amendments made by this section such sums as may be necessary for each of fiscal years 2011 through 2015. sec. 10412. automated defibrillation in adam's memory act. section 312 of the public health service act (42 u.s.c. 244) is amended- (1) in subsection (c)(6), after "clearinghouse" insert ", that shall be administered by an organization that has substantial expertise in pediatric education, pediatric medicine, and electrophysiology and sudden death,"; and (2) in the first sentence of subsection (e), by striking "fiscal year 2003" and all that follows through "2006" and inserting "for each of fiscal years 2003 through 2014".

sec. 10413. young women's breast health awareness and support of young women diagnosed with breast cancer. (a) short title. this section may be cited as the "young women's breast health education and awareness requires learning young act of 2009" or the "early act". (b) amendment. title iii of the public health service act (42 u.s.c. 241 et seq.), as amended by this act, is further amended by adding at the end the following: "part v-programs relating to breast health and cancer "sec. 399nn. young women's breast health awareness and support of young women diagnosed with breast cancer. "(a) public education campaign. "(1) in general. the secretary, acting through the director of the centers for disease control and prevention, shall conduct a national evidence-based education

campaign to increase awareness of young women's knowledge regarding- "(a) breast health in young women of all racial, ethnic, and cultural backgrounds; "(b) breast awareness and good breast health habits; "(c) the occurrence of breast cancer and the general and specific risk factors in women who may be at high risk for breast cancer based on familial, racial, ethnic, and cultural backgrounds such as ashkenazi jewish populations; "(d) evidence-based information that would encourage young women and their health care professional to increase early detection of breast cancers; and "(e) the availability of health information and other resources for young women diagnosed with breast cancer. "(2) evidence-based, age appropriate messages. the campaign shall provide evidence-based, age-appropriate messages and materials as developed by the centers for disease control and prevention and the advisory committee established under paragraph (4). "(3) media campaign. in conducting the education campaign under paragraph (1), the secretary shall award grants

to entities to establish national multimedia campaigns oriented to young women that may include advertising through television, radio, print media, billboards, posters, all forms of existing and especially emerging social networking media, other internet media, and any other medium determined appropriate by the secretary. "(4) advisory committee.- "(a) establishment. not later than 60 days after the date of the enactment of this section, the secretary, acting through the director of the centers for disease control and prevention, shall establish an advisory committee to assist in creating and conducting the education campaigns under paragraph (1) and subsection (b)(1). "(b) membership.-the secretary, acting through the director of the centers for disease control and prevention, shall appoint to the advisory committee under subparagraph (a) such members as deemed necessary to properly advise the secretary, and shall include organizations and individuals with expertise in breast cancer, disease

prevention, early detection, diagnosis, public health, social marketing, genetic screening and counseling, treatment, rehabilitation, palliative care, and survivorship in young women. "(b) health care professional education campaign. the secretary, acting through the director of the centers for disease control and prevention, and in consultation with the administrator of the health resources and services administration, shall conduct an education campaign among physicians and other health care professionals to increase awareness- "(1) of breast health, symptoms, and early diagnosis and treatment of breast cancer in young women, including specific risk factors such as family history of cancer and women that may be at high risk for breast cancer, such as ashkenazi jewish population; "(2) on how to provide counseling to young women about their breast health, including knowledge of their family cancer history and importance of providing regular clinical breast examinations; "(3) concerning the importance of discussing healthy behaviors, and increasing awareness of services and programs available

to address overall health and wellness, and making patient referrals to address tobacco cessation, good nutrition, and physical activity; "(4) on when to refer patients to a health care provider with genetics expertise; "(5) on how to provide counseling that addresses long-term survivorship and health concerns of young women diagnosed with breast cancer; and "(6) on when to provide referrals to organizations and institutions that provide credible health information and substantive assistance and support to young women diagnosed with breast cancer. "(c) prevention research activities. the secretary, acting through- "(1) the director of the centers for disease control and prevention, shall conduct prevention research on breast cancer in younger women, including- "(a) behavioral, survivorship studies, and other research on the impact of breast cancer diagnosis on young women; "(b) formative research to assist with the development of educational messages and

information for the public, targeted populations, and their families about breast health, breast cancer, and healthy lifestyles; "(c) testing and evaluating existing and new social marketing strategies targeted at young women; and "(d) surveys of health care providers and the public regarding knowledge, attitudes, and practices related to breast health and breast cancer prevention and control in high-risk populations; and "(2) the director of the national institutes of health, shall conduct research to develop and validate new screening tests and methods for prevention and early detection of breast cancer in young women. "(d) support for young women diagnosed with breast cancer. "(1) in general. the secretary shall award grants to organizations and institutions to provide health information from credible sources and substantive assistance directed to young women diagnosed with breast cancer and pre-neoplastic breast diseases. "(2) priority. in making grants under paragraph (1), the secretary shall give priority to applicants that deal

specifically with young women diagnosed with breast cancer and pre-neoplastic breast disease. "(e) no duplication of effort. in conducting an education campaign or other program under subsections (a), (b), (c), or (d), the secretary shall avoid duplicating other existing federal breast cancer education efforts. "(f) measurement; reporting. the secretary, acting through the director of the centers for disease control and prevention, shall- "(1) measure- "(a) young women's awareness regarding breast health, including knowledge of family cancer history, specific risk factors and early warning signs, and young women's proactive efforts at early detection; "(b) the number or percentage of young women utilizing information regarding lifestyle interventions that foster healthy behaviors; "(c) the number or percentage of young women receiving regular clinical breast exams; and "(d) the number or percentage of young women who perform breast self exams, and the frequency of such exams, before the implementation of this section;

"(2) not less than every 3 years, measure the impact of such activities; and "(3) submit reports to the congress on the results of such measurements. "(g) definition.-in this section, the term 'young women' means women 15 to 44 years of age. "(h) authorization of appropriations. to carry out subsections (a), (b), (c)(1), and (d), there are authorized to be appropriated $9,000,000 for each of the fiscal years 2010 through 2014.". subtitle e-provisions relating to title v sec. 10501. amendments to the public health service act, the social security act, and title v of this act. (a) section 5101 of this act is amended- (1) in subsection (c)(2)(b)(i)(ii), by inserting ", including representatives of small business and self-employed individuals" after "employers";

(2) in subsection (d)(4)(a)- (a) by redesignating clause (iv) as clause (v); and (b) by inserting after clause (iii) the following: "(iv) an analysis of, and recommendations for, eliminating the barriers to entering and staying in primary care, including provider compensation."; and (3) in subsection (i)(2)(b), by inserting "optometrists, ophthalmologists," after "occupational therapists,". (b) subtitle b of title v of this act is amended by adding at the end the following: "sec. 5104. interagency task force to assess and improve access to health care in the state of alaska. "(a) establishment. there is established a task force to be known as the 'interagency access to health care in alaska task force' (referred to in this section as the 'task force'). "(b) duties.

the task force shall- authorization of appropriations. there are authorized to be appropriated $4 million for each of the fiscal years 2010 for 2013. m1, section 768 of the public health service act, 42 u.s.c., 295c. is amended to read as follows. section 68, preventive medicine and public health training grant

program. a, grants. the secretary, acting through the administrator of the health resources and services administration and in consultation with the director of the centers for disease control and prevention, shall award grants to or enter into contracts with eligible entities to provide training to graduate medical residents and preventive medicine special siz. -- specialties. "(1) assess access to health care for beneficiaries of federal health care systems in alaska; and "(2) develop a strategy for the federal government to improve delivery of health care to federal beneficiaries in the

state of alaska. "(c) membership.-the task force shall be comprised of federal members who shall be appointed, not later than 45 days after the date of enactment of this act, as follows: "(1) the secretary of health and human services shall appoint one representative of each of the following: "(a) the department of health and human services. "(b) the centers for medicare and medicaid services. "(c) the indian health service. "(2) the secretary of defense shall appoint one representative of the tricare management activity. "(3) the secretary of the army shall appoint one representative of the army medical department. "(4) the secretary of the air force shall appoint one representative of the air force, from among officers at the air force performing medical service functions. "(5) the secretary of veterans affairs shall appoint one representative of each of the following: "(a) the department of veterans affairs. "(b) the veterans health administration. "(6) the secretary of homeland security shall appoint one representative of the united states coast guard.

"(d) chairperson. one chairperson of the task force shall be appointed by the secretary at the time of appointment of members under subsection (c), selected from among the members appointed under paragraph (1). "(e) meetings. the task force shall meet at the call of the chairperson. "(f) report. not later than 180 days after the date of enactment of this act, the task force shall submit to congress a report detailing the activities of the task force and containing the findings, strategies, recommendations, policies, and initiatives developed pursuant to the duty described in subsection (b)(2). in preparing such report, the task force shall consider completed and ongoing efforts by federal agencies to improve access to health care in the state of alaska. "(g) termination. the task force shall be terminated on the date of submission of the report described in subsection (f).". (c) section 399v of the public health service act, as added by

section 5313, is amended- (1) in subsection (b)(4), by striking "identify, educate, refer, and enroll" and inserting "identify and refer"; and (2) in subsection (k)(1), by striking ", as defined by the department of labor as standard occupational classification [21-1094]". (d) section 738(a)(3) of the public health service act (42 u.s.c. 293b(a)(3)) is amended by inserting "schools offering physician assistant education programs," after "public health,". (e) subtitle d of title v of this act is amended by adding at the end the following: "sec. 5316. demonstration grants for family nurse practitioner training programs. "(a) establishment of program. the secretary of health and human services (referred to in this section as the 'secretary') shall establish a training demonstration program for family

nurse practitioners (referred to in this section as the 'program') to employ and provide 1-year training for nurse practitioners who have graduated from a nurse practitioner program for careers as primary care providers in federally qualified health centers (referred to in this section as 'fqhcs') and nurse-managed health clinics (referred to in this section as 'nmhcs'). "(b) purpose.-the purpose of the program is to enable each grant recipient to- "(1) provide new nurse practitioners with clinical training to enable them to serve as primary care providers in fqhcs and nmhcs; "(2) train new nurse practitioners to work under a model of primary care that is consistent with the principles set forth by the institute of medicine and the needs of vulnerable populations; and "(3) create a model of fqhc and nmhc training for nurse practitioners that may be replicated nationwide.

"(c) grants. the secretary shall award 3-year grants to eligible entities that meet the requirements established by the secretary, for the purpose of operating the nurse practitioner primary care programs described in subsection (a) in such entities. "(d) eligible entities.-to be eligible to receive a grant under this section, an entity shall- "(1) (a) be a fqhc as defined in section 1861(aa) of the social security act (42 u.s.c. 1395x(aa)); or "(b) be a nurse-managed health clinic, as defined in section 330a-1 of the public health service act (as added by section 5208 of this act); and "(2) submit to the secretary an application at such time, in such manner, and containing such information as the secretary may require. "(e) priority in awarding grants.-in awarding grants under this section, the secretary shall give priority to eligible entities that-

"(1) demonstrate sufficient infrastructure in size, scope, and capacity to undertake the requisite training of a minimum of 3 nurse practitioners per year, and to provide to each awardee 12 full months of full-time, paid employment and benefits consistent with the benefits offered to other full-time employees of such entity; "(2) will assign not less than 1 staff nurse practitioner or physician to each of 4 precepted clinics; "(3) will provide to each awardee specialty rotations, including specialty training in prenatal care and women's health, adult and child psychiatry, orthopedics, geriatrics, and at least 3 other high-volume, high-burden specialty areas; "(4) provide sessions on high-volume, high-risk health problems and have a record of training health care professionals in the care of children, older adults, and underserved populations; and "(5) collaborate with other safety net providers, schools, colleges, and universities that provide health professions training. "(f) eligibility of nurse practitioners.- "(1) in general.-to be eligible

for acceptance to a program funded through a grant awarded under this section, an individual shall- "(a) be licensed or eligible for licensure in the state in which the program is located as an advanced practice registered nurse or advanced practice nurse and be eligible or board-certified as a family nurse practitioner; and "(b) demonstrate commitment to a career as a primary care provider in a fqhc or in a nmhc. "(2) preference.-in selecting awardees under the program, each grant recipient shall give preference to bilingual candidates that meet the requirements described in paragraph (1). "(3) deferral of certain service.-the starting date of required service of individuals in the national health service corps service program under title ii of the public health service act (42 u.s.c. 202 et seq.) who receive training under this section shall be deferred until the date that is 22 days after the date of completion of the program. "(g) grant amount.-each grant awarded under this section shall

be in an amount not to exceed $600,000 per year. a grant recipient may carry over funds from 1 fiscal year to another without obtaining approval from the secretary. "(h) technical assistance grants.-the secretary may award technical assistance grants to 1 or more fqhcs or nmhcs that have demonstrated expertise in establishing a nurse practitioner residency training program. such technical assistance grants shall be for the purpose of providing technical assistance to other recipients of grants under subsection (c). "(i) authorization of appropriations.-to carry out this section, there is authorized to be appropriated such sums as may be necessary for each of fiscal years 2011 through 2014.". (f) (1) section 399w of the public health service act, as added by sti 5405, is redesignated as section 399v-1.

(2) section 399v-1 of the public health service act, as so redesignated, is amended in subsection (b)(2)(a) by striking "and the departments of 1 or more health professions schools in the state that train providers in primary care" and inserting "and the departments that train providers in primary care in 1 or more health professions schools in the state". (3) section 934 of the public health service act, as added by section 3501, is amended by striking "399w" each place such term appears and inserting "399v-1". (4) section 935(b) of the public health service act, as added by section 3503, is amended by striking "399w" and inserting "399v-1". (g) part p of title iii of the public health service act 42

u.s.c. 280g et seq.), as amended by section 10411, is amended by adding at the end the following: "sec. 399v-3. national diabetes prevention program. "(a) in general.-the secretary, acting through the director of the centers for disease control and prevention, shall establish a national diabetes prevention program (referred to in this section as the 'program') targeted at adults at high risk for diabetes in order to eliminate the preventable burden of diabetes. "(b) program activities.-the program described in subsection (a) shall include- "(1) a grant program for community-based diabetes prevention program model sites; "(2) a program within the centers for disease control and prevention to determine eligibility of entities to deliver community-based diabetes prevention services; "(3) a training and outreach program for lifestyle intervention instructors; and "(4) evaluation, monitoring and technical assistance, and

applied research carried out by the centers for disease control and prevention. "(c) eligible entities.-to be eligible for a grant under subsection (b)(1), an entity shall be a state or local health department, a tribal organization, a national network of community-based non-profits focused on health and wellbeing, an academic institution, or other entity, as the secretary determines. "(d) authorization of appropriations.-for the purpose of carrying out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2010 through 2014.". (h) the provisions of, and amendment made by, section 5501(c) of this act are repealed. (i) (1) the provisions of, and amendments made by, section 5502 of this act are repealed. (2) (a) section 1861(aa)(3)(a)

of the social security act (42 u.s.c. 1395w(aa)(3)(a)) is amended to read as follows: "(a) services of the type described in subparagraphs (a) through (c) of paragraph (1) and preventive services (as defined in section 1861(ddd)(3)); and". (b) the amendment made by subparagraph (a) shall apply to services furnished on or after january 1, 2011. (3) (a) section 1834 of the social security act (42 u.s.c. 1395m), as amended by section 4105, is amended by adding at the end the following new subsection: "(o) development and implementation of prospective payment system.- "(1) development.- "(a) in general.-the secretary shall develop a prospective payment system for payment for federally qualified health center services furnished by federally qualified health centers under this title. such system shall include a process

for appropriately describing the services furnished by federally qualified health centers and shall establish payment rates for specific payment codes based on such appropriate descriptions of services. such system shall be established to take into account the type, intensity, and duration of services furnished by federally qualified health centers. such system may include adjustments, including geographic adjustments, determined appropriate by the secretary. "(b) collection of data and evaluation.-by not later than january 1, 2011, the secretary shall require federally qualified health centers to submit to the secretary such information as the secretary may require in order to develop and implement the prospective payment system under this subsection, including the reporting of services using hcpcs codes. "(2) implementation.- "(a) in general.-notwithstanding section 1833(a)(3)(a), the secretary shall provide, for cost reporting periods beginning

on or after october 1, 2014, for payments of prospective payment rates for federally qualified health center services furnished by federally qualified health centers under this title in accordance with the prospective payment system developed by the secretary under paragraph (1). "(b) payments.- "(i) initial payments.-the secretary shall implement such prospective payment system so that the estimated aggregate amount of prospective payment rates (determined prior to the application of section 1833(a)(1)(z)) under this title for federally qualified health center services in the first year that such system is implemented is equal to 100 percent of the estimated amount of reasonable costs (determined without the application of a per visit payment limit or productivity screen and prior to the application of section 1866(a)(2)(a)(ii)) that would have occurred for such services under this title in such year if the system had not been implemented. "(ii) payments in subsequent

years.-payment rates in years after the year of implementation of such system shall be the payment rates in the previous year increased- "(i) in the first year after implementation of such system, by the percentage increase in the mei (as defined in section 1842(i)(3)) for the year involved; and "(ii) in subsequent years, by the percentage increase in a market basket of federally qualified health center goods and services as promulgated through regulations, or if such an index is not available, by the percentage increase in the mei (as defined in section 1842(i)(3)) for the year involved. "(c) preparation for pps implementation.-notwithstanding any other provision of law, the secretary may establish and implement by program instruction or otherwise the payment codes to be used under the prospective payment system under this section.". (b) section 1833(a)(1) of the social security act (42 u.s.c.

1395l(a)(1)), as amended by section 4104, is amended- (i) by striking "and" before "(y)"; and (ii) by inserting before the semicolon at the end the following: ", and (z) with respect to federally qualified health center services for which payment is made under section 1834(o), the amounts paid shall be 80 percent of the lesser of the actual charge or the amount the actual charge or the amount determined under such section". (c) section 1833(a) of the social security act (42 u.s.c. 1395l(a)) is amended- (i) in paragraph (3)(b)(i)- (i) by inserting "(i)" after "otherwise been provided"; and (ii) by inserting ", or (ii) in the case of such services furnished on or after the implementation date of the prospective payment system under section 1834(o), under such section (calculated as if '100 percent' were substituted for

'80 percent' in such section) for such services if the individual had not been so enrolled" after "been so enrolled"; and (ii) by adding at the end the following flush sentence: "paragraph (3)(a) shall not apply to federally qualified health center services furnished on or after the implementation date of the prospective payment system under section 1834(0).". (j) section 5505 is amended by adding at the end the following new subsection: "(d) application.-the amendments made by this section shall not be applied in a manner that requires reopening of any settled cost reports as to which there is not a jurisdictionally proper appeal pending as of the date of the enactment of this act on the issue of payment for indirect costs of medical education under section 1886(d)(5)(b) of the social security act (42 u.s.c. 1395ww(d)(5)(b)) or for direct graduate medical education costs under section 1886(h) of such

act (42 u.s.c. 1395ww(h)).". (k) subtitle g of title v of this act is amended by adding at the end the following: "sec. 5606. state grants to health care providers who provide services to a high percentage of medically underserved populations or other special populations. "(a) in general.-a state may award grants to health care providers who treat a high percentage, as determined by such state, of medically underserved populations or other special populations in such state. "(b) source of funds.-a grant program established by a state under subsection (a) may not be established within a department, agency, or other entity of such state that administers the medicaid program under title xix of the social security act (42 u.s.c. 1396 et seq.), and no federal or state funds allocated to such medicaid program, the medicare program under title xviii of the social security act (42 u.s.c. 1395 et seq.), or the