S 174
Version: Introduced
Author: Harkin
112th CONGRESS
1st Session
S. 174
To improve the health of Americans and reduce health care costs by reorienting
the Nation's health care system toward prevention, wellness, and health
promotion.
IN THE SENATE OF THE UNITED STATES
January 25 (legislative day, January 5), 2011
MR. HARKIN introduced the following bill; which was read twice and referred to
the Committee on Finance
A BILL
To improve the health of Americans and reduce health care costs by reorienting
the Nation's health care system toward prevention, wellness, and health
promotion.
Be it enacted by the Senate and House of Representatives of the United States
of America in Congress assembled,
SEC. 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).
"(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 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
(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 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
"(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 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 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;
"(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).
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 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. " .