatitis C prevention especially in the
ethnic populations with high rates of chronic hepatitis B and chronic hepatitis
C and other high-risk groups;</text>
</paragraph><paragraph commented="no" id="HAEB9764A6DA548BB8442C7CBF067D7D1"><enum>(2)</enum><text>conduct research
on hepatitis B and hepatitis C natural history, pathophysiology, improved
treatments and prevention (such as the hepatitis C vaccine), and noninvasive
tests that help to predict the risk of progression to liver cirrhosis and liver
cancer;</text>
</paragraph><paragraph commented="no" id="HD72E0ED7D54F453DA4644923457C1FCB"><enum>(3)</enum><text>conduct research
that will lead to better noninvasive or blood tests to screen for liver cancer,
and more effective treatments of liver cancer caused by chronic hepatitis B and
chronic hepatitis C; and</text>
</paragraph><paragraph commented="no" id="H1038A644366A4DD9B6FF16A3BCF10896"><enum>(4)</enum><text>conduct research
comparing the effectiveness of screening, diagnostic, management, and treatment
approaches for chronic hepatitis B, chronic hepatitis C, and liver cancer in
the affected communities.</text>
</paragraph></subsection><subsection commented="no" id="HA58BB65158E9444FBED85509C5DF99F0"><enum>(e)</enum><header>Underserved and
disproportionately affected populations</header><text>In carrying out this
section, the Secretary shall provide expanded support for individuals with
limited access to health education, testing, and health care services and
groups that may be disproportionately affected by hepatitis B and hepatitis
C.</text>
</subsection><subsection commented="no" id="HB886A625472544049F7463B6224A20E2"><enum>(f)</enum><header>Evaluation of
program</header><text>The Secretary shall develop benchmarks for evaluating the
effectiveness of the programs and activities conducted under this section and
make determinations as to whether such benchmarks have been achieved.</text>
</subsection></section><section commented="no" id="H742A8DA6CC2942E8801F872317EDDFA3"><enum>399NN–2.</enum><header>Grants</header>
<subsection commented="no" id="H8D4C6347A9D8457ABB530B3376D743C1"><enum>(a)</enum><header>In
general</header><text>The Secretary may award grants to, or enter into
contracts or cooperative agreements with, States, political subdivisions of
States, territories, Indian tribes, or nonprofit entities that have special
expertise relating to hepatitis B, hepatitis C, or both, to carry out
activities under this part.</text>
</subsection><subsection commented="no" id="H209035481D964A24BCB0FB1D1B6585BA"><enum>(b)</enum><header>Application</header><text>To
be eligible for a grant, contract, or cooperative agreement under subsection
(a), an entity shall prepare and submit to the Secretary an application at such
time, in such manner, and containing such information as the Secretary may
require.</text>
</subsection></section><section commented="no" id="HEF8FB8853E1A439783BF4AE098679464"><enum>399NN–3.</enum><header>Authorization
of appropriations</header><text display-inline="no-display-inline">There are
authorized to be appropriated to carry out this part $90,000,000 for fiscal
year 2012, $90,000,000 for fiscal year 2013, $110,000,000 for fiscal year 2014,
$130,000,000 for fiscal year 2015, and $150,000,000 for fiscal year
2016.</text>
</section></part><after-quoted-block>. </after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H3FA6703FA5F64E878ACACA837C2CBDD7"><enum>(d)</enum><header>Enhancing
SAMHSA’s role in hepatitis activities</header><text>Paragraph (6) of section
501(d) of the Public Health Service Act (42 U.S.C. 290aa(d)) is amended by
striking <quote>HIV or tuberculosis</quote> and inserting <quote>HIV,
tuberculosis, or hepatitis</quote>.</text>
</subsection></section></subtitle><subtitle id="HC97CAF679D8E431EBDE9495BCAABC116"><enum>C</enum><header>Acquired Bone
Marrow Failure Diseases</header>
<section id="H7BFFB5287C69444BB525038E7065636D"><enum>721.</enum><header>Acquired Bone
Marrow Failure Diseases</header>
<subsection id="H74FB517B8D3A4F03891FEB07330B52B5"><enum>(a)</enum><header>Short
title</header><text>This subtitle may be cited as the <quote><short-title>Bone Marrow Failure Disease Research and Treatment Act of
2011</short-title></quote>.</text>
</subsection><subsection id="HEA454E88AD6C44219F46ADEE4EF79258"><enum>(b)</enum><header>Findings</header><text>The
Congress finds the following:</text>
<paragraph id="H3C2CCBB693A54A22ADFDCCA554595BAE"><enum>(1)</enum><text>Between 20,000 and
30,000 Americans are diagnosed each year with myelodysplastic syndromes,
aplastic anemia, paroxysmal nocturnal hemoglobinuria, and other acquired bone
marrow failure diseases.</text>
</paragraph><paragraph id="H5F47E70E9B184FD88F780DA3884D5622"><enum>(2)</enum><text>Acquired bone
marrow failure diseases have a debilitating and often fatal impact on those
diagnosed with these diseases.</text>
</paragraph><paragraph id="H24B44F645B544CE4A7BBC9F5F61439D3"><enum>(3)</enum><text>While some
treatments for acquired bone marrow failure diseases can prolong and improve
the quality of patients’ lives, there is no single cure for these
diseases.</text>
</paragraph><paragraph id="H36445D5BDF5247BEAA0B519BD90280CD"><enum>(4)</enum><text>The prevalence of
acquired bone marrow failure diseases in the United States will continue to
grow as the general public ages.</text>
</paragraph><paragraph id="HE280C72CB44344529A6EA4B0B5DF638C"><enum>(5)</enum><text>Evidence exists
suggesting that acquired bone marrow failure diseases occur more often in
minority populations, particularly in Asian-American and
Hispanic/Latin-American populations.</text>
</paragraph><paragraph id="H8ACE6922E7F045A5B80BFCC5E30E24D7"><enum>(6)</enum><text>The National
Heart, Lung, and Blood Institute and the National Cancer Institute have
conducted important research into the causes of and treatments for acquired
bone marrow failure diseases.</text>
</paragraph><paragraph id="HD0D5E758AE1A47CC8072133705EF10BD"><enum>(7)</enum><text>The National
Marrow Donor Program Registry has made significant contributions to the fight
against bone marrow failure diseases by connecting millions of potential marrow
donors with individuals and families suffering from these conditions.</text>
</paragraph><paragraph id="HD06574824596405EAA6B298D5E5BAF26"><enum>(8)</enum><text>Despite these
advances, a more comprehensive Federal strategic effort among numerous Federal
agencies is needed to discover a cure for acquired bone marrow failure
disorders.</text>
</paragraph><paragraph id="H09DCE17AE06D43B19B61F0ADE5B2D793"><enum>(9)</enum><text>Greater Federal
surveillance of acquired bone marrow failure diseases is needed to gain a
better understanding of the causes of acquired bone marrow failure
diseases.</text>
</paragraph><paragraph id="H29BA8620148A4A1495B905D330162E44"><enum>(10)</enum><text>The Federal
Government should increase its research support for and engage with public and
private organizations in developing a comprehensive approach to combat and cure
acquired bone marrow failure diseases.</text>
</paragraph></subsection><subsection id="H2778EB0C2BBB4045BC62B260D106AC68"><enum>(c)</enum><header>National
Acquired Bone Marrow Failure Disease Registry</header><text>Part B of the
Public Health Service Act (42 U.S.C. 311 et seq.) is amended by inserting after
section 317W, as added, the following:</text>
<quoted-block display-inline="no-display-inline" id="HE45A890BCC194847BC8B6085E0F71251" style="OLC">
<section id="H42FABC331CAC4A18B172C2A7DAE30E5F"><enum>317X.</enum><header>National
Acquired Bone Marrow Failure Disease Registry</header>
<subsection id="HF716255B66A14E318FF26F9CD05F5002"><enum>(a)</enum><header>Establishment of
registry</header>
<paragraph id="H654C0F24905149D88D445C246F06B56E"><enum>(1)</enum><header>In
general</header><text>Not later than 6 months after the date of the enactment
of this section, the Secretary, acting through the Director of the Centers for
Disease Control and Prevention, shall—</text>
<subparagraph id="H4EE613943BFB41F98AD7ED139FE26125"><enum>(A)</enum><text>develop a system
to collect data on acquired bone marrow failure diseases; and</text>
</subparagraph><subparagraph id="H6E1CF49E6B6946C2987A3005707BDAD8"><enum>(B)</enum><text>establish and
maintain a national and publicly available registry, to be known as the
National Acquired Bone Marrow Failure Disease Registry, in accordance with
paragraph (3).</text>
</subparagraph></paragraph><paragraph id="HF04E1C461FBB4FDF845EAD2CA2446729"><enum>(2)</enum><header>Recommendations
of advisory committee</header><text display-inline="yes-display-inline">In
carrying out this subsection, the Secretary shall take into consideration the
recommendations of the Advisory Committee on Acquired Bone Marrow Failure
Diseases established under subsection (b).</text>
</paragraph><paragraph id="HEAF24C85027A49B9BF74291C6AF001C5"><enum>(3)</enum><header>Purposes of
registry</header><text>The National Acquired Bone Marrow Failure Disease
Registry—</text>
<subparagraph id="H628E3DFEABD44303B9C961F491A7DC6E"><enum>(A)</enum><text>shall identify the
incidence and prevalence of acquired bone marrow failure diseases in the United
States;</text>
</subparagraph><subparagraph id="H743AAC84D7894168A9D3EB965B40A1D2"><enum>(B)</enum><text display-inline="yes-display-inline">shall be used to collect and store data on
acquired bone marrow failure diseases, including data concerning—</text>
<clause id="HEA8F39E865304AB18C953D73AB4DCF55"><enum>(i)</enum><text>the age, race or
ethnicity, general geographic location, sex, and family history of individuals
who are diagnosed with acquired bone marrow failure diseases, and any other
characteristics of such individuals determined appropriate by the
Secretary;</text>
</clause><clause id="H67F5651A78D34961BF7E133C244081A7"><enum>(ii)</enum><text>the genetic and
environmental factors that may be associated with developing acquired bone
marrow failure diseases;</text>
</clause><clause id="H99B6BE555E1246CDB06438EA95E61353"><enum>(iii)</enum><text>treatment
approaches for dealing with acquired bone marrow failure diseases;</text>
</clause><clause id="H115567F9FA1E4292BB257E40FA17B0C0"><enum>(iv)</enum><text>outcomes for
individuals treated for acquired bone marrow failure diseases, including
outcomes for recipients of stem cell therapeutic products as contained in the
database established pursuant to section 379A; and</text>
</clause><clause id="H04110D85B0D340778BDD1244DCC06844"><enum>(v)</enum><text>any other factors
pertaining to acquired bone marrow failure diseases determined appropriate by
the Secretary; and</text>
</clause></subparagraph><subparagraph id="H2F94681BBE0F41E89B9B075DF759EA34"><enum>(C)</enum><text>shall be made
available—</text>
<clause id="HD5F353C21E304518813748C2B6B21718"><enum>(i)</enum><text>to
the general public; and</text>
</clause><clause id="H0BA463BF1DB74A139397FCF7FB095DD9"><enum>(ii)</enum><text>to researchers to
facilitate further research into the causes of, and treatments for, acquired
bone marrow failure diseases in accordance with standard practices of the
Centers for Disease Control and Preventions.</text>
</clause></subparagraph></paragraph></subsection><subsection id="H7B82414B15884D54AE0A2C3DAF2ABC28"><enum>(b)</enum><header>Advisory
committee</header>
<paragraph id="HA2510B10D9554DDF9FFE3C6585A4C277"><enum>(1)</enum><header>Establishment</header><text>Not
later than 6 months after the date of the enactment of this section, the
Secretary, acting through the Director of the Centers for Disease Control and
Prevention, shall establish an advisory committee, to be known as the Advisory
Committee on Acquired Bone Marrow Failure Diseases.</text>
</paragraph><paragraph id="HAC211376E8424528A15E9D05A902D70E"><enum>(2)</enum><header>Members</header><text display-inline="yes-display-inline">The members of the Advisory Committee on
Acquired Bone Marrow Failure Diseases shall be appointed by the Secretary,
acting through the Director of the Centers for Disease Control and Prevention,
and shall include at least one representative from each of the
following:</text>
<subparagraph id="H5AAC9937F68F461A9631BDA15B784414"><enum>(A)</enum><text>A national patient
advocacy organization with experience advocating on behalf of patients
suffering from acquired bone marrow failure diseases.</text>
</subparagraph><subparagraph id="H99FB1F9AAD2F4A4BA7B4FFBA96281427"><enum>(B)</enum><text>The National
Institutes of Health, including at least one representative from each
of—</text>
<clause id="H1C758F8B8D6E49588AF35024F21B2096"><enum>(i)</enum><text>the National
Cancer Institute;</text>
</clause><clause id="HFE83CDF2BF2046478124F7E338A8012C"><enum>(ii)</enum><text>the National
Heart, Lung, and Blood Institute; and</text>
</clause><clause id="H0514FF7E6957469DAEF0EA0BDD1FB5E3"><enum>(iii)</enum><text>the Office of
Rare Diseases.</text>
</clause></subparagraph><subparagraph id="H885870B53648437FB4B456BE19F4C7BA"><enum>(C)</enum><text>The Centers for
Disease Control and Prevention.</text>
</subparagraph><subparagraph id="H42D8B9DA4A4C4C4984689C4802EE0818"><enum>(D)</enum><text>Clinicians with
experience in—</text>
<clause id="HDD1D6CF38A2D456180B0DC01F8752810"><enum>(i)</enum><text>diagnosing or
treating acquired bone marrow failure diseases; and</text>
</clause><clause id="H568A0D3D4D734D008BD557AD77F44365"><enum>(ii)</enum><text>medical data
registries.</text>
</clause></subparagraph><subparagraph id="H921CD434E93946159A37C4A3F97260B4"><enum>(E)</enum><text>Epidemiologists
who have experience with data registries.</text>
</subparagraph><subparagraph id="H921132C58A854AD0BD4854878FF7F0BA"><enum>(F)</enum><text>Publicly or
privately funded researchers who have experience researching acquired bone
marrow failure diseases.</text>
</subparagraph><subparagraph id="HAF11575B1D6B4FC48C9F3705B858D10E"><enum>(G)</enum><text>The entity
operating the C.W. Bill Young Cell Transplantation Program established pursuant
to section 379 and the entity operating the C.W. Bill Young Cell
Transplantation Program Outcomes Database.</text>
</subparagraph></paragraph><paragraph id="H2EA1A174D7DE47CDA2A4FDE193DB3435"><enum>(3)</enum><header>Responsibilities</header><text display-inline="yes-display-inline">The Advisory Committee on Acquired Bone
Marrow Failure Diseases shall provide recommendations to the Secretary on the
establishment and maintenance of the National Acquired Bone Marrow Failure
Disease Registry, including recommendations on the collection, maintenance, and
dissemination of data.</text>
</paragraph><paragraph id="HF8E27BEBA1634DC2B2FBF81B343D6DFA"><enum>(4)</enum><header>Public
availability</header><text>The Secretary shall make the recommendations of the
Advisory Committee on Acquired Bone Marrow Failure Disease publicly
available.</text>
</paragraph></subsection><subsection id="HA3A8C609F2354FDB9C0638D5E07529EB"><enum>(c)</enum><header>Grants</header><text>The
Secretary, acting through the Director of the Centers for Disease Control and
Prevention, may award grants to, and enter into contracts and cooperative
agreements with, public or private nonprofit entities for the management of, as
well as the collection, analysis, and reporting of data to be included in, the
National Acquired Bone Marrow Failure Disease Registry.</text>
</subsection><subsection id="HCA0DABDA13AC4E4D8E6715A4F7ADFBCC"><enum>(d)</enum><header>Definition</header><text>In
this section, the term <term>acquired bone marrow failure disease</term>
means—</text>
<paragraph id="H3280B401ECB94AAE8E4ECEC56BF11FA1"><enum>(1)</enum><text>myelodysplastic
syndromes (MDS);</text>
</paragraph><paragraph id="H60D745DC87934511BD0C5CCA70809386"><enum>(2)</enum><text>aplastic
anemia;</text>
</paragraph><paragraph id="HB21EDBA5D4E044C5B011D75E4EBDD8B0"><enum>(3)</enum><text>paroxysmal
nocturnal hemoglobinuria (PNH);</text>
</paragraph><paragraph id="HA51248A2F2AB4745B90C88B73123A6E7"><enum>(4)</enum><text>pure red cell
aplasia;</text>
</paragraph><paragraph id="HDC709D7116AA4E9B9004444B1A821B34"><enum>(5)</enum><text display-inline="yes-display-inline">acute myeloid leukemia that has progressed
from myelodysplastic syndromes; or</text>
</paragraph><paragraph id="HA12729CC826A40ADA2492CDD96568EE2"><enum>(6)</enum><text>large granular
lymphocytic leukemia.</text>
</paragraph></subsection><subsection id="H29FD805FEDF74E92B4AE1835DC3FE610"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section $3,000,000 for each of fiscal years 2012 through
2016.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H052E005EF32A4E8BBCCCD99ECFBDCF7C"><enum>(d)</enum><header>Pilot studies
through the agency for toxic substances and disease registry</header>
<paragraph id="H697062FD242E45F3BDBF80269C7B9A16"><enum>(1)</enum><header>Pilot
studies</header><text>The Secretary of Health and Human Services, acting
through the Administrator of the Agency for Toxic Substances and Disease
Registry, shall conduct pilot studies to determine which environmental factors,
including exposure to toxins, may cause acquired bone marrow failure
diseases.</text>
</paragraph><paragraph id="HFF88F70888C84929940987526BA63559"><enum>(2)</enum><header>Collaboration
with the Radiation Injury Treatment Network</header><text display-inline="yes-display-inline">In carrying out the directives of this
section, the Secretary may collaborate with the Radiation Injury Treatment
Network of the C.W. Bill Young Cell Transplantation Program established
pursuant to section 379 of the Public Health Service Act (42 U.S.C. 274j)
to—</text>
<subparagraph id="H9D30C9734167442C83B9D01FE33D3111"><enum>(A)</enum><text>augment data for
the pilot studies authorized by this section;</text>
</subparagraph><subparagraph id="HC7EB11A13360427AA7A85F087694C8F3"><enum>(B)</enum><text>access technical
assistance that may be provided by the Radiation Injury Treatment Network;
or</text>
</subparagraph><subparagraph id="H7BC02C253EAF47DE91FCBA71DFD2F509"><enum>(C)</enum><text>perform joint
research projects.</text>
</subparagraph></paragraph><paragraph id="H46B6DEF004E941AC9A5D8B98C9667B22"><enum>(3)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section $1,000,000 for each of fiscal years 2012 through 2016.</text>
</paragraph></subsection><subsection id="H94FA9BB9F693418B8EED2CA2954E19E7"><enum>(e)</enum><header>Minority-Focused
programs on acquired bone marrow failure diseases</header><text>Title XVII of
the Public Health Service Act (42 U.S.C. 300u et seq.) is amended by inserting
after section 1707A the following:</text>
<quoted-block display-inline="no-display-inline" id="H36A8E05EDEFE4D5EB8FEB832E5057EEC" style="traditional">
<section id="H443ED3EA8C00438591B40FDC9A724E5E"><enum>1707B.</enum><header>Minority-focused programs on acquired bone marrow failure
diseases</header><subsection commented="no" display-inline="yes-display-inline" id="H2808CC5563914BF880DAE2CE5D4C56EE"><enum>(a)</enum><header>Information and
referral services</header>
<paragraph id="HC46CD3AD6389480A81FF87E5E30DE776"><enum>(1)</enum><header>In
general</header><text>Not later than 6 months after the date of the enactment
of this section, the Secretary, acting through the Deputy Assistant Secretary
for Minority Health, shall establish and coordinate outreach and informational
programs targeted to minority populations affected by acquired bone marrow
failure diseases.</text>
</paragraph><paragraph id="H8B417EBA5CD0409CB15F1CAD06AFCC1F"><enum>(2)</enum><header>Program
requirements</header><text>Minority-focused outreach and informational programs
authorized by this section—</text>
<subparagraph id="H3EE541896F1A4AE9A09CECF99D2C3220"><enum>(A)</enum><text>shall make
information about treatment options and clinical trials for acquired bone
marrow failure diseases publicly available, and</text>
</subparagraph><subparagraph id="H2A7A04CE38864084A77E75F63CD3A82D"><enum>(B)</enum><text>shall provide
referral services for treatment options and clinical trials,</text>
</subparagraph><continuation-text continuation-text-level="paragraph">at the
national minority health resource center supported under section 1707(b)(8)
(including by means of the center’s Web site, through appropriate locations
such as the center’s knowledge center, and through appropriate programs such as
the center’s resource persons network) and through minority health consultants
located at each Department of Health and Human Services regional office.</continuation-text></paragraph></subsection><subsection id="H44A7EB471FD74839BD8232A8EDC72F6B"><enum>(b)</enum><header>Hispanic and
asian-American and pacific islander outreach</header>
<paragraph id="HAA20E0D306E94A7B9C75A990010067FF"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, acting
through the Deputy Assistant Secretary for Minority Health, shall undertake a
coordinated outreach effort to connect Hispanic, Asian-American, and Pacific
Islander communities with comprehensive services focused on treatment of, and
information about, acquired bone marrow failure diseases.</text>
</paragraph><paragraph id="H8E79D80F7856478E9EA00E47DE353353"><enum>(2)</enum><header>Collaboration</header><text>In
carrying out this subsection, the Secretary may collaborate with public health
agencies, nonprofit organizations, community groups, and online entities to
disseminate information about treatment options and clinical trials for
acquired bone marrow failure diseases.</text>
</paragraph></subsection><subsection id="H2A988EDF02424E2196293EBD7CFD42E5"><enum>(c)</enum><header>Grants and
cooperative agreements</header>
<paragraph id="H6BCFA90D56D047C5A46DDB35CE8EF859"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">Not later than 6
months after the date of the enactment of this section, the Secretary, acting
through the Deputy Assistant Secretary for Minority Health, shall award grants
to, or enter into cooperative agreements with, entities to perform research on
acquired bone marrow failure diseases.</text>
</paragraph><paragraph id="HB65D492DE2F246A893BD41ECDF7383AF"><enum>(2)</enum><header>Requirement</header><text>Grants
and cooperative agreements authorized by this subsection shall be awarded or
entered into on a competitive, peer-reviewed basis.</text>
</paragraph><paragraph id="HB63AA27115914D38AD82EDAB5C0597CE"><enum>(3)</enum><header>Scope of
research</header><text>Research funded under this section shall examine factors
affecting the incidence of acquired bone marrow failure diseases in minority
populations.</text>
</paragraph></subsection><subsection id="HD8E4C659AD444AE19F845DE7236D2280"><enum>(d)</enum><header>Definition</header><text display-inline="yes-display-inline">In this section, the term <term>acquired
bone marrow failure disease</term> has the meaning given to such term in
section 317X(d).</text>
</subsection><subsection id="H458A69C5654E43C2B5E120A37D9F5E3D"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section $2,000,000 for each of fiscal years 2012 through
2016.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H7A986C47A8664CA5AAA3834606032795"><enum>(f)</enum><header>Diagnosis and
quality of care for acquired bone marrow failure diseases</header>
<paragraph id="HB307A9A726D94EDD9ACC165E861BF87A"><enum>(1)</enum><header>Grants</header><text>The
Secretary of Health and Human Services, acting through the Director of the
Agency for Healthcare Research and Quality, shall award grants to entities to
improve diagnostic practices and quality of care with respect to patients with
acquired bone marrow failure diseases.</text>
</paragraph><paragraph id="H3325EF06FC8348E0B61E314AEC7F99C9"><enum>(2)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section $2,000,000 for each of fiscal years 2012 through 2016.</text>
</paragraph></subsection><subsection id="HD6F9A4603A854F24AFE0F6C6B56B8454"><enum>(g)</enum><header>Definition</header><text>In
this section, the term <term>acquired bone marrow failure disease</term>
means—</text>
<paragraph id="H9D927181B0B7405DAF84F461A7BA181E"><enum>(1)</enum><text>myelodysplastic
syndromes (MDS);</text>
</paragraph><paragraph id="H10226F415C934314A3533FF15F231C30"><enum>(2)</enum><text>aplastic
anemia;</text>
</paragraph><paragraph id="HD30174B622B64F76ABB98A13799EE8C8"><enum>(3)</enum><text>paroxysmal
nocturnal hemoglobinuria (PNH);</text>
</paragraph><paragraph id="H3916E570883741B9B735DF25ACB6B400"><enum>(4)</enum><text>pure red cell
aplasia;</text>
</paragraph><paragraph id="HE38C2EDD6F3F453185448FCC3FC1797D"><enum>(5)</enum><text display-inline="yes-display-inline">acute myeloid leukemia that progressed from
myelodysplastic syndromes; or</text>
</paragraph><paragraph id="H653AC0971BF5419FAAB5AEC83A090890"><enum>(6)</enum><text>large granular
lymphocytic leukemia.</text>
</paragraph></subsection></section></subtitle><subtitle id="H2E826890D2734B27AF5415591AD4EE84"><enum>D</enum><header>Cardiovascular
Disease, Chronic Disease, and Other Disease Issues</header>
<section display-inline="no-display-inline" id="HD128F4F253214B54BA2B9A211BE63AA9" section-type="subsequent-section"><enum>731.</enum><header>Guidelines for
disease screening for minority patients</header>
<subsection id="HF02FAA3EA3A846AC8D529CFF79860C41"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Director of the Agency
for Healthcare Research and Quality, shall convene a series of meetings to
develop guidelines for disease screening for minority patient populations which
have a higher than average risk for many chronic diseases and cancers.</text>
</subsection><subsection id="HC2DB494AD87F4A55B3250B28405BAF15"><enum>(b)</enum><header>Participants</header><text>In
convening meetings under subsection (a), the Secretary shall ensure that
meeting participants include representatives of—</text>
<paragraph id="H2B39AF27C9A843B9BF967C779634B278"><enum>(1)</enum><text>professional
societies and associations;</text>
</paragraph><paragraph id="HEF3FF4504B6245B0B020BDB829703003"><enum>(2)</enum><text>minority health
organizations;</text>
</paragraph><paragraph id="HC7967D6AE2B84898B0CEF01091B87B11"><enum>(3)</enum><text>health care
researchers and providers, including those with expertise in minority
health;</text>
</paragraph><paragraph id="HBCB15E821815469BB2CB26EA842178C1"><enum>(4)</enum><text>Federal health
agencies, including the Office of Minority Health, the National Institute on
Minority Health and Health Disparities, and the National Institutes of Health;
and</text>
</paragraph><paragraph id="HBEA96B26C35249268E98D27EF3C31B99"><enum>(5)</enum><text>other experts
determined appropriate by the Secretary.</text>
</paragraph></subsection><subsection id="HF66BA2EAB5A140E8BDBAF65E9989BAE2"><enum>(c)</enum><header>Diseases</header><text>Screening
guidelines for minority populations shall be developed as appropriate under
subsection (a) for—</text>
<paragraph id="HB50D195F2BBF403FBC8025A548F87302"><enum>(1)</enum><text>hypertension;</text>
</paragraph><paragraph id="H5734D2BEAFF04D479ED3C9808199D221"><enum>(2)</enum><text>hypercholesterolemia;</text>
</paragraph><paragraph id="HB8953B3D2FD34F19AB38F7F5D7A2CDBF"><enum>(3)</enum><text>diabetes;</text>
</paragraph><paragraph id="HDEDB50131A394B1AB0A9D22696F5F606"><enum>(4)</enum><text>cardiovascular
disease;</text>
</paragraph><paragraph id="H9EB199C0CA5445F8864DB7F8533F9B63"><enum>(5)</enum><text>cancers, including
breast, prostate, colon, cervical, and lung cancer;</text>
</paragraph><paragraph id="H3D84801A962F4146BAA31FE34C69B39C"><enum>(6)</enum><text>asthma;</text>
</paragraph><paragraph id="HE85F373F2BC0429B9A7C7E64B229F6A1"><enum>(7)</enum><text>diabetes;</text>
</paragraph><paragraph id="HA94BC9AB009D462FA74A695C6ABE8E27"><enum>(8)</enum><text>kidney
diseases;</text>
</paragraph><paragraph id="H5F1E90C3586A46ECB8821C08B71235C2"><enum>(9)</enum><text>eye diseases and
disorders, including glaucoma;</text>
</paragraph><paragraph id="HDCFE9EFB498D4AE68899606FC282D2FF"><enum>(10)</enum><text>HIV/AIDS and
sexually transmitted diseases;</text>
</paragraph><paragraph id="HCB82BA2B355D4867B51F20E059D05723"><enum>(11)</enum><text>uterine
fibroids;</text>
</paragraph><paragraph id="H6486A8F1D72F477DAAA0913D5497F414"><enum>(12)</enum><text>autoimmune
disease;</text>
</paragraph><paragraph id="HAED8E7386CEB477D9C928E00D3AB8695"><enum>(13)</enum><text>mental health
conditions;</text>
</paragraph><paragraph id="H85C339A5CE814E679AB61DA82CFCF51A"><enum>(14)</enum><text>dental health
conditions and oral diseases;</text>
</paragraph><paragraph id="H52BBEF981D71418B8F7034F8288BB9FD"><enum>(15)</enum><text>environmental and
related health illnesses and conditions;</text>
</paragraph><paragraph id="H6C0AA82836124959AA65EAD95A3CABBA"><enum>(16)</enum><text>Sickle cell
disease;</text>
</paragraph><paragraph id="HA322EFBADE7E4250A1F05EAF5F37B57C"><enum>(17)</enum><text>violence and
injury prevention and control;</text>
</paragraph><paragraph id="H1A86BB9840EF47598F0282BEA1C64AED"><enum>(18)</enum><text>genetic and
related conditions;</text>
</paragraph><paragraph id="H2513266238664382A50958107900A9C2"><enum>(19)</enum><text>heart disease and
stroke;</text>
</paragraph><paragraph id="HF45B2E61ED6A4CB09F1D8B0A81A1DA76"><enum>(20)</enum><text>tuberculosis;</text>
</paragraph><paragraph id="H39F3306CE92147FDAEBA86176A712F4D"><enum>(21)</enum><text>chronic
obstructive pulmonary disease; and</text>
</paragraph><paragraph id="H56DA9F0782064EF2A68A4F897720084A"><enum>(22)</enum><text>other diseases
determined appropriate by the Secretary.</text>
</paragraph></subsection><subsection id="HE24D4E52A1974F31A3382773993EAA74"><enum>(d)</enum><header>Dissemination</header><text>Not
later than 24 months after the date of enactment of this title, the Secretary
shall publish and disseminate to health care provider organizations the
guidelines developed under subsection (a).</text>
</subsection><subsection id="H2CD72D99EB794E0EA51F0A052794F2A2"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through 2016.</text>
</subsection></section><section display-inline="no-display-inline" id="H59C7C48693B749F4AB86E10CEEB7E1F0" section-type="subsequent-section"><enum>732.</enum><header>Coverage of the
shingles vaccine under the Medicare program</header>
<subsection id="H1744363C999D4592A686AAD1B7903442"><enum>(a)</enum><header>In
general</header><text>Section 1861 of the Social Security Act (42 U.S.C. 1395x)
is amended—</text>
<paragraph id="HCD4EED966ADB45C3B29D3608CF141109"><enum>(1)</enum><text>in subsection
(s)(10)(A), by inserting <quote>, shingles vaccine and its
administration,</quote> before <quote>and, subject to</quote>; and</text>
</paragraph><paragraph id="H607E1D2A4D334290ACB3FB7D3E3D00A1"><enum>(2)</enum><text>in subsection
(ww)(2)(A), by inserting <quote>shingles,</quote> after
<quote>Pneumococcal,</quote>.</text>
</paragraph></subsection><subsection id="HA9FBC01AA4C846ABB97F4C744229450A"><enum>(b)</enum><header>Effective
date</header><text>The amendments made by subsection (a) shall apply to
shingles vaccine furnished on or after January 1 of the first calendar year
beginning more than 60 days after the date of the enactment of this Act.</text>
</subsection></section><section id="H6B547C8414944D668746CC60AA8931EB"><enum>733.</enum><header>CDC Wisewoman
Screening Program</header><text display-inline="no-display-inline">Section 1509
of the Public Health Service Act (42 U.S.C. 300n–4a) is amended—</text>
<paragraph id="HF2A7DF05E714409F864D81F63E34B875"><enum>(1)</enum><text>in subsection
(a)—</text>
<subparagraph id="HE5162F3FE96F49748B0BF13167732E34"><enum>(A)</enum><text>by striking the
heading and inserting <quote><header-in-text level="subsection" style="OLC">In
General</header-in-text>.—</quote>; and</text>
</subparagraph><subparagraph id="HB1CFF4AEFB3C4ED1B0DFE3DF84F0DF9D"><enum>(B)</enum><text>in the matter
preceding paragraph (1), by striking <quote>may make grants</quote> and all
that follows through <quote>purpose</quote> and inserting the following:
<quote>may make grants to such States for the purpose</quote>; and</text>
</subparagraph></paragraph><paragraph id="HF6AE056462CA4731B1B12CA5A95EFD19"><enum>(2)</enum><text>in subsection
(d)(1), by striking <quote>there are authorized</quote> and all that follows
through the period and inserting <quote>there are authorized to be appropriated
$23,000,000 for fiscal year 2012, $25,300,000 for fiscal year 2013, $27,800,000
for fiscal year 2014, $30,800,000 for fiscal year 2015, and $34,000,000 for
fiscal year 2016.</quote>.</text>
</paragraph></section><section id="H6E72E191DBE54FB49D53744DC0AC1F81"><enum>734.</enum><header>Report on
cardiovascular care for women and minorities</header><text display-inline="no-display-inline">Part P of title III of the Public Health
Service Act (42 U.S.C. 280g et seq.) is amended by adding at the end the
following:</text>
<quoted-block id="H84A06229D6DF4E91B4588B812521E099" style="OLC">
<section id="H998A89BD1D5A40FB83ADA4E723DFAAEC"><enum>399V–5.</enum><header>Report on
cardiovascular care for women and minorities</header><text display-inline="no-display-inline">Not later than September 30, 2014, and
annually thereafter, the Secretary shall prepare and submit to the Congress a
report on the quality of and access to care for women and minorities with heart
disease, stroke, and other cardiovascular diseases. The report shall contain
recommendations for eliminating disparities in, and improving the treatment of,
heart disease, stroke, and other cardiovascular diseases in women, racial and
ethnic minorities, those for whom English is not their primary language, and
individuals with
disabilities.</text>
</section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" display-inline="no-display-inline" id="HB9DCE172B10043B1B6B0E77022D595A7" section-type="subsequent-section"><enum>735.</enum><header display-inline="yes-display-inline">Coverage of comprehensive tobacco cessation
services in Medicaid</header>
<subsection commented="no" display-inline="no-display-inline" id="H87650EC9BB2547FCA56F3499D9ABA0C9"><enum>(a)</enum><header display-inline="yes-display-inline">Requiring coverage of counseling and
pharmacotherapy for cessation of tobacco use</header><text display-inline="yes-display-inline">Section 1905 of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 1396d)
is amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H0DD223666F0C4984A4F99170ADA6C0C3"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a)(4)(D) is amended by
striking <quote>by pregnant women</quote>; and</text>
</paragraph><paragraph id="HB5A57BB29D44485DA79EB85F20C2CBB7"><enum>(2)</enum><text>in subsection
(bb)—</text>
<subparagraph id="H5DC82E27A849433EBCC702513081D0D9"><enum>(A)</enum><text>by striking
<quote>by pregnant women</quote> each place it appears;</text>
</subparagraph><subparagraph id="H5D9768ED16CB4206B0328330C912972A"><enum>(B)</enum><text>in paragraph (1),
in the matter before subparagraph (A), by inserting <quote>by
individuals</quote> before <quote>who use tobacco</quote>; and</text>
</subparagraph><subparagraph id="H7C8ADC481B24464C84FEE76974509FCE"><enum>(C)</enum><text>in paragraph
(2)(A), by striking <quote>with respect to pregnant women</quote>.</text>
</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H91198F9C26724BC189D41FBD1FBA9221"><enum>(b)</enum><header display-inline="yes-display-inline">Exception from optional restriction under
medicaid prescription drug coverage</header><text display-inline="yes-display-inline">Section 1927(d)(2)(F) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1396r–8(d)(2)(F)) is amended by striking <quote>in the case of pregnant
women</quote>.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="H1199ED8DD5F74E2C865C8D122DA233BB"><enum>(c)</enum><header display-inline="yes-display-inline">Removal of cost sharing for counseling and
pharmacotherapy for cessation of tobacco use</header>
<paragraph commented="no" display-inline="no-display-inline" id="HCB545F756D92471999F1861C2C8A837F"><enum>(1)</enum><header display-inline="yes-display-inline">General cost sharing
limitations</header><text display-inline="yes-display-inline">Section 1916 of
the <act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1396o) is amended—</text>
<subparagraph id="H4F1A1D5D11DF48DA88C97F32B163AF51"><enum>(A)</enum><text>in subsections
(a)(2)(B) and (b)(2)(B), by striking <quote>and counseling and
pharmacotherapy for cessation of tobacco use by pregnant women (as defined
in section 1905(bb)) 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(bb)(2)(A)</quote>
each place it appears; and</text>
</subparagraph><subparagraph id="H8DB502B3C8FE46A8A1004E99693D4AE4"><enum>(B)</enum><text>in each of
subsections (a)(2)(D) and (b)(2)(D) by inserting <quote>and counseling and
pharmacotherapy for cessation of tobacco use (as defined in section 1905(bb))
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 in accordance with the Guideline referred to in
section 1905(bb)(2)(A),</quote> after <quote>section
1905(a)(4)(C),</quote>.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HDFF608FFA399436E8CFA11E064CA4663"><enum>(2)</enum><header display-inline="yes-display-inline">Application to alternative
costsharing</header><text display-inline="yes-display-inline">Section
1916A(b)(3)(B) of such Act (42 U.S.C. 1396o–1(b)(3)(B)) is amended—</text>
<subparagraph id="H2A0B6DFF5D594BB3B57B5FA89EDAB411"><enum>(A)</enum><text display-inline="yes-display-inline">in clause (iii), by striking <quote>, and
counseling and pharmacotherapy for cessation of tobacco use by pregnant
women (as defined in section 1905(bb))</quote>; and</text>
</subparagraph><subparagraph id="H5398B45E49F44A0B993D92E23AD5C935"><enum>(B)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="HE88F6B8022154BCEBCD588600F436C79" style="OLC">
<clause commented="no" display-inline="no-display-inline" id="HE64F281B5C5F416C8033A178854362A0"><enum>(xi)</enum><text display-inline="yes-display-inline">Counseling and pharmacotherapy for
cessation of tobacco use (as defined in section 1905(bb)) 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 in accordance with the Guideline referred to in section
1905(bb)(2)(A).</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection><subsection commented="no" id="H6DC9415726AA4ACF8B8B50E5E972C6BD"><enum>(d)</enum><header>Effective
date</header><text>The amendments made by this section shall take effect on
October 1, 2012.</text>
</subsection></section><section id="H85CB5450CE684135B6367E2CE15F4BCC"><enum>736.</enum><header>Clinical
research funding for oral health</header>
<subsection id="HBE9B228605144002A05FD4E8F895E01B"><enum>(a)</enum><header>In
general</header><text>The Secretary of Health and Human Services shall expand
and intensify the conduct and support of the research activities of the
National Institutes of Health and the National Institute of Dental and
Craniofacial Research to improve the oral health of the population through the
prevention and management of oral diseases and conditions.</text>
</subsection><subsection id="HCBD2201BF5934FB2B4A27B0C8A0A3CB0"><enum>(b)</enum><header>Included
research activities</header><text>Research activities under subsection (a)
shall include—</text>
<paragraph id="H51FEABB40AF14E1CA0F9BF49C2D5770B"><enum>(1)</enum><text display-inline="yes-display-inline">comparative effectiveness research and
clinical disease management research addressing early childhood caries and oral
cancer; and</text>
</paragraph><paragraph id="H6D0AA98970F04A5EB41DDCB2807DAD9F"><enum>(2)</enum><text>awarding of grants
and contracts to support the training and development of health services
researchers, comparative effectiveness researchers, and clinical researchers
whose research improves the oral health of the population.</text>
</paragraph></subsection></section></subtitle><subtitle commented="no" id="H088D9777EAA34AB695D3266F057FC17B"><enum>E</enum><header>HIV/AIDS</header>
<section id="HF5AFF42BD8F84100BC8929BFED363C03"><enum>741.</enum><header>Findings</header><text display-inline="no-display-inline">The Congress finds the following:</text>
<paragraph id="H436CE04AD6D24B2CA3BA03FC974C75CE"><enum>(1)</enum><text>Over one million
people are estimated to be living with HIV in the United States according to
the Centers for Disease Control and Prevention.</text>
</paragraph><paragraph id="H6489DEB8C7C046CA9DE04B20E4C37827"><enum>(2)</enum><text>Annually there are
over 17,000 deaths in people with an HIV diagnoses in 40 States and 5 dependent
areas of the United States.</text>
</paragraph><paragraph id="H74095F79992745A69CD659704C343130"><enum>(3)</enum><text>The Centers for
Disease Control and Prevention estimates that in 2009 there were approximately
48,100 people newly infected with HIV. Though this number seems to be staying
relatively stable, the number of new infections is rapidly increasing among
certain populations especially among young African-American men who have sex
with men who had an overall 48 percent increase in new infections from 2006 to
2009.</text>
</paragraph><paragraph id="HE507A5ECC5BB42EC9E00C32FCE61EDFE"><enum>(4)</enum><text>HIV
disproportionately affects certain populations in the United States. Though
African-Americans represent less than 13 percent of the population,
African-Americans account for almost half (46 percent) of all people living
with HIV in the United States. Men who have sex with men (MSM) make up
approximately 2 percent of the population, but account for over half (53
percent) of individuals living with HIV and are the only risk group in which
HIV infections continue to increase.</text>
</paragraph><paragraph id="HE88F585111234F3C936DC6CB69E4577A"><enum>(5)</enum><text>Disparities exist
among Latin-Americans; they make up 15 percent of US population and 17 percent
of new infections (2006).</text>
</paragraph><paragraph id="H9DC56BA71AA94D6680FA06875D562A07"><enum>(6)</enum><text>Though American
Indians/Alaska Natives represent less than 1 percent of the total number of
HIV/AIDS cases, American Indians and Alaska Natives rank third in rates of
HIV/AIDS diagnosis, after African-Americans and Latin-Americans.</text>
</paragraph><paragraph id="HDB6E793B403D4B6B9C3E2FE141CA4BE5"><enum>(7)</enum><text>While
Asian-Americans, Native Hawaiians, and Pacific Islanders HIV/AIDS cases account
for approximately 1 percent of cases nationally, Asian Americans and Pacific
Islanders were the only racial/ethnic groups with a statistically significant
increase in new HIV diagnoses between 2001 and 2008.</text>
</paragraph><paragraph id="H4AB009F2FE7D41C89DA8B94F347EAE9B"><enum>(8)</enum><text>The limited data
available on transgender individuals point to a disproportionate burden of HIV
infection.</text>
</paragraph><paragraph id="HE1468C0963F74054894E495419A64B84"><enum>(9)</enum><text>Stigma and
discrimination contribute to these disparities.</text>
</paragraph><paragraph id="HA0C9530D2FE34777BD80F900FAA19244"><enum>(10)</enum><text>For HIV, early
detection and treatment can have huge effects. New research suggests that
treatment of individuals not only slows disease progression, but can also
greatly reduce the risk of transmission to other individuals.</text>
</paragraph><paragraph id="HC2589471CE2345E3AF4F704B444CB359"><enum>(11)</enum><text>To combat the HIV
epidemic in the United States, the National HIV/AIDS Strategy (NHAS) from the
White House Office of National AIDS Policy provides a framework of increasing
access to care, reducing new infections, and eliminating HIV-related health
disparities. The vision of NHAS is <quote>The United States will become a place
where new HIV infections are rare and when they do occur, every person,
regardless of age, gender, race/ethnicity, sexual orientation, gender identity,
or socio-economic circumstance, will have unfettered access to high quality,
life extending care, free from stigma and discrimination.</quote>.</text>
</paragraph><paragraph id="H4CD58B774BA14E77B360BD31CAA5F83E"><enum>(12)</enum><text>Although the cost
of education, treatment and care, and research are not inconsequential, they
are substantially less than the annual health care cost attributable to HIV in
the United States. The lifetime cost of HIV care and treatment in 2004 was
estimated to be $405,000 to $648,000 dollars annually. Preventing 40,000 new
infections in the United States each year would save $12.8 billion
annually.</text>
</paragraph></section><section commented="no" id="H25CF975662144358B2975AB2C01F8C13"><enum>742.</enum><header>Addressing
HIV/AIDS in communities of color</header>
<subsection commented="no" id="HCDD6096577B2403C992A1F1D4D9C68BD"><enum>(a)</enum><header>National
observance days</header><text>It is the sense of the Congress that national
observance days highlighting the impact of HIV/AIDS on communities of color
include the following:</text>
<paragraph commented="no" id="HE69746D76E314ED890632026C4654590"><enum>(1)</enum><text>National Black
HIV/AIDS Awareness Day.</text>
</paragraph><paragraph commented="no" id="HAB01F3CB94824F458E0945F8FF88D59B"><enum>(2)</enum><text>National Latino
AIDS Awareness Day.</text>
</paragraph><paragraph commented="no" id="H018DE4FFA0CC452C853D9E1BC1552E7A"><enum>(3)</enum><text>National Asian and
Pacific Islander HIV/AIDS Awareness Day.</text>
</paragraph><paragraph commented="no" id="HBD97E340B06F4B3DBCA87F9E120646B3"><enum>(4)</enum><text>National Native
HIV/AIDS Awareness Day.</text>
</paragraph><paragraph commented="no" id="HA27B0DC81C5F4E0A817C178FC6CE1494"><enum>(5)</enum><text>Caribbean American
HIV/AIDS Awareness Day.</text>
</paragraph></subsection><subsection commented="no" id="HC0DABB2B70CD40FAAC3276866D34B7C8"><enum>(b)</enum><header>Call to
action</header><text>It is the sense of the Congress that the President should
call on members of communities of color—</text>
<paragraph commented="no" id="HFE87C2999B664660932CFDB82E00BB89"><enum>(1)</enum><text>to become involved
at the local community level in HIV/AIDS testing, policy, and advocacy;</text>
</paragraph><paragraph commented="no" id="H44BE0384960946CAAF4CC0DB4945728D"><enum>(2)</enum><text>to become aware,
engaged, and empowered on the HIV/AIDS epidemic within their communities;
and</text>
</paragraph><paragraph commented="no" id="H0BD08E780CCD492092AC698DB31BF308"><enum>(3)</enum><text>to urge members of
their communities to reduce risk factors, practice safe sex and other
preventive measures, be tested for HIV/AIDS, and seek care when
appropriate.</text>
</paragraph></subsection></section><section commented="no" id="H46A32A4C48B44F878E120F2CD1B8CA92"><enum>743.</enum><header>HIV/AIDS
reduction in racial and ethnic minority communities</header>
<subsection commented="no" id="H5C79CA0695F747DF99B77329DC5E6E2E"><enum>(a)</enum><header>Expanded
funding</header><text>The Secretary, in collaboration with the Deputy Assistant
Secretary for Minority Health, the Director of the Centers for Disease Control
and Prevention, the Administrator of the Health Resources and Services
Administration, and the Administrator of the Substance Abuse and Mental Health
Services Administration, shall provide funds and carry out activities to expand
the Minority HIV/AIDS Initiative.</text>
</subsection><subsection commented="no" id="HD1F99857474B4F4DA2F5158086FBABCE"><enum>(b)</enum><header>Use of
funds</header><text>The additional funds made available under this section may
be used, through the Minority AIDS Initiative, to support the following
activities:</text>
<paragraph commented="no" id="HD6E3B315C2D84BA5A29C2D9F6E9DA190"><enum>(1)</enum><text>Providing
technical assistance and infrastructure support to reduce HIV/AIDS in minority
populations.</text>
</paragraph><paragraph commented="no" id="H492301C4F3ED489BA8A19AEA187C19A7"><enum>(2)</enum><text>Increasing
minority populations’ access to HIV/AIDS prevention and care services.</text>
</paragraph><paragraph commented="no" id="HF887C2916A80449882FCB71CAE316167"><enum>(3)</enum><text>Building strong
community programs and partnerships to address HIV prevention and the health
care needs of specific racial and ethnic minority populations.</text>
</paragraph></subsection><subsection commented="no" id="HAEC0E2732FAC4100993D64B071161435"><enum>(c)</enum><header>Priority
interventions</header><text>Within the racial and ethnic minority populations
referred to in subsection (b), priority in conducting intervention services
shall be given to—</text>
<paragraph commented="no" id="H3917931124094516906A677391FD86F1"><enum>(1)</enum><text>women;</text>
</paragraph><paragraph commented="no" id="H5A551CD13E7B4ACBADABE4CDE36CABF0"><enum>(2)</enum><text>youth;</text>
</paragraph><paragraph commented="no" id="HBFEF1FEF4235410CAEA0B46C6FEC9854"><enum>(3)</enum><text>men who have sex
with men;</text>
</paragraph><paragraph commented="no" id="H64723309A04947ABA81391B2BA10C61F"><enum>(4)</enum><text>persons who engage
in intravenous drug abuse;</text>
</paragraph><paragraph commented="no" id="HD410D7CBA61B453A8CDCB13348D83348"><enum>(5)</enum><text>homeless
individuals; and</text>
</paragraph><paragraph commented="no" id="H64532B8A4231491AACB5D91D3EA7F0A9"><enum>(6)</enum><text>individuals
incarcerated or in the penal system.</text>
</paragraph></subsection><subsection commented="no" id="H512229A523814F1EA7E751093A5A8C12"><enum>(d)</enum><header>Authorization of
appropriations</header><text>For carrying out this section, there are
authorized to be appropriated $610,000,0000 for fiscal year 2012 and such sums
as may be necessary for each of fiscal years 2013 through 2016.</text>
</subsection></section><section id="HAFDD0CB53DEC42FF81A644D87D930FA5"><enum>744.</enum><header>
Repealing ineffective and incomplete abstinence-only education program</header>
<subsection id="H45AE42790B1F418A9FFD39F7314A240A"><enum>(a)</enum><header>In
general</header><text>Title V of the Social Security Act (42 U.S.C. 701 et
seq.) is amended by striking section 510.</text>
</subsection><subsection id="H7E14F8EF8B1D4C4DBB42968F546AC992"><enum>(b)</enum><header>Rescission</header><text>Amounts
appropriated for each of fiscal years 2010 and 2011 under section 510(d) of the
Social Security Act (42 U.S.C. 710(d)) (as in effect on the day before the date
of enactment of this Act) that are unobligated as of the date of enactment of
this Act are rescinded.</text>
</subsection><subsection id="H60116DA69742426587370ADCB2A92410"><enum>(c)</enum><header>Reprogram of
eliminated abstinence-Only funds for the personal responsibility education
program (prep)</header><text>Section 513(f) of the Social Security Act (42
U.S.C. 713(f)) is amended by striking <quote>for each of fiscal years 2010
through 2014</quote> and inserting <quote>for fiscal year 2010, $75,000,000
increased by an amount equal to the unobligated portion of funds appropriated
for each of fiscal years 2010 and 2011 under section 510(d) that are rescinded
under subsection (b), and $125,000,000 for each of fiscal years 2012 through
2014</quote>.</text>
</subsection></section><section commented="no" id="H21C2009EF41F48BB9AD67E2DAE67AA73"><enum>745.</enum><header>Dental
Education Loan Repayment Program</header>
<subsection commented="no" id="H130CC5267F664F3F8E3D91EF06128992"><enum>(a)</enum><header>In
general</header><text>The Secretary of Health and Human Services may enter into
an agreement with any dentist under which—</text>
<paragraph commented="no" id="HA0EF8E655B424864A8DBC871A9772964"><enum>(1)</enum><text>the dentist agrees
to serve as a dentist for a period of not less than 2 years at a facility with
a critical shortage of dentists (as determined by the Secretary) in an area
with a high incidence of HIV/AIDS; and</text>
</paragraph><paragraph commented="no" id="HA5DD998FA0BA4D348E7B87FEB4C0C610"><enum>(2)</enum><text>the Secretary
agrees to make payments in accordance with subsection (b) on the dental
education loans of the dentist.</text>
</paragraph></subsection><subsection commented="no" id="H412D03375C054F179BC475BF15EC2183"><enum>(b)</enum><header>Manner of
payments</header><text>The payments described in subsection (a) shall be made
by the Secretary as follows:</text>
<paragraph commented="no" id="H22F36B3B0FBF4F1C809E6D0353DC963D"><enum>(1)</enum><text>Upon completion by
the dentist for whom the payments are to be made of the first year of the
service specified in the agreement entered into with the Secretary under
subsection (a), the Secretary shall pay 30 percent of the principal of and the
interest on the dental education loans of the dentist.</text>
</paragraph><paragraph commented="no" id="HDEE57AE05E2F47F695EB2B1EABEB5B1C"><enum>(2)</enum><text>Upon completion by
the dentist of the second year of such service, the Secretary shall pay another
30 percent of the principal of and the interest on such loans.</text>
</paragraph><paragraph commented="no" id="HFCABBB8C79474CDE819584BD6911DB6B"><enum>(3)</enum><text>Upon completion by
that individual of a third year of such service, the Secretary shall pay
another 25 percent of the principal of and the interest on such loans.</text>
</paragraph></subsection><subsection commented="no" id="H835780B2B2514ECB95CBFC432D8C4320"><enum>(c)</enum><header>Applicability of
certain provisions</header><text>The provisions of subpart III of part D of
title III of the Public Health Service Act (42 U.S.C. 254l et seq.) shall,
except as inconsistent with this section, apply to the program carried out
under this section in the same manner and to the same extent as such provisions
apply to the National Health Service Corps Loan Repayment Program.</text>
</subsection><subsection commented="no" id="HC36C85C9FB77485D9CF56B6BB599A834"><enum>(d)</enum><header>Reports</header><text>Not
later than 18 months after the date of the enactment of this Act, and annually
thereafter, the Secretary shall prepare and submit to the Congress a report
describing the program carried out under this section, including statements
regarding the following:</text>
<paragraph commented="no" id="H1CAA0107B5674725A13A8597AB4A0367"><enum>(1)</enum><text>The number of
dentists enrolled in the program.</text>
</paragraph><paragraph commented="no" id="HF127FD5BB916415A8097B30B7487B371"><enum>(2)</enum><text>The number and
amount of loan repayments.</text>
</paragraph><paragraph commented="no" id="H6DC8B273999E43B9BC306D0E9DFAA934"><enum>(3)</enum><text>The placement
location of loan repayment recipients at facilities described in subsection
(a)(1).</text>
</paragraph><paragraph commented="no" id="H98F547CA8B204F9E9168243E217F4B6B"><enum>(4)</enum><text>The default rate
and actions required.</text>
</paragraph><paragraph commented="no" id="H59E8C6BF94DD431684A0CF5BF6B6B776"><enum>(5)</enum><text>The amount of
outstanding default funds.</text>
</paragraph><paragraph commented="no" id="H5E499B6A4BD1415D9E5ECA6ADB6BB0E1"><enum>(6)</enum><text>To the extent that
it can be determined, the reason for the default.</text>
</paragraph><paragraph commented="no" id="HC170EC6006944A78855154DFBDAEF231"><enum>(7)</enum><text>The demographics
of individuals participating in the program.</text>
</paragraph><paragraph commented="no" id="H3A077E73B0674C7C97017DD2A0ABC715"><enum>(8)</enum><text>An evaluation of
the overall costs and benefits of the program.</text>
</paragraph></subsection><subsection commented="no" id="H4528BF0274C4444E8E5BAEF80C8AE1A5"><enum>(e)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph commented="no" id="H11452CA72A5A46339F1AA77FBCC289E3"><enum>(1)</enum><text>The term
<term>dental education loan</term>—</text>
<subparagraph commented="no" id="H75D420D6BCA849A39E2A7F5DCE1BDD9D"><enum>(A)</enum><text>means a loan that
is incurred for the cost of attendance (including tuition, other reasonable
educational expenses, and reasonable living costs) at a school of dentistry;
and</text>
</subparagraph><subparagraph commented="no" id="HEED7DFD0B1B34083AF13D61E85E3D2FA"><enum>(B)</enum><text>includes only the
portion of the loan that is outstanding on the date the dentist involved begins
the service specified in the agreement under subsection (a).</text>
</subparagraph></paragraph><paragraph commented="no" id="H199BF5916DF649F68A948462A05F05FF"><enum>(2)</enum><text>The term
<term>dentist</term> means a graduate of a school of dentistry who has
completed postgraduate training in general or pediatric dentistry.</text>
</paragraph><paragraph commented="no" id="H148B1EC712534EFCB7688A638CB1F9B7"><enum>(3)</enum><text>The term
<term>HIV/AIDS</term> means human immunodeficiency virus and acquired immune
deficiency syndrome.</text>
</paragraph><paragraph commented="no" id="HAE243DC8F74E4F5C8547B9EDA0D14701"><enum>(4)</enum><text>The term
<term>school of dentistry</term> has the meaning given to that term in section
799B of the Public Health Service Act (42 U.S.C. 295p).</text>
</paragraph><paragraph commented="no" id="H3DCB9AC713C343F4B47F09D1DE9D4DDD"><enum>(5)</enum><text>The term
<term>Secretary</term> means the Secretary of Health and Human Services.</text>
</paragraph></subsection><subsection commented="no" id="HA6BB6C32747E4EEFB1BA9EACDFE4569A"><enum>(f)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated such sums as may be necessary for each of fiscal years 2012
through 2016.</text>
</subsection></section><section commented="no" id="H4DB9323DA97F40548108F0D407A855AF"><enum>746.</enum><header>Report on the
implementation of the national HIV/AIDS strategy</header>
<subsection commented="no" id="HFD97CB4A8DFE4C569C8738751D10C055"><enum>(a)</enum><header>Report
required</header><text>Not later than 6 months after the date of the enactment
of this Act, the President, in consultation with the heads of all relevant
agencies including the Department of Education, the Department of Health and
Human Services, the Department of Housing and Urban Development, the Department
of Justice, the Department of Labor, the Department of Veterans Affairs, and
the Social Security Administration, shall transmit to the Congress and make
publicly available a report on the status of the implementation of the National
HIV/AIDS Strategy.</text>
</subsection><subsection commented="no" id="HA3951DAD9B674199A43C0747217671EE"><enum>(b)</enum><header>Contents</header><text>The
report required by subsection (a) shall include a description, analysis, and
evaluation of—</text>
<paragraph commented="no" id="HB0E37D5847DB48909DF54BE1F111424B"><enum>(1)</enum><text>key steps taken by
the Federal Government towards the achievement of the goals of the National
HIV/AIDS Strategy, including the goals of—</text>
<subparagraph commented="no" id="HD8AC332B76654ACE847A0A76B821AE21"><enum>(A)</enum><text>reducing the
number of people who become infected with HIV;</text>
</subparagraph><subparagraph commented="no" id="H243F3A4C07D14EF484523FBD8F75F876"><enum>(B)</enum><text>increasing access
to care and optimizing health outcomes for people living with HIV; and</text>
</subparagraph><subparagraph commented="no" id="H194360E179904D42AF542A9BCAD6D2D8"><enum>(C)</enum><text>reducing
HIV-related health disparities;</text>
</subparagraph></paragraph><paragraph commented="no" id="H3699213E6C4E42F5B776EE7FB4FA4CE7"><enum>(2)</enum><text>the extent to
which the National HIV/AIDS Strategy has improved coordination of efforts to
maximize the effective delivery of HIV/AIDS prevention, care, and treatment
services at the community level, including coordination—</text>
<subparagraph commented="no" id="HEAF35AD9A5B1405AA186069203891176"><enum>(A)</enum><text>within and among
Federal agencies and departments;</text>
</subparagraph><subparagraph commented="no" id="H4294F198E7724BD496F19DA2FC368C57"><enum>(B)</enum><text>between the
Federal Government and State and local governments and health
departments;</text>
</subparagraph><subparagraph commented="no" id="H92B10421232840FA8EC9CF44989FE8C0"><enum>(C)</enum><text>between the
Federal Government and nonprofit foundations and civil society organizations,
including community- and faith-based organizations focused on addressing the
issue of HIV/AIDS; and</text>
</subparagraph><subparagraph commented="no" id="HCD7ACFA400B1490F80073CF59BBFCE96"><enum>(D)</enum><text>between the
Federal Government and private businesses;</text>
</subparagraph></paragraph><paragraph commented="no" id="H0C929D3ACB3D4EC5BD7E23347C432D51"><enum>(3)</enum><text>efforts by the
Federal Government to educate, involve, and establish and strengthen
partnerships with civil society organizations, including community- and
faith-based organizations, in order to implement the National HIV/AIDS Strategy
and achieve its goals;</text>
</paragraph><paragraph commented="no" id="HD93308D119BB431695BD6B987194CF8F"><enum>(4)</enum><text>how Federal
resources are being deployed to implement the Strategy, including—</text>
<subparagraph commented="no" id="HEDCF1A02510C456DA12826C4BA53ABF4"><enum>(A)</enum><text>the amount of
funding used to date, by each Federal agency and department, to implement the
National HIV/AIDS Strategy;</text>
</subparagraph><subparagraph commented="no" id="HB81778D3DCF2410CB26EFBCF357F469B"><enum>(B)</enum><text>a brief summary
for each Federal agency and department of the number and function of all
Federal employees assisting in implementing the Strategy; and</text>
</subparagraph><subparagraph commented="no" id="H6E8B7589A50D42CD94E8831542676365"><enum>(C)</enum><text>an estimate of the
amount of funding necessary to implement the National HIV/AIDS Strategy, by
each Federal agency and department, for the next fiscal year; and</text>
</subparagraph></paragraph><paragraph commented="no" id="H9DDC225F45664EF5BFE211D090BDD8D0"><enum>(5)</enum><text>what additional
steps, if any, are necessary to fully implement the National HIV/AIDS Strategy,
including—</text>
<subparagraph commented="no" id="H068F60D7D5A44EA198606E26496E42AE"><enum>(A)</enum><text>whether any
existing statutory laws, policies, or regulations are impeding the
implementation of the National HIV/AIDS Strategy, at the Federal, State, or
local level, and whether any changes to such laws, policies, or regulations are
necessary or recommended; and</text>
</subparagraph><subparagraph commented="no" id="H1F5E6193A88E43FA9D439E0557ECECBC"><enum>(B)</enum><text>whether any
Federal agencies or departments require additional statutory authority to
effectively carry out their duties as part of the National HIV/AIDS
Strategy.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H4995C0FA984A49CBA34B46D0FB317443"><enum>(c)</enum><header>Use of
previously appropriated funds</header><text>Funding for the report required
under subsection (a) shall derive from discretionary funds of the departments
and agencies specified in such subsection.</text>
</subsection></section><section commented="no" id="HD8210279FA564BCE97B2C5E09FD2A101"><enum>747.</enum><header>Addressing
HIV/AIDS in the African-American community</header>
<subsection commented="no" id="HB5768837C1C54979AD73E408E28EC3F4"><enum>(a)</enum><header>Sense of
Congress on National Black Clergy HIV/AIDS Awareness Sunday</header><text>It is
the sense of Congress that—</text>
<paragraph commented="no" id="H36713947B8A3498BA9F3488181AE78B9"><enum>(1)</enum><text>there should be
established a National Black Clergy HIV/AIDS Awareness Sunday on which the
Congress and the President call on members of the Black clergy—</text>
<subparagraph commented="no" id="H54BA9CAD9A3E46E08D65EAA4D39B69DF"><enum>(A)</enum><text>to become involved
at the local community level in HIV/AIDS testing, policy, and advocacy;</text>
</subparagraph><subparagraph commented="no" id="H8CF4114EEE7C49C48E0B4180EFEB2854"><enum>(B)</enum><text>to discuss the
HIV/AIDS epidemic with their congregations and the community at-large;
and</text>
</subparagraph><subparagraph commented="no" id="H2AA78D8E1486442F8ABA794B7DE80C71"><enum>(C)</enum><text>to urge members of
their congregations to reduce risk factors, practice safe sex and other
preventive measures, be tested for HIV/AIDS, and seek care when appropriate;
and</text>
</subparagraph></paragraph><paragraph commented="no" id="H71E1D04231894B619BC49A1350FFF181"><enum>(2)</enum><text display-inline="yes-display-inline">an appropriate Sunday should be selected
for this occasion.</text>
</paragraph></subsection><subsection commented="no" id="H0C0FC090FAC948EE8E7AF32C65F1DCB2"><enum>(b)</enum><header>Sense of
Congress on Federal agencies with responsibility for preventing, testing for,
and treating HIV/AIDS</header><text>It is the sense of Congress that all
Federal agencies with a responsibility for preventing, testing for, and
treating HIV/AIDS should—</text>
<paragraph commented="no" id="H0343664E054C483B9BF81DEB3DD4D092"><enum>(1)</enum><text>adopt policies for
prevention, testing, and treatment that are consistent with the guidelines
issued in 2006 by the Centers for Disease Control and Prevention, entitled
<quote>Revised Recommendations for HIV Testing of Adults, Adolescents, and
Pregnant Women in Health-Care Settings</quote>; and</text>
</paragraph><paragraph commented="no" id="HD8616CFB37804DBC98C815BFFDCAA580"><enum>(2)</enum><text>begin a systemic,
aggressive approach to implementing voluntary, routine testing as part of all
health exams, including in emergency rooms, clinics, and private physician
offices.</text>
</paragraph></subsection><subsection commented="no" id="H5748A513ED4B4F2E8730EFB17EDA402A"><enum>(c)</enum><header>Sense of
Congress on Federal Bureau of Prisons procedures for inmates with
HIV</header><text>It is the sense of Congress that the Federal Bureau of
Prisons should implement procedures for—</text>
<paragraph commented="no" id="H2236D76C608A46BCA38BBD9985FA5DB3"><enum>(1)</enum><text>voluntary HIV
testing as a routine component of inmate care; and</text>
</paragraph><paragraph commented="no" id="H8F6375012DEF4A61802911762DFD68BC"><enum>(2)</enum><text>referral to care
as a routine component of release planning for inmates with HIV/AIDS, including
referral to community-based care and faith-based institutions.</text>
</paragraph></subsection></section><section id="HE65C0874C9104F07BFDE7DC3D58F51C0"><enum>748.</enum><header>National Black
Clergy for the Elimination of HIV/AIDS</header>
<subsection id="H0141D980D9DF45EA9B4A3BA27A2AF2E7"><enum>(a)</enum><header>Short
title</header><text>This section may be cited as the <quote><short-title>National Black Clergy for the Elimination of HIV/AIDS Act
of 2011</short-title></quote>.</text>
</subsection><subsection id="HCAB1150B1A794558BD716AAA9995B6FB"><enum>(b)</enum><header>Findings</header><text>Congress
finds the following:</text>
<paragraph id="H726C3BD9B61141B3BEAC62BD7DDF66BF"><enum>(1)</enum><text>It has been
estimated that more than 1,200,000 people in the United States are living with
HIV/AIDS, and approximately 500,000 of them are Black. Blacks are 8 times more
likely to have AIDS than their White counterparts. Within the Black community,
the subpopulation most disproportionately impacted by HIV/AIDS is Black men who
have sex with men (MSM) with prevalence rates twice those of White MSM. Black
women account for the majority of new AIDS cases among women and are 23 times
more likely to be living with AIDS than White women and 4 times more likely
than Latinas.</text>
</paragraph><paragraph id="H0F9C5FB547BB4EA689688C1E0C83849D"><enum>(2)</enum><text>On October 7–8,
2007, 186 Black clergy, consisting of Baptist, COGIC, Methodist, Protestant,
AME, and Pentecostal, together with, medical, policy, and AIDS leaders, were
brought together by the National Black Leadership Commission on AIDS (NBLCA),
the oldest and largest Black AIDS organization of its kind in America, hosted
by Time Warner, Inc., with other foundation support, to participate in the
National Black Clergy Conclave On HIV/AIDS Policy.</text>
</paragraph><paragraph id="H8CEA0D3D97FF4D3688D6ABCC8F9DD59C"><enum>(3)</enum><text>The attendees
included faith leaders across traditional, mega, and activist churches
representing millions of congregants: the National Medical Association (NMA)
representing 30,000 African-American physicians; the National Conference of
Black Mayors; the National Caucus of Black State Legislators; and the Health
Brain Trust of the Congressional Black Caucus and key African-American HIV/AIDS
advocates from across the United States. This group developed a plan of action
that has become the <short-title>National Black Clergy for
the Elimination of HIV/AIDS Act of 2011</short-title> to respond to the
<quote>on the ground</quote> emergency in prevention, care, and treatment for
AIDS in Black America.</text>
</paragraph><paragraph id="H35E1EF6EC6B841488799634DB6071169"><enum>(4)</enum><text>In August 2007,
the NMA, the oldest and largest organization representing 30,000
African-American physicians, released a consensus report entitled
<quote>Addressing The HIV/AIDS Crisis In The African American Community: Fact,
Fiction and Policy</quote>; and specifically called on the next President of
the United States to declare HIV/AIDS in African-American communities a public
health emergency and worked with NBLCA to organize clergy to advocate for the
specific needs of Black physicians, their patients, and those at risk in
African-American communities; and have pledged to advocate and work with clergy
to develop, execute, and implement these initiatives as a part of their
rightful role of leadership in African-American communities and culture.</text>
</paragraph><paragraph id="HA1C2B8F4BD814401A4E5EE2E566A5385"><enum>(5)</enum><text>The National
Conference of Black Mayors has pledged to work with clergy, medical, and
community leaders to develop and support these initiatives on a local level and
to help them to continue to develop a policy agenda leading to the elimination
of HIV/AIDS.</text>
</paragraph><paragraph id="HEC6EA4EF04A14622B114E0FECCBAA277"><enum>(6)</enum><text>The National
Caucus of Black State Legislators pledged to take the initiatives herein to
their body and develop plans of action for Black State Legislators to work with
local clergy, health departments, and CBOs to adopt and implement these
initiatives on a national level.</text>
</paragraph><paragraph id="H2E4A9638C02149968B426F8C7DBA4A3C"><enum>(7)</enum><text>At their April
2008 annual meeting, the National Policy Alliance (NPA), consisting of the
Joint Center For Political and Economic Studies (secretariat) and the National
Black Caucus of School Board Members, National Black Caucus of Local Elected
Officials; the Judicial Council of the National Bar Association; the National
Association of Black County Officials; Blacks in Government and the CBC; NCBM;
WCM, voted unanimously to support, endorse, and encourage the passage of the
<short-title>National Black Clergy for the Elimination of
HIV/AIDS Act of 2011</short-title> and to organize their respective members to
endorse and support the passage of this bill.</text>
</paragraph><paragraph id="H616F56AF74B24B3DA598CE1D996A8679"><enum>(8)</enum><text>The World
Conference of Black Mayors has ratified its support of these initiatives and
legislation, and pledged to assist the clergy to take them
internationally.</text>
</paragraph><paragraph id="H9CE25A0DD35F4A9FBA83C78896BACA54"><enum>(9)</enum><text>The National Black
Leadership Commission on AIDS, the Balm in Gilead, and the Black AIDS Institute
have been recognized by the clergy for their tradition and history of service
and will work with clergy to conduct community and policy development, linkages
to local departments of health and other services, infrastructure development,
education media, and fund development activities.</text>
</paragraph><paragraph id="HECAAAEBDAA034B41894A8BDF02206ACC"><enum>(10)</enum><text>Bishop T.D. Jakes
of the Potters House in Dallas, Texas, and Rev. Calvin O. Butts of the
Abyssinian Baptist Church in Harlem, New York, and chairman of the National
Black Leadership Commission on AIDS have been recognized as the organizers of
this group and will help guide and lead the development efforts of fellow
clergy through this process.</text>
</paragraph><paragraph id="HCB81DDB2149F4E109CEE078AE5311DA2"><enum>(11)</enum><text>The National
Conclave on HIV/AIDS for Black Clergy calls upon the President, Congress, and
corporate America to declare the HIV/AIDS crisis in the African-American
community a <quote>public health emergency</quote>.</text>
</paragraph><paragraph id="HFF5FDDFCEC1E482DB1A258556EFA3708"><enum>(12)</enum><text>The Black clergy
will aggressively seek to have every person under the sphere of their influence
tested for HIV in order to know the person’s status.</text>
</paragraph><paragraph id="H44E8C800C1F34353A4935CE96895F246"><enum>(13)</enum><text>The Black clergy
will promote HIV/AIDS awareness to ensure that all Black clergy serving in
their denominations and other congregations are equipped to address issues
related to this disease in a factual and scientifically sound manner.</text>
</paragraph><paragraph id="HA5970A3B3E174B40A2CFB03862224C6A"><enum>(14)</enum><text>The Black clergy
will use the ABC/D model as a behavioral guideline for prevention
initiatives:</text>
<subparagraph id="H821956C8C0ED4CFB80561574A5CDE622"><enum>(A)</enum><text>A–Abstain.</text>
</subparagraph><subparagraph id="HE9FE259AFC9A42FF9201EB8025B35C18"><enum>(B)</enum><text>B–Be
Faithful.</text>
</subparagraph><subparagraph id="HF842B78AEED841338068BBF6ABF9DC23"><enum>(C)</enum><text>C–Use
Condoms.</text>
</subparagraph><subparagraph id="H77FAF23241FD492C80DB9C9F2A5B8FA5"><enum>(D)</enum><text>D–Don’t Engage in
Risky Behaviors.</text>
</subparagraph></paragraph></subsection><subsection id="H9DCF9AE0C54841EEBBD102E7DF8EAB31"><enum>(c)</enum><header>Definitions
applicable throughout section</header><text>In this section—</text>
<paragraph id="H3067FD472084493597BFA3756C7C8E59"><enum>(1)</enum><text>the terms
<term>HIV</term> and <term>HIV/AIDS</term> have the meanings given to such
terms in section 2689 of the Public Health Service Act (42 U.S.C. 300ff–88);
and</text>
</paragraph><paragraph id="H119816390A374E86945D1538EEEF4D79"><enum>(2)</enum><text display-inline="yes-display-inline">the term <term>Secretary</term> means the
Secretary of Health and Human Services.</text>
</paragraph></subsection><subsection id="H67C6DFC011A54B2CBD810CC109A70DBE"><enum>(d)</enum><header>Services To
reduce HIV/AIDS in the African-American community</header>
<paragraph id="H28AA37B54BA14B4B91752AB3996C234F"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">For the purpose of
reducing HIV/AIDS in the African-American community, the Secretary, acting
through the Deputy Assistant Secretary for Minority Health, may make grants to
public health agencies and faith-based organizations to conduct—</text>
<subparagraph id="H724748E785D14664B88021383E499F82"><enum>(A)</enum><text>outreach
activities related to HIV/AIDS prevention and testing activities;</text>
</subparagraph><subparagraph id="H77182D95807B40379580BB060DF45B41"><enum>(B)</enum><text>HIV/AIDS
prevention activities; and</text>
</subparagraph><subparagraph id="H70E3CC9E34D1482DB6134A58C7814971"><enum>(C)</enum><text>HIV/AIDS testing
activities.</text>
</subparagraph></paragraph><paragraph id="H79C9C7249BBC4367AE3B3E9383F6A652"><enum>(2)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated $50,000,000 for fiscal year 2012, and such sums as may be
necessary for fiscal years 2013 through 2016.</text>
</paragraph></subsection><subsection id="H3B5F87AC123640C885DEA9919BA402D1"><enum>(e)</enum><header>Grants for
substance abuse and mental health services to public health agencies and
faith-Based organizations</header>
<paragraph id="HBF70CA8F2D9A495F82AB22436E492714"><enum>(1)</enum><header>In
general</header><text>The Secretary, acting through the Administrator of the
Substance Abuse and Mental Health Services Administration, may make grants to
public health agencies and faith-based organizations to—</text>
<subparagraph id="H6190EAB88ECC4F978F9804243A9C84C8"><enum>(A)</enum><text>conduct HIV/AIDS
and sexually transmitted disease outreach, prevention, and testing activities
that are targeted to the African-American community; and</text>
</subparagraph><subparagraph id="H7B92BCFD2D794182A022208D74498A5B"><enum>(B)</enum><text>in connection with
such activities, provide substance abuse testing and mental health services to
members of such community.</text>
</subparagraph></paragraph><paragraph id="H03194937511144CFA570A06E81AB3921"><enum>(2)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated $90,000,000 for fiscal year 2012 and such sums as may be
necessary for fiscal years 2013 through 2016.</text>
</paragraph></subsection><subsection id="H9CC3BD2062B34767AD5307F283FDC00C"><enum>(f)</enum><header>Services for
HIV/AIDS affected youth who are separated from their families</header>
<paragraph id="HF54F2FE5D29E40C098EB2A796A3C14D0"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, acting
through the Administrator of the Substance Abuse and Mental Health Services
Administration, may make grants to faith- and community-based organizations to
provide family reunification services, mental health counseling, HIV/AIDS and
sexually transmitted disease testing, and substance abuse testing and treatment
to youth who—</text>
<subparagraph id="HD369FBDB434647BCBBCEDD69D69B39F3"><enum>(A)</enum><clause commented="no" display-inline="yes-display-inline" id="H6412E7102F3F46E483AA6FF2DBC74FA2"><enum>(i)</enum><text>have run away from
home;</text>
</clause><clause id="H8A600589126F4D7B9A0D69A7BDEFF1C5" indent="up1"><enum>(ii)</enum><text>are homeless; or</text>
</clause><clause id="H64F72FAA889D4B3FBCD004C4B2456432" indent="up1"><enum>(iii)</enum><text>reside in a detention center or
foster care; and</text>
</clause></subparagraph><subparagraph id="HDAC1872A28794BBABFB75F8EE56CBD62"><enum>(B)</enum><text>are HIV positive
or at risk for HIV/AIDS, including young men who have sex with men.</text>
</subparagraph></paragraph><paragraph id="H68DB0983EB71423B9F455D2BDC34A6E9"><enum>(2)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated $5,000,000 for fiscal year 2012, and such sums as may be
necessary for fiscal years 2013 through 2016.</text>
</paragraph></subsection><subsection id="HEF86316FFC2449749835A9E865B9B05F"><enum>(g)</enum><header>Public health
intervention and prevention activities</header>
<paragraph id="HA93AC84DCEAC4CC69FFEE0A28B894B7C"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">For the purpose of
reducing HIV/AIDS, sexually transmitted diseases, tuberculosis, and viral
hepatitis in African-American communities, the Secretary, acting through the
Director of the Centers for Disease Control and Prevention, may make grants to
faith-based organizations for public health intervention and prevention
activities, including the use of rapid testing in traditional and
nontraditional settings to increase the number of individuals who know their
status at the point of care and are put into treatment.</text>
</paragraph><paragraph id="HD3879AC4C81B474AB3607DE353722FF8"><enum>(2)</enum><header>Partnerships</header><text>In
carrying out this section, the Secretary shall encourage grantees to enter into
partnerships with public health agencies.</text>
</paragraph><paragraph id="HF4ADB1CF6B334B919279D70F40DCE147"><enum>(3)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">To carry out
this section, there are authorized to be appropriated $100,000,000 for fiscal
year 2012, and such sums as may be necessary for fiscal years 2013 through
2016.</text>
</paragraph></subsection><subsection id="HB02948DD2FAD46C4B35F9901CA750CC3"><enum>(h)</enum><header>HIV/AIDS
prevention and education</header>
<paragraph id="HF8B4E30F9E4D46E68568DEC54F8283D6"><enum>(1)</enum><header>Prevention
activities</header><text display-inline="yes-display-inline">The Secretary,
acting through the Director of the Centers for Disease Control and Prevention,
shall expand and intensify HIV/AIDS prevention activities in African-American
communities. Such activities—</text>
<subparagraph id="H7A7E03FA2A6A4E3FB1128E414EE22C3B"><enum>(A)</enum><text>shall be targeted
to specific populations;</text>
</subparagraph><subparagraph id="H138BD599569642E29AF7105553C411C0"><enum>(B)</enum><text>shall be
comprehensive and accurately based on science and research; and</text>
</subparagraph><subparagraph id="H6B41D2A4C9D746C392C3F17236B43FC8"><enum>(C)</enum><text>shall include
information on abstinence, the proper use of condoms, risks associated with
unprotected sex, and the value of sexual delay particularly among young
adolescents and teenagers.</text>
</subparagraph></paragraph><paragraph id="HC8B8BAA258A54DC199539ACCEC770D53"><enum>(2)</enum><header>Education</header><text>The
Secretary, acting through the Director of the Centers for Disease Control and
Prevention, shall expand and intensify HIV/AIDS educational activities
targeting Black women, youth, and men who have sex with men.</text>
</paragraph><paragraph id="H9222F87BE4AF4C8B92DA282FDFB798F9"><enum>(3)</enum><header>Coordination</header><text>The
Secretary shall carry out this section in coordination with public schools of
all levels, Black organizations, historically Black colleges and universities,
and faith-based organizations and institutions.</text>
</paragraph><paragraph id="HB5C115969BC94C7B9FE316848FBF6366"><enum>(4)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">To carry out
this section, there are authorized to be appropriated $90,000,000 for fiscal
year 2012, and such sums as may be necessary for fiscal years 2013 through
2016.</text>
</paragraph></subsection><subsection id="H3CD1FFD839334C85B352E6B39F2CE3BE"><enum>(i)</enum><header>Building
capacity of communities</header>
<paragraph id="H2CF1DE7C898F4912A9C73A8434F31785"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, acting
through the Director of the Centers for Disease Control and Prevention, shall
expand funding to eligible entities to build the capacity of African-American
communities to respond to HIV/AIDS.</text>
</paragraph><paragraph id="HD7E91D1D53C3440AB4320657969A4F78"><enum>(2)</enum><header>Emphasis</header><text>In
carrying out this section, the Secretary shall emphasize the provision of
funding for policy development, education, technical assistance, and
training—</text>
<subparagraph id="HF8BBC035673045EDBFADA9884920FB01"><enum>(A)</enum><text>to national and
local faith-based organizations; and</text>
</subparagraph><subparagraph id="HE036DB4D48F2432A9DB4197C0E27688F"><enum>(B)</enum><text display-inline="yes-display-inline">to organizations with a significant history
of working within the African-American community on HIV/AIDS issues, an
interdenominational center of seminaries specializing in the training of
African-American clergy, and historically Black colleges and
universities.</text>
</subparagraph></paragraph><paragraph id="H1F240647DA224BD4AEFB0329B7173587"><enum>(3)</enum><header>Definition</header><text>In
this section, the term <term>eligible entity</term> means a national or
community-based organization with a history and tradition of service to
African-American communities.</text>
</paragraph><paragraph id="H12F6CC1980434DAB99F1467A35D6532B"><enum>(4)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">To carry out
this section, there are authorized to be appropriated $25,000,000 for fiscal
year 2012, and such sums as may be necessary for fiscal years 2013 through
2016.</text>
</paragraph></subsection><subsection id="H5E8837468C1C4F8B9E94207ED7CC9559"><enum>(j)</enum><header>National media
outreach campaign</header>
<paragraph id="HB2AA249FD0134FDB9F91B892B15F418E"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, acting
through the Director of the Centers for Disease Control and Prevention, shall
implement a national media outreach campaign that urges all sexually active
individuals to be tested for and know their HIV/AIDS status.</text>
</paragraph><paragraph id="HCB0572DE0C9C4B36995B873C33E43927"><enum>(2)</enum><header>Requirements</header><text>The
national media outreach campaign under this subsection shall—</text>
<subparagraph id="H73943826573B4C82A376FD9A36471F22"><enum>(A)</enum><text>be science-driven
and targeted to African-American men, women, and youth; and</text>
</subparagraph><subparagraph id="H4484A51F03BF4D5C8FC2AF97EEA4DE70"><enum>(B)</enum><text>give special
emphasis to Black women and men who have sex with men.</text>
</subparagraph></paragraph><paragraph id="H368DC06F6A904504A48524822CD49153"><enum>(3)</enum><header>Coordination;
consultation</header><text>The Secretary shall carry out this
subsection—</text>
<subparagraph id="H7F4E39CA681C4C4E93F896913BE30313"><enum>(A)</enum><text display-inline="yes-display-inline">in coordination with Black media outlets
for print, electronic, and Web-based media and Black media associations,
including the National Association of Black Owned Broadcasters and the National
Newspaper Publishers Association; and</text>
</subparagraph><subparagraph id="H199AFBBB94CC458E97C37372F41FBAC9"><enum>(B)</enum><text>in consultation
with an advisory board including representatives of the National Medical
Association, faith leaders, elected and appointed officials, social marketing
experts, and business and community stakeholders.</text>
</subparagraph></paragraph><paragraph id="H6FA6595AE120444C802E4BBC4BB27734"><enum>(4)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">To carry out
this subsection, there are authorized to be appropriated $10,000,000 for fiscal
year 2012, and such sums as may be necessary for fiscal years 2013 through
2016.</text>
</paragraph></subsection><subsection id="HDEA05155DA7A4CD0BE1B98DCF16F511C"><enum>(k)</enum><header>Research To
develop behavioral strategies To reduce transmission of HIV/AIDS</header>
<paragraph id="HA911CAE926B54CC18E7D7B8A8E945344"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, acting
through the Director of the National Institutes of Health, may conduct or
support culturally competent research to develop evidence-based behavioral
strategies to reduce the transmission of HIV/AIDS within the African-American
community.</text>
</paragraph><paragraph id="HDE2C100BB5364BD5894490BC7307FA19"><enum>(2)</enum><header>Priority</header><text>In
carrying out this section, the Secretary shall prioritize research that focuses
on populations within the African-American community that are at increased risk
for HIV/AIDS, including—</text>
<subparagraph id="H8062E527B02A40908C264B8FC21EFD34"><enum>(A)</enum><text>men who have sex
with men; and</text>
</subparagraph><subparagraph id="H89A9DE1E1C704CD6B8BDACE420810865"><enum>(B)</enum><text>women.</text>
</subparagraph></paragraph><paragraph id="H545D7AE8BCCE439BB4B9E021869D8195"><enum>(3)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated $10,000,000 for fiscal year 2012, and such sums as may be
necessary for fiscal years 2013 through 2016.</text>
</paragraph></subsection><subsection id="HFA99EA1F73A04D16A3FC1A3969673873"><enum>(l)</enum><header>Study of
biological and behavioral factors</header>
<paragraph id="HB3AD2E2DF7B44B9F88078DFBBF28C071"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, acting
through the Director of the National Institute on Minority Health and Health
Disparities, may make grants for—</text>
<subparagraph id="H420C8D4C640D4630AC7A73AC92532A0C"><enum>(A)</enum><text>the study of
biological and behavioral factors that lead to increased HIV/AIDS prevalence in
the African-American community, to be conducted by researchers with a history
and tradition of service to Black communities; and</text>
</subparagraph><subparagraph id="HF7F1D76D274B42BF9913C39AFB96FEFD"><enum>(B)</enum><text>behavioral and
structural network research and interventions, in collaboration with other
institutes and centers of the National Institutes of Health, indigenous faith
and national and community-based organizations with a history and tradition of
conducting such research for Black communities, with a special emphasis on
Black women and Black men who have sex with men.</text>
</subparagraph></paragraph><paragraph id="HD6358DC9FB21433982DA7303D542808F"><enum>(2)</enum><header>Authorization of
appropriations</header><text>To carry out this subsection, there are authorized
to be appropriated $100,000,000 for fiscal year 2012, and such sums as may be
necessary for fiscal years 2013 through 2016.</text>
</paragraph></subsection><subsection commented="no" id="HD4BFB360B2C54B5091A09ACF28C4CC98"><enum>(m)</enum><header>Health care
professionals treating individuals with HIV/AIDS</header><text>Part E of title
VII of the Public Health Service Act (42 U.S.C. 294n et seq.) is amended by
adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H92A351943BDF46DB8D8F4BC589D064B5" style="OLC">
<subpart commented="no" id="HC927FE5902B440E6A059D828045EEF22"><enum>4</enum><header>Health Care
Professionals Treating Individuals With HIV/AIDS</header>
<section commented="no" id="HF699F43303274F2799558A3D0AEC1D19"><enum>781.</enum><header>Better care for
individuals with HIV/AIDS</header>
<subsection commented="no" id="HE6674F9AB4974911A6DECCE903904217"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Administrator of the
Health Resources and Services Administration and in consultation with the
African-American church community, may award grants for any of the
following:</text>
<paragraph commented="no" id="H6F391B6E938145829E5A1773F44D1780"><enum>(1)</enum><text>Development of
curricula for training primary care providers in HIV/AIDS prevention and
care.</text>
</paragraph><paragraph commented="no" id="H389EF486682B4B6789694A6CF375F522"><enum>(2)</enum><text>Training health
care professionals with expertise in HIV/AIDS to provide care to individuals
with HIV/AIDS.</text>
</paragraph><paragraph commented="no" id="H17A01AF3C6E64629BF41FDADB59D24D4"><enum>(3)</enum><text>Development by
grant recipients under title XXVI and other persons of policies for providing
culturally relevant and sensitive treatment to individuals with HIV/AIDS, with
particular emphasis on treatment to African-Americans and children with
HIV/AIDS.</text>
</paragraph><paragraph commented="no" id="H48FFFA27DEB64840A01DA3FB83DB7F0A"><enum>(4)</enum><text>Development and
implementation of programs to increase the use of telemedicine to respond to
HIV/AIDS-specific health care needs in rural and minority communities, with
particular emphasis given to medically underserved communities and the southern
States.</text>
</paragraph><paragraph id="HD606569401C040FF954750BFC1571912"><enum>(5)</enum><text>Creation of faith-
and community-based certification programs for providers in HIV/AIDS care and
support services.</text>
</paragraph><paragraph id="H8FD86884ECAA442DAC5B97304C132502"><enum>(6)</enum><text>Establishment of
comfort care centers that provide mental, emotional, and psychosocial
counseling for people with HIV/AIDS and implement additional protocols to be
carried out in the centers that address the needs of children and young adults
who are infected with the disease and are transitioning from childhood to
adulthood.</text>
</paragraph><paragraph id="HF78149A5089843E1883FFEAF0E423965"><enum>(7)</enum><text>Incentive payments
to health care providers supported by the Health Resources and Services
Administration to implement HIV/AIDS testing consistent with the guidelines
issued in 2006 by the Centers for Disease Control and Prevention entitled
<quote>Revised Recommendations for HIV Testing of Adults, Adolescents, and
Pregnant Women in Health-Care Settings</quote>.</text>
</paragraph></subsection><subsection commented="no" id="HCA2FBB68A1C24BBDB3DBB6BB27462879"><enum>(b)</enum><header>Definition</header><text>In
this section, the term <term>HIV/AIDS</term> has the meaning given to such term
in section 2689.</text>
</subsection><subsection commented="no" id="HBB0F5FE22927474E96ACF8097AB8FB96"><enum>(c)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">To carry out
this section, there are authorized to be appropriated $100,000,000 for fiscal
year 2012, and such sums as may be necessary for fiscal years 2013 through
2016.</text>
</subsection></section></subpart><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HA90043F7F1BC46BD927A6E9BF057996E"><enum>(n)</enum><header>Report on impact
of HIV/AIDS in the African-American community</header>
<paragraph id="H53FBD1B462E84300949CEBAFFA597C9E"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary shall
submit to Congress and the President an annual report on the impact of HIV/AIDS
in the African-American community.</text>
</paragraph><paragraph id="H45C08720D90F46F29D42707443C5A40D"><enum>(2)</enum><header>Contents</header><text>The
report under
<internal-xref idref="H53FBD1B462E84300949CEBAFFA597C9E" legis-path="161.(a)">subsection (a)</internal-xref> shall include information
on the—</text>
<subparagraph id="HC898DE049FC34BC8869C9082110AD4E2"><enum>(A)</enum><text>progress that has
been made in reducing the impact of HIV/AIDS in such community;</text>
</subparagraph><subparagraph id="HC9ACAFC94752482687D05BF0D6624B87"><enum>(B)</enum><text display-inline="yes-display-inline">opportunities that exist to make additional
progress in reducing the impact of HIV/AIDS in such community;</text>
</subparagraph><subparagraph id="H230D9D48727848348516B984C672E9E2"><enum>(C)</enum><text>challenges that
may impede such additional progress; and</text>
</subparagraph><subparagraph id="H137E16FB938F4C20B266AA6B4A66DB01"><enum>(D)</enum><text>Federal funding
necessary to achieve substantial reductions in HIV/AIDS in the African-American
community.</text>
</subparagraph></paragraph></subsection></section><section id="H151944D4F1714066BAF253FE4AC93981"><enum>749.</enum><header>Reducing the
spread of sexually transmitted infections in correctional facilities</header>
<subsection id="H097CF0F75DCA44D6B1A21343E87DCA42"><enum>(a)</enum><header>Short
title</header><text>This section may be cited as the <quote><short-title>Justice for the Unprotected Against Sexually Transmitted
Infections among the Confined and Exposed Act</short-title></quote> or the
<quote><short-title>JUSTICE
Act</short-title></quote>.</text>
</subsection><subsection id="H1B28F97FEBC044FEA539F606CF10959C"><enum>(b)</enum><header>Findings</header><text>The
Congress makes the following findings:</text>
<paragraph id="H8190670F08A94824B64CE28ACBE9DAF1"><enum>(1)</enum><text display-inline="yes-display-inline">According to the Bureau of Justice
Statistics (BJS), 2,292,133 persons were incarcerated in the United States as
of the end of 2009. Between 1998 and 2008, the number of persons incarcerated
in Federal or State correctional facilities increased by an average of 2.4
percent per year. One in every 32 United States residents was on probation, in
jail or prison, or on parole at the end of 2009.</text>
</paragraph><paragraph id="H35459369F12A473286C0C459C3CBCC23"><enum>(2)</enum><text display-inline="yes-display-inline">As of 2009, 66.8 percent of incarcerated
persons were racial or ethnic minorities. Based on current incarceration rates,
BJS estimates that African-American males are 6 times more likely to be held in
custody than White males, while Hispanic males are a little more than 2 times
more likely to be held in custody. Across all age categories, African-American
males were incarcerated at higher rates than Hispanic or White males.</text>
</paragraph><paragraph id="HBD244AC871BB49E9B5307C090991A366"><enum>(3)</enum><text>There is a
disproportionately high rate of HIV/AIDS among incarcerated persons, especially
among minorities. Approximately 25 percent of the HIV-positive population of
the United States passes through correctional facilities each year. BJS has
determined that the rate of confirmed AIDS cases is 2.4 times higher among
incarcerated persons than in the general population. Minorities account for the
majority of AIDS-related deaths among incarcerated persons, with
African-American incarcerated persons 2.8 times more likely than White
incarcerated persons and 1.4 times more likely than Hispanic incarcerated
persons to die from AIDS-related causes. Nearly two-thirds of AIDS-related
deaths are among Black, non-Hispanic males.</text>
</paragraph><paragraph id="HF716ACB13C6F44B9864A39BCC8300202"><enum>(4)</enum><text display-inline="yes-display-inline">Studies suggest that other sexually
transmitted infections (STIs), such as gonorrhea, chlamydia, syphilis, genital
herpes, viral hepatitis, and human papillomavirus, also exist at a higher rate
among incarcerated persons than in the general population. For instance,
researchers have estimated that the rate of hepatitis C (HCV) infection among
incarcerated persons is somewhere between 8 and 20 times higher than that of
the general population.</text>
</paragraph><paragraph id="H60848DA8088C4A378532CFC3402D697C"><enum>(5)</enum><text display-inline="yes-display-inline">Correctional facilities lack a uniform
system of STI testing and reporting. Establishing a uniform data collection
system would assist in developing and targeting counseling and treatment
programs for incarcerated persons. Better developed and targeted programs may
reduce the spread of STIs.</text>
</paragraph><paragraph id="H211A75C681274E668107B7D75BCE1180"><enum>(6)</enum><text display-inline="yes-display-inline">Although Congress has acted to reduce the
spread of sexual violence in correctional facilities by enacting the National
Prison Rape Elimination Act (PREA) of 2003, BJS reported that approximately 4.4
percent of incarcerated persons in prisons and 3.1 percent of persons in jail
reported experiencing one or more incidents of sexual victimization by another
incarcerated person or correctional facility staff in the previous year.</text>
</paragraph><paragraph id="HCC3802F917E84714B9C84CCFE6AB6939"><enum>(7)</enum><text display-inline="yes-display-inline">Approximately 95 percent of all
incarcerated persons eventually return to society. According to one study,
every year approximately 100,000 persons infected with both HIV and HCV are
released from correctional facilities. These individuals comprise approximately
50 percent of all persons with both infections in the United States.</text>
</paragraph><paragraph id="HEEB8F9B541164186A93C178544D16FB9"><enum>(8)</enum><text display-inline="yes-display-inline">According to the Centers for Disease
Control and Prevention (CDC), latex condoms, when used consistently and
correctly, are highly effective in preventing the transmission of HIV. Latex
condoms also reduce the risk of other STIs. Despite the effectiveness of
condoms in reducing the spread of STIs, the Bureau of Prisons does not
recommend their use in correctional facilities.</text>
</paragraph><paragraph id="H2E7015E5E154411083D1A8CA1CD65275"><enum>(9)</enum><text display-inline="yes-display-inline">The distribution of condoms in correctional
facilities is currently legal in certain parts of the United States and the
world. The States of Vermont and Mississippi and the District of Columbia allow
condom distribution programs in their correctional facilities. The cities of
New York, San Francisco, Los Angeles, Washington DC, and Philadelphia also
allow condom distribution in their correctional facilities. However, these
States and cities operate fewer than 1 percent of all correctional
facilities.</text>
</paragraph><paragraph id="HE4665F0409C54948AF98DA523D4FCF81"><enum>(10)</enum><text>A 2007 report by
the Massachusetts General Hospital Division of Infectious Diseases and the
University of California, San Francisco, found that the proportion of European
prison systems allowing condoms rose from 53 percent in 1989 to 81 percent in
1997. The same report also found that no prison system allowing the
distribution of condoms had reversed their decision, and no prison system
reported an increase in sexual activity among incarcerated persons as a result
of a decision to allow condom distribution.</text>
</paragraph><paragraph id="HC168A4AECAAA412C82B2F83F83BB51CE"><enum>(11)</enum><text display-inline="yes-display-inline">In 2000 and 2001, researchers surveyed 300
incarcerated persons and 100 correctional officers at the Central Detention
Facility, a correctional facility operated by the District of Columbia at which
condoms are available. Researchers found that both incarcerated persons and
correctional officers generally supported the condom distribution program and
considered it to be important. Furthermore, the researchers determined that the
program had not caused any major security infractions. In Canada, the Expert
Committee on AIDS and Prisons surveyed more than 400 correctional officers in
the Federal prison system of Canada in 1995 and reported that 82 percent of
those responding indicated that the availability of condoms had created no
problems at their facility.</text>
</paragraph><paragraph id="H0FEF7844DDE34087B6FD33DF22AA80A3"><enum>(12)</enum><text display-inline="yes-display-inline">The American Public Health Association, the
United Nations Joint Program on HIV/AIDS, and the World Health Organization
have endorsed the effectiveness of condom distribution programs in correctional
facilities.</text>
</paragraph><paragraph id="HBC8D64C0B44E4E23873B6679532B045F"><enum>(13)</enum><text display-inline="yes-display-inline">Many correctional facilities in the United
States do not provide comprehensive testing and treatment programs to reduce
the spread of STIs. According to BJS surveys from 2005, only 996 of the 1,821
Federal and State correctional facilities (i.e. 54.7 percent) provided HIV/AIDS
counseling programs.</text>
</paragraph><paragraph id="HB6AA263F7C09453F93C0FD4B5E90E9A1"><enum>(14)</enum><text display-inline="yes-display-inline">Individuals who are enrolled in Medicaid
prior to incarceration face a suspension of their benefits upon incarceration,
and in some States a termination of their Medicaid eligibility. The Federal
Government encourages States to automatically re-enroll incarcerated persons on
Medicaid upon their release from a correctional facility, unless the State
reaches a determination that the individual is no longer eligible for reasons
other than their prior incarceration.</text>
</paragraph><paragraph id="HBAD5F4F304B447EAB0E93543F6785ED0"><enum>(15)</enum><text>Formerly
incarcerated individuals who are newly released from correctional facilities
often face delays in the resumption of their Medicaid benefits which may
exacerbate any health issues which they face.</text>
</paragraph><paragraph id="H88C3E4A1AAE74A608ED4825D2EF0378A"><enum>(16)</enum><text>Incarcerated
individuals living with HIV/AIDS who are eligible for Medicaid would benefit
from prompt and automatic enrollment upon their release in order to ensure
their continued ability to access health services, including antiretroviral
treatment.</text>
</paragraph></subsection><subsection id="H1AF256C61D5C49B989D5383BC204C342"><enum>(c)</enum><header>Authority To
allow community organizations To provide STI counseling, STI prevention
education, and sexual barrier protection devices in Federal correctional
facilities</header>
<paragraph id="H6211BA3C4E9B4248A45E502A48B1EEA0"><enum>(1)</enum><header>Directive to
Attorney General</header><text display-inline="yes-display-inline">Not later
than 30 days after the date of enactment of this Act, the Attorney General
shall direct the Bureau of Prisons to allow community organizations to
distribute sexual barrier protection devices and to engage in STI counseling
and STI prevention education in Federal correctional facilities. These
activities shall be subject to all relevant Federal laws and regulations which
govern visitation in correctional facilities.</text>
</paragraph><paragraph id="H6DA88D15058649D1A04524555134C09A"><enum>(2)</enum><header>Information
requirement</header><text display-inline="yes-display-inline">Any community
organization permitted to distribute sexual barrier protection devices under
paragraph (1) must ensure that the persons to whom the devices are distributed
are informed about the proper use and disposal of sexual barrier protection
devices in accordance with established public health practices. Any community
organization conducting STI counseling or STI prevention education under
paragraph (1) must offer comprehensive sexuality education.</text>
</paragraph><paragraph id="H00616F374B644C68A2DA5F4913F3E78C"><enum>(3)</enum><header>Possession of
device protected</header><text>No Federal correctional facility may, because of
the possession or use of a sexual barrier protection device—</text>
<subparagraph id="HDEC55A4C741446BC92D3DA81E089F5FB"><enum>(A)</enum><text>take adverse
action against an incarcerated person; or</text>
</subparagraph><subparagraph id="H5869E3F2A3A3494F9DD44B941637241C"><enum>(B)</enum><text>consider
possession or use as evidence of prohibited activity for the purpose of any
Federal correctional facility administrative proceeding.</text>
</subparagraph></paragraph><paragraph id="H36C899CA73F4470A9178DC7C648EBE54"><enum>(4)</enum><header>Implementation</header><text>The
Attorney General and Bureau of Prisons shall implement this section according
to established public health practices in a manner that protects the health,
safety, and privacy of incarcerated persons and of correctional facility
staff.</text>
</paragraph></subsection><subsection id="HE27271740DD04FA3A2907549F37D9ECA"><enum>(d)</enum><header>Sense of
Congress regarding distribution of sexual barrier protection devices in State
prison systems</header><text>It is the sense of Congress that States should
allow for the legal distribution of sexual barrier protection devices in State
correctional facilities to reduce the prevalence and spread of STIs in those
facilities.</text>
</subsection><subsection commented="no" id="HB2DE2B57C66E4712AC03CE69B070ECDF"><enum>(e)</enum><header>Automatic
reinstatement of Medicaid benefits</header>
<paragraph commented="no" id="H66CD5165B6F44DD8A7DD08927758C00D"><enum>(1)</enum><header>In
general</header><text>Section 1902(e) of the Social Security Act (42 U.S.C.
1396a(e)) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H4CFE97ECCA684FA383A2E6E57317F03C" style="OLC">
<paragraph commented="no" id="H509DD196E6814D7EB8E92B776664653A"><enum>(15)</enum><header>Enrollment of
ex-offenders</header>
<subparagraph commented="no" id="H1917C8B8BD624156A35C0B1A4366D73C"><enum>(A)</enum><header>Automatic
enrollment or reinstatement</header>
<clause id="H6F1D9CFB1C43457786D09C2A647087C3"><enum>(i)</enum><header>In
general</header><text>The State plan shall provide for the automatic enrollment
or reinstatement of enrollment of an eligible individual if—</text>
<subclause commented="no" display-inline="no-display-inline" id="H991F05285562447A98ED0FE0ED2E665B"><enum>(I)</enum><text>such individual is
scheduled to be released from a public institution due to the completion of
sentence, not less than 30 days prior to the scheduled date of the release;
and</text>
</subclause><subclause commented="no" id="H1A998E15882C4ED08101611B19B40D88"><enum>(II)</enum><text>such individual
is to be released from a public institution on parole or on probation, as soon
as possible after the date on which the determination to release such
individual was made, and before the date such individual is released.</text>
</subclause></clause><clause id="HA37B37A4B6AA41C786A6A980B9DAFD36"><enum>(ii)</enum><header>Exception</header><text display-inline="yes-display-inline">If a State makes a determination that an
individual is not eligible to be enrolled under the State plan—</text>
<subclause display-inline="no-display-inline" id="H15A7CB15B5FB4F9DBF0F50753D2323B8"><enum>(I)</enum><text>on or before the
date by which the individual would be enrolled under
<internal-xref idref="H6F1D9CFB1C43457786D09C2A647087C3" legis-path="(15)(A)(i)">clause (i)</internal-xref>, such clause shall not apply
to such individual; or</text>
</subclause><subclause id="H1C50B542E7624D69A77FD633944B6B94"><enum>(II)</enum><text>after such date,
the State may terminate the enrollment of such individual.</text>
</subclause></clause></subparagraph><subparagraph id="H0A02631714B849EBBFA5A70D07D5B99D"><enum>(B)</enum><header>Relationship of
enrollment to payment for services</header>
<clause id="HBA47A0220150473D944BBB15FEF600CE"><enum>(i)</enum><header>In
general</header><text>Subject to
<internal-xref idref="HA37B37A4B6AA41C786A6A980B9DAFD36" legis-path="(15)(A)(ii)">subparagraph (A)(ii)</internal-xref>, an eligible
individual who is enrolled, or whose enrollment is reinstated under
<internal-xref idref="H1917C8B8BD624156A35C0B1A4366D73C" legis-path="(15)(A)">subparagraph (A)</internal-xref>, shall be eligible for
medical assistance that is provided after the date that the eligible individual
is released from the public institution</text>
</clause><clause commented="no" id="HFE72F4B9806345A389FD50156A9E53AB"><enum>(ii)</enum><header>Relationship to
payment prohibition for inmates</header><text display-inline="yes-display-inline">No provision of this paragraph may be
construed to permit payment for care or services for which payment is excluded
under the subparagraph (A), following paragraph (29), of section
1905(a).</text>
</clause></subparagraph><subparagraph commented="no" id="HA3F6F2730E9B49718F4C1D21742EB14B"><enum>(C)</enum><header>Treatment of
continuous eligibility</header>
<clause commented="no" id="HF84C45CF16F7406D99F9A6271AF56236"><enum>(i)</enum><header>Suspension for
inmates</header><text>Any period of continuous eligibility under this title
shall be suspended on the date an individual enrolled under this title becomes
an inmate of a public institution (except as a patient of a medical
institution).</text>
</clause><clause commented="no" id="H941683026CCC4AACAC8DB4B3B7ACD467"><enum>(ii)</enum><header>Determination
of remaining period</header><text>Notwithstanding any changes to State law
related to continuous eligibility during the time that an individual is an
inmate of a public institution (except as a patient of a medical institution),
subject to
<internal-xref idref="HE296AC9B38074CC2A1FEDB7EFDD963FF" legis-path="(15)(C)(iii)">clause (iii)</internal-xref>, with respect to an
eligible individual who was subject to a suspension under
<internal-xref idref="HF84C45CF16F7406D99F9A6271AF56236" legis-path="(15)(A)(ii)(I)">subclause (I)</internal-xref>, on the date that
such individual is released from a public institution the suspension of
continuous eligibility under such subclause shall be lifted for a period that
is equal to the time remaining in the period of continuous eligibility for such
individual on the date that such period was suspended under such
subclause.</text>
</clause><clause id="HE296AC9B38074CC2A1FEDB7EFDD963FF"><enum>(iii)</enum><header>Exception</header><text display-inline="yes-display-inline">If a State makes a determination that an
individual is not eligible to be enrolled under the State plan—</text>
<subclause display-inline="no-display-inline" id="HB539D6DE9E78421DB682305E10236D62"><enum>(I)</enum><text>on or before the
date that the suspension of continuous eligibility is lifted under
<internal-xref idref="H941683026CCC4AACAC8DB4B3B7ACD467" legis-path="(15)(C)(ii)">clause (ii)</internal-xref>, such clause shall not
apply to such individual; or</text>
</subclause><subclause id="H4E4C4CD0D22B40D590FC35431C5326DD"><enum>(II)</enum><text>after such date,
the State may terminate the enrollment of such individual.</text>
</subclause></clause></subparagraph><subparagraph id="H58695B584641404F8660A5D03902D11B"><enum>(D)</enum><header>Automatic
enrollment or reinstatement of enrollment defined</header><text display-inline="yes-display-inline">For purposes of this paragraph, the term
<term>automatic enrollment or reinstatement of enrollment</term> means that the
State determines eligibility for medical assistance under the State plan
without a program application from, or on behalf of, the eligible individual,
but an individual can only be automatically enrolled in the State Medicaid plan
if the individual affirmatively consents to being enrolled through affirmation
in writing, by telephone, orally, through electronic signature, or through any
other means specified by the Secretary.</text>
</subparagraph><subparagraph commented="no" id="HAF5A364D00924CC08506A41F07F0D8A2"><enum>(E)</enum><header>Eligible
individual defined</header><text display-inline="yes-display-inline">For
purposes of this paragraph, the term <term>eligible individual</term> means an
individual who is an inmate of a public institution (except as a patient in a
medical institution)—</text>
<clause commented="no" id="HD3585772D0134E5CA066B61B67BBBF6F"><enum>(i)</enum><text display-inline="yes-display-inline">who was enrolled under the State plan for
medical assistance immediately before becoming an inmate of such an
institution; or</text>
</clause><clause commented="no" id="H5B6FEE3C73E44E34B6467A429D2A8D3B"><enum>(ii)</enum><text display-inline="yes-display-inline">is diagnosed with human immunodeficiency
virus.</text>
</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HF8A3CBA262124A589038EF21A749FB98"><enum>(2)</enum><header>Supplemental
Funding for State Implementation of Automatic Reinstatement of Medicaid
Benefits</header>
<subparagraph commented="no" id="HED6125465FD442D3BFB993716008C495"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">Subject to
<internal-xref idref="H090C6DC3321C4EEDAD7A62909CAAB2A6" legis-path="5.(b)(6)">paragraph (6)</internal-xref>, for each State for which
the Secretary of Health and Human Services has approved an application under
<internal-xref idref="H00D7A3C14FE14415A00DC200F87CA2DD" legis-path="5.(b)(3)">paragraph (3)</internal-xref>, the Federal matching
payments (including payments based on the Federal medical assistance
percentage) made to such State under section 1903 of the Social Security Act
(42 U.S.C. 1396b) shall be increased by 5.0 percentage points for payments to
the State for the activities permitted under
<internal-xref idref="HFBE4B23F34704001AC62BB6E3E80A7EB" legis-path="5.(b)(2)">paragraph (2)</internal-xref> for a period of one
year.</text>
</subparagraph><subparagraph commented="no" id="HFBE4B23F34704001AC62BB6E3E80A7EB"><enum>(B)</enum><header>Use of
funds</header><text>A State may only use increased matching payments authorized
under
<internal-xref idref="HED6125465FD442D3BFB993716008C495" legis-path="5.(b)(1)">paragraph (1)</internal-xref>—</text>
<clause commented="no" id="HFBB1D37127DA4F68BED1A66669FFACE6"><enum>(i)</enum><text>to strengthen the
State’s enrollment and administrative resources for the purpose of improving
processes for enrolling (or reinstating the enrollment of) eligible individuals
(as such term is defined in section 1902(e)(15)(E) of the Social Security Act);
and</text>
</clause><clause commented="no" id="HE47CD7F48B7741688C8DDEA8093ECBB8"><enum>(ii)</enum><text>for medical
assistance (as such term is defined in section 1905(a) of the Social Security
Act) provided to such eligible individuals.</text>
</clause></subparagraph><subparagraph commented="no" id="H00D7A3C14FE14415A00DC200F87CA2DD"><enum>(C)</enum><header>Application and
agreement</header><text>The Secretary may only make payments to a State in the
increased amount if—</text>
<clause commented="no" id="HEE26C50A2FFB4D71B040C9CD1068AA1D"><enum>(i)</enum><text display-inline="yes-display-inline">the State has amended the State plan under
section 1902 of the Social Security Act to incorporate the requirements of
subsection (e)(15) of such section;</text>
</clause><clause commented="no" id="H3635A2B4F4204502A6DB7DF5B32F08B2"><enum>(ii)</enum><text>the State has
submitted an application to the Secretary that includes a plan for implementing
the requirements of section 1902(e)(15) of the Social Security Act under the
State’s amended State plan before the end of the 90-day period beginning on the
date that the State receives increased matching payments under
<internal-xref idref="HED6125465FD442D3BFB993716008C495" legis-path="5.(b)(1)">paragraph (1)</internal-xref>;</text>
</clause><clause commented="no" id="H1E234E477DBF4246951CD4C0C338B1D4"><enum>(iii)</enum><text>the State’s
application meets the satisfaction of the Secretary; and</text>
</clause><clause commented="no" id="H667D27000F734D48B71797867FC30E9D"><enum>(iv)</enum><text>the State enters
an agreement with the Secretary that states that—</text>
<subclause commented="no" id="HB95001E6ECB44FFC9E4F0F250E6FF186"><enum>(I)</enum><text>the State will
only use the increased matching funds for the uses permitted under
<internal-xref idref="HFBE4B23F34704001AC62BB6E3E80A7EB" legis-path="5.(b)(2)">paragraph (2)</internal-xref>; and</text>
</subclause><subclause commented="no" id="HAAC9FEFC450D46F5AA2FF241B43ACF1F"><enum>(II)</enum><text display-inline="yes-display-inline">at the end of the period under
<internal-xref idref="HED6125465FD442D3BFB993716008C495" legis-path="5.(b)(1)">paragraph (1)</internal-xref>, the State will submit to
the Secretary, and make publicly available, a report that contains the
information required under
<internal-xref idref="H8A02218C47E041278D98F312476EC605" legis-path="5.(b)(4)">paragraph (4)</internal-xref>.</text>
</subclause></clause></subparagraph><subparagraph commented="no" id="H8A02218C47E041278D98F312476EC605"><enum>(D)</enum><header>Required report
information</header><text display-inline="yes-display-inline">The information
that is required in the report under
<internal-xref idref="HAAC9FEFC450D46F5AA2FF241B43ACF1F" legis-path="5.(b)(3)(D)(ii)">paragraph (3)(D)(ii)</internal-xref>
includes—</text>
<clause commented="no" display-inline="no-display-inline" id="H30E92A9CD88240028D5D14A339ACADB7"><enum>(i)</enum><text>the results of an
evaluation of the impact of the implementation of the requirements of section
1902(e)(15) of the Social Security Act on improving the State’s processes for
enrolling of individuals who are released for public institutions into the
Medicaid program;</text>
</clause><clause commented="no" id="H691995B7B80941A0A04E689A2AB24224"><enum>(ii)</enum><text>the number of
individuals who were automatically enrolled (or whose enrollment is reinstated)
under such section 1902(e)(15) during the period under
<internal-xref idref="HED6125465FD442D3BFB993716008C495" legis-path="5.(b)(1)">paragraph (1)</internal-xref>; and</text>
</clause><clause commented="no" id="HB0EFF69062D84B1F8E7133B600D917A0"><enum>(iii)</enum><text>any other
information that is required by the Secretary.</text>
</clause></subparagraph><subparagraph commented="no" id="HBB087F182F29474FBFDB56EDEFAA2D96"><enum>(E)</enum><header>Increase in cap
on Medicaid payments to territories</header><text display-inline="yes-display-inline">Subject to
<internal-xref idref="H090C6DC3321C4EEDAD7A62909CAAB2A6" legis-path="5.(b)(6)">paragraph (6)</internal-xref>, the amounts otherwise
determined for Puerto Rico, the United States Virgin Islands, Guam, the
Commonwealth of the Northern Mariana Islands, and American Samoa under
subsections (f) and (g) of section 1108 of the Social Security Act (42 U.S.C.
1308) shall each be increased by the necessary amount to allow for the increase
in the Federal matching payments under
<internal-xref idref="HED6125465FD442D3BFB993716008C495" legis-path="5.(b)(1)">paragraph (1)</internal-xref>, but only for the period
under such paragraph for such State. In the case of such an increase for a
territory, subsection (a)(1) of such section 1108 shall be applied without
regard to any increase in payment made to the territory under part E of title
IV of such Act that is attributable to the increase in Federal medical
assistance percentage effected under
<internal-xref idref="HED6125465FD442D3BFB993716008C495" legis-path="5.(b)(1)">paragraph (1)</internal-xref> for the territory.</text>
</subparagraph><subparagraph commented="no" id="H090C6DC3321C4EEDAD7A62909CAAB2A6"><enum>(F)</enum><header>Limitations</header>
<clause commented="no" id="H27FC0022AF894EF9BC8CD1ADEA2E9DFF"><enum>(i)</enum><header>Timing</header><text display-inline="yes-display-inline">With respect to a State, at the end of the
period under
<internal-xref idref="HED6125465FD442D3BFB993716008C495" legis-path="5.(b)(1)">paragraph (1)</internal-xref>, no increased matching
payments may be made to such State under this subsection.</text>
</clause><clause commented="no" id="HDD31700913D44D5D9A3A19539F9C0DA9"><enum>(ii)</enum><header>Maintenance of
eligibility</header>
<subclause id="H5CE1394681E441879D375ED4D5F4FC9E"><enum>(I)</enum><header>In
general</header><text>Subject to
<internal-xref idref="H6FA2A15CE0E74BFBB5EAB14D6D7A5C73" legis-path="5.(b)(6)(B)(ii)">clause (ii)</internal-xref>, a State is not
eligible for an increase in its Federal matching payments under
<internal-xref idref="HED6125465FD442D3BFB993716008C495" legis-path="5.(b)(1)">paragraph (1)</internal-xref>, or an increase in a cap
amount under
<internal-xref idref="HBB087F182F29474FBFDB56EDEFAA2D96" legis-path="5.(b)(5)">paragraph (5)</internal-xref>, if eligibility standards,
methodologies, or procedures under its State plan under title XIX of the Social
Security Act (including any waiver under such title or under section 1115 of
such Act (42 U.S.C. 1315)) are more restrictive than the eligibility standards,
methodologies, or procedures, respectively, under such plan (or waiver) as in
effect on the date of enactment of this Act.</text>
</subclause><subclause id="H6FA2A15CE0E74BFBB5EAB14D6D7A5C73"><enum>(II)</enum><header>State
reinstatement of eligibility permitted</header><text display-inline="yes-display-inline">A State that has restricted eligibility
standards, methodologies, or procedures under its State plan under title XIX of
the Social Security Act (including any waiver under such title or under section
1115 of such Act (42 U.S.C. 1315)) after the date of enactment of this Act, is
no longer ineligible under
<internal-xref idref="H5CE1394681E441879D375ED4D5F4FC9E" legis-path="5.(b)(6)(B)(i)">clause (i)</internal-xref> beginning with the first
calendar quarter in which the State has reinstated eligibility standards,
methodologies, or procedures that are no more restrictive than the eligibility
standards, methodologies, or procedures, respectively, under such plan (or
waiver) as in effect on such date.</text>
</subclause></clause><clause commented="no" id="H804E986E825E494692FB9EE871B3DB6D"><enum>(iii)</enum><header>No waiver
authority</header><text>The Secretary may not waive the application of this
subsection under section 1115 of the Social Security Act or otherwise.</text>
</clause><clause commented="no" id="H6999A81177004D75956B7DF3BF00BF89"><enum>(iv)</enum><header>Limitation of
matching payments to 100 percent</header><text>In no case shall an increase in
Federal matching payments under this subsection result in Federal matching
payments that exceed 100 percent.</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="HF159556C47F24D6CA2D4F5AF84FF310D"><enum>(3)</enum><header>Effective
date</header>
<subparagraph commented="no" id="HBB85B6CDFDDC48989BE064CF9BB820DF"><enum>(A)</enum><header>In
general</header><text>Except as provided in
<internal-xref idref="HD89CE8EF622743EE964CFDBACAD6E109" legis-path="5.(c)(2)">paragraph (2)</internal-xref>, the amendments made by
<internal-xref idref="H66CD5165B6F44DD8A7DD08927758C00D" legis-path="5.(a)">subsection (a)</internal-xref> shall take effect 180 days
after the date of the enactment of this Act and shall apply to services
furnished on or after such date.</text>
</subparagraph><subparagraph commented="no" id="HD89CE8EF622743EE964CFDBACAD6E109"><enum>(B)</enum><header>Rule for changes
requiring State legislation</header><text>In the case of a State plan for
medical assistance under title XIX of the Social Security Act which the
Secretary of Health and Human Services determines requires State legislation
(other than legislation appropriating funds) in order for the plan to meet the
additional requirement imposed by the amendments made by this subsection, the
State plan shall not be regarded as failing to comply with the requirements of
such title solely on the basis of its failure to meet this additional
requirement before the first day of the first calendar quarter beginning after
the close of the first regular session of the State legislature that begins
after the date of the enactment of this Act. For purposes of the previous
sentence, in the case of a State that has a 2-year legislative session, each
year of such session shall be deemed to be a separate regular session of the
State legislature.</text>
</subparagraph></paragraph></subsection><subsection id="H53DB9C6A94D34DCD87C14FE918CA33C6"><enum>(f)</enum><header> Survey of and
report on correctional facility programs aimed at reducing the spread of
STIs</header>
<paragraph id="H61F3427E8C494DD49470DBADC5657BF2"><enum>(1)</enum><header>Survey</header><text display-inline="yes-display-inline">The Attorney General, after consulting with
the Secretary of Health and Human Services, State officials, and community
organizations, shall, to the maximum extent practicable, conduct a survey of
all Federal and State correctional facilities, no later than 180 days after the
date of enactment of this Act and annually thereafter for 5 years, to determine
the following:</text>
<subparagraph id="H48C6DA163CCE4DDCA33CE9A800E894FB"><enum>(A)</enum><header>Prevention
education offered</header><text>The type of prevention education, information,
or training offered to incarcerated persons and correctional facility staff
regarding sexual violence and the spread of STIs, including whether such
education, information, or training—</text>
<clause id="HD287E4CA716345CCB56A9A270B1F7854"><enum>(i)</enum><text>constitutes
comprehensive sexuality education;</text>
</clause><clause id="H99E3422051CE496C8311FBD57409BA96"><enum>(ii)</enum><text>is
compulsory for new incarcerated persons and for new staff; and</text>
</clause><clause id="H89ABB76213FE4157AA955EB9389B0F25"><enum>(iii)</enum><text>is
offered on an ongoing basis.</text>
</clause></subparagraph><subparagraph id="H698BF41DA1CB4F4A88AAABF50625DFF6"><enum>(B)</enum><header>Access to sexual
barrier protection devices</header><text>Whether incarcerated persons
can—</text>
<clause id="H0069F09750174EAC9CBC7ADF92DE9AAE"><enum>(i)</enum><text>possess sexual
barrier protection devices;</text>
</clause><clause id="H575363089D1C4E90A787AEE81556A287"><enum>(ii)</enum><text>purchase sexual
barrier protection devices;</text>
</clause><clause id="H4E5AFCF8E9084AC8A1244FB55E29A360"><enum>(iii)</enum><text>purchase sexual
barrier protection devices at a reduced cost; and</text>
</clause><clause id="HEEEDEBDB7F264EE18DD9F96D6B043826"><enum>(iv)</enum><text>obtain sexual
barrier protection devices without cost.</text>
</clause></subparagraph><subparagraph id="HEA21B9B04DA74EACB7C6F30EF3D62BB9"><enum>(C)</enum><header>Incidence of
sexual violence</header><text>The incidence of sexual violence and assault
committed by incarcerated persons and by correctional facility staff.</text>
</subparagraph><subparagraph id="HF05841C4BECB4E3B99FF2F4E59D8175E"><enum>(D)</enum><header>Counseling,
treatment, and supportive services</header><text display-inline="yes-display-inline">Whether the correctional facility requires
incarcerated persons to participate in counseling, treatment, and supportive
services related to STIs, or whether it offers such programs to incarcerated
persons.</text>
</subparagraph><subparagraph id="H25739C218CA8449BB42D3E2BD61489FD"><enum>(E)</enum><header>STI
testing</header><text>Whether the correctional facility tests incarcerated
persons for STIs or gives them the option to undergo such testing—</text>
<clause id="H43D3AD2F7AB94A4883220CB1363C69C8"><enum>(i)</enum><text>at
intake;</text>
</clause><clause id="H194DFE77A4DA4F1988DB293A26CAB5E2"><enum>(ii)</enum><text>on
a regular basis; and</text>
</clause><clause id="H0C255D078D404466B06A67F07C933A70"><enum>(iii)</enum><text>prior to
release.</text>
</clause></subparagraph><subparagraph id="H13D9DB7FCAE84B8F846B7547CDD86797"><enum>(F)</enum><header>STI test
results</header><text>The number of incarcerated persons who are tested for
STIs and the outcome of such tests at each correctional facility, disaggregated
to include results for—</text>
<clause id="H1CC7778375444A5E8E75547C2E33AFB6"><enum>(i)</enum><text>the
type of sexually transmitted infection tested for;</text>
</clause><clause id="HB6CBF3BB8E7C4F0ABDCC166343601120"><enum>(ii)</enum><text>the
race and/or ethnicity of individuals tested;</text>
</clause><clause id="HF880B86700DD45C8B1EC88E3AF273696"><enum>(iii)</enum><text>the age of
individuals tested; and</text>
</clause><clause id="H01EF40DB82A440A9859873FBEECE12B3"><enum>(iv)</enum><text>the
gender of individuals tested.</text>
</clause></subparagraph><subparagraph id="HE7AF05007CAA4D28B27DDF666C409BB7"><enum>(G)</enum><header>Pre-release
referral policy</header><text display-inline="yes-display-inline">Whether
incarcerated persons are informed prior to release about STI-related services
or other health services in their communities, including free and low-cost
counseling and treatment options.</text>
</subparagraph><subparagraph id="HE78A3C0D81BE401DB9DBC2400EFCCD0F"><enum>(H)</enum><header>Pre-release
referrals made</header><text>The number of referrals to community-based
organizations or public health facilities offering STI-related or other health
services provided to incarcerated persons prior to release, and the type of
counseling or treatment for which the referral was made.</text>
</subparagraph><subparagraph id="H3AC8743FB0C6423E9204FD5DBCEC6025"><enum>(I)</enum><header>Reinstatement of
medicaid benefits</header><text>Whether the correctional facility assists
incarcerated persons that were enrolled in the State Medicaid program prior to
their incarceration, in reinstating their enrollment upon release and whether
such individuals receive referrals as provided by paragraph (8) to entities
that accept the State Medicaid program, including if applicable—</text>
<clause id="HE3E2BFF68548460EB21FD154E4E5CAE6"><enum>(i)</enum><text>the
number of such individuals, including those diagnosed with the human
immunodeficiency virus, that have been reinstated;</text>
</clause><clause id="H6A819B82830445AC9096FF912E468EFE"><enum>(ii)</enum><text>a
list of obstacles to reinstating enrollment or to making determinations of
eligibility for reinstatement, if any; and</text>
</clause><clause id="H4BC580C6B1204A03B3E53E80B9FD3754"><enum>(iii)</enum><text>the number of
individuals denied enrollment.</text>
</clause></subparagraph><subparagraph id="H0FA71639D89F48C587FF784ECFC584E3"><enum>(J)</enum><header>Other actions
taken</header><text>Whether the correctional facility has taken any other
action, in conjunction with community organizations or otherwise, to reduce the
prevalence and spread of STIs in that facility.</text>
</subparagraph></paragraph><paragraph id="HC39FE42D0E7E49878838EA91217395B1"><enum>(2)</enum><header>Privacy</header><text>In
conducting the survey, the Attorney General shall not request or retain the
identity of any person who has sought or been offered counseling, treatment,
testing, or prevention education information regarding an STI (including
information about sexual barrier protection devices), or who has tested
positive for an STI.</text>
</paragraph><paragraph id="H2E48E74EF46D41FE9EA33510B1C84759"><enum>(3)</enum><header>Report</header><text display-inline="yes-display-inline">The Attorney General shall transmit to
Congress and make publicly available the results of the survey required under
paragraph (1), both for the Nation as a whole and disaggregated as to each
State and each correctional facility. To the maximum extent possible, the
Attorney General shall issue the first report no later than 1 year after the
date of enactment of this Act and shall issue reports annually thereafter for 5
years.</text>
</paragraph></subsection><subsection id="HE848C589C1CC4B8783D999919013ACED"><enum>(g)</enum><header>Strategy</header>
<paragraph id="H61960E7AABDD45D88BB0CFA7BE7A915E"><enum>(1)</enum><header>Directive to
Attorney General</header><text display-inline="yes-display-inline">The Attorney
General, in consultation with the Secretary of Health and Human Services, State
officials, and community organizations, shall develop and implement a 5-year
strategy to reduce the prevalence and spread of STIs in Federal and State
correctional facilities. To the maximum extent possible, the strategy shall be
developed, transmitted to Congress, and made publicly available no later than
180 days after the transmission of the first report required under subsection
(h)(3).</text>
</paragraph><paragraph display-inline="no-display-inline" id="H82CA9E3BF18F4861A4B243D86AFA81C1"><enum>(2)</enum><header>Contents of
strategy</header><text>The strategy shall include the following:</text>
<subparagraph id="HB343D9A037B54A7B8DD7785A028EF5D1"><enum>(A)</enum><header>Prevention
education</header><text>A plan for improving prevention education, information,
and training offered to incarcerated persons and correctional facility staff,
including information and training on sexual violence and the spread of STIs,
and comprehensive sexuality education.</text>
</subparagraph><subparagraph id="HBEF7326CADE546FB8E7D252866BEB647"><enum>(B)</enum><header>Sexual barrier
protection device access</header><text>A plan for expanding access to sexual
barrier protection devices in correctional facilities.</text>
</subparagraph><subparagraph display-inline="no-display-inline" id="H871C648ED87249C58BC3616ECF1186B3"><enum>(C)</enum><header>Sexual violence
reduction</header><text>A plan for reducing the incidence of sexual violence
among incarcerated persons and correctional facility staff, developed in
consultation with the National Prison Rape Elimination Commission.</text>
</subparagraph><subparagraph id="H9CB5AC9770D343438CAC5910744C63E8"><enum>(D)</enum><header>Counseling and
supportive services</header><text>A plan for expanding access to counseling and
supportive services related to STIs in correctional facilities.</text>
</subparagraph><subparagraph id="HE03C3B8D1CC541D3955014DCAD6529F2"><enum>(E)</enum><header>Testing</header><text>A
plan for testing incarcerated persons for STIs during intake, during regular
health exams, and prior to release, and that—</text>
<clause id="HCABB67CBCE38451A84EBFB7F8448B213"><enum>(i)</enum><text>is
conducted in accordance with guidelines established by the Centers for Disease
Control and Prevention;</text>
</clause><clause id="H0E78CFEF11684A67B0B35F9CCCFE1D43"><enum>(ii)</enum><text>includes pre-test
counseling;</text>
</clause><clause id="HA0E2B6DDF8A846E3A8665F8E1212A51A"><enum>(iii)</enum><text>requires that
incarcerated persons are notified of their option to decline testing at any
time;</text>
</clause><clause id="HB8AA89A7F192438C9B70AEC223AFD6E9"><enum>(iv)</enum><text display-inline="yes-display-inline">requires that incarcerated persons are
confidentially notified of their test results in a timely manner; and</text>
</clause><clause id="H9530378E46D843559D63D7DC7455FDFA"><enum>(v)</enum><text>ensures that
incarcerated persons testing positive for STIs receive post-test counseling,
care, treatment, and supportive services.</text>
</clause></subparagraph><subparagraph id="H2BC5132116A440A69059C5B0101D5069"><enum>(F)</enum><header>Treatment</header><text>A
plan for ensuring that correctional facilities have the necessary medicine and
equipment to treat and monitor STIs and for ensuring that incarcerated persons
living with or testing positive for STIs receive and have access to care and
treatment services.</text>
</subparagraph><subparagraph id="H14A8AAFD33C8467490A391901F18EA2F"><enum>(G)</enum><header>Strategies for
demographic groups</header><text>A plan for developing and implementing
culturally appropriate, sensitive, and specific strategies to reduce the spread
of STIs among demographic groups heavily impacted by STIs.</text>
</subparagraph><subparagraph id="H9C5576B883984242A31925F7D35D2877"><enum>(H)</enum><header>Linkages with
communities and facilities</header><text display-inline="yes-display-inline">A
plan for establishing and strengthening linkages to local communities and
health facilities that—</text>
<clause id="HD4F618E1C6A648DBA46A8794FC2561EE"><enum>(i)</enum><text>provide
counseling, testing, care, and treatment services;</text>
</clause><clause id="HE9D561B270FC42F1B2B67770DB19C74E"><enum>(ii)</enum><text>may
receive persons recently released from incarceration who are living with STIs;
and</text>
</clause><clause id="H0D70170D97B342C3A26A0634954ECABF"><enum>(iii)</enum><text>accept payment
through the State Medicaid program.</text>
</clause></subparagraph><subparagraph id="H14FC7032C32A4FCDB6A55704A92C3E45"><enum>(I)</enum><header>Enrollment in
State Medicaid programs</header><text>Plans to ensure that incarcerated persons
who were—</text>
<clause id="H1A0D1087DF954160AC95E102AAA71737"><enum>(i)</enum><text>enrolled in their
State Medicaid program prior to incarceration in a correctional facility are
automatically re-enrolled in such program upon their release; and</text>
</clause><clause id="HE06E306DB5D640CEA9372259867F0D84"><enum>(ii)</enum><text>not
enrolled in their State Medicaid program prior to incarceration, but who are
diagnosed with the human immunodeficiency virus while incarcerated in a
correctional facility, are automatically enrolled in such program upon their
release.</text>
</clause></subparagraph><subparagraph display-inline="no-display-inline" id="HB5E3D51E2038452080AEE04F3123F6AB"><enum>(J)</enum><header>Other
plans</header><text>Any other plans developed by the Attorney General for
reducing the spread of STIs or improving the quality of health care in
correctional facilities.</text>
</subparagraph><subparagraph id="HE4F963236D204107AFC90255FAF887E2"><enum>(K)</enum><header>Monitoring
system</header><text>A monitoring system that establishes performance goals
related to reducing the prevalence and spread of STIs in correctional
facilities and which, where feasible, expresses such goals in quantifiable
form.</text>
</subparagraph><subparagraph id="H158A53BFE34F43D1B6C7EEEDAE75BE0A"><enum>(L)</enum><header>Monitoring
system performance indicators</header><text>Performance indicators that measure
or assess the achievement of the performance goals described in subparagraph
(I).</text>
</subparagraph><subparagraph id="H5A4AFC1A03C1404E869F83C1E0302857"><enum>(M)</enum><header>Cost
estimate</header><text>A detailed estimate of the funding necessary to
implement the strategy at the Federal and State levels for all 5 years,
including the amount of funds required by community organizations to implement
the parts of the strategy in which they take part.</text>
</subparagraph></paragraph><paragraph id="H1E3D3790AFA4469692BD44D6BD932DAE"><enum>(3)</enum><header>Report</header><text display-inline="yes-display-inline">The Attorney General shall transmit to
Congress and make publicly available an annual progress report regarding the
implementation and effectiveness of the strategy described in subsection (a).
The progress report shall include an evaluation of the implementation of the
strategy using the monitoring system and performance indicators provided for in
subparagraphs (I) and (J) of paragraph (2).</text>
</paragraph></subsection><subsection id="H071D570C08C44BEEB86655FCD138E0BC"><enum>(h)</enum><header>Appropriations</header>
<paragraph id="H6EEB97910375447F82093539386B11CB"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">There are authorized
to be appropriated such sums as may be necessary to carry out this section for
each of the fiscal years 2012 through 2018.</text>
</paragraph><paragraph id="HBB913B8DCA834FDAAAD337D36A0057F5"><enum>(2)</enum><header>Availability of
funds</header><text>Amounts made available under subsection (a) are authorized
to remain available until expended.</text>
</paragraph></subsection><subsection id="H65617CAEEA584A98AC98BFC793F9EDAE"><enum>(i)</enum><header>Definitions</header><text>For
the purposes of this section:</text>
<paragraph id="H3737851726CD4D41ADBBA7190B750E4E"><enum>(1)</enum><header>Community
Organization</header><text display-inline="yes-display-inline">The term
<term>community organization</term> means a public health care facility or a
nonprofit organization which provides health- or STI-related services according
to established public health standards.</text>
</paragraph><paragraph id="HCD0F25112DF74EC499D1BE97B6DAAC8C"><enum>(2)</enum><header>Comprehensive
Sexuality Education</header><text display-inline="yes-display-inline">The term
<term>comprehensive sexuality education</term> means sexuality education that
includes information about abstinence and about the proper use and disposal of
sexual barrier protection devices and which is—</text>
<subparagraph id="HF2DC80E701D8418A94C8B40D1710B4B1"><enum>(A)</enum><text>evidence-based;</text>
</subparagraph><subparagraph id="HC8C2A1F2596D43BD98415A6F9250F69E"><enum>(B)</enum><text>medically
accurate;</text>
</subparagraph><subparagraph id="H205D5D71A6354682A707A5D4706B1DC0"><enum>(C)</enum><text>age and
developmentally appropriate;</text>
</subparagraph><subparagraph id="HCE8E2CDBEEE64630866E2C8B9EC28843"><enum>(D)</enum><text>gender and
identity sensitive;</text>
</subparagraph><subparagraph id="HE099F86850FC43E084571D2CBC1A1258"><enum>(E)</enum><text>culturally and
linguistically appropriate; and</text>
</subparagraph><subparagraph id="H377A5905F2FF443AA389614C1E82D4DF"><enum>(F)</enum><text>structured to
promote critical thinking, self-esteem, respect for others, and the development
of healthy attitudes and relationships.</text>
</subparagraph></paragraph><paragraph id="H91C5C14FBF344EE3A9B8CEB3C50CBF0F"><enum>(3)</enum><header>Correctional
Facility</header><text display-inline="yes-display-inline">The term
<term>correctional facility</term> means any prison, penitentiary, adult
detention facility, juvenile detention facility, jail, or other facility to
which persons may be sent after conviction of a crime or act of juvenile
delinquency within the United States.</text>
</paragraph><paragraph id="H462E043293E249C5B38BC9E9F0C127A7"><enum>(4)</enum><header>Incarcerated
Person</header><text display-inline="yes-display-inline">The term
<term>incarcerated person</term> means any person who is serving a sentence in
a correctional facility after conviction of a crime.</text>
</paragraph><paragraph id="HEEB940302F2B45DD829D9B8A55FDF7A7"><enum>(5)</enum><header>Sexually
Transmitted Infection</header><text display-inline="yes-display-inline">The
term <term>sexually transmitted infection</term> or <term>STI</term> means any
disease or infection that is commonly transmitted through sexual activity,
including HIV/AIDS, gonorrhea, chlamydia, syphilis, genital herpes, viral
hepatitis, and human papillomavirus.</text>
</paragraph><paragraph id="H4D034403A4634395BB41BC987521F165"><enum>(6)</enum><header>Sexual Barrier
Protection Device</header><text>The term <term>sexual barrier protection
device</term> means any FDA-approved physical device which has not been
tampered with and which reduces the probability of STI transmission or
infection between sexual partners, including female condoms, male condoms, and
dental dams.</text>
</paragraph><paragraph id="HBDFD2D7A8F6549F8AFD9E0F5E9A97282"><enum>(7)</enum><header>State</header><text>The
term <term>State</term> includes the District of Columbia, American Samoa, the
Commonwealth of the Northern Mariana Islands, Guam, Puerto Rico, and the United
States Virgin Islands.</text>
</paragraph></subsection></section><section id="H847D14E266074EDB877A0D6606DB30D2" section-type="subsequent-section"><enum>750.</enum><header>Stop AIDS in
prison</header>
<subsection display-inline="no-display-inline" id="H35885B53176942A588CBFBEEDECDBA0F"><enum>(a)</enum><header>Short
title</header><text>This section may be cited as the <quote><short-title>Stop AIDS in Prison Act of
2011</short-title></quote>.</text>
</subsection><subsection id="H86E9381DEDB44D84A7D1B3A54E931AD6"><enum>(b)</enum><header>Comprehensive
HIV/AIDS Policy</header>
<paragraph id="HB11AB4424DF14FACB34F313EC027834E"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Bureau of Prisons
(hereinafter in this section referred to as the <term>Bureau</term>) shall
develop a comprehensive policy to provide HIV testing, treatment, and
prevention for inmates within the correctional setting and upon reentry.</text>
</paragraph><paragraph id="H255462296A634E0EAB65112BB9BFE017"><enum>(2)</enum><header>Purpose</header><text display-inline="yes-display-inline">The purposes of such policy are the
following:</text>
<subparagraph id="H41D5ECFC15B84C968540D77138607796"><enum>(A)</enum><text display-inline="yes-display-inline">To stop the spread of HIV/AIDS among
inmates.</text>
</subparagraph><subparagraph id="H65EA30952FDE475D844ACF3781A54DFE"><enum>(B)</enum><text display-inline="yes-display-inline">To protect prison guards and other
personnel from HIV/AIDS infection.</text>
</subparagraph><subparagraph id="H09558469062B4ADD8ED35D640C67F7C2"><enum>(C)</enum><text display-inline="yes-display-inline">To provide comprehensive medical treatment
to inmates who are living with HIV/AIDS.</text>
</subparagraph><subparagraph id="H5BF514F3C88543AE8596A3C13BA2C101"><enum>(D)</enum><text display-inline="yes-display-inline">To promote HIV/AIDS awareness and
prevention among inmates.</text>
</subparagraph><subparagraph id="H02BEFB14E72B4DB09BC2BD38FD93EF1D"><enum>(E)</enum><text display-inline="yes-display-inline">To encourage inmates to take personal
responsibility for their health.</text>
</subparagraph><subparagraph id="HC628053D953D447DAF39137B466A1FEF"><enum>(F)</enum><text display-inline="yes-display-inline">To reduce the risk that inmates will
transmit HIV/AIDS to other persons in the community following their release
from prison.</text>
</subparagraph></paragraph><paragraph id="H77421C0B9B1142A6B11D97524ED4F9E9"><enum>(3)</enum><header>Consultation</header><text display-inline="yes-display-inline">The Bureau shall consult with appropriate
officials of the Department of Health and Human Services, the Office of
National Drug Control Policy, the Office of National AIDS Policy, and the
Centers for Disease Control regarding the development of such policy.</text>
</paragraph><paragraph id="H1BF25B252CB94D52A3006156114D8CBA"><enum>(4)</enum><header>Time
limit</header><text display-inline="yes-display-inline">The Bureau shall draft
appropriate regulations to implement such policy not later than 1 year after
the date of the enactment of this Act.</text>
</paragraph></subsection><subsection id="HB7424FA66CAF44EC8C56F20B71BBB1BE"><enum>(c)</enum><header>Requirements for
policy</header><text>The policy created under subsection (b) shall provide for
the following:</text>
<paragraph id="HC0882A0EA9DE4A55B03B5D0CD815F276"><enum>(1)</enum><header>Testing and
counseling upon intake</header>
<subparagraph id="H6A10CD7E2E404704A0D39700C7B786D4"><enum>(A)</enum><clause commented="no" display-inline="yes-display-inline" id="H623B35F85C5249E2ADA87E8F50429372"><enum>(i)</enum><text>Subject to clause (ii),
health care personnel shall provide routine HIV testing to all inmates as a
part of a comprehensive medical examination immediately following admission to
a facility.</text>
</clause><clause id="H9FCF0BA331FA49F3A1D0B9F364F99BC4" indent="up1"><enum>(ii)</enum><text>Health care personnel shall not be
required to provide routine HIV testing to an inmate who is transferred to a
facility from another facility if the inmate’s medical records are transferred
with the inmate and indicate that the inmate has been tested previously.</text>
</clause></subparagraph><subparagraph id="H2EB7123C7CD34A5DAD9A5DC3D0EF6DB0"><enum>(B)</enum><text display-inline="yes-display-inline">To all inmates admitted to a facility prior
to the effective date of this policy, health care personnel shall provide
routine HIV testing within no more than 6 months. HIV testing for these inmates
may be performed in conjunction with other health services provided to these
inmates by health care personnel.</text>
</subparagraph><subparagraph id="H2382E9DC3BBB4408A4F8C7B63F8B8CB7"><enum>(C)</enum><text>All HIV tests
under this paragraph shall comply with paragraph (9).</text>
</subparagraph></paragraph><paragraph id="H8B3F6D01B50542BF81FA1DD0F21C7B83"><enum>(2)</enum><header>Pre-Test and
Post-Test Counseling</header><text display-inline="yes-display-inline">Health
care personnel shall provide confidential pre-test and post-test counseling to
all inmates who are tested for HIV. Counseling may be included with other
general health counseling provided to inmates by health care personnel.</text>
</paragraph><paragraph id="H2DE8CF0230A24DF0887DE3FC5EFA4A9F"><enum>(3)</enum><header>HIV/AIDS
Prevention Education</header>
<subparagraph id="H4335490F572B477887B3A944584C17A2"><enum>(A)</enum><text>Health care
personnel shall improve HIV/AIDS awareness through frequent educational
programs for all inmates. HIV/AIDS educational programs may be provided by
community based organizations, local health departments, and inmate peer
educators. Such HIV/AIDS educational programs shall include information on
modes of transmission, including transmission through tattooing, sexual
contact, and intravenous drug use; prevention methods; treatment; and disease
progression. HIV/AIDS educational programs shall be culturally sensitive,
conducted in a variety of languages, and present scientifically accurate
information in a clear and understandable manner.</text>
</subparagraph><subparagraph id="H1B2A4CDE5B384837BBE460798DD1B0D9"><enum>(B)</enum><text>HIV/AIDS
educational materials shall be made available to all inmates at orientation, at
health care clinics, at regular educational programs, and prior to release.
Both written and audio-visual materials shall be made available to all inmates.
These materials shall be culturally sensitive, written for low literacy levels,
and available in a variety of languages.</text>
</subparagraph></paragraph><paragraph id="H89BE9D3F8E0047FE8216B61D7D4AB954"><enum>(4)</enum><header>HIV Testing upon
request</header>
<subparagraph id="HEF1D151BCBF640449447F15193D5A4C0"><enum>(A)</enum><text display-inline="yes-display-inline">Health care personnel shall allow inmates
to obtain HIV tests upon request once per year or whenever an inmate has a
reason to believe the inmate may have been exposed to HIV. Health care
personnel shall, both orally and in writing, inform inmates, during orientation
and periodically throughout incarceration, of their right to obtain HIV
tests.</text>
</subparagraph><subparagraph id="HCBC2476200BD4249BE1A71A3B09E0612"><enum>(B)</enum><text display-inline="yes-display-inline">Health care personnel shall encourage
inmates to request HIV tests if the inmate is sexually active, has been raped,
uses intravenous drugs, receives a tattoo, or if the inmate is concerned that
the inmate may have been exposed to HIV/AIDS.</text>
</subparagraph><subparagraph id="H45EC9192324E45E8950FAE6C01C500F4"><enum>(C)</enum><text>An inmate’s
request for an HIV test shall not be considered an indication that the inmate
has put himself or herself at risk of infection or committed a violation of
prison rules.</text>
</subparagraph></paragraph><paragraph id="H5F52B98D27BB4CF4BB569A4A13659866"><enum>(5)</enum><header>HIV Testing of
Pregnant Woman</header>
<subparagraph id="H96EAA839B3664D10A052C8894FEA68CE"><enum>(A)</enum><text>Health care
personnel shall provide routine HIV testing to all inmates who become
pregnant.</text>
</subparagraph><subparagraph id="H9BFF1A80E3F143D0A1B8927F68DD046C"><enum>(B)</enum><text>All HIV tests
under this paragraph shall comply with paragraph (9).</text>
</subparagraph></paragraph><paragraph id="HA213493C190449CC986B7884D40029FA"><enum>(6)</enum><header>Comprehensive
treatment</header>
<subparagraph display-inline="no-display-inline" id="H1CEAD40F3528446D943CCF582CBA448F"><enum>(A)</enum><text>Health care
personnel shall provide all inmates who test positive for HIV—</text>
<clause id="H718DC0A8FD904CEE96776ACB15F79B93"><enum>(i)</enum><text display-inline="yes-display-inline">timely, comprehensive medical
treatment;</text>
</clause><clause id="HE39DDF98EA304A6DA03BCF5E03C8A705"><enum>(ii)</enum><text display-inline="yes-display-inline">confidential counseling on managing their
medical condition and preventing its transmission to other persons; and</text>
</clause><clause id="H1E0CDCCB3E604E18B94FAACF98E4B794"><enum>(iii)</enum><text>voluntary
partner notification services.</text>
</clause></subparagraph><subparagraph id="H806893EE8D044993B5A8C8DF2934C377"><enum>(B)</enum><text>Medical care
provided under this paragraph shall be consistent with current Department of
Health and Human Services guidelines and standard medical practice. Health care
personnel shall discuss treatment options, the importance of adherence to
antiretroviral therapy, and the side effects of medications with inmates
receiving treatment.</text>
</subparagraph><subparagraph id="H0CE90CEFDBF34C3D8E8FD0DAF87CA4E7"><enum>(C)</enum><text>Health care
personnel and pharmacy personnel shall ensure that the facility formulary
contains all Food and Drug Administration-approved medications necessary to
provide comprehensive treatment for inmates living with HIV/AIDS, and that the
facility maintains adequate supplies of such medications to meet inmates’
medical needs. Health care personnel and pharmacy personnel shall also develop
and implement automatic renewal systems for these medications to prevent
interruptions in care.</text>
</subparagraph><subparagraph id="HCD9ED437EF14408F95BD0698501DF7A0"><enum>(D)</enum><text>Correctional
staff, health care personnel, and pharmacy personnel shall develop and
implement distribution procedures to ensure timely and confidential access to
medications.</text>
</subparagraph></paragraph><paragraph id="H0CE40832911D4E14995BBDB604238826"><enum>(7)</enum><header>Protection of
Confidentiality</header>
<subparagraph id="HCADBCF7241DA4D40A41D0EE8EA19907A"><enum>(A)</enum><text>Health care
personnel shall develop and implement procedures to ensure the confidentiality
of inmate tests, diagnoses, and treatment. Health care personnel and
correctional staff shall receive regular training on the implementation of
these procedures. Penalties for violations of inmate confidentiality by health
care personnel or correctional staff shall be specified and strictly
enforced.</text>
</subparagraph><subparagraph id="H2203B204D66042638CF0BFF84EEA2F26"><enum>(B)</enum><text>HIV testing,
counseling, and treatment shall be provided in a confidential setting where
other routine health services are provided and in a manner that allows the
inmate to request and obtain these services as routine medical services.</text>
</subparagraph></paragraph><paragraph id="HEF35C0E6853D4C2B97DA7655201262F0"><enum>(8)</enum><header>Testing,
counseling, and referral prior to reentry</header>
<subparagraph id="HB52144B0546547AE8D3F1C7C4F0053D4"><enum>(A)</enum><clause commented="no" display-inline="yes-display-inline" id="H5F206264F5684B7CBA9F1A405953B08F"><enum>(i)</enum><text>Subject to clauses (ii)
and (iii), health care personnel shall provide routine HIV testing to all
inmates no more than 3 months prior to their release and reentry into the
community.</text>
</clause><clause id="H21635F05F62D4C67B4E8048F62FA6C5E" indent="up1"><enum>(ii)</enum><text>Inmates who are already known to
be infected shall not be required to be tested again.</text>
</clause><clause id="HDE7BBD47A473460D9B20CE5E450F1D71" indent="up1"><enum>(iii)</enum><text>The requirement under clause (i)
may be waived if an inmate’s release occurs without sufficient notice to the
Bureau to allow health care personnel to perform a routine HIV test and notify
the inmate of the results.</text>
</clause></subparagraph><subparagraph id="H3548C72C57604367B057475AE1079D0F"><enum>(B)</enum><text>All HIV tests
under this paragraph shall comply with paragraph (9).</text>
</subparagraph><subparagraph id="H0264AF7ED49E49A19135069B5EE548BF"><enum>(C)</enum><text display-inline="yes-display-inline">To all inmates who test positive for HIV
and all inmates who already are known to have HIV/AIDS, health care personnel
shall provide—</text>
<clause id="H85488E7C342C4C6FAB8229E8D21AE15B"><enum>(i)</enum><text display-inline="yes-display-inline">confidential prerelease counseling on
managing their medical condition in the community, accessing appropriate
treatment and services in the community, and preventing the transmission of
their condition to family members and other persons in the community;</text>
</clause><clause id="H2D6DB8159015452D9AEC3C8B23C9AB88"><enum>(ii)</enum><text display-inline="yes-display-inline">referrals to appropriate health care
providers and social service agencies in the community that meet the inmate’s
individual needs, including voluntary partner notification services and
prevention counseling services for people living with HIV/AIDS; and</text>
</clause><clause id="HBF1296857C6A4EA3A5F23A1E13762FDE"><enum>(iii)</enum><text display-inline="yes-display-inline">a 30-day supply of any medically necessary
medications the inmate is currently receiving.</text>
</clause></subparagraph></paragraph><paragraph id="H5373BEC43C2A4DB3905DB4CE03E29453"><enum>(9)</enum><header>Opt-Out
Provision</header><text display-inline="yes-display-inline">Inmates shall have
the right to refuse routine HIV testing. Inmates shall be informed both orally
and in writing of this right. Oral and written disclosure of this right may be
included with other general health information and counseling provided to
inmates by health care personnel. If an inmate refuses a routine test for HIV,
health care personnel shall make a note of the inmate’s refusal in the inmate’s
confidential medical records. However, the inmate’s refusal shall not be
considered a violation of prison rules or result in disciplinary action.</text>
</paragraph><paragraph id="HB5BF80334C6F48319A71E552AE26B99F"><enum>(10)</enum><header>Exclusion of
Tests Performed Under Section <enum-in-header>4014(b) </enum-in-header> from
the Definition of Routine HIV Testing</header><text display-inline="yes-display-inline">HIV testing of an inmate under section
4014(b) of title 18, United States Code, is not routine HIV testing for the
purposes of paragraph (9). Health care personnel shall document the reason for
testing under section 4014(b) of title 18, United States Code, in the inmate’s
confidential medical records.</text>
</paragraph><paragraph id="H42DABD9B249949AD875AF80D6E2B73E9"><enum>(11)</enum><header>Timely
notification of test results</header><text>Health care personnel shall provide
timely notification to inmates of the results of HIV tests.</text>
</paragraph></subsection><subsection id="H3DFAC69D0604454F9776094CB1AE7582"><enum>(d)</enum><header>Changes in
existing law</header>
<paragraph id="H151EDF76D2A14892AA3475668B93405F"><enum>(1)</enum><header>Screening in
general</header><text display-inline="yes-display-inline">Section 4014(a) of
title 18, United States Code, is amended—</text>
<subparagraph id="H1FB0DB612F6A4E44B8AFCC75ECB91D20"><enum>(A)</enum><text>by striking
<quote>for a period of 6 months or more</quote>;</text>
</subparagraph><subparagraph id="HE71B6215EEE54E52AD65FD327485614B"><enum>(B)</enum><text>by striking
<quote>, as appropriate,</quote>; and</text>
</subparagraph><subparagraph id="H41871A2B457C487CAAC8557F850A7345"><enum>(C)</enum><text>by striking
<quote>if such individual is determined to be at risk for infection with such
virus in accordance with the guidelines issued by the Bureau of Prisons
relating to infectious disease management</quote> and inserting <quote>unless
the individual declines. The Attorney General shall also cause such individual
to be so tested before release unless the individual declines.</quote>.</text>
</subparagraph></paragraph><paragraph id="H7407712D908D4F9BBEF7C1C2FBFF5E1A"><enum>(2)</enum><header>Inadmissibility
of HIV Test Results in civil and criminal proceedings</header><text>Section
4014(d) of title 18, United States Code, is amended by inserting <quote>or
under the <short-title>Stop AIDS in Prison Act of
2011</short-title></quote> after <quote>under this section</quote>.</text>
</paragraph><paragraph id="HBA3A7EAEA9704DCB959F4A320804DB78"><enum>(3)</enum><header>Screening as
part of routine screening</header><text>Section 4014(e) of title 18, United
States Code, is amended by adding at the end the following: <quote>Such rules
shall also provide that the initial test under this section be performed as
part of the routine health screening conducted at intake.</quote>.</text>
</paragraph></subsection><subsection id="H768F698F8DC24333B0978E47CE036619"><enum>(e)</enum><header>Reporting
requirements</header>
<paragraph id="H12EAB4ED987A46AFABCBFA30254D9C4E"><enum>(1)</enum><header>Report on
hepatitis and other diseases</header><text display-inline="yes-display-inline">Not later than 1 year after the date of the
enactment of this Act, the Bureau shall provide a report to the Congress on
Bureau policies and procedures to provide testing, treatment, and prevention
education programs for hepatitis and other diseases transmitted through sexual
activity and intravenous drug use. The Bureau shall consult with appropriate
officials of the Department of Health and Human Services, the Office of
National Drug Control Policy, the Office of National AIDS Policy, and the
Centers for Disease Control and Prevention regarding the development of this
report.</text>
</paragraph><paragraph id="HABE700D4E30D498F95E1249857578C5C"><enum>(2)</enum><header>Annual
reports</header>
<subparagraph id="HE0654103CEE7427099FEEF07B3DE5999"><enum>(A)</enum><header>Generally</header><text>Not
later than 2 years after the date of the enactment of this Act, and then
annually thereafter, the Bureau shall report to Congress on the incidence among
inmates of diseases transmitted through sexual activity and intravenous drug
use.</text>
</subparagraph><subparagraph id="HAB7BB0207E624EA898C2446A8AE6D240"><enum>(B)</enum><header>Matters
pertaining to various diseases</header><text>Reports under subparagraph (A)
shall discuss—</text>
<clause id="HFC89559E49554E1EB684479EA1C2AA42"><enum>(i)</enum><text display-inline="yes-display-inline">the incidence among inmates of HIV/AIDS,
hepatitis, and other diseases transmitted through sexual activity and
intravenous drug use; and</text>
</clause><clause id="H3ACF15BD5A10416485C2C6602B93761D"><enum>(ii)</enum><text>updates on Bureau
testing, treatment, and prevention education programs for these
diseases.</text>
</clause></subparagraph><subparagraph id="HAB7C873839C3402BBF6014A56FD4441F"><enum>(C)</enum><header>Matters
pertaining to HIV/AIDS only</header><text display-inline="yes-display-inline">Reports under subparagraph (A) shall also
include—</text>
<clause id="H1E7BCEFAF97C41BD8F2F2C137CAF6749"><enum>(i)</enum><text display-inline="yes-display-inline">the number of inmates who tested positive
for HIV upon intake;</text>
</clause><clause id="HB77258D8651C4516A5CCF63F85F459B4"><enum>(ii)</enum><text>the
number of inmates who tested positive prior to reentry;</text>
</clause><clause id="HCC054596C62A46FDA631A56106DCD949"><enum>(iii)</enum><text>the number of
inmates who were not tested prior to reentry because they were released without
sufficient notice;</text>
</clause><clause id="H5EF1092A687B4C588269996577200239"><enum>(iv)</enum><text>the
number of inmates who opted-out of taking the test;</text>
</clause><clause id="HFBFD0E6B9C0041C09814C8864DBCDAEA"><enum>(v)</enum><text>the
number of inmates who were tested under section 4014(b) of title 18, United
States Code; and</text>
</clause><clause id="H211E3C4295FE46DEBA546CEEB3FCC323"><enum>(vi)</enum><text>the
number of inmates under treatment for HIV/AIDS.</text>
</clause></subparagraph><subparagraph id="HA1E69A364A0C454DA4B5935026187199"><enum>(D)</enum><header>Consultation</header><text display-inline="yes-display-inline">The Bureau shall consult with appropriate
officials of the Department of Health and Human Services, the Office of
National Drug Control Policy, the Office of National AIDS Policy, and the
Centers for Disease Control and Prevention regarding the development of reports
under subparagraph (A).</text>
</subparagraph></paragraph></subsection></section><section commented="no" id="H0AC5429FF99844C98489308258EC47B3"><enum>751.</enum><header>Services to
reduce HIV/AIDS in racial and ethnic minority communities</header>
<subsection commented="no" id="H065DDE85534447BF982493746B72E542"><enum>(a)</enum><header>In
general</header><text>For the purpose of reducing HIV/AIDS in racial and ethnic
minority communities, the Secretary, acting through the Deputy Assistant
Secretary for Minority Health, may make grants to public health agencies and
faith-based organizations to conduct—</text>
<paragraph commented="no" id="H773D6ED548BA4004B595A5386CE9F913"><enum>(1)</enum><text>outreach
activities related to HIV/AIDS prevention and testing activities;</text>
</paragraph><paragraph commented="no" id="H9E34531D5730427FBAEF45E3240B01B9"><enum>(2)</enum><text>HIV/AIDS
prevention activities; and</text>
</paragraph><paragraph commented="no" id="HD4AEFC6ADFA44F63A3CF0B39E9A95DA3"><enum>(3)</enum><text>HIV/AIDS testing
activities.</text>
</paragraph></subsection><subsection commented="no" id="H2CDD6FA2559B470F98D485EA96C4B3C2"><enum>(b)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated $50,000,000 for fiscal year 2012, and such sums as may be
necessary for fiscal years 2013 through 2016.</text>
</subsection></section><section commented="no" id="HE7AF11AC6862414EA0A1C0A118C0FE91"><enum>752.</enum><header>Health care
professionals treating individuals with HIV/AIDS</header><text display-inline="no-display-inline">Part E of title VII of the Public Health
Service Act (42 U.S.C. 294n et seq.) is amended by adding at the end the
following:</text>
<quoted-block display-inline="no-display-inline" id="HCA55A9A06DDA4C4FBC61BCF400CFA8D4" style="OLC">
<subpart commented="no" id="HBFA5020E39ED4BDEBA5CECC79C4E0D9F"><enum>5</enum><header>Health Care
Professionals Treating Individuals With HIV/AIDS</header>
<section commented="no" id="HBEB020693C1D4059B480B7AC9DEA5136"><enum>785.</enum><header>Health care
professionals treating individuals with HIV/AIDS</header>
<subsection commented="no" id="HDE24346ACF2042A495A937F94F09D1D4"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Administrator of the
Health Resources and Services Administration and in consultation with racial
and ethnic minority community organizations, may award grants for any of the
following:</text>
<paragraph commented="no" id="H8DB65F1FD0CB44069D02865677194FEC"><enum>(1)</enum><text>Development of
curricula for training primary care providers in HIV/AIDS prevention and
care.</text>
</paragraph><paragraph commented="no" id="H8AB634D4B85D4E2380FA4F71C97D2E6C"><enum>(2)</enum><text>Training health
care professionals with expertise in HIV/AIDS to provide care to individuals
with HIV/AIDS.</text>
</paragraph><paragraph commented="no" id="H2A5851389F2E4992B973D1F4D97AB177"><enum>(3)</enum><text>Development by
grant recipients under title XXVI and other persons of policies for providing
culturally relevant and sensitive treatment to individuals with HIV/AIDS, with
particular emphasis on treatment to racial and ethnic minorities, men who have
sex with men, and women and children with HIV/AIDS.</text>
</paragraph><paragraph commented="no" id="H54FF45F679034B7CA5F22D9A281971B9"><enum>(4)</enum><text>Development and
implementation of programs to increase the use of telemedicine to respond to
HIV/AIDS-specific health care needs in rural and minority communities, with
particular emphasis given to medically underserved communities and insular
areas.</text>
</paragraph><paragraph commented="no" id="H43CD987F68694F35A3B5173BC25689A4"><enum>(5)</enum><text>Creation of faith-
and community-based certification programs for providers in HIV/AIDS care and
support services.</text>
</paragraph><paragraph commented="no" id="HC2190B482B184FA0AE18CDD145CDD6E4"><enum>(6)</enum><text>Establishment of
comfort care centers that provide mental, emotional, and psychosocial
counseling for people with HIV/AIDS and implement additional protocols to be
carried out in the centers that address the needs of children and young adults
who are infected with the disease and are transitioning from childhood to
adulthood.</text>
</paragraph><paragraph commented="no" id="H2FFF97ED745047A19A96566CE2BE000D"><enum>(7)</enum><text>Incentive payments
to health care providers supported by the Health Resources and Services
Administration to implement HIV/AIDS testing consistent with the guidelines
issued in 2006 by the Centers for Disease Control and Prevention entitled
<quote>Revised Recommendations for HIV Testing of Adults, Adolescents, and
Pregnant Women in Health-Care Settings</quote>.</text>
</paragraph></subsection><subsection commented="no" id="H00198699C51B44CC9452C6E82DE4406A"><enum>(b)</enum><header>Definition</header><text>In
this section, the term <term>HIV/AIDS</term> has the meaning given to such term
in section 2689.</text>
</subsection><subsection commented="no" id="H7A79483718134361B09541215D3CD2A7"><enum>(c)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated $100,000,000 for fiscal year 2012, and such sums as may be
necessary for fiscal years 2013 through
2016.</text>
</subsection></section></subpart><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section commented="no" id="H0CFC0821625249C69C3A65A371ED8E6D"><enum>753.</enum><header>Report on
impact of HIV/AIDS in racial and ethnic minority communities</header>
<subsection commented="no" id="HB165D87345FD4944A47CFC30A22BC2EE"><enum>(a)</enum><header>In
general</header><text>The Secretary shall submit to the Congress and the
President an annual report on the impact of HIV/AIDS in racial and ethnic
minority communities.</text>
</subsection><subsection commented="no" id="H9E1CE62D56584ACDB2E512F97DA40DA8"><enum>(b)</enum><header>Contents</header><text>The
report under subsection (a) shall include information on the—</text>
<paragraph commented="no" id="HD747B94104B2470AB6935B672075B526"><enum>(1)</enum><text>progress that has
been made in reducing the impact of HIV/AIDS in such communities;</text>
</paragraph><paragraph commented="no" id="H5DCCE9F940C74335AE4A31B16446973C"><enum>(2)</enum><text>opportunities that
exist to make additional progress in reducing the impact of HIV/AIDS in such
communities;</text>
</paragraph><paragraph commented="no" id="HA5851937622442C8AAF0C190ABA440A9"><enum>(3)</enum><text>challenges that
may impede such additional progress; and</text>
</paragraph><paragraph commented="no" id="H1C19F5369B134546AAAFFCFADDA7494B"><enum>(4)</enum><text>Federal funding
necessary to achieve substantial reductions in HIV/AIDS in racial and ethnic
minority communities.</text>
</paragraph></subsection></section><section id="H2EEA4731C1D2497B9F5D5B5ECE6FC242"><enum>754.</enum><header>Study on status
of HIV/AIDS epidemic among African-Americans</header>
<subsection id="H27534456E53C4AB7AD79B19F2E7A8FD0"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary
shall—</text>
<paragraph id="H227EAFB1849B4201852211F50B8158ED"><enum>(1)</enum><text display-inline="yes-display-inline">seek to enter into an agreement with the
Institute of Medicine to document, in collaboration with an academic
organization which specializes in the identification and reduction of health
disparities within the African-American community, all aspects of the HIV/AIDS
epidemic among African-Americans, including the role that historical racial or
ethnic barriers play in sustaining the epidemic among African-Americans;</text>
</paragraph><paragraph id="HE3910B0D3DD84D20AEC03EF45F2BFFE6"><enum>(2)</enum><text>submit a report to
the President, the Director of the Office of National AIDS Policy Coordination,
the Director of the White House Domestic Policy Council, the Director of White
House Office of Faith-Based and Neighborhood Partnerships, key Federal
agencies, and the relevant committees of the Congress on the status of the
HIV/AIDS epidemic among African-Americans in the United States; and</text>
</paragraph><paragraph id="H0DF1D6C8F28F431EBAD7E82D6409DE3B"><enum>(3)</enum><text>include in such
report—</text>
<subparagraph id="H376C9EFBD7AB40F596D33B1FA2B712AD"><enum>(A)</enum><text>specific
recommendations on the implementation of Federal policies to reduce the burden
of HIV/AIDS in the African-American community; and</text>
</subparagraph><subparagraph id="H900BEB7AE341434F84190D2AEAA70612"><enum>(B)</enum><text>a special focus on
the Black clergy and the church as a unique resource in the African-American
community.</text>
</subparagraph></paragraph></subsection><subsection id="HC232FA56C0574E8F844F54BB9F2F53A4"><enum>(b)</enum><header>Authorization of
appropriations</header>
<paragraph id="H0EDD4342FBCC484EAB6F2871FD566C99"><enum>(1)</enum><header>In
general</header><text>To carry out this section, there is authorized to be
appropriated $2,000,000 for each of fiscal years 2012 and 2013.</text>
</paragraph><paragraph id="H6D66498322834CF4B9B9C789DA74D33C"><enum>(2)</enum><header>Special
rule</header><text>Of the amount of funds appropriated to carry out this
section for a fiscal year—</text>
<subparagraph id="HAC1597ADEC2F4EE29A358547D4533676"><enum>(A)</enum><text>45 percent shall
be allocated to the Institutes of Medicine pursuant to the agreement entered
into under subsection (a)(1);</text>
</subparagraph><subparagraph id="HC8D57A31EF8D40D28B247721F2E2B404"><enum>(B)</enum><text>45 percent shall
be allocated to an academic organization which specializes in the
identification and reduction of health disparities within the African-American
community pursuant to such agreement; and</text>
</subparagraph><subparagraph id="H90431842FBC7412DA4323DC03E1C445B"><enum>(C)</enum><text>10 percent shall
be allocated for administrative costs and other activities under this
subsection.</text>
</subparagraph></paragraph></subsection></section></subtitle><subtitle id="HB17506B6301048B18918A3F3FCDAE055"><enum>F</enum><header>Diabetes</header>
<section id="H1F0D997EB811460DA1662859BEE9FF05"><enum>755.</enum><header>Treatment of
diabetes in minority communities</header>
<subsection display-inline="no-display-inline" id="H8C0E5B8C1EBF4CF590C3AB77BACF5D71"><enum>(a)</enum><header>Short
title</header><text>This subtitle may be cited as the <quote><short-title>Minority Diabetes Initiative
Act</short-title></quote>.</text>
</subsection><subsection id="HC0773BFBD47A4FA295C90F36DB4F6C1C"><enum>(b)</enum><header>Grants regarding
treatment of diabetes in minority communities</header><text>Part D of title III
of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42
U.S.C. 254b et seq.) is amended by inserting after section 330L the
following:</text>
<quoted-block act-name="Public Health Service Act" id="H6C59049510AE4CDE91C1F9536FB47233">
<section id="HE0D5C0DAC7C74CCB9295849730DE1CB6"><enum>330M.</enum><header>Grants
regarding treatment of diabetes in minority communities</header>
<subsection id="HBAAA84958A664254B17348A2C008C1EA"><enum>(a)</enum><header>In
general</header><text>The Secretary may make grants to public and nonprofit
private health care providers for the purpose of providing treatment for
diabetes in minority communities.</text>
</subsection><subsection id="H21C0F7C969CF410DB3BF4A0D2029E6A7"><enum>(b)</enum><header>Recipients of
grants</header><text>The public and nonprofit private health care providers to
whom grants may be made under subsection (a) include physicians, podiatrists,
community-based organizations, health care organizations, community health
centers, and State, local, and tribal health departments.</text>
</subsection><subsection id="H7B61ED35CCC040809AF29DBC68D9C7DB"><enum>(c)</enum><header>Scope of
treatment activities</header><text>The Secretary shall ensure that grants under
subsection (a) cover a variety of diabetes-related health care services,
including routine care for diabetic patients, public education on diabetes
prevention and control, eye care, foot care, and treatment for kidney disease
and other complications of diabetes.</text>
</subsection><subsection id="H20ADD7F46FE84C319E8E59B6B92BA3EC"><enum>(d)</enum><header>Appropriate
cultural context</header><text display-inline="yes-display-inline">A condition
for the receipt of a grant under subsection (a) is that the applicant involved
agrees that, in the program carried out with the grant, services will be
provided in the languages most appropriate for, and with consideration for the
cultural backgrounds of, the individuals for whom the services are
provided.</text>
</subsection><subsection id="H49C5DE38BD3B4390865ECE9C0524055D"><enum>(e)</enum><header>Outreach
services</header><text>A condition for the receipt of a grant under subsection
(a) is that the applicant involved agrees to provide outreach activities to
inform the public of the services of the program, and to provide offsite
information on diabetes.</text>
</subsection><subsection id="H386C6C515EAB4054AEBA3D2346692C05"><enum>(f)</enum><header>Application for
grant</header><text>A grant may be made under subsection (a) only if an
application for the grant is submitted to the Secretary and the application is
in such form, is made in such manner, and contains such agreements, assurances,
and information as the Secretary determines to be necessary to carry out this
section.</text>
</subsection><subsection id="H66C825A8CC8D4A869CE44B7267F82239"><enum>(g)</enum><header>Authorization of
appropriations</header><text>For the purpose of carrying out this section,
there are authorized to be appropriated such sums as may be necessary for each
of the fiscal years 2012 through
2017.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="H74878CF1ED134FA7BA512755741861BC"><enum>756.</enum><header>Eliminating
disparities in diabetes prevention access and care</header>
<subsection id="H657EE373504C4CCCA22926A2E7D53367"><enum>(a)</enum><header>Research,
treatment, and education</header>
<paragraph id="HF668493536834F8AAEEC599E9EE48186"><enum>(1)</enum><header>In
General</header><text>Subpart 3 of part C of title IV of the Public Health
Service Act (42 U.S.C. 285c et seq.) is amended by adding at the end the
following new section:</text>
<quoted-block id="H4586C56ED1FB458BA79866DD06F06A07" style="OLC">
<section id="H4DD5A0CB94EB47078245337CCAFBFCA2"><enum>434B.</enum><header>Diabetes in
minority populations</header>
<subsection id="H35C94E43B045444E82B6222C5163380E"><enum>(a)</enum><header>In
General</header><text>The Director of the National Institutes of Health shall
expand, intensify, and support ongoing research and other activities with
respect to pre-diabetes and diabetes, particularly type 2, in minority
populations, including research to identify clinical, socioeconomic,
geographical, cultural, and organizational factors that contribute to type 2
diabetes in such populations.</text>
</subsection><subsection id="HEAA5280060044B20BC39D58D31489B85"><enum>(b)</enum><header>Certain
Activities</header><text>Activities under subsection (a) regarding type 2
diabetes in minority populations shall include the following:</text>
<paragraph id="H467C837A3C36480887CCB55724C66944"><enum>(1)</enum><text>Continuing
research on behavior and obesity, including through the obesity research center
that is sponsored by the National Institutes of Health.</text>
</paragraph><paragraph id="H3513766DE30945A79664622B8DA113B3"><enum>(2)</enum><text>Research on
environmental factors that may contribute to the increase in type 2
diabetes.</text>
</paragraph><paragraph id="H87D925F6CCC74AE88E0C47DD69EE77FD"><enum>(3)</enum><text>Support for new
methods to identify environmental triggers and genetic interactions that lead
to the development of type 2 diabetes in minority newborns. Such research
should follow the newborns through puberty, an increasingly high-risk period
for developing type 2 diabetes.</text>
</paragraph><paragraph id="H06C0600A02DF4488A7A2B05376B56FB8"><enum>(4)</enum><text>Research to
identify genes that predispose individuals to the onset of developing type 1
and type 2 diabetes and to the development of complications.</text>
</paragraph><paragraph id="H4F5A6E0E7CB84994952C810FCE6A7A1D"><enum>(5)</enum><text>Research to
prevent complications in individuals who have already developed diabetes, such
as research that attempts to identify the genes that predispose individuals
with diabetes to the development of complications.</text>
</paragraph><paragraph id="HB52C5A4683F64C6685F35E269ADBF0EC"><enum>(6)</enum><text>Research methods
and alternative therapies to control blood glucose.</text>
</paragraph><paragraph id="H029F1606517F404597DB81A0BE91B0D4"><enum>(7)</enum><text>Support of ongoing
research efforts examining the level of glycemia at which adverse outcomes
develop during pregnancy and to address the many clinical issues associated
with minority mothers and fetuses during diabetic and gestational diabetic
pregnancies.</text>
</paragraph></subsection><subsection id="HBD19DB1B727E4908884908B58CCEBEF6"><enum>(c)</enum><header>Education</header><text>The
Director of the National Institutes of Health shall—</text>
<paragraph id="H353D14881F45433FBFCAE74ACBEDE814"><enum>(1)</enum><text>through the
National Institute on Minority Health and Health Disparities and the National
Diabetes Education Program—</text>
<subparagraph id="HC312BD73196242B486AD4B5F17C62EC2"><enum>(A)</enum><text>make grants to
programs funded under section 485F (relating to centers of excellence) for the
purpose of establishing a mentoring program for health care professionals to be
more involved in weight counseling, obesity research, and nutrition; and</text>
</subparagraph><subparagraph id="HD31A9D64256641DA8DA7D88503C7910C"><enum>(B)</enum><text>provide for the
participation of minority health professionals in diabetes-focused research
programs; and</text>
</subparagraph></paragraph><paragraph id="H4B09EB8D52844A1EBEEA09B31FE9EECE"><enum>(2)</enum><text>make grants for
programs to establish a pipeline from high school to professional school that
will increase minority representation in diabetes-focused health fields by
expanding Minority Access to Research Careers (MARC) program internships and
mentoring opportunities for recruitment.</text>
</paragraph></subsection><subsection id="H431F4C5A7BBB4214B0D60009CE533CF6"><enum>(d)</enum><header>Definition</header><text>For
purposes of this section, the term <term>minority population</term> means a
racial and ethnic minority group, as defined in section 1707(g).</text>
</subsection><subsection id="H97D636D339A04D2394F3E2E84DC6AFC2"><enum>(e)</enum><header>Authorization of
Appropriations</header><text>For the purpose of carrying out this section,
there are authorized to be appropriated such sums as are necessary for fiscal
year 2012 and each subsequent fiscal
year.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" id="H10CA7D109FA24F9DBB8B6EA108C58409"><enum>(2)</enum><header>Diabetes
Mellitus Interagency Coordinating Committee</header><text>Section 429 of the
Public Health Service Act (42 U.S.C. 285c–3) is amended by adding at the end
the following new subsection:</text>
<quoted-block id="HFB22F94D1C834F76B2F9AF12FEC9F6D9" style="OLC">
<subsection commented="no" id="H3E7ED5D126734FCC84BDF967AC965969"><enum>(c)</enum><paragraph commented="no" display-inline="yes-display-inline" id="HF84722A308314B3495E24A5D58EC9605"><enum>(1)</enum><text>The Diabetes Mellitus
Interagency Coordinating Committee shall submit to the Secretary a biennial
report that shall include an assessment of the Federal activities and programs
related to diabetes in minority populations. Such assessment shall—</text>
<subparagraph commented="no" id="HFA815CAF19FF48038DD56927CA8911C1" indent="up1"><enum>(A)</enum><text>compile the current activities of all
current Federal health programs to allow for the assessment of their adequacy
as a systemic method of addressing the impact of diabetes mellitus on minority
populations;</text>
</subparagraph><subparagraph commented="no" id="H759E6A0EF9244903B7870CFA93BB1EF7" indent="up1"><enum>(B)</enum><text>develop strategic planning activities
to develop an effective and comprehensive Federal plan to address diabetes
mellitus within minority populations which will involve all appropriate Federal
health programs and shall—</text>
<clause commented="no" id="HE86A869192204144B491ECEE573534A3"><enum>(i)</enum><text>include steps to address issues
including type 1 and type 2 diabetes in children and the disproportionate
impact of diabetes mellitus on minority populations; and</text>
</clause><clause commented="no" id="HB36ACFCA291D46AA818543D84082BF64"><enum>(ii)</enum><text display-inline="yes-display-inline">remain consistent with the programs and
activities identified in section 399O, as well as remaining consistent with the
intent of the Eliminating Disparities in Diabetes Prevention Access and Care
Act of 2010; and</text>
</clause></subparagraph><subparagraph commented="no" id="HE821C61EF00F4299A1FEDBBFF5757F0E" indent="up1"><enum>(C)</enum><text>assess the implementation of such a
plan throughout Federal health programs.</text>
</subparagraph></paragraph><paragraph commented="no" id="H347376A2E9F841F18F2FB9A4C52E99CE" indent="up1"><enum>(2)</enum><text>For the purposes of this subsection,
the term <term>minority population</term> means a racial and ethnic minority
group, as defined in section 1707(g).</text>
</paragraph><paragraph commented="no" id="H01367F2488A04184AD3A974ADEB559BA" indent="up1"><enum>(3)</enum><text>For the purpose of carrying out this
subsection, there are authorized to be appropriated such sums as are necessary
for fiscal year 2012 and each subsequent fiscal
year.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H62DAB0085C464CE79B67B1DFA2ACD4FF"><enum>(b)</enum><header>Research,
education, and other activities</header><text>Part B of title III of the Public
Health Service Act (42 U.S.C. 243 et seq.) is amended by inserting after
section 317T the following section:</text>
<quoted-block id="HA44E7D842137409ABE3BFEF78B845FCE" style="OLC">
<section id="H8C9D980359344357BB0C42DE8D930C93"><enum>317U.</enum><header>Diabetes in
minority populations</header>
<subsection id="H89EFF95F0D5A4CE5B5D664EA931531B0"><enum>(a)</enum><header>Research and
Other Activities</header>
<paragraph id="HA7D4CBBDC4AE40B18BA273059568CE6B"><enum>(1)</enum><header>In
general</header><text>The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, shall conduct and support research and
other activities with respect to diabetes in minority populations.</text>
</paragraph><paragraph id="HD8F38E615AE94186ABBC42CBEFB07BB6"><enum>(2)</enum><header>Certain
activities</header><text>Activities under paragraph (1) regarding diabetes in
minority populations shall include the following:</text>
<subparagraph id="H3012FA76D64C4D5CAC7A33E425D75D1B"><enum>(A)</enum><text>Expanding the
National Diabetes Laboratory capacity for translational research and the
identification of genetic and immunological risk factors associated with
diabetes.</text>
</subparagraph><subparagraph id="H19F62776639845ECAED3E02213D8C949"><enum>(B)</enum><text>Improving the
understanding of diabetes prevalence among Asian-American, Native Hawaiian and
other Pacific Islanders by enhancing data in the National Health and Nutrition
Examination Survey by oversampling these populations in appropriate geographic
areas, or by another method determined appropriate to collect this data.</text>
</subparagraph><subparagraph id="H6BD1249BF5824E93811BA0046558E4D1"><enum>(C)</enum><text>Within the
Division of Diabetes Translation, providing for prevention research to better
understand how to influence health care systems changes to improve quality of
care being delivered to such populations, and within the Division of Diabetes
Translation, carrying out model demonstration projects to design, implement,
and evaluate effective diabetes prevention and control intervention for such
populations.</text>
</subparagraph><subparagraph id="HC5FFFD045C114153BB9AD5270FFB03A2"><enum>(D)</enum><text>Through the
Division of Diabetes Translation, carrying out culturally appropriate
community-based interventions designed to address issues and problems
experienced by such populations.</text>
</subparagraph><subparagraph id="HBEEE2974EBFD469994650AEFBDB97867"><enum>(E)</enum><text>Conducting applied
research within the Division of Diabetes Translation to reduce health
disparities within such populations with diabetes.</text>
</subparagraph><subparagraph id="H08D971A70BCC4BC793465E87B75360C2"><enum>(F)</enum><text>Conducting applied
research on primary prevention within the Division of Diabetes Translation to
specifically focus on such populations with pre-diabetes.</text>
</subparagraph></paragraph></subsection><subsection id="HDBE2101B124B4DD28F2D2210D5DF056A"><enum>(b)</enum><header>Education</header>
<paragraph id="HE80BB352A2F441E1B64984EFA1AD7AD9"><enum>(1)</enum><header>In
general</header><text>The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, shall direct the Division of Diabetes
Translation to conduct and support programs to educate the public on the causes
and effects of diabetes in minority populations.</text>
</paragraph><paragraph id="H94E77FB2A6CA48569F323804AFF235B9"><enum>(2)</enum><header>Certain
activities</header><text>Programs under paragraph (1) regarding education on
diabetes in minority populations shall include carrying out public awareness
campaigns directed toward such populations to aggressively emphasize the
importance and impact of physical activity and diet in regard to diabetes and
diabetes-related complications through the National Diabetes Education
Program.</text>
</paragraph></subsection><subsection id="HFBCF651BB09D4A1D83428B79AB276EE8"><enum>(c)</enum><header>Diabetes; Health
Promotion, Prevention Activities, and Access</header>
<paragraph id="H5AC1C2F298D34DDEBD7304B0D88E17E3"><enum>(1)</enum><header>In
general</header><text>The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, shall carry out culturally appropriate
diabetes health promotion and prevention programs for minority
populations.</text>
</paragraph><paragraph id="HC783BA8C02D645E7B515CD0932918A9A"><enum>(2)</enum><header>Certain
activities</header><text>Activities regarding culturally appropriate diabetes
health promotion and prevention programs for minority populations shall include
the following:</text>
<subparagraph id="H9899A11A7DC84E26A83FCC2EFCEA52E4"><enum>(A)</enum><text>Expanding the
Diabetes Prevention and Control Program (currently existing in all the States
and territories) and providing funds for education and community outreach on
diabetes.</text>
</subparagraph><subparagraph id="H280BE466885B4ED7B87F0402BC4F9F20"><enum>(B)</enum><text>Providing funds
for an expansion of the Diabetes Prevention Program Initiative that focuses on
physical inactivity and diet and its relation to type 2 diabetes within such
populations.</text>
</subparagraph><subparagraph id="H6A2C23785DA14C9BB527A6C9F6F67877"><enum>(C)</enum><text>Providing funds to
strengthen existing surveillance systems to improve the quality, accuracy, and
timeliness of morbidity and mortality diabetes data for such
populations.</text>
</subparagraph></paragraph></subsection><subsection id="H5E12A9EC26184FBAB895BE54D872ADDF"><enum>(d)</enum><header>Definition</header><text>For
purposes of this section, the term <term>minority population</term> means a
racial and ethnic minority group, as defined in section 1707(g).</text>
</subsection><subsection id="H938F035CFB7A43518A08E270305A967B"><enum>(e)</enum><header>Authorization of
Appropriations</header><text>For the purpose of carrying out this section,
there are authorized to be appropriated such sums as are necessary for fiscal
year 2012 and each subsequent fiscal
year.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HD950DF2184CD436FAA16095770638A33"><enum>(c)</enum><header>Research,
education, and other activities</header><text>Part P of title III of the Public
Health Service Act is amended—</text>
<paragraph id="HC70686A0C371448E9EA4A01973C448E5"><enum>(1)</enum><text display-inline="yes-display-inline">by redesignating the section 399R inserted
by section 2 of Public Law 110–373 as section 399S;</text>
</paragraph><paragraph id="HD792EB4744E34D828BCD3E8176195D71"><enum>(2)</enum><text>by redesignating
the section 399R inserted by section 3 of Public Law 110–374 as section 399T;
and</text>
</paragraph><paragraph id="H182F5A2D4B7C4B3FB1F298467D5BC1AF"><enum>(3)</enum><text>by adding at the
end the following new section:</text>
<quoted-block display-inline="no-display-inline" id="H59EF2C2A997246F497462E2DECD6570E" style="OLC">
<section id="HD0BEE02740B7486AA339D4C0B3B6BC5E"><enum>399V–6.</enum><header>Programs to
educate health providers on the causes and effects of diabetes in minority
populations</header>
<subsection id="HFBD58ADC1E4D485D9FFD5D7B3F5E02A7"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Director of the Health
Resources and Services Administration, shall conduct and support programs
described in subsection (b) to educate health professionals on the causes and
effects of diabetes in minority populations.</text>
</subsection><subsection id="HED39156F25FE4D3792A4AE8DF261C1F1"><enum>(b)</enum><header>Programs</header><text>Programs
described in this subsection, with respect to education on diabetes in minority
populations, shall include the following:</text>
<paragraph id="H7430256CE414427BA5CAB689001DF6D2"><enum>(1)</enum><text>Making grants for
diabetes-focused education classes or training programs on cultural sensitivity
and patient care within such populations for health care providers.</text>
</paragraph><paragraph id="HE1B05D780701418BBA9DB7788FB7A2DA"><enum>(2)</enum><text>Providing funds to
community health centers for programs that provide diabetes services and
screenings.</text>
</paragraph><paragraph id="H5FD80516C1424EF893AA265233736685"><enum>(3)</enum><text>Providing
additional funds for the Health Careers Opportunity Program, Centers for
Excellence, and the Minority Faculty Fellowship Program to partner with the
Office of Minority Health under section 1707 and the National Institutes of
Health to strengthen programs for career opportunities within minority
populations focused on diabetes treatment and care.</text>
</paragraph><paragraph id="HAD654C4B1BBE4EE197F530458B4AC0CB"><enum>(4)</enum><text>Developing a
diabetes focus within, and providing additional funds for, the National Health
Service Corps Scholarship program to place individuals in areas that are
disproportionately affected by diabetes and to provide health care services to
such areas.</text>
</paragraph><paragraph id="HA07DC97DCB3D4224B809A3710C1059D0"><enum>(5)</enum><text>Establishing a
diabetes ambassador program for recruitment efforts to increase the number of
underrepresented minorities currently serving in student, faculty, or
administrative positions in institutions of higher learning, hospitals, and
community health centers.</text>
</paragraph><paragraph id="H3AB119BB4A654B14A225F50A4AE8DC01"><enum>(6)</enum><text>Establishing a
loan repayment program that focuses on diabetes care and prevention in minority
populations.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H2491BBA2D3274F0986A4765915BADCE0"><enum>(d)</enum><header>Research,
education, and other activities</header><text>Part P of title III of the Public
Health Service Act (42 U.S.C. 280g et seq.), as amended by subsection (c), is
further amended by adding at the end the following section:</text>
<quoted-block display-inline="no-display-inline" id="H08295CE548F640B9A84992D99F808F45" style="OLC">
<section id="H46A7FAB8FB3D4437A5F7062904293356"><enum>399V–7.</enum><header>Research,
education, and other activities regarding diabetes in minority
populations</header>
<subsection id="H3FB47780739B4E6B80C00865123908D4"><enum>(a)</enum><header>Research and
Other Activities</header>
<paragraph id="H3A428B163D29438B97A2BD190F7BE160"><enum>(1)</enum><header>In
general</header><text>In addition to activities under sections 317U and 434B,
the Secretary shall conduct and support research and other activities with
respect to diabetes within minority populations.</text>
</paragraph><paragraph id="H0B645F2EF2F941BAA1C44CB0E1DCF98B"><enum>(2)</enum><header>Certain
activities</header><text>Activities under paragraph (1) regarding diabetes in
minority populations shall include the following:</text>
<subparagraph id="HE961E5C1F455431893563D913A1ACB43"><enum>(A)</enum><text>Through the
National Center on Minority Health and Health Disparities, the Office of
Minority Health under section 1707, the Health Resources and Services
Administration, the Centers for Disease Control and Prevention, and the Indian
Health Service, establishing partnerships within minority populations to
conduct studies on cultural, familial, and social factors that may influence
health promotion, diabetes management, and prevention.</text>
</subparagraph><subparagraph id="H45AB90E6EFA34101B4A71B889315FE88"><enum>(B)</enum><text>Through the Indian
Health Service, in collaboration with other appropriate Federal agencies,
coordinating the collection of data on ethnic and culturally appropriate
diabetes treatment, care, prevention, and services by health care professionals
to the American Indian population.</text>
</subparagraph></paragraph><paragraph id="H9B9ABBE7B5814E16A152656AA199122C"><enum>(3)</enum><header>Programs
relating to clinical research</header>
<subparagraph id="H1EA27265833C4EA7B29795F8798E8C1D"><enum>(A)</enum><header>Education
regarding clinical trials</header><text>The Secretary shall carry out education
and awareness programs designed to increase participation of minority
populations in clinical trials.</text>
</subparagraph><subparagraph id="H814EE7B3D5A7468299EE5E24A65FBAE4"><enum>(B)</enum><header>Minority
researchers</header><text>The Secretary shall carry out mentorship programs for
minority researchers who are conducting or intend to conduct research on
diabetes in minority populations.</text>
</subparagraph><subparagraph id="H72F9B895CBB14545B9BFC38639FEF82A"><enum>(C)</enum><header>Supplementing
clinical research regarding children</header><text>The Secretary shall make
grants to supplement clinical research programs to assist such programs in
obtaining the services of health professionals and other resources to provide
specialized care for children with type 1 and type 2 diabetes.</text>
</subparagraph></paragraph><paragraph commented="no" id="H0BD760B5864B40B5A1A02B1C52136A34"><enum>(4)</enum><header>Additional
programs</header><text>Activities under paragraph (1) regarding education on
diabetes shall include providing funds for new and existing diabetes-focused
education grants and programs for present and future students and clinicians in
the medical field from minority populations, including for the
following:</text>
<subparagraph commented="no" id="H3F0631D7183D46D0BD517D01D8AA5857"><enum>(A)</enum><text>For Federal and
State loan repayment programs for health profession students within communities
of color.</text>
</subparagraph><subparagraph commented="no" id="H3C9ACEB0CEAB4B25993A1C9C9F4CABA2"><enum>(B)</enum><text>For the Office of
Minority Health under section 1707 for training health profession students to
focus on diabetes within such populations.</text>
</subparagraph></paragraph></subsection><subsection id="HF0E7E957DE8D4E1EB04C84895EF68C07"><enum>(b)</enum><header>Definition</header><text>For
purposes of this section, the term <term>minority population</term> means a
racial and ethnic minority group as defined in section 1707(g).</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HCA976F1F26324ECA955C47E1EABCF811"><enum>(c)</enum><header>Authorization of
Appropriations</header><text>For the purpose of carrying out this section,
there are authorized to be appropriated such sums as are necessary for fiscal
year 2012 and each subsequent fiscal
year.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H937EB1A48CAC42A08654A7F17BABC0C3"><enum>(e)</enum><header>Sense of the
Congress</header><text>It is the sense of the Congress that States and
localities are encourage to recognize established times of diabetes awareness,
such as American Diabetes Month (November), American Diabetes Alert Day
(annually on the 4th Tuesday of March), and World Diabetes Day (November
14th).</text>
</subsection></section></subtitle><subtitle id="HA59324FF54A7449092B6CF5EC4EA93F8"><enum>G</enum><header>Lung Disease
</header>
<section id="HA699C1E678564FC29F46C825FC34E335"><enum>761.</enum><header>Expansion of
the National Asthma Education and Prevention Program</header>
<subsection id="HC168FA69D1A74703B1855D030BBAD030"><enum>(a)</enum><header>In
general</header><text>Not later than 2 years after the date of the enactment of
this Act, the Secretary of Health and Human Services shall convene a working
group comprised of patient groups, nonprofit organizations, medical societies,
and other relevant governmental and nongovernmental entities, including those
that participate in the National Asthma Education and Prevention Program, to
develop a report to Congress that—</text>
<paragraph id="H0FEB74849EAF4575A518414B233A3FB6"><enum>(1)</enum><text>catalogs, with
respect to asthma prevention, management, and surveillance—</text>
<subparagraph id="H0C607B887AE14C11865CE3E7A9BED369"><enum>(A)</enum><text>the activities of
the Federal Government, including identifying all Federal programs that carry
out asthma-related activities, as well as assessment of the progress of the
Federal Government and States, with respect to achieving the goals of the
Healthy People 2020 initiative; and</text>
</subparagraph><subparagraph id="H1DB7268F2ED146A69FD0FE78082BF4EB"><enum>(B)</enum><text>the activities of
other entities that participate in the program, including nonprofit
organizations, patient advocacy groups, and medical societies; and</text>
</subparagraph></paragraph><paragraph id="HE20B11DAF1C34528B2A781A794C5AC75"><enum>(2)</enum><text>makes
recommendations for the future direction of asthma activities, in consultation
with researchers from the National Institutes of Health and other member bodies
of the National Asthma Education and Prevention Program who are qualified to
review and analyze data and evaluate interventions, including—</text>
<subparagraph id="H215878D9B90C491BBB4D61E8A61D5552"><enum>(A)</enum><text>description of how
the Federal Government may better coordinate and improve its response to asthma
including identifying any barriers that may exist;</text>
</subparagraph><subparagraph id="HE20F6CDFF1634A02BC491B1CB816DE7C"><enum>(B)</enum><text>description of how
the Federal Government may continue, expand, and improve its private-public
partnerships with respect to asthma including identifying any barriers that may
exist;</text>
</subparagraph><subparagraph id="H09F4BD0E1A2344DB9F83E73980D34853"><enum>(C)</enum><text>identification of
steps that may be taken to reduce the—</text>
<clause id="HD80B66066AF94313B9105DB881F799A1"><enum>(i)</enum><text>morbidity,
mortality, and overall prevalence of asthma;</text>
</clause><clause id="H63270D142E8F4879BCCBD973784BEA65"><enum>(ii)</enum><text>financial burden
of asthma on society;</text>
</clause><clause id="HA171D3E1DA6347EDACBEE3479CB8D1CD"><enum>(iii)</enum><text>burden of asthma
on disproportionately affected areas, particularly those in medically
underserved populations (as defined in section 330(b)(3) of the Public Health
Service Act (42 U.S.C. 254b(b)(3)); and</text>
</clause><clause id="HF61A8B508123477CB2980C8A1CF428CA"><enum>(iv)</enum><text>burden of asthma
as a chronic disease;</text>
</clause></subparagraph><subparagraph id="HC6B27114AE11422381EFC52913CB85B1"><enum>(D)</enum><text>identification of
programs and policies that have achieved the steps described in subparagraph
(C), and steps that may be taken to expand such programs and policies to
benefit larger populations; and</text>
</subparagraph><subparagraph id="H9ADA79B110A7492485D043890B8BE32E"><enum>(E)</enum><text>recommendations
for future research and interventions.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H887AD07398994CFAACED502A05DD9CD2"><enum>(b)</enum><header>Report to
Congress</header><text display-inline="yes-display-inline">At the end of the
5-year period following the submission of the report under subsection (a), the
National Asthma Education and Prevention Program shall evaluate the analyses
and recommendations under such report and determine whether a new report to the
Congress is necessary, and make appropriate recommendations to the
Congress.</text>
</subsection></section><section id="HD152EBDEFCE14E76A7F570B82C84C8D1"><enum>762.</enum><header>Asthma-related
activities of the centers for disease control and prevention</header><text display-inline="no-display-inline">Section 317I of the Public Health Service
Act (42 U.S.C. 247b–10) is amended to read as follows:</text>
<quoted-block id="H17145BBAE43F4D5498FDAEA0DA97BFFC" style="OLC">
<section id="H7FCD0DACB62348BA80F26AC5F1E145D0"><enum>317I.</enum><header>Asthma-related
activities of the centers for disease control and prevention</header>
<subsection id="HB4DF3469088A40C69381AFF2142410C4"><enum>(a)</enum><header>Program for
providing information and education to the public</header><text>The Secretary,
acting through the Director of the Centers for Disease Control and Prevention,
shall collaborate with State and local health departments to conduct
activities, including the provision of information and education to the public
regarding asthma including—</text>
<paragraph id="H03AE96456B8A4B33A26280531CC7A9C9"><enum>(1)</enum><text>deterring the
harmful consequences of uncontrolled asthma; and</text>
</paragraph><paragraph id="H585578205D6A4692872CDF7583FCFD4A"><enum>(2)</enum><text>disseminating
health education and information regarding prevention of asthma episodes and
strategies for managing asthma.</text>
</paragraph></subsection><subsection id="HBF06906985F64435B88F751F687CCBED"><enum>(b)</enum><header>Development of
state asthma plans</header><text>The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, shall collaborate with State
and local health departments to develop State plans incorporating public health
responses to reduce the burden of asthma, particularly regarding
disproportionately affected populations.</text>
</subsection><subsection id="H977B4CA583734C57AF9DBD9D81E30162"><enum>(c)</enum><header>Compilation of
data</header><text>The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, shall, in cooperation with State and local
public health officials—</text>
<paragraph id="H76FE14AF91AF4B24B82395D08CC2D1E1"><enum>(1)</enum><text>conduct asthma
surveillance activities to collect data on the prevalence and severity of
asthma, the effectiveness of public health asthma interventions, and the
quality of asthma management, including—</text>
<subparagraph id="HB9DFB04C0D9E4ABFA5EB72A16C5B35A4"><enum>(A)</enum><text>collection of
household data on the local burden of asthma;</text>
</subparagraph><subparagraph id="HAA76A0C160564B5DBC3EF2E1DC104B51"><enum>(B)</enum><text>surveillance of
health care facilities; and</text>
</subparagraph><subparagraph id="HAC37C8E8860C4568B8409BB14D23064F"><enum>(C)</enum><text>collection of data
not containing individually identifiable information from electronic health
records or other electronic communications;</text>
</subparagraph></paragraph><paragraph id="H89F2030EB9FE472C94E46DBBF31616EE"><enum>(2)</enum><text>compile and
annually publish data regarding the prevalence and incidence of childhood
asthma, the child mortality rate, and the number of hospital admissions and
emergency department visits by children associated with asthma nationally and
in each State and at the county level by age, sex, race, and ethnicity, as well
as lifetime and current prevalence; and</text>
</paragraph><paragraph id="H373BE68A3FAA42A893E751D8B15FD92A"><enum>(3)</enum><text>compile and
annually publish data regarding the prevalence and incidence of adult asthma,
the adult mortality rate, and the number of hospital admissions and emergency
department visits by adults associated with asthma nationally and in each State
and at the county level by age, sex, race, ethnicity, industry, and occupation,
as well as lifetime and current prevalence.</text>
</paragraph></subsection><subsection id="H78E22DC4DBE64322A7702454708089A9"><enum>(d)</enum><header>Coordination of
data collection</header><text>The Director of the Centers for Disease Control
and Prevention, in conjunction with State and local health departments, shall
coordinate data collection activities under subsection (c)(2) so as to maximize
comparability of results.</text>
</subsection><subsection id="H1C6627CF8BCC4BD8B1F149E53D031D61"><enum>(e)</enum><header>Collaboration</header><text>The
Centers for Disease Control and Prevention are encouraged to collaborate with
national, State, and local nonprofit organizations to provide information and
education about asthma, and to strengthen such collaborations when
possible.</text>
</subsection><subsection id="HB7FBA7AA7C154405B37F6A5B3BAD16B8"><enum>(f)</enum><header>Additional
funding</header><text>In addition to any other authorization of appropriations
that is available to the Centers for Disease Control and Prevention for the
purpose of carrying out this section, there are authorized to be appropriated
to such Centers such sums as may be necessary for each of fiscal years 2012
through 2016 for the purpose of carrying out this
section.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H4B766805B21F4062AE26B02AEB944379"><enum>763.</enum><header>Influenza and
pneumonia vaccination campaign</header>
<subsection id="H8D4D8858A7CC4AA6863AFDC88CE7EABC"><enum>(a)</enum><header>In
general</header><text>The Secretary of Health and Human Services shall—</text>
<paragraph id="HE82666A0AA924A6787432FFF64E216AC"><enum>(1)</enum><text>enhance the annual
campaign by the Department of Health and Human Services to increase the number
of people vaccinated each year for influenza and pneumonia; and</text>
</paragraph><paragraph id="H673FD729C41643B6B10FDBE9ABFD2203"><enum>(2)</enum><text>include in such
campaign the use of written educational materials, public service
announcements, physician education, and any other means which the Secretary
deems effective.</text>
</paragraph></subsection><subsection id="H3199D39AC4714F79B7062AFCBFA4193F"><enum>(b)</enum><header>Materials and
announcements</header><text>In carrying out the annual campaign described in
subsection (a), the Secretary of Health and Human Services shall ensure
that—</text>
<paragraph id="H3621B440C096420480920CE21E2125CC"><enum>(1)</enum><text>educational
materials and public service announcements are readily and widely available in
communities experiencing disparities in the incidence and mortality rates of
influenza and pneumonia; and</text>
</paragraph><paragraph id="HBDAC7689173F466090DB6CA3CEDC82A4"><enum>(2)</enum><text>the campaign uses
targeted, culturally appropriate messages and messengers to reach underserved
communities.</text>
</paragraph></subsection><subsection id="H8B83449C384145A488AF1F0F1BB1FE62"><enum>(c)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section such sums as may be necessary for each of fiscal years 2012
through 2016.</text>
</subsection></section><section id="HBE951846C2DA4BACAEFF3D86B1346111"><enum>764.</enum><header>Chronic
obstructive pulmonary disease action plan</header>
<subsection id="HF603E12158734C6BA2AA37A45FE868D6"><enum>(a)</enum><header>In
general</header><text>The Director of the Centers for Disease Control and
Prevention shall conduct, support, and expand public health strategies,
prevention, diagnosis, surveillance, and public and professional awareness
activities regarding chronic obstructive pulmonary disease.</text>
</subsection><subsection id="HC8580D3312D94C27A8E8CEBB4DEDBB47"><enum>(b)</enum><header>National action
plan</header>
<paragraph id="HE24D07EC8CDD4494A95912136166D42C"><enum>(1)</enum><header>Development</header><text>Not
later than 2 years after the date of the enactment of this Act, the Director of
the National Heart, Lung, and Blood Institute, in consultation with the
Director of the Centers for Disease Control and Prevention, shall develop a
national action plan to address chronic obstructive pulmonary disease in the
United States with participation from patients, caregivers, health
professionals, patient advocacy organizations, researchers, providers, public
health professionals, and other stakeholders.</text>
</paragraph><paragraph id="H5B7347E08EA745EDAF898695BA5D3172"><enum>(2)</enum><header>Contents</header><text>At
a minimum, such plan shall include recommendations for—</text>
<subparagraph id="HB391FD1048564DCD8584015A677E738E"><enum>(A)</enum><text>public health
interventions for the purpose of implementation of the national plan;</text>
</subparagraph><subparagraph id="HA072807D88E54D628E915470D2428FC0"><enum>(B)</enum><text>biomedical, health
services, and public health research on chronic obstructive pulmonary disease;
and</text>
</subparagraph><subparagraph id="H8632A77BD99143AB9A2F62D43B0EBFA8"><enum>(C)</enum><text>inclusion of
chronic obstructive pulmonary disease in the health data collections of all
Federal agencies.</text>
</subparagraph></paragraph><paragraph id="H36602F6966044892B246F8C89458AF57"><enum>(3)</enum><header>Consideration</header><text display-inline="yes-display-inline">In developing such plan, the Director of
the National Heart, Lung, and Blood Institute shall consider the
recommendations and findings of the Institute of Medicine in the report
entitled <quote>A Nationwide Framework for Surveillance of Cardiovascular and
Chronic Lung Diseases</quote> (July 22, 2011).</text>
</paragraph></subsection><subsection id="H42FC59D64B7741D2B2B36AE1363BADE0"><enum>(c)</enum><header>Chronic disease
prevention programs</header><text display-inline="yes-display-inline">The
Director of the National Heart, Lung, and Blood Institute shall carry out the
following:</text>
<paragraph id="HFBDA3830DA094736BCAD1C7C7FCC40FF"><enum>(1)</enum><text display-inline="yes-display-inline">Conduct public education and awareness
activities with patient and professional organizations to stimulate earlier
diagnosis and improve patient outcomes from treatment of chronic obstructive
pulmonary disease. To the extent known and relevant, such public education and
awareness activities shall reflect differences in chronic obstructive pulmonary
disease by cause (tobacco, environmental, occupational, biological, and
genetic) and include a focus on outreach to undiagnosed and, as appropriate,
minority populations.</text>
</paragraph><paragraph id="H8BA7522B59834FDC8C93403CDCA1218F"><enum>(2)</enum><text display-inline="yes-display-inline">Supplement and expand upon the activities
of the National Heart, Lung, and Blood Institute by making grants to nonprofit
organizations, State and local jurisdictions, and Indian tribes for the purpose
of reducing the burden of chronic obstructive pulmonary disease, especially in
disproportionately impacted communities, through public health interventions
and related activities.</text>
</paragraph><paragraph id="HCE9B07E553A14B6696ECC9B10A8AFCAA"><enum>(3)</enum><text>Coordinate with
the Centers for Disease Control and Prevention, the Indian Health Service, the
Health Resources and Services Administration, and the Department of Veterans
Affairs to develop pilot programs to demonstrate best practices for the
diagnosis and management of chronic obstructive pulmonary disease.</text>
</paragraph><paragraph id="H274675713A8A468D9666553CCDF4BB7C"><enum>(4)</enum><text display-inline="yes-display-inline">Develop improved techniques and identify
best practices, in coordination with the Secretary of Veterans Affairs, for
assisting chronic obstructive pulmonary disease patients to successfully stop
smoking, including identification of subpopulations with different needs.
Initiatives under this paragraph may include research to determine whether
successful smoking cessation strategies are different for chronic obstructive
pulmonary disease patients compared to such strategies for patients with other
chronic diseases.</text>
</paragraph></subsection><subsection id="H2C73D3521DB5480D8EE63EC8E0987B74"><enum>(d)</enum><header>Environmental
and occupational health programs</header><text>The Director of the Centers for
Disease Control and Prevention shall—</text>
<paragraph id="H53ADE47A687C414B974CF20EAD6B4670"><enum>(1)</enum><text>support research
into the environmental and occupational causes and biological mechanisms that
contribute to chronic obstructive pulmonary disease; and</text>
</paragraph><paragraph id="H54C60754C28F40AC8EEB23D29AB21DCB"><enum>(2)</enum><text>develop and
disseminate public health interventions that will lessen the impact of
environmental and occupational causes of chronic obstructive pulmonary
disease.</text>
</paragraph></subsection><subsection id="H620FB437C5754C54BCB7AF1C5E0C710E"><enum>(e)</enum><header>Data
Collection</header><text display-inline="yes-display-inline">Not later than 180
days after the enactment of this Act, the Director of the National Heart, Lung,
and Blood Institute and the Director of the Centers for Disease Control and
Prevention, acting jointly, shall assess the depth and quality of information
on chronic obstructive pulmonary disease that is collected in surveys and
population studies conducted by the Centers for Disease Control and Prevention,
including whether there are additional opportunities for information to be
collected in the National Health and Nutrition Examination Survey, the National
Health Interview Survey, and the Behavioral Risk Factors Surveillance System
surveys. The Director of the National Heart, Lung, and Blood Institute shall
include the results of such assessment in the national action plan under
subsection (b).</text>
</subsection><subsection commented="no" id="H0279915AB1524CC6A50D70AA0F1C5501"><enum>(f)</enum><header>Authorization of
Appropriations</header><text display-inline="yes-display-inline">There are
authorized to be appropriated to carry out this section such sums as may be
necessary for each of fiscal years 2012 through 2016.</text>
</subsection></section></subtitle><enum>VIII</enum><header>Health
Information Technology </header>
<subtitle id="H789E4880E1924DA49762C1C4EE89125E"><enum>A</enum><header>Reducing Health
Disparities Through Health IT</header>
<section id="H52E46278CBCE41DF83C937230ECFFE81"><enum>801.</enum><header>HRSA assistance
to health centers for promotion of Health IT</header><text display-inline="no-display-inline">The Secretary of Health and Human Services,
acting through the Administrator of the Health Resources and Services
Administration, shall expand and intensify the programs and activities of the
Administration (directly or through grants or contracts) to provide technical
assistance and resources to health centers (as defined in section 330(a) of the
Public Health Service Act (42 U.S.C. 254b(a)) to adopt and meaningfully use
certified EHR technology (as defined in section 3000(1) of such Act (42 U.S.C.
300jj(1)) for the management of chronic diseases and health conditions.</text>
</section><section id="H9E9D6CB1842F48EF9EFB3B784E4495F0"><enum>802.</enum><header>Assessment of
impact of Health IT on racial and ethnic minority communities; outreach and
adoption of Health IT in such communities</header><text display-inline="no-display-inline">Section 3001(c)(6)(C) of the Public Health
Service Act (42 U.S.C. 300jj–11(c)(6)(C)) is amended—</text>
<paragraph id="HBDA06737B61F4B6A9D8A744B9087F370"><enum>(1)</enum><text>in the heading by
inserting <quote><header-in-text level="subparagraph" style="OLC">, racial and
ethnic minority communities,</header-in-text></quote> after
<quote><header-in-text level="subparagraph" style="OLC">health
disparities</header-in-text></quote>;</text>
</paragraph><paragraph id="H7738BF8AB46C4B8DB33A23C5F0C55D10"><enum>(2)</enum><text>by inserting
<quote>, in communities with a high proportion of individuals from racial and
ethnic minority groups (as defined in section 1707(g)),</quote> after
<quote>communities with health disparities</quote>; and</text>
</paragraph><paragraph id="HDD2F21547BDB40ED9E5F85F0A22DDB42"><enum>(3)</enum><text>by adding at the
end the following new sentence:</text>
<quoted-block display-inline="yes-display-inline" id="H53F0427446BC490F8CCE4A30D5A79E5F" style="OLC">
<text>In any
publication under the previous sentence, the National Coordinator shall include
best practices for encouraging partnerships between the Federal Government and
private entities to expand outreach for and the adoption of such technology in
communities with a high proportion of individuals from racial and ethnic
minority groups (as so defined), while also maintaining the accessibility
requirements of section 508 of the Rehabilitation Act to encourage patient
involvement in their own health care. The National Coordinator
shall—</text><clause id="H1C5346859EE4402E95EE724C0DDBEF86"><enum>(i)</enum><text display-inline="yes-display-inline">not later than 6 months after the
submission to the Congress of the reports required by sections 832 and 833 of
the <short-title>Health Equity and Accountability Act of
2011</short-title>, establish criteria for evaluating the impact of health
information technology on communities with a high proportion of individuals
from racial and ethnic minority groups (as so defined) taking into account the
findings in such reports; and</text>
</clause><clause id="HC2B85D2FE0D74F958DFAB9B4A5A856DA"><enum>(ii)</enum><text>not later than 12
months after the submission to the Congress of such reports, conduct and
publish the results of an evaluation of such
impact.</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section></subtitle><subtitle id="H404C04E4DEF64DC79CF8428040A0513C"><enum>B</enum><header>Modifications to
Achieve Parity in Existing Programs</header>
<section id="HB9D53417905745FD8C5A5978B3D5CFFC"><enum>811.</enum><header>Extending
funding to strengthen the Health IT infrastructure in racial and ethnic
minority communities</header><text display-inline="no-display-inline">Section
3011 of the Public Health Service Act (42 U.S.C. 300jj–31) is amended—</text>
<paragraph id="HA97A1B2789414DE5BED92934499C82D9"><enum>(1)</enum><text>in subsection (a),
by adding at the end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H7D7498BC355C4156A35627CD636D9366" style="OLC">
<paragraph id="H5E6EBBD2E0C34BB6AA32F2E1D4A74057"><enum>(8)</enum><text display-inline="yes-display-inline">Activities described in the previous
paragraphs of this subsection with respect to communities with a high
proportion of individuals from racial and ethnic minority groups (as defined in
section 1707(g)).</text>
</paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="HE0A40641304E4BE2A116413BAF8D72C3"><enum>(2)</enum><text>by adding at the
end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H473D51FC9FA4464083776967820908BC" style="OLC">
<subsection id="HE00A2F54CCCD4AF09E538B4B24FFC210"><enum>(e)</enum><header>Annual report on
expenditures</header><text display-inline="yes-display-inline">The National
Coordinator shall report annually to the Congress on activities and
expenditures under this
section.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="H1129147CF114462A8D1BDA8804F27927"><enum>812.</enum><header>Prioritizing
regional extension center assistance to racial and ethnic minority
groups</header>
<subsection id="H408682749FDA47A9AB6268F6CCF5D3BC"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 3012(c)(4)(C)
of the Public Health Service Act (42 U.S.C. 300jj–32(c)(4)(C)) is amended by
inserting <quote>or individuals from racial and ethnic minority groups (as
defined in section 1707(g))</quote> after <quote>medically underserved
individuals</quote>.</text>
</subsection><subsection id="H307C141457FD4104A58BCB1E60C5BF1C"><enum>(b)</enum><header>Biennial
evaluation</header><text display-inline="yes-display-inline">Section 3012(c)(8)
of such Act (42 U.S.C. 300jj–32(c)(8)) is amended—</text>
<paragraph commented="no" id="HD03D60867F2C44D1B6F5E0CCA5D9DF10"><enum>(1)</enum><text>by inserting:
<quote>Each evaluation panel shall include at least one consumer advocate from
a racial and ethnic minority community served by the center involved and at
least one representative of a minority-serving institution.</quote> after
‘<quote>and of Federal officials.</quote>; and</text>
</paragraph><paragraph id="H5180432D993D404FA6F55EE49706E135"><enum>(2)</enum><text>by inserting
<quote>and shall determine the degree to which such center provides outreach
and assistance to providers predominantly serving racial and ethnic minority
groups (as defined in section 1707(g))</quote> after <quote>specified in
paragraph (3)</quote>.</text>
</paragraph></subsection></section><section id="H29FD6945402F4A90B18C5A741864960D"><enum>813.</enum><header>Extending
competitive grants for the development of loan programs to facilitate adoption
of certified EHR technology by providers serving racial and ethnic minority
groups</header><text display-inline="no-display-inline">Section 3014(e) of the
Public Health Service Act (42 U.S.C. 300jj–34(e)) is amended—</text>
<paragraph id="HC8A8503383F5426D8B7B1384DD00C13A"><enum>(1)</enum><text>in paragraph (3),
by striking at the end <quote>or</quote>;</text>
</paragraph><paragraph id="HCDE667983AAC4E89A8827A9D74F3D74D"><enum>(2)</enum><text>in paragraph (4),
by striking the period at the end and inserting <quote>; or</quote>; and</text>
</paragraph><paragraph id="H5081C31525E5436AA8E84F44DE263FDE"><enum>(3)</enum><text>by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H229138943CCE4C829CD3230E4DE8D2BA" style="OLC">
<paragraph id="HBA366B68F2D846738BB7C1BE957EEA1E"><enum>(5)</enum><text display-inline="yes-display-inline">carry out any of the activities described
in a previous paragraph of this subsection with respect to communities with a
high proportion of individuals from racial and ethnic minority groups (as
defined in section
1707(g)).</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section></subtitle><subtitle id="H335C989046284B6E8036385D18CEDB56"><enum>C</enum><header>Additional
Research and Studies </header>
<section id="H1BB90EB6BD584C0BBC51CCE8C9A4DB97"><enum>831.</enum><header>Data collection
and assessments conducted in coordination with minority-serving
institutions</header><text display-inline="no-display-inline">Section
3001(c)(6) of the Public Health Service Act (42 U.S.C. 300jj–11(c)(6)) is
amended by adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H9A97D44912144CD49903572385758EEE" style="OLC">
<subparagraph id="H18550087793B45A8942DA3FE0D5D881D"><enum>(F)</enum><header>Data collection
and assessments conducted in coordination with minority-serving
institutions</header>
<clause id="H92874FBEE21B46DAB351222853BFC01F"><enum>(i)</enum><header>In
general</header><text>In carrying out subparagraph (C) with respect to
communities with a high proportion of individuals from racial and ethnic
minority groups (as defined in section 1707(g)), the National Coordinator
shall, to the greatest extent possible, coordinate with an entity described in
clause (ii).</text>
</clause><clause id="HE599B760BCE745889654171154850F22"><enum>(ii)</enum><header>Minority-serving
institutions</header><text display-inline="yes-display-inline">For purposes of
clause (i), an entity described in this clause is a historically Black college
or university, an Hispanic-serving institution, a tribal college or university,
or an Asian-American-, Native American-, and Pacific Islander-serving
institution with an accredited public health, health policy, or health services
research
program.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H57B636F82D6D499198956B9EFF214BC4"><enum>832.</enum><header>IOM study and
report on privacy concerns of certain minority populations</header>
<subsection id="H5C1B6E44C59B4DF4B8624EC71DC27D66"><enum>(a)</enum><header>In
general</header><text>The Secretary of Health and Human Services shall seek to
enter into an agreement with the Institute of Medicine of the National
Academies to—</text>
<paragraph id="HF8CCAA6D2E6849CAA43A4B5D65EED8F9"><enum>(1)</enum><text>complete a
study—</text>
<subparagraph id="HA10E3FDE9DD3431F98039CF06F4C2935"><enum>(A)</enum><text>on the privacy
concerns, relating to the exchange of health information, of individuals
described in subsection (b);</text>
</subparagraph><subparagraph id="HC54254EC33C544C3A1A343F41DD12C14"><enum>(B)</enum><text>on how such
concerns may create barriers for such individuals to access health care or
participate in the exchange of health information; and</text>
</subparagraph><subparagraph id="H35AABD34E355483EBB6CE7CAF1C1A4F0"><enum>(C)</enum><text>including
recommendations for overcoming such barriers for such individuals; and</text>
</subparagraph></paragraph><paragraph id="H299836737C8B4AA39C9C9FD361EBA2D4"><enum>(2)</enum><text>not later than 24
months after the date of the enactment of this Act, submit to Congress a report
on the results of such study.</text>
</paragraph><continuation-text continuation-text-level="subsection">If such
Institute declines to conduct the study and submit the report, the Secretary
shall enter into an agreement with another appropriate public or nonprofit
private entity to conduct the study and submit the report.</continuation-text></subsection><subsection id="H6E47A965890F4D1DB75D9943E1BB30CF"><enum>(b)</enum><header>Individuals
described</header><text>For purposes of subsection (a), the individuals
described in this subsection are individuals from racial and ethnic minority
groups (as defined in section 1707(g)), including such individuals who—</text>
<paragraph id="H270CFF4CC5DB4793B9DB7646993CEE7F"><enum>(1)</enum><text>are immigrants, as
well as citizens living within immigrant households (<term>mixed-status</term>
households) in the United States;</text>
</paragraph><paragraph id="H4867FBC3685D4CA5A680BCF8E385B5DA"><enum>(2)</enum><text display-inline="yes-display-inline">are lesbian, gay, bisexual, or transgender;
or</text>
</paragraph><paragraph id="HDBB3B866A1124BC8A054D85385B8623D"><enum>(3)</enum><text>have a mental
health disability or a record of a mental health disability or treatment for a
mental health disability.</text>
</paragraph></subsection></section><section id="H015BA1D18FA24031A9ACC339EDCB3040"><enum>833.</enum><header>Study of health
information technology in medically underserved communities</header>
<subsection id="H9F5920BB0D1C453A98E17D31B4E63A13"><enum>(a)</enum><header>Study</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services
shall seek to enter into an agreement with the Institute of Medicine of the
National Academies to conduct a study on the development and implementation of
health information technology in communities with a high proportion of
individuals from racial and ethnic minority groups (as defined in section
1707(g)) and submit the report under subsection (b). The study shall—</text>
<paragraph id="H6DAAEF2B81264B0AB6E981AA2EC10EDD"><enum>(1)</enum><text>identify barriers
to successful implementation of health information technology in these
communities;</text>
</paragraph><paragraph id="HC627793D14BA4355B4DFDE423CE285FD"><enum>(2)</enum><text>examine the impact
of health information technology on providing quality care and reducing the
cost of care to these communities;</text>
</paragraph><paragraph id="H8BDFDD30C6D3432B9663081FD34326F0"><enum>(3)</enum><text>examine urban and
rural community health systems and determine the impact that health information
technology may have on the capacity of primary health providers;</text>
</paragraph><paragraph id="HF3CCF6F7929F4545AAFCCCFB00D7176E"><enum>(4)</enum><text>identify specific
best practices for using health information technology to foster the consistent
provision of physical accessibility and reasonable policy accommodations in
health care to individuals with disabilities in these communities; and</text>
</paragraph><paragraph id="H8940ECE7CEFF4880B3ABF6C8080D27BE"><enum>(5)</enum><text>assess the
feasibility and the costs of associated with the use of health information
technology in these communities.</text>
</paragraph><continuation-text continuation-text-level="subsection">If such
Institute declines to conduct the study, the Secretary shall enter into an
agreement with another appropriate public or nonprofit private entity to
conduct the study.</continuation-text></subsection><subsection id="HDD242026240746F1B4BFC98E2EF794A2"><enum>(b)</enum><header>Report</header><text display-inline="yes-display-inline">The Secretary shall ensure that, not later
than 24 months after the date of the enactment of this Act, the study required
under subsection (a) is completed and a report on the study is submitted to
Congress, including any recommendations for legislation or administrative
action.</text>
</subsection></section></subtitle><subtitle id="H595E80DEABDA469A82C5338B3DBD34DC"><enum>D</enum><header>Closing Gaps in
Funding To Adopt Certified EHRs</header>
<section id="H3C558AD3159E4D10BA854FBF0AAF026D"><enum>841.</enum><header>Application of
Medicare HITECH payments to hospitals in Puerto Rico</header>
<subsection id="HC907042D93104EB8B59C0F982ECF5624"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Subsection (n)(6)(B)
of section 1886 of the Social Security Act (42 U.S.C. 1395ww) is amended by
striking <quote>subsection (d) hospital</quote> and inserting <quote>hospital
that is a subsection (d) hospital or a subsection (d) Puerto Rico
hospital</quote>.</text>
</subsection><subsection id="H98737E9907EB49A38A9A5347784FE5E2"><enum>(b)</enum><header>Offsetting
reduction</header><text>Subsection (n)(2) of such section is amended by adding
at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H4C4BD37D3C28440EA75CBC42A7B88217" style="OLC">
<subparagraph id="H1C1DD65B14FA4A47808D4C05A9148FBD"><enum>(H)</enum><header>Budget
neutrality adjustment</header><text display-inline="yes-display-inline">The
Secretary shall reduce the applicable amounts that would otherwise be
determined under this subsection with respect to—</text>
<clause id="H61E5E29731BF457082F6240004C7829F"><enum>(i)</enum><text>the first fiscal
year to which this subparagraph applies by an amount that the Secretary
estimates would ensure that estimated aggregate payments under this subsection
for such fiscal year are not increased as a result of the amendments made by
subsection (a) of section 841 of the Health Equity and Accountability Act of
2011; or</text>
</clause><clause id="H7235733939C842668FAC04C433771409"><enum>(ii)</enum><text display-inline="yes-display-inline">a succeeding fiscal year by an amount that
the Secretary estimates would ensure that estimated aggregate payments under
this subsection for such fiscal year are not increased as a result of the
amendments made by subsections (a) and (c) of such
section.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H7D11D48143224A9AA8748E8C1E89E2CE"><enum>(c)</enum><header>Conforming
amendments</header><paragraph commented="no" display-inline="yes-display-inline" id="H7D067189C24C478FB2123ECA21B6AC61"><enum>(1)</enum><text>Subsection (b)(3)(B)(ix)
of such section is amended—</text>
<subparagraph id="H4DBE32AF317D4FBCA73713633596949D" indent="up1"><enum>(A)</enum><text>in subclause (I), by striking
<quote>(n)(6)(A)</quote> and inserting <quote>(n)(6)(B)</quote>; and</text>
</subparagraph><subparagraph id="H928514FEE9EE455C84601A20DB73DFAD" indent="up1"><enum>(B)</enum><text>in subclause (II), by striking
<quote>subsection (d) hospital</quote> and inserting <quote>an eligible
hospital</quote>.</text>
</subparagraph></paragraph><paragraph id="H0630233D0CF446DCBC53BF3CC14000C2" indent="up1"><enum>(2)</enum><text>Paragraphs (2) and (4)(A) of section
1853(m) of the Social Security Act (42 U.S.C. 1395w–23(m)) are each amended by
striking <quote>1886(n)(6)(A)</quote> and inserting
<quote>1886(n)(6)(B)</quote>.</text>
</paragraph></subsection><subsection id="HE3D40D5B4C584F938F74F1FA5D96250F"><enum>(d)</enum><header>Implementation</header><text display-inline="yes-display-inline">Notwithstanding any other provision of law,
the Secretary of Health and Human Services may implement the amendments made by
subsections (a), (b) and (c) by program instruction or otherwise.</text>
</subsection><subsection commented="no" id="HDFE1F222235E4897896A91C188C57054"><enum>(e)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to payments
for payment years for fiscal years beginning after the date of the enactment of
this Act.</text>
</subsection></section><section commented="no" id="H41C2B893FF6242A98436276E0C326934"><enum>842.</enum><header>Extending
Medicaid EHR incentive payments to long-term care facilities and home health
agencies</header><text display-inline="no-display-inline">Section 1903(t)(2)(B)
of the Social Security Act (42 U.S.C. 1396b(t)(2)(B)) is amended—</text>
<paragraph commented="no" id="H98BF5755EBA146CEA51D2EB79F6C44F1"><enum>(1)</enum><text>in clause (i), by
striking <quote>, or</quote> and inserting a semicolon;</text>
</paragraph><paragraph commented="no" id="HE664A37623DE4EA98B7B736D68A65484"><enum>(2)</enum><text>in clause (ii), by
striking the period at the end and inserting a semicolon; and</text>
</paragraph><paragraph commented="no" id="H44B51600BECA4893B06A186143F723A1"><enum>(3)</enum><text>by adding at the
end the following new clauses:</text>
<quoted-block id="HF20397BFE13544C9858D27E3EE2760F0" style="OLC">
<clause commented="no" id="HC78BF65340A842179EE782935111B8AD" indent="up1"><enum>(iii)</enum><text>a long-term care facility;
or</text>
</clause><clause commented="no" id="HC2254DB6653A458395631BD3CD7AB8E1" indent="up1"><enum>(iv)</enum><text>a home health agency (as defined
in section
1861(o)).</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section commented="no" display-inline="no-display-inline" id="H6496F55BB7CA411199E2840B163C49D4" section-type="subsequent-section"><enum>843.</enum><header>Extending physician
assistant eligibility for Medicaid electronic health record incentive
payments</header>
<subsection commented="no" id="HFA636B7EE9464377950042F0B2AF00DD"><enum>(a)</enum><header>In
general</header><text>Section 1903(t)(3)(B)(v) of the Social Security Act (42
U.S.C. 1396b(t)(3)(B)(v)) is amended by striking <quote>insofar as the
assistant is practicing</quote> and all that follows through <quote>so
led</quote>.</text>
</subsection><subsection commented="no" id="H01B768ED3B2643BF8B0FF4534055FA28"><enum>(b)</enum><header>Effective
date</header><text display-inline="yes-display-inline">The amendment made by
subsection (a) shall apply with respect to amounts expended under 1903(a)(3)(F)
of the Social Security Act (42 U.S.C. 1396b(a)(3)(F)) for calendar quarters
beginning on or after the date of the enactment of this Act.</text>
</subsection></section></subtitle><enum>IX</enum><header>Accountability
and Evaluation</header>
<section id="H9484549FCFAA47D888B9BE4D4BF21BC8"><enum>901.</enum><header>Prohibition on
discrimination in Federal assisted health care services and research programs
on the basis of sex, race, color, national origin, sexual orientation, gender
identity, or disability status</header><text display-inline="no-display-inline">No person in the United States shall, on the
basis of sex, race, color, national origin, sexual orientation, gender
identity, or disability status, be excluded from participation in, be denied
the benefits of, or be subjected to discrimination under any health care
service or research program or activity receiving Federal financial
assistance.</text>
</section><section id="H8652D891A2134FCDA91D87FD7F3C4DBC"><enum>902.</enum><header>Treatment of
Medicare payments under Title VI of the Civil Rights Act of 1964</header><text display-inline="no-display-inline">A payment to a provider of services,
physician, or other supplier under part B, C, or D of title XVIII of the Social
Security Act shall be deemed a grant, and not a contract of insurance or
guaranty, for the purposes of title VI of the Civil Rights Act of 1964.</text>
</section><section id="HDB8B4D9F08E34BEC8EDBE81292FF0118"><enum>903.</enum><header>Accountability
and transparency within the Department of Health and Human
Services</header><text display-inline="no-display-inline">Title XXXIV of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name>, as amended
by titles I, II, and III of this Act, is further amended by inserting after
subtitle B the following:</text>
<quoted-block act-name="Public Health Service Act" id="HE892E61BDB6C47BEB57870145201D35B">
<subtitle id="H4C2F0AFB689541A4BFC9E5E1C36162AC"><enum>C</enum><header>Strengthening
accountability</header>
<section id="H96FDC32EB9774DBDAA84680CFBF108C3"><enum>3441.</enum><header>Elevation of
the Office of Civil Rights</header>
<subsection id="H6EABDE227E4E4D099DD3F15DF388A1E5"><enum>(a)</enum><header>In
general</header><text>The Secretary shall establish within the Office for Civil
Rights an Office of Health Disparities, which shall be headed by a director to
be appointed by the Secretary.</text>
</subsection><subsection id="H3B27AE6258B44063A0600FA4C932B38F"><enum>(b)</enum><header>Purpose</header><text>The
Office of Health Disparities shall ensure that the health programs, activities,
and operations of health entities which receive Federal financial assistance
are in compliance with title VI of the Civil Rights Act, which prohibits
discrimination on the basis of race, color, or national origin. The activities
of the Office shall include the following:</text>
<paragraph id="HDE3E2C5F18A243B49BD3B039A861E96D"><enum>(1)</enum><text display-inline="yes-display-inline">The development and implementation of an
action plan to address racial and ethnic health care disparities, which shall
address concerns relating to the Office for Civil Rights as released by the
United States Commission on Civil Rights in the report entitled <quote>Health
Care Challenge: Acknowledging Disparity, Confronting Discrimination, and
Ensuring Equity</quote> (September 1999) in conjunction with the reports by the
Institute of Medicine entitled <quote>Unequal Treatment: Confronting Racial and
Ethnic Disparities in Health Care</quote>, <quote>Crossing the Quality Chasm: A
New Health System for the 21st Century</quote>, and <quote>In the Nation's
Compelling Interest: Ensuring Diversity in the Health Care Workforce</quote>,
and <quote>The National Partnership for Action to End Health
Disparities</quote>, and other related reports by the Institute of Medicine.
This plan shall be publicly disclosed for review and comment and the final plan
shall address any comments or concerns that are received by the Office.</text>
</paragraph><paragraph id="HF7957B29B4DD4471944AB2B56F952344"><enum>(2)</enum><text>Investigative and
enforcement actions against intentional discrimination and policies and
practices that have a disparate impact on minorities.</text>
</paragraph><paragraph id="HAB0611344D6E4253AC584272567A85A8"><enum>(3)</enum><text>The review of
racial, ethnic, and primary language health data collected by Federal health
agencies to assess health care disparities related to intentional
discrimination and policies and practices that have a disparate impact on
minorities.</text>
</paragraph><paragraph id="H2E6C532A74304991A1DB07539A4DC189"><enum>(4)</enum><text>Outreach and
education activities relating to compliance with title VI of the Civil Rights
Act.</text>
</paragraph><paragraph id="H88EDD90C68404765AEDFF31C3CF19522"><enum>(5)</enum><text>The provision of
technical assistance for health entities to facilitate compliance with title VI
of the Civil Rights Act.</text>
</paragraph><paragraph id="HFF70BF30648F4E01BA7E2A4E28CB2531"><enum>(6)</enum><text>Coordination and
oversight of activities of the civil rights compliance offices established
under section 3442.</text>
</paragraph><paragraph id="HC71FEB0D8A59424FA315E2498AEA6B75"><enum>(7)</enum><text>Ensuring
compliance with the 1997 Office of Management and Budget Standards for
Maintaining, Collecting, and Presenting Federal Data on Race, Ethnicity and the
available language standards.</text>
</paragraph></subsection><subsection id="HDBF20AC35FDD48A39CF6DE2309F00A85"><enum>(c)</enum><header>Funding and
staff</header><text>The Secretary shall ensure the effectiveness of the Office
of Health Disparities by ensuring that the Office is provided with—</text>
<paragraph id="HF360B8F98BE0424094331DD3C19209B2"><enum>(1)</enum><text>adequate funding
to enable the Office to carry out its duties under this section; and</text>
</paragraph><paragraph id="HEFA2EE224057478E978591C7965A7B2F"><enum>(2)</enum><text>staff with
expertise in—</text>
<subparagraph id="HA6C2B5485EC74842B681248F980A5512"><enum>(A)</enum><text>epidemiology;</text>
</subparagraph><subparagraph id="H2BEBD93A2815459890DE386BB2EC654E"><enum>(B)</enum><text>statistics;</text>
</subparagraph><subparagraph id="H5A8CF0261276411BB81237DFBDBAA6D5"><enum>(C)</enum><text>health quality
assurance;</text>
</subparagraph><subparagraph id="H0AB44A6B8A1541FC9801E9C897B3D676"><enum>(D)</enum><text>minority health
and health disparities;</text>
</subparagraph><subparagraph id="HA59F5CC9E49D4C0F826E1B671967E707"><enum>(E)</enum><text>cultural and
linguistic competency; and</text>
</subparagraph><subparagraph id="H731B565ECFE24E219617992E7A820766"><enum>(F)</enum><text>civil
rights.</text>
</subparagraph></paragraph></subsection><subsection id="HE09FC27C51444101834CCBB2685CCCF2"><enum>(d)</enum><header>Report</header><text>Not
later than December 31, 2012, and annually thereafter, the Secretary, in
collaboration with the Director of the Office for Civil Rights and the Deputy
Assistant Secretary for Minority Health, shall submit a report to the Committee
on Health, Education, Labor, and Pensions of the Senate and the Committee on
Energy and Commerce of the House of Representatives that includes—</text>
<paragraph id="H9C71BCE442CF4A4AAE556D845C5F2168"><enum>(1)</enum><text>the number of
cases filed, broken down by category;</text>
</paragraph><paragraph id="HB37DCAE131784CCBA0F693ECB2DBCA49"><enum>(2)</enum><text>the number of
cases investigated and closed by the office;</text>
</paragraph><paragraph id="H43CB30295B5D4BEDABA4FA75163F230D"><enum>(3)</enum><text>the outcomes of
cases investigated;</text>
</paragraph><paragraph id="HEB25689760734122A8B3F53EE9612FC1"><enum>(4)</enum><text>the staffing
levels of the office including staff credentials;</text>
</paragraph><paragraph id="H396F16FA315E417997C7C1549EFCAB6A"><enum>(5)</enum><text>the number of
other lingering and emerging cases in which civil rights inequities can be
demonstrated; and</text>
</paragraph><paragraph id="HBF67255AC0BC44B888E183489A7D46CD"><enum>(6)</enum><text>the number of
cases remaining open and an explanation for their open status.</text>
</paragraph></subsection><subsection id="H56A13ABA7D744F0BA9CD7169D04A3B9A"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2012
through 2017.</text>
</subsection></section><section id="HD817BA55D47D44D0BA98EDF70523745D"><enum>3442.</enum><header>Establishment
of Health Program offices for Civil Rights within Federal Health and human
services agencies</header>
<subsection id="HE2FBA52CD4914F309CBB7F612A762526"><enum>(a)</enum><header>In
general</header><text>The Secretary shall establish civil rights compliance
offices in each agency within the Department of Health and Human Services that
administers health programs.</text>
</subsection><subsection id="HDCDD30F165B941BDAEAAC2394009A544"><enum>(b)</enum><header>Purpose of
offices</header><text>Each office established under subsection (a) shall ensure
that recipients of Federal financial assistance under Federal health programs
administer their programs, services, and activities in a manner that—</text>
<paragraph id="HEA8C11BE72A74B4894EAAACD94D0126B"><enum>(1)</enum><text>does not
discriminate, either intentionally or in effect, on the basis of race, national
origin, language, ethnicity, sex, age, disability, sexual orientation, and
gender identity; and</text>
</paragraph><paragraph id="H6C5E7D72754C4618B4E5A99BC70607BB"><enum>(2)</enum><text display-inline="yes-display-inline">promotes the reduction and elimination of
disparities in health and health care based on race, national origin, language,
ethnicity, sex, age, disability, sexual orientation, and gender
identity.</text>
</paragraph></subsection><subsection id="H9E656D611973476D8E1D5E0D82EE596E"><enum>(c)</enum><header>Powers and
duties</header><text>The offices established in subsection (a) shall have the
following powers and duties:</text>
<paragraph id="HA18966CCDA8548F6A48C8D8B6A704B7A"><enum>(1)</enum><text display-inline="yes-display-inline">The establishment of compliance and program
participation standards for recipients of Federal financial assistance under
each program administered by an agency within the Department of Health and
Human Services including the establishment of disparity reduction standards to
encompass disparities in health and health care related to race, national
origin, language, ethnicity, sex, age, disability, sexual orientation, and
gender identity.</text>
</paragraph><paragraph id="H1BA5F3490158401684A2D33A6C3208EC"><enum>(2)</enum><text>The development
and implementation of program-specific guidelines that interpret and apply
Department of Health and Human Services guidance under title VI of the
<act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name> and section
1557 of the Patient Protection and Affordable Care Act to each Federal health
program administered by the agency.</text>
</paragraph><paragraph id="H23DC730AB49E4E3BB06F9B1A0096C092"><enum>(3)</enum><text>The development of
a disparity-reduction impact analysis methodology that shall be applied to
every rule issued by the agency and published as part of the formal rulemaking
process under sections 555, 556, and 557 of title 5, United States Code.</text>
</paragraph><paragraph id="H59CC857903A741A6A20889EB1A4265EE"><enum>(4)</enum><text>Oversight of data
collection, analysis, and publication requirements for all recipients of
Federal financial assistance under each Federal health program administered by
the agency, and compliance with the 1997 Office of Management and Budget
Standards for Maintaining, Collecting, and Presenting Federal Data on Race and
Ethnicity and the available language standards.</text>
</paragraph><paragraph id="HC7C38A0A014A4030B9D08FA0C28D2D80"><enum>(5)</enum><text>The conduct of
publicly available studies regarding discrimination within Federal health
programs administered by the agency as well as disparity reduction initiatives
by recipients of Federal financial assistance under Federal health
programs.</text>
</paragraph><paragraph id="H0C1284922EDE4875934FC990FD64DCB3"><enum>(6)</enum><text>Annual reports to
the Committee on Health, Education, Labor, and Pensions and the Committee on
Finance of the Senate and the Committee on Energy and Commerce and the
Committee on Ways and Means of the House of Representatives on the progress in
reducing disparities in health and health care through the Federal programs
administered by the agency.</text>
</paragraph></subsection><subsection id="H6A4AAE5042F34BEDA769662C7E12A72E"><enum>(d)</enum><header>Relationship to
Office for Civil Rights in the Department of Justice</header>
<paragraph id="H0E4F7FB2D46E4D3BA3D202FDED0FC06B"><enum>(1)</enum><header>Department of
Health and Human Services</header><text>The Office for Civil Rights in the
Department of Health and Human Services shall provide standard-setting and
compliance review investigation support services to the Civil Rights Compliance
Office for each agency.</text>
</paragraph><paragraph id="H646628E9BAE44322B18957CFE4D4297B"><enum>(2)</enum><header>Department of
Justice</header><text>The Office for Civil Rights in the Department of Justice
shall continue to maintain the power to institute formal proceedings when an
agency Office for Civil Rights determines that a recipient of Federal financial
assistance is not in compliance with the disparity reduction standards of the
agency.</text>
</paragraph></subsection><subsection id="H58613A7B886D453D80681042BEBAE196"><enum>(e)</enum><header>Definition</header><text>In
this section, the term <term>Federal health programs</term> mean
programs—</text>
<paragraph id="H5B572EFC45DA469C990B0A9A590034A8"><enum>(1)</enum><text>under the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 301 et
seq.) that pay for health care and services; and</text>
</paragraph><paragraph id="H18BCA9410C744D7DB0465A844643B74B"><enum>(2)</enum><text>under this Act
that provide Federal financial assistance for health care, biomedical research,
health services research, and programs designed to improve the public’s
health.</text>
</paragraph></subsection></section></subtitle><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HD25B41DE3B494E38AFCB32BD34593A80"><enum>904.</enum><header>United States
Commission on Civil Rights</header>
<subsection id="H002526E5804E42FEBA9DBB93285EDBE1"><enum>(a)</enum><header>Coordination
within Department of Justice of activities regarding Health
disparities</header><text>Section 3 of the Civil Rights Commission Act of 1983
(42 U.S.C. 1975a) is amended—</text>
<paragraph id="HCBBA6689D00E46C2B08E416606B519A9"><enum>(1)</enum><text>in paragraph (1),
by striking <quote>and</quote> at the end;</text>
</paragraph><paragraph id="HB48E28CF333D446197D22FF099676E4B"><enum>(2)</enum><text>in paragraph (2),
by striking the period at the end and inserting <quote>; and</quote>;
and</text>
</paragraph><paragraph id="H5BC4348F69944EEB852589EB8B0AF6D5"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block id="H3F853CFBE7E6456B8C255A65C8FEA73C">
<paragraph id="H39CB1A85A0604896BE8F87B5B3B21786"><enum>(3)</enum><text>shall, with
respect to activities carried out in health care and correctional facilities
toward the goal of eliminating health disparities between the general
population and members of racial or ethnic minority groups, coordinate such
activities of—</text>
<subparagraph id="H78D411182954416F8C0F935EDCF14F1B"><enum>(A)</enum><text>the Office for
Civil Rights within the Department of Justice;</text>
</subparagraph><subparagraph id="H355DF395AE3245C083E09F9DC92F3A0C"><enum>(B)</enum><text>the Office of
Justice Programs within the Department of Justice;</text>
</subparagraph><subparagraph id="HFE97013127984713A4C385231D27EDD2"><enum>(C)</enum><text>the Office for
Civil Rights within the Department of Health and Human Services; and</text>
</subparagraph><subparagraph id="H2E234A9521204E10A42F217D11E082EA"><enum>(D)</enum><text>the Office of
Minority Health within the Department of Health and Human Services (headed by
the Deputy Assistant Secretary for Minority
Health).</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H402E08FAC2584A619FAD89EB1FABF404"><enum>(b)</enum><header>Authorization of
appropriations</header><text>Section 5 of the Civil Rights Commission Act of
1983 (42 U.S.C. 1975c) is amended by striking the first sentence and inserting
the following: <quote>For the purpose of carrying out this Act, there are
authorized to be appropriated $30,000,000 for fiscal year 2012, and such sums
as may be necessary for each of the fiscal years 2013 through
2017.</quote>.</text>
</subsection></section><section id="H634E48C605784818ABA41DAFE446E67D"><enum>905.</enum><header>Sense of
Congress concerning full funding of activities to eliminate racial and ethnic
health disparities</header>
<subsection id="H985D5275E2E148ED99797460C2C746F6"><enum>(a)</enum><header>Findings</header><text>Congress
makes the following findings:</text>
<paragraph id="H68070BA063DC4805A3F0E8EBFB1D950B"><enum>(1)</enum><text>The health status
of the American populace is declining and the United States currently ranks
below most industrialized nations in health status measured by longevity,
sickness, and mortality.</text>
</paragraph><paragraph id="HFE93AF4EBFDF42C9AC4A49C54034D60E"><enum>(2)</enum><text>Racial and ethnic
minority populations tend have the poorest health status and face substantial
cultural, social, and economic barriers to obtaining quality health
care.</text>
</paragraph><paragraph id="H957559F4965145BEA15A38DA38CAFCEA"><enum>(3)</enum><text>Efforts to improve
minority health have been limited by inadequate resources (funding, staffing,
and stewardship) and accountability.</text>
</paragraph></subsection><subsection id="H285049ABBED54DD68B5F335567CFFE8D"><enum>(b)</enum><header>Sense of
Congress</header><text display-inline="yes-display-inline">It is the sense of
Congress that—</text>
<paragraph id="H3FACDF1164804ADBB7ECB2EAE0BB9FAF"><enum>(1)</enum><text>funding should be
doubled by fiscal year 2013 for the National Institute for Minority Health
Disparities, the Office of Civil Rights in the Department of Health and Human
Services, the National Institute of Nursing Research, and the Office of
Minority Health;</text>
</paragraph><paragraph id="HEFF02CDD6706491D943ADA408F5245F6"><enum>(2)</enum><text>adequate funding
by fiscal year 2013, and subsequent funding increases, should be provided for
health professions training programs, the Racial and Ethnic Approaches to
Community Health (REACH) at the Centers for Disease Control and Prevention, the
Minority HIV/AIDS Initiative, and the Excellence Centers to Eliminate
Ethnic/Racial Disparities (EXCEED) Program at the Agency for Healthcare
Research and Quality;</text>
</paragraph><paragraph id="H812D60352B1C46F4895995D96872C4F6"><enum>(3)</enum><text>funding should be
restored to the Racial and Ethnic Approaches to Community Health (REACH)
program at the Centers for Disease Control and Prevention, which has been a
successful program at the community health level;</text>
</paragraph><paragraph id="H909F0AA7BD83417CA26A18ABCBFACF94"><enum>(4)</enum><text>current and newly
created health disparity elimination incentives, programs, agencies, and
departments under this Act (and the amendments made by this Act) should receive
adequate staffing and funding by fiscal year 2013; and</text>
</paragraph><paragraph id="H8B9E233C6D8E4726939657AA4D820645"><enum>(5)</enum><text>stewardship and
accountability should be provided to the Congress and the President for
measurable and sustainable progress toward health disparity elimination.</text>
</paragraph></subsection></section><section id="HDE47367EF06548868BA867AB22777635" section-type="subsequent-section"><enum>906.</enum><header>GAO and NIH
reports</header>
<subsection id="HBD0DAD899C3349689FA0D62AA7B39BCB"><enum>(a)</enum><header>GAO report on
NIH grant racial and ethnic diversity</header>
<paragraph id="H9CCAFF407DF84BF4812380AE4C609F4F"><enum>(1)</enum><header>In
general</header><text>The Comptroller General of the United States shall
conduct a study on the racial and ethnic diversity among the following
groups:</text>
<subparagraph id="H70DCF49DFCE14BBAA5AB2C2E82162E9B"><enum>(A)</enum><text>All applicants for
grants, contracts, and cooperative agreements awarded by the National
Institutes of Health during the period beginning January 1, 1990, and ending
December 31, 2011.</text>
</subparagraph><subparagraph id="HD9FDC16EFC8C4E2FAFEFEFFD5F64AFE5"><enum>(B)</enum><text>All recipients of
such grants, contracts, and cooperative agreements.</text>
</subparagraph><subparagraph id="H0DB0A4369C3C46C48E42EE4BDEFE2DFB"><enum>(C)</enum><text>All members of the
peer review panels of such applicants and recipients, respectively.</text>
</subparagraph></paragraph><paragraph id="HC89B0614432846F191AB8B4CE832FF94"><enum>(2)</enum><header>Report</header><text>Not
later than six months after the date of the enactment of this Act, the
Comptroller General shall complete the study under paragraph (1) and submit to
Congress a report containing the results of such study.</text>
</paragraph></subsection><subsection id="H2962A066399E442D96A7B1766CB94344"><enum>(b)</enum><header>NIH report on
certain authority of National Institute on Minority Health and Health
Disparities</header><text>Not later than six months after the date of the
enactment of this Act, and biennially thereafter, the Director of the National
Institutes of Health, in collaboration with the Director of the National
Institute on Minority Health and Health Disparities, shall submit to Congress a
report that details and evaluates—</text>
<paragraph id="H5F55519B597E46ED88A0DD9621FF6726"><enum>(1)</enum><text>the steps taken
during the applicable report period by the Director of the National Institutes
of Health to enforce the expanded planning, coordination, review, and
evaluation authority provided the National Institute on Minority Health and
Health Disparities under section 464z–3(h) of the Public Health Service Act (42
U.S.C. 285(h)), as added by section 10334(c) of the Patient Protection and
Affordable Care Act, over all minority health and health disparity research
that is conducted or supported by the Institutes and Centers at the National
Institutes of Health; and</text>
</paragraph><paragraph id="H8AB40B1171864115865B66A2CE5D1593"><enum>(2)</enum><text>the outcomes of
such steps.</text>
</paragraph></subsection><subsection id="HF85307783D274B83831640FD5FD3C896"><enum>(c)</enum><header>GAO report
related to recipients of PPACA funding</header><text>Not later than one year
after the date of the enactment of this Act and biennially thereafter until
2020, the Comptroller General of the United States shall submit to Congress a
report that identifies, with respect to minority community-based organizations
that applied during the applicable report period for Federal funding provided
pursuant to the provisions of (and amendments made by) the Patient Protection
and Affordable Care Act for purposes of achieving health equity and eliminating
health disparities, the percentage of such organizations that were awarded such
funding.</text>
</subsection><subsection id="H5E1E061DDD44454CB856805614473E99"><enum>(d)</enum><header>Annual report on
activities of National Institute on Minority Health and Health
Disparities</header><text display-inline="yes-display-inline">The Director of
the National Institute on Minority Health and Health Disparities shall prepare
an annual report on the activities carried out or to be carried out by the
Institute, and shall submit each such report to the Committee on Health,
Education, Labor, and Pensions of the Senate, the Committee on Energy and
Commerce of the House of Representatives, the Secretary of Health and Human
Services, and the Director of the National Institutes of Health. With respect
to the fiscal year involved, the report shall—</text>
<paragraph id="H8BCE4CD4925346029B3C77A25ECFAD5E"><enum>(1)</enum><text>describe and
evaluate the progress made in health disparities research conducted or
supported by institutes and centers of the National Institutes of
Health;</text>
</paragraph><paragraph id="HD9BA9AB3BE674A76A9D26F23C8281D7E"><enum>(2)</enum><text>summarize and
analyze expenditures made for activities with respect to health disparities
research conducted or supported by the National Institutes of Health;</text>
</paragraph><paragraph id="HCAC645FBC52B482FA40B83D9CACD7D32"><enum>(3)</enum><text>include a separate
statement applying the requirements of paragraphs (1) and (2) specifically to
minority health disparities research; and</text>
</paragraph><paragraph id="H75A68C298E5C4A2498D956E00256DD8E"><enum>(4)</enum><text>contain such
recommendations as the Director of the Institute considers appropriate.</text>
</paragraph></subsection></section><enum>X</enum><header>Addressing Social
Determinants and Improving Environmental Justice</header>
<section id="H320EF4F8728A4F049E95676D4D9266EB"><enum>1001.</enum><header>Codification
of Executive Order 12898</header>
<subsection id="H2C927F58CD234F87B4B5F46607D650A8"><enum>(a)</enum><header>In
general</header><text>The President of the United States is authorized and
directed to execute, administer, and enforce as a matter of Federal law the
provisions of Executive Order 12898, dated February 11, 1994 (<term>Federal
Actions To Address Environmental Justice In Minority Populations and Low-Income
Populations</term>), with such modifications as are provided in this
section.</text>
</subsection><subsection id="H822022C810124EAF881875712ED51CC3"><enum>(b)</enum><header>Definition of
environmental justice</header><text>For purposes of carrying out the provisions
of Executive Order 12898, the following definitions shall apply:</text>
<paragraph id="HC3951927A7C54A7289C5A46C79BBF115"><enum>(1)</enum><text>The term
<term>environmental justice</term> means the fair treatment and meaningful
involvement of all people regardless of race, color, national origin,
educational level, or income with respect to the development, implementation,
and enforcement of environmental laws and regulations in order to ensure
that—</text>
<subparagraph id="HC53CA4A0EDC04902B6444D99A4788C5B"><enum>(A)</enum><text>minority and
low-income communities have access to public information relating to human
health and environmental planning, regulations, and enforcement; and</text>
</subparagraph><subparagraph id="HAA8F8B78DD92494487F113AC9A79E049"><enum>(B)</enum><text>no minority or
low-income population is forced to shoulder a disproportionate burden of the
negative human health and environmental impacts of pollution or other
environmental hazard.</text>
</subparagraph></paragraph><paragraph id="H19AB038A4F00406EA34DA8D50A2159F8"><enum>(2)</enum><text>The term
<term>fair treatment</term> means policies and practices that ensure that no
group of people, including racial, ethnic, or socioeconomic groups bear
disproportionately high and adverse human health or environmental effects
resulting from Federal agency programs, policies, and activities.</text>
</paragraph></subsection><subsection id="H0AB389D1A9F24912834DDC6CBF4B9576"><enum>(c)</enum><header>Judicial review
and rights of action</header><text>The provisions of section 6–609 of Executive
Order 12898 shall not apply for purposes of this Act.</text>
</subsection></section><section id="H10260F69DD5F47F9924F98EF98B1BE20"><enum>1002.</enum><header>Implementation
of recommendations by Environmental Protection Agency</header>
<subsection id="H2F584335549C4C7AB98A9BAC152900D1"><enum>(a)</enum><header>Inspector
general recommendations</header><text>The Administrator of the Environmental
Protection Agency shall, as promptly as practicable, carry out each of the
following recommendations of the Inspector General of the agency as set forth
in Report No. 2006–P–00034 entitled <quote>EPA needs to conduct environmental
justice reviews of its programs, policies and activities</quote>:</text>
<paragraph id="HCA6FB4123ED14959A8CDA8C9FD4BA423"><enum>(1)</enum><text>The recommendation
that the Agency’s program and regional offices identify which programs,
policies, and activities need environmental justice reviews and require these
offices to establish a plan to complete the necessary reviews.</text>
</paragraph><paragraph id="HEA274A0D87BB446987257177A4917392"><enum>(2)</enum><text>The recommendation
that the Administrator of the Agency ensure that these reviews determine
whether the programs, policies, and activities may have a disproportionately
high and adverse health or environmental impact on minority and low-income
populations.</text>
</paragraph><paragraph id="H7EFF307A79974E30B455DDE479D1054A"><enum>(3)</enum><text>The recommendation
that each program and regional office develop specific environmental justice
review guidance for conducting environmental justice reviews.</text>
</paragraph><paragraph id="HB96FDED5AF25495CA40BD6A6BE0EED65"><enum>(4)</enum><text>The recommendation
that the Administrator designate a responsible office to compile results of
environmental justice reviews and recommend appropriate actions.</text>
</paragraph></subsection><subsection id="H03C7C3F1727B49A69984D91AE319C8C3"><enum>(b)</enum><header>GAO
recommendations</header><text>In developing rules under laws administered by
the Environmental Protection Agency, the Administrator of the Agency shall, as
promptly as practicable, carry out each of the following recommendations of the
Comptroller General of the United States as set forth in GAO Report numbered
GAO–05–289 entitled <quote>EPA Should Devote More Attention to Environmental
Justice when Developing Clean Air Rules</quote>:</text>
<paragraph id="H7B4D901A74BB4BC48F22D10AD75D263D"><enum>(1)</enum><text>The recommendation
that the Administrator ensure that workgroups involved in developing a rule
devote attention to environmental justice while drafting and finalizing the
rule.</text>
</paragraph><paragraph id="HD694A32B719E4F83B8DE2FDF11B5FA43"><enum>(2)</enum><text>The recommendation
that the Administrator enhance the ability of such workgroups to identify
potential environmental justice issues through such steps as providing
workgroup members with guidance and training to helping them identify potential
environmental justice problems and involving environmental justice coordinators
in the workgroups when appropriate.</text>
</paragraph><paragraph id="H3E22306EC6394B4EBD86B3747055E8E4"><enum>(3)</enum><text>The recommendation
that the Administrator improve assessments of potential environmental justice
impacts in economic reviews by identifying the data and developing the modeling
techniques needed to assess such impacts.</text>
</paragraph><paragraph id="HDF8CC7ABE69C412EB72976F580EB18ED"><enum>(4)</enum><text>The recommendation
that the Administrator direct appropriate Agency officers and employees to
respond fully when feasible to public comments on environmental justice,
including improving the Agency’s explanation of the basis for its conclusions,
together with supporting data.</text>
</paragraph></subsection><subsection id="H5895E5C0A8E9438CB142D85B7AF24B20"><enum>(c)</enum><header>2004 inspector
general report</header><text>The Administrator of the Environmental Protection
Agency shall, as promptly as practicable, carry out each of the following
recommendations of the Inspector General of the Agency as set forth in the
report entitled <quote>EPA Needs to Consistently Implement the Intent of the
Executive Order on Environmental Justice</quote> (Report No.
2004–P–00007):</text>
<paragraph id="HFF7BFBDB0D4F449F9F5CAD8F7CF6B06C"><enum>(1)</enum><text>The recommendation
that the Agency clearly define the mission of the Office of Environmental
Justice (OEJ) and provide Agency staff with an understanding of the roles and
responsibilities of the Office.</text>
</paragraph><paragraph id="H3D7363068893429CB16D0B94E1A8F189"><enum>(2)</enum><text>The recommendation
that the Agency establish (through issuing guidance or a policy statement from
the Administrator) specific time frames for the development of definitions,
goals, and measurements regarding environmental justice and provide the regions
and program offices a standard and consistent definition for a minority and
low-income community, with instructions on how the Agency will implement and
operationalize environmental justice into the Agency’s daily activities.</text>
</paragraph><paragraph id="HC6180B45D09E485ABE9F66C8BDD97941"><enum>(3)</enum><text>The recommendation
that the Agency ensure the comprehensive training program currently under
development includes standard and consistent definitions of the key
environmental justice concepts (such as <term>low-income</term>,
<term>minority</term>, and <term>disproportionately impacted</term>) and
instructions for implementation of those concepts.</text>
</paragraph><continuation-text continuation-text-level="subsection">The
Administrator shall submit an initial report to Congress within 6 months after
the enactment of this Act regarding the Administrator’s strategy for
implementing the recommendations referred to in paragraphs (1), (2), and (3).
Thereafter, the Administrator shall provide semiannual reports to Congress
regarding the Administrator’s progress in implementing such recommendations and
modifying the Administrator’s emergency management procedures to incorporate
environmental justice in the Agency’s Incident Command Structure (in accordance
with the December 18, 2006, letter from the Deputy Administrator to the Acting
Inspector General of the Agency).</continuation-text></subsection><subsection id="HC08B22EA719F410295CEEB7A6C379D37"><enum>(d)</enum><header>Federal action
plan for saving lives, protecting people and their families from radon</header>
<paragraph id="H1488D7978A0C4D659F6ECBEC61EA3F86"><enum>(1)</enum><header>In
general</header><text>Because radon is a naturally occurring radioactive gas
that is recognized as the leading cause of lung cancer among nonsmokers and is
a particular environmental threat for low-income and minority individuals
because of the lack of information about radon levels in their own homes, the
Administrator of the Environmental Protection Agency shall within 6 months
after the date of the enactment of this Act, implement the action plan entitled
<quote>Protecting People and Families from Radon: A Federal Action Plan for
Saving Lives</quote> (June 20, 2011), working with the Secretary of Health and
Human Services acting through the Director of the Centers for Disease Control
and Prevention, and with the other Federal agencies mentioned in and as set
forth in the action plan.</text>
</paragraph><paragraph id="H7308D9DAE4A840FBB3218B419D618F6C"><enum>(2)</enum><header>Specific
steps</header><text>In carrying out paragraph (1), the Administrator shall take
steps to achieve each of the following:</text>
<subparagraph id="HDEA13A5A3FCA42FA85ED1909EF3ED3F7"><enum>(A)</enum><text>The recommendation
that the workgroup comprised of the Federal agencies participating in the
development of the action plan referred to in paragraph (1) implement specific
steps within the current authority and activities of each Federal agency to
reduce exposure to radon.</text>
</subparagraph><subparagraph id="HACCF739D27B54B8897B34C4D585A19AA"><enum>(B)</enum><text display-inline="yes-display-inline">The recommendation that such workgroup meet
on the 1-year anniversary of the plan to assess and recognize achievements of
the plan.</text>
</subparagraph></paragraph><paragraph id="H0665303E1E44434BB25C219B9D95527B"><enum>(3)</enum><header>Report</header><text>The
Administrator shall report to the Congress on the 1-year assessment of the
plan’s implementation, including the challenges remaining and the progress in
reducing radon exposure particularly to low-income and minority
families.</text>
</paragraph></subsection></section><section id="H365E3A94DA2F440D908CC976796D10C5"><enum>1003.</enum><header>Grant
program</header>
<subsection id="H492EB7CA7E7741B99AC19C9BE1803BAD"><enum>(a)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H0E658F588C494CCEB80011A794781905"><enum>(1)</enum><header>Director</header><text>The
term <term>Director</term> means the Director of the Centers for Disease
Control and Prevention, acting in collaboration with the Administrator of the
Environmental Protection Agency and the Director of the National Institute of
Environmental Health Sciences.</text>
</paragraph><paragraph id="H719B199FA4354F36B8125DC296ADFEE5"><enum>(2)</enum><header>Eligible
entity</header><text>The term <term>eligible entity</term> means a State or
local community that—</text>
<subparagraph id="H3531D5CF118248AD9BB6B68F33FFEDB0"><enum>(A)</enum><text>bears a
disproportionate burden of exposure to environmental health hazards;</text>
</subparagraph><subparagraph id="H8D18038FB305422DB42E7DC9E1805EE6"><enum>(B)</enum><text>has established a
coalition—</text>
<clause id="H2107FE3022024BABBB43AE2AD4B6D53B"><enum>(i)</enum><text>with
not less than 1 community-based organization; and</text>
</clause><clause id="H2030C595B8994591BF1E5D8D614CBA96"><enum>(ii)</enum><text>with not less
than 1—</text>
<subclause id="H09263BA3F2744C5AB8A387FDF7DF5149"><enum>(I)</enum><text>public health
entity;</text>
</subclause><subclause id="H0764EC0F37064469BA84601D178B2B8B"><enum>(II)</enum><text>health care
provider organization; or</text>
</subclause><subclause id="HAF1D506657EE4239A0D0C0DE6955EF3C"><enum>(III)</enum><text>academic
institution, including any minority-serving institution (including an
Hispanic-serving institution, a historically Black college or university, and a
tribal college or university);</text>
</subclause></clause></subparagraph><subparagraph id="H643984DC93024951A984268B9CCE49B1"><enum>(C)</enum><text>ensures planned
activities and funding streams are coordinated to improve community health;
and</text>
</subparagraph><subparagraph id="H1E2644B7B9EA4B79A761F37E22C2B040"><enum>(D)</enum><text>submits an
application in accordance with subsection (c).</text>
</subparagraph></paragraph></subsection><subsection id="HE4FDC7A26E9D4F3A9AB79B773F0EF7C4"><enum>(b)</enum><header>Establishment</header><text>The
Director shall establish a grant program under which eligible entities shall
receive grants to conduct environmental health improvement activities.</text>
</subsection><subsection id="H649CB1A50C854A71B6E6325D8B40B560"><enum>(c)</enum><header>Application</header><text>To
receive a grant under this section, an eligible entity shall submit an
application to the Director at such time, in such manner, and accompanied by
such information as the Director may require.</text>
</subsection><subsection id="H1F930A87F4AC439B978663B991274F88"><enum>(d)</enum><header>Cooperative
agreements</header><text>An eligible entity may use a grant under this
section—</text>
<paragraph id="H2D7ECF5F4CAE4F0F9075B4A2229CBAF6"><enum>(1)</enum><text>to promote
environmental health; and</text>
</paragraph><paragraph id="H70DD55B61AE748CF8D4A22101BA7F7AB"><enum>(2)</enum><text>to address
environmental health disparities.</text>
</paragraph></subsection><subsection id="H787AA8E64D494362816E4309DB6455EC"><enum>(e)</enum><header>Amount of
cooperative agreement</header>
<paragraph id="H3F2C5B5FB90046648695909A2BABB4A1"><enum>(1)</enum><header>In
general</header><text>The Director shall award grants to eligible entities at
the 2 different funding levels described in this subsection.</text>
</paragraph><paragraph id="HC942221425744E66A356A7D6C753D323"><enum>(2)</enum><header>Level 1
cooperative agreements</header>
<subparagraph id="H87E4C31EE6AF41F79C8B09B9920FC0E8"><enum>(A)</enum><header>In
general</header><text>An eligible entity awarded a grant under this paragraph
shall use the funds to identify environmental health problems and solutions
by—</text>
<clause id="HAA5BB0F27AC64BEFAA6D90E38A85EB65"><enum>(i)</enum><text>establishing a
planning and prioritizing council in accordance with subparagraph (B);
and</text>
</clause><clause id="H3099838F39E74F1E833066E4420397F7"><enum>(ii)</enum><text>conducting an
environmental health assessment in accordance with subparagraph (C).</text>
</clause></subparagraph><subparagraph id="HD753C1E063F34F3EBB80F30384D9D4FE"><enum>(B)</enum><header>Planning and
prioritizing council</header>
<clause id="H8D092D1271F2419CA32B2D41448702BF"><enum>(i)</enum><header>In
general</header><text>A prioritizing and planning council established under
subparagraph (A)(i) (referred to in this paragraph as a <term>PPC</term>) shall
assist the environmental health assessment process and environmental health
promotion activities of the eligible entity.</text>
</clause><clause id="H7C0916233B82409889791B36AA8E18D8"><enum>(ii)</enum><header>Membership</header><text>Membership
of a PPC shall consist of representatives from various organizations within
public health, planning, development, and environmental services and shall
include stakeholders from vulnerable groups such as children, the elderly,
disabled, and minority ethnic groups that are often not actively involved in
democratic or decisionmaking processes.</text>
</clause><clause id="H328054B7F35942F2873CAB4AD7AE1ACA"><enum>(iii)</enum><header>Duties</header><text>A
PPC shall—</text>
<subclause id="HE6400F0D61084928B4FE9A90F1D74AC4"><enum>(I)</enum><text>identify key
stakeholders and engage and coordinate potential partners in the planning
process;</text>
</subclause><subclause id="HD6248B64E6644B37BC80C203C1A97A0B"><enum>(II)</enum><text>establish a
formal advisory group to plan for the establishment of services;</text>
</subclause><subclause id="HCAC7F38300034FE18BD189A9F50928EC"><enum>(III)</enum><text>conduct an
in-depth review of the nature and extent of the need for an environmental
health assessment, including a local epidemiological profile, an evaluation of
the service provider capacity of the community, and a profile of any target
populations; and</text>
</subclause><subclause id="H08860D2C96DC4060A3EE44AE1780AF6C"><enum>(IV)</enum><text>define the
components of care and form essential programmatic linkages with related
providers in the community.</text>
</subclause></clause></subparagraph><subparagraph id="H746141DAA217475B8714F95C8FA53A22"><enum>(C)</enum><header>Environmental
health assessment</header>
<clause id="H08FF4D7D70CA40258CD9F9E4B5F8AD23"><enum>(i)</enum><header>In
general</header><text>A PPC shall carry out an environmental health assessment
to identify environmental health concerns.</text>
</clause><clause id="H5961C4A161484CF39BD15160CB5B2A64"><enum>(ii)</enum><header>Assessment
process</header><text>The PPC shall—</text>
<subclause id="HF1E112ABD83C45EDAACA9323D86C0FAA"><enum>(I)</enum><text>define the goals
of the assessment;</text>
</subclause><subclause id="H71913CDFF6224CA3B034FBBAB444827E"><enum>(II)</enum><text>generate the
environmental health issue list;</text>
</subclause><subclause id="H38AB7A2EFE0D47D5A64C15E7E46453FB"><enum>(III)</enum><text>analyze issues
with a systems framework;</text>
</subclause><subclause id="HD6F1F37D4A704C56ABA751308F5AB961"><enum>(IV)</enum><text>develop
appropriate community environmental health indicators;</text>
</subclause><subclause id="H875283539C4D48108DC01B335AE924C7"><enum>(V)</enum><text>rank the
environmental health issues;</text>
</subclause><subclause id="H4F05D47C9A034CB295BFF5957E0BE142"><enum>(VI)</enum><text>set priorities
for action;</text>
</subclause><subclause id="H79FB524EDE954C4C8D02BDF3C9D78CF6"><enum>(VII)</enum><text>develop an
action plan;</text>
</subclause><subclause id="HECC5D3A2C0A747858C0A2F61C1440DD3"><enum>(VIII)</enum><text>implement the
plan; and</text>
</subclause><subclause id="H8D6C0327F4C74B6E99674EA0D6D611EA"><enum>(IX)</enum><text>evaluate progress
and planning for the future.</text>
</subclause></clause></subparagraph><subparagraph id="H058DFA470CD84A6D9BFB1C53B300CD47"><enum>(D)</enum><header>Evaluation</header><text>Each
eligible entity that receives a grant under this paragraph shall evaluate,
report, and disseminate program findings and outcomes.</text>
</subparagraph><subparagraph id="H1BD18E487522422884FFC026B7B15470"><enum>(E)</enum><header>Technical
assistance</header><text>The Director may provide such technical and other
non-financial assistance to eligible entities as the Director determines to be
necessary.</text>
</subparagraph></paragraph><paragraph id="HB547DB5528684BFC975543BD053BE7AC"><enum>(3)</enum><header>Level 2
cooperative agreements</header>
<subparagraph id="HAE66ED90FB09496D806230F38A382043"><enum>(A)</enum><header>Eligibility</header>
<clause id="H9BE23FB19E8C4BE9B0D22EACAA381C59"><enum>(i)</enum><header>In
general</header><text>The Director shall award grants under this paragraph to
eligible entities that have already—</text>
<subclause id="H866832CAAEC642F6958804CD16F24954"><enum>(I)</enum><text>established
broad-based collaborative partnerships; and</text>
</subclause><subclause id="H00E913960F5F4EAE9DA1D4A9263AE4ED"><enum>(II)</enum><text>completed
environmental assessments.</text>
</subclause></clause><clause id="H537A406C9D914EC6931F1CAD65807772"><enum>(ii)</enum><header>No level 1
requirement</header><text>To be eligible to receive a grant under this
paragraph, an eligible entity is not required to have successfully completed a
Level 1 Cooperative Agreement (as described in paragraph (2)).</text>
</clause></subparagraph><subparagraph id="HBFD995E6D9784504BD4F083CBFF090BE"><enum>(B)</enum><header>Use of grant
funds</header><text>An eligible entity awarded a grant under this paragraph
shall use the funds to further activities to carry out environmental health
improvement activities, including—</text>
<clause id="HE46527237CF340C39531B0D2E0A215FF"><enum>(i)</enum><text>addressing
community environmental health priorities in accordance with paragraph
(2)(C)(ii), including—</text>
<subclause id="H789A5AAC16FD40BE85AC107FFFA00F56"><enum>(I)</enum><text>air
quality;</text>
</subclause><subclause id="H6A8F3C6A307847C6A07272A773B3457E"><enum>(II)</enum><text>water
quality;</text>
</subclause><subclause id="HEDEDC4A3E7794BDA8BE720922DF5B4AB"><enum>(III)</enum><text>solid
waste;</text>
</subclause><subclause id="HFF0FCF2C2EFC4EDABD4FC0C963E0BFF8"><enum>(IV)</enum><text>land use;</text>
</subclause><subclause id="H670A41F5A25E4FCDB68DFF5773D41850"><enum>(V)</enum><text>housing;</text>
</subclause><subclause id="H19E70E1F76BC4770B8EF440C7D43DDD9"><enum>(VI)</enum><text>food
safety;</text>
</subclause><subclause id="H1D68E77273994C5E8233EA521D7DFE38"><enum>(VII)</enum><text>crime;</text>
</subclause><subclause id="HDD1EB85AEE4242608E867AF9BB6E98DF"><enum>(VIII)</enum><text>injuries;
and</text>
</subclause><subclause id="H0160767C0C1D4E4D9A75142F96203608"><enum>(IX)</enum><text>health care
services;</text>
</subclause></clause><clause id="H57228D5C1BF94D2D894A553AEDC9C79D"><enum>(ii)</enum><text>building
partnerships between planning, public health, and other sectors, to address how
the built environment impacts food availability and access and physical
activity to promote healthy behaviors and lifestyles and reduce overweight and
obesity, asthma, respiratory conditions, dental, oral and mental health
conditions, poverty, and related co-morbidities;</text>
</clause><clause id="H818E51C37F684E4DA498EA2BF5FFE496"><enum>(iii)</enum><text>establishing
programs to address—</text>
<subclause id="H83C8B14CD8BF4A67BB0F5084C689A460"><enum>(I)</enum><text>how environmental
and social conditions of work and living choices influence physical activity
and dietary intake; or</text>
</subclause><subclause id="H12A392762BA8449E85F568F6793AF62D"><enum>(II)</enum><text>how those
conditions influence the concerns and needs of people who have impaired
mobility and use assistance devices, including wheelchairs and lower limb
prostheses; and</text>
</subclause></clause><clause id="H8DDC3D8E60DB438792D1C5CC78A8F249"><enum>(iv)</enum><text>convening
intervention programs that examine the role of the social environment in
connection with the physical and chemical environment in—</text>
<subclause id="HBBCA6CA397C64FA9AA32207B601F4F46"><enum>(I)</enum><text>determining access
to nutritional food; and</text>
</subclause><subclause id="HA06F34766D0A4CB5AB5F989958AD836E"><enum>(II)</enum><text>improving
physical activity to reduce morbidity and increase quality of life.</text>
</subclause></clause></subparagraph></paragraph></subsection><subsection id="H9E4FBFF201DF47AD91F3DFDDE0C8B56D"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section—</text>
<paragraph id="HFD9E237351154F38B92DDC342DFAB0D1"><enum>(1)</enum><text>$25,000,000 for
fiscal year 2012; and</text>
</paragraph><paragraph id="HAEDAC19692DD46AB9DF0382F2558A597"><enum>(2)</enum><text>such sums as may
be necessary for fiscal years 2013 through 2016.</text>
</paragraph></subsection></section><section id="HCB40FF7EC51041D3AEDE05BCD5F75387"><enum>1004.</enum><header>Additional
research on the relationship between the built environment and the health of
community residents</header>
<subsection id="H797F6410F06D46F5AAB974F12CDA6D0B"><enum>(a)</enum><header>Definition of
eligible institution</header><text>In this section, the term <term>eligible
institution</term> means a public or private nonprofit institution that submits
to the Secretary of Health and Human Services (in this section referred to as
the <term>Secretary</term>) and the Administrator of the Environmental
Protection Agency (in this section referred to as the
<term>Administrator</term>) an application for a grant under the grant program
authorized under subsection (b)(2) at such time, in such manner, and containing
such agreements, assurances, and information as the Secretary and Administrator
may require.</text>
</subsection><subsection id="H8134AF7FCC6A467782E31566F3D8B3F2"><enum>(b)</enum><header>Research grant
program</header>
<paragraph id="HE2D284F71B1D4C7A8D6A06030ECDA698"><enum>(1)</enum><header>Definition of
health</header><text>In this section, the term <term>health</term>
includes—</text>
<subparagraph id="H5EBD830ED8254446A745D4ABFCBE0764"><enum>(A)</enum><text>levels of physical
activity;</text>
</subparagraph><subparagraph id="HC0BEB7DE3E28405283A77AB75B2EE8FD"><enum>(B)</enum><text>consumption of
nutritional foods;</text>
</subparagraph><subparagraph id="H145A66F53EDE425E988E878CCFCAEF46"><enum>(C)</enum><text>rates of
crime;</text>
</subparagraph><subparagraph id="H347F080A9D734E8BA35A775E39D977CC"><enum>(D)</enum><text>air, water, and
soil quality;</text>
</subparagraph><subparagraph id="H8D9745498EA0428B8EDD700BD128C668"><enum>(E)</enum><text>risk of
injury;</text>
</subparagraph><subparagraph id="H2FB90192FFFB49A6830BD033FB216A9E"><enum>(F)</enum><text>accessibility to
health care services; and</text>
</subparagraph><subparagraph id="H4F788B82813D4893B2B05892946CAFDF"><enum>(G)</enum><text>other indicators
as determined appropriate by the Secretary.</text>
</subparagraph></paragraph><paragraph id="HC26DB341C15249459B78F9326A25152F"><enum>(2)</enum><header>Grants</header><text>The
Secretary, in collaboration with the Administrator, shall provide grants to
eligible institutions to conduct and coordinate research on the built
environment and its influence on individual and population-based health.</text>
</paragraph><paragraph id="H1E28BF97F7CA44A79000A4DBFE97ED59"><enum>(3)</enum><header>Research</header><text>The
Secretary shall support research that—</text>
<subparagraph id="H08C64F5635304063BDB0FE1F924C702E"><enum>(A)</enum><text>investigates and
defines the causal links between all aspects of the built environment and the
health of residents;</text>
</subparagraph><subparagraph id="HE272A6E1CF8C4C7B8867E3487D74560F"><enum>(B)</enum><text>examines—</text>
<clause id="H26C62C7F546E4518B27ECF19C38C7824"><enum>(i)</enum><text>the
extent of the impact of the built environment (including the various
characteristics of the built environment) on the health of residents;</text>
</clause><clause id="H2C8CF905E5F24EA184698C887B7B7658"><enum>(ii)</enum><text>the
variance in the health of residents by—</text>
<subclause id="H3B97E7FCFD1D4D8CAB6E8E7B26D477A2"><enum>(I)</enum><text>location (such as
inner cities, inner suburbs, and outer suburbs); and</text>
</subclause><subclause id="H57A67C372BE94381A89C06AD57C199B4"><enum>(II)</enum><text>population
subgroup (such as children, the elderly, the disadvantaged); or</text>
</subclause></clause><clause id="H2B508D68E0B14B6BB52FAA20815B83DB"><enum>(iii)</enum><text>the importance
of the built environment to the total health of residents, which is the primary
variable of interest from a public health perspective;</text>
</clause></subparagraph><subparagraph id="HD29AC03D4C104F67B377EFAA8F8B4B82"><enum>(C)</enum><text>is used to
develop—</text>
<clause id="HF5D8AD08C2E24CBCA6380BCA9A4D5B00"><enum>(i)</enum><text>measures to
address health and the connection of health to the built environment;
and</text>
</clause><clause id="H051E0395873F44ED9855EB6FE596CAD1"><enum>(ii)</enum><text>efforts to link
the measures to travel and health databases; and</text>
</clause></subparagraph><subparagraph id="H62644D0A734846328548E4C7F45A05EA"><enum>(D)</enum><text>distinguishes
carefully between personal attitudes and choices and external influences on
observed behavior to determine how much an observed association between the
built environment and the health of residents, versus the lifestyle preferences
of the people that choose to live in the neighborhood, reflects the physical
characteristics of the neighborhood; and</text>
</subparagraph><subparagraph id="H88B8BFCC852C413980A482BE79F5B7C2"><enum>(E)</enum><clause commented="no" display-inline="yes-display-inline" id="H8D6947517E3C4CBF9D556AA9A4421308"><enum>(i)</enum><text>identifies or develops
effective intervention strategies to promote better health among residents with
a focus on behavioral interventions and enhancements of the built environment
that promote increased use by residents; and</text>
</clause><clause id="HEC5B1A7FC0FC479280AA3102ED5C5FCB" indent="up1"><enum>(ii)</enum><text>in developing the intervention
strategies under clause (i), ensures that the intervention strategies will
reach out to high-risk populations, including racial and ethnic minorities and
low-income urban and rural communities.</text>
</clause></subparagraph></paragraph><paragraph id="H77FE162835484BB0AA953D4B07E3E53B"><enum>(4)</enum><header>Priority</header><text>In
providing assistance under the grant program authorized under paragraph (2),
the Secretary and the Administrator shall give priority to research that
incorporates—</text>
<subparagraph id="H7D2EB2774F194F27813544136FBA4084"><enum>(A)</enum><text>minority-serving
institutions as grantees;</text>
</subparagraph><subparagraph id="HA9AFD090FA7846789A38BE2C59C42197"><enum>(B)</enum><text>interdisciplinary
approaches; or</text>
</subparagraph><subparagraph id="HE4ACE0CA6D1E4B199DF9FF7DBF0198E7"><enum>(C)</enum><text>the expertise of
the public health, physical activity, urban planning, and transportation
research communities in the United States and abroad.</text>
</subparagraph></paragraph></subsection></section><section id="H1311D92B3ACB45398A0A394B8D31D705"><enum>1005.</enum><header> Environment
and public health restoration</header>
<subsection id="H4D6AF2E6665B43BA85C43C38C1FB0FFD"><enum>(a)</enum><header>Findings</header>
<paragraph id="H44C51048A38B4344908C8649970992A2"><enum>(1)</enum><header>General
findings</header><text>The Congress finds as follows:</text>
<subparagraph id="H3BD036A1D209496A93F6377A35C530B6"><enum>(A)</enum><text display-inline="yes-display-inline">As human beings, we share our environment
with a wide variety of habitats and ecosystems that nurture and sustain a
diversity of species.</text>
</subparagraph><subparagraph id="H86099CED0B314698B31EAB10149EBCAC"><enum>(B)</enum><text>The abundance of
natural resources in our environment forms the basis for our economy and has
greatly contributed to human development throughout history.</text>
</subparagraph><subparagraph id="H216BDC99FE1B4D31849316B2F0E07E22"><enum>(C)</enum><text>The accelerated
pace of human development over the last several hundred years has significantly
impacted our natural environment and its resources, the health and diversity of
plant and animal wildlife, the availability of critical habitats, the quality
of our air and our water, and our global climate.</text>
</subparagraph><subparagraph id="H1D25BD715D3A449DA6375780BBFBA4B1"><enum>(D)</enum><text>The intervention
of the Federal Government is necessary to minimize and mitigate human impact on
the environment for the benefit of public health, to maintain air quality and
water quality, to sustain the diversity of plants and animals, to combat global
climate change, and to protect the environment.</text>
</subparagraph><subparagraph id="H61A40F1BD1D246D4A6F711235BA501FE"><enum>(E)</enum><text>Laws and
regulations in the United States have been created and promulgated to minimize
and mitigate human impact on the environment for the benefit of public health,
to maintain air quality and water quality, to sustain wildlife, and to protect
the environment.</text>
</subparagraph><subparagraph id="HF3F0FEB1C8474B9A90E00182C6E47468"><enum>(F)</enum><text display-inline="yes-display-inline">Such laws include the Antiquities Act of
1906 (16 U.S.C. 431 et seq.) initiated by President Theodore Roosevelt to
create the national park system, the National Environmental Policy Act of 1969
(42 U.S.C. 4321 et seq.), the Clean Air Act (42 U.S.C. 7401 et seq.), the
Federal Water Pollution Control Act (33 U.S.C. 1251 et seq.), the Comprehensive
Environmental Response, Compensation, and Liability Act of 1980 (Public Law
96–510), the Endangered Species Act of 1973 (Public Law 93–205), and the
National Forest Management Act of 1976 (Public Law 94–588).</text>
</subparagraph><subparagraph id="H8012563435AB4B949F2CC03C9A0523EF"><enum>(G)</enum><text>Attempts to repeal
or weaken key environmental safeguards pose dangers to the public health, air
quality, water quality, wildlife, and the environment.</text>
</subparagraph></paragraph><paragraph id="H8EB8DAA97074422287803BE5AF6B3EEF"><enum>(2)</enum><header>Findings on
changes and proposed changes in law</header><text>The Congress finds that,
since 2001, the following changes and proposed changes to existing law or
regulations have negatively impacted or will negatively impact the environment
and public health:</text>
<subparagraph id="H00B4EBEE0DCC4780A6F7C2AD3A2E322F"><enum>(A)</enum><header>Clean
water</header>
<clause id="HB02D4523712D491C811595FC494053EF"><enum>(i)</enum><text>On
May 9, 2002, the Environmental Protection Agency (EPA) and the Army Corps of
Engineers put forth a final rule that reconciled regulations implementing
section 404 of the Federal Water Pollution Control Act by redefining the term
<term>fill material</term> and amending the definition of the term
<term>discharge of fill material</term>, reversing a 25-year-old regulation.
The new rule fails to restrict the dumping of hardrock mining waste,
construction debris, and other industrial wastes into rivers, streams, lakes,
and wetlands. The rule further allows destructive mountaintop removal coal
mining companies to dump waste into streams and lakes, polluting the
surrounding natural habitat and poisoning plants and animals that depend on
those water sources.</text>
</clause><clause id="HB73CB46CC7684E3B85935196356A9ECE"><enum>(ii)</enum><text display-inline="yes-display-inline">On February 12, 2003, the Environmental
Protection Agency published the rule <quote>National Pollutant Discharge
Elimination System Permit Regulation and Effluent Limitation Guidelines and
Standards for Concentrated Animal Feeding Operations</quote>, new livestock
waste regulations that aimed to control factory farm pollution but which would
severely undermine existing protections under the Federal Water Pollution
Control Act. This regulation allows large-scale animal factories to foul the
Nation’s waters with animal waste, allows livestock owners to draft their own
pollution-management plans and avoid ground water monitoring, legalizes the
discharge of contaminated runoff water rich in nitrogen, phosphorus, bacteria,
and metals, and ensures that large factory farms are not held liable for the
environmental damage they cause. In a 2005 Federal court decision
(<quote>Waterkeeper Alliance, et al. v. Enviromental Protection Agency</quote>,
399 F.3d 486 (2nd Cir. 2005)), major parts of the rule were upheld, others
vacated, and still others remanded back to the EPA. On November 20, 2008, the
Environmental Protection Agency published a revised final rule which undermines
environmental protection provisions by removing mandatory permitting
requirements and allowing large animal farms to self-certify the absence of
pollutant discharge activity.</text>
</clause><clause id="HD93D817270F540A09C3BD57617F6ED90"><enum>(iii)</enum><text>On
March 19, 2003, the Environmental Protection Agency published a new rule
regarding the Total Maximum Daily Load program of the Federal Water Pollution
Control Act that regulates the maximum amount of a particular pollutant that
can be present in a body of water and still meet water quality standards. The
new rule withdrew the existing regulation put forth on July 13, 2000, and
halted momentum in cleaning up polluted waterways throughout the Nation. By
abandoning the existing rule, the Environmental Protection Agency is
undermining the effectiveness of clean-up plans and is allowing States to avoid
cleaning polluted waters entirely by dropping them from their clean-up lists.
Waterways play a crucial role in the lives of the people of the United States
and are critical to the livelihood of fish and wildlife. The result of dropping
the July 2000 rule is that the restoration of polluted rivers, shorelines, and
lakes will be delayed, harming more fish and wildlife and worsening the quality
of drinking water.</text>
</clause><clause id="H9E26FC61D74E4BAF93061A826269A2B4"><enum>(iv)</enum><text>On
December 2, 2008, the Environmental Protection Agency and the Army Corps of
Engineers jointly issued a guidance document in the form of a legal memorandum,
titled <quote>Clean Water Act Jurisdiction Following the U.S. Supreme Court’s
Decision in Rapanos v. United States & Carabell v. United States</quote>.
This new guidance dictates enforcement actions under the Federal Water
Pollution Control Act and calls for a complicated <term>case-by-case</term>
analysis to determine jurisdiction for waterways that do not flow all year.
Such actions endanger small streams and wetlands that serve as important
habitats for aquatic life, which play a fundamental role in safeguarding
sources of clean drinking water and mitigate the risks and effects of floods
and droughts. Further, the definition provided therein for <term>waters of the
United States</term> is applicable to the Federal Water Pollution Control Act
as a whole, potentially affecting programs that control industrial pollution
and sewage levels, prevent oil spills, and set water quality standards for all
waters in the United States protected under the Federal Water Pollution Control
Act.</text>
</clause></subparagraph><subparagraph id="H8F42202A8C9145AE99386BB501F49F91"><enum>(B)</enum><header>Forests and land
management</header>
<clause id="HABE64F85B40B42E9B1C2870B5ADD621A"><enum>(i)</enum><text display-inline="yes-display-inline">On December 3, 2003, the President signed
into law the Healthy Forests Restoration Act of 2003 (Public Law 108–148; 16
U.S.C. 6501 et seq.). Although the law attempts to reduce the risk of
catastrophic forest fires, it provides a boon to timber companies by
accelerating the aggressive thinning of backcountry forests that are far from
at-risk communities. The law allows for increased logging of large,
fire-resistant trees that are not in close proximity of homes and communities;
it undermines critical protections for endangered species by exempting Federal
land management agencies from consulting with the United States Fish and
Wildlife Service before approving any action that could harm endangered plants
or wildlife; and it limits public participation by reducing the number of
environmental project reviews.</text>
</clause><clause id="HE09EB57207874E95B278B6AD497D4608"><enum>(ii)</enum><text>On
April 21, 2008, the Department of Agriculture issued a Final Planning Rule and
Record of Decision for National Forest System Land Management Planning. Similar
to rules enacted by the Administration on January 5, 2005, later remanded back
to the agency in Federal district court for violating the National
Environmental Policy Act of 1969, the Endangered Species Act of 1973, and the
Administrative Procedure Act (<quote>Citizens for Better Forestry v. United
States Department of Agriculture</quote>, 481 F. Supp. 2d 1059 (N.D. Cal.
2007)), this revised rule eliminates strict forest planning standards
established in 1982, and opens millions of acres of public lands to damaging
and invasive logging, mining, and drilling operations. These regulations would
reverse more than 20 years of protection for wildlife and national forests by
removing the overall goal of ensuring ecological sustainability in managing the
national forest system, weakening the National Forest Management Act of 1976,
and effectively ending the review of forest management plans under the National
Environmental Policy Act of 1969.</text>
</clause><clause id="HD12F882F70A6416DB32788B9F178449C"><enum>(iii)</enum><text display-inline="yes-display-inline">On September 20, 2006, the District Court
for the Northern District of California vacated the Protection of Inventoried
Roadless Areas rule, enacted on May 13, 2005, which gave State Governors 18
months to petition the Federal Government to either restore the previous rule
for their States, or submit a new management and development plan for national
forest areas inventoried under the rule. Despite the enjoinment of the
Administration’s 2005 rule, and the subsequent restoration of the original
Roadless Area Conservation Rule, the U.S. Forest Service has continued to allow
States to petition for a special rule under the authority of the Administrative
Procedure Act, publishing a final special rule for Idaho on October 16, 2008.
As a result, 58.5 million acres of wild national forests are still vulnerable
to logging, road building, and other developments that may fragment natural
habitats and negatively impact fish and wildlife.</text>
</clause><clause id="H0721A5B96D6E4F02B67B56722539D9F0"><enum>(iv)</enum><text display-inline="yes-display-inline">On November 17, 2008, the Department of the
Interior’s Bureau of Land Management (BLM) signed the Record of Decision (ROD)
amending 12 resource management plans in Colorado, Utah, and Wyoming, opening
2,000,000 acres of public lands to commercial tar sands and oil shale
exploration and development. On November 18, 2008, the BLM published a final
rule for Oil Shale Management setting the policies and procedures for a
commercial leasing program for the management of federally owned oil shale in
those three States. Previously barred by a congressional moratorium on the
commercial leasing regulations for oil shale until September 30, 2008, the
development of oil shale on public lands poses a serious threat to land
conservation, endangered and threatened species, and critical habitat. Domestic
shale oil production allowed by these regulations is highly water and energy
intensive, the impacts of which will intensify existing water scarcity in the
arid Western Region and potentially degrade air and water quality for
surrounding populations.</text>
</clause></subparagraph><subparagraph id="H88E12E2C0BFC461AAB2C6334912F45CD"><enum>(C)</enum><header>Scientific
review</header><text>On December 16, 2008, the United States Fish and Wildlife
Service of the Department of the Interior and the National Oceanic and
Atmospheric Administration of the Department of Commerce jointly issued a new
rule amending regulations governing interagency cooperation under section 7 of
the Endangered Species Act of 1973 (ESA). This rule undermines the intention of
the ESA to protect species and the ecosystems upon which they depend by
allowing Federal agencies to carry out, permit, or fund an action without
proper environmental review and expert third-party consultation from Federal
wildlife experts. Under this new rule, Federal agencies can unilaterally
circumvent the formal review process, eliminating longstanding and
scientifically grounded safeguards that serve to protect the biodiversity of
our Nation’s ecosystems and avert harm to thousands of endangered and
threatened species.</text>
</subparagraph></paragraph></subsection><subsection id="H101888505FEC44A19869C4C42056C167"><enum>(b)</enum><header>Statement of
policy</header><text>It is the policy of the United States Government to work
in conjunction with States, territories, tribal governments, international
organizations, and foreign governments in order to act as a steward of the
environment for the benefit of public health, to maintain air quality and water
quality, to sustain the diversity of plant and animal species, to combat global
climate change, and to protect the environment for future generations to
enjoy.</text>
</subsection><subsection id="H36D0A1329694422297207FF22DBD883D"><enum>(c)</enum><header>Study and report
on public health or environmental impact of revised rules, regulations, laws,
or proposed laws</header>
<paragraph id="HD02281ED5C4248148FE8E3AE8FAFB589"><enum>(1)</enum><header>Study</header><text>Not
later than 30 days after the date of enactment of this Act, the President shall
enter into an arrangement under which the National Academy of Sciences will
conduct a study to determine the impact on public health, air quality, water
quality, wildlife, and the environment of the following regulations, laws, and
proposed laws:</text>
<subparagraph id="HA46C9A0B78A947EB80E1C0453A2C3F48"><enum>(A)</enum><header>Clean
water</header>
<clause id="HEDDBFA6085D34806B28219133EF6443A"><enum>(i)</enum><text>Final revisions to
the Federal Water Pollution Control Act regulatory definitions of <term>fill
material</term> and <term>discharge of fill material</term>, finalized and
published in the Federal Register on May 9, 2002 (67 FR 31129), amending part
232 of title 40, Code of Federal Regulations.</text>
</clause><clause id="H2F9B3D2BE8A044A9AD0CCF81F5E55911"><enum>(ii)</enum><text display-inline="yes-display-inline">Revised National Pollutant Discharge
Elimination System Permit Regulation and Effluent Limitation Guidelines and
Standards for Concentrated Animal Feeding Operations in response to the
<quote>Waterkeeper Alliance, et al. v. Enviromental Protection Agency</quote>
decision, finalized and published in the Federal Register on November 20, 2008
(73 FR 225), amending parts 9, 122, and 412 of title 40, Code of Federal
Regulations.</text>
</clause><clause id="H6A452D3C944A4AC2968BF67083662D3D"><enum>(iii)</enum><text>A
March 19, 2003, rule published in the Federal Register (68 FR 13608)
withdrawing a July 13, 2000, rule revising the Total Maximum Daily Load program
of the Federal Water Pollution Control Act (65 FR 43586), amending parts 9,
122, 123, 124, and 130 of title 40, Code of Federal Regulations.</text>
</clause><clause id="HB2AB11C0B12F40A2970FBE828A335B51"><enum>(iv)</enum><text>Official Guidance
Document, <quote>Clean Water Act Jurisdiction Following the United States
Supreme Court’s Decision in Rapanos v. United States & Carabell v. United
States</quote>, issued on December 2, 2008, relating to jurisdiction under
section 404 of the Federal Water Pollution Control Act.</text>
</clause></subparagraph><subparagraph id="H5423F4E8C6F14F57A3CAF99BDBE4DC27"><enum>(B)</enum><header>Forests and land
management</header>
<clause id="H33CEF8427F5648DC81E16F5C67634FA0"><enum>(i)</enum><text>Healthy Forests
Restoration Act of 2003, signed into law on December 3, 2003 (Public Law
108–148; 16 U.S.C. 6501 et seq.).</text>
</clause><clause id="HC941812CBA96402D8127803648E93B2F"><enum>(ii)</enum><text>National Forest
System Land Management Planning Rule, finalized and published in the Federal
Register on April 21, 2008 (73 FR 21468), replacing the 2005 final rule (70 FR
1022, Jan. 5, 2005), as amended March 3, 2006 (71 FR 10837) and the 2000 final
rule adopted on November 9, 2000 (65 FR 67514) as amended on September 29, 2004
(69 FR 58055), amending title 36, Code of Federal Regulations, part 219.</text>
</clause><clause id="H3AAA1E8A26C9496791A98379B865429F"><enum>(iii)</enum><text>The application
of the Administrative Procedure Act (5 U.S.C. 551 to 559, 701 to 706, et seq.),
such that States may petition for a special rule for the roadless areas in all
or part of said State.</text>
</clause><clause id="HA07895C247BF45A7B6425CFD0AB70EA6"><enum>(iv)</enum><text>Record of
Decision, <quote>Oil Shale and Tar Sands Resources Resource Management Plan
Amendments</quote>, issued on November 17, 2008, along with the Final Rule, Oil
Shale Management-General, published in the Federal Register on November 18,
2008 (73 FR 223), amending title 43, Code of Federal Regulations, parts 3900,
3910, 3920, and 3930.</text>
</clause></subparagraph><subparagraph id="HB7703654C870410CAC684BF547CED12A"><enum>(C)</enum><header>Scientific
review</header><text>Final Rule, Interagency Cooperation Under the Endangered
Species Act, published in the Federal Register on December 16, 2008, amending
title 50, Code of Federal Regulations, part 402.</text>
</subparagraph></paragraph><paragraph id="HBC0B82E6FE3A41789E497764BC129076"><enum>(2)</enum><header>Method</header><text>In
conducting the study under paragraph (1), the National Academy of Sciences may
utilize and compare existing scientific studies regarding the regulations,
laws, and proposed laws listed in paragraph (1).</text>
</paragraph><paragraph id="H37376EE65EDC4CA2A8793ED78F5DB79A"><enum>(3)</enum><header>Report</header><text>Under
the arrangement entered into under paragraph (1), not later than 270 days after
the date on which such arrangement is entered into, the National Academy of
Sciences shall make publicly available and shall submit to the Congress and to
the head of each department and agency of the Federal Government that issued,
implements, or would implement a regulation, law, or proposed law listed in
paragraph (1), a report containing—</text>
<subparagraph id="H30023431F37845829452AAD3C7F7E2CF"><enum>(A)</enum><text>a description of
the impact of all such regulations, laws, and proposed laws on public health,
air quality, water quality, wildlife, and the environment, compared to the
impact of preexisting regulations, or laws in effect, including—</text>
<clause id="HEB8D0A54F38A4A43AA0164D6F6F45115"><enum>(i)</enum><text>any
negative impacts to air quality or water quality;</text>
</clause><clause id="HD3384D32809C4EEDBF3C6DBC9DAF02FA"><enum>(ii)</enum><text>any
negative impacts to wildlife;</text>
</clause><clause id="H02C097BE675F40E9B8B1085D28AA1527"><enum>(iii)</enum><text>any delays in
hazardous waste cleanup that are projected to be hazardous to public health;
and</text>
</clause><clause id="H0F2B64140F164AF3AB6E523270ADDE73"><enum>(iv)</enum><text>any
other negative impact on public health or the environment; and</text>
</clause></subparagraph><subparagraph id="HDFADCFD1E68B4DE4B1C0E65C7EA792BA"><enum>(B)</enum><text>any
recommendations that the National Academy of Sciences considers appropriate to
maintain, restore, or improve in whole or in part protections for public
health, air quality, water quality, wildlife, and the environment for each of
the regulations, laws, and proposed laws listed in paragraph (1), which may
include recommendations for the adoption of any regulation or law in place or
proposed prior to January 1, 2001.</text>
</subparagraph></paragraph></subsection><subsection id="H919485CB21694790B6D5FD375CD1F648"><enum>(d)</enum><header>Department and
agency revision of existing rules, regulations, or laws</header><text>Not later
than 180 days after the date on which the report is submitted pursuant to
<internal-xref idref="H37376EE65EDC4CA2A8793ED78F5DB79A" legis-path="915.(c)(3)">subsection (c)(3)</internal-xref>, the head of each
department and agency that has issued or implemented a regulation or law listed
in
<internal-xref idref="HD02281ED5C4248148FE8E3AE8FAFB589" legis-path="915.(c)(1)">subsection (c)(1)</internal-xref> shall submit to the
Congress a plan describing the steps such department or such agency will take,
or has taken, to restore or improve protections for public health and the
environment in whole or in part that were in existence prior to the issuance of
such regulation or law.</text>
</subsection></section><section id="H749F49B797C64241A6CA78A742D66C43"><enum>1006.</enum><header>Healthy Food
Financing Initiative</header>
<subsection id="HF9D2CF731EB449CD924994C2A754DBE2"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Subtitle D of the
Department of Agriculture Reorganization Act of 1994 (7 U.S.C. 6951) is amended
by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HE7B1F666D4BB48FAB6EDB4432ECAA942" style="OLC">
<section id="H37E993DE6BA74C3E93448A2A09309D5C"><enum>242.</enum><header>Healthy Food
Financing Initiative</header>
<subsection id="HE92DA5ED97B5426A993CFC18425A805F"><enum>(a)</enum><header>Purpose</header><text>The
purpose of this section is to establish a program to improve access to healthy
foods in underserved areas, to create and preserve quality jobs, and to
revitalize low-income communities by providing loans and grants to eligible
fresh, healthy food retailers to overcome the higher costs and initial barriers
to entry in underserved, urban, suburban, and rural areas.</text>
</subsection><subsection id="HC760C0E0D9F44570A7296CFD97FF7EBA"><enum>(b)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section:</text>
<paragraph id="H81C5ED9E408847709F36113C628D4616"><enum>(1)</enum><header>Community
development financial institution</header><text>The term <term>community
development financial institution</term> has the meaning given the term in
section 103 of the Community Development Banking and Financial Institutions Act
of 1994 (12 U.S.C. 4702).</text>
</paragraph><paragraph id="HFA92A1AB77AD4DD987661E2B83E4A07C"><enum>(2)</enum><header>Food access
organization</header><text>The term <term>food access organization</term> means
a nonprofit organization with expertise in improving access to healthy food in
underserved communities.</text>
</paragraph><paragraph id="H8515612F41E54A779DD5249FDC7E36A4"><enum>(3)</enum><header>Initiative</header><text>The
term <term>Initiative</term> means the Healthy Food Financing Initiative
established in the Department by subsection (c)(1).</text>
</paragraph><paragraph id="H05E37034FA784A4FAE00C38706FF50B0"><enum>(4)</enum><header>Local
funds</header><text>The term <term>local funds</term> means the allocation of
national funds and any other forms of financial assistance (including grants,
loans, and equity investments) that are raised by partnerships to carry out the
purposes of this section.</text>
</paragraph><paragraph id="H4FB0635FFB5744F7A1F33E9E1FEF6818"><enum>(5)</enum><header>National
funds</header><text>The term <term>national funds</term> means any Federal
appropriation made to carry out this section and any other forms of financial
assistance (including grants, loans, and equity investments) that are raised by
the national fund manager to carry out the purposes of this section.</text>
</paragraph><paragraph id="H4200CA2177344478808472E08DF90540"><enum>(6)</enum><header>National fund
manager</header><text>The term <term>national fund manager</term> means a
community development financial institution in existence as of the date of
enactment of this section and certified by the Community Development Financial
Institutions Fund of the Department of the Treasury that is designated by the
Secretary to manage the Initiative for purposes of—</text>
<subparagraph id="HD86B561A638F40BABAAD48C8E33180CF"><enum>(A)</enum><text>raising private
capital;</text>
</subparagraph><subparagraph id="HD4B992FD9FA54CB38AF9861BBD70F76A"><enum>(B)</enum><text>providing
financial and technical assistance to partnerships; and</text>
</subparagraph><subparagraph id="HE211A6BDA7544D408208AD9CB5B1B2C9"><enum>(C)</enum><text>funding eligible
projects directly at the request of partnerships to attract fresh, healthy food
retailers to underserved urban, suburban, and rural areas, in accordance with
this section.</text>
</subparagraph></paragraph><paragraph id="H78FDC441CFDC4E9C95B70766C7DFDCB1"><enum>(7)</enum><header>Partnership</header>
<subparagraph id="HE3D0175B4ACA42C1BE1C2C6CF78F9609"><enum>(A)</enum><header>In
general</header><text>The term <term>partnership</term> means a regional,
State, or local public and private partnership that is organized to improve
access to fresh, healthy foods by providing financial and technical assistance
to eligible projects.</text>
</subparagraph><subparagraph id="HEC6F735731E8437E9C32C76C4D71381B"><enum>(B)</enum><header>Inclusions</header><text>The
term <term>partnership</term> includes—</text>
<clause id="HF6EBB02948FD425888D43404960FCA3C"><enum>(i)</enum><text>an
unit of State, local, or tribal government or a quasi-public State or local
government agency;</text>
</clause><clause id="H6954C06AE9914B33BAAE0CEE5FF5F556"><enum>(ii)</enum><text>a
food access or community health organization committed to improving access to
healthy foods;</text>
</clause><clause id="HA17FA84C5B864B92BF2E5CEB15BEFAC2"><enum>(iii)</enum><text>a community
development financial institution or other organization that is capable of
administering a loan and grant program in accordance with this section;
and</text>
</clause><clause id="H90B853CC7A4349D581F4732E4637C598"><enum>(iv)</enum><text>other
organizations interested in improving access to healthy foods in underserved
areas.</text>
</clause></subparagraph></paragraph></subsection><subsection id="HA9A401D5635B4C2FA31FC1C37300D006"><enum>(c)</enum><header>Establishment</header>
<paragraph id="HBAB3AAC028094BC5A3AE3A139E5A7A03"><enum>(1)</enum><header>In
general</header><text>There is established in the Department a Healthy Food
Financing Initiative.</text>
</paragraph><paragraph id="H89649A226D374978AF6CC3AD6572DEF1"><enum>(2)</enum><header>Management</header><text>Not
later than 1 year after the date of enactment of this section, the Secretary
shall select and enter into a grant agreement with a national fund manager who
shall be responsible for the management of the Initiative nationally.</text>
</paragraph><paragraph id="H2F5FCE9271F142CA99A2A1276640B55B"><enum>(3)</enum><header>Eligible
projects</header>
<subparagraph id="H96B37E8251D34898BE5923BB6DF91AAE"><enum>(A)</enum><header>In
general</header><text>Subject to the requirements of this paragraph, the
national fund manager shall establish the eligibility criteria for projects to
be assisted by the Initiative.</text>
</subparagraph><subparagraph id="H32B942E6C68F47498D4E00CD8604238E"><enum>(B)</enum><header>Requirements</header><text>To
be eligible to receive assistance through the Initiative, a project
shall—</text>
<clause id="H29AA1C07385642EEBBD579170C236CC3"><enum>(i)</enum><text>include a
supermarket, grocery store, farmers market, or other fresh, healthy food
retailer;</text>
</clause><clause id="H78E30D8EADB741FE992E643680709387"><enum>(ii)</enum><text>consist of a
for-profit business enterprise, a member- or worker-owned cooperative, or a
nonprofit organization;</text>
</clause><clause id="H497DAF39AF77466EA3FFD2C4A07113CE"><enum>(iii)</enum><text>meet the
eligibility criteria established under this section;</text>
</clause><clause id="H7DB05068BDA940F3A85A413301046154"><enum>(iv)</enum><text>continue to be a
viable business enterprise with a financial viability plan;</text>
</clause><clause id="H4527F135EC234F988FCC93380018C337"><enum>(v)</enum><text>require an
investment of public funding to move forward and be competitive;</text>
</clause><clause id="H28CAC91C1018402696B44FEAA4658360"><enum>(vi)</enum><text>operate on a
self-service basis;</text>
</clause><clause id="H1D4D5022DEE64099B871CC36538EA28D"><enum>(vii)</enum><text>in accordance
with subparagraph (C), expand or preserve the availability of healthy, fresh,
high quality unprepared and unprocessed foods, particularly fresh fruits and
vegetables, in underserved areas; and</text>
</clause><clause id="H9ED669539EB64BEBB07C06D8FB80F841"><enum>(viii)</enum><text>agree to accept
benefits under the supplemental nutrition assistance program established under
the <act-name parsable-cite="FSA77">Food and Nutrition Act of 2008</act-name>
(7 U.S.C. 2011 et seq.).</text>
</clause></subparagraph><subparagraph id="H693F664AF316458FA8A1A63E8F4901F8"><enum>(C)</enum><header>Requirements</header>
<clause id="HE89B8FA6FC04421A833CEE45FBA9D59C"><enum>(i)</enum><header>Definitions</header><text>In
this subparagraph:</text>
<subclause id="H944D1EFE67FD490FA1CB37A962B37EB7"><enum>(I)</enum><header>Perishable
food</header>
<item id="HF3C5F3CA2C374295A1DA0B5CD1CD6EAC"><enum>(aa)</enum><header>In
general</header><text>The term <term>perishable food</term> means food that is
fresh, refrigerated, or frozen.</text>
</item><item id="H1C6F27155AFB475395A63CD90406F72C"><enum>(bb)</enum><header>Exclusion</header><text>The
term <term>perishable food</term> does not include packaged or canned
goods.</text>
</item></subclause><subclause id="HCA158DAF2AA34E879A99F5278AD15238"><enum>(II)</enum><header>Staple
food</header>
<item id="H79B4B9486EA842B3AF7E7700C1A36277"><enum>(aa)</enum><header>In
general</header><text>The term <term>staple food</term> means food that is a
basic dietary item, including bread, flour, fruits, vegetables, and
meat.</text>
</item><item id="H52F6869231D744C6B31D594D59F07CE7"><enum>(bb)</enum><header>Exclusions</header><text>The
term <term>staple food</term> does not include snack or accessory food (such as
chips, soda, coffee, condiments, and spices) or ready-to-eat, prepared
food.</text>
</item></subclause><subclause id="H1914171114AD45F38A91EFAF008B19C1"><enum>(III)</enum><header>Variety</header><text>The
term <term>variety</term> means an assortment of different types of food
items.</text>
</subclause></clause><clause id="H255166F3C56F41C5A5330C2927FC38E4"><enum>(ii)</enum><header>In
general</header><text>For purposes of subparagraph (B)(vii), to expand or
preserve the availability of fresh fruits and vegetables in underserved areas
shall mean, with respect to a project, that the project maintains a store
that—</text>
<subclause id="H29FAF9E8DEAB40AB9491A0ADA4E10D25"><enum>(I)</enum><text>carries a full
line of fresh produce, as defined by the national fund manager to reflect
differences in project size and overall store size;</text>
</subclause><subclause id="H2189317242AC4719851A70E6A465A633"><enum>(II)</enum><text>sells food for
home preparation and consumption; and</text>
</subclause><subclause id="HDC46D4E1F9454E069408AFA7986C3615"><enum>(III)</enum><text>at a
minimum—</text>
<item id="H2DF836824F9945099F03913146DD6F4C"><enum>(aa)</enum><text>offers for sale
at least 3 different varieties of food in each of the 4 staple food groups
(bread and grains, dairy, fruits and vegetables, and meat, poultry, and fish),
with perishable food in at least 2 categories, on a daily basis; or</text>
</item><item id="HE0DA48EB557F4596A4640C2B6C109965"><enum>(bb)</enum><text>has
a store at which at least 50 percent of the total sales of the store (including
food and nonfood items or services) are from the sale of eligible staple
food.</text>
</item></subclause></clause></subparagraph><subparagraph id="H81EAD278981047BD92542C1A736A7022"><enum>(D)</enum><header>Income
criteria</header><text>Each eligible project shall be located in—</text>
<clause id="HA800BE6959CA4877A8311EAA3DF60934"><enum>(i)</enum><text>a
low- or moderate-income census tract, as determined by the Bureau of the Census
of the Department of Commerce;</text>
</clause><clause id="HC58FD3F214F44D2FBDC99F8982BA1442"><enum>(ii)</enum><text>a
population census tract that is treated as a low-income community under section
45D(e) of the Internal Revenue Code of 1986; or</text>
</clause><clause id="H51558EFBB35146689620515FF8E3E067"><enum>(iii)</enum><text>an area that
significantly serves an adjacent area that meets the criteria described in
clause (i) or (ii), as approved by the national fund manager.</text>
</clause></subparagraph><subparagraph id="HD02726DA1BC045289C2A01890F41A207"><enum>(E)</enum><header>Underserved
criteria</header>
<clause id="H9EE7BA9669FA49A38F0BFCDF1C4F4139"><enum>(i)</enum><header>In
general</header><text>Each eligible project shall be located in an underserved
area, as determined by the partnerships according to criteria established by
the national fund manager.</text>
</clause><clause id="H0262B1236A904E8DB1ED78848518DEA0"><enum>(ii)</enum><header>Factors</header><text>In
determining whether an area is an underserved area, the following factors shall
be taken into consideration:</text>
<subclause id="HB9B3D4C110EE428E9C16ACA5EF2E13A5"><enum>(I)</enum><text>Population
density.</text>
</subclause><subclause id="HE84231334B3F4127AD94B0F19764CEE4"><enum>(II)</enum><text>Below average
supermarket density or sales.</text>
</subclause><subclause id="HE641FF3C19EE4428AD131245907B911D"><enum>(III)</enum><text>Car
ownership.</text>
</subclause><subclause id="HB17DD578427C4C01957D0FA6ACD31776"><enum>(IV)</enum><text>Geographical or
physical barriers, such as highways, mountains, major parks, or bodies of
water.</text>
</subclause></clause><clause id="HC76607C242A34906BC5CFEA2CD1AC4F1"><enum>(iii)</enum><header>Locations</header><text>On
an annual basis, the national fund manager shall collect data and publish maps
that show the location of underserved areas.</text>
</clause></subparagraph></paragraph><paragraph id="HA87F2E44806C4521A079FE7A4B7DBD32"><enum>(4)</enum><header>Priority
projects</header>
<subparagraph id="H2DEA38FAAAFC448EB66CFF3A3850DBC9"><enum>(A)</enum><header>In
general</header><text>Priority shall be given to projects that—</text>
<clause id="H304F765EF1A048DA83A06453435525BA"><enum>(i)</enum><text>are located in
severely distressed low-income communities, as defined by the Community
Development Financial Institutions Fund of the Department of the Treasury;
and</text>
</clause><clause id="H49B75EF34EDF481BA57E73FD7C4497C5"><enum>(ii)</enum><text>include 1 or more
of the following characteristics:</text>
<subclause id="HCC7FCF6474044E99AB0C52E5AF8AEF35"><enum>(I)</enum><text>The project will
create or retain quality jobs in the community, as determined in accordance
with subparagraph (B).</text>
</subclause><subclause id="H9BED5857AE4A43AB863A7DBEAEEF459D"><enum>(II)</enum><text>The project has
community support in terms of store quality, affordability, site location, and
coordination with local community plans or other programs promoting community
and economic development.</text>
</subclause><subclause id="HB612356CFC764ED0B48B20A390683BF2"><enum>(III)</enum><text>The project
supports regional food systems and locally grown foods, to the extent
available.</text>
</subclause><subclause id="HCEA2487C23EF4E358490A928DF715D01"><enum>(IV)</enum><text>In major
metropolitan areas, the project is associated with a transit-oriented
development project.</text>
</subclause><subclause id="H32FF32A8E1A24C77A0E831ADAAE37F93"><enum>(V)</enum><text>In areas with
public transit, the project is accessible by public transit.</text>
</subclause><subclause id="HFA14F02230744A069E304CBC50F39FC1"><enum>(VI)</enum><text>The project
involves the reuse of a building that is listed in or eligible for the National
Register of Historic Places.</text>
</subclause><subclause id="H146FBF24E7A24ED79DA421D9DABBCDC4"><enum>(VII)</enum><text>The project
involves a brownfield or grayfield (as those terms are used in the
<act-name parsable-cite="CERCL">Comprehensive Environmental Response,
Compensation, and Liability Act of 1980</act-name> (42 U.S.C. 9601 et
seq.)).</text>
</subclause><subclause id="H59350111D2954ED19D42257CBACF9EDF"><enum>(VIII)</enum><text>The estimated
energy consumption of the project, calculated using building energy software
approved by the Department of Energy, will qualify the project for designation
under the Energy Star program established by section 324A of the Energy Policy
and Conservation Act (42 U.S.C. 6294a).</text>
</subclause><subclause id="H8C16D979733C423F98EC303F04CABB7C"><enum>(IX)</enum><text>The project
involves women- and minority-owned businesses.</text>
</subclause></clause></subparagraph><subparagraph id="HC61D5787D7ED4B4AB75A2392D9EDA855"><enum>(B)</enum><header>Quality
jobs</header><text>For purposes of subparagraph (A)(ii)(I), a quality job is a
job that—</text>
<clause id="H5BB09863998E4F25BBCB80A553EB53D2"><enum>(i)</enum><text>provides wages
that are comparable to or better than similar positions in existing businesses
of similar size in similar local economies;</text>
</clause><clause id="HEA005F9639CB474F8EC5D4624B040FAD"><enum>(ii)</enum><text>offers benefits
that are comparable to or better than what is offered for similar positions in
existing local businesses of similar size in similar local economies;
and</text>
</clause><clause id="H786B699A167E4483862926783334E3BB"><enum>(iii)</enum><text>is targeted for
residents of neighborhoods with a high proportion of persons of low income (as
that term is defined in section 102(a) of the Housing and Community Development
Act of 1974 (42 U.S.C. 5302(a))) through local targeted hiring programs.</text>
</clause></subparagraph></paragraph></subsection><subsection id="H73CD7F2EE6A349F0A930472547EBCF07"><enum>(d)</enum><header>Duties of the
Secretary</header>
<paragraph id="HBCA01BCAC8F04E479C58AFD18CABA52F"><enum>(1)</enum><header>In
general</header><text>The Secretary shall—</text>
<subparagraph id="H3F960589472D423A874B04DF044A6F47"><enum>(A)</enum><text>designate a
national fund manager to manage national funds;</text>
</subparagraph><subparagraph id="H8738FB1E88D74D6B88B7E8C738267BA7"><enum>(B)</enum><text>oversee the
Initiative nationally;</text>
</subparagraph><subparagraph id="HCB95D014727E416F88890F89D2E702B1"><enum>(C)</enum><text>work closely with
the designated national fund manager—</text>
<clause id="H0E241B0FAAAE49AF81FA615E69CDB265"><enum>(i)</enum><text>to
ensure that funds are used appropriately and in the most effective manner
practicable; and</text>
</clause><clause id="H51A8023A8EF34F1F9FB9D749AAF5D52A"><enum>(ii)</enum><text>to develop the
program strategy into a detailed work plan, program, and operating
budget;</text>
</clause></subparagraph><subparagraph id="H086E74D64C9E4704ACA239EFC5ED3032"><enum>(D)</enum><text>review and approve
the operating budget for the national fund manager to ensure that the
administrative costs are—</text>
<clause id="HCA572A0770DB41EBAAC68DF6B120632B"><enum>(i)</enum><text>reasonable (not
more than 5 percent of the total budget);</text>
</clause><clause id="H85A8E925B0E44F0781BFABFA77028EB8"><enum>(ii)</enum><text>connected to the
costs of operations; and</text>
</clause><clause id="HC0A342E129B241DCB1A03A8AB27E7052"><enum>(iii)</enum><text>reflect
efficient operations by the national fund manager; and</text>
</clause></subparagraph><subparagraph id="H8CB2B39DFDB34396A1F25D8A25751BFD"><enum>(E)</enum><text>make available to
the public an annual report, using data obtained from the Department of
Agriculture, the Department of Health and Human Services, and the Community
Development Financial Institutions, that describes the impacts of the
Initiative, including tracking health and economic development indicators at
the local, State, and national levels to determine the impacts of individual
projects and the collective impact in local areas and statewide of funded
projects and the Initiative overall.</text>
</subparagraph></paragraph><paragraph id="H371F94AD6A024DEAAB569CB2D83D464F"><enum>(2)</enum><header>National fund
manager</header><text>The Secretary shall—</text>
<subparagraph id="HE6566B2AF321410E912DD2588108E8AF"><enum>(A)</enum><text>select the
national fund manager through a competitive process from among community
development financial institutions that have a proven and recent track record
of success and effectiveness in—</text>
<clause id="H5CC478C7A9B943FAB5AF54C2B38000D3"><enum>(i)</enum><text>attracting private
capital;</text>
</clause><clause id="H59453B6DC2834B38AF71D510BB3BBD48"><enum>(ii)</enum><text>developing and
managing programs that provide grants and loans to support supermarkets and
other fresh, healthy food retail business enterprises in low- and
moderate-income communities, including the development of grocery stores,
farmers markets, and other fresh, healthy food retail models;</text>
</clause><clause id="H868A43A74FE544968359BED3B8289607"><enum>(iii)</enum><text>making and
servicing loans that are similar to loans proposed in the Initiative or having
a record of otherwise successfully investing in fresh, healthy food retail
development projects;</text>
</clause><clause id="H7F883E27F2924ABBAB5BED0FF97B41D0"><enum>(iv)</enum><text>effectively
managing multiple contracts and subcontractors;</text>
</clause><clause id="H996F9E0C87674003982434BF1C6340D8"><enum>(v)</enum><text>effectively
managing large capital pools, of at least $100,000,000; and</text>
</clause><clause id="H34B5FA92BB3A42249C2D8B8D827314C5"><enum>(vi)</enum><text>providing or
contracting for the provision of technical assistance; and</text>
</clause></subparagraph><subparagraph id="HD40BFE2CE3D34F52972A83A70785A6A0"><enum>(B)</enum><text>administer the
Initiative by approving the disbursement of funds to the national fund manager
in a manner that facilitates the implementation of the overall
Initiative.</text>
</subparagraph></paragraph><paragraph id="HF3045BD31AF34765BC513A3E3F8F159F"><enum>(3)</enum><header>Coordination</header>
<subparagraph id="HBE481EFF96CA436D9847A02DBDBD5082"><enum>(A)</enum><header>In
general</header><text>Not later than 45 days after the date of receipt of an
award, the national fund manager shall develop, with guidance from and in
consultation with the Secretary, and submit to the Secretary, a detailed work
plan.</text>
</subparagraph><subparagraph id="HB99F1CBEC7914620A3DD538AE964F53D"><enum>(B)</enum><header>Approval
required</header><text>The Secretary shall review and approve the work plan,
program budget, and administrative costs under subsection (e)(4)(C) prior to
entering into an agreement with the national fund manager to administer the
Initiative.</text>
</subparagraph></paragraph><paragraph id="HB016BF6021E546EB955DE1784D5BE9BF"><enum>(4)</enum><header>Performance
targets</header>
<subparagraph id="H62A6C277CF4E4AA7A9D80071C08B7A46"><enum>(A)</enum><header>In
general</header><text>The Secretary shall conduct financial audits of, and
establish performance targets for, the national fund manager, which shall
include, at a minimum, the requirements described in this paragraph.</text>
</subparagraph><subparagraph id="HC92B83B2A7074F279CDBA547EE379F97"><enum>(B)</enum><header>Geographic
spread</header><text>Partnerships funded by the Initiative shall be
geographically diverse and representative of the underserved areas across the
United States.</text>
</subparagraph><subparagraph id="H8F7A6152EA7140B292DC1B6B31F85449"><enum>(C)</enum><header>Focus on
low-income communities</header><text>A substantial portion of the projects
funded by partnerships shall serve very low- and low-income communities, as
defined by the Bureau of the Census of the Department of Commerce.</text>
</subparagraph><subparagraph id="H63665B3C867D4A509B80DE214A5D4BF7"><enum>(D)</enum><header>Financial
effectiveness of the national fund manager</header><text>The national fund
manager and any local financial institution involved in a partnership shall
demonstrate on-going capacity and timeliness in raising private capital and
disbursing funds as required under the Initiative.</text>
</subparagraph><subparagraph id="HEFEC4772E5E044D49AA03B8C77ED5167"><enum>(E)</enum><header>Technical
assistance effectiveness of the national fund manager</header><text>The
provision of technical assistance by the national fund manager shall be
evaluated based on—</text>
<clause id="HA5C50C578BE74DD8B9A737DB7B5EBBB3"><enum>(i)</enum><text>the responsiveness
of the national fund manager to requests for assistance; and</text>
</clause><clause id="H3EF519BD32C54803A83073406B9B98B6"><enum>(ii)</enum><text>the ability of
the national fund manager to craft programs that develop needed new capacities
in partnerships.</text>
</clause></subparagraph><subparagraph id="HEB3D22FA598743DBAE99A76A07187335"><enum>(F)</enum><header>Impact</header><text>Performance
targets shall address the allocation of funds by the national fund manager to
partnerships and the tracking and reporting of the impacts of the funds in
improving access to fresh, healthy foods and in achieving other related
impacts.</text>
</subparagraph></paragraph></subsection><subsection id="HD6AB9550BD1E4530888C29CE5C69C204"><enum>(e)</enum><header>Duties of the
national fund manager</header>
<paragraph id="H332399DB8F7B4EA1AD69B4D39B3B6DD1"><enum>(1)</enum><header>Allocation of
funds</header>
<subparagraph id="H5F749024E1624393AF732792F1AD7FA6"><enum>(A)</enum><header>In
general</header><text>The national fund manager shall—</text>
<clause id="H28FE0825C71A4BA4AFC30322D18BA58C"><enum>(i)</enum><text>allocate at least
70 percent of any Federal appropriation made to carry out this section to
partnerships that are selected based on the criteria described in paragraph
(3); and</text>
</clause><clause id="H626446F8BE8249C6825ECA9AE304B14E"><enum>(ii)</enum><text>retain not more
than 30 percent of any Federal appropriation made to carry out this section to
undertake financing activities described in subparagraph (C), including a
reasonable amount for administrative costs (not to exceed 5 percent) approved
by the Secretary in accordance with paragraph (4)(C).</text>
</clause></subparagraph><subparagraph id="H7CF0C14BECB5487E8EEB1F35E11197AE"><enum>(B)</enum><header>Use of the
national funds by partnership programs</header>
<clause id="H3389D08222114E2C897DE71C2A412ECC"><enum>(i)</enum><header>In
general</header><text>As a condition on the receipt of funds, each partnership
shall use—</text>
<subclause id="H39D2D330375F48A8AADB2E1AD8967C7A"><enum>(I)</enum><text>the national funds
received from the national fund manager under subparagraph (A)(i) to create 1
or more revolving loan programs or other revolving pools of capital or other
products to facilitate financing of local projects as determined by the
agreement between the partnership and the national fund manager; and</text>
</subclause><subclause id="H509DA8D8B56F441DA81D7D5AD3B3B616"><enum>(II)</enum><text>any remaining
funds for grants, or, as approved, for innovative financing mechanisms.</text>
</subclause></clause><clause id="HFCD77DA99465453E99518A8796488D5E"><enum>(ii)</enum><header>Limitations</header>
<subclause id="HBFEEE826C7DA4725BB8A94C35E97F4BB"><enum>(I)</enum><header>In
general</header><text>Use of funds for administrative costs and other purposes
shall be—</text>
<item id="HFF4CC0B21A424FF3A060F63C6EC9E34E"><enum>(aa)</enum><text>limited in
accordance with the terms of the agreement negotiated between the national fund
manager and partnerships;</text>
</item><item id="H669AD0A33BE84AF5BA39BA721AA5F1D1"><enum>(bb)</enum><text>based on whether
administrative costs are reasonable, connected to the costs of operation, and
reflect efficient operations by the partnership; and</text>
</item><item id="H5236A4262E324312A17172B0ED4CA7B0"><enum>(cc)</enum><text>determined using
criteria including geographic coverage, program duration, and total funding
amount.</text>
</item></subclause><subclause id="HA438C8431465413CA6955E266433C3CF"><enum>(II)</enum><header>Goal</header><text>The
goal of this clause to limit administrative costs to the maximum extent
practicable, but in no case may the amount used for administrative costs exceed
10 percent of the Federal funds allocated.</text>
</subclause></clause></subparagraph><subparagraph id="HD33DFC5D79A14278AFF139A24B1F6DD9"><enum>(C)</enum><header>Use of the
national funds by the national fund manager</header><text>The national fund
manager shall use national funds described in subparagraph (A)(ii) to undertake
financing and other activities to enhance and maximize the effectiveness of the
Initiative, as determined by the agreement with the Secretary,
including—</text>
<clause id="H8B3B1EF3273E48FA9DD921CC20B7D91F"><enum>(i)</enum><text>attracting other
forms of financial assistance to match or leverage the national funds;</text>
</clause><clause id="H3E15054CE68F4010A253373B9EBA28F3"><enum>(ii)</enum><text>awarding national
funds to partnerships in accordance with paragraph (3);</text>
</clause><clause id="H65896F63700049B087D6A48375BAD236"><enum>(iii)</enum><text>creating and
managing pools of grant or loan capital that blend or leverage national funds
with other forms of financial assistance, including capital in the form of tax
credits under section 45D of the Internal Revenue Code of 1986, for the benefit
of partnerships;</text>
</clause><clause id="HE3BD2D4955B0400D926DD57C4BC2598F"><enum>(iv)</enum><text>creating and
managing pools of grant or loan capital that blend or leverage the national
funds with other forms of financial assistance, including capital in the form
of tax credits under section 45D of the Internal Revenue Code of 1986, to
finance eligible local projects identified by partnerships or the national fund
manager that have special or unique characteristics;</text>
</clause><clause id="HF9D71846B62C4259B2C2A7D15786C2F2"><enum>(v)</enum><text>providing loans or
grants directly to eligible local projects as matching funds if requested by a
partnership;</text>
</clause><clause id="H6CC8449D0441412CBCC9059C368423DE"><enum>(vi)</enum><text>providing credit
enhancement or other financial products and instruments for the benefit of
partnerships or eligible local projects;</text>
</clause><clause id="H5B31D48B1B03413B8F15C4CF355352FC"><enum>(vii)</enum><text>providing
technical assistance; and</text>
</clause><clause id="HCFDD184B3EA745FA96942B742ACB5ACB"><enum>(viii)</enum><text>funding
reasonable administrative costs approved by the Secretary in accordance with
paragraph (4)(C).</text>
</clause></subparagraph></paragraph><paragraph id="HF38F08C74DCB485FBF9955B643F5AACC"><enum>(2)</enum><header>Responsibilities
of the national fund manager</header><text>The designated national fund manager
shall—</text>
<subparagraph id="HB92D43B4584F42319D8E9D8DE39D7B6F"><enum>(A)</enum><text>raise other forms
of financial assistance to match or leverage the national funds;</text>
</subparagraph><subparagraph id="H43B0513477834EC189B1215A00F978BE"><enum>(B)</enum><text>use administrative
funds to develop appropriate training programs and offer technical assistance
services to—</text>
<clause id="H18D9A4E5A7254779A0CA4079821C9EBA"><enum>(i)</enum><text>partnerships;</text>
</clause><clause id="HFB9EBE2AE9D742B6AAC7F61696AF70C8"><enum>(ii)</enum><text>State, local, and
tribal governments;</text>
</clause><clause id="H099B300C61B041C4AD4FC4F452B1314A"><enum>(iii)</enum><text>the food retail
industry; and</text>
</clause><clause id="HECCCDA4DD7744768B602BA489391575A"><enum>(iv)</enum><text>food access and
health advocacy organizations to augment local capacities;</text>
</clause></subparagraph><subparagraph id="H245A8C0F50F04E989EAB9010685D745F"><enum>(C)</enum><text>develop financial
products such as loans, grants, and credit enhancement tools that can be used
by partnerships to incentivize and support the development and retention of
supermarkets and other fresh, healthy food retail in underserved areas;</text>
</subparagraph><subparagraph id="H0192CC79A266495F9317D29EAC146646"><enum>(D)</enum><text>award Initiative
funds to eligible partnerships through an annual competitive process in
accordance with paragraph (3);</text>
</subparagraph><subparagraph id="H103016971CD444F5BC70336A83B6BDED"><enum>(E)</enum><text>contract with a
national food access organization to assist in the review of applications from
partnerships and to provide technical assistance to local food access
organizations in the proposed partnerships;</text>
</subparagraph><subparagraph id="H64F64F9531CE493085E4C98A1AA629EC"><enum>(F)</enum><text>award and disburse
funds to partnerships or eligible local projects in a timely manner;</text>
</subparagraph><subparagraph id="H655673DEFB194F6CBC342C68BD8978D4"><enum>(G)</enum><text>create and meet
performance benchmarks and reporting guidelines, as approved by the Secretary,
including for—</text>
<clause id="H5D4DB9B48043414DBEA0DC024A5480CA"><enum>(i)</enum><text>the amount of
capital raised and leveraged from financial institutions, partnerships, and
other resources;</text>
</clause><clause id="HC249F4F54C7F43E5A60302B59049ABEC"><enum>(ii)</enum><text>the geographic
diversity of partnerships; and</text>
</clause><clause id="H108074FC744748F696DD779DA3E7CDFA"><enum>(iii)</enum><text>the proportion
of projects funded by the partnership that are in severely distressed
low-income communities;</text>
</clause></subparagraph><subparagraph id="H32AED5868D6F4FCFA0F2FEE4C324F37E"><enum>(H)</enum><text>develop program
guidelines and operating procedures for the Initiative, including—</text>
<clause id="H4BFD5FF1B9F8470A823F6EF371A29D30"><enum>(i)</enum><text>maximum grant and
loan amounts for projects;</text>
</clause><clause id="HB2496544F6974A5AB0203D59E1C883B1"><enum>(ii)</enum><text>eligible uses of
funds;</text>
</clause><clause id="HBCD43E792E184ABEB4AC369B455EDB42"><enum>(iii)</enum><text>prudent
underwriting criteria;</text>
</clause><clause id="H0FCE02775BE3469CB7DEF6CB16B2C2BF"><enum>(iv)</enum><text>performance
targets;</text>
</clause><clause id="HC1C1B0FA13854DA19BFBF06A47C7D60B"><enum>(v)</enum><text>reporting
guidelines;</text>
</clause><clause id="HCCD3612E7203481E8A5AED944F3A18A7"><enum>(vi)</enum><text>limits on
administrative costs; and</text>
</clause><clause id="H75ED87DE2C0B4B6F9C966DD0D13B6261"><enum>(vii)</enum><text>implementation
milestones;</text>
</clause></subparagraph><subparagraph id="HD18F7619274E470B9CC13DBAB90B45AC"><enum>(I)</enum><text>monitor the
performance of partnerships; and</text>
</subparagraph><subparagraph id="HF9C61A3ECBEE41B0870A94A87C02E473"><enum>(J)</enum><text>collect data,
compile information, and conduct such research studies as the national fund
manager determines to be relevant to the successful implementation of the
Initiative, including—</text>
<clause id="H37318F79C8534ABD9B0FEA93B23B9A44"><enum>(i)</enum><text>to
assess national and local market conditions;</text>
</clause><clause id="H4B3775BB3AAD401AB8FB0849A1583B3F"><enum>(ii)</enum><text>to determine
barriers to market entry; and</text>
</clause><clause id="H2C6BF95D850D44F0B97DF57507A429E2"><enum>(iii)</enum><text>to identify
opportunities for the development or retention of supermarkets and other fresh,
healthy food retail enterprises in underserved communities.</text>
</clause></subparagraph></paragraph><paragraph id="H7B628E85D9314FE0AD5AA89E7A042C39"><enum>(3)</enum><header>Criteria for
awarding national funds to partnerships</header>
<subparagraph id="HCD34D92AD9904CCC83A3F26F6B51DE46"><enum>(A)</enum><header>In
general</header><text>The national fund manager shall award national funds to
partnerships through a competitive process on an annual basis.</text>
</subparagraph><subparagraph id="H2AA55A4E81C849B7A69ADCD85B937022"><enum>(B)</enum><header>First round
priority</header><text>In the first round of funding, the national fund manager
shall give priority to existing partnerships that have demonstrable capacity to
implement fresh food financing programs in underserved areas quickly.</text>
</subparagraph><subparagraph id="H1C7C8EA9F8524763A86C4926F808E8CC"><enum>(C)</enum><header>Additional
rounds</header><text>Additional rounds shall be designed to promote geographic
diversity.</text>
</subparagraph><subparagraph id="H757E7B07EA8A4247BB67F5631F022D2D"><enum>(D)</enum><header>Criteria</header><text>In
awarding national funds to partnerships, the national fund manager shall
consider—</text>
<clause id="H180129A2A8E046C99047A6116E960971"><enum>(i)</enum><text>the amount of
funds and other resources pledged by a partnership to match or leverage
national funds;</text>
</clause><clause id="HB998834B1CF34ADD9861C0FACA215423"><enum>(ii)</enum><text>the degree of
State, local, or tribal government support of the partnership as evidenced by
matching grant and loan funds or other types of support, such as allocation of
tax-exempt bonds, loan guarantees, and coordination of resources from other
State or local economic development programs;</text>
</clause><clause id="H6B07E546C6354E32A4A5B201351495F9"><enum>(iii)</enum><text>the capacity of
the partnership to successfully develop and manage loan and grant
programs;</text>
</clause><clause id="HF33C7E9195084F52AD4B668247E0F820"><enum>(iv)</enum><text>the lack of
supermarkets and other fresh, healthy food retail enterprises in low- and
moderate-income areas that would be served by the partnership;</text>
</clause><clause id="HC2889578580E4338B04A63845CA77F94"><enum>(v)</enum><text>the experience of
the food access or community health organization of the partnership in outreach
about access to healthy foods and local healthy food access issues;</text>
</clause><clause id="H4FAA48638733445CB2928247454A8B91"><enum>(vi)</enum><text>the degree of
community engagement and support in the development and retention of
supermarkets and other fresh, healthy food retail enterprises; and</text>
</clause><clause id="HBA7F13A1D71F4DFE8FA2F654B93C98F3"><enum>(vii)</enum><text>the contribution
of the program of the partnership to the overall geographic diversity of the
Initiative.</text>
</clause></subparagraph></paragraph><paragraph id="H6068494A371442BE8C72BA66427274F7"><enum>(4)</enum><header>Administrative
costs</header>
<subparagraph id="H9C46BFB247194F708B0672E3F001D75B"><enum>(A)</enum><header>In
general</header><text>Not later than 45 days after the date of receipt of an
award, the national fund manager shall submit to the Secretary for approval a
3-year program and operating budget and detailed work plan that shall
include—</text>
<clause id="HBCC3AB2695E24952B00DB4103476A370"><enum>(i)</enum><text>costs for research
and evaluation, technical assistance, and training; and</text>
</clause><clause id="HEF0DA6521693490FBD61168B679FAB0D"><enum>(ii)</enum><text>program and
operating costs.</text>
</clause></subparagraph><subparagraph id="H12FA70D742784F308437389A683D5E5A"><enum>(B)</enum><header>Earned
revenues</header><text>Earned revenues from loan fees and interest may be
expended on program and operating costs in accordance with the budget approved
by the Secretary.</text>
</subparagraph><subparagraph id="HF5EBDB8512FA4DA4BAB4924CC0487DE8"><enum>(C)</enum><header>Basis of
review</header><text>The Secretary shall base the review under subparagraph (A)
on—</text>
<clause id="H75D5A3B6A2A7484AA04D434407E1E404"><enum>(i)</enum><text>the likelihood of
the plan and expenditures to further the purposes of this section; and</text>
</clause><clause id="H7870532AC9594421A93CDF0DEA08B2D2"><enum>(ii)</enum><text>whether the
administrative costs are reasonable, connected to the costs of operation, and
reflect efficient operations by the national fund manager.</text>
</clause></subparagraph></paragraph></subsection><subsection id="HDE5B2AC2E7AC46238C1CFD0555120D02"><enum>(f)</enum><header>Partnerships</header>
<paragraph id="HE294161994194D03B7F9ED4D2760420B"><enum>(1)</enum><header>In
general</header><text>Each partnership that receives assistance through the
Initiative shall provide financial and technical assistance to eligible fresh,
healthy food retail projects in underserved areas within the defined
communities of the partnership.</text>
</paragraph><paragraph id="HC438C7243A214302AA50243F7B5A64C5"><enum>(2)</enum><header>Administration</header><text>Each
partnership shall designate a community development financial institution or
other organization that is capable of administering a loan and grant
program—</text>
<subparagraph id="H37014F7D812146D89B146937BA6460AA"><enum>(A)</enum><text>to execute grant
agreements with the national fund manager; and</text>
</subparagraph><subparagraph id="H007D5CCA7D5D47F6811FA72B4BE08624"><enum>(B)</enum><text>to serve as the
manager of local funds.</text>
</subparagraph></paragraph><paragraph id="H426A3A7EC40E4E1D928B0C570B5D3050"><enum>(3)</enum><header>Responsibilities
of partnerships</header><text>A partnership shall—</text>
<subparagraph id="H7260D54A38224759AB07FF4E86209E67"><enum>(A)</enum><text>raise other forms
of financial assistance to match the national funds received by the
partnership;</text>
</subparagraph><subparagraph id="H7BC19A2939E3414B935B0D4D4EBA6DB0"><enum>(B)</enum><text>provide marketing
and outreach to communities, the supermarket industry, other fresh, healthy
food retailers, State and local government officials, and civic and public
interest organizations—</text>
<clause id="H0B7811D76D414A4A883B221B0DF3661D"><enum>(i)</enum><text>to
solicit applications from underserved areas from across the State or locality
to be served by the partnership; and</text>
</clause><clause id="HAAB157B6FC504604BEB05E09CD7C5BD8"><enum>(ii)</enum><text>to inform the
communities and other persons about the availability of grants, loans,
training, and technical assistance;</text>
</clause></subparagraph><subparagraph id="HC2288D979BF04FA5AC8A3406B21F3A34"><enum>(C)</enum><text>review and
underwrite projects to determine whether—</text>
<clause id="HD901B56008B541B09AB0954569BC3A75"><enum>(i)</enum><text>a
proposed project meets the criteria for eligible projects under subsection
(c)(3); and</text>
</clause><clause id="H35D4B89573C244EB898C8D585EFD72E3"><enum>(ii)</enum><text>a
proposed project meets the criteria for priority projects under subsection
(c)(4);</text>
</clause></subparagraph><subparagraph id="HEC970718193F40448C27504BB306AEB1"><enum>(D)</enum><text>provide technical
assistance services to eligible fresh, healthy food retail operators and
developers;</text>
</subparagraph><subparagraph id="HDFF0434C274145FA8BDED5128D9C94F6"><enum>(E)</enum><text>track and report
outcomes, including—</text>
<clause id="HBE23864F5F7C4AB6B368B94BD31875BF"><enum>(i)</enum><text>the number of jobs
created or retained;</text>
</clause><clause id="H387B1F4D4579486283A30F99717E40D3"><enum>(ii)</enum><text>the quantity of
fresh, healthy food retail space created or retained; and</text>
</clause><clause id="H750856CEE010490E82AFB76C325BF9E8"><enum>(iii)</enum><text>such other
health and economic indicators as are required by the national fund
manager;</text>
</clause></subparagraph><subparagraph id="H4FE17210DE7C429585E2D6D88625A697"><enum>(F)</enum><text>monitor and audit
funded projects to ensure compliance with the Initiative, the national fund
manager, and partnership program requirements for a period of at least 3
years;</text>
</subparagraph><subparagraph id="H09C20B3E51524F638E7C29F487374678"><enum>(G)</enum><text>submit an annual
report to the national fund manager that describes—</text>
<clause id="H5B8490EE902743BCAA63B6B1A6F29620"><enum>(i)</enum><text>the activities of
the partnership;</text>
</clause><clause id="HA316597D4E5247B2AC6B6F84AD225E49"><enum>(ii)</enum><text>the expenditure
of local funds; and</text>
</clause><clause id="H4726F71DC25E4356AE052C859236C58C"><enum>(iii)</enum><text>success in
meeting performance targets and satisfying such other terms and conditions as
are specified in the agreement between the partnership and the national fund
manager; and</text>
</clause></subparagraph><subparagraph id="HCC8C7CAB6E6E431181268BC2A54BB242"><enum>(H)</enum><text>coordinate with
the national fund manager for the smooth operation of the Initiative.</text>
</subparagraph></paragraph><paragraph id="HD8C4742F0E8847C6B7B889103292E6C1"><enum>(4)</enum><header>Administrative
costs</header>
<subparagraph id="H8A6D4F377E474E2E8659E6306BF3BB1F"><enum>(A)</enum><header>In
general</header><text>As a condition on the receipt of assistance under this
section, each partnership shall submit to the national fund manager for
approval a 3-year budget and plan for all program and operating costs,
including—</text>
<clause id="H42F01DA0B99949FD859D6CBC7D97417D"><enum>(i)</enum><text>costs for research
and evaluation, technical assistance, and training; and</text>
</clause><clause id="HDB6CCFEE8F6A491EAD32AD88639ACFC8"><enum>(ii)</enum><text>administrative
and operating costs.</text>
</clause></subparagraph><subparagraph id="HCC160E622A40491C9EC4E88DBC88328E"><enum>(B)</enum><header>Earned
revenues</header><text>Earned revenues from loan fees and interest may be
expended on program and operating costs in accordance with the budget approved
by the national fund manager.</text>
</subparagraph><subparagraph id="H9A804EA3B32E4B6FAE1E621E05699BBC"><enum>(C)</enum><header>Basis of
review</header><text>The national fund manager shall base the review under
subparagraph (A) on the likelihood of the budget and plan to further the
purposes of this section.</text>
</subparagraph></paragraph></subsection><subsection id="HBA0C949735D24B6A8C57830B283A68B7"><enum>(g)</enum><header>Evaluation and
monitoring</header>
<paragraph id="HAC7A5AD619864A51AF9B2F630A2B57AB"><enum>(1)</enum><header>In
general</header><text>Program evaluation and financial audits shall occur at
all levels of the Initiative to ensure that—</text>
<subparagraph id="H2E1300EDC9A04AD1803C6BF3EAE5CC65"><enum>(A)</enum><text>national and local
funds are used properly; and</text>
</subparagraph><subparagraph id="HBE09DD7AC73A433CB8BD3549B77535BF"><enum>(B)</enum><text>the objectives of
the Initiative are met.</text>
</subparagraph></paragraph><paragraph id="H54BB7BDAB8C24AD182D53828E7759ABE"><enum>(2)</enum><header>Program
evaluation and financial audits</header>
<subparagraph id="H7810D1DB1E0741AA8D3CEA87AE59A212"><enum>(A)</enum><header>In
general</header><text>The Secretary shall—</text>
<clause id="HBFB418B2DBB24F43A6F92C72392DF40F"><enum>(i)</enum><text>conduct periodic
program evaluations and financial audits of the national fund manager,
partnerships, and projects funded by the Initiative; and</text>
</clause><clause id="H3A4C627AA2A8404DB321231A2AB859AA"><enum>(ii)</enum><text>share with the
national fund manager the results of the evaluations and audits.</text>
</clause></subparagraph><subparagraph id="H6E947338092C4D2399EA3C95DCA2A195"><enum>(B)</enum><header>Funded
projects</header><text>The Secretary or the national fund manager shall
evaluate partnerships to assess the health and economic impacts of projects
funded by the Initiative.</text>
</subparagraph><subparagraph id="HB627FD092F2641E686BE794493773658"><enum>(C)</enum><header>Other
impacts</header>
<clause id="H9453ABF4249A4667AC19D79BBF253FE3"><enum>(i)</enum><header>Secretary of
Health and Human Services</header><text>The Secretary of Health and Human
Services shall conduct research studies and evaluate the health impacts of the
Initiative.</text>
</clause><clause id="H1FD9F4DD310A42DEA868D95A51BDC4BF"><enum>(ii)</enum><header>Community
Development Financial Institutions</header><text>Representatives of the
Community Development Financial Institutions shall conduct research studies and
evaluate the economic impacts of the Initiative.</text>
</clause></subparagraph><subparagraph id="HE192AEE378EE4C83BF774B1C7AC6482D"><enum>(D)</enum><header>Partnerships</header>
<clause id="HE12B27D6788B4D96AC0D323358F8A6D5"><enum>(i)</enum><header>In
general</header><text>Each partnership shall—</text>
<subclause id="HBEC689EEC33B4DF7B811CD2DB082BC85"><enum>(I)</enum><text>conduct periodic
administrative and financial audits of projects funded by the Initiative;
and</text>
</subclause><subclause id="H9F287AD4326246458645D15CF5C99C19"><enum>(II)</enum><text>share with the
national fund manager the results of the audits.</text>
</subclause></clause><clause id="H70E206E2E61E4287A3C01C8F57F87D35"><enum>(ii)</enum><header>Failure of
partnership</header><text>In a case in which a partnership fails, the national
fund manager shall take over the portfolio of the failed partnership.</text>
</clause></subparagraph></paragraph></subsection><subsection id="H70DE9577AF7145F2B6D2A89118AB938F"><enum>(h)</enum><header>Administrative
provisions</header><text display-inline="yes-display-inline">Not later than 180
days after the date of enactment of this section, the Secretary shall
promulgate such regulations as may be necessary to carry out this section,
including regulations—</text>
<paragraph id="H821727C2FFB4405EBCD2FEF35439409F"><enum>(1)</enum><text>for the conduct of
a performance evaluation at the end of the initial 5-year period;</text>
</paragraph><paragraph id="HA0D7B9A4123241228BD36760AD594679"><enum>(2)</enum><text>to terminate the
contract for cause; and</text>
</paragraph><paragraph id="H7208A96CE48842CAA3C508A7B1C8DF30"><enum>(3)</enum><text>to extend the
contract for an additional 5-year period.</text>
</paragraph></subsection><subsection id="HC66F6D865668423890787F87F617FAAC"><enum>(i)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">There is
authorized to be appropriated to the Secretary to carry out this section
$500,000,000, to remain available until
expended.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H634733DE2ACC4C5489CFAC62D578E72E"><enum>(b)</enum><header>Conforming
amendment</header><text>Section 296(b) of the Department of Agriculture
Reorganization Act of 1994 (7 U.S.C. 7014(b)) is amended—</text>
<paragraph id="H5165E13DB12B4CA588BDF078DAF94AD7"><enum>(1)</enum><text>in paragraph
(6)(C), by striking <quote>or</quote> at the end;</text>
</paragraph><paragraph id="HADF624ACD5FD4AF39504ADFB50FD3B94"><enum>(2)</enum><text>in paragraph (7),
by striking the period at the end and inserting <quote>; or</quote>; and</text>
</paragraph><paragraph id="H51A5909680BB4DC291913DD1F9CD9B81"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="HBA7E9071A950439FB974D82C09A86E9C" style="OLC">
<paragraph id="HF3CA3EBC206544CB8779577BE149A3F3"><enum>(8)</enum><text>the authority of
the Secretary to establish in the Department the Healthy Food Financing
Initiative in accordance with section
242.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="H47AA8DC03CE1461380D10648E5ADCDC2"><enum>1007.</enum><header>GAO report on
health effects of Deepwater Horizon oil rig explosion in the Gulf
Coast</header>
<subsection id="HDCDF606BB8084230AB3548C40FF200B0"><enum>(a)</enum><header>Study</header><text>The
Comptroller General of the United States shall conduct a study on the type and
scope of health care services administered through the Department of Health and
Human Services addressing the provision of health care to racial and ethnic
minorities (whether residents, clean-up workers, or volunteers) affected by the
explosion of the mobile offshore drilling unit Deepwater Horizon that occurred
on April 20, 2010.</text>
</subsection><subsection id="H2164755B38AA4BCB86C9775003C68317"><enum>(b)</enum><header>Specific
components; reporting</header><text>In carrying out subsection (a), the
Comptroller General shall—</text>
<paragraph id="H9FA4FA184BA2455C9D864AF7B259A9F7"><enum>(1)</enum><text>assess the type,
size, and scope of programs administered by the Department of Health and Human
Services that focus on provision of health care to communities in the Gulf
Coast;</text>
</paragraph><paragraph id="H267C4828C01C49C8A64E4BF19A39F33C"><enum>(2)</enum><text>identify the
merits and disadvantages associated with each the programs;</text>
</paragraph><paragraph id="H2D553FFF638A48958CAD2249149547AB"><enum>(3)</enum><text>perform an
analysis of the costs and benefits of the programs;</text>
</paragraph><paragraph id="H3F13A64538404B169B4AB987E1109CFB"><enum>(4)</enum><text>determine whether
there is any duplication of programs; and</text>
</paragraph><paragraph id="H5355BE218DE145E39E7DD7859C382A7A"><enum>(5)</enum><text>not later than 180
days after the date of the enactment of this Act, report findings and
recommendations for improving access to health care for racial and ethnic
minorities to the Congress.</text>
</paragraph></subsection></section>