[Congressional Record Volume 157, Number 10 (Tuesday, January 25, 2011)]
[Senate]
[Pages S228-S239]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. HARKIN:
  S. 174. A bill to improve the health of Americans and reduce health 
care costs by reorienting the Nation's health care

[[Page S229]]

system toward prevention, wellness, and health promotion; to the 
Committee on Finance.
  Mr. HARKIN. Mr. President, the Healthy Lifestyles and Prevention 
America Act, also known as the HeLP America Act, will improve the 
health of Americans and reduce health care costs by emphasizing 
prevention, wellness, and health promotion in our communities, 
workplaces and schools.
  We made a significant investment in prevention and wellness as part 
of the passing of the historic Affordable Care Act into law. The robust 
array of provisions contained in the HeLP America Act continue to build 
off the investments made by the Affordable Care Act and together, they 
will significantly transform our current sick care system into a true 
health care system.
  Make no mistake about it; these combined efforts will continue our 
transformation into a genuine wellness society by keeping people from 
developing chronic diseases and from costly hospitalizations in the 
first place.
  Currently, the United States spends more than $2 trillion on health 
care each year but historically we invest just four cents out of every 
dollar in prevention and public health--let me repeat that--just four 
cents out of every dollar is invested in prevention and public health.
  This is pennies despite all the research that shows that prevention 
and public health can effectively reduce health care spending. This is 
why I fought for the Prevention and Public Health Fund that is included 
in the health reform law.
  But transforming our Nation into a true wellness society requires a 
comprehensive approach to make being healthier easier for all 
Americans.
  It just doesn't make any sense why we don't put a greater emphasis on 
making health promotion easier--why would we focus so little on 
prevention and public health when we know that these initiatives can 
make us healthier and reduce our annual health care spending?
  Well, I am proud that the bill before the Senate continues to make 
significant investments in prevention and wellness. The HeLP America 
Act will put additional systems into place that will improve access to 
nutritious foods, opportunities for physical activity, and 
affordability of recommended preventive services.
  The bill focuses on initiatives to make kids and schools healthier. 
In particular, it will support State efforts to provide resources to 
child care providers to help them meet high-quality physical activity 
and healthy eating standards. It also directs the Department of 
Education to provide guidance and technical assistance to schools to 
provide equal opportunities for students with disabilities for physical 
education and extracurricular athletics.
  In addition, the bill focuses on initiatives to make healthier 
communities and workplaces. For example, it requires the Secretary of 
Health and Human Services to establish guidelines in physical activity 
for children under the age of 5 and the Secretary of Agriculture to 
establish a grant program promoting and expanding efforts to create 
community gardens. Specific to small businesses and workplace wellness 
programs, there is a provision that allows employers to deduct the cost 
of athletic facility memberships for their employees and exempts this 
benefit as taxable income for employees.
  The HeLP America Act also creates systems that give Americans the 
information they need to make informed decisions. In particular, there 
is a provision that requires uniform guidelines be developed for the 
use of nutrient labeling symbols or systems on the front of food 
packages. There are provisions meant to strengthen federal initiatives 
to improve the health literacy of consumers by making health 
information easier to understand and health care systems easier to 
navigate.
  Let me be clear, this bill doesn't just tinker around the edges; it 
changes the very paradigm of a variety of systems to make it easier for 
Americans to be healthy. After many years of advocating for wellness 
and prevention, I am thrilled to see that these things were at the very 
heart of the historic Affordable Care Act passed into law. But there is 
still much more to be done, and the HeLP America Act is an important 
step in continuing our transformation into a genuine wellness society 
and getting health care costs under control.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the additional material was ordered to be 
printed in the Record, as follows:

                                 S. 174

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Healthy 
     Lifestyles and Prevention America Act'' or the ``HeLP America 
     Act''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.

                  TITLE I--HEALTHIER KIDS AND SCHOOLS

Sec. 101. Nutrition and physical activity in child care quality 
              improvement.
Sec. 102. Access to local foods and school gardens at preschools and 
              child care.
Sec. 103. Fresh fruit and vegetable program.
Sec. 104. Equal physical activity opportunities for students with 
              disabilities.

             TITLE II--HEALTHIER COMMUNITIES AND WORKPLACES

               Subtitle A--Creating Healthier Communities

Sec. 201. Technical assistance for the development of joint use 
              agreements.
Sec. 202. Community sports programs for individuals with disabilities.
Sec. 203. Community gardens.
Sec. 204. Physical activity guidelines for Americans.
Sec. 205. Tobacco taxes parity.
Sec. 206. Leveraging and coordinating federal resources for improved 
              health.

            Subtitle B--Incentives for a Healthier Workforce

Sec. 211. Tax credit to employers for costs of implementing wellness 
              programs.
Sec. 212. Employer-provided off-premises athletic facilities.
Sec. 213. Task force for the promotion of breastfeeding in the 
              workplace.
Sec. 214. Improving healthy eating and active living options in Federal 
              workplaces.

        TITLE III--RESPONSIBLE MARKETING AND CONSUMER AWARENESS

Sec. 301. Guidelines for reduction in sodium content in certain foods.
Sec. 302. Nutrition labeling for food products sold principally for use 
              in restaurants or other retail food establishments.
Sec. 303. Front-label food guidance systems.
Sec. 304. Rulemaking authority for advertising to children.
Sec. 305. Health Literacy: research, coordination and dissemination.
Sec. 306. Disallowance of deductions for advertising and marketing 
              expenses relating to tobacco product use.
Sec. 307. Incentives to reduce tobacco use.

           TITLE IV--EXPANDED COVERAGE OF PREVENTIVE SERVICES

Sec. 401. Required coverage of preventive services under the Medicaid 
              program.
Sec. 402. Coverage for comprehensive workplace wellness program and 
              preventive services.
Sec. 403. Health professional education and training in healthy eating.

                           TITLE V--RESEARCH

Sec. 501. Grants for Body Mass Index data analysis.
Sec. 502. National assessment of mental health needs.

                  TITLE I--HEALTHIER KIDS AND SCHOOLS

     SEC. 101. NUTRITION AND PHYSICAL ACTIVITY IN CHILD CARE 
                   QUALITY IMPROVEMENT.

       Section 658G of the Child Care and Development Block Grant 
     Act of 1990 (42 U.S.C. 9858e) is amended--
       (1) by striking ``choice, and'' and inserting ``choice,''; 
     and
       (2) by inserting after ``referral services)'' the 
     following: ``, and the provision of resources to enable 
     eligible child care providers to meet, exceed, or sustain 
     success in meeting or exceeding Federal or State high-quality 
     program standards relating to health, mental health, 
     nutrition, physical activity, and physical development''.

     SEC. 102. ACCESS TO LOCAL FOODS AND SCHOOL GARDENS AT 
                   PRESCHOOLS AND CHILD CARE.

       Section 18(g) of the Richard B. Russell National School 
     Lunch Act (42 U.S.C. 1769(g)) is amended--
       (1) by redesignating paragraphs (1) through (4) as 
     paragraphs (2) through (5), respectively;
       (2) by inserting before paragraph (2) (as redesignated by 
     paragraph (1)) the following:
       ``(1) Definitions.--In this subsection:
       ``(A) Child care center.--The term `child care center' 
     means a child care center participating in the program under 
     section 17 (other than a child care center that solely 
     participates in the program under subsection (r) of that 
     section).

[[Page S230]]

       ``(B) Sponsoring organization.--The term `sponsoring 
     organization' means an institution described in subparagraphs 
     (C), (D), or (E) of section 17(a)(2).'';
       (3) in paragraph (2) (as so redesignated)--
       (A) in the paragraph heading, by striking ``IN GENERAL'' 
     and inserting ``ASSISTANCE'';
       (B) in the matter preceding subparagraph (A), by inserting 
     ``, child care centers, sponsoring organizations for home-
     based care,'' after ``schools''; and
       (C) in subparagraph (A), by inserting ``, child care 
     centers, sponsoring organizations for home-based care,'' 
     after ``schools'';
       (4) in paragraph (3) (as so redesignated), by striking 
     ``paragraph (1)'' and inserting ``paragraph (2)''; and
       (5) in paragraph (4) (as so redesignated)--
       (A) in subparagraph (A)(i)--
       (i) in subclause (I), by striking ``or'';
       (ii) in subclause (II), by striking the period at the end 
     and inserting ``; or''; and
       (iii) by adding at the end the following:

       ``(III) a consortium of at least 2 child care centers or 
     sponsoring organizations for home-based care with hands-on 
     vegetable gardening and nutrition education that is 
     incorporated into the curriculum for 1 or more age groups at 
     2 or more eligible centers or family child care homes 
     supported by sponsoring organizations for home-based care.''; 
     and

       (B) in subparagraph (F), by striking ``paragraph (1)(H)'' 
     and inserting ``paragraph (2)(H)''.

     SEC. 103. FRESH FRUIT AND VEGETABLE PROGRAM.

       Section 19 of the Richard B. Russell National School Lunch 
     Act (42 U.S.C. 1769a) is amended--
       (1) by striking subsections (c) and (d) and inserting the 
     following:
       ``(c) School Participation.--
       ``(1) In general.--Each State shall carry out the program 
     in each elementary school (as defined in section 9101 of the 
     Elementary and Secondary Education Act of 1965 (20 U.S.C. 
     7801)) in the State--
       ``(A) in which not less than 50 percent of the students are 
     eligible for free or reduced price meals under this Act; and
       ``(B) that submits an application in accordance with 
     paragraph (2).
       ``(2) Application.--
       ``(A) In general.--An interested elementary school shall 
     submit to the State an application containing--
       ``(i) information pertaining to the percentage of students 
     enrolled in the school who are eligible for free or reduced 
     price school lunches under this Act;
       ``(ii) a certification of support for participation in the 
     program signed by the school food manager, the school 
     principal, and the district superintendent (or equivalent 
     positions, as determined by the school);
       ``(iii) a plan for implementation of the program, including 
     efforts to integrate activities carried out under this 
     section with other efforts to promote sound health and 
     nutrition, reduce overweight and obesity, or promote physical 
     activity; and
       ``(iv) such other information as may be requested by the 
     Secretary.
       ``(B) Partnerships.--Each State shall encourage interested 
     elementary schools to submit a plan for implementation of the 
     program that includes a partnership with 1 or more entities 
     that will provide non-Federal resources (including entities 
     representing the fruit and vegetable industry).'';
       (2) by striking subsection (i) and inserting the following:
       ``(i) Funding.--
       ``(1) In general.--Out of any funds in the Treasury not 
     otherwise appropriated, the Secretary of the Treasury shall 
     transfer to the Secretary to carry out this section such sums 
     as are necessary, to remain available until expended.
       ``(2) Receipt and acceptance.--The Secretary shall be 
     entitled to receive, shall accept, and shall use to carry out 
     this section the funds transferred under paragraph (1), 
     without further appropriation.''; and
       (3) by redesignating subsections (e) through (i) as 
     subsections (d) through (h), respectively.

     SEC. 104. EQUAL PHYSICAL ACTIVITY OPPORTUNITIES FOR STUDENTS 
                   WITH DISABILITIES.

       (a) In General.--Title V of the Rehabilitation Act of 1973 
     (29 U.S.C. 791 et seq.) is amended by adding at the end the 
     following:

     ``SEC. 511. EQUAL PHYSICAL ACTIVITY OPPORTUNITIES FOR 
                   STUDENTS WITH DISABILITIES.

       ``(a) In General.--The Secretary shall promote equal 
     opportunities for students with disabilities to be included 
     and to participate in physical education and extracurricular 
     athletics implemented in, or in conjunction with, elementary 
     schools, secondary schools, and institutions of higher 
     education, by ensuring the provision of appropriate technical 
     assistance and guidance for schools and institutions 
     described in this subsection and their personnel.
       ``(b) Technical Assistance and Guidance.--The provision of 
     technical assistance and guidance described in subsection (a) 
     shall include--
       ``(1) providing technical assistance to elementary schools, 
     secondary schools, local educational agencies, State 
     educational agencies, and institutions of higher education, 
     regarding--
       ``(A) inclusion and participation of students with 
     disabilities, in a manner equal to that of the other 
     students, in physical education opportunities (including 
     classes), and extracurricular athletics opportunities, 
     including technical assistance on providing reasonable 
     modifications to policies, practices, and procedures, and 
     providing supports to ensure such inclusion and 
     participation;
       ``(B) provision of adaptive sports programs, in the 
     physical education and extracurricular athletics 
     opportunities, including programs with competitive sports 
     leagues or competitions, for students with disabilities; and
       ``(C) responsibilities of the schools, institutions, and 
     agencies involved under section 504, the Americans with 
     Disabilities Act of 1990 (42 U.S.C. 12101 et seq.), and any 
     other applicable Federal law to provide students with 
     disabilities equal access to extracurricular athletics;
       ``(2) facilitating information sharing among the schools, 
     institutions, and agencies, and students with disabilities, 
     on ways to provide inclusive opportunities in physical 
     education and extracurricular athletics for students with 
     disabilities; and
       ``(3) monitoring the extent to which physical education and 
     extracurricular athletics opportunities for students with 
     disabilities are implemented in, or in conjunction with, 
     elementary schools, secondary schools, and institutions of 
     higher education.
       ``(c) Definitions.--In this section:
       ``(1) Agencies.--The terms `local educational agency' and 
     `State educational agency' have the meanings given the terms 
     in section 9101 of the Elementary and Secondary Education Act 
     of 1965 (20 U.S.C. 7801).
       ``(2) Schools.--The terms `elementary school', `secondary 
     school', and `institution of higher education' mean an 
     elementary school, secondary school, or institution of higher 
     education, respectively (as defined in section 9101 of the 
     Elementary and Secondary Education Act of 1965), that 
     receives or has 1 or more students that receive, Federal 
     financial assistance.
       ``(3) Student with a disability.--
       ``(A) In general.--The term `student with a disability' 
     means an individual who--
       ``(i) attends an elementary school, secondary school, or 
     institution of higher education; and
       ``(ii) who--

       ``(I) is eligible for, and receiving, special education or 
     related services under part B of the Individuals with 
     Disabilities Education Act (20 U.S.C. 1411 et seq.); or
       ``(II) is an individual with a disability, for purposes of 
     section 504 or the Americans with Disabilities Act of 1990.

       ``(B) Students with disabilities.--The term `students with 
     disabilities' means more than 1 student with a disability.''.
       (b) Table of Contents.--The table of contents in section 
     1(b) of the Rehabilitation Act of 1973 is amended by 
     inserting after the item relating to section 509 the 
     following:

``Sec. 510. Establishment of standards for accessible medical 
              diagnostic equipment.
``Sec. 511. Equal physical activity opportunities for students with 
              disabilities.''.

             TITLE II--HEALTHIER COMMUNITIES AND WORKPLACES

               Subtitle A--Creating Healthier Communities

     SEC. 201. TECHNICAL ASSISTANCE FOR THE DEVELOPMENT OF JOINT 
                   USE AGREEMENTS.

       (a) In General.--The Secretary of Health and Human 
     Services, acting through the Director of the Centers for 
     Disease Control and Prevention and in coordination with the 
     Secretary of Education and in consultation with leading 
     national experts and organizations advancing healthy living 
     in the school environment, shall develop and disseminate 
     guidelines and best practices, including model documents, and 
     provide technical assistance to elementary and secondary 
     schools to assist such schools with the development of joint 
     use agreements so as to address liability, operational and 
     management, and cost issues that may otherwise impede the 
     ability of community members to use school facilities for 
     recreational and nutritional purposes during nonschool hours.
       (b) Definition.--In this section, the term ``joint use 
     agreement'' means a formal agreement between an elementary or 
     secondary school and another entity relating to the use of 
     the school's facilities, equipment, or property, including 
     recreational and food services facilities, equipment, and 
     property, by individuals other than the school's students or 
     staff.

     SEC. 202. COMMUNITY SPORTS PROGRAMS FOR INDIVIDUALS WITH 
                   DISABILITIES.

       Part P of title III of the Public Health Service Act (42 
     U.S.C. 280g et seq.) is amended by adding at the end the 
     following:

     ``SEC. 399V-5. COMMUNITY SPORTS PROGRAMS FOR INDIVIDUALS WITH 
                   DISABILITIES.

       ``(a) In General.--
       ``(1) Individual with a disability defined.--For purposes 
     of this section, the term `individual with a disability' 
     means any person who has a disability as defined in section 3 
     of the Americans with Disabilities Act of 1990 ( 42 U.S.C. 
     12102).
       ``(2) Individual with a physical disability.--The term 
     `individual with a physical disability' means an individual 
     with a disability that has a physical or visual disability.
       ``(3) Community sports grants program.--The Secretary, in 
     collaboration with the National Advisory Committee on 
     Community Sports Programs for Individuals with Disabilities, 
     may award grants on a competitive basis to public and 
     nonprofit private entities to implement community-based, 
     sports and

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     athletic programs for individuals with disabilities, 
     including youth with disabilities.
       ``(b) Application.--To be eligible to receive a grant under 
     this section, a public or nonprofit private entity shall 
     submit to the Secretary an application at such time, in such 
     manner, and containing such agreements, assurances, and 
     information as the Secretary determines to be necessary to 
     carry out this section.
       ``(c) Authorized Activities.--Amounts awarded under a grant 
     under subsection (a) shall be used for--
       ``(1) community-based sports programs, leagues, or 
     competitions in individual or team sports for individuals 
     with physical disabilities;
       ``(2) regional sports programs or competitions in 
     individual or team sports for individuals with physical 
     disabilities;
       ``(3) the development of competitive team and individual 
     sports programs for individuals with disabilities at the high 
     school and collegiate level; or
       ``(4) the development of mentoring programs to encourage 
     participation in sports programs for individuals with 
     disabilities, including individuals with recently acquired 
     disabilities.
       ``(d) Priorities.--
       ``(1) Advisory committee.--The Secretary shall establish a 
     National Advisory Committee on Community Sports Programs for 
     Individuals with Disabilities that shall--
       ``(A) establish priorities for the implementation of this 
     section;
       ``(B) review grant proposals;
       ``(C) make recommendations for distribution of the 
     available appropriated funds to specific applicants; and
       ``(D) annually evaluate the progress of programs carried 
     out under this section in implementing such priorities.
       ``(2) Representation.--The Advisory Committee established 
     under paragraph (1) shall include representatives of--
       ``(A) the Department of Health and Human Services Office on 
     Disability;
       ``(B) the United States Surgeon General;
       ``(C) the Centers for Disease Control and Prevention;
       ``(D) disabled sports organizations;
       ``(E) organizations that represent the interests of 
     individuals with disabilities; and
       ``(F) individuals with disabilities (including athletes 
     with physical disabilities) or their family members.
       ``(e) Dissemination of Information.--The Secretary shall 
     disseminate information about the availability of grants 
     under this section in a manner that is designed to reach 
     public entities and nonprofit private organizations that are 
     dedicated to providing outreach, advocacy, or independent 
     living services to individuals with disabilities.
       ``(f) Technical Assistance.--The Secretary, in conjunction 
     with the United States Olympic Committee and disabled sports 
     organizations, shall establish a technical assistance center 
     to provide training, support, and information to grantees 
     under this section on establishing and operating community 
     sports programs for individuals with disabilities.
       ``(g) Report to Congress.--Not later than 180 days after 
     the date of the enactment of this section, and annually 
     thereafter, the Secretary shall submit to Congress a report 
     summarizing activities, findings, outcomes, and 
     recommendations resulting from the grant projects funded 
     under this section during the year for which the report is 
     being prepared.
       ``(h) Authorization of Appropriations.--
       ``(1) In general.--To carry out this section, there are 
     authorized to be appropriated such sums as may be necessary.
       ``(2) Limitation.--Not to exceed 10 percent of the amount 
     appropriated in each fiscal year shall be used to carry out 
     activities under subsection (c)(4).''.

     SEC. 203. COMMUNITY GARDENS.

       Subtitle D of title X of the Food, Conservation, and Energy 
     Act of 2008 (Public Law 110-246; 122 Stat. 2109) is amended 
     by adding at the end the following:

     ``SEC. 10405. COMMUNITY GARDEN GRANT PROGRAM.

       ``(a) Definitions.--In this section:
       ``(1) Eligible entity.--The term `eligible entity' means--
       ``(A) a nonprofit organization; or
       ``(B) a unit of general local government, or tribal 
     government, located on tribal land or in a low-income 
     community.
       ``(2) Low-income community.--The term `low-income 
     community' means--
       ``(A) a community in which not less than 50 percent of 
     children are eligible for free or reduced priced meals under 
     the Richard B. Russell National School Lunch Act (42 U.S.C. 
     1751 et seq.); or
       ``(B) any other community determined by the Secretary to be 
     low-income for purposes of this section.
       ``(3) Unit of general local government.--The term `unit of 
     general local government' has the meaning given the term in 
     section 102 of the Housing and Community Development Act of 
     1974 (42 U.S.C. 5302).
       ``(b) Program Established.--Using such amounts as are 
     appropriated to carry out this section, the Secretary shall 
     award grants to eligible entities to expand, establish, or 
     maintain community gardens.
       ``(c) Application.--To be considered for a grant under this 
     section, an eligible entity shall submit to the Secretary an 
     application at such time, in such manner, and containing such 
     information as the Secretary may require, including--
       ``(1) an assurance that priority for hiring for jobs 
     created by the expansion, establishment, or maintenance of a 
     community garden funded with a grant received under this 
     section will be given to individuals who reside in the 
     community in which the garden is located; and
       ``(2) a demonstration that the eligible entity is committed 
     to providing non-Federal financial or in-kind support (such 
     as providing a water supply) for the community garden for 
     which the entity receives funds under this section.''.

     SEC. 204. PHYSICAL ACTIVITY GUIDELINES FOR AMERICANS.

       (a) Report.--
       (1) In general.--At least every 5 years, the Secretary of 
     Health and Human Services (in this Act referred to as the 
     ``Secretary'') shall publish a report entitled ``Physical 
     Activity Guidelines for Americans''. Each such report shall 
     contain physical activity information and guidelines for the 
     general public, and shall be promoted by each Federal agency 
     in carrying out any Federal health program.
       (2) Basis of guidelines.--The information and guidelines 
     contained in each report required under paragraph (1) shall 
     be based on the preponderance of the scientific and medical 
     knowledge which is current at the time the report is 
     prepared, and shall include guidelines for identified 
     population subgroups, including children, if the 
     preponderance of scientific and medical knowledge indicates 
     those subgroups require different levels of physical 
     activity.
       (b) Approval by Secretary.--
       (1) Review.--Any Federal agency that proposes to issue any 
     physical activity guidance for the general population or 
     identified population subgroups shall submit the text of such 
     guidance to the Secretary for a 60-day review period.
       (2) Basis of review.--
       (A) In general.--During the 60-day review period 
     established in paragraph (1), the Secretary shall review and 
     approve or disapprove such guidance to assure that the 
     guidance either is consistent with the ``Physical Activity 
     Guidelines for Americans'' or that the guidance is based on 
     medical or new scientific knowledge which is determined to be 
     valid by the Secretary. If after such 60-day review period 
     the Secretary has not notified the proposing agency that such 
     guidance has been disapproved, then such guidance may be 
     issued by the agency. If the Secretary disapproves such 
     guidance, it shall be returned to the agency. If the 
     Secretary finds that such guidance is inconsistent with the 
     ``Physical Activity Guidelines for Americans'' and so 
     notifies the proposing agency, such agency shall follow the 
     procedures set forth in this subsection before disseminating 
     such proposal to the public in final form. If after such 60-
     day period, the Secretary disapproves such guidance as 
     inconsistent with the ``Physical Activity Guidelines for 
     Americans'' the proposing agency shall--
       (i) publish a notice in the Federal Register of the 
     availability of the full text of the proposal and the 
     preamble of such proposal which shall explain the basis and 
     purpose for the proposed physical activity guidance;
       (ii) provide in such notice for a public comment period of 
     30 days; and
       (iii) make available for public inspection and copying 
     during normal business hours any comment received by the 
     agency during such comment period.
       (B) Review of comments.--After review of comments received 
     during the comment period, the Secretary may approve for 
     dissemination by the proposing agency a final version of such 
     physical activity guidance along with an explanation of the 
     basis and purpose for the final guidance which addresses 
     significant and substantive comments as determined by the 
     proposing agency.
       (C) Announcement.--Any such final physical activity 
     guidance to be disseminated under subparagraph (B) shall be 
     announced in a notice published in the Federal Register, 
     before public dissemination along with an address where 
     copies may be obtained.
       (D) Notification of disapproval.--If after the 30-day 
     period for comment as provided under subparagraph (A)(ii), 
     the Secretary disapproves a proposed physical activity 
     guidance, the Secretary shall notify the Federal agency 
     submitting such guidance of such disapproval, and such 
     guidance may not be issued, except as provided in 
     subparagraph (E).
       (E) Review of disapproval.--If a proposed physical activity 
     guidance is disapproved by the Secretary under subparagraph 
     (D), the Federal agency proposing such guidance may, within 
     15 days after receiving notification of such disapproval 
     under subparagraph (D), request the Secretary to review such 
     disapproval. Within 15 days after receiving a request for 
     such a review, the Secretary shall conduct such review. If, 
     pursuant to such review, the Secretary approves such proposed 
     physical activity guidance, such guidance may be issued by 
     the Federal agency.
       (3) Definitions.--In this subsection:
       (A) The term ``physical activity guidance for the general 
     population'' does not include any rule or regulation issued 
     by a Federal agency.
       (B) The term ``identified population subgroups'' shall 
     include, but not be limited to, groups based on factors such 
     as age, sex, race, or physical disability.
       (c) Existing Authority Not Affected.--This section does not 
     place any limitations on--
       (1) the conduct or support of any scientific or medical 
     research by any Federal agency; or

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       (2) the presentation of any scientific or medical findings 
     or the exchange or review of scientific or medical 
     information by any Federal agency.

     SEC. 205. TOBACCO TAXES PARITY.

       (a) Increase in Excise Tax on Small Cigarettes and Small 
     Cigars.--
       (1) Section 5701(a)(1) of the Internal Revenue Code of 1986 
     is amended by striking ``$50.33'' and inserting ``$77.83''.
       (2) Section 5701(b)(1) of the Internal Revenue Code of 1986 
     is amended by striking ``$50.33'' and inserting ``$77.83''
       (b) Tax Parity for Pipe Tobacco and Roll-your-own 
     Tobacco.--
       (1) Section 5701(f) of the Internal Revenue Code of 1986 is 
     amended by striking ``$2.8311 cents'' and inserting 
     ``$38.32''.
       (2) Section 5701(g) of the Internal Revenue Code of 1986 is 
     amended by striking ``$24.78'' and inserting ``$38.32''.
       (c) Clarification of Definition of Small Cigars.--
     Paragraphs (1) and (2) of section 5701(a) of the Internal 
     Revenue Code of 1986 are each amended by striking ``three 
     pounds per thousand'' and inserting ``four and one-half 
     pounds per thousand''.
       (d) Clarification of Definition of Cigarette.--Paragraph 
     (2) of section 5702(b) of the Internal Revenue Code of 1986 
     is amended by insert before the final period the following: 
     ``, which includes any roll for smoking containing tobacco 
     that weighs no more than four and a half pounds per thousand, 
     unless it is wrapped in whole tobacco leaf and does not have 
     a cellulose acetate or other cigarette-style filter''.
       (e) Tax Parity for Smokeless Tobacco.--
       (1) Section 5701(e) of the Internal Revenue Code of 1986 is 
     amended--
       (A) in paragraph (1), by striking ``$1.51'' and inserting 
     ``$20.75'';
       (B) in paragraph (2), by striking ``50.33 cents'' and 
     inserting ``$8.30''; and
       (C) by adding at the end the following:
       ``(3) Smokeless tobacco sold in discrete single-use 
     units.--On discrete single-use units, $77.83 per each 1,000 
     single-use units.''.
       (2) Section 5702(m) of the Internal Revenue Code of 1986 is 
     amended--
       (A) in paragraph (1), ``or chewing tobacco'' and inserting 
     ``chewing tobacco, discrete single-use unit'';
       (B) in paragraphs (2) and (3), by inserting ``that is not a 
     discrete single-use unit'' before the period in each such 
     paragraph;
       (C) by adding at the end the following:
       ``(4) Discrete single-use unit.--The term `discrete single-
     use unit' means any product containing tobacco that--
       ``(A) is intended or expected to be consumed without being 
     combusted; and
       ``(B) is in the form of a lozenge, tablet, pill, pouch, 
     dissolvable strip, or other discrete single-use or single-
     dose unit.''.
       (f) Clarifying Other Tobacco Tax Definitions.--
       (1) Tobacco product definition.--Section 5702(c) of the 
     Internal Revenue Code of 1986 is amended by inserting before 
     the period the following: ``, and any other product 
     containing tobacco that is intended or expected to be 
     consumed''.
       (2) Cigarette paper definition.--Section 5702(e) of the 
     Internal Revenue Code of 1986 is amended by striking ``except 
     tobacco,'' and inserting ``or cigar''.
       (3) Cigarette tube definition.--Section 5702(f) of the 
     Internal Revenue Code of 1986 is amended by inserting before 
     the period ``or cigars''.
       (4) Importer definition.--Section 5702(k) of the Internal 
     Revenue Code of 1986 is amended by inserting ``or any other 
     tobacco product'' after ``cigars or cigarettes''.
       (g) Floor Stocks Taxes.--
       (1) Imposition of tax.--On tobacco products manufactured in 
     or imported into the United States which are removed before 
     any tax increase date and held on such date for sale by any 
     person, there is hereby imposed a tax in an amount equal to 
     the excess of--
       (A) the tax which would be imposed under section 5701 of 
     the Internal Revenue Code of 1986 on the article if the 
     article had been removed on such date, over
       (B) the prior tax (if any) imposed under section 5701 of 
     such Code on such article.
       (2) Credit against tax.--Each person shall be allowed as a 
     credit against the taxes imposed by paragraph (1) an amount 
     equal to $500. Such credit shall not exceed the amount of 
     taxes imposed by paragraph (1) on such date for which such 
     person is liable.
       (3) Liability for tax and method of payment.--
       (A) Liability for tax.--A person holding tobacco products 
     on any tax increase date to which any tax imposed by 
     paragraph (1) applies shall be liable for such tax.
       (B) Method of payment.--The tax imposed by paragraph (1) 
     shall be paid in such manner as the Secretary shall prescribe 
     by regulations.
       (C) Time for payment.--The tax imposed by paragraph (1) 
     shall be paid on or before the date that is 120 days after 
     the effective date of the tax rate increase.
       (4) Articles in foreign trade zones.--Notwithstanding the 
     Act of June 18, 1934 (commonly known as the Foreign Trade 
     Zone Act, 48 Stat. 998, 19 U.S.C. 81a et seq.) or any other 
     provision of law, any article which is located in a foreign 
     trade zone on any tax increase date shall be subject to the 
     tax imposed by paragraph (1) if--
       (A) internal revenue taxes have been determined, or customs 
     duties liquidated, with respect to such article before such 
     date pursuant to a request made under the 1st proviso of 
     section 3(a) of such Act, or
       (B) such article is held on such date under the supervision 
     of an officer of the United States Customs and Border 
     Protection of the Department of Homeland Security pursuant to 
     the 2d proviso of such section 3(a).
       (5) Definitions.--For purposes of this subsection--
       (A) In general.--Any term used in this subsection which is 
     also used in section 5702 of such Code shall have the same 
     meaning as such term has in such section.
       (B) Tax increase date.--The term ``tax increase date'' 
     means the effective date of any increase in any tobacco 
     product excise tax rate pursuant to the amendments made by 
     this section.
       (C) Secretary.--The term ``Secretary'' means the Secretary 
     of the Treasury or the Secretary's delegate.
       (6) Controlled groups.--Rules similar to the rules of 
     section 5061(e)(3) of such Code shall apply for purposes of 
     this subsection.
       (7) Other laws applicable.--All provisions of law, 
     including penalties, applicable with respect to the taxes 
     imposed by section 5701 of such Code shall, insofar as 
     applicable and not inconsistent with the provisions of this 
     subsection, apply to the floor stocks taxes imposed by 
     paragraph (1), to the same extent as if such taxes were 
     imposed by such section 5701. The Secretary may treat any 
     person who bore the ultimate burden of the tax imposed by 
     paragraph (1) as the person to whom a credit or refund under 
     such provisions may be allowed or made.
       (h) Effective Date.--The amendments made by this section 
     shall apply to articles removed (as defined in section 
     5702(j) of the Internal Revenue Code of 1986) after December 
     31, 2010.

     SEC. 206. LEVERAGING AND COORDINATING FEDERAL RESOURCES FOR 
                   IMPROVED HEALTH.

       (a) Health Impacts of Non-health Legislation.--
       (1) In general.--Not later than 6 months after the date of 
     enactment of this Act, the National Prevention, Health 
     Promotion and Public Health Council, shall enter into a 
     contract with the Institute of Medicine of the National 
     Academy of Sciences for the conduct of a study to assess the 
     potential health impacts of major non-health related 
     legislation that is likely to be considered by Congress 
     within a year of completion of the study. Such study shall 
     identify the ways in which such legislation involved is 
     likely to impact the health of Americans and shall contain 
     recommendations to Congress on ways to maximize the positive 
     health impacts and minimize the negative health impacts.
       (2) Timing.--The timing of the study under paragraph (1) 
     shall be provide for in a manner that ensures that the 
     results of the study will be available at least 3 months 
     prior to the consideration of the legislation involved by 
     Congress.
       (3) Guidelines.--To the extent practicable, the Council 
     under paragraph (1) shall ensure that the study conducted 
     under this subsection complies with the consensus guidelines 
     on how to carry out a health impact assessment, including 
     stakeholder engagement guidelines, such as the HIA of the 
     Americas Practice Guidelines and guidelines promulgated by 
     the World Health Organization and other consensus bodies.
       (4) Report.--Upon completion of the study under this 
     subsection, the Institute of Medicine shall submit to the 
     Council under paragraph (1), and make available to the 
     general public, a report that--
       (A) summarizes the direct, indirect, and cumulative health 
     impacts identified in the assessment; and
       (B) contains recommendations for how to maximize positive 
     health impacts and minimize negative health impacts of the 
     legislation involved.
       (5) Type of legislation.--For purposes of this subsection, 
     the term ``non-health related legislation'' shall have the 
     meaning given such term by the Council under paragraph (1), 
     and shall include legislation that is likely to have impacts 
     on the health of Americans where such impacts are not likely 
     to be considered by Congress to the extent required by their 
     scope without the conduct of an assessment under this 
     subsection. Examples of major non-health related legislation 
     that could be the subject of the study include 
     reauthorizations of the Safe, Accountable, Flexible, 
     Efficient Transportation Equity Act: A Legacy for Users 
     (SAFETEA-LU; Public Law 109-59), the Food, Conservation, and 
     Energy Act of 2008 (Public Law 110-246), and the Elementary 
     and Secondary Education Act of 1965 (20 U.S.C. 6301 et seq.).
       (b) Improving Health Impacts of Federal Agency 
     Activities.--
       (1) In general.--The Secretary, acting through the Director 
     of the Centers for Disease Control and Prevention and in 
     coordination with the National Prevention, Health Promotion 
     and Public Health Council, shall detail employees of the 
     Department of Health and Human Services to policy and program 
     planning offices of other Federal departments and agencies, 
     including the Department of Transportation, the Department of 
     Housing and Urban Development, the Department of Agriculture, 
     the Department of Education, and the Department of the 
     Interior, in order to assist those departments and agencies 
     to consider the impacts of their activities on the health of 
     the populations served and to assist with the integration of 
     health goals into the activities of the departments and 
     agencies, as appropriate.
       (2) Duties.--Employees detailed under paragraph (1) shall 
     assist with assessments of the potential impacts of the 
     programs and

[[Page S233]]

     activities of the department or agency involved on the health 
     and well-being of the populations served, the development of 
     metrics and performance standards that can be incorporated, 
     as appropriate, into the activities, performance 
     measurements, and grant and contract standards of the 
     department or agency, and the development of the report 
     detailed in paragraph (3).
       (3) Reports.--Not later than 1 year after the date of 
     enactment of this Act, and annually thereafter, each 
     department and agency with a detailee under this section 
     shall submit to the National Prevention, Health Promotion and 
     Public Health Council, 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 
     detailing the health impacts of the department or agency's 
     activities and any plans to improve those impacts.''

            Subtitle B--Incentives for a Healthier Workforce

     SEC. 211. TAX CREDIT TO EMPLOYERS FOR COSTS OF IMPLEMENTING 
                   WELLNESS PROGRAMS.

       (a) In General.--Subpart D of part IV of subchapter A of 
     chapter 1 of the Internal Revenue Code of 1986 is amended by 
     adding at the end the following:

     ``SEC. 45S. WELLNESS PROGRAM CREDIT.

       ``(a) Allowance of Credit.--
       ``(1) In general.--For purposes of section 38, the wellness 
     program credit determined under this section for any taxable 
     year during the credit period with respect to an employer is 
     an amount equal to 50 percent of the costs paid or incurred 
     by the employer in connection with a qualified wellness 
     program during the taxable year.
       ``(2) Limitation.--The amount of credit allowed under 
     paragraph (1) for any taxable year shall not exceed the sum 
     of--
       ``(A) the product of $200 and the number of employees of 
     the employer not in excess of 200 employees, plus
       ``(B) the product of $100 and the number of employees of 
     the employer in excess of 200 employees.
       ``(b) Qualified Wellness Program.--For purposes of this 
     section--
       ``(1) Qualified wellness program.--The term `qualified 
     wellness program' means a program which--
       ``(A) consists of any 3 of the wellness program components 
     described in subsection (c), and
       ``(B) which is certified by the Secretary of Health and 
     Human Services, in consultation with the Secretary of the 
     Treasury and Secretary of Labor, as a qualified wellness 
     program under this section.
       ``(2) Programs must be consistent with research and best 
     practices.--
       ``(A) In general.--The Secretary of Health and Human 
     Services shall not certify a program as a qualified wellness 
     program unless the program--
       ``(i) is consistent with evidence-based research and best 
     practices, as identified by persons with expertise in 
     employer health promotion and wellness programs,
       ``(ii) includes multiple, evidence-based strategies which 
     are based on the existing and emerging research and careful 
     scientific reviews, including the Guide to Community 
     Preventive Services, the Guide to Clinical Preventive 
     Services, and the National Registry for Effective Programs, 
     and
       ``(iii) includes strategies which focus on employee 
     populations with a disproportionate burden of health 
     problems.
       ``(B) Periodic updating and review.--The Secretary of 
     Health and Human Services shall establish procedures for 
     periodic review and recertifications of programs under this 
     subsection. Such procedures shall require revisions of 
     programs if necessary to ensure compliance with the 
     requirements of this section and require updating of the 
     programs to the extent the Secretary, in consultation with 
     the Secretary of the Treasury and the Secretary of Labor, 
     determines necessary to reflect new scientific findings.
       ``(3) Health literacy.--The Secretary of Health and Human 
     Services shall, as part of the certification process, 
     encourage employers to make the programs culturally competent 
     and to meet the health literacy needs of the employees 
     covered by the programs.
       ``(c) Wellness Program Components.--For purposes of this 
     section, the wellness program components described in this 
     subsection are the following:
       ``(1) Health awareness component.--A health awareness 
     component which provides for the following:
       ``(A) Health education.--The dissemination of health 
     information which addresses the specific needs and health 
     risks of employees.
       ``(B) Health screenings.--The opportunity for periodic 
     screenings for health problems and referrals for appropriate 
     follow up measures.
       ``(2) Employee engagement component.--An employee 
     engagement component which provides for--
       ``(A) the establishment of a committee to actively engage 
     employees in worksite wellness programs through worksite 
     assessments and program planning, delivery, evaluation, and 
     improvement efforts, and
       ``(B) the tracking of employee participation.
       ``(3) Behavioral change component.--A behavioral change 
     component which provides for altering employee lifestyles to 
     encourage healthy living through counseling, seminars, on-
     line programs, or self-help materials which provide technical 
     assistance and problem solving skills. Such component may 
     include programs relating to--
       ``(A) tobacco use,
       ``(B) overweight and obesity,
       ``(C) stress management,
       ``(D) physical activity,
       ``(E) nutrition,
       ``(F) substance abuse,
       ``(G) depression, and
       ``(H) mental health promotion (including anxiety).
       ``(4) Supportive environment component.--A supportive 
     environment component which includes the following:
       ``(A) On-site policies.--Policies and services at the 
     worksite which promote a healthy lifestyle, including 
     policies relating to--
       ``(i) tobacco use at the worksite,
       ``(ii) the nutrition of food available at the worksite 
     through cafeterias and vending options,
       ``(iii) minimizing stress and promoting positive mental 
     health in the workplace,
       ``(iv) where applicable, accessible and attractive stairs, 
     and
       ``(v) the encouragement of physical activity before, 
     during, and after work hours.
       ``(B) Participation incentives.--
       ``(i) In general.--Qualified incentive benefits for each 
     employee who participates in the health screenings described 
     in paragraph (1)(B) or the behavioral change programs 
     described in paragraph (3).
       ``(ii) Qualified incentive benefit.--For purposes of clause 
     (i), the term `qualified incentive benefit' means any benefit 
     which is approved by the Secretary of Health and Human 
     Services, in consultation with the Secretary of the Treasury 
     and the Secretary of Labor. Such benefit may include an 
     adjustment in health insurance premiums or co-pays.
       ``(C) Employee input.--The opportunity for employees to 
     participate in the management of any qualified wellness 
     program to which this section applies.
       ``(d) Participation Requirement.--
       ``(1) In general.--No credit shall be allowed under 
     subsection (a) unless the Secretary of Health and Human 
     Services, in consultation with the Secretary of the Treasury 
     and Secretary of Labor, as a part of any certification 
     described in subsection (b), that each wellness program 
     component of the qualified wellness program applies to all 
     qualified employees of the employer. The Secretary of Health 
     and Human Services shall prescribe rules under which an 
     employer shall not be treated as failing to meet the 
     requirements of this subsection merely because the employer 
     provides specialized programs for employees with specific 
     health needs or unusual employment requirements or provides a 
     pilot program to test new wellness strategies.
       ``(2) Qualified employee.--For purposes of paragraph (1), 
     the term `qualified employee' means an employee who works an 
     average of not less than 25 hours per week during the taxable 
     year.
       ``(e) Other Definitions and Special Rules.--For purposes of 
     this section--
       ``(1) Employee and employer.--
       ``(A) Partners and partnerships.--The term `employee' 
     includes a partner and the term `employer' includes a 
     partnership.
       ``(B) Certain rules to apply.--Rules similar to the rules 
     of section 52 shall apply.
       ``(2) Certain costs not included.--Costs paid or incurred 
     by an employer for food or health insurance shall not be 
     taken into account under subsection (a).
       ``(3) No credit where grant awarded.--No credit shall be 
     allowable under subsection (a) with respect to any qualified 
     wellness program of any taxpayer (other than an eligible 
     employer described in subsection (f)(2)(A)) who receives a 
     grant provided by the United States, a State, or a political 
     subdivision of a State for use in connection with such 
     program. The Secretary shall prescribe rules providing for 
     the waiver of this paragraph with respect to any grant which 
     does not constitute a significant portion of the funding for 
     the qualified wellness program.
       ``(4) Credit period.--
       ``(A) In general.--The term `credit period' means the 
     period of 10 consecutive taxable years beginning with the 
     taxable year in which the qualified wellness program is first 
     certified under this section.
       ``(B) Special rule for existing programs.--In the case of 
     an employer (or predecessor) which operates a wellness 
     program for its employees on the date of the enactment of 
     this section, subparagraph (A) shall be applied by 
     substituting `3 consecutive taxable years' for `10 
     consecutive taxable years'. The Secretary shall prescribe 
     rules under which this subsection shall not apply if an 
     employer is required to make substantial modifications in the 
     existing wellness program in order to qualify such program 
     for certification as a qualified wellness program.
       ``(C) Controlled groups.--For purposes of this paragraph, 
     all persons treated as a single employer under subsection 
     (b), (c), (m), or (o) of section 414 shall be treated as a 
     single employer.
       ``(f) Portion of Credit Made Refundable.--
       ``(1) In general.--In the case of an eligible employer of 
     an employee, the aggregate credits allowed to a taxpayer 
     under subpart C shall be increased by the lesser of--
       ``(A) the credit which would be allowed under this section 
     without regard to this subsection and the limitation under 
     section 38(c), or

[[Page S234]]

       ``(B) the amount by which the aggregate amount of credits 
     allowed by this subpart (determined without regard to this 
     subsection) would increase if the limitation imposed by 
     section 38(c) for any taxable year were increased by the 
     amount of employer payroll taxes imposed on the taxpayer 
     during the calendar year in which the taxable year begins.

     The amount of the credit allowed under this subsection shall 
     not be treated as a credit allowed under this subpart and 
     shall reduce the amount of the credit otherwise allowable 
     under subsection (a) without regard to section 38(c).
       ``(2) Eligible employer.--For purposes of this subsection, 
     the term `eligible employer' means an employer which is--
       ``(A) a State or political subdivision thereof, the 
     District of Columbia, a possession of the United States, or 
     an agency or instrumentality of any of the foregoing, or
       ``(B) any organization described in section 501(c) of the 
     Internal Revenue Code of 1986 which is exempt from taxation 
     under section 501(a) of such Code.
       ``(3) Employer payroll taxes.--For purposes of this 
     subsection--
       ``(A) In general.--The term `employer payroll taxes' means 
     the taxes imposed by--
       ``(i) section 3111(b), and
       ``(ii) sections 3211(a) and 3221(a) (determined at a rate 
     equal to the rate under section 3111(b)).
       ``(B) Special rule.--A rule similar to the rule of section 
     24(d)(2)(C) shall apply for purposes of subparagraph (A).
       ``(g) Termination.--This section shall not apply to any 
     amount paid or incurred after December 31, 2017.''.
       (b) Treatment as General Business Credit.--Subsection (b) 
     of section 38 of the Internal Revenue Code of 1986 is amended 
     by striking ``plus'' at the end of paragraph (35), by 
     striking the period at the end of paragraph (36) and 
     inserting ``, plus'', and by adding at the end the following:
       ``(37) the wellness program credit determined under section 
     45S.''.
       (c) Denial of Double Benefit.--Section 280C of the Internal 
     Revenue Code of 1986 is amended by adding at the end the 
     following new subsection:
       ``(j) Wellness Program Credit.--
       ``(1) In general.--No deduction shall be allowed for that 
     portion of the costs paid or incurred for a qualified 
     wellness program (within the meaning of section 45S) 
     allowable as a deduction for the taxable year which is equal 
     to the amount of the credit allowable for the taxable year 
     under section 45S.
       ``(2) Similar rule where taxpayer capitalizes rather than 
     deducts expenses.--If--
       ``(A) the amount of the credit determined for the taxable 
     year under section 45S, exceeds
       ``(B) the amount allowable as a deduction for such taxable 
     year for a qualified wellness program,
     the amount chargeable to capital account for the taxable year 
     for such expenses shall be reduced by the amount of such 
     excess.
       ``(3) Controlled groups.--In the case of a corporation 
     which is a member of a controlled group of corporations 
     (within the meaning of section 41(f)(5)) or a trade or 
     business which is treated as being under common control with 
     other trades or business (within the meaning of section 
     41(f)(1)(B)), this subsection shall be applied under rules 
     prescribed by the Secretary similar to the rules applicable 
     under subparagraphs (A) and (B) of section 41(f)(1).''.
       (d) Clerical Amendment.--The table of sections for subpart 
     D of part IV of subchapter A of chapter 1 of the Internal 
     Revenue Code of 1986 is amended by adding at the end the 
     following:

``Sec. 45S. Wellness program credit.''.

       (e) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after the date of 
     enactment of this Act.
       (f) Outreach.--
       (1) In general.--The Secretary of the Treasury, in 
     conjunction with the Director of the Centers for Disease 
     Control and members of the business community, shall 
     institute an outreach program to inform businesses about the 
     availability of the wellness program credit under section 45S 
     of the Internal Revenue Code of 1986 as well as to educate 
     businesses on how to develop programs according to recognized 
     and promising practices and on how to measure the success of 
     implemented programs.
       (2) Authorization of appropriations.--There are authorized 
     to be appropriated such sums as are necessary to carry out 
     the outreach program described in paragraph (1).

     SEC. 212. EMPLOYER-PROVIDED OFF-PREMISES ATHLETIC FACILITIES.

       (a) Treatment as Fringe Benefit.--Subparagraph (A) of 
     section 132(j)(4) of the Internal Revenue Code of 1986 is 
     amended to read as follows:
       ``(A) In general.--Gross income shall not include--
       ``(i) the value of any on-premises athletic facility 
     provided by an employer to its employees, and
       ``(ii) so much of the fees, dues, or membership expenses 
     paid by an employer to an athletic or fitness facility 
     described in subparagraph (C) on behalf of its employees as 
     does not exceed $900 per employee per year.''.
       (b) Athletic Facilities Described.--Paragraph (4) of 
     section 132(j) of the Internal Revenue Code of 1986 is 
     amended by adding at the end the following new subparagraph:
       ``(C) Certain athletic or fitness facilities described.--
     For purposes of subparagraph (A)(ii), an athletic or fitness 
     facility described in this subparagraph is a facility--
       ``(i) which provides instruction in a program of physical 
     exercise, offers facilities for the preservation, 
     maintenance, encouragement, or development of physical 
     fitness, or is the site of such a program of a State or local 
     government,
       ``(ii) which is not a private club owned and operated by 
     its members,
       ``(iii) which does not offer golf, hunting, sailing, or 
     riding facilities,
       ``(iv) whose health or fitness facility is not incidental 
     to its overall function and purpose, and
       ``(v) which is fully compliant with the State of 
     jurisdiction and Federal anti-discrimination laws.''.
       (c) Exclusion Applies to Highly Compensated Employees Only 
     if No Discrimination.--Section 132(j)(1) of the Internal 
     Revenue Code of 1986 is amended--
       (1) by striking ``Paragraphs (1) and (2) of subsection 
     (a)'' and inserting ``Subsections (a)(1), (a)(2), and 
     (j)(4)'', and
       (2) by striking the heading thereof through ``apply'' and 
     inserting ``Certain exclusions apply''.
       (d) Employer Deduction for Dues to Certain Athletic 
     Facilities.--
       (1) In general.--Paragraph (3) of section 274(a) of the 
     Internal Revenue Code of 1986 is amended by adding at the end 
     the following new sentence: ``The preceding sentence shall 
     not apply to so much of the fees, dues, or membership 
     expenses paid to athletic or fitness facilities (within the 
     meaning of section 132(j)(4)(C)) as does not exceed $900 per 
     employee per year.''.
       (2) Conforming amendment.--The last sentence of section 
     274(e)(4) of such Code is amended by inserting ``the first 
     sentence of'' before ``subsection (a)(3)''.
       (e) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after the date of the 
     enactment of this Act.

     SEC. 213. TASK FORCE FOR THE PROMOTION OF BREASTFEEDING IN 
                   THE WORKPLACE.

       (a) Establishment.--The Secretary of Health and Human 
     Services and the Secretary of Labor, or their designees, 
     shall convene a task force for the purpose of promoting 
     breastfeeding among working mothers (referred to in this 
     section as the ``Task Force'').
       (b) Membership.--The Task Force shall be composed of 
     members who are--
       (1) expert staff from the Department of Labor with 
     expertise in workforce issues;
       (2) expert staff from the Department of Health and Human 
     Services with expertise in the areas of breastfeeding and 
     breastfeeding promotion;
       (3) members of the United States Breastfeeding Committee;
       (4) expert staff from the Department of Agriculture; and
       (5) appointed by the Secretary of Health and Human Services 
     and the Secretary of Labor, including--
       (A) working mothers who have experience in working and 
     breastfeeding; and
       (B) representatives of the human resource departments of 
     both large and small employers that have successfully 
     promoted breastfeeding and breastmilk pumping support at 
     work.
       (c) Period of Appointment; Vacancies.--Members shall be 
     appointed for the life of the Task Force. Any vacancy in the 
     Task Force shall not affects its powers, but shall be filled 
     in the same manner as the original appointment.
       (d) Chair.--The Task Force shall be chaired jointly by the 
     Secretary of Health and Human Services and the Secretary of 
     Labor, or their designees.
       (e) Duties of the Task Force.--
       (1) Examination.--Consistent with the Department of Health 
     and Human Services Blueprint for Action on Breastfeeding 
     (2000), the Task Force shall examine the following issues:
       (A) The challenges that mothers face with continuing 
     breastfeeding when the mothers return to work after giving 
     birth.
       (B) The challenges that employers face in accommodating 
     mothers who seek to continue to breastfeed or to express milk 
     when the mothers re-enter the workforce, including different 
     challenges that mothers of varying socio-economic status and 
     in different professions may face.
       (C) The benefits that accrue to mothers, babies, and to 
     employers when mothers are able to continue to breastfeed or 
     to express breastmilk at work after the mothers have re-
     entered the workforce.
       (D) Federal and State statutes that may have the effect of 
     reducing breastfeeding and breastfeeding retention rates 
     among working mothers.
       (2) Reports.--
       (A) In general.--Not later than 1 year after the date of 
     enactment of this section, the Task Force shall issue a 
     public report with recommendations on the following:
       (i) Steps that can be taken to promote breastfeeding among 
     working mothers and to remove barriers to breastfeeding among 
     working mothers.
       (ii) Potential ways in which the Federal Government can 
     work with employers to promote breastfeeding among working 
     mothers.
       (iii) Areas in which changes to existing Federal, State, or 
     local laws would likely

[[Page S235]]

     have the effect of making it easier for working mothers to 
     breastfeed or would remove impediments to breastfeeding that 
     currently exist in such laws.
       (iv) Whether or not increased rates of breastfeeding among 
     working mothers would likely have the result of reducing 
     health care costs among such mothers and their children, and, 
     in particular, whether increased rates of breastfeeding would 
     be likely to result in lower Federal expenditures on health 
     care for such mothers and their children.
       (v) Areas in which the Federal Government, through 
     increased efforts by Federal agencies, or changes to existing 
     Federal law, can and should increase the Federal Government's 
     efforts to promote breastfeeding among working mothers.
       (B) Copy to congress.--Upon completion of the report 
     described in subparagraph (A), the Task Force shall submit a 
     copy of the report to the Committee on Health, Education, 
     Labor, and Pensions of the Senate, the Committee on 
     Appropriations of the Senate, the Committee on Education and 
     the Workforce of the House of Representatives, and the 
     Committee on Appropriations of the House of Representatives.
       (f) Powers of the Task Force.--
       (1) Hearings.--The Task Force may hold such hearings, sit 
     and act at such times and places, take such testimony, and 
     receive such evidence as the Task Force considers advisable 
     to carry out this section.
       (2) Information from federal agencies.--The Task Force may 
     secure directly from any Federal department or agency such 
     information as the Task Force considers necessary to carry 
     out this section. Upon request of the Chair of the Task 
     Force, the head of such department or agency shall furnish 
     such information to the Task Force.
       (3) Postal services.--The Task Force may use the United 
     States mails in the same manner and under the same conditions 
     as other departments and agencies of the Federal Government.
       (4) Donations.--The Task Force may accept, use, and dispose 
     of donations of services or property.
       (g) Operating Expenses.--The operating expenses of the Task 
     Force, including travel expenses for members of the Task 
     Force, shall be paid for from the general operating expenses 
     funds of the Secretary of Health and Human Services and the 
     Secretary of Labor.

     SEC. 214. IMPROVING HEALTHY EATING AND ACTIVE LIVING OPTIONS 
                   IN FEDERAL WORKPLACES.

       (a) Menu Labeling in Federal Food Establishments.--
       (1) In general.--
       (A) Executive and judicial buildings.--Section 403(q) of 
     the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 343(q)) 
     is amended by adding at the end the following:
       ``(6)(A) The requirements of subparagraph (5)(H) shall 
     apply--
       ``(i) to a restaurant or similar retail food establishment 
     located in a Federal building in the same manner as such 
     subparagraph applies to a restaurant or similar retail food 
     establishment that is part of a chain with 20 or more 
     locations, as described in subparagraph (5)(H)(i); and
       ``(ii) to a person that operates a vending machine located 
     in a Federal building in the same manner as such subparagraph 
     applies to a person who is engaged in the business of owning 
     or operating 20 or more vending machines, as described in 
     subparagraph (5)(H)(viii).
       ``(B) In this subparagraph, the term `Federal building' 
     means a building that is--
       ``(i) under the control of the Federal agency (as defined 
     in section 102 of title 40, United States Code);
       ``(ii) owned by the Federal Government; and
       ``(iii) located in a State, the District of Columbia, 
     Puerto Rico, or a territory or possession of the United 
     States.''.
       (B) Applicability.--The requirement in the amendment made 
     by paragraph (1) shall apply to restaurants or similar retail 
     food establishments and vending machines located in a Federal 
     building beginning 12 months after the date of enactment of 
     this Act.
       (2) Congressional buildings.--The Architect of the Capitol, 
     in coordination with the Committee on Rules and 
     Administration of the Senate and the Committee on House 
     Administration of the House of Representatives, shall 
     establish a program to apply the requirements of section 
     403(q)(5)(H) of the Federal Food, Drug, and Cosmetic Act (21 
     U.S.C. 343(q)(5)(H)) (as amended by paragraph (1)) to--
       (A) food that is served in restaurants or other similar 
     retail food establishments that are located in Congressional 
     buildings and installations;
       (B) food that is sold through vending machines that are 
     operated in Congressional buildings and installations; and
       (C) food that is served to individuals within Congressional 
     buildings and installations pursuant to a contract with a 
     private entity.
       (b) Nutritional Standards for Food in Federal Buildings.--
       (1) Executive and judicial buildings.--Subchapter V of 
     chapter 5 of subtitle I of title 40, United States Code, is 
     amended by adding at the end the following:

     ``SEC. 594. NUTRITIONAL STANDARDS FOR FOOD IN FEDERAL 
                   BUILDINGS.

       ``(a) In General.--The Administrator of General Services, 
     in consultation with the Secretary of Health and Human 
     Services, shall establish, by regulation, nutritional 
     standards for all food products provided at Federal buildings 
     and installations (including food products provided by 
     contractors or vending machines).
       ``(b) Use of Amounts.--Amounts appropriated to an executive 
     agency for installation, repair, and maintenance, generally, 
     may be used to achieve compliance with the regulations 
     promulgated pursuant to this section.
       ``(c) Liability.--Nothing in this section increases or 
     enlarges the tort liability of the Federal Government for any 
     injury to an individual or damage to property.''.
       (2) Congressional buildings.--The Architect of the Capitol, 
     in coordination with the Committee on Rules and 
     Administration of the Senate and the Committee on House 
     Administration of the House of Representatives shall 
     establish nutritional standards for all food products 
     provided at Congressional buildings and installations 
     (including food products provided by contractors or vending 
     machines).
       (c) Encouragement of Use of Stairs.--
       (1) Executive and judicial buildings.--Subchapter V of 
     chapter 5 of subtitle I of title 40, United States Code, as 
     amended by subsection (b), is further amended by adding at 
     the end the following:

     ``SEC. 595. ENCOURAGEMENT OF USE OF STAIRS.

       ``(a) In General.--Each Federal agency shall install point-
     of-decision prompts encouraging individuals to use stairs 
     wherever practicable at each relevant building and 
     installation that is--
       ``(1) under the control of the Federal agency;
       ``(2) owned by the Federal Government; and
       ``(3) located in a State, the District of Columbia, Puerto 
     Rico, or a territory or possession of the United States.
       ``(b) Reimbursement.--Subsection (a) may be carried out 
     by--
       ``(1) reimbursement to a State or political subdivision of 
     a State, the District of Columbia, Puerto Rico, or a 
     territory or possession of the United States; or
       ``(2) a means other than reimbursement.
       ``(c) Regulations.--Subsection (a) shall be carried out in 
     accordance with such regulations as the Administrator of 
     General Services may promulgate, with the approval of the 
     Director of the Office of Management and Budget.
       ``(d) Use of Amounts.--Amounts appropriated to a Federal 
     agency for installation, repair, and maintenance, generally, 
     shall be available to carry out this section.
       ``(e) Liability.--Nothing in this section increases or 
     enlarges the tort liability of the Federal Government for any 
     injury to an individual or damage to property.''.
       (2) Congressional buildings.--The Architect of the Capitol 
     shall implement a program to install point-of-decision 
     prompts encouraging individuals to use stairs wherever 
     practicable in Congressional buildings and installations in 
     the same manner as established under section 595 of title 40, 
     United States Code (as added by paragraph (1)).
       (d) Accommodations for Bicycle Commuters.--
       (1) Executive and judicial federal buildings.--Subchapter V 
     of chapter 5 of subtitle I of title 40, United States Code, 
     as amended by subsection (c), is further amended by adding at 
     the end the following:

     ``SEC. 596. ACCOMMODATIONS FOR BICYCLE COMMUTERS.

       ``(a) In General.--Each Federal agency shall install and 
     maintain a bicycle storage area and equipment (such as a 
     bicycle rack) and a shower for bicycle commuters at each 
     relevant parking structure that is--
       ``(1) under the control of the Federal agency;
       ``(2) owned by the Federal Government; and
       ``(3) located in a State, the District of Columbia, Puerto 
     Rico, or a territory or possession of the United States.
       ``(b) Reimbursement.--Subsection (a) may be carried out 
     by--
       ``(1) reimbursement to a State or political subdivision of 
     a State, the District of Columbia, Puerto Rico, or a 
     territory or possession of the United States; or
       ``(2) a means other than reimbursement.
       ``(c) Regulations.--Subsection (a) shall be carried out in 
     accordance with such regulations as the Administrator of 
     General Services may promulgate, with the approval of the 
     Director of the Office of Management and Budget.
       ``(d) Use of Amounts.--Amounts appropriated to a Federal 
     agency for installation, repair, and maintenance, generally, 
     shall be available to carry out this section.
       ``(e) Liability.--Nothing in this section increases or 
     enlarges the tort liability of the Federal Government for any 
     injury to an individual or damage to property.''.
       (2) Congressional buildings.--The Architect of the Capitol, 
     in coordination with the Sergeant at Arms and Doorkeeper of 
     the Senate, the Sergeant at Arms of the House of 
     Representatives, and the United States Capitol Police, shall 
     implement, within their respective jurisdictions, a program 
     to make accommodations for bicycle commuters on the United 
     States Capitol complex in the same manner as established 
     under section 596 of title 40, United States Code (as added 
     by paragraph (1)).

        TITLE III--RESPONSIBLE MARKETING AND CONSUMER AWARENESS

     SEC. 301. GUIDELINES FOR REDUCTION IN SODIUM CONTENT IN 
                   CERTAIN FOODS.

       (a) In General.--Not later than 180 days after the date of 
     enactment of this Act, the

[[Page S236]]

     Secretary of Health and Human Services shall promulgate 
     regulations establishing guidelines for the reduction, over a 
     2 year period, in the sodium content of processed food and 
     restaurant food following, as appropriate, the 
     recommendations made by the Institute of Medicine report 
     entitled ``Strategies to Reduce Sodium Intake in the United 
     States''.
       (b) Definitions.--For purposes of this section--
       (1) the term ``processed food'' has the meaning given such 
     term in section 201(gg) of the Federal Food, Drug, and 
     Cosmetic Act (21 U.S.C. 321(gg)); and
       (2) the term ``restaurant food'' means food subject to the 
     requirements of section 403(q)(5)(H) of the Federal Food, 
     Drug, and Cosmetic Act (21 U.S.C. 343(q)(5)(H)).

     SEC. 302. NUTRITION LABELING FOR FOOD PRODUCTS SOLD 
                   PRINCIPALLY FOR USE IN RESTAURANTS OR OTHER 
                   RETAIL FOOD ESTABLISHMENTS.

       Section 403(q)(5) of the Federal Food, Drug, and Cosmetic 
     Act (21 U.S.C. 343(q)(5)) is amended by striking clause (G).

     SEC. 303. FRONT-LABEL FOOD GUIDANCE SYSTEMS.

       (a) In General.--Not later than 6 months after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services (referred to in this section as the ``Secretary'') 
     shall begin soliciting public comments regarding--
       (1) the use of retail front-label food guidance systems to 
     convey nutrition information to the public using logos, 
     symbols, signs, emblems, insignia, or other graphic 
     representations on the labeling of food intended for human 
     consumption that are intended to provide simple, 
     standardized, and understandable nutrition information to the 
     public in graphic form;
       (2) appropriate nutrition standards by which a retail 
     front-label food guidance system may convey the relative 
     nutritional value of different foods in simple graphic form; 
     and
       (3) whether American consumers would be better served by 
     establishing a single, standardized retail front-label food 
     guidance system regulated by the Food and Drug 
     Administration, or by allowing individual food companies, 
     trade associations, nonprofit organizations, and others to 
     continue to develop their own retail front-label food 
     guidance systems.
       (b) Effect on Nutrition Facts Panel.--In soliciting public 
     comments under subsection (a), the Secretary shall inform the 
     public that any retail front-label food guidance system is 
     intended to supplement, not replace, the Nutrition Facts 
     Panel that appears on food labels pursuant to section 403(q) 
     of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
     343(q)).
       (c) Proposed Regulation.--Not later than 12 months 
     following the closure of the public comment solicitation 
     period under subsection (a), the Secretary shall--
       (1) publish a notice in the Federal Register that 
     summarizes the public comments and describes the suggested 
     retail front-label food guidance systems received through 
     such solicitation; and
       (2) publish proposed regulations that--
       (A) establish a single, standardized retail front-label 
     food guidance system; or
       (B) establish the conditions under which individual food 
     companies, trade associations, nonprofit organizations, and 
     other entities may continue to develop their own retail 
     front-label food guidance systems.

     SEC. 304. RULEMAKING AUTHORITY FOR ADVERTISING TO CHILDREN.

       (a) Purpose.--The purpose of this section is to restore the 
     authority of the Federal Trade Commission to issue 
     regulations that restrict the marketing or advertising of 
     foods and beverages to children under the age of 18 years if 
     the Federal Trade Commission determines that there is 
     evidence that consumption of certain foods and beverages is 
     detrimental to the health of children.
       (b) Authority.--Section 18 of the Federal Trade Commission 
     Act (15 U.S.C. 57a) is amended--
       (1) in subsection (a), by striking ``Except as provided in 
     subsection (h), the'' and inserting ``The'';
       (2) by amending subsection (b) to read as follows:
       ``(b) Procedure Applicable.--When prescribing a rule under 
     subsection (a)(1)(B) of this section, the Commission shall 
     proceed in accordance with section 553 of title 5 (without 
     regard to any reference in such section to sections 556 and 
     557 of such title).'';
       (3) by striking subsections (c), (f), (h), (i), and (j);
       (4) by striking subsection (d) and inserting the following:
       ``(c) When any rule under subsection (a)(1)(B) takes effect 
     a subsequent violation thereof shall constitute an unfair or 
     deceptive act or practice in violation of section 5(a)(1) of 
     this Act, unless the Commission otherwise expressly provides 
     in such rule.'';
       (5) by redesignating subsections (e) and (g) as subsections 
     (d) and (e), respectively; and
       (6) in subsection (d), as redesignated--
       (A) in paragraph (1)(B), by striking ``the transcript 
     required by subsection (c)(5),'';
       (B) in paragraph (3), by striking ``error)'' and all that 
     follows through the period at the end and inserting 
     ``error).''; and
       (C) in paragraph (5), by striking subparagraph (C).

     SEC. 305. HEALTH LITERACY: RESEARCH, COORDINATION AND 
                   DISSEMINATION.

       (a) In General.--Part A of title IX of the Public Health 
     Service Act (42 U.S.C. 299 et seq.) is amended by adding at 
     the end the following:

     ``SEC. 904. HEALTH LITERACY: RESEARCH, COORDINATION AND 
                   DISSEMINATION.

       ``(a) Definition.--In this section, the term `health 
     literacy' means a consumer's ability to obtain, process, and 
     understand basic health information and services needed to 
     make appropriate health care decisions and the adaptation of 
     services to enhance a consumer's understanding and navigation 
     of applicable health care services.
       ``(b) Health Literacy Program.--
       ``(1) Establishment.--The Director shall establish within 
     the Agency a program (referred to in this section as the 
     `program') to strengthen health literacy by improving 
     measurement, research, development, and information 
     dissemination.
       ``(2) Duties.--In carrying out the program, the Director 
     shall--
       ``(A) gather health literacy resources from public and 
     private sources and make such resources available to 
     researchers, health care providers, and the general public;
       ``(B) identify and fill research gaps relating to health 
     literacy that have direct applicability to--
       ``(i) prevention;
       ``(ii) self-management of chronic disease;
       ``(iii) quality improvement;
       ``(iv) the barriers to health literacy;
       ``(v) relationships between health literacy and health 
     disparities, particularly with respect to language and 
     cultural competency; and
       ``(vi) the utilization of information on comparative 
     effectiveness of health treatments;
       ``(C) sponsor demonstration and evaluation projects with 
     respect to interventions and tools designed to strengthen 
     health literacy, including projects focused on--
       ``(i) the provision of simplified, patient-centered written 
     materials;
       ``(ii) technology-based communication techniques;
       ``(iii) consumer navigation services; and
       ``(iv) the training of health professional providers;
       ``(D) give preference to health literacy initiatives that--
       ``(i) focus on the particular needs of vulnerable 
     populations such as the elderly, racial and ethnic 
     minorities, children, individuals with limited English 
     proficiency, and individuals with disabilities; and
       ``(ii) partner with institutions in the community such as 
     schools, libraries, senior centers, literacy groups, 
     recreation centers, early childhood education centers, area 
     health education centers, and public assistance programs;
       ``(E) assist appropriate Federal agencies in establishing 
     specific objectives and strategies for carrying out the 
     program, in monitoring the programs of such agencies, and 
     incorporating health literacy into research design, human 
     subjects protections, and informed consent in clinical 
     research;
       ``(F) seek to enter into implementation partnerships with 
     organizations and agencies, including other agencies within 
     the Department of Health and Human Services, such as the 
     Centers for Medicare & Medicaid Services and the Health 
     Resources and Services Administration, the Office of the 
     Surgeon General, the Joint Commission on the Accreditation of 
     Healthcare Organizations, the Office of the National 
     Coordinator for Health Information Technology, and the 
     National Committee for Quality Assurance, to promote the 
     adoption of interventions and tools developed under this 
     section, particularly in the training of health 
     professionals; and
       ``(G) coordinate with other agencies within the Department 
     of Health and Human Services to collect data that monitors 
     national trends in health literacy by including relevant 
     items in surveys such as the Medical Expenditure Panel 
     Survey, the National Health Interview Survey, and the 
     National Hospital Discharge Survey.
       ``(3) Report.--The Agency for Healthcare Research and 
     Quality shall annually submit to Congress a report that 
     includes--
       ``(A) a comprehensive and detailed description of the 
     operations, activities, financial condition, and 
     accomplishments of the Agency in the field of health 
     literacy; and
       ``(B) a description of how plans for the operation of the 
     program for the succeeding fiscal year will facilitate 
     achievement of the goals of the program.
       ``(4) Authorization of appropriations.--There are 
     authorized to be appropriated to carry out this subsection 
     such sums as may be necessary for each of fiscal years 2012 
     through 2016.
       ``(c) State Health Literacy Grants.--
       ``(1) Grants.--The Director of the Agency shall award 
     grants to eligible entities to facilitate State and community 
     efforts to strengthen health literacy.
       ``(2) Use of funds.--An entity receiving a grant under this 
     subsection shall use amounts received under such grant to--
       ``(A) support efforts to monitor and strengthen health 
     literacy within a State or community;
       ``(B) assist public and private efforts in the State or 
     community in coordinating and delivering health literacy 
     services;
       ``(C) encourage partnerships among State and local 
     governments, community organizations, non-profit entities, 
     academic institutions, and businesses to coordinate efforts 
     to strengthen health literacy;

[[Page S237]]

       ``(D) provide technical and policy assistance to State and 
     local governments and service providers; and
       ``(E) monitor and evaluate programs conducted under this 
     grant.
       ``(3) Report.--Not later than September 30 of each fiscal 
     year for which a grant is received by an entity under this 
     section, the entity shall submit to the Director a report 
     that describes the programs supported by the grant and the 
     results of monitoring and evaluation of those programs.
       ``(4) Authorization of appropriations.--There are 
     authorized to be appropriated such sums as may be necessary 
     to carry out this subsection for each of fiscal years 2012 
     through 2016.''.
       (b) Institute of Medicine Study and Report.--
       (1) Study.--The Secretary of Health and Human Services 
     shall seek to enter into a contract with the Institute of 
     Medicine to conduct a study identifying opportunities within 
     the Department of Health and Human Services to strengthen the 
     health literacy of health care providers and health care 
     consumers in accordance with the Patient Protection and 
     Affordable Care Act (Public law 111-148).
       (2) Report.--A contract entered into under paragraph (1) 
     shall include a provision requiring the Institute of 
     Medicine, not later than 1 year after the date of enactment 
     of this Act, to submit a report concerning the results of the 
     study conducted under paragraph (1) to the Secretary of 
     Health and Human Services and the appropriate committees of 
     Congress.''.

     SEC. 306. DISALLOWANCE OF DEDUCTIONS FOR ADVERTISING AND 
                   MARKETING EXPENSES RELATING TO TOBACCO PRODUCT 
                   USE.

       (a) In General.--Part IX of subchapter B of chapter 1 of 
     subtitle A of the Internal Revenue Code of 1986 (relating to 
     items not deductible) is amended by adding at the end the 
     following new section:

     ``SEC. 280I. DISALLOWANCE OF DEDUCTION FOR ADVERTISING AND 
                   MARKETING EXPENSES RELATING TO TOBACCO PRODUCT 
                   USE.

       ``No deduction shall be allowed under this chapter for 
     expenses relating to advertising or marketing cigars, 
     cigarettes, smokeless tobacco, pipe tobacco, or any other 
     tobacco product. For purposes of this section, any term used 
     in this section which is also used in section 5702 shall have 
     the same meaning given such term by section 5702.''.
       (b) Conforming Amendment.--The table of sections for such 
     part IX is amended by adding after the item relating to 
     section 280H the following new item:

``Sec. 280I. Disallowance of deduction for tobacco advertising and 
              marketing expenses.''.

       (c) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after the date of the 
     enactment of this Act.

     SEC. 307. INCENTIVES TO REDUCE TOBACCO USE.

       (a) Child Tobacco Use Surveys.--
       (1) Annual performance survey.--
       (A) In general.--Not later than August 31, 2012, and 
     annually thereafter, the Secretary of Health and Human 
     Services (referred to in this section as the ``Secretary'') 
     shall publish the results of an annual tobacco use survey, to 
     be carried out not later than 18 months after the date of 
     enactment of this Act and completed on an annual basis 
     thereafter, to determine--
       (i) the percentage of all young individuals who used 
     tobacco products within the 30-day period prior to the 
     conduct of the survey involved; and
       (ii) the percentage of young individuals who identify each 
     brand of each type of tobacco product as the usual brand used 
     within such 30-day period.
       (B) Young individuals.--For the purposes of this section, 
     the term ``young individuals'' means individuals who are 
     under 18 years of age.
       (2) Size and methodology.--
       (A) In general.--The survey referred to in paragraph (1) 
     may be the National Survey on Drug Use and Health or shall at 
     least be comparable in size and methodology to the NSDUH that 
     was completed in 2009 to measure the use of cigarettes (by 
     brand) by youths under 18 years of age within the 30-day 
     period prior to the conduct of the study.
       (B) Conclusive accurateness.--A survey using the 
     methodology described in subparagraph (A) shall be deemed 
     conclusively proper, correct, and accurate for purposes of 
     this section.
       (C) Definition.--In this section, the term ``National 
     Survey on Drug Use and Health'' or ``NSDUH'' means the annual 
     nationwide survey of randomly selected individuals, aged 12 
     and older, conducted by the Substance Abuse and Mental Health 
     Services Administration.
       (3) Reduction.--The Secretary, based on a comparison of the 
     results of the first annual tobacco product survey referred 
     to in paragraph (1) and the most recent NSDUH referred to in 
     paragraph (2)(A) completed prior to the date of enactment of 
     this Act, shall determine the percentage reduction (if any) 
     in youth tobacco use for each manufacturer of tobacco 
     products.
       (4) Participation in survey.--Notwithstanding any other 
     provision of law, the Secretary may conduct a survey under 
     this subsection involving minors if the results of such 
     survey with respect to such minors are kept confidential and 
     not disclosed.
       (5) Nonapplicability.--Chapter 35 of title 44, United 
     States Code, shall not apply to information required for the 
     purposes of carrying out this section.
       (b) Tobacco Use Reduction Goal and Noncompliance.--
       (1) Goal.--It shall be the tobacco use reduction goal that 
     youth tobacco use be reduced by at least 5 percent or a level 
     determined significantly sufficient by the Secretary between 
     the most recent NSDUH referred to in subsection (a)(2)(A) and 
     the completion of the first annual cigarette survey (and such 
     subsequent surveys as compared to the previous year's survey) 
     referred to in subsection (a)(1).
       (2) Noncompliance.--
       (A) Industry-wide penalty.--If the Secretary determines 
     that the tobacco use reduction goal under paragraph (1) has 
     not been achieved, the Secretary shall, not later than 
     September 10, 2012, and September 10 of each year thereafter, 
     impose an industry-wide penalty on the manufacturers of 
     cigarettes in an amount that is in the aggregate equal to 
     $3,000,000,000.
       (B) Payment.--The industry-wide penalty imposed under this 
     subsection shall be paid by each manufacturer based on the 
     brand share among youth ages 12-17 (as determined by the 
     survey described in subsection (a)(1)) as such percentage 
     relates to the total amount to be paid by all manufacturers.
       (C) Final determination.--The determination of the 
     Secretary as to the amount and allocation of a surcharge 
     under this section shall be final and the manufacturer shall 
     pay such surcharge within 10 days of the date on which the 
     manufacturer is assessed. Such payment shall be retained by 
     the Secretary pending final judicial review of what, if any, 
     change in the surcharge is appropriate.
       (D) Limitation.--With respect to cigarettes, a manufacturer 
     with a market share of 1 percent or less of youth tobacco use 
     shall not be liable for the payment of a surcharge under this 
     paragraph.
       (E) Use of amounts.--Amounts collected under subparagraph 
     (A) shall be deposited into the Prevention and Public Health 
     Fund established under section 4002 of the Patient Protection 
     and Affordable Care Act (42 U.S.C. 300u-11). Such funds shall 
     remain available for transfer through September 30th of the 
     fifth fiscal year following their collection, subject to the 
     terms and conditions of such section 4002.
       (3) Penalties nondeductible.--The payment of penalties 
     under this section shall not be considered to be an ordinary 
     and necessary expense in carrying on a trade or business for 
     purposes of the Internal Revenue Code of 1986 and shall not 
     be deductible.
       (4) Judicial review.--
       (A) After payment.--A manufacturer of cigarettes may seek 
     judicial review of any action under this section only after 
     the assessment involved has been paid by the manufacturer to 
     the Department of the Treasury and only in the United States 
     District Court for the District of Columbia.
       (B) Review by attorney general.--Prior to the filing of an 
     action by a manufacturer seeking judicial review of an action 
     under this section, the manufacturer shall notify the 
     Attorney General of such intent to file and the Attorney 
     General shall have 30 days in which to respond to the action.
       (C) Review.--The amount of any surcharge paid under this 
     section shall be subject to judicial review by the United 
     States Court of Appeals for the District of Columbia Circuit, 
     based on the arbitrary and capricious standard of section 706 
     of title 5, United States Code. Notwithstanding any other 
     provision of law, no court shall have the authority to stay 
     any surcharge payment due to the Secretary under this section 
     pending judicial review until the Secretary has made or 
     failed to make a compliance determination, as described under 
     this section, that has adversely affected the person seeking 
     the review.
       (c) Enforcement.--
       (1) Initial penalty.--There is hereby imposed an initial 
     penalty on the failure of any manufacturer to make any 
     payment required under this section not later than a period 
     determined sufficient by the Secretary after the date on 
     which such payment is due.
       (2) Amount of penalty.--The amount of the penalty imposed 
     by paragraph (1) on any failure with respect to a 
     manufacturer shall be an amount equal to 2 percent of the 
     penalty owed under subsection (b) for each day during the 
     noncompliance period.
       (3) Noncompliance period.--For purposes of this subsection, 
     the term ``noncompliance period'' means, with respect to any 
     failure to make the surcharge payment required under this 
     section, the period--
       (A) beginning on the due date for such payment; and
       (B) ending on the date on which such payment is paid in 
     fall.
       (4) Limitations.--No penalty shall be imposed by paragraph 
     (1) on--
       (A) any failure to make a surcharge payment under this 
     section during any period for which it is established to the 
     satisfaction of the Secretary that none of the persons 
     responsible for such failure knew or, exercising reasonable 
     diligence, would have known, that such failure existed; or
       (B) any manufacturer that produces less than 1 percent of 
     cigarettes used by youth in that year (as determined by the 
     annual survey).

[[Page S238]]

           TITLE IV--EXPANDED COVERAGE OF PREVENTIVE SERVICES

     SEC. 401. REQUIRED COVERAGE OF PREVENTIVE SERVICES UNDER THE 
                   MEDICAID PROGRAM.

       (a) Mandatory Coverage.--Section 1905 of the Social 
     Security Act (42 U.S.C. 1396d), as amended by section 
     4107(a)(1) of the Patient Protection and Affordable Care Act 
     (Public Law 111-148), is amended--
       (1) in subsection (a)(4)--
       (A) by striking ``and'' before ``(D)''; and
       (B) by inserting before the semicolon at the end the 
     following new subparagraph: ``; and (E) preventive services 
     described in subsection (ee);'' and
       (2) by adding at the end the following new subsection:
       ``(ee) Preventive Services.--For purposes of subsection 
     (a)(4)(E), the preventives services described in this 
     subsection are diagnostic, screening, preventive, and 
     rehabilitative services not otherwise described in subsection 
     (a) or (r) that the Secretary determines are appropriate for 
     individuals entitled to medical assistance under this title, 
     including--
       ``(1) evidence-based services that are assigned a grade of 
     A or B by the United States Preventive Services Task Force; 
     and
       ``(2) with respect to an adult individual, approved 
     vaccines recommended for routine use by the Advisory 
     Committee on Immunization Practices of the Centers for 
     Disease Control and Prevention.''.
       (b) Elimination of Cost-sharing.--
       (1) Subsections (a)(2)(D) and (b)(2)(D) of section 1916 of 
     the Social Security Act (42 U.S.C. 1396o) are each amended by 
     inserting ``preventive services described in section 
     1905(ee),'' after ``emergency services (as defined by the 
     Secretary),''.
       (2) Section 1916A(a)(1) of such Act (42 U.S.C. 1396o-
     1(a)(1)) is amended by inserting ``, preventive services 
     described in section 1905(ee),'' after ``subsection (c)''.
       (c) Conforming Amendment.--Effective as if included in the 
     enactment of the Patient Protection and Affordable Care Act 
     (Public Law 111-148), the provisions of, and amendments made 
     by, section 4106 of such Act are repealed.
       (d) Interval Period for Inclusion of New Recommendations in 
     State Plans.--With respect to a recommendation issued on or 
     after the date of enactment of this Act by an organization 
     described in subsection (ee) of section 1905 of the Social 
     Security Act for a preventive service included under such 
     subsection, the Secretary of Health and Human Services shall 
     establish a minimum interval period, which shall be not less 
     than 12 months, between the date on which the recommendation 
     is issued and the plan year for which a State plan for 
     medical assistance under title XIX of the Social Security Act 
     shall be required to include such preventive service.
       (e) Effective Date.--
       (1) In general.--Except as provided in paragraph (2), the 
     amendments made by subsections (a) and (b) take effect on the 
     date of enactment of this Act.
       (2) Extension of effective date for state law amendment.--
     In the case of a State plan under title XIX of the Social 
     Security Act (42 U.S.C. 1396 et seq.) which the Secretary of 
     Health and Human Services determines requires State 
     legislation or State regulation in order for the plan to meet 
     the additional requirements imposed by the amendments made by 
     subsections (a) and (b), 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 these additional 
     requirements 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 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 the session is considered 
     to be a separate regular session of the State legislature.

     SEC. 402. COVERAGE FOR COMPREHENSIVE WORKPLACE WELLNESS 
                   PROGRAM AND PREVENTIVE SERVICES.

       Section 8904(a) of title 5, United States Code, is 
     amended--
       (1) in paragraph (1), by adding at the end the following:
       ``(G) Comprehensive workplace wellness program benefits 
     that meet the requirements of section 10408 of the Patient 
     Protection and Affordable Care Act (Public Law 111-148).
       ``(H) Preventive services benefits deemed an `A' or `B' 
     service by the United States Preventive Services Taskforce.
       ``(I) Immunizations that have in effect a recommendation 
     from the Advisory Committee on Immunization Practices of the 
     Centers for Disease Control and Prevention with respect to 
     the individuals involved.
       ``(J) With respect to infants, children, and adolescents, 
     evidence-informed preventive care and screenings provided for 
     in the comprehensive guidelines supported by the Health 
     Resources and Services Administration of the Department of 
     Health and Human Services.''; and
       (2) in paragraph (2), by adding at the end the following:
       ``(G) Comprehensive workplace wellness program benefits 
     that meet the requirements of section 10408 of the Patient 
     Protection and Affordable Care Act (Public Law 111-148).
       ``(H) Preventive services benefits deemed an `A' or `B' 
     service by the United States Preventive Services Taskforce.
       ``(I) Immunizations that have in effect a recommendation 
     from the Advisory Committee on Immunization Practices of the 
     Centers for Disease Control and Prevention with respect to 
     the individuals involved.
       ``(J) With respect to infants, children, and adolescents, 
     evidence-informed preventive care and screenings provided for 
     in the comprehensive guidelines supported by the Health 
     Resources and Services Administration of the Department of 
     Health and Human Services.''.

     SEC. 403. HEALTH PROFESSIONAL EDUCATION AND TRAINING IN 
                   HEALTHY EATING.

       Part Q of title III of the Public Health Service Act (42 
     U.S.C. 280h et seq.) is amended by striking section 399Z and 
     inserting the following:

     ``SEC. 399Z. HEALTH PROFESSIONAL EDUCATION AND TRAINING IN 
                   HEALTHY EATING.

       ``(a) In General.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     in collaboration with the Administrator of the Health 
     Resources and Services Administration and the heads of other 
     agencies, and in consultation with appropriate health 
     professional associations, shall develop and carry out a 
     program to educate and train health professionals in 
     effective strategies to--
       ``(1) better identify patients at-risk of becoming 
     overweight or obese or developing an eating disorder;
       ``(2) detect overweight or obesity or eating disorders 
     among a diverse patient population;
       ``(3) counsel, refer, or treat patients with overweight or 
     obesity or an eating disorder;
       ``(4) educate patients and the families of patients about 
     effective strategies to establish healthy eating habits and 
     appropriate levels of physical activity; and
       ``(5) assist in the creation and administration of 
     community-based overweight and obesity and eating disorder 
     prevention efforts.
       ``(b) Eating Disorder.--In this section, the term `eating 
     disorder' includes anorexia nervosa, bulimia nervosa, binge 
     eating disorder, and eating disorders not otherwise 
     specified, as defined in the fourth edition of the Diagnostic 
     and Statistical Manual of Mental Disorders or any subsequent 
     edition.
       ``(c) Authorization of Appropriations.--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.''.

                           TITLE V--RESEARCH

     SEC. 501. GRANTS FOR BODY MASS INDEX DATA ANALYSIS.

       (a) Establishment.--The Secretary of Health and Human 
     Services may make grants to not more than 20 eligible 
     entities to analyze body mass index (hereinafter in this 
     section referred to as ``BMI'') measurements of children, 
     ages 2 through 18.
       (b) Eligibility.--An eligible entity for purposes of this 
     section is a State (including the District of Columbia, the 
     Commonwealth of Puerto Rico, and each territory of the United 
     States) that has a statewide immunization information system 
     that--
       (1) has the capacity to store basic demographic information 
     (including date of birth, gender, and geographic area of 
     residence), height, weight, and immunization data for each 
     resident of the State;
       (2) is accessible to doctors, nurses, other licensed 
     medical professionals, and officials of the relevant 
     department in the State charged with maintaining health and 
     immunization records; and
       (3) has the capacity to integrate large amounts of data for 
     the analysis of BMI measurements.
       (c) Use of Funds.--A State that receives a grant under this 
     section shall use the grant for the following purposes:
       (1) Analyzing the effectiveness of obesity prevention 
     programs and wellness policies carried out in the State.
       (2) Purchasing new computers, computer equipment, and 
     software to upgrade computers to be used for a statewide 
     immunization information system.
       (3) The hiring and employment of personnel to maintain and 
     analyze BMI data.
       (4) The development and implementation of training programs 
     for medical professionals to aid such professionals in taking 
     BMI measurements and discussing such measurements with 
     patients.
       (5) Providing information to parents and legal guardians in 
     accordance with subsection (e)(2).
       (d) Selection Criteria.--In selecting recipients of grants 
     under this section, the Secretary shall give priority to 
     States in which a high percentage of public and private 
     health care providers submit data to a statewide immunization 
     information system that--
       (1) contains immunization data for not less than 20 percent 
     of the population of such State that is under the age of 18; 
     and
       (2) includes data collected from men and women who are of a 
     wide variety of ages and who reside in a wide variety of 
     geographic areas in a State (as determined by the Secretary).
       (e) Conditions.--As a condition of receiving a grant under 
     this section, a State shall--
       (1) ensure that BMI measurements will be recorded for 
     children ages 2 through 18--
       (A) on an annual basis by a licensed physician, nurse, 
     nurse practitioner, or physicians assistant during an annual 
     physical examination, wellness visit, or similar visit with a 
     physician; and
       (B) in accordance with data collection protocols published 
     by the American Academy

[[Page S239]]

     of Pediatrics in the 2007 Expert Committee Recommendations; 
     and
       (2) for each child in the State for whom such measurements 
     indicate a BMI greater than the 95th percentile for such 
     child's age and gender, provide to the parents or legal 
     guardians of such child information on how to lower BMI and 
     information on State and local obesity prevention programs.
       (f) Reports.--
       (1) Reports to the secretary.--Not later than 5 years after 
     the receipt of a grant under this section, the State 
     receiving such grant shall submit to the Secretary the 
     following reports:
       (A) A report containing an analysis of BMI data collected 
     using the grant, including--
       (i) the differences in obesity trends by gender, 
     disability, geographic area (as determined by the State), and 
     socioeconomic status within such State; and
       (ii) the demographic groups and geographic areas most 
     affected by obesity within such State.
       (B) A report containing an analysis of the effectiveness of 
     obesity prevention programs and State wellness policies, 
     including--
       (i) an analysis of the success of such programs and 
     policies prior to the receipt of the grant; and
       (ii) a discussion of the means to determine the most 
     effective strategies to combat obesity in the geographic 
     areas identified under subparagraph (A).
       (2) Report to congress and certain executive agencies.--Not 
     later than 1 year after the Secretary receives all the 
     reports required pursuant to paragraph (1), the Secretary 
     shall submit to the Secretary of Education, the Secretary of 
     Agriculture, and to Congress a report that contains the 
     following:
       (A) An analysis of trends in childhood obesity, including 
     how such trends vary across regions of the United States, and 
     how such trends vary by gender and socioeconomic status.
       (B) A description of any programs that--
       (i) the Secretary has determined significantly lower 
     childhood obesity rates for certain geographic areas in the 
     United States, including urban, rural, and suburban areas; 
     and
       (ii) the Secretary recommends to be implemented by the 
     States (including States that did not receive a grant under 
     this section).
       (g) Authorization of Appropriations.--There is authorized 
     to be appropriated to the Secretary such sums as may be 
     necessary to carry out this section for each of fiscal years 
     2012 through 2016.

     SEC. 502. NATIONAL ASSESSMENT OF MENTAL HEALTH NEEDS.

       Title V of the Public Health Service Act (42 U.S.C. 290aa 
     et seq.) is amended by inserting after section 506B (42 
     U.S.C. 290aa-5b) the following:

     ``SEC. 506C. NATIONAL ASSESSMENT OF MENTAL HEALTH NEEDS.

       ``(a) In General.--The Secretary, acting through the 
     Administrator, and in consultation with the Centers for 
     Disease Control and Prevention and the Director of the 
     National Institutes of Health, shall establish and implement 
     public health monitoring measures to address the mental and 
     behavioral health status of the population of the United 
     States and other populations served by the Administration, 
     that include--
       ``(1) monitoring the mental health status of the 
     population, including the incidence and prevalence of mental 
     and behavioral health conditions across the lifespan;
       ``(2) monitoring access to appropriate diagnostic and 
     treatment services for mental and behavioral health 
     conditions, including trends in unmet need for services;
       ``(3) monitoring mental and behavioral health conditions as 
     risk factors for obesity and chronic diseases to the extent 
     practicable;
       ``(4) enhancing existing public health monitoring systems 
     by including measures assessing mental and behavioral health 
     status and associated risk factors; and
       ``(5) to the extent practicable, monitoring the immediate 
     and long-term impact of disasters or catastrophic events, 
     whether natural or man-made on the mental and behavioral 
     health of affected populations.
       ``(b) Distinguishing Among Age Groups.--In designing and 
     implementing the measures described in subsection (a) the 
     Secretary shall ensure that data collection and reporting 
     standards stratify data by age groups, in particular, to the 
     extent practicable, children under the age of 5 years.
       ``(c) Report.--Not later than 1 year after the date of 
     enactment of this section, the Secretary shall submit a 
     report to Congress that describes the progress on the 
     implementation of the monitoring measures described in 
     subsection (a).
       ``(d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section such sums as may 
     be necessary to carry out this section for each of fiscal 
     years 2012 through 2016.''.
                                 ______