S.Amdt. 2827

SA 2827. Mr. TESTER submitted an amendment intended to be proposed to
amendment SA 2786 proposed by Mr. Reid (for himself, Mr. Baucus, Mr.
Dodd, and Mr. Harkin) to the bill H.R. 3590, to amend the Internal
Revenue Code of 1986 to modify the first-time homebuyers credit in the
case of members of the Armed Forces and certain other Federal
employees, and for other purposes; which was ordered to lie on the
table; as follows:

Beginning on page 1203, strike line 19 and all that follows
through page 1209, line 20 and insert the following:

SEC. 4201. COMMUNITY TRANSFORMATION GRANTS.

(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary''), acting
through the Director of the Centers for Disease Control and
Prevention (referred to in this section as the ``Director''),
shall award competitive grants to State and local
governmental agencies and community-based organizations for
the implementation, evaluation, and dissemination of
evidence-based community preventive health activities in
order to reduce chronic disease rates, prevent the
development of secondary conditions, address health
disparities, and develop a stronger evidence-base of
effective prevention programming, with not less than 20
percent of such grants being made to State or local
government agencies and community-based organizations located
in or serving, or both, rural areas.
(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall--
(1) be--
(A) a State governmental agency;
(B) a local governmental agency;
(C) a national network of community-based organizations;
(D) a State or local non-profit organization; or
(E) an Indian tribe; and
(2) submit to the Director an application at such time, in
such a manner, and containing such information as the
Director may require, including a description of the program
to be carried out under the grant; and
(3) demonstrate a history or capacity, if funded, to
develop relationships necessary to engage key stakeholders
from multiple sectors within and beyond health care and
across a community, such as healthy futures corps and health
care providers.
(c) Use of Funds.--
(1) In general.--An eligible entity shall use amounts
received under a grant under this section to carry out
programs described in this subsection.
(2) Community transformation plan.--
(A) In general.--An eligible entity that receives a grant
under this section shall submit to the Director (for
approval) a detailed plan that includes the policy,
environmental, programmatic, and as appropriate
infrastructure changes needed to promote healthy living and
reduce disparities.
(B) Activities.--Activities within the plan may focus on
(but not be limited to)--
(i) creating healthier school environments, including
increasing healthy food options, physical activity
opportunities, promotion of healthy lifestyle, emotional
wellness, and prevention curricula, and activities to prevent
chronic diseases;
(ii) creating the infrastructure to support active living
and access to nutritious foods in a safe environment;
(iii) developing and promoting programs targeting a variety
of age levels to increase access to nutrition, physical
activity and smoking cessation, improve social and emotional
wellness, enhance safety in a community, or address any other
chronic disease priority area identified by the grantee;
(iv) assessing and implementing worksite wellness
programming and incentives;
(v) working to highlight healthy options at restaurants and
other food venues;

[[Page S12168]]

(vi) prioritizing strategies to reduce racial and ethnic
disparities, including social, economic, and geographic
determinants of health; and
(vii) addressing special populations needs, including all
age groups and individuals with disabilities, and individuals
in both urban, rural, and frontier areas.
(3) Community-based prevention health activities.--
(A) In general.--An eligible entity shall use amounts
received under a grant under this section to implement a
variety of programs, policies, and infrastructure
improvements to promote healthier lifestyles.
(B) Activities.--An eligible entity shall implement
activities detailed in the community transformation plan
under paragraph (2).
(C) In-kind support.--An eligible entity may provide in-
kind resources such as staff, equipment, or office space in
carrying out activities under this section.
(4) Evaluation.--
(A) In general.--An eligible entity shall use amounts
provided under a grant under this section to conduct
activities to measure changes in the prevalence of chronic
disease risk factors among community members participating in
preventive health activities
(B) Types of measures.--In carrying out subparagraph (A),
the eligible entity shall, with respect to residents in the
community, measure--
(i) changes in weight;
(ii) changes in proper nutrition;
(iii) changes in physical activity;
(iv) changes in tobacco use prevalence;
(v) changes in emotional well-being and overall mental
health;
(vi) other factors using community-specific data from the
Behavioral Risk Factor Surveillance Survey; and
(vii) other factors as determined by the Secretary,
including differential susceptibility, mortality, or
morbidity due to chronic diseases such as cancer, diabetes,
and cardiovascular disease.
(C) Reporting.--An eligible entity shall annually submit to
the Director a report containing an evaluation of activities
carried out under the grant.
(5) Dissemination.--A grantee under this section shall--
(A) meet at least annually in regional or national meetings
to discuss challenges, best practices, and lessons learned
with respect to activities carried out under the grant; and
(B) develop models for the replication of successful
programs and activities and the mentoring of other eligible
entities.
(d) Training.--
(1) In general.--The Director shall develop a program to
provide training for eligible entities on effective
strategies for the prevention and control of chronic disease
and the link between physical, emotional, and social well-
being.
(2) Community transformation plan.--The Director shall
provide appropriate feedback and technical assistance to
grantees to establish community transformation plans
(3) Evaluation.--The Director shall provide a literature
review and framework for the evaluation of programs conducted
as part of the grant program under this section, in addition
to working with academic institutions or other entities with
expertise in outcome evaluation.
(e) Prohibition.--A grantee shall not use funds provided
under a grant under this section to create video games or to
carry out any other activities that may lead to higher rates
of obesity or inactivity.
(f) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section, such sums as
may be necessary for each fiscal years 2010 through 2014.

SEC. 4201A. REDUCTION OF HEALTH DISPARITIES IN RURAL AREAS.

(a) Authorization of Initiative.--
(1) In general.--The Secretary of Health and Human
Services, in collaboration or conjunction with the Director
of the National Center for Health Disparities and Deputy
Assistant Secretary for Minority Health, shall establish an
initiative--
(A) that is specifically directed toward addressing the
issue of health disparities attributable to chronic diseases
in rural and frontier areas by creating and promoting
educational, screening, and outreach programs that reduce the
prevalence, morbidity, and mortality of chronic diseases or
susceptibility to such diseases; and
(B) whose goal is to significantly improve access to, and
utilization of, beneficial chronic disease interventions in
rural communities experiencing health disparities in order to
reduce such disparities.
(2) Health disparity population.--
(A) In general.--For purposes of carrying out the
initiative described in paragraph (1), a population shall be
considered a health disparity population if there is a
significant disparity in the overall rate of chronic disease
incidence, prevalence, morbidity, mortality, or survival
rates in the population as compared to the health status of
the general population.
(B) Chronic diseases.--In this paragraph, the term
``chronic disease'' includes hypertension, diabetes, cancer,
and heart disease.
(b) Common Administrative Structure.--The initiative
described in subsection (a) shall--
(1) utilize a common administrative structure to ensure
coordinated implementation, oversight, and accountability;
(2) be amenable to regional organization in order to meet
the specific needs of rural communities throughout the United
States; and
(3) involve elements located in rural communities and
areas.
(c) Design.--The initiative described in subsection (a)
shall be designed to reach rural communities and populations
that experience a disproportionate share of chronic disease
burden, including African Americans, American Indians or
Alaska Natives, Hawaiian Natives and other Pacific Islanders,
Asians, Hispanics or Latinos, and other underserved rural
populations.
(d) Establishment of Initiative and Grants.--In carrying
out the initiative described in subsection (a), the Secretary
of Health and Human Services shall, from funds appropriated
to carry out this section--
(1) use 50 percent for the establishment of such
initiative; and
(2) use 50 percent to award competitive grants or contracts
to organizations, universities, or similar entities to carry
out the initiative, with preference given to entities having
a demonstrable track record of service to rural communities,
including tribally-affiliated colleges or universities.
______