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1 ‘‘(9) other information as determined necessary
2 by the Secretary.
3 ‘‘(j) EVALUATION.—
4 ‘‘(1) IN GENERAL.—The Secretary shall, by
5 grant or contract, provide for the conduct of an
6 independent evaluation of the effectiveness of home
7 visitation programs receiving funds provided under
8 this section, which shall examine the following:
9 ‘‘(A) The effect of home visitation pro-
10 grams on child and parent outcomes, including
11 child maltreatment, child health and develop-
12 ment, school readiness, and links to community
13 services.
14 ‘‘(B) The effectiveness of home visitation
15 programs on different populations, including
16 the extent to which the ability of programs to
17 improve outcomes varies across programs and
18 populations.
19 ‘‘(2) REPORTS TO THE CONGRESS.—

20 ‘‘(A) INTERIM REPORT.—Within 3 years

21 after the date of the enactment of this section,
22 the Secretary shall submit to the Congress an
23 interim report on the evaluation conducted pur-
24 suant to paragraph (1).

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1 ‘‘(B) FINAL REPORT.—Within 5 years
2 after the date of the enactment of this section,
3 the Secretary shall submit to the Congress a
4 final report on the evaluation conducted pursu-
5 ant to paragraph (1).
6 ‘‘(k) ANNUAL REPORTS TO THE CONGRESS.—The
7 Secretary shall submit annually to the Congress a report
8 on the activities carried out using funds made available
9 under this section, which shall include a description of the
10 following:
11 ‘‘(1) The high need communities targeted by
12 States for programs carried out under this section.
13 ‘‘(2) The service delivery models used in the
14 programs receiving funds provided under this sec-
15 tion.
16 ‘‘(3) The characteristics of the programs, in-
17 cluding—
18 ‘‘(A) the qualifications and demographic
19 characteristics of program staff; and
20 ‘‘(B) recipient characteristics including the
21 number of families served, the demographic
22 characteristics of the families served, and fam-
23 ily retention and duration of services.
24 ‘‘(4) The outcomes reported by the programs.

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1 ‘‘(5) The research-based instruction, materials,
2 and activities being used in the activities funded
3 under the grant.
4 ‘‘(6) The training and technical activities, in-
5 cluding on-going professional development, provided
6 to the programs.
7 ‘‘(7) The annual costs of implementing the pro-
8 grams, including the cost per family served under
9 the programs.
10 ‘‘(8) The indicators and methods used by States
11 to monitor whether the programs are being been im-
12 plemented as designed.
13 ‘‘(l) RESERVATIONS OF FUNDS.—From the amounts
14 appropriated for a fiscal year under subsection (m), the
15 Secretary shall reserve—
16 ‘‘(1) an amount equal to 5 percent of the
17 amounts to pay the cost of the evaluation provided
18 for in subsection (j), and the provision to States of
19 training and technical assistance, including the dis-
20 semination of best practices in early childhood home
21 visitation; and
22 ‘‘(2) after making the reservation required by
23 paragraph (1), an amount equal to 3 percent of the
24 amount so appropriated, to pay for grants to Indian
25 tribes under this section.

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1 ‘‘(m) APPROPRIATIONS.—Out of any money in the
2 Treasury of the United States not otherwise appropriated,
3 there is appropriated to the Secretary to carry out this
4 section—
5 ‘‘(1) $50,000,000 for fiscal year 2010;
6 ‘‘(2) $100,000,000 for fiscal year 2011;
7 ‘‘(3) $150,000,000 for fiscal year 2012;
8 ‘‘(4) $200,000,000 for fiscal year 2013; and
9 ‘‘(5) $250,000,000 for fiscal year 2014.
10 ‘‘(n) INDIAN TRIBES TREATED AS STATES.—In this
11 section, paragraphs (4), (5), and (6) of section 431(a)
12 shall apply.’’.
13 SEC. 1905. IMPROVED COORDINATION AND PROTECTION

14 FOR DUAL ELIGIBLES.

15 Title XI of the Social Security Act is amended by

16 inserting after section 1150 the following new section:
17 ‘‘IMPROVED COORDINATION AND PROTECTION FOR DUAL

18 ELIGIBLES

19 ‘‘SEC. 1150A. (a) IN GENERAL.—The Secretary shall

20 provide, through an identifiable office or program within
21 the Centers for Medicare & Medicaid Services, for a fo-
22 cused effort to provide for improved coordination between
23 Medicare and Medicaid and protection in the case of dual
24 eligibles (as defined in subsection (e)). The office or pro-
25 gram shall—

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1 ‘‘(1) review Medicare and Medicaid policies re-
2 lated to enrollment, benefits, service delivery, pay-
3 ment, and grievance and appeals processes under
4 parts A and B of title XVIII, under the Medicare
5 Advantage program under part C of such title, and
6 under title XIX;
7 ‘‘(2) identify areas of such policies where better
8 coordination and protection could improve care and
9 costs; and
10 ‘‘(3) issue guidance to States regarding improv-
11 ing such coordination and protection.
12 ‘‘(b) ELEMENTS.—The improved coordination and
13 protection under this section shall include efforts—
14 ‘‘(1) to simplify access of dual eligibles to bene-
15 fits and services under Medicare and Medicaid;
16 ‘‘(2) to improve care continuity for dual eligi-
17 bles and ensure safe and effective care transitions;
18 ‘‘(3) to harmonize regulatory conflicts between
19 Medicare and Medicaid rules with regard to dual eli-
20 gibles; and
21 ‘‘(4) to improve total cost and quality perform-
22 ance under Medicare and Medicaid for dual eligibles.
23 ‘‘(c) RESPONSIBILITIES.—In carrying out this sec-
24 tion, the Secretary shall provide for the following:

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1 ‘‘(1) An examination of Medicare and Medicaid
2 payment systems to develop strategies to foster more
3 integrated and higher quality care.
4 ‘‘(2) Development of methods to facilitate ac-
5 cess to post-acute and community-based services and
6 to identify actions that could lead to better coordina-
7 tion of community-based care.
8 ‘‘(3) A study of enrollment of dual eligibles in
9 the Medicare Savings Program (as defined in section
10 1144(c)(7)), under Medicaid, and in the low-income
11 subsidy program under section 1860D–14 to identify
12 methods to more efficiently and effectively reach and
13 enroll dual eligibles.
14 ‘‘(4) An assessment of communication strate-
15 gies for dual eligibles to determine whether addi-
16 tional informational materials or outreach is needed,
17 including an assessment of the Medicare website, 1–
18 800–MEDICARE, and the Medicare handbook.
19 ‘‘(5) Research and evaluation of areas where
20 service utilization, quality, and access to cost sharing
21 protection could be improved and an assessment of
22 factors related to enrollee satisfaction with services
23 and care delivery.
24 ‘‘(6) Collection (and making available to the
25 public) of data and a database that describe the eli-

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1 gibility, benefit and cost-sharing assistance available
2 to dual eligibles by State.
3 ‘‘(7) Monitoring total combined Medicare and
4 Medicaid program costs in serving dual eligibles and
5 making recommendations for optimizing total quality
6 and cost performance across both programs.
7 ‘‘(8) Coordination of activities relating to Medi-
8 care Advantage plans under 1859(b)(6)(B)(ii) and
9 Medicaid.
10 ‘‘(d) PERIODIC REPORTS.—Not later than 1 year
11 after the date of the enactment of this section and every
12 3 years thereafter the Secretary shall submit to Congress
13 a report on progress in activities conducted under this sec-
14 tion.
15 ‘‘(e) DEFINITIONS.—In this section:
16 ‘‘(1) DUAL ELIGIBLE.—The term ‘dual eligible’
17 means an individual who is dually eligible for bene-
18 fits under title XVIII, and medical assistance under
19 title XIX, including such individuals who are eligible
20 for benefits under the Medicare Savings Program
21 (as defined in section 1144(c)(7)).
22 ‘‘(2) MEDICARE; MEDICAID.—The terms ‘Medi-
23 care’ and ‘Medicaid’ mean the programs under titles
24 XVIII and XIX, respectively.’’.

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1 DIVISION C—PUBLIC HEALTH
2 AND WORKFORCE DEVELOP-
3 MENT
4 SEC. 2001. TABLE OF CONTENTS; REFERENCES.

5 (a) TABLE OF CONTENTS.—The table of contents of

6 this division is as follows:
Sec. 2001. Table of contents; references.
Sec. 2002. Public Health Investment Fund.

TITLE I—COMMUNITY HEALTH CENTERS

Sec. 2101. Increased funding.

TITLE II—WORKFORCE

Subtitle A—Primary Care Workforce

PART 1—NATIONAL HEALTH SERVICE CORPS

Sec. 2201. National Health Service Corps.

Sec. 2202. Authorizations of appropriations.

PART 2—PROMOTION OF PRIMARY CARE AND DENTISTRY

Sec. 2211. Frontline health providers.

‘‘SUBPART XI—HEALTH PROFESSIONAL NEEDS AREAS

‘‘Sec. 340H. In general.

‘‘Sec. 340I. Loan repayments.
‘‘Sec. 340J. Report.
‘‘Sec. 340K. Allocation.
Sec. 2212. Primary care student loan funds.
Sec. 2213. Training in family medicine, general internal medicine, general pedi-
atrics, geriatrics, and physician assistantship.
Sec. 2214. Training of medical residents in community-based settings.
Sec. 2215. Training for general, pediatric, and public health dentists and dental
hygienists.
Sec. 2216. Authorization of appropriations.

Subtitle B—Nursing Workforce

Sec. 2221. Amendments to Public Health Service Act.

Subtitle C—Public Health Workforce

Sec. 2231. Public Health Workforce Corps.

‘‘SUBPART XII—PUBLIC HEALTH WORKFORCE

‘‘Sec. 340L. Public Health Workforce Corps.

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