Missouri Department of Health and Senior Services Margaret Donnelly, Director

Rebalancing Long-Term Care Establishes an optional benefit through which states could provide Medicaid beneficiaries with disabilities a home- or community-based attendant. Allows people with disabilities to remain in their communities and avoid entering a hospital, nursing home or other institutional setting. Section becomes effective Oct. 1, Establishes CLASS, a self-funded public long-term care insurance plan for people with disabilities. - five-year vesting period for eligibility of benefits; - no taxpayer funds Section becomes effective Jan. 1, 2011.

Maternal, Infant, and Early Childhood Programs Assess communities with high rates of premature birth, infant mortality, poverty, crime, domestic violence, high- school dropouts, substance abuse and unemployment; Evaluate and demonstrate how state programs can mitigate and reverse these trends. Funding: FY 2010 $100 million Rising to $400 million in 2014 Program takes effect on Oct. 1, 2010 Requires states to:

Personal Responsibility Education Strives to reduce teen pregnancy and sexually transmitted diseases by teaching adolescents about both abstinence and contraception. Money also available for innovative pregnancy prevention strategies to high-risk groups. Funding: $75 million per year through 2014 Appropriates $50 million per year through 2014 for abstinence education. Takes effect on Oct. 1, 2010

Prevention and Public Health Fund Provides money for a sustained national investment in prevention and public health programs. Supports prevention research, health screenings and initiatives and immunization programs. Funding levels: FY $500 million; Rising to $2 billion in 2015

Oral Health Establishes demonstration grants to show the effectiveness of research- based dental caries disease management. Includes school-based sealant programs, oral health infrastructure and surveillance.

Community Transformation Grants Grants are open to state and local governments and to community groups to: develop preventive health activities to reduce chronic disease address health disparities develop stronger evidence of programs that really work Activities include: healthier school environments programs to support active living and better nutrition; smoking cessation worksite wellness healthy options in food venues Takes effect July 1, 2010

Funding for Childhood Obesity Demonstration Project $25 million authorized to fight childhood obesity authorized for five years Takes effect July 1, 2010

Health Care Work Force National Level Establishes a commission to assess the status of the health care workforce and recommend ways to alleviate shortages. State level Establishes program to develop strategies at the state and local levels. First year funding: $150 million + $8 million for planning Establishes loan repayment program to eliminate critical shortages in federal, state, local and tribal public health agencies. First year funding: $195 million Establishes scholarships for mid-career public health professionals. First year funding:$60 million Fellowships for public health staff in disease tracking, laboratory science and public health statistics. Funding $15 million for four years

Nutrition Labeling of Standard Menu Items at Chain Restaurants Establishes nutrition labeling of standard menu items at restaurant chains with 20 or more locations. Includes disclosing: Calories on menu boards Total calories from fat Amounts of fat and saturated fat, cholesterol, sodium, total and complex carbohydrates, sugars, dietary fiber and protein