"(f) MAINTENANCE OF EFFORT.-The Secretary may award a grant to an entity under subsection (b) only if the entity demonstrates to the satisfaction of the Secretary that "(1) funds received through the grant will be expended only to supplement, and not supplant, non-Federal and Federal funds otherwise available to the entity for the purpose of addressing core public health infrastructure needs; and (2) with respect to activities for which the grant is awarded, the entity will maintain expenditures of non-Federal amounts for such activities at a level not less than the level of such expenditures maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives the grant. "(g) ESTABLISHMENT OF A PUBLIC HEALTH ACCREDITATION PROGRAM. "(1) IN GENERAL.-The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall "(A) develop, and periodically review and update, standards for voluntary accreditation of State, local, or tribal health departments and public health laboratories for the purpose of advancing the quality and performance of such departments and laboratories; and "(B) implement a program to accredit such health departments and laboratories in accordance with such standards. "(2) COOPERATIVE AGREEMENT.-The Secretary may enter into a cooperative agreement with a private nonprofit entity to carry out paragraph (1). "(h) REPORT.-The Secretary shall submit to the Congress an annual report on progress being made to accredit entities under subsection (g), including "(1) a strategy, including goals and objectives, for accrediting entities under subsection (g) and achieving the purpose described in subsection (g)(1); and "(2) identification of gaps in research related to core public health infrastructure and recommendations of priority areas for such research. "SEC. 3162. CORE PUBLIC HEALTH INFRASTRUCTURE AND ACTIVITIES FOR CDC. “(a) IN GENERAL.-The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall expand and improve the core public health infrastructure and activities of the Centers for Disease Control and Prevention to address unmet and emerging public health needs. "(b) REPORT.-The Secretary shall submit to the Congress an annual report on the activities funded through this section. "Subtitle G-General Provisions "SEC. 3171. DEFINITIONS. "In this title: "(1) The term 'core public health infrastructure' includes workforce capacity and competency; laboratory systems; health information, health information systems, and health information analysis; communications; financing; other relevant components of organizational capacity; and other related activities. "(2) The terms 'Department' and 'departmental' refer to the Department of Health and Human Services. "(3) The term 'health disparities' includes health and health care disparities and means population-specific differences in the presence of disease, health outcomes, or access to health care. For purposes of the preceding sentence, a population may be delineated by race, ethnicity, geographic setting, and other populations or subpopulations determined by the Secretary to experience significant gaps in disease, health outcomes, or access to health care. (4) The term 'tribal' refers to an Indian tribe, a Tribal organization, or an Urban Indian organization, as such terms are defined in section 4 of the Indian Health Care Improvement Act.". (b) TRANSITION PROVISIONS APPLICABLE TO TASK FORCES.— (1) FUNCTIONS, PERSONNEL, ASSETS, LIABILITIES, AND ADMINISTRATIVE ACTIONS.-All functions, personnel, assets, and liabilities of, and administrative actions applicable to, the Preventive Services Task Force convened under section 915(a) of the Public Health Service Act and the Task Force on Community Preventive Services (as such section and Task Forces were in existence on the day before the date of the enactment of this Act) shall be transferred to the Task Force on Clinical Preventive Services and the Task Force on Community Preventive Services, respectively, established under sections 3121 and 3122 of the Public Health Service Act, as added by subsection (a). (2) RECOMMENDATIONS.-All recommendations of the Preventive Services Task Force and the Task Force on Community Preventive Services, as in existence on the day before the date of the enactment of this Act, shall be considered 267 to be recommendations of the Task Force on Clinical Preventive Services and the Task Force on Community Preventive Services, respectively, established under sections 3121 and 3122 of the Public Health Service Act, as added by subsection (a). (3) MEMBERS ALREADY SERVING.— (A) INITIAL MEMBERS.-The Secretary of Health and Human Services may select those individuals already serving on the Preventive Services Task Force and the Task Force on Community Preventive Services, as in existence on the day before the date of the enactment of this Act, to be among the first members appointed to the Task Force on Clinical Preventive Services and the Task Force on Community Preventive Services, respectively, under sections 3121 and 3122 of the Public Health Service Act, as added by subsection (a). (B) CALCULATION OF TOTAL SERVICE.-In calculating the total years of service of a member of a task force for purposes of section 3131(d)(2)(A) or 3132(d)(2)(A) of the Public Health Service Act, as added by subsection (a), the Secretary of Health and Human Services shall not include any period of service by the member on the Preventive Services Task Force or the Task Force on Community Preventive Services, respectively, as in existence on the day before the date of the enactment of this Act. (c) PERIOD BEFORE COMPLETION OF NATIONAL STRATEGY.-Pending completion of the national strategy under section 3121 of the Public Health Service Act, as added by subsection (a), the Secretary of Health and Human Services, acting through the relevant agency head, may make a judgment about how the strategy will address an issue and rely on such judgment in carrying out any provision of subtitle C, D, E, or F of title XXXI of such Act, as added by subsection (a), that requires the Secretary (1) to take into consideration such strategy; (2) to conduct or support research or provide services in priority areas identified in such strategy; or (3) to take any other action in reliance on such strategy. (d) CONFORMING AMENDMENTS. (1) Paragraph (61) of section 3(b) of the Indian Health Care Improvement Act (25 U.S.C. 1602) is amended by striking "United States Preventive Services Task Force" and inserting "Task Force on Clinical Preventive Services”. (2) Section 126 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (Appendix F of Public Law 106-554) is amended by striking "United States Preventive Services Task Force" each place it appears and inserting "Task Force on Clinical Preventive Services". (3) Paragraph (7) of section 317D(a) of the Public Health Service Act (42 U.S.C. 247b-5(a)) is amended by striking "United States Preventive Services Task Force" and inserting "Task Force on Clinical Preventive Services". (4) Section 915 of the Public Health Service Act (42 U.S.C. 299b-4) is amended by striking subsection (a). (5) Subsections (s)(2)(AA)(iii)(II), (xx)(1), and (ddd)(1)(B) of section 1861 of the Social Security Act (42 U.S.C. 1395x) are amended by striking "United States Preventive Services Task Force" each place it appears and inserting "Task Force on Clinical Preventive Services". TITLE IV-QUALITY AND SURVEILLANCE SEC. 2401. IMPLEMENTATION OF BEST PRACTICES IN THE DELIVERY OF HEALTH CARE. (a) IN GENERAL.-Title IX of the Public Health Service Act (42 U.S.C. 299 et seq.) is amended (1) by redesignating part D as part E; (2) by redesignating sections 931 through 938 as sections 941 through 948, respectively; (3) in section 948(1), as redesignated, by striking "931" and inserting "941"; and (4) by inserting after part C the following: "PART D-IMPLEMENTATION OF BEST PRACTICES IN THE DELIVERY OF HEALTH CARE "SEC. 931. CENTER FOR QUALITY IMPROVEMENT. "(a) IN GENERAL.-There is established the Center for Quality Improvement (referred to in this part as the 'Center'), to be headed by the Director. "(b) PRIORITIZATION.— "(1) IN GENERAL.-The Director shall prioritize areas for the identification, development, evaluation, and implementation of best practices (including innovative methodologies and strategies) for quality improvement activities in the delivery of health care services (in this section referred to as 'best practices'). "(2) CONSIDERATIONS.-In prioritizing areas under paragraph (1), the Director shall consider "(A) the priorities established under section 1191 of the Social Security Act; and "(B) the key health indicators identified by the Assistant Secretary for Health Information under section 1709. "(3) LIMITATIONS.-In conducting its duties under this subsection, the Center for Quality Improvement shall not develop quality-adjusted life year measures or any other methodologies that can be used to deny benefits to a beneficiary against the beneficiary's wishes on the basis of the beneficiary's age, life expectancy, present or predicted disability, or expected quality of life. "(c) OTHER RESPONSIBILITIES.-The Director, acting directly or by awarding a grant or contract to an eligible entity, shall— "(1) identify existing best practices under subsection (e); "(4) implement best practices under subsection (h); "(5) ensure that best practices are identified, developed, evaluated, and implemented under this section consistent with standards adopted by the Secretary under section 3004 for health information technology used in the collection and reporting of quality information (including for purposes of the demonstration of meaningful use of certified electronic health record (EHR) technology by physicians and hospitals under the Medicare program (under sections 1848(0)(2) and 1886(n)(3), respectively, of the Social Security Act)); and "(6) provide for dissemination of information and reporting under subsections (i) and (j). "(d) ELIGIBILITY.-To be eligible for a grant or contract under subsection (c), an entity shall "(1) be a nonprofit entity; "(2) agree to work with a variety of institutional health care providers, physicians, nurses, and other health care practitioners; and “(3) if the entity is not the organization holding a contract under section 1153 of the Social Security Act for the area to be served, agree to cooperate with and avoid duplication of the activities of such organization. "(e) IDENTIFYING EXISTING BEST PRACTICES.-The Secretary shall identify best practices that are "(1) currently utilized by health care providers (including hospitals, physician and other clinician practices, community cooperatives, and other health care entities) that deliver consistently high-quality, efficient health care services; and "(2) easily adapted for use by other health care providers and for use across a variety of health care settings. "(f) DEVELOPING NEW BEST PRACTICES.-The Secretary shall develop best practices that are— "(1) based on a review of existing scientific evidence; "(2) sufficiently detailed for implementation and incorporation into the workflow of health care providers; and "(3) designed to be easily adapted for use by health care providers across a variety of health care settings. "(g) EVALUATION OF BEST PRACTICES.-The Director shall evaluate best practices identified or developed under this section. Such evaluation— "(1) shall include determinations of which best practices "(A) most reliably and effectively achieve significant progress in improving the quality of patient care; and "(B) are easily adapted for use by health care providers across a variety of health care settings; "(2) shall include regular review, updating, and improvement of such best practices; and “(3) may include in-depth case studies or empirical assessments of health care providers (including hospitals, physician and other clinician practices, community cooperatives, and other health care entities) and simulations of such best practices for determinations under paragraph (1). "(h) IMPLEMENTATION OF BEST PRACTICES. "(1) IN GENERAL.-The Director shall enter into arrangements with entities in a State or region to implement best practices identified or developed under this section. Such implementation "(A) may include forming collaborative multi-institutional teams; and "(B) shall include an evaluation of the best practices being implemented, including the measurement of patient outcomes before, during, and after implementation of such best practices. "(2) PREFERENCES.-In carrying out this subsection, the Director shall give priority to health care providers implementing best practices that— "(A) have the greatest impact on patient outcomes and satisfaction; "(B) are the most easily adapted for use by health care providers across a variety of health care settings; "(C) promote coordination of health care practitioners across the continuum of care; and "(D) engage patients and their families in improving patient care and out comes. “(i) PUBLIC DISSEMINATION OF INFORMATION.-The Director shall provide for the public dissemination of information with respect to best practices and activities under this section. Such information shall be made available in appropriate formats and languages to reflect the varying needs of consumers and diverse levels of health literacy. "(j) REPORT. "(1) IN GENERAL.-The Director shall submit an annual report to the Congress and the Secretary on activities under this section. "(2) CONTENT.-Each report under paragraph (1) shall include— "(A) information on activities conducted pursuant to grants and contracts awarded; “(B) summary data on patient outcomes before, during, and after implementation of best practices; and "(C) recommendations on the adaptability of best practices for use by health providers.". (b) INITIAL QUALITY IMPROVEMENT ACTIVITIES AND INITIATIVES TO BE IMPLEMENTED.—Until the Director of the Agency for Healthcare Research and Quality has established initial priorities under section 931(b) of the Public Health Service Act, as added by subsection (a), the Director shall, for purposes of such section, prioritize the following: (1) HEALTH CARE-ASSOCIATED INFECTIONS.-Reducing health care-associated infections, including infections in nursing homes and outpatient settings. (2) SURGERY.-Increasing hospital and outpatient perioperative patient safety, including reducing surgical-site infections and surgical errors (such as wrongsite surgery and retained foreign bodies). (3) EMERGENCY ROOM.-Improving care in hospital emergency rooms, including through the use of principles of efficiency of design and delivery to improve patient flow. (4) OBSTETRICS.-Improving the provision of obstetrical and neonatal care, including the identification of interventions that are effective in reducing the risk of preterm and premature labor and the implementation of best practices for labor and delivery care. (5) PEDIATRICS.-Improving the provision of preventive and developmental child health services, including interventions that can reduce child health disparities and reduce the risk of developing chronic health-threatening conditions that affect an individual's life course development. (c) REPORT.-Not later than 18 months after the date of the enactment of this Act, the Director of the Agency for Healthcare Research and Quality shall submit a report to the Congress on the impact of the nurse-to-patient ratio on the quality of care and patient outcomes, including recommendations for further integration into quality measurement and quality improvement activities. SEC. 2402. ASSISTANT SECRETARY FOR HEALTH INFORMATION. (a) ESTABLISHMENT.-Title XVII (42 U.S.C. 300u et seq.) is amended (1) by redesignating sections 1709 and 1710 as sections 1710 and 1711, respectively; and (2) by inserting after section 1708 the following: "SEC. 1709. ASSISTANT SECRETARY FOR HEALTH INFORMATION. "(a) IN GENERAL.-There is established within the Department an Assistant Secretary for Health Information (in this section referred to as the 'Assistant Secretary'), to be appointed by the Secretary. "(b) RESPONSIBILITIES.-The Assistant Secretary shall "(1) ensure the collection, collation, reporting, and publishing of information (including full and complete statistics) on key health indicators regarding the Nation's health and the performance of the Nation's health care; "(2) facilitate and coordinate the collection, collation, reporting, and publishing of information regarding the Nation's health and the performance of the Nation's health care (other than information described in paragraph (1)); "(3)(A) develop standards for the collection of data regarding the Nation's health and the performance of the Nation's health care; and "(B) in carrying out subparagraph (A)— "(i) ensure appropriate specificity and standardization for data collection at the national, regional, State, and local levels; "(ii) include standards, as appropriate, for the collection of accurate data on health and health care by race, ethnicity, primary language, sex, sexual orientation, gender identity, disability, socioeconomic status, rural, urban, or other geographic setting, and any other population or subpopulation determined appropriate by the Secretary; "(iii) ensure, with respect to data on race and ethnicity, consistency with the 1997 Office of Management and Budget Standards for Maintaining, Collecting and Presenting Federal Data on Race and Ethnicity (or any successor standards); and "(iv) in consultation with the Director of the Office of Minority Health, and the Director of the Office of Civil Rights, of the Department, develop standards for the collection of data on health and health care with respect to primary language; "(4) provide support to Federal departments and agencies whose programs have a significant impact upon health (as determined by the Secretary) for the collection and collation of information described in paragraphs (1) and (2); “(5) ensure the sharing of information described in paragraphs (1) and (2) among the agencies of the Department; "(6) facilitate the sharing of information described in paragraphs (1) and (2) by Federal departments and agencies whose programs have a significant impact upon health (as determined by the Secretary); "(7) identify gaps in information described in paragraphs (1) and (2) and the appropriate agency or entity to address such gaps; (8) facilitate and coordinate identification and monitoring by the agencies of the Department of health disparities to inform program and policy efforts to reduce such disparities, including facilitating and funding analyses conducted in cooperation with the Social Security Administration, the Bureau of the Census, and other appropriate agencies and entities; "(9) consistent with privacy, proprietary, and other appropriate safeguards, facilitate public accessibility of datasets (such as de-identified Medicare datasets or publicly available data on key health indicators) by means of the Internet; and "(10) award grants or contracts for the collection and collation of information described in paragraphs (1) and (2) (including through statewide surveys that provide standardized information). "(c) KEY HEALTH INDICATORS. "(1) IN GENERAL.-In carrying out subsection (b)(1), the Assistant Secretary shall "(A) identify, and reassess at least once every 3 years, key health indicators described in such subsection; "(B) publish statistics on such key health indicators for the public— *(i) not less than annually; and "(ii) on a supplemental basis whenever warranted by "(I) the rate of change for a key health indicator; or "(II) the need to inform policy regarding the Nation's health and the performance of the Nation's health care; and "(C) ensure consistency with the national strategy developed by the Secretary under section 3121 and consideration of the indicators specified in the reports under sections 308, 903(a)(6), and 913(b)(2). "(2) RELEASE OF KEY HEALTH INDICATORS.-The regulations, rules, processes, and procedures of the Office of Management and Budget governing the review, release, and dissemination of key health indicators shall be the same as the regulations, rules, processes, and procedures of the Office of Management and |