42 U.S.C. § 300u — General authority of Secretary

Page 1366 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 300t–13 1 See References in Text note below. eral revision of subchapter V of this chapter by Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 1994. Pub. L. 102–408 enacted a new section 705 of act July 1, 1944, re- lating to eligibility of borrowers and terms of insured loans, and a new section 706, relating to certificates of loan insurance, which are classified to sections 292d and 292e, respectively, of this title. The Social Security Act, referred to in subsec. (e), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XVIII of the Social Security Act is classified generally to sub- chapter XVIII (§ 1395 et seq.) of chapter 7 of this title. For complete classification of this Act to the Code, see section 1305 of this title and Tables. CODIFICATION In subsec. (b)(1)(D), ‘‘sections 3141–3144, 3146, and 3147 of title 40’’ substituted for ‘‘the Act of March 3, 1931 (40 U.S.C. 276a—276a–5, known as the Davis-Bacon Act)’’ and ‘‘section 3145 of title 40’’ substituted for ‘‘section 2 of the Act of June 13, 1934 (40 U.S.C. 276c)’’ on authority of Pub. L. 107–217, § 5(c), Aug. 21, 2002, 116 Stat. 1303, the first section of which enacted Title 40, Public Build- ings, Property, and Works. Statutory Notes and Related Subsidiaries CHANGE OF NAME ‘‘Secretary of Health and Human Services’’ sub- stituted for ‘‘Secretary of Health, Education, and Wel- fare’’ in subsecs. (a), (b), and (c) pursuant to section 509(b) of Pub. L. 96–88, which is classified to section 3508(b) of Title 20, Education. § 300t–13. Grants to States for reduction of excess hospital capacity (a) ‘‘Excess hospital capacity’’ defined; particular activities For the purpose of demonstrating the effec- tiveness of various means for reducing excesses in resources and facilities of hospitals (referred to in this section as ‘‘excess hospital capacity’’), the Secretary may make grants to State Agen- cies designated under section 300m(b)(3) 1 of this title to assist such Agencies in— (1) identifying (by geographic region or by health service) excess hospital capacity, (2) developing programs to inform the public of the costs associated with excess hospital ca- pacity, (3) developing programs to reduce excess hospital capacity in a manner which will produce the greatest savings in the cost of health care delivery, (4) developing means to overcome barriers to the reduction of excess hospital capacity, (5) in planning, evaluating, and carrying out programs to decertify health care facilities providing health services that are not appro- priate, and (6) any other activity related to the reduc- tion of excess hospital capacity. (b) Terms and conditions Grants under subsection (a) shall be made on such terms and conditions as the Secretary may prescribe. (July 1, 1944, ch. 373, title XVI, § 1643, as added Pub. L. 96–79, title III, § 301(a), Oct. 4, 1979, 93 Stat. 639.) Editorial Notes REFERENCES IN TEXT Section 300m of this title, referred to in subsec. (a), was in the original a reference to section 1521 of act July 1, 1944, which was repealed effective Jan. 1, 1987, by Pub. L. 99–660, title VII, § 701(a), Nov. 14, 1986, 100 Stat. 3799. Pub. L. 101–354, § 2, Aug. 10, 1990, 104 Stat. 410, enacted section 1503 of act July 1, 1944, which is classi- fied to section 300m of this title. § 300t–14. Authorization of appropriations To make payments under grants under sec- tions 300t–12 and 300t–13 of this title there are authorized to be appropriated $30,000,000 for the fiscal year ending September 30, 1980, $50,000,000 for the fiscal year ending September 30, 1981, and $75,000,000 for the fiscal year ending September 30, 1982, except that in any fiscal year not more than 10 percent of the amount appropriated under this section may be obligated for grants under section 300t–13 of this title. (July 1, 1944, ch. 373, title XVI, § 1644, as added Pub. L. 96–79, title III, § 301(a), Oct. 4, 1979, 93 Stat. 640.) SUBCHAPTER XV—HEALTH INFORMATION AND HEALTH PROMOTION § 300u. General authority of Secretary (a) Development, support, and implementation of programs, activities, etc. The Secretary shall— (1) formulate national goals, and a strategy to achieve such goals, with respect to health information and health promotion, preventive health services, and education in the appro- priate use of health care; (2) analyze the necessary and available re- sources for implementing the goals and strat- egy formulated pursuant to paragraph (1), and recommend appropriate educational and qual- ity assurance policies for the needed man- power resources identified by such analysis; (3) undertake and support necessary activi- ties and programs to— (A) incorporate appropriate health edu- cation components into our society, espe- cially into all aspects of education and health care, (B) increase the application and use of health knowledge, skills, and practices by the general population in its patterns of daily living, and (C) establish systematic processes for the exploration, development, demonstration, and evaluation of innovative health pro- motion concepts; (4) undertake and support research and dem- onstrations respecting health information and health promotion, preventive health services, and education in the appropriate use of health care; (5) undertake and support appropriate train- ing in, and undertake and support appropriate training in the operation of programs con- cerned with, health information and health promotion, preventive health services, and education in the appropriate use of health care; Page 1367 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 300u (6) undertake and support, through improved planning and implementation of tested models and evaluation of results, effective and effi- cient programs respecting health information and health promotion, preventive health serv- ices, and education in the appropriate use of health care; (7)(A) develop model programs through which employers in the public sector, and em- ployers that are small businesses (as defined in section 632 of title 15), can provide for their employees a program to promote healthy be- haviors and to discourage participation in unhealthy behaviors; (B) provide technical assistance to public and private employers in implementing such programs (including private employers that are not small businesses and that will imple- ment programs other than the programs devel- oped by the Secretary pursuant to subpara- graph (A)); and (C) in providing such technical assistance, give preference to small businesses; (8) foster the exchange of information re- specting, and foster cooperation in the con- duct of, research, demonstration, and training programs respecting health information and health promotion, preventive health services, and education in the appropriate use of health care; (9) provide technical assistance in the pro- grams referred to in paragraph (8); (10) use such other authorities for programs respecting health information and health pro- motion, preventive health services, and edu- cation in the appropriate use of health care as are available and coordinate such use with programs conducted under this subchapter; and (11) establish in the Office of the Assistant Secretary for Health an Office of Disease Pre- vention and Health Promotion, which shall— (A) coordinate all activities within the De- partment which relate to disease prevention, health promotion, preventive health serv- ices, and health information and education with respect to the appropriate use of health care; (B) coordinate such activities with similar activities in the private sector; (C) establish a national information clear- inghouse to facilitate the exchange of infor- mation concerning matters relating to health information and health promotion, preventive health services (which may in- clude information concerning models and standards for insurance coverage of such services), and education in the appropriate use of health care, to facilitate access to such information, and to assist in the anal- ysis of issues and problems relating to such matters; and (D) support projects, conduct research, and disseminate information relating to preven- tive medicine, health promotion, and phys- ical fitness and sports medicine. The Secretary shall appoint a Director for the Office of Disease Prevention and Health Pro- motion established pursuant to paragraph (11) of this subsection. The Secretary shall administer this subchapter in cooperation with health care providers, educators, voluntary organizations, businesses, and State and local health agencies in order to encourage the dissemination of health information and health promotion activi- ties. (b) Authorization of appropriations For the purpose of carrying out this section and sections 300u–1 through 300u–4 of this title, there are authorized to be appropriated $10,000,000 for fiscal year 1992, and such sums as may be necessary for each of the fiscal years 1993 through 2002. (c) Application; submission and approval as pre- requisite; form and content No grant may be made or contract entered into under this subchapter unless an application therefor has been submitted to and approved by the Secretary. Such an application shall be sub- mitted in such form and manner and contain such information as the Secretary may pre- scribe. Contracts may be entered into under this subchapter without regard to section 3324(a) and (b) of title 31 and section 6101 of title 41. (July 1, 1944, ch. 373, title XVII, § 1701, as added Pub. L. 94–317, title I, § 102, June 23, 1976, 90 Stat. 695; amended Pub. L. 96–32, § 7(n), July 10, 1979, 93 Stat. 85; Pub. L. 96–76, title II, § 209, Sept. 29, 1979, 93 Stat. 584; Pub. L. 98–551, § 2(a), Oct. 30, 1984, 98 Stat. 2815; Pub. L. 100–607, title III, § 312(a)(1), (b)(1), (c), Nov. 4, 1988, 102 Stat. 3113, 3114; Pub. L. 102–168, title I, § 101, Nov. 26, 1991, 105 Stat. 1102; Pub. L. 102–531, title III, § 311(b)(1), Oct. 27, 1992, 106 Stat. 3503; Pub. L. 105–392, title IV, § 414, Nov. 13, 1998, 112 Stat. 3590.) Editorial Notes CODIFICATION In subsec. (c), ‘‘section 3324(a) and (b) of title 31 and section 6101 of title 41’’ substituted for ‘‘sections 3648 and 3709 of the Revised Statutes (31 U.S.C. 529; 41 U.S.C. 5)’’ on authority of Pub. L. 97–258, § 4(b), Sept. 13, 1982, 96 Stat. 1067, which Act enacted Title 31, Money and Fi- nance, and Pub. L. 111–350, § 6(c), Jan. 4, 2011, 124 Stat. 3854, which Act enacted Title 41, Public Contracts. AMENDMENTS 1998—Subsec. (b). Pub. L. 105–392 substituted ‘‘2002’’ for ‘‘1996’’. 1992—Subsec. (a)(11)(C). Pub. L. 102–531 substituted ‘‘preventive health services (which may include infor- mation concerning models and standards for insurance coverage of such services),’’ for ‘‘preventive health services,’’. 1991—Subsec. (b). Pub. L. 102–168 amended subsec. (b) generally. Prior to amendment, subsec. (b) read as fol- lows: ‘‘To carry out sections 300u through 300u–4 of this title, there are authorized to be appropriated $9,000,000 for the fiscal year ending September 30, 1985, $9,500,000 for the fiscal year ending September 30, 1986, $10,000,000 for the fiscal year ending September 30, 1987, and $10,000,000 for each of the fiscal years 1989 through 1991.’’ 1988—Subsec. (a). Pub. L. 100–607, § 312(c)(2), in con- cluding provisions, struck out ‘‘The Secretary shall ad- minister this subchapter in a manner consistent with the national health priorities set forth in section 300k–2 of this title.’’ before ‘‘The Secretary shall appoint’’, and substituted ‘‘paragraph (11)’’ for ‘‘paragraph (10)’’. Subsec. (a)(7), (8). Pub. L. 100–607, § 312(b)(1), added par. (7) and redesignated former par. (7) as (8). Former par. (8) redesignated (9). Subsec. (a)(9). Pub. L. 100–607, § 312(c)(1), substituted ‘‘paragraph (8)’’ for ‘‘paragraph (7)’’. Page 1368 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 300u Pub. L. 100–607, § 312(b)(1)(A), redesignated par. (8) as (9). Former par. (9) redesignated (10). Subsec. (a)(10), (11). Pub. L. 100–607, § 312(b)(1)(A), re- designated pars. (9) and (10) as (10) and (11), respec- tively. Subsec. (b). Pub. L. 100–607, § 312(a)(1), substituted ‘‘sections 300u through 300u–4 of this title’’ for ‘‘this subchapter’’, struck out ‘‘and’’ after ‘‘September 30, 1986,’’, and inserted ‘‘, and $10,000,000 for each of the fis- cal years 1989 through 1991’’. 1984—Subsec. (a). Pub. L. 98–551, § 2(a)(1), added par. (10), and in provisions following par. (10) struck out ‘‘and with health planning and resource development activities undertaken under subchapters XIII and XIV of this chapter’’ after ‘‘section 300k–2 of this title’’ and inserted provisions for appointment of a Director for Office of Disease Prevention and Health Promotion and cooperation in administration of this subchapter. Subsec. (b). Pub. L. 98–551, § 2(a)(2), substituted ‘‘To carry out this subchapter, there are authorized to be appropriated $9,000,000 for the fiscal year ending Sep- tember 30, 1985, $9,500,000 for the fiscal year ending Sep- tember 30, 1986, and $10,000,000 for the fiscal year ending September 30, 1987’’ for ‘‘For payments under grants and contracts under this subchapter (other than grants and contracts under sections 300u–6, 300u–7, and 300u–8 of this title) there are authorized to be appropriated $7,000,000 for the fiscal year ending September 30, 1977, $10,000,000 for the fiscal year ending September 30, 1978, $14,000,000 for the fiscal year ending September 30, 1979, $14,000,000 for the fiscal year ending September 30, 1980, $15,000,000 for the fiscal year ending September 30, 1981, and $16,000,000 for the fiscal year ending September 30, 1982.’’ 1979—Subsec. (b). Pub. L. 96–76 inserted provisions au- thorizing appropriations for fiscal years ending Sept. 30, 1980, Sept. 30, 1981, and Sept. 30, 1982. Pub. L. 96–32 inserted ‘‘(other than grants and con- tracts under sections 300u–6, 300u–7, and 300u–8 of this title)’’ after ‘‘grants and contracts under this sub- chapter’’. Statutory Notes and Related Subsidiaries SHORT TITLE For short title of title I of Pub. L. 94–317, which en- acted this subchapter as the ‘‘National Consumer Health Information and Health Promotion Act of 1976’’, see section 101 of Pub. L. 94–317, set out as a Short Title of 1976 Amendments note under section 201 of this title. MODEL PROGRAMS FOR EMPLOYEE HEALTH PROMOTION AND DISEASE PREVENTION; DEVELOPMENT COMPLETION Section 312(b)(2) of Pub. L. 100–607 required Secretary of Health and Human Services, not later than 18 months after Nov. 4, 1988, to complete development of model programs required in section 1701(a)(7)(A) of the Public Health Service Act (subsec. (a)(7)(A) of this sec- tion). Executive Documents EXECUTIVE ORDER NO. 12345 Ex. Ord. No. 12345, Feb. 2, 1982, 47 F.R. 5189, as amend- ed by Ex. Ord. No. 12539, Dec. 3, 1985, 50 F.R. 49829; Ex. Ord. No. 12694, Oct. 11, 1989, 54 F.R. 42285; Ex. Ord. No. 12709, Apr. 4, 1990, 55 F.R. 13097; Ex. Ord. No. 13138, § 8, Sept. 30, 1999, 64 F.R. 53881, which provided for the Sec- retary of Health and Human Services to develop and co- ordinate a national program for physical fitness and sports, continued the President’s Council on Physical Fitness and Sports, and provided for termination of the Council on Dec. 31, 1982, was revoked by Ex. Ord. No. 13265, § 5(c), June 6, 2002, 67 F.R. 39842, set out below, prior to amendment by Ex. Ord. No. 13545, June 22, 2010, 75 F.R. 37283. EX. ORD. NO. 13265. PRESIDENT’S COUNCIL ON SPORTS, FITNESS, AND NUTRITION Ex. Ord. No. 13265, June 6, 2002, 67 F.R. 39841, as amended by Ex. Ord. No. 13545, June 22, 2010, 75 F.R. 37283; Ex. Ord. No. 13824, Feb. 26, 2018, 83 F.R. 8923; Ex. Ord. No. 14048, § 7, Sept. 30, 2021, 86 F.R. 55467, provided: By the authority vested in me as President by the Constitution and the laws of the United States of America, and to expand the executive branch’s program for physical fitness and sports and establish the Presi- dent’s Council on Sports, Fitness, and Nutrition (the ‘‘Council’’), it is hereby ordered as follows: SECTION 1. Purpose. My Administration recognizes the benefits of youth sports participation, physical activ- ity, and a nutritious diet in helping create habits that support a healthy lifestyle and improve the overall health of the American people. My Administration therefore aims to expand and encourage youth sports participation, and to promote the overall physical fit- ness, health, and nutrition of all Americans. Good health, including physical activity and proper nutrition, supports Americans’, particularly children’s, well-being, growth, and development. Participating in sports allows children to experience the connection be- tween effort and success, and it enhances their aca- demic, economic, and social prospects. Many of Amer- ica’s leaders attribute their lifetime achievements to lessons learned through sports participation and ath- letic activity. Additionally, youth sports help working parents and guardians by providing their children op- portunities to engage in productive, positive activities outside of school. Unfortunately, during the past dec- ade youth participation in team sports has declined. As of 2016, only 37 percent of children played team sports on a regular basis, down from 45 percent in 2008. Par- ticularly troubling is that sports participation dis- proportionately lags among young girls and children who are from economically distressed areas. SEC. 2. Policy. (a) The Secretary of Health and Human Services (Secretary), in carrying out the Secretary’s responsibilities for public health and human services, shall continue to promulgate a national strategy (the National Youth Sports Strategy) to expand children’s participation in youth sports, encourage regular phys- ical activity, including active play, and promote good nutrition for all Americans. This national strategy shall focus on children and youth in communities with below-average sports participation and communities with limited access to athletic facilities or recreational areas. Through this national strategy, the Secretary shall seek to: (i) increase awareness of the benefits of participation in sports and regular physical activity, as well as the importance of good nutrition; (ii) promote private and public sector strategies to increase participation in sports, encourage regular physical activity, and improve nutrition; (iii) develop metrics that gauge youth sports partici- pation and physical activity to inform efforts that will improve participation in sports and regular physical activity among young Americans; (iv) establish a national and local strategy to recruit volunteers who will encourage and support youth par- ticipation in sports and regular physical activity, through coaching, mentoring, teaching, or admin- istering athletic and nutritional programs; (v) expand national awareness of the importance of mental health as it pertains to physical fitness and nu- trition; and (vi) share information about the positive effects of physical activity on mental health, particularly as it relates to children and adolescents, to combat the neg- ative mental health impacts of the coronavirus disease 2019 (COVID–19) pandemic. SEC. 3. The President’s Council on Sports, Fitness, and Nutrition. (a) There is hereby established the Presi- dent’s Council on Sports, Fitness, and Nutrition (Coun- cil). (b) The Council shall be composed of up to 30 mem- bers recommended by the Secretary and appointed by the President. Members shall serve for a term of 2 years, shall be eligible for reappointment, and may continue to serve after the expiration of their terms until the appointment of a successor. The President Page 1369 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 300u may designate one or more of the members as Chair or Vice Chair. SEC. 4. Functions of the Council. (a) The Council shall advise the President, through the Secretary, con- cerning progress made in carrying out the provisions of this order and shall recommend to the President, through the Secretary, actions to accelerate such progress. (b) The Council shall recommend to the Secretary ac- tions to expand opportunities at the national, State, and local levels for participation in sports and engage- ment in physical fitness and activity. (c) The Council’s performance of these functions shall take into account the Department of Health and Human Services’ Physical Activity Guidelines for Americans, including consideration for youth with dis- abilities. (d) The Council members shall function as liaisons and spokespersons on behalf of the Council to relevant State, local, and private entities, and share informa- tion about the work of the Council in order to advise the Secretary regarding opportunities to extend and improve physical activity, fitness, sports, and nutrition programs and services at the State, local, and national levels. SEC. 5. Administration. (a) Each executive department and agency shall, to the extent permitted by law and subject to the availability of funds, furnish such infor- mation and assistance to the Secretary and the Council as they may request. (b) The members of the Council shall serve without compensation for their work on the Council. Members of the Council may, however, receive travel expenses, including per diem in lieu of subsistence, as authorized by law for persons serving intermittently in Govern- ment service (5 U.S.C. 5701–5707). (c) To the extent permitted by law, the Secretary shall furnish the Council with necessary staff, supplies, facilities, and other administrative services. The ex- penses of the Council shall be paid from funds available to the Secretary. (d) The Secretary shall appoint an Executive Director of the Council who shall serve as a liaison to the Sec- retary and the Advisor to the President on matters and activities pertaining to the Council. (e) The Council may, with the approval of the Sec- retary, establish subcommittees as appropriate to aid in its work. (f) The seal prescribed by Executive Order 10830 of July 24, 1959, as amended, shall be modified to reflect the name of the Council as established by this order. SEC. 6. General Provisions. (a) Insofar as the Federal Advisory Committee Act, as amended ([former] 5 U.S.C. App.) [see 5 U.S.C. 1001 et seq.] (Act), may apply to the administration of any portion of this order, any func- tions of the President under the Act, except that of re- porting to the Congress, shall be performed by the Sec- retary in accordance with the guidelines and proce- dures issued by the Administrator of General Services. (b) The Council shall terminate 2 years from the date of this order, unless extended by the President. (c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforce- able at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person. (d) Nothing in this order shall be construed to impair or otherwise affect: (i) the authority granted by law to an executive de- partment or agency, or the head thereof; or (ii) the functions of the Director of the Office of Man- agement and Budget relating to budgetary, administra- tive, or legislative proposals. (e) This order shall be implemented consistent with applicable law and subject to the availability of appro- priations. (f) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforce- able at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person. [Ex. Ord. No. 13824, § 2(c), (d), which directed amend- ment of Ex. Ord. No. 13265, set out above, by revising sections ‘‘1 through 5’’ and renumbering section 5 as 6 (with additional amendments), was executed by sub- stituting sections 1 to 5 for former sections 1 to 4 and renumbering former section 5 as 6.] [Ex. Ord. No. 13824, § 1, revoked Ex. Ord. No. 13545, which had amended Ex. Ord. No. 13265, set out above.] EXTENSION OF TERM OF PRESIDENT’S COUNCIL ON FITNESS, SPORTS, AND NUTRITION Term of President’s Council on Fitness, Sports, and Nutrition (renamed President’s Council on Sports, Fit- ness, and Nutrition) extended until Sept. 30, 2025, by Ex. Ord. No. 14109, Sept. 29, 2023, 88 F.R. 68447, set out as a note under section 1013 of Title 5, Government Or- ganization and Employees. Previous extensions of term of President’s Council on Fitness, Sports, and Nutrition, formerly President’s Council on Physical Fitness and Sports, were contained in the following prior Executive Orders: Ex. Ord. No. 14048, Sept. 30, 2021, 86 F.R. 55465, ex- tended term until Sept. 30, 2023. Ex. Ord. No. 13889, Sept. 27, 2019, 84 F.R. 52743, ex- tended term until Sept. 30, 2021. Ex. Ord. No. 13811, Sept. 29, 2017, 82 F.R. 46363, ex- tended term until Sept. 30, 2019. Ex. Ord. No. 13708, Sept. 30, 2015, 80 F.R. 60271, ex- tended term until Sept. 30, 2017. Ex. Ord. No. 13652, Sept. 30, 2013, 78 F.R. 61817, ex- tended term until Sept. 30, 2015. Ex. Ord. No. 13585, Sept. 30, 2011, 76 F.R. 62281, ex- tended term until Sept. 30, 2013. Ex. Ord. No. 13511, Sept. 29, 2009, 74 F.R. 50909, ex- tended term until Sept. 30, 2011. Ex. Ord. No. 13446, Sept. 28, 2007, 72 F.R. 56175, ex- tended term until Sept. 30, 2009. Ex. Ord. No. 13385, Sept. 29, 2005, 70 F.R. 57989, ex- tended term until Sept. 30, 2007. Ex. Ord. No. 13316, Sept. 17, 2003, 68 F.R. 55255, ex- tended term until Sept. 30, 2005. Ex. Ord. No. 13225, Sept. 28, 2001, 66 F.R. 50291, ex- tended term until Sept. 30, 2003. Ex. Ord. No. 13138, Sept. 30, 1999, 64 F.R. 53879, ex- tended term until Sept. 30, 2001. Ex. Ord. No. 13062, Sept. 29, 1997, 62 F.R. 51755, ex- tended term until Sept. 30, 1999. Ex. Ord. No. 12974, Sept. 29, 1995, 60 F.R. 51875, ex- tended term until Sept. 30, 1997. Ex. Ord. No. 12869, Sept. 30, 1993, 58 F.R. 51751, ex- tended term until Sept. 30, 1995. Ex. Ord. No. 12774, Sept. 27, 1991, 56 F.R. 49835, ex- tended term until Sept. 30, 1993. Ex. Ord. No. 12692, Sept. 29, 1989, 54 F.R. 40627, ex- tended term until Sept. 30, 1991. Ex. Ord. No. 12610, Sept. 30, 1987, 52 F.R. 36901, ex- tended term until Sept. 30, 1989. Ex. Ord. No. 12534, Sept. 30, 1985, 50 F.R. 40319, ex- tended term until Sept. 30, 1987. Ex. Ord. No. 12489, Sept. 28, 1984, 49 F.R. 38927, ex- tended term until Sept. 30, 1985. Ex. Ord. No. 12399, Dec. 31, 1982, 48 F.R. 379, extended term until Sept. 30, 1984. EX. ORD. NO. 13266. ACTIVITIES TO PROMOTE PERSONAL FITNESS Ex. Ord. No. 13266, June 20, 2002, 67 F.R. 42467, pro- vided: By the authority vested in me as President by the Constitution and the laws of the United States of America, and in order to improve the efficiency and co- ordination of Federal policies related to personal fit- ness of the general public, it is hereby ordered as fol- lows: SECTION 1. Policy. This order is issued consistent with the following findings and principles: (a) Growing scientific evidence indicates that an in- creasing number of Americans are suffering from neg- ligible physical activity, poor dietary habits, insuffi- Page 1370 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 300u cient utilization of preventive health screenings, and engaging in risky behaviors such as abuse of alcohol, tobacco, and drugs. (b) Existing information on the importance of appro- priate physical activity, diet, preventive health screenings, and avoiding harmful substances is often not received by the public, or, if received, is not acted on sufficiently. (c) Individuals of all ages, locations, and levels of per- sonal fitness can benefit from some level of appropriate physical activity, dietary guidance, preventive health screening, and making healthy choices. (d) While personal fitness is an individual responsi- bility, the Federal Government may, within the au- thority and funds otherwise available, expand the op- portunities for individuals to empower themselves to improve their general health. Such opportunities may include improving the flow of information about per- sonal fitness, assisting in the utilization of that infor- mation, increasing the accessibility of resources for physical activity, and reducing barriers to achieving good personal fitness. SEC. 2. Agency Responsibilities in Promoting Personal Fitness. (a) The Secretaries of Agriculture, Education, Health and Human Services (HHS), Housing and Urban Devel- opment, Interior, Labor, Transportation, and Veterans Affairs, and the Director of the Office of National Drug Policy shall review and evaluate the policies, pro- grams, and regulations of their respective departments and offices that in any way relate to the personal fit- ness of the general public. Based on that review, the Secretaries and the Director shall determine whether existing policies, programs, and regulations of their re- spective departments and offices should be modified or whether new policies or programs could be imple- mented. These new policies and programs shall be con- sistent with otherwise available authority and appro- priated funds, and shall improve the Federal Govern- ment’s assistance of individuals, private organizations, and State and local governments to (i) increase phys- ical activity; (ii) promote responsible dietary habits; (iii) increase utilization of preventive health screenings; and (iv) encourage healthy choices con- cerning alcohol, tobacco, drugs, and safety among the general public. (b) Each department and office included in section 2(a) shall report to the President, through the Sec- retary of Health and Human Services, its proposed ac- tions within 90 days of the date of this order. (c) There shall be a Personal Fitness Interagency Working Group (Working Group), composed of the Sec- retaries or Director of the departments and office in- cluded in section 2(a) (or their designees) and chaired by the Secretary of HHS or his designee. In order to im- prove efficiency through information sharing and to eliminate waste and overlap, the Working Group shall work to ensure the cooperation of Federal agencies in coordinating Federal personal fitness activities. The Working Group shall meet subject to the call of the Chair, but not less than twice a year. The Department of Health and Human Services shall provide such ad- ministrative support to the Working Group as the Sec- retary of HHS deems necessary. Each member of the Working Group shall be a full-time or permanent part- time officer or employee of the Federal Government. SEC. 3. General Provisions. This order is intended only to improve the internal management of the executive branch and it is not intended to, and does not, create any right, benefit, trust, or responsibility, substantive or procedural, enforceable at law or equity by a party against the United States, its departments, agencies or entities, its officers or employees, or any person. GEORGE W. BUSH. EX. ORD. NO. 13335. INCENTIVES FOR THE USE OF HEALTH INFORMATION TECHNOLOGY AND ESTABLISHING THE PO- SITION OF THE NATIONAL HEALTH INFORMATION TECH- NOLOGY COORDINATOR Ex. Ord. No. 13335, Apr. 27, 2004, 69 F.R. 24059, pro- vided: By the authority vested in me as President by the Constitution and the laws of the United States of America, and to provide leadership for the development and nationwide implementation of an interoperable health information technology infrastructure to im- prove the quality and efficiency of health care, it is hereby ordered as follows: SECTION 1. Establishment. (a) The Secretary of Health and Human Services (Secretary) shall establish within the Office of the Secretary the position of National Health Information Technology Coordinator. (b) The National Health Information Technology Co- ordinator (National Coordinator), appointed by the Secretary in consultation with the President or his des- ignee, will report directly to the Secretary. (c) The Secretary shall provide the National Coordi- nator with appropriate staff, administrative support, and other resources to meet its responsibilities under this order. (d) The Secretary shall ensure that the National Co- ordinator begins operations within 90 days of the date of this order. SEC. 2. Policy. In fulfilling its responsibilities, the work of the National Coordinator shall be consistent with a vision of developing a nationwide interoperable health information technology infrastructure that: (a) Ensures that appropriate information to guide medical decisions is available at the time and place of care; (b) Improves health care quality, reduces medical er- rors, and advances the delivery of appropriate, evi- dence-based medical care; (c) Reduces health care costs resulting from ineffi- ciency, medical errors, inappropriate care, and incom- plete information; (d) Promotes a more effective marketplace, greater competition, and increased choice through the wider availability of accurate information on health care costs, quality, and outcomes; (e) Improves the coordination of care and information among hospitals, laboratories, physician offices, and other ambulatory care providers through an effective infrastructure for the secure and authorized exchange of health care information; and (f) Ensures that patients’ individually identifiable health information is secure and protected. SEC. 3. Responsibilities of the National Health Informa- tion Technology Coordinator. (a) The National Coordi- nator shall, to the extent permitted by law, develop, maintain, and direct the implementation of a strategic plan to guide the nationwide implementation of inter- operable health information technology in both the public and private health care sectors that will reduce medical errors, improve quality, and produce greater value for health care expenditures. The National Coor- dinator shall report to the Secretary regarding progress on the development and implementation of the strategic plan within 90 days after the National Co- ordinator begins operations and periodically thereafter. The plan shall: (i) Advance the development, adoption, and imple- mentation of health care information technology standards nationally through collaboration among public and private interests, and consistent with cur- rent efforts to set health information technology standards for use by the Federal Government; (ii) Ensure that key technical, scientific, economic, and other issues affecting the public and private adoption of health information technology are ad- dressed; (iii) Evaluate evidence on the benefits and costs of interoperable health information technology and as- sess to whom these benefits and costs accrue; (iv) Address privacy and security issues related to interoperable health information technology and rec- ommend methods to ensure appropriate authoriza- tion, authentication, and encryption of data for transmission over the Internet; (v) Not assume or rely upon additional Federal re- sources or spending to accomplish adoption of inter- operable health information technology; and Page 1371 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 300u (vi) Include measurable outcome goals. (b) The National Coordinator shall: (i) Serve as the Secretary’s principal advisor on the development, application, and use of health informa- tion technology, and direct the Department of Health and Human Service’s health information technology programs; (ii) Ensure that health information technology pol- icy and programs of the Department of Health and Human Services (HHS) are coordinated with those of relevant executive branch agencies (including Fed- eral commissions) with a goal of avoiding duplication of efforts and of helping to ensure that each agency undertakes activities primarily within the areas of its greatest expertise and technical capability; (iii) To the extent permitted by law, coordinate outreach and consultation by the relevant executive branch agencies (including Federal commissions) with public and private parties of interest, including consumers, providers, payers, and administrators; and (iv) At the request of the Office of Management and Budget, provide comments and advice regarding spe- cific Federal health information technology pro- grams. SEC. 4. Reports. To facilitate the development of interoperable health information technologies, the Sec- retary of Health and Human Services shall report to the President within 90 days of this order on options to provide incentives in HHS programs that will promote the adoption of interoperable health information tech- nology. In addition, the following reports shall be sub- mitted to the President through the Secretary: (a) The Director of the Office of Personnel Manage- ment shall report within 90 days of this order on op- tions to provide incentives in the Federal Employee Health Benefit Program that will promote the adoption of interoperable health information technology; and (b) Within 90 days, the Secretary of Veterans Affairs and the Secretary of Defense shall jointly report on the approaches the Departments could take to work more actively with the private sector to make their health information systems available as an affordable option for providers in rural and medically underserved com- munities. SEC. 5. Administration and Judicial Review. (a) The ac- tions directed by this order shall be carried out subject to the availability of appropriations and to the extent permitted by law. (b) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforce- able at law or in equity against the United States, its agencies, its entities or instrumentalities, its officers or employees, or any other person. GEORGE W. BUSH. EX. ORD. NO. 13410. PROMOTING QUALITY AND EFFICIENT HEALTH CARE IN FEDERAL GOVERNMENT ADMINISTERED OR SPONSORED HEALTH CARE PROGRAMS Ex. Ord. No. 13410, Aug. 22, 2006, 71 F.R. 51089, pro- vided: By the authority vested in me as President by the Constitution and the laws of the United States, and in order to promote federally led efforts to implement more transparent and high-quality health care, it is hereby ordered as follows: SECTION 1. Purpose. It is the purpose of this order to ensure that health care programs administered or spon- sored by the Federal Government promote quality and efficient delivery of health care through the use of health information technology, transparency regarding health care quality and price, and better incentives for program beneficiaries, enrollees, and providers. It is the further purpose of this order to make relevant in- formation available to these beneficiaries, enrollees, and providers in a readily useable manner and in col- laboration with similar initiatives in the private sector and non-Federal public sector. Consistent with the pur- pose of improving the quality and efficiency of health care, the actions and steps taken by Federal Govern- ment agencies should not incur additional costs for the Federal Government. SEC. 2. Definitions. For purposes of this order: (a) ‘‘Agency’’ means an agency of the Federal Govern- ment that administers or sponsors a Federal health care program. (b) ‘‘Federal health care program’’ means the Federal Employees Health Benefit Program, the Medicare pro- gram, programs operated directly by the Indian Health Service, the TRICARE program for the Department of Defense and other uniformed services, and the health care program operated by the Department of Veterans Affairs. For purposes of this order, ‘‘Federal health care program’’ does not include State operated or fund- ed federally subsidized programs such as Medicaid, the State Children’s Health Insurance Program, or services provided to Department of Veterans’ Affairs bene- ficiaries under 38 U.S.C. 1703. (c) ‘‘Interoperability’’ means the ability to commu- nicate and exchange data accurately, effectively, se- curely, and consistently with different information technology systems, software applications, and net- works in various settings, and exchange data such that clinical or operational purpose and meaning of the data are preserved and unaltered. (d) ‘‘Recognized interoperability standards’’ means interoperability standards recognized by the Secretary of Health and Human Services (the ‘‘Secretary’’), in ac- cordance with guidance developed by the Secretary, as existing on the date of the implementation, acquisi- tion, or upgrade of health information technology sys- tems under subsections (1) or (2) of section 3(a) of this order. SEC. 3. Directives for Agencies. Agencies shall perform the following functions: (a) Health Information Technology. (1) For Federal Agencies. As each agency implements, acquires, or upgrades health information technology systems used for the direct exchange of health informa- tion between agencies and with non-Federal entities, it shall utilize, where available, health information tech- nology systems and products that meet recognized interoperability standards. (2) For Contracting Purposes. Each agency shall re- quire in contracts or agreements with health care pro- viders, health plans, or health insurance issuers that as each provider, plan, or issuer implements, acquires, or upgrades health information technology systems, it shall utilize, where available, health information tech- nology systems and products that meet recognized interoperability standards. (b) Transparency of Quality Measurements. (1) In General. Each agency shall implement pro- grams measuring the quality of services supplied by health care providers to the beneficiaries or enrollees of a Federal health care program. Such programs shall be based upon standards established by multi-stake- holder entities identified by the Secretary or by an- other agency subject to this order. Each agency shall develop its quality measurements in collaboration with similar initiatives in the private and non-Federal pub- lic sectors. (2) Facilitation. An agency satisfies the requirements of this subsection if it participates in the aggregation of claims and other appropriate data for the purposes of quality measurement. Such aggregation shall be based upon standards established by multi-stakeholder enti- ties identified by the Secretary or by another agency subject to this order. (c) Transparency of Pricing Information. Each agen- cy shall make available (or provide for the availability) to the beneficiaries or enrollees of a Federal health care program (and, at the option of the agency, to the public) the prices that it, its health insurance issuers, or its health insurance plans pay for procedures to pro- viders in the health care program with which the agen- cy, issuer, or plan contracts. Each agency shall also, in collaboration with multi-stakeholder groups such as those described in subsection (b)(1), participate in the Page 1372 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 300u–1 development of information regarding the overall costs of services for common episodes of care and the treat- ment of common chronic diseases. (d) Promoting Quality and Efficiency of Care. Each agency shall develop and identify, for beneficiaries, en- rollees, and providers, approaches that encourage and facilitate the provision and receipt of high-quality and efficient health care. Such approaches may include pay-for-performance models of reimbursement con- sistent with current law. An agency will satisfy the re- quirements of this subsection if it makes available to beneficiaries or enrollees consumer-directed health care insurance products. SEC. 4. Implementation Date. Agencies shall comply with the requirements of this order by January 1, 2007. SEC. 5. Administration and Judicial Review. (a) This order does not assume or rely upon addi- tional Federal resources or spending to promote qual- ity and efficient health care. Further, the actions di- rected by this order shall be carried out subject to the availability of appropriations and to the maximum ex- tent permitted by law. (b) This order shall be implemented in new contracts or new contract cycles as they may be renewed from time to time. Renegotiation outside of the normal con- tract cycle processes should be avoided. (c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforce- able at law or in equity against the United States, its departments, agencies, or entities, its officers, employ- ees, or agents, or any other person. GEORGE W. BUSH. § 300u–1. Grants and contracts for research pro- grams; authority of Secretary; review of ap- plications; additional functions; periodic public survey (a) The Secretary is authorized to conduct and support by grant or contract (and encourage others to support) research in health informa- tion and health promotion, preventive health services, and education in the appropriate use of health care. Applications for grants and con- tracts under this section shall be subject to ap- propriate peer review. The Secretary shall also— (1) provide consultation and technical assist- ance to persons who need help in preparing re- search proposals or in actually conducting re- search; (2) determine the best methods of dissemi- nating information concerning personal health behavior, preventive health services and the appropriate use of health care and of affecting behavior so that such information is applied to maintain and improve health, and prevent disease, reduce its risk, or modify its course or severity; (3) determine and study environmental, oc- cupational, social, and behavioral factors which affect and determine health and ascer- tain those programs and areas for which edu- cational and preventive measures could be im- plemented to improve health as it is affected by such factors; (4) develop (A) methods by which the cost and effectiveness of activities respecting health information and health promotion, pre- ventive health services, and education in the appropriate use of health care, can be meas- ured, including methods for evaluating the ef- fectiveness of various settings for such activi- ties and the various types of persons engaged in such activities, (B) methods for reimburse- ment or payment for such activities, and (C) models and standards for the conduct of such activities, including models and standards for the education, by providers of institutional health services, of individuals receiving such services respecting the nature of the institu- tional health services provided the individuals and the symptoms, signs, or diagnoses which led to provision of such services; (5) develop a method for assessing the cost and effectiveness of specific medical services and procedures under various conditions of use, including the assessment of the sensi- tivity and specificity of screening and diag- nostic procedures; and (6) enumerate and assess, using methods de- veloped under paragraph (5), preventive health measures and services with respect to their cost and effectiveness under various condi- tions of use (which measures and services may include blood pressure screening, cholesterol screening and control, smoking cessation pro- grams, substance abuse programs, cancer screening, dietary and nutritional counseling, diabetes screening and education, intraocular pressure screening, and stress management). (b) The Secretary shall make a periodic survey of the needs, interest, attitudes, knowledge, and behavior of the American public regarding health and health care. The Secretary shall take into consideration the findings of such surveys and the findings of similar surveys conducted by national and community health education orga- nizations, and other organizations and agencies for formulating policy respecting health infor- mation and health promotion, preventive health services, and education in the appropriate use of health care. (July 1, 1944, ch. 373, title XVII, § 1702, as added Pub. L. 94–317, title I, § 102, June 23, 1976, 90 Stat. 696; amended Pub. L. 102–531, title III, § 311(b)(2), Oct. 27, 1992, 106 Stat. 3504.) Editorial Notes AMENDMENTS 1992—Subsec. (a)(6). Pub. L. 102–531 inserted before pe- riod ‘‘(which measures and services may include blood pressure screening, cholesterol screening and control, smoking cessation programs, substance abuse pro- grams, cancer screening, dietary and nutritional coun- seling, diabetes screening and education, intraocular pressure screening, and stress management)’’. § 300u–2. Grants and contracts for community health programs (a) Authority of Secretary; particular activities The Secretary is authorized to conduct and support by grant or contract (and encourage others to support) new and innovative programs in health information and health promotion, preventive health services, and education in the appropriate use of health care, and may specifi- cally— (1) support demonstration and training pro- grams in such matters which programs (A) are in hospitals, ambulatory care settings, home care settings, schools, day care programs for children, and other appropriate settings rep- resentative of broad cross sections of the pop- ulation, and include public education activi-