I

108TH CONGRESS

1ST SESSION H. R. 2363

To improve early learning opportunities and promote preparedness by increasing the availability of Head Start programs, to increase the availability

and affordability of quality child care, to reduce child hunger and encourage healthy eating habits, to facilitate parental involvement, and for

other purposes.

IN THE HOUSE OF REPRESENTATIVES

JUNE 5, 2003

Ms. DELAURO (for herself, Mr. CUMMINGS, Mrs. JONES of Ohio, Ms. WOOLSEY, Mr. MCNULTY, Mr. OWENS, Mr. SANDERS, Ms. SOLIS, Ms. KAPTUR, Mr. PALLONE, Mr. SERRANO, Mr. WAXMAN, Ms. JACKSON-LEE of

Texas, Mr. RODRIGUEZ, Mr. FROST, Ms. LOFGREN, Mr. CONYERS, Mr.

ALLEN, and Mr. BROWN of Ohio) introduced the following bill; which was

referred to the Committee on Education and the Workforce, and in addition to the Committees on Energy and Commerce, Ways and Means,

House Administration, Government Reform, and Agriculture, for a period

to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee

concerned

A BILL

To improve early learning opportunities and promote preparedness by increasing the availability of Head Start

programs, to increase the availability and affordability

of quality child care, to reduce child hunger and encourage healthy eating habits, to facilitate parental involvement, and for other purposes.
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1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

4 (a) SHORT TITLE.—This Act may be cited as the

5 ‘‘Right Start Act of 2003’’.

6 (b) TABLE OF CONTENTS.—The table of contents of

7 this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Findings.

TITLE I—INVESTING IN HEAD START

Sec. 101. Authorization of appropriations.

TITLE II—IMPROVING THE AFFORDABILITY AND QUALITY OF

CHILD CARE FOR WORKING FAMILIES

Sec. 201. Increase in funding for child care.

Sec. 202. Clarification of authority of States to use TANF funds carried over

from prior years to provide TANF benefits and services.

TITLE III—FIGHTING CHILDHOOD HUNGER AND PROMOTING

HEALTHY EATING HABITS

Sec. 301. Short title.

Sec. 302. Findings.

Sec. 303. Definitions.

Subtitle A—Training Grants

Sec. 311. Grants to provide training for health profession students.

Sec. 312. Grants to provide training for health professionals.

Subtitle B—Local Grants

Sec. 321. Grants to increase physical activity and improve nutrition.

Subtitle C—School Health Program

Sec. 331. Establishment of a coordinated school health program.

Sec. 332. National Center for Health Statistics.

Subtitle D—Institute of Medicine Study

Sec. 341. Study of the food supplement and nutrition programs of the Department of Agriculture.

Subtitle E—Agency for Healthcare Research and Quality Studies

Sec. 351. Evidence report on weight reduction programs.

Sec. 352. Health disparities report.
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Subtitle F—Preventive Health and Health Services Block Grant

Sec. 361. Use of allotments.

Subtitle G—Medicare Nutrition Therapy Demonstration Project

Sec. 371. Demonstration project to reduce obesity and other chronic disease

risks.

Subtitle H—Overweight and Obesity Treatment and Prevention

Demonstration Projects

Sec. 381. Grants to local healthcare delivery systems.

Subtitle I—Research on Obesity

Sec. 391. Report on obesity research.

Subtitle J—Youth Media Campaign

Sec. 395. Grants and contracts for a national campaign to change children’s

health behaviors.

Subtitle K—Sense of the Senate

Sec. 399. Sense of the Senate concerning nutrition.

TITLE IV—SUPPORTING SERVICES TO LOW-INCOME FAMILIES

THROUGH THE SOCIAL SERVICES BLOCK GRANT

Sec. 401. Increase in funding.

TITLE V—EXPANDING THE FAMILY AND MEDICAL LEAVE ACT

Sec. 501. Short title.

Sec. 502. Findings.

Subtitle A—Family Income To Respond to Significant Transitions

Sec. 511. Short title.

Sec. 512. Purposes.

Sec. 513. Definitions.

Sec. 514. Demonstration projects.

Sec. 515. Notification.

Sec. 516. Evaluations and reports.

Sec. 517. Authorization of appropriations.

Sec. 518. Technical and conforming amendments.

Subtitle B—Family Friendly Workplaces

Sec. 521. Short title.

Sec. 522. Coverage of employees.

Subtitle C—Employment Protection for Battered Women

Sec. 531. Entitlement to leave for addressing domestic violence for non-Federal

employees.

Sec. 532. Entitlement to leave for addressing domestic violence for Federal employees.

Sec. 533. Existing leave usable for domestic violence.
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Subtitle D—Federal Employees Paid Parental Leave

Sec. 541. Short title.

Sec. 542. Demonstration project.

Sec. 543. Technical and conforming amendments.

Sec. 544. Effective date.

Subtitle E—Time for Schools

Sec. 551. Short title.

Sec. 552. General requirements for leave.

Sec. 553. School involvement leave for civil service employees.

Sec. 554. Effective date.

1 SEC. 2. FINDINGS.

2 Congress makes the following findings:

3 (1) Learning is an active process that begins at

4 birth, is dependent on the existence of strong and

5 stable relationships, is influenced by a child’s phys6 ical, emotional, social, and cognitive capacities, and

7 is shaped by a combination of biology and experi8 ence.

9 (2) Before children reach the age of 2 years,

10 measurable differentiation in their development and

11 skills begins to appear. In the absence of interven12 tion, that differentiation may increase over the pre13 school years.

14 (3) Early childhood, which is the period in a

15 child’s life from birth through the age of 6 years, is

16 a critical time for children to develop the physical,

17 emotional, social, and cognitive skills they will need

18 for the rest of their lives. Good nutrition and health
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1 care are essential to maximize the development proc2 ess.

3 (4) Young children receive care in a wide vari4 ety of settings. While 38 percent of young children

5 receive care solely from their parents, the remaining

6 62 percent receive care through a variety of full-time

7 and part-time arrangements, including by relatives,

8 by nonrelatives (in a variety of home-based settings),

9 and through center-based programs.

10 (5) The cognitive, social, and emotional develop11 ment of young children can be enhanced through pa12 rental involvement and high-quality early care, and

13 developmentally appropriate early education activi14 ties.

15 (6) Research indicates that successful academic

16 achievement in education programs for children in

17 kindergarten and grades 1 through 12 is linked to

18 participation in high quality early care, including ac19 cess to health care and nutrition, and early edu20 cation activities.

21 (7) The United States will be stronger now and

22 in the future if the Nation invests in its children

23 today.
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1 TITLE I—INVESTING IN HEAD

2 START

3 SEC. 101. AUTHORIZATION OF APPROPRIATIONS.

4 (a) IN GENERAL.—Section 639(a) of the Head Start

5 Act (42 U.S.C. 9834(a)) is amended by striking ‘‘such

6 sums’’ and all that follows and inserting the following:

7 ‘‘$7,500,000,000 for fiscal year 2004, $8,290,000,000 for

8 fiscal year 2005, $9,040,000,000 for fiscal year 2006,

9 $9,890,000,000 for fiscal year 2007, and

10 $10,890,000,000 for fiscal year 2008.’’.

11 (b) CONFORMING AMENDMENTS.—

12 (1) RESERVATIONS.—Paragraphs (1) and (3) of

13 section 639(b) of the Head Start Act (42 U.S.C.

14 9834(b)) are amended by striking ‘‘2003’’ and in15 serting ‘‘2008’’.

16 (2) DISTRIBUTION.—Paragraphs (3)(A)(i)(I)

17 and (6)(A) of section 640(a) of the Head Start Act

18 (42 U.S.C. 9835(a)) are amended by striking ‘‘fiscal

19 year 2003’’ and inserting ‘‘each of fiscal years 2004

20 through 2008’’.
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1 TITLE II—IMPROVING THE AF2 FORDABILITY AND QUALITY

3 OF CHILD CARE FOR WORK4 ING FAMILIES

5 SEC. 201. INCREASE IN FUNDING FOR CHILD CARE.

6 (a) INCREASE IN FUNDING.—Section 418(a)(3) of

7 the Social Security Act (42 U.S.C. 618(a)(3)) is

8 amended—

9 (1) by striking ‘‘and’’ at the end of subpara10 graph (E);

11 (2) by striking the period at the end of sub12 paragraph (F) and inserting a semicolon; and

13 (3) by adding at the end the following:

14 ‘‘(G) $3,717,000,000 for fiscal year 2004;

15 ‘‘(H) $4,217,000,000 for fiscal year 2005;

16 ‘‘(I) $4,917,000,000 for fiscal year 2006;

17 ‘‘(J) $5,617,000,000 for fiscal year 2007;

18 and

19 ‘‘(K) $6,367,000,000 for fiscal year

20 2008.’’.

21 (b) INCREASE IN SET ASIDE FOR CHILD CARE QUAL22 ITY.—Section 658G of the Child Care and Development

23 Block Grant Act of 1990 (42 U.S.C. 9858e) is amended

24 by striking ‘‘4 percent’’ and inserting ‘‘10 percent’’.

25 (c) INDIAN TRIBES AND PUERTO RICO.—
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1 (1) IN GENERAL.—Section 418(a) of the Social

2 Security Act (42 U.S.C. 618(a)) is amended by

3 striking paragraph (4) and inserting the following:

4 ‘‘(4) AMOUNTS RESERVED.—

5 ‘‘(A) INDIAN TRIBES.—The Secretary shall

6 reserve 2 percent of the aggregate amount ap7 propriated to carry out this section under para8 graphs (3) and (5) for each fiscal year for pay9 ments to Indian tribes and tribal organizations

10 for each such fiscal year for the purpose of pro11 viding child care assistance.

12 ‘‘(B) PUERTO RICO.—The Secretary shall

13 reserve $10,000,000 of the amount appro14 priated under paragraph (3) for each fiscal year

15 for payments to the Commonwealth of Puerto

16 Rico for each such fiscal year for the purpose

17 of providing child care assistance.’’.

18 (2) CONFORMING AMENDMENT.—Section

19 1108(a)(2) of the Social Security Act (42 U.S.C.

20 1308(a)(2)) is amended by striking ‘‘or 413(f)’’ and

21 inserting ‘‘413(f), or 418(a)(4)(B)’’.
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1 SEC. 202. CLARIFICATION OF AUTHORITY OF STATES TO

2 USE TANF FUNDS CARRIED OVER FROM

3 PRIOR YEARS TO PROVIDE TANF BENEFITS

4 AND SERVICES.

5 Section 404(e) of the Social Security Act (42 U.S.C.

6 604(e)) is amended—

7 (1) in the subsection heading, by striking ‘‘AS8 SISTANCE’’ and inserting ‘‘BENEFITS OR SERVICES’’;

9 and

10 (2) after the heading, by striking ‘‘assistance’’

11 and inserting ‘‘any benefit or service that may be

12 provided’’.

13 TITLE III—FIGHTING CHILD14 HOOD HUNGER AND PRO15 MOTING HEALTHY EATING

16 HABITS

17 SEC. 301. SHORT TITLE.

18 This title may be cited as the ‘‘Improved Nutrition

19 and Physical Activity Act’’ or the ‘‘IMPACT Act’’.

20 SEC. 302. FINDINGS.

21 Congress makes the following findings:

22 (1) An estimated 61 percent of United States

23 adults and 13 percent of children and adolescents

24 are overweight or obese.
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1 (2) The prevalence of obesity and being over2 weight is increasing among all age groups. There are

3 twice the number of overweight children and 3 times

4 the number of overweight adolescents as there were

5 29 years ago.

6 (3) An estimated 300,000 deaths a year are as7 sociated with being overweight or obese.

8 (4) Obesity and being overweight are associated

9 with increased risk for heart disease (the leading

10 cause of death), cancer (the second leading cause of

11 death), diabetes (the 6th leading cause of death),

12 and musculoskeletal disorders.

13 (5) Individuals who are obese have a 50 to 100

14 percent increased risk of premature death.

15 (6) The Healthy People 2010 goals identify

16 obesity and being overweight as one of the Nation’s

17 leading health problems and include objectives of in18 creasing the proportion of adults who are at a

19 healthy weight, reducing the proportion of adults

20 who are obese, and reducing the proportion of chil21 dren and adolescents who are overweight or obese.

22 (7) Another goal of Healthy People 2010 is to

23 eliminate health disparities among different seg24 ments of the population. Obesity is a health problem
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1 that disproportionally impacts medically underserved

2 populations.

3 (8) The United States Surgeon General’s report

4 ‘‘A Call To Action’’ lists the treatment and preven5 tion of obesity as a top national priority.

6 (9) The estimated direct and indirect annual

7 cost of obesity in the United States is

8 $117,000,000,000, which exceeds the cost of to9 bacco-related illnesses and appears to be rising dra10 matically.

11 (10) Weight control programs should promote a

12 healthy lifestyle including regular physical activity

13 and healthy eating, as consistently discussed and

14 identified in a variety of public and private con15 sensus documents, including ‘‘A Call to Action’’ and

16 other documents prepared by the Department of

17 Health and Human Services and other agencies.

18 SEC. 303. DEFINITIONS.

19 In this title:

20 (1) OBESE.—The term ‘‘obese’’ means an adult

with a Body Mass Index (BMI) of 30 kg/m2 21 or

22 greater.

23 (2) OVERWEIGHT.—The term ‘‘overweight’’

24 means an adult with a Body Mass Index (BMI) of

25 to 29.9 kg/m2 25 and a child or adolescent with a
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1 BMI at or above the 95th percentile on the revised

2 Centers for Disease Control and Prevention growth

3 charts.

4 (3) SECRETARY.—Unless otherwise indicated,

5 term ‘‘Secretary’’ means the Secretary of Health

6 and Human Services.

7 Subtitle A—Training Grants

8 SEC. 311. GRANTS TO PROVIDE TRAINING FOR HEALTH

9 PROFESSION STUDENTS.

10 Section 747(c)(3) of title VII of the Public Health

11 Service Act (42 U.S.C. 293k(c)(3)) is amended by striking

12 ‘‘and victims of domestic violence’’ and inserting ‘‘victims

13 of domestic violence, and individuals (including children)

14 who are overweight or obese (as such terms are defined

15 in section 303 of the Improved Nutrition and Physical Ac16 tivity Act) and at risk for related, serious and chronic

17 medical conditions’’.

18 SEC. 312. GRANTS TO PROVIDE TRAINING FOR HEALTH

19 PROFESSIONALS.

20 Section 399Z of the Public Health Service Act (42

21 U.S.C. 280h–3) is amended by striking subsection (b) and

22 inserting the following:

23 ‘‘(b) GRANTS.—

24 ‘‘(1) IN GENERAL.—The Secretary may award

25 grants to qualified entities to train primary care
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1 physicians and other licensed or certified health pro2 fessionals on how to identify, treat, and prevent obe3 sity and aid individuals who are overweight (as such

4 term is defined in section 303 of the Improved Nu5 trition and Physical Activity Act).

6 ‘‘(2) APPLICATION.—An entity that desires a

7 grant under this subsection shall submit an applica8 tion at such time, in such form, and containing such

9 information as the Secretary may require, including

10 a plan for the use of funds that may be awarded and

11 an evaluation of the training that will be provided.

12 ‘‘(3) USE OF FUNDS.—An entity that receives

13 a grant under this subsection shall use the funds

14 made available through such grant to—

15 ‘‘(A) conduct educational conferences, in16 cluding Internet-based courses and telecon17 ferences, on—

18 ‘‘(i) how to treat and prevent obesity

19 and being overweight using nutritional

20 counseling, methods to increase physical

21 activity, pharmacological therapies, motiva22 tional counseling to promote positive

23 changes in health behaviors and to assist

24 patients in identifying potential barriers to
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1 adhering to medical recommendations, and

2 other proven interventions;

3 ‘‘(ii) how to discuss varied strategies

4 to promote positive behavior change and

5 healthy lifestyles to avoid obesity, being

6 overweight, and other eating disorders;

7 ‘‘(iii) how to identify overweight and

8 obese patients and those who are at risk

9 for obesity and being overweight and there10 fore at risk for related serious and chronic

11 medical conditions;

12 ‘‘(iv) how to conduct a comprehensive

13 assessment of individual and familial

14 health risk factors, such as poor nutri15 tional status, physical inactivity, and per16 sonal and family history of obesity and re17 lated serious and chronic medical condi18 tions; and

19 ‘‘(v) how to educate patients and their

20 families about effective strategies to im21 prove dietary habits and establish appro22 priate levels of physical activity;

23 ‘‘(B) conduct training to enhance cultural

24 and linguistic competency and communication

25 skills needed to effectively interact with patients
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1 from diverse populations regarding weight,

2 health, and nutritional status, including raising

3 awareness of issues regarding stigma and preju4 dice about obesity or being overweight;

5 ‘‘(C) evaluate the effectiveness of the train6 ing provided by such entity in increasing knowl7 edge and changing attitudes and behaviors of

8 trainees;

9 ‘‘(D) develop training materials and course

10 content using evidence-based findings or rec11 ommendations that pertain to obesity and over12 weight treatment and prevention ; and

13 ‘‘(E) collaborate with other training pro14 grams related to overweight and obesity preven15 tion and treatment.

16 ‘‘(4) EVALUATION.—

17 ‘‘(A) IN GENERAL.—An entity that re18 ceives a grant under this subsection shall sub19 mit to the Secretary an evaluation that de20 scribes the activities carried out by such entity

21 with funds received under this section.

22 ‘‘(B) CONTENTS.—Such evaluation shall

23 include an assessment of the effectiveness of the

24 activities in increasing physical activity, improv25 ing nutrition, and preventing individuals from
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1 becoming overweight or obese, treating individ2 uals who are overweight or obese, and any other

3 information that the Secretary may require.

4 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There

5 is authorized to be appropriated to carry out this section,

6 $10,000,000 for fiscal year 2004, and such sums as may

7 be necessary for each of the fiscal years 2005 through

8 2008.’’.

9 Subtitle B—Local Grants

10 SEC. 321. GRANTS TO INCREASE PHYSICAL ACTIVITY AND

11 IMPROVE NUTRITION.

12 Title III of the Public Health Service Act (42 U.S.C.

13 241 et seq.) is amended by adding at the end the fol14 lowing:

15 ‘‘SEC. 399AA. GRANTS TO INCREASE PHYSICAL ACTIVITY

16 AND IMPROVE NUTRITION.

17 ‘‘(a) IN GENERAL.—The Secretary, acting through

18 the Director of the Centers for Disease Control and Pre19 vention and in consultation with Administrator of the

20 Health Resources and Services Administration, the Direc21 tor of the Indian Health Service, and the heads of other

22 appropriate agencies, shall award competitive grants to

23 cities, counties, tribes, and States to plan, implement, and

24 evaluate culturally and linguistically appropriate and com25 petent community-based programs and promote good nu-
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1 trition and physical activity to prevent overweight, obesity

2 (as such terms are defined in section 303 of the Improved

3 Nutrition and Physical Activity Act), and related serious

4 and chronic medical conditions that may result from being

5 overweight or obese (as such terms are defined in section

6 303 of the Improved Nutrition and Physical Activity Act).

7 ‘‘(b) AWARD OF GRANTS.—A city, county, tribe, or

8 State desiring a grant under this section shall submit an

9 application to the Secretary at such time, in such form,

10 and containing such information as the Secretary may re11 quire, including a plan describing how funds received

12 through a grant under this section will be used and an

13 evaluation of the programs that will be provided. In

14 awarding grants under this section, the Secretary shall en15 sure that the proposed programs are coordinated in sub16 stance and format with programs currently funded

17 through other Federal agencies and operating within the

18 community.

19 ‘‘(c) USE OF FUNDS.—A city, county, tribe, or State

20 that receives a grant under this section shall use the funds

21 made available through the grant to carry out 3 or more

22 of the following activities:

23 ‘‘(1) Planning for and promotion of bike paths,

24 walking paths, or other similar or related environ25 mental changes that promote physical activity.
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1 ‘‘(2) Forming partnerships and activities with

2 businesses and other entities to increase activity lev3 els at the workplace and while traveling to and from

4 the workplace, develop wellness programs that relate

5 to overweight and obesity, and to enhance nutri6 tional status by improving food options.

7 ‘‘(3) Establishing tax and other incentives for

8 businesses to increase the activity levels and improve

9 the nutrition of their employees by encouraging such

10 employees to—

11 ‘‘(A) walk or bike to work;

12 ‘‘(B) engage in other physical activity dur13 ing working hours; and

14 ‘‘(C) improve available food options.

15 ‘‘(4) Forming partnerships with public and pri16 vate entities including schools, faith-based entities,

17 and other facilities providing recreational services to

18 establish programs that use their facilities for after19 school and weekend activities for the community.

20 ‘‘(5) Establishing tax or other incentives for re21 tail food stores, grocery stores, and other retail food

22 outlets that offer nutritious foods, to encourage such

23 stores and outlets to locate in economically de24 pressed areas to improve the nutritional status of

25 the community.
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1 ‘‘(6) Forming partnerships with senior centers

2 and nursing homes to establish programs for older

3 people to foster physical activity and improved nutri4 tion, including strength, flexibility, and aerobic class5 es.

6 ‘‘(7) Providing educational activities targeting

7 healthier eating, such as cooking and shopping dem8 onstrations, onsite consultation by nutrition profes9 sionals at restaurants, and community educational

10 outreach using evidence-based nutrition rec11 ommendations.

12 ‘‘(8) Forming partnerships with day care facili13 ties to establish programs that promote improved

14 nutritional status and physical activity.

15 ‘‘(9) Providing training and supervision of com16 munity health workers by health professionals to—

17 ‘‘(A) educate families regarding the rela18 tionship between nutrition, eating habits, phys19 ical activity, and obesity;

20 ‘‘(B) educate families about effective strat21 egies to improve nutrition, establish healthy

22 eating patterns, and establish appropriate levels

23 of physical activity;
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1 ‘‘(C) educate and guide parents regarding

2 the ability to model and communicate positive

3 health behaviors; and

4 ‘‘(D) educate and refer individuals to ap5 propriate health care agencies and community6 based programs and organizations in order to

7 increase access to quality health care services,

8 including preventive health services.

9 ‘‘(10) Other activities as deemed appropriate by

10 the Secretary.

11 ‘‘(d) EVALUATION.—A city, county, tribe, or State

12 that receives a grant under this section shall submit to

13 the Secretary an evaluation, in collaboration with an aca14 demic health center or other qualified community-based

15 entity, that describes activities carried out with funds re16 ceived under this section, the long-term effectiveness of

17 such activities in increasing physical activity, improving

18 nutrition, and preventing individuals from becoming over19 weight or obese, and such other information as the Sec20 retary may require.

21 ‘‘(e) MATCHING FUNDS.—In awarding grants under

22 subsection (a), the Secretary may give priority to appli23 cants who provide matching funds.

24 ‘‘(f) TECHNICAL ASSISTANCE.—The Secretary may

25 set aside an amount not to exceed 15 percent of the total
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1 amount appropriated for a fiscal year under subsection (g)

2 to permit the Director of the Centers for Disease Control

3 and Prevention to—

4 ‘‘(1) provide grantees with technical support in

5 the development, implementation, and evaluation of

6 programs under this section; and

7 ‘‘(2) disseminate culturally and linguistically

8 appropriate and competent information about strate9 gies and interventions in preventing and treating

10 obesity through the promotion of good nutrition and

11 physical activity.

12 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There

13 is authorized to be appropriated to carry out this section

14 $40,000,000 for fiscal year 2004, and such sums as may

15 be necessary for each of fiscal years 2005 through 2008.’’.

16 Subtitle C—School Health Program

17 SEC. 331. ESTABLISHMENT OF A COORDINATED SCHOOL

18 HEALTH PROGRAM.

19 Part Q of title III of the Public Health Service Act

20 (42 U.S.C. 280h et seq.) is amended by striking section

21 399W and inserting the following:

22 ‘‘SEC. 399W. GRANTS.

23 ‘‘(a) STATE EDUCATIONAL GRANTS.—The Secretary,

24 acting through the Director of the Centers for Disease

25 Control and Prevention and in consultation with the Ad-
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1 ministrator of the Health Resources and Services Admin2 istration, the Secretary of Education, the Secretary of Ag3 riculture, and the Secretary of the Interior, shall, as part

4 of the Centers for Disease Control and Prevention’s co5 ordinated school health program currently operated pursu6 ant to the Director’s general authority, award competitive

7 grants to State, tribal, and local educational agencies

8 (where applicable) to—

9 ‘‘(1) develop and disseminate school-based cur10 ricula or programs that focus on a healthy lifestyle

11 that includes promotion of balanced dietary patterns

12 and physical activity to prevent becoming overweight

13 or obese and related, serious, and chronic medical

14 conditions that are associated with being overweight

15 or obese (as such terms are defined in section 303

16 of the Improved Nutrition and Physical Activity

17 Act);

18 ‘‘(2) provide education and training to edu19 cation professionals, including health education,

20 physical education, and food service professionals;

21 ‘‘(3) develop and implement policies that create

22 a healthy school environment in relation to nutrition

23 and physical activity; and

24 ‘‘(4) evaluate activities conducted under para25 graphs (1) through (3).
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1 ‘‘(b) LOCAL EDUCATIONAL GRANTS.—

2 ‘‘(1) IN GENERAL.—The Secretary, acting

3 through the Director of the Centers for Disease

4 Control and Prevention and in consultation with the

5 Secretary of Education, the Secretary of Agriculture,

6 and the Secretary of the Interior, shall award com7 petitive grants to local educational agencies to plan,

8 implement, and evaluate culturally and linguistically

9 appropriate and competent programs to promote a

10 healthy lifestyle, including programs that, in collabo11 ration with statewide coordinated school health pro12 grams, when applicable, increase physical activity

13 and improve the nutritional status of the students at

14 elementary and secondary schools.

15 ‘‘(2) AWARD OF GRANTS.—A local educational

16 agency desiring a grant under this subsection shall

17 submit an application to the Secretary at such time,

18 in such manner, and containing such information as

19 the Secretary may require, including a plan describ20 ing how funds received under this section will be

21 used and an evaluation of the program.

22 ‘‘(3) USE OF FUNDS.—A local educational

23 agency that receives a grant under this subsection

24 shall use the funds made available through the grant

25 to carry out 4 or more of the following activities:
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1 ‘‘(A) Planning and implementing a healthy

2 lifestyle curriculum or program with an empha3 sis on nutrition and physical activity for each

4 grade level.

5 ‘‘(B) Planning and implementing a phys6 ical education and activity curriculum or pro7 gram for each grade level and purchasing ap8 propriate equipment, with no more than 15 per9 cent of a grant award used for purchasing such

10 equipment.

11 ‘‘(C) Planning and implementing healthy

12 lifestyle classes or programs for parents and

13 guardians, with an emphasis on nutrition and

14 physical activity.

15 ‘‘(D) Planning and implementing after16 hours physical activity programs.

17 ‘‘(E) Creating opportunities for students to

18 choose foods to improve nutritional status.

19 ‘‘(F) Training teachers and staff, including

20 food service workers, on how to teach good nu21 trition and physical activity practices.

22 ‘‘(G) Other activities as deemed appro23 priate by the Secretary.

24 ‘‘(4) EVALUATION.—An agency that receives a

25 grant under this subsection shall submit to the Sec-
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1 retary an evaluation, in collaboration with an aca2 demic department or other qualified community3 based entity, describing the activities carried out

4 under the grant, the effectiveness of the activities in

5 increasing physical activity, improving nutrition, and

6 preventing individuals from becoming overweight

7 and obese, and such other information as the Sec8 retary may require.

9 ‘‘(c) COMMUNITY EDUCATIONAL GRANTS.—

10 ‘‘(1) IN GENERAL.—The Secretary, acting

11 through the Centers for Disease Control and Preven12 tion, shall award competitive grants to universities,

13 colleges, or community-based nonprofit organizations

14 to develop, implement, and evaluate programs to

15 promote healthy eating and physical activity in

16 youth and to conduct effectiveness reports to iden17 tify programs that have demonstrated effectiveness

18 in improving nutritional status and physical activity

19 in youth.

20 ‘‘(2) AWARD OF GRANTS.—A university, college,

21 or qualified community-based nonprofit entity desir22 ing a grant under this subsection shall submit an

23 application to the Secretary at such time, in such

24 manner, and containing such information as the Sec25 retary may require.
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1 ‘‘(3) INFORMATION AVAILABILITY.—Informa2 tion about programs funded with grants authorized

3 under this subsection shall be made available to

4 State, tribal, and local educational agencies and may

5 be used in planning and implementing programs de6 scribed in subsections (a) and (b).

7 ‘‘(d) TECHNICAL ASSISTANCE.—The Secretary may

8 set aside an amount not to exceed 15 percent of the total

9 amount appropriated for a fiscal year under subsection (e)

10 to permit the Director of the Centers for Disease Control

11 and Prevention to—

12 ‘‘(1) provide grantees with technical support in

13 the development, implementation, and evaluation of

14 programs under this section; and

15 ‘‘(2) disseminate culturally and linguistically

16 appropriate and competent information about strate17 gies and interventions in preventing and treating

18 obesity through the promotion of good nutrition and

19 physical activity.

20 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There

21 is authorized to be appropriated to carry out this section

22 $40,000,000 for fiscal year 2004, and such sums as may

23 be necessary for each of fiscal years 2005 through 2008.’’.
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1 SEC. 332. NATIONAL CENTER FOR HEALTH STATISTICS.

2 Section 306 of the Public Health Service Act (42

3 U.S.C. 242k) is amended by striking subsection (n) and

4 inserting the following:

5 ‘‘(n)(1) The Secretary, acting through the Center,

6 may provide for the—

7 ‘‘(A) collection of data for determining the fit8 ness levels of children and youth; and

9 ‘‘(B) analysis of data collected as part of the

10 National Health and Nutrition Examination Survey

11 and other data sources.

12 ‘‘(2) In carrying out paragraph (1), the Secretary,

13 acting through the Center, may make grants to states,

14 public and nonprofit entities.

15 ‘‘(3) The Secretary, acting through the Center, may

16 provide technical assistance, standards, and methodologies

17 to grantees supported by this subsection in order to maxi18 mize the data quality and comparability with other stud19 ies.’’.

20 Subtitle D—Institute of Medicine

21 Study

22 SEC. 341. STUDY OF THE FOOD SUPPLEMENT AND NUTRI23 TION PROGRAMS OF THE DEPARTMENT OF

24 AGRICULTURE.

25 (a) IN GENERAL.—The Secretary of Agriculture shall

26 request that the Institute of Medicine conduct, or contract
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1 with another entity to conduct, a study on the food and

2 nutrition assistance programs run by the Department of

3 Agriculture.

4 (b) CONTENT.—Such study shall—

5 (1) investigate whether the nutrition programs

6 and nutrition recommendations are based on the lat7 est scientific evidence;

8 (2) investigate whether the food assistance pro9 grams contribute to either preventing or enhancing

10 obesity and being overweight in children, adoles11 cents, and adults;

12 (3) investigate whether the food assistance pro13 grams can be improved or altered to contribute to

14 the prevention of obesity and becoming overweight;

15 and

16 (4) identify obstacles that prevent or hinder the

17 programs from achieving their objectives.

18 (c) REPORT.—Not later than 24 months after the

19 date of enactment of this Act, the Secretary of Agriculture

20 shall submit to the appropriate committees of Congress

21 a report containing the results of the Institute of Medicine

22 study authorized under this section.

23 (d) AUTHORIZATION OF APPROPRIATIONS.—There is

24 authorized to be appropriated to carry out this section

25 $750,000 for fiscal years 2004 and 2005.
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1 Subtitle E—Agency for Healthcare

2 Research and Quality Studies

3 SEC. 351. EVIDENCE REPORT ON WEIGHT REDUCTION PRO4 GRAMS.

5 (a) IN GENERAL.—The Secretary, acting through the

6 Director of the Agency for Healthcare Research and Qual7 ity, shall conduct or support an evidence report on the ef8 fectiveness of weight reduction programs.

9 (b) CONTENT.—The study described in subsection (a)

10 shall evaluate the available scientific evidence regarding

11 the safety and effectiveness of the programs, including

12 programs that use dietary supplements, behavior modifica13 tion, and other weight loss methods, and how successful

14 the programs are in helping individuals achieve short-term

15 weight loss and sustain long-term weight maintenance.

16 (c) REPORT.—The Secretary shall, not later than 18

17 months after the date of enactment of this Act, prepare

18 and submit to the relevant committees of Congress a re19 port that describes the results of the evidence report de20 scribed in this section. Such report shall be made available

21 on the web site of the Agency for Healthcare Research

22 and Quality.

23 (d) AUTHORIZATION OF APPROPRIATIONS.—There is

24 authorized to be appropriated to carry out this section,

25 $500,000 for fiscal year 2004.
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1 SEC. 352. HEALTH DISPARITIES REPORT.

2 Not later than 18 months after the date of enactment

3 of this Act, and annually thereafter, the Director of the

4 Agency for Healthcare Research and Quality shall review

5 all research that results from the activities outlined in this

6 Act and determine if particular information may be impor7 tant to the report on health disparities required by section

8 903(c)(3) of the Public Health Service Act (42 U.S.C.

9 299a–1(c)(3)).

10 Subtitle F—Preventive Health and

11 Health Services Block Grant

12 SEC. 361. USE OF ALLOTMENTS.

13 Section 1904(a)(1) of title XIX of the Public Health

14 Service Act (42 U.S.C. 300w–3(a)(1)) is amended by add15 ing at the end the following:

16 ‘‘(H) Activities and community education pro17 grams designed to address and prevent overweight,

18 obesity, and eating disorders through effective pro19 grams to promote healthy eating, and exercise habits

20 and behaviors.’’.

21 Subtitle G—Medicare Nutrition

22 Therapy Demonstration Project

23 SEC. 371. DEMONSTRATION PROJECT TO REDUCE OBESITY

24 AND OTHER CHRONIC DISEASE RISKS.

25 (a) DEMONSTRATION.—The Secretary, in consulta26 tion with the Administrator of the Centers for Medicare
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1 & Medicaid Services, shall conduct a demonstration

2 project to develop a comprehensive and systematic model

3 for improving the health of older Americans.

4 (b) CONTENT.—The demonstration project described

5 in subsection (a) shall—

6 (1) identify, through self-assessment, behavioral

7 risk factors, such as obesity and overweight, poor

8 nutrition, physical inactivity, alcohol use, tobacco

9 use, and mental health problems among those target

10 individuals;

11 (2) identify, through self-assessment, needed

12 medicare clinical preventive and screening benefits

13 among those target individuals;

14 (3) identify, through self-assessment, functional

15 and self-management information the Secretary de16 termines to be appropriate;

17 (4) provide ongoing support to reduce risk fac18 tors and promote the appropriate use of preventive

19 and screening benefits; and

20 (5) improve health outcomes, satisfaction, qual21 ity of life, and appropriate use of medicare-covered

22 services among those target individuals.

23 (c) DEFINITIONS.—

24 In this section:
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1 (1) TARGET INDIVIDUALS.—The term ‘‘target

2 individuals’’ means individuals who are medicare

3 beneficiaries under title XVIII of the Social Security

4 Act (42 U.S.C. 1395 et seq.) who shall include dif5 ferent segments of the population including racial

6 and ethnic minority groups and persons of lower so7 cioeconomic status. The demonstration is completely

8 voluntary on the part of target individuals.

9 (2) SELF-ASSESSMENT.—The term ‘‘self-assess10 ment’’ means a form delivered by the Secretary to

11 each target individual that—

12 (A) includes questions regarding—

13 (i) behavioral risk factors;

14 (ii) needed preventive and screening

15 services; and

16 (iii) target individuals’ preferences for

17 receiving followup information; and

18 (B) is then assessed using such computer

19 generated assessment programs and provides

20 ongoing support to the individual as the Sec21 retary determines appropriate.

22 (3) ONGOING SUPPORT.—The term ‘‘ongoing

23 support’’ means—
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1 (A) to provide target individuals with in2 formation, feedback, health coaching, and rec3 ommendations regarding—

4 (i) the results of the self-assessment;

5 (ii) behavior modification based on the

6 self-assessment; and

7 (iii) any need for clinical preventive

8 and screening services or treatment includ9 ing medical nutrition therapy;

10 (B) to provide target individuals with re11 ferrals to community resources and programs

12 (such as senior centers) available to assist the

13 target individual in reducing health risks;

14 (C) information on available volunteer op15 portunities to promote active engagement in the

16 community; and

17 (D) to provide the information described in

18 subparagraph (A) to a health care provider, if

19 designated by the target individual to receive

20 such information.

21 (d) PROGRAM DESIGN.—

22 (1) INITIAL DESIGN.—Not later than 1 year

23 after the date of enactment of this Act, the Sec24 retary shall design the demonstration project. The

25 demonstration should draw upon promising, innova-
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1 tive models and incentives to reduce behavioral risk

2 factors. The Administrator of the Centers for Medi3 care & Medicaid Services shall consult with the Di4 rector of the Centers for Disease Control and Pre5 vention, the Director of the Office of Minority

6 Health, and the heads other agencies in the Depart7 ment of Health and Human Services, and profes8 sional organizations, as the Secretary determines to

9 be appropriate on the design, conduct, and evalua10 tion of the demonstration.

11 (2) NUMBER AND PROJECT AREAS.—Not later

12 than 2 years after the date of enactment of this Act,

13 the Secretary shall implement 1 demonstration

14 project designed to determine whether similar pro15 grams should be implemented for the general medi16 care population.

17 (e) REPORT TO CONGRESS.—Not later than 3 years

18 after the date the Secretary implements the demonstration

19 project under this section, the Secretary shall submit to

20 Congress a report that describes the project, evaluates the

21 effectiveness and cost effectiveness of the project, evalu22 ates the beneficiary satisfaction under the project, and in23 cludes any other information the Secretary determines to

24 be appropriate.
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1 (f) WAIVER AUTHORITY.—The Secretary shall waive

2 compliance with the requirements of title XVIII of the So3 cial Security Act (42 U.S.C. 1395 et seq.) to such extent

4 and for such period as the Secretary determines is nec5 essary to conduct the demonstration project under this

6 section.

7 (g) FUNDING.—The Secretary shall provide for the

8 transfer from the Federal Hospital Insurance Trust Fund

9 and the Federal Supplementary Insurance Trust Fund

10 under title XVIII of the Social Security Act (42 U.S.C.

11 1395 et seq.) an amount not to exceed $25,000,000 for

12 the costs of designing, implementing, and evaluating the

13 demonstration project under this section.

14 Subtitle H—Overweight and Obe15 sity Treatment and Prevention

16 Demonstration Projects

17 SEC. 381. GRANTS TO LOCAL HEALTHCARE DELIVERY SYS18 TEMS.

19 Title III of the Public Health Service Act (42 U.S.C.

20 241 et seq.) as amended in section 321, is further amend21 ed by adding at the end the following:

22 ‘‘SEC. 399BB. GRANTS TO LOCAL HEALTHCARE DELIVERY

23 SYSTEMS.

24 ‘‘(a) IN GENERAL.—The Secretary shall award

25 grants to eligible entities to implement demonstration
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1 overweight and obesity (as such terms are defined in sec2 tion 303 of the Improved Nutrition and Physical Activity

3 Act) treatment and prevention programs using evidence4 based recommendations.

5 ‘‘(b) ELIGIBLE ENTITY.—In this section, the term

6 ‘eligible entity’ means a federally qualified health center

7 (as defined in section 1861(aa)(4) of the Social Security

8 Act (42 U.S.C. 1395x(aa)(4)), rural health clinic, health

9 department, Indian Health Service hospital or clinic, In10 dian tribal health facility, urban Indian facility, or other

11 health care service provider, as determined appropriate by

12 the Secretary.

13 ‘‘(c) AWARD OF GRANTS.—An eligible entity desiring

14 a grant under this section shall submit an application to

15 the Secretary at such time, in such manner, and con16 taining such information as the Secretary may require, in17 cluding a plan for the use of funds awarded under the

18 grant and an evaluation of the program.

19 ‘‘(d) USE OF FUNDS.—An eligible entity that receives

20 a grant under this section shall use the funds made avail21 able through the grant to carry out 3 or more of the fol22 lowing activities in a culturally and linguistically appro23 priate and competent manner:
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1 ‘‘(1) Providing nutrition and physical activity

2 services by a health professional to treat or prevent

3 overweight and obesity.

4 ‘‘(2) Providing patient education and counseling

5 to increase physical activity and improve nutrition.

6 ‘‘(3) Providing community education on nutri7 tion and physical activity by a health professional to

8 provide better understanding of the relationship be9 tween diet, physical activity, and obesity.

10 ‘‘(4) Training health professionals on how to

11 identify and treat obese and overweight individuals

12 which may include nutrition and physical activity

13 counseling.

14 ‘‘(5) Providing education and referring individ15 uals to appropriate health care agencies and commu16 nity-based programs and organizations in order to

17 increase access to quality health care services, in18 cluding preventive health services.

19 ‘‘(6) Training and supervising community

20 health workers by qualified health professionals to—

21 ‘‘(A) educate families regarding the rela22 tionship between nutrition, eating habits, phys23 ical activity, and obesity;

24 ‘‘(B) educate families about effective strat25 egies to improve nutrition, establish healthy
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1 eating patterns and establish appropriate levels

2 of physical activity; and

3 ‘‘(C) educate and guide parents regarding

4 the ability to model and communicate positive

5 health behaviors.

6 ‘‘(7) Other activities that are deemed appro7 priate by the Secretary.

8 ‘‘(e) EVALUATION.—An eligible entity that receives a

9 grant under this section shall, in collaboration with an

10 academic health center or other qualified community11 based entity, submit to the Secretary a report describing

12 the activities carried out under the grant, the effectiveness

13 of the activities in increasing physical activity, improving

14 nutrition, and preventing overweight and obesity, and such

15 other information as the Secretary may require.

16 ‘‘(f) TECHNICAL ASSISTANCE.—The Secretary may

17 set aside an amount not to exceed 15 percent of the total

18 amount appropriated for a fiscal year under subsection (g)

19 to—

20 ‘‘(1) provide grantees with technical support in

21 the development, implementation, and evaluation of

22 programs under this section; and

23 ‘‘(2) disseminate culturally and linguistically

24 appropriate and competent information about strate25 gies and interventions in preventing and treating
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1 obesity through the promotion of good nutrition and

2 physical activity.

3 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There

4 is authorized to be appropriated to carry out this section,

5 $40,000,000 for fiscal year 2004, and such sums as may

6 be necessary for each of fiscal years 2005 through 2008.’’.

7 Subtitle I—Research on Obesity

8 SEC. 391. REPORT ON OBESITY RESEARCH.

9 (a) IN GENERAL.—Not later than 1 year after the

10 date of enactment of this Act, the Secretary shall submit

11 to the Committee on Health, Education, Labor, and Pen12 sions of the Senate and the Committee on Energy and

13 Commerce of the House of Representatives a report on

14 research on causes and health implications of obesity and

15 being overweight.

16 (b) CONTENT.—The report described in subsection

17 (a) shall contain—

18 (1) descriptions on the status of relevant, cur19 rent, ongoing research being conducted in the de20 partment including—

21 (A) the types and numbers of studies com22 pleted or being conducted by the National Insti23 tutes of Health on—

24 (i) mechanisms responsible for obesity

25 (including nutrition, physical activity, ge-
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1 netic causes such as syndrome X), the pre2 vention of and the treatment for obesity

3 and related, serious, and chronic medical

4 conditions (including diabetes and cardio5 vascular disease); and

6 (ii) psychosocial aspects of obesity;

7 (B) the types and number of studies com8 pleted or being conducted by the Centers for

9 Disease Control and Prevention on individual

10 and community interventions to prevent individ11 uals from becoming overweight or obese;

12 (C) the types of studies completed or being

13 conducted by the Agency for Healthcare Re14 search and Quality on the treatment and pre15 vention of overweight and obesity;

16 (D) the types of studies being conducted

17 by the Health Resources and Services Adminis18 tration on the prevention of overweight and obe19 sity; and

20 (E) what these studies have shown about

21 the causes of, prevention of, and treatment of

22 overweight and obesity; and

23 (2) recommendations on further research that

24 is needed, including research among diverse popu25 lations, the department’s plan for conducting such
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1 research, and how current knowledge can be dissemi2 nated.

3 Subtitle J—Youth Media Campaign

4 SEC. 395. GRANTS AND CONTRACTS FOR A NATIONAL CAM5 PAIGN TO CHANGE CHILDREN’S HEALTH BE6 HAVIORS.

7 Section 399Y of the Public Health Service Act (42

8 U.S.C. 280h–2) is amended by striking subsection (b) and

9 inserting the following:

10 ‘‘(b) GRANTS.—

11 ‘‘(1) IN GENERAL.—As part of the campaign

12 described in subsection (a), the Secretary, acting

13 through the Director of the Centers for Disease

14 Control and Prevention, shall award grants or con15 tracts to eligible entities to design and implement

16 culturally and linguistically appropriate and com17 petent campaigns to change children’s health behav18 iors.

19 ‘‘(2) ELIGIBLE ENTITY.—In this subsection, the

20 term ‘eligible entity’ means a marketing, public rela21 tions, advertising, or other appropriate entity.

22 ‘‘(3) CONTENT.—An eligible entity that receives

23 a grant under this subsection shall use funds re24 ceived through such grant or contract to utilize mar25 keting and communication strategies to—
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1 ‘‘(A) communicate messages to help young

2 people develop habits that will foster good

3 health over a lifetime;

4 ‘‘(B) provide young people with motivation

5 to engage in sports and other physical activi6 ties;

7 ‘‘(C) influence youth to develop good

8 health habits such as regular physical activity

9 and good nutrition;

10 ‘‘(D) educate parents of young people on

11 the importance of physical activity and improv12 ing nutrition, how to maintain healthy behav13 iors for the entire family, and how to encourage

14 children to develop good nutrition and physical

15 activity habits; and

16 ‘‘(E) discourage stigmatization and dis17 crimination based on body size or shape.

18 ‘‘(4) REPORT.—The Secretary shall evaluate

19 the effectiveness of the campaign described in para20 graph (1) in changing children’s behaviors and re21 port such results to the Committee on Health, Edu22 cation, Labor, and Pensions of the Senate and the

23 Committee on Energy and Commerce of the House

24 of Representatives.
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1 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There

2 is authorized to be appropriated to carry out this section,

3 $125,000,000 for fiscal year 2004, and such sums as nec4 essary for each of fiscal years 2005 through 2008.’’.

5 Subtitle K—Sense of the Senate

6 SEC. 399. SENSE OF THE SENATE CONCERNING NUTRITION.

7 (a) FINDINGS.—Congress makes the following find8 ings:

9 (1) Key child nutrition programs are up for re10 authorization in the 108th Congress, including the

11 School Breakfast Program, School Lunch Program,

12 Special Milk Program, Child and Adult Care Food

13 Program, Summer Food Service Program, and the

14 Women’s, Infant’s, and Children’s (WIC) Program.

15 (2) The United States Department of Agri16 culture reports, based on national United States

17 Census Bureau data, that in 2000 10.5 percent of

18 all United States households, representing

19 20,000,000 adults and 13,000,000 children, were

20 ‘‘food insecure’’. Of the 11,000,000 households that

21 were food insecure, 3,300,000 suffered from food in22 security that was so severe that USDA’s very con23 servative measure classified them as ‘‘hungry’’.

24 2,700,000 children lived in these hungry households.
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1 (3) Households with children experience food

2 insecurity at more than double the rate for house3 holds without children.

4 (4) Mental and physical changes accompany in5 adequate food intake which can have harmful effects

6 on learning, development, productivity, physical and

7 psychological health, and family life. These effects

8 are particularly harmful to children, and can have a

9 lasting impact.

10 (5) The Surgeon General has established as an

11 important health objective, to increase the food secu12 rity from 88 percent of all United States households

13 (in 1995) to 94 percent by the year 2010.

14 (6) A national survey of emergency feeding pro15 grams conducted by America’s Second Harvest in

16 2001 found their food bank network of emergency

17 food providers served 23,000,000 people in a year,

18 9 percent more than were served in 1997, and more

19 than 9,000,000 of those served were children.

20 (7) United States Conference of Mayors data

21 indicates that between November 2000 to November

22 2001, only one-third of the major cities surveyed re23 ported that they were able to provide an adequate

24 quantity of food to meet the need. Eighty-five per25 cent of the cities reported that emergency food as-
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1 sistance facilities have had to decrease the quantity

2 of food provided or the number of times families or

3 individuals may receive food. Across the cities sur4 veyed, 54 percent of those requesting emergency as5 sistance were either children or their parents. The

6 average increase in the number of families with chil7 dren requesting emergency food was 19 percent.

8 (8) Adequate nutrition in the earliest years of

9 life is essential for healthy child development and for

10 school readiness.

11 (9) Congress recently enacted, and the Presi12 dent signed into law, the No Child Left Behind Act

13 to increase student academic achievement. Numer14 ous studies indicate that hunger can have a detri15 mental effect on a child’s ability to learn and thrive

16 in school.

17 (10) Food insecurity and overweight frequently

18 co-exist in the population.

19 (11) Federal child nutrition programs can be an

20 efficient and effective means to reduce hunger, re21 duce overweight prevalence, and promote healthy

22 eating habits among children in the United States.

23 (b) SENSE OF THE SENATE.—It is the Sense of the

24 Senate, that as Congress works to reauthorize the child

25 nutrition laws of the United States, it should—
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1 (1) carefully evaluate elements of those pro2 grams to strengthen efficiency and effectiveness, in3 cluding streamlining program administration, reduc4 ing paperwork burdens, and simplifying access for

5 parents;

6 (2) improve the healthfulness of meals served,

7 as well as that of other foods and beverages made

8 available in schools;

9 (3) strengthen the educational component of

10 the programs to encourage healthy eating habits and

11 promote physical activity;

12 (4) review eligibility guidelines, and reimburse13 ment rates; and

14 (5) provide significant additional funding to

15 carry out these and other vital priorities to make

16 sure pregnant women, and children from infancy

17 through school have access to nutritious food to opti18 mize health and prevent overweight.

19 TITLE IV—SUPPORTING SERV20 ICES TO LOW-INCOME FAMI21 LIES THROUGH THE SOCIAL

22 SERVICES BLOCK GRANT

23 SEC. 401. INCREASE IN FUNDING.

24 Section 2003(c) of the Social Security Act (42 U.S.C.

25 1379b(c)) is amended—
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1 (1) in paragraph (10), by striking ‘‘and’’;

2 (2) in paragraph (11), by striking ‘‘and each

3 fiscal year thereafter.’’ and inserting a semicolon;

4 and

5 (3) by adding at the end the following:

6 ‘‘(12) $2,800,000,000 for each of the fiscal

7 years 2004 through 2008; and

8 ‘‘(13) $1,700,000,000 for the fiscal year 2009

9 and each fiscal year thereafter.’’.

10 TITLE V—EXPANDING THE FAM11 ILY AND MEDICAL LEAVE ACT

12 SEC. 501. SHORT TITLE.

13 This title may be cited as the ‘‘Family and Medical

14 Leave Expansion Act’’.

15 SEC. 502. FINDINGS.

16 Congress makes the following findings:

17 (1) Since the enactment of the Family and

18 Medical Leave Act of 1993 (29 U.S.C. 2601 et seq.),

19 more than 35,000,000 Americans have taken leave

20 for family or medical reasons.

21 (2) Of those taking leave under the Family and

22 Medical Leave Act of 1993, 52 percent took the

23 leave for their own serious health conditions, and 26

24 percent took the leave to care for a new child or for

25 maternity disability reasons.
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1 (3) While the leave provided by the Family and

2 Medical Leave Act of 1993 has proven to be a crit3 ical resource for millions of Americans, too many

4 people are left behind because the Act provides only

5 unpaid leave.

6 (4) According to a 2000 Department of Labor

7 survey—

8 (A) 3,500,000 Americans needed family

9 and medical leave but could not afford to take

10 time off without pay;

11 (B) nearly four-fifths (78 percent) of those

12 surveyed who needed the leave but did not take

13 it said they could not afford unpaid leave;

14 (C) nine percent of those taking family and

15 medical leave and receiving less than full pay

16 during their longest period of the leave had to

17 go on public assistance to cover their lost

18 wages; and

19 (D) seventy-three percent of those taking

20 family and medical leave had incomes above

21 $30,000.

22 (5) In 1970, only 27 percent of mothers with

23 infants under age 1 were in the labor force.

24 (6) In 1999, nearly 60 percent of mothers with

25 infants under age 1 were working.
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1 (7) Worldwide, 128 countries of the 172 re2 sponding to an International Social Security Asso3 ciation survey in 1999 provided at least some paid

4 and job protected maternity leave, and, on average,

5 provided 16 weeks of basic paid maternity leave. In

6 some countries, paid maternity leave is mandatory

7 and in others it is voluntary.

8 (8) A European Union directive mandating 14

9 weeks of paid maternity leave was adopted as a

10 health and safety measure in 1992.

11 (9) Among the 29 Organization for Economic

12 Cooperation and Development (OECD) countries,

13 the most advanced industrialized countries, the aver14 age period of childbirth-related leave (including ma15 ternity, paternity, and parental leaves) is 44 weeks

16 (10 months) with additional time provided in some

17 countries for leave to care for a sick child. In those

18 countries, the average duration of paid childbirth-re19 lated leave is 36 weeks.

20 (10) In more than half of the OECD countries

21 (16 countries), the cash benefit provided while on

22 the paid childbirth-related leave replaces between 70

23 and 100 percent of prior wages.
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1 (11) Among the OECD countries, adoptive

2 mothers and adoptive parents are increasingly eligi3 ble for the paid childbirth-related leave.

4 Subtitle A—Family Income To

5 Respond to Significant Transitions

6 SEC. 511. SHORT TITLE.

7 This subtitle may be cited as the ‘‘Family Income to

8 Respond to Significant Transitions Insurance Act’’.

9 SEC. 512. PURPOSES.

10 The purposes of this subtitle are—

11 (1) to establish a demonstration program that

12 supports the efforts of States and political subdivi13 sions to provide partial or full wage replacement,

14 often referred to as FIRST insurance, to new par15 ents so that the new parents are able to spend time

16 with a new infant or newly adopted child, and to

17 other employees; and

18 (2) to learn about the most effective mecha19 nisms for providing the wage replacement assistance.

20 SEC. 513. DEFINITIONS.

21 In this subtitle:

22 (1) EMPLOYER; SON OR DAUGHTER; STATE.—

23 The terms ‘‘employer’’, ‘‘son or daughter’’, and

24 ‘‘State’’ have the meanings given the terms in sec-
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1 tion 101 of the Family and Medical Leave Act of

2 1993 (29 U.S.C. 2611).

3 (2) SECRETARY.—The term ‘‘Secretary’’ means

4 the Secretary of Labor, acting after consultation

5 with the Secretary of Health and Human Services.

6 SEC. 514. DEMONSTRATION PROJECTS.

7 (a) GRANTS.—

8 (1) IN GENERAL.—The Secretary shall make

9 grants to eligible entities to pay for the Federal

10 share of the cost of carrying out projects that assist

11 families by providing, through various mechanisms,

12 wage replacement for eligible individuals who are re13 sponding to—

14 (A) caregiving needs resulting from the

15 birth or adoption of a son or daughter; or

16 (B) other family caregiving needs.

17 (2) PERIODS.—The Secretary shall make the

18 grants for periods of 5 years.

19 (b) ELIGIBLE ENTITIES.—To be eligible to receive a

20 grant under this section, an entity shall be a State or polit21 ical subdivision of a State.

22 (c) USE OF FUNDS.—

23 (1) IN GENERAL.—An entity that receives a

24 grant under this section may use the funds made

25 available through the grant to provide partial or full
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1 wage replacement as described in subsection (a) to

2 eligible individuals—

3 (A) directly;

4 (B) through an insurance program, such

5 as a State temporary disability insurance pro6 gram or the State unemployment compensation

7 benefit program;

8 (C) through a private disability or other

9 insurance plan, or another mechanism provided

10 by a private employer; or

11 (D) through another mechanism.

12 (2) PERIOD.—In carrying out a project under

13 this section, the entity shall provide partial or full

14 wage replacement to eligible individuals for not less

15 than 6 weeks during a period of leave, or an absence

16 from employment, described in subsection (d)(2),

17 during any 12-month period. Wage replacement

18 available to an individual under this paragraph shall

19 be in addition to any compensation from annual or

20 sick leave that the individual may elect to use during

21 a period of leave, or an absence from employment,

22 described in subsection (d)(2), during any 12-month

23 period.

24 (3) ADMINISTRATIVE COSTS.—No entity may

25 use more than 10 percent of the total funds made
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1 available through the grant during the 5-year period

2 of the grant to pay for the administrative costs re3 lating to a project described in subsection (a).

4 (d) ELIGIBLE INDIVIDUALS.—To be eligible to re5 ceive wage replacement under subsection (a), an individual

6 shall—

7 (1) meet such eligibility criteria as the eligible

8 entity providing the wage replacement may specify

9 in an application described in subsection (e); and

10 (2) be—

11 (A) an individual who is taking leave,

12 under the Family and Medical Leave Act of

13 1993 (29 U.S.C. 2601 et seq.), other Federal,

14 State, or local law, or a private plan, for a rea15 son described in subparagraph (A) or (B) of

16 section 102(a)(1) of the Family and Medical

17 Leave Act of 1993 (29 U.S.C. 2612(a)(1));

18 (B) at the option of the eligible entity, an

19 individual who—

20 (i) is taking leave, under that Act,

21 other Federal, State, or local law, or a pri22 vate plan, for a reason described in sub23 paragraph (C), (D), (E), or (F) of section

24 102(a)(1) of the Family and Medical
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1 Leave Act of 1993 (29 U.S.C. 2612(a)(1));

2 or

3 (ii) leaves employment, and has an ab4 sence from employment, because the indi5 vidual has elected to care for a son or

6 daughter under age 1; or

7 (C) at the option of the eligible entity, an

8 individual who has an absence from employ9 ment and has other characteristics specified by

10 the eligible entity in an application described in

11 subsection (e).

12 (e) APPLICATION.—To be eligible to receive a grant

13 under this section, an entity shall submit an application

14 to the Secretary, at such time, in such manner, and con15 taining such information as the Secretary may require, in16 cluding, at a minimum—

17 (1) a plan for the project to be carried out with

18 the grant;

19 (2) information demonstrating that the appli20 cant consulted representatives of employers and em21 ployees, including labor organizations, in developing

22 the plan;

23 (3) estimates of the costs and benefits of the

24 project;
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1 (4)(A) information on the number and type of

2 families to be covered by the project, and the extent

3 of such coverage in the area served under the grant;

4 and

5 (B) information on any criteria or characteris6 tics that the entity will use to determine whether an

7 individual is eligible for wage replacement under

8 subsection (a), as described in paragraphs (1) and

9 (2)(C) of subsection (d);

10 (5) if the project will expand on State and pri11 vate systems of wage replacement for eligible indi12 viduals, information on the manner in which the

13 project will expand on the systems;

14 (6) information demonstrating the manner in

15 which the wage replacement assistance provided

16 through the project will assist families in which an

17 individual takes leave or is absent from employment

18 as described in subsection (d)(2); and

19 (7) an assurance that the applicant will partici20 pate in efforts to evaluate the effectiveness of the

21 project.

22 (f) SELECTION CRITERIA.—In selecting entities to re23 ceive grants for projects under this section, the Secretary

24 shall—

25 (1) take into consideration—
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1 (A) the scope of the proposed projects;

2 (B) the cost-effectiveness, feasibility, and

3 financial soundness of the proposed projects;

4 (C) the extent to which the proposed

5 projects would expand access to wage replace6 ment in response to family caregiving needs,

7 particularly for low-wage employees, in the area

8 served by the grant; and

9 (D) the benefits that would be offered to

10 families and children through the proposed

11 projects; and

12 (2) to the extent feasible, select entities pro13 posing projects that utilize diverse mechanisms, in14 cluding expansion of State unemployment compensa15 tion benefit programs, and establishment or expan16 sion of State temporary disability insurance pro17 grams, to provide the wage replacement.

18 (g) FEDERAL SHARE.—

19 (1) IN GENERAL.—The Federal share of the

20 cost described in subsection (a) shall be—

21 (A) 50 percent for the first year of the

22 grant period;

23 (B) 40 percent for the second year of that

24 period;
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1 (C) 30 percent for the third year of that

2 period; and

3 (D) 20 percent for each subsequent year.

4 (2) NON-FEDERAL SHARE.—The non-Federal

5 share of the cost may be in cash or in kind, fairly

6 evaluated, including plant, equipment, and services

7 and may be provided from State, local, or private

8 sources, or Federal sources other than this subtitle.

9 (h) SUPPLEMENT NOT SUPPLANT.—Funds appro10 priated pursuant to the authority of this subtitle shall be

11 used to supplement and not supplant other Federal, State,

12 and local public funds and private funds expended to pro13 vide wage replacement.

14 (i) EFFECT ON EXISTING RIGHTS.—Nothing in this

15 subtitle shall be construed to supersede, preempt, or other16 wise infringe on the provisions of any collective bargaining

17 agreement or any employment benefit program or plan

18 that provides greater rights to employees than the rights

19 established under this subtitle.

20 SEC. 515. NOTIFICATION.

21 An eligible entity that provides partial or full wage

22 replacement to an eligible individual under this subtitle

23 shall notify (in a form and manner prescribed by the Sec24 retary)—
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1 (1) the employer of the individual of the

2 amount of the wage replacement provided; and

3 (2) the individual and the employer of the indi4 vidual that the employer shall count an appropriate

5 period of leave, calculated under section 102(g) of

6 the Family and Medical Leave Act of 1993 (29

7 U.S.C. 2612(g)), as added by section 518, against

8 the total amount of leave (if any) to which the em9 ployee is entitled under section 102(a)(1) of that Act

10 (29 U.S.C. 2612(a)(1)).

11 SEC. 516. EVALUATIONS AND REPORTS.

12 (a) AVAILABLE FUNDS.—The Secretary shall use not

13 more than 2 percent of the funds made available under

14 section 517 to carry out this section.

15 (b) EVALUATIONS.—The Secretary shall, directly or

16 by contract, evaluate the effectiveness of projects carried

17 out with grants made under section 514, including

18 conducting—

19 (1) research relating to the projects, including

20 research comparing—

21 (A) the scope of the projects, including the

22 type of insurance or other wage replacement

23 mechanism used, the method of financing used,

24 the eligibility requirements, the level of the

25 wage replacement benefit provided (such as the
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1 percentage of salary replaced), and the length

2 of the benefit provided, for the projects;

3 (B) the utilization of the projects, includ4 ing the characteristics of individuals who ben5 efit from the projects, particularly low-wage

6 workers, and factors that determine the ability

7 of eligible individuals to obtain wage replace8 ment through the projects; and

9 (C) the costs of and savings achieved by

10 the projects, including the cost-effectiveness of

11 the projects and their benefits for children and

12 families;

13 (2) analysis of the overall need for wage re14 placement; and

15 (3) analysis of the impact of the projects on the

16 overall availability of wage replacement.

17 (c) REPORTS.—

18 (1) INITIAL REPORT.—Not later than 3 years

19 after the beginning of the grant period for the first

20 grant made under section 514, the Secretary shall

21 prepare and submit to Congress a report that con22 tains information resulting from the evaluations con23 ducted under subsection (b).

24 (2) SUBSEQUENT REPORTS.—Not later than 4

25 years after the beginning of that grant period, and
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1 annually thereafter, the Secretary shall prepare and

2 submit to Congress a report that contains—

3 (A) information resulting from the evalua4 tions conducted under subsection (b); and

5 (B) usage data for the demonstration

6 projects, for the most recent year for which the

7 data are available.

8 SEC. 517. AUTHORIZATION OF APPROPRIATIONS.

9 There are authorized to be appropriated to carry out

10 this subtitle $400,000,000 for fiscal year 2004 and such

11 sums as may be necessary for each subsequent fiscal year.

12 SEC. 518. TECHNICAL AND CONFORMING AMENDMENTS.

13 (a) IN GENERAL.—Section 102 of the Family and

14 Medical Leave Act of 1993 (29 U.S.C. 2612) is amended

15 by adding at the end the following:

16 ‘‘(g) RELATIONSHIP TO FIRST INSURANCE.—

17 ‘‘(1) FULL WAGE REPLACEMENT.—If an eligible

18 entity provides full wage replacement to an employee

19 for a period under subtitle A of the Family and

20 Medical Leave Expansion Act, the employee’s em21 ployer shall count an amount of leave, equal to that

22 period, against the total amount of leave (if any) to

23 which the employee is entitled under subsection

24 (a)(1).
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1 ‘‘(2) PARTIAL WAGE REPLACEMENT.—If an eli2 gible entity provides partial wage replacement to an

3 employee for a period under subtitle A of the Family

4 and Medical Leave Expansion Act, the employee’s

5 employer shall—

6 ‘‘(A) total the amount of partial wage re7 placement provided for that period;

8 ‘‘(B) convert the total into a corresponding

9 amount of full wage replacement provided for a

10 proportionately reduced period; and

11 ‘‘(C) count an amount of leave, equal to

12 the period described in subparagraph (B),

13 against the total amount of leave (if any) to

14 which the employee is entitled under subsection

15 (a)(1).’’.

16 (b) TECHNICAL AND CONFORMING AMENDMENTS.—

17 Section 102(d)(2) of the Family and Medical Leave Act

18 of 1993 (29 U.S.C. 2612(d)(2)) is amended by striking

19 ‘‘for leave’’ each place it appears and inserting ‘‘for any

20 unpaid leave’’.

21 Subtitle B—Family Friendly

22 Workplaces

23 SEC. 521. SHORT TITLE.

24 This subtitle may be cited as the ‘‘Family and Med25 ical Leave Fairness Act of 2003’’.
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1 SEC. 522. COVERAGE OF EMPLOYEES.

2 Paragraphs (2)(B)(ii) and (4)(A)(i) of section 101 of

3 the Family and Medical Leave Act of 1993 (29 U.S.C.

4 2611(2)(B)(ii) and (4)(A)(i)) are amended by striking

5 ‘‘50’’ each place it appears and inserting ‘‘25’’.

6 Subtitle C—Employment

7 Protection for Battered Women

8 SEC. 531. ENTITLEMENT TO LEAVE FOR ADDRESSING DO9 MESTIC VIOLENCE FOR NON-FEDERAL EM10 PLOYEES.

11 (a) DEFINITIONS.—Section 101 of the Family and

12 Medical Leave Act of 1993 (29 U.S.C. 2611) is amended

13 by adding at the end the following:

14 ‘‘(14) ADDRESSING DOMESTIC VIOLENCE AND

15 ITS EFFECTS.—The term ‘addressing domestic vio16 lence and its effects’ means—

17 ‘‘(A) being unable to attend or perform

18 work due to an incident of domestic violence;

19 ‘‘(B) seeking medical attention for or re20 covering from injuries caused by domestic vio21 lence;

22 ‘‘(C) seeking legal assistance or remedies,

23 including communicating with the police or an

24 attorney, or participating in any legal pro25 ceeding, related to domestic violence;
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1 ‘‘(D) obtaining services from a domestic vi2 olence shelter or program or rape crisis center

3 as a result of domestic violence;

4 ‘‘(E) obtaining psychological counseling re5 lated to experiences of domestic violence;

6 ‘‘(F) participating in safety planning and

7 other actions to increase safety from future do8 mestic violence, including temporary or perma9 nent relocation; and

10 ‘‘(G) participating in any other activity ne11 cessitated by domestic violence that must be un12 dertaken during the hours of employment in13 volved.

14 ‘‘(15) DOMESTIC VIOLENCE.—The term ‘domes15 tic violence’ means domestic violence, and dating vio16 lence, as such terms are defined in section 2105 of

17 the Omnibus Crime Control and Safe Streets Act of

18 1968 (42 U.S.C. 3796hh–4).’’.

19 (b) LEAVE REQUIREMENT.—Section 102 of the Fam20 ily and Medical Leave Act of 1993 (29 U.S.C. 2612) is

21 amended—

22 (1) in subsection (a)(1), by adding at the end

23 the following:

24 ‘‘(E) In order to care for the son, daugh25 ter, or parent of the employee, if such son,
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1 daughter, or parent is addressing domestic vio2 lence and its effects.

3 ‘‘(F) Because the employee is addressing

4 domestic violence and its effects, which make

5 the employee unable to perform the functions of

6 the position of such employee.’’;

7 (2) in subsection (b), by adding at the end the

8 following:

9 ‘‘(3) DOMESTIC VIOLENCE.—Leave under sub10 paragraph (E) or (F) of subsection (a)(1) may be

11 taken by an eligible employee intermittently or on a

12 reduced leave schedule. The taking of leave intermit13 tently or on a reduced leave schedule pursuant to

14 this paragraph shall not result in a reduction in the

15 total amount of leave to which the employee is enti16 tled under subsection (a) beyond the amount of leave

17 actually taken.’’; and

18 (3) in subsection (d)(2)(B), by striking ‘‘(C) or

19 (D)’’ and inserting ‘‘(C), (D), (E), or (F)’’.

20 (c) CERTIFICATION.—Section 103 of the Family and

21 Medical Leave Act of 1993 (29 U.S.C. 2613) is

22 amended—

23 (1) in the title of the section, by inserting be24 fore the period the following: ‘‘; CONFIDEN25 TIALITY’’; and
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1 (2) by adding at the end the following:

2 ‘‘(f) DOMESTIC VIOLENCE.—In determining if an em3 ployee meets the requirements of subparagraph (E) or (F)

4 of section 102(a)(1), the employer of an employee may re5 quire the employee to provide—

6 ‘‘(1) a written statement describing the domes7 tic violence and its effects;

8 ‘‘(2) documentation of the domestic violence in9 volved, such as a police or court record, or docu10 mentation from a shelter worker, an employee of a

11 domestic violence program, an attorney, a member

12 of the clergy, or a medical or other professional,

13 from whom the employee has sought assistance in

14 addressing domestic violence and its effects; or

15 ‘‘(3) other corroborating evidence, such as a

16 statement from any other individual with knowledge

17 of the circumstances that provide the basis for the

18 claim of domestic violence, or physical evidence of

19 domestic violence, such as a photograph, torn or

20 bloody clothing, or any other damaged property.

21 ‘‘(g) CONFIDENTIALITY.—All evidence provided to

22 the employer under subsection (f) of domestic violence ex23 perienced by an employee or the son, daughter, or parent

24 of an employee, including a statement of an employee, any

25 other documentation or corroborating evidence, and the
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1 fact that an employee has requested leave for the purpose

2 of addressing, or caring for a son, daughter, or parent who

3 is addressing, domestic violence and its effects, shall be

4 retained in the strictest confidence by the employer, except

5 to the extent that disclosure is requested, or consented to,

6 by the employee for the purpose of—

7 ‘‘(1) protecting the safety of the employee or a

8 family member or co-worker of the employee; or

9 ‘‘(2) assisting in documenting domestic violence

10 for a court or agency.’’.

11 (d) TABLE OF CONTENTS.—The table of contents in

12 section 1(b) of the Family and Medical Leave Act of 1993

13 (29 U.S.C. prec. 2601) is amended by striking the item

14 relating to section 103 and inserting the following:

‘‘Sec. 103. Certification; confidentiality.’’.

15 SEC. 532. ENTITLEMENT TO LEAVE FOR ADDRESSING DO16 MESTIC VIOLENCE FOR FEDERAL EMPLOY17 EES.

18 (a) DEFINITIONS.—Section 6381 of title 5, United

19 States Code, is amended—

20 (1) at the end of paragraph (5), by striking

21 ‘‘and’’;

22 (2) in paragraph (6), by striking the period and

23 inserting a semicolon; and

24 (3) by adding at the end the following:
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1 ‘‘(7) the term ‘addressing domestic violence and

2 its effects’ has the meaning given the term in section

3 101 of the Family and Medical Leave Act of 1993

4 (29 U.S.C. 2611); and

5 ‘‘(8) the term ‘domestic violence’ means domes6 tic violence, and dating violence, as such terms are

7 defined in section 2105 of the Omnibus Crime Con8 trol and Safe Streets Act of 1968 (42 U.S.C.

9 3796hh–4).’’.

10 (b) LEAVE REQUIREMENT.—Section 6382 of title 5,

11 United States Code, is amended—

12 (1) in subsection (a)(1), by adding at the end

13 the following:

14 ‘‘(E) In order to care for the son, daughter, or

15 parent of the employee, if such son, daughter, or

16 parent is addressing domestic violence and its ef17 fects.

18 ‘‘(F) Because the employee is addressing do19 mestic violence and its effects, which make the em20 ployee unable to perform the functions of the posi21 tion of such employee.’’;

22 (2) in subsection (b), by adding at the end the

23 following:

24 ‘‘(3) DOMESTIC VIOLENCE.—Leave under sub25 paragraph (E) or (F) of subsection (a)(1) may be
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1 taken by an employee intermittently or on a reduced

2 leave schedule. The taking of leave intermittently or

3 on a reduced leave schedule pursuant to this para4 graph shall not result in a reduction in the total

5 amount of leave to which the employee is entitled

6 under subsection (a) beyond the amount of leave ac7 tually taken.’’; and

8 (3) in subsection (d), by striking ‘‘(C), or (D)’’

9 and inserting ‘‘(C), (D), (E), or (F)’’.

10 (c) CERTIFICATION.—Section 6383 of title 5, United

11 States Code, is amended—

12 (1) in the title of the section, by adding at the

13 end the following: ‘‘; confidentiality’’; and

14 (2) by adding at the end the following:

15 ‘‘(f) In determining if an employee meets the require16 ments of subparagraph (E) or (F) of section 6382(a)(1),

17 the employing agency of an employee may require the em18 ployee to provide—

19 ‘‘(1) a written statement describing the domes20 tic violence and its effects;

21 ‘‘(2) documentation of the domestic violence in22 volved, such as a police or court record, or docu23 mentation from a shelter worker, an employee of a

24 domestic violence program, an attorney, a member

25 of the clergy, or a medical or other professional,
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1 from whom the employee has sought assistance in

2 addressing domestic violence and its effects; or

3 ‘‘(3) other corroborating evidence, such as a

4 statement from any other individual with knowledge

5 of the circumstances that provide the basis for the

6 claim of domestic violence, or physical evidence of

7 domestic violence, such as a photograph, torn or

8 bloody clothing, or other damaged property.

9 ‘‘(g) All evidence provided to the employing agency

10 under subsection (f) of domestic violence experienced by

11 an employee or the son, daughter, or parent of an em12 ployee, including a statement of an employee, any other

13 documentation or corroborating evidence, and the fact

14 that an employee has requested leave for the purpose of

15 addressing, or caring for a son, daughter, or parent who

16 is addressing, domestic violence and its effects, shall be

17 retained in the strictest confidence by the employing agen18 cy, except to the extent that disclosure is requested, or

19 consented to, by the employee for the purpose of—

20 ‘‘(1) protecting the safety of the employee or a

21 family member or co-worker of the employee; or

22 ‘‘(2) assisting in documenting domestic violence

23 for a court or agency.’’.

24 (d) TABLE OF SECTIONS.—The table of sections for

25 chapter 63 of title 5, United States Code, is amended by
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1 striking the item relating to section 6383 and inserting

2 the following:

‘‘6383. Certification; confidentiality.’’.

3 SEC. 533. EXISTING LEAVE USABLE FOR DOMESTIC VIO4 LENCE.

5 (a) DEFINITIONS.—In this section:

6 (1) ADDRESSING DOMESTIC VIOLENCE AND ITS

7 EFFECTS.—The term ‘‘addressing domestic violence

8 and its effects’’ has the meaning given the term in

9 section 101 of the Family and Medical Leave Act of

10 1993 (29 U.S.C. 2611), as amended in section

11 531(a).

12 (2) EMPLOYEE.—The term ‘‘employee’’ means

13 any person employed by an employer. In the case of

14 an individual employed by a public agency, such

15 term means an individual employed as described in

16 section 3(e) of the Fair Labor Standards Act of

17 1938 (29 U.S.C. 203(e)).

18 (3) EMPLOYER.—The term ‘‘employer’’—

19 (A) means any person engaged in com20 merce or in any industry or activity affecting

21 commerce who employs individuals, if such per22 son is also subject to the Family and Medical

23 Leave Act of 1993 (29 U.S.C. 2601 et seq.) or

24 to any provision of a State or local law, collec25 tive bargaining agreement, or employment bene-
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1 fits program or plan, addressing paid or unpaid

2 leave from employment (including family, med3 ical, sick, annual, personal, or similar leave);

4 and

5 (B) includes any person acting directly or

6 indirectly in the interest of an employer in rela7 tion to any employee, and includes a public

8 agency, who is subject to a law, agreement, pro9 gram, or plan described in subparagraph (A),

10 but does not include any labor organization

11 (other than when acting as an employer) or

12 anyone acting in the capacity of officer or agent

13 of such labor organization.

14 (4) EMPLOYMENT BENEFITS.—The term ‘‘em15 ployment benefits’’ has the meaning given the term

16 in section 101 of the Family and Medical Leave Act

17 of 1993 (29 U.S.C. 2611).

18 (5) PARENT; SON OR DAUGHTER.—The terms

19 ‘‘parent’’ and ‘‘son or daughter’’ have the meanings

20 given the terms in section 101 of the Family and

21 Medical Leave Act of 1993 (29 U.S.C. 2611).

22 (6) PUBLIC AGENCY.—The term ‘‘public agen23 cy’’ has the meaning given the term in section 3 of

24 the Fair Labor Standards Act of 1938 (29 U.S.C.

25 203).
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1 (b) USE OF EXISTING LEAVE.—An employee who is

2 entitled to take paid or unpaid leave (including family,

3 medical, sick, annual, personal, or similar leave) from em4 ployment, pursuant to State or local law, a collective bar5 gaining agreement, or an employment benefits program or

6 plan, shall be permitted to use such leave for the purpose

7 of addressing domestic violence and its effects, or for the

8 purpose of caring for a son or daughter or parent of the

9 employee, if such son or daughter or parent is addressing

10 domestic violence and its effects.

11 (c) CERTIFICATION.—In determining whether an em12 ployee qualifies to use leave as described in subsection (b),

13 an employer may require a written statement, documenta14 tion of domestic violence, or corroborating evidence con15 sistent with section 103(f) of the Family and Medical

16 Leave Act of 1993 (29 U.S.C. 2613(f)), as amended by

17 section 531(c).

18 (d) CONFIDENTIALITY.—All evidence provided to the

19 employer under subsection (c) of domestic violence experi20 enced by an employee or the son or daughter or parent

21 of the employee, including a statement of an employee,

22 any other documentation or corroborating evidence, and

23 the fact that an employee has requested leave for the pur24 pose of addressing, or caring for a son or daughter or par25 ent who is addressing, domestic violence and its effects,
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1 shall be retained in the strictest confidence by the em2 ployer, except to the extent that disclosure is requested,

3 or consented to, by the employee for the purpose of—

4 (1) protecting the safety of the employee or a

5 family member or co-worker of the employee; or

6 (2) assisting in documenting domestic violence

7 for a court or agency.

8 (e) PROHIBITED ACTS.—

9 (1) INTERFERENCE WITH RIGHTS.—

10 (A) EXERCISE OF RIGHTS.—It shall be un11 lawful for any employer to interfere with, re12 strain, or deny the exercise of or the attempt to

13 exercise, any right provided under this section.

14 (B) DISCRIMINATION.—It shall be unlaw15 ful for any employer to discharge or in any

16 other manner discriminate against an individual

17 for opposing any practice made unlawful by this

18 section.

19 (2) INTERFERENCE WITH PROCEEDINGS OR IN20 QUIRIES.—It shall be unlawful for any person to dis21 charge or in any other manner discriminate against

22 any individual because such individual—

23 (A) has filed any charge, or had instituted

24 or caused to be instituted any proceeding,

25 under or related to this section;
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1 (B) has given, or is about to give, any in2 formation in connection with any inquiry or

3 proceeding relating to any right provided under

4 this section; or

5 (C) has testified, or is about to testify, in

6 any inquiry or proceeding relating to any right

7 provided under this section.

8 (f) ENFORCEMENT.—

9 (1) PUBLIC ENFORCEMENT.—The Secretary of

10 Labor shall have the powers set forth in subsections

11 (b), (c), (d), and (e) of section 107 of the Family

12 and Medical Leave Act of 1993 (29 U.S.C. 2617)

13 for the purpose of public agency enforcement of any

14 alleged violation of subsection (e) against any em15 ployer.

16 (2) PRIVATE ENFORCEMENT.—The remedies

17 and procedures set forth in section 107(a) of the

18 Family and Medical Leave Act of 1993 (29 U.S.C.

19 2617(a)) shall be the remedies and procedures pur20 suant to which an employee may initiate a legal ac21 tion against an employer for alleged violations of

22 subsection (e).

23 (3) REFERENCES.—For purposes of paragraph

24 (1) and (2), references in section 107 of the Family

25 and Medical Leave Act of 1993 (29 U.S.C. 2617) to
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1 section 105 of such Act (29 U.S.C. 2615) shall be

2 considered to be references to subsection (e).

3 (4) EMPLOYER LIABILITY UNDER OTHER

4 LAWS.—Nothing in this section shall be construed to

5 limit the liability of an employer to an employee for

6 harm suffered relating to the employee’s experience

7 of domestic violence pursuant to any other Federal

8 or State law, including a law providing for a legal

9 remedy.

10 Subtitle D—Federal Employees

11 Paid Parental Leave

12 SEC. 541. SHORT TITLE.

13 This subtitle may be cited as the ‘‘Federal Employees

14 Paid Parental Leave Act of 2003’’.

15 SEC. 542. DEMONSTRATION PROJECT.

16 Subchapter V of chapter 63 of title 5, United States

17 Code, is amended—

18 (1) by redesignating section 6387 as section

19 6388; and

20 (2) by inserting after section 6386 the fol21 lowing:

22 ‘‘§ 6387. Paid leave demonstration project

23 ‘‘(a) The Office of Personnel Management may,

24 through an agreement or contract with 1 or more employ25 ing agencies described in subsection (b), conduct under
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1 section 4703 a demonstration project that assists families

2 by providing paid leave for eligible individuals who are re3 sponding to—

4 ‘‘(1) caregiving needs resulting from the birth

5 or adoption of a son or daughter; or

6 ‘‘(2) other family caregiving needs.

7 ‘‘(b) In carrying out a project under this section, an

8 employing agency of 1 or more employees shall provide

9 partial or full paid leave to eligible individuals for not less

10 than 6 weeks during a period of leave, or an absence from

11 employment, described in subsection (c)(2), during any

12 12-month period. Paid leave available to an individual

13 under this subsection shall be in addition to any annual

14 or sick leave that the individual may elect to use during

15 a period of leave, or an absence from employment, de16 scribed in subsection (c)(2), during any 12-month period.

17 ‘‘(c) To be eligible to receive paid leave under sub18 section (a), an individual shall—

19 ‘‘(1) be an employee who meets such eligibility

20 criteria as the Office of Personnel Management may

21 specify in a plan described in section 4703(b); and

22 ‘‘(2) be—

23 ‘‘(A) an individual who is taking leave,

24 under this subchapter, or other Federal law, for
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1 a reason described in subparagraph (A) or (B)

2 of section 6382(a)(1);

3 ‘‘(B) at the option of the Office of Per4 sonnel Management, an individual who—

5 ‘‘(i) is taking leave, under this sub6 chapter, or other Federal law, for a reason

7 described in subparagraph (C), (D), (E),

8 or (F) of section 6382(a)(1); or

9 ‘‘(ii) leaves employment, and has an

10 absence from employment, because the in11 dividual has elected to care for a son or

12 daughter under age 1; or

13 ‘‘(C) at the option of the Office of Per14 sonnel Management, an individual who has an

15 absence from employment and has other char16 acteristics specified by the Office of Personnel

17 Management in a plan described in section

18 4703(b).

19 ‘‘(d) An employing agency that provides partial or

20 full paid leave to an eligible individual under this section

21 shall notify (in a form and manner prescribed by the Of22 fice of Personnel Management) the individual that the em23 ploying agency shall count an appropriate period of leave,

24 calculated under section 6382(f), against the total amount
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1 of leave (if any) to which the employee is entitled under

2 section 6382(a)(1).

3 ‘‘(e)(1) A demonstration project conducted under this

4 section shall not be counted toward the 10-project limit

5 established in section 4703(d)(2).

6 ‘‘(2) The Office of Personnel Management may pro7 vide a waiver for the demonstration project in accordance

8 with section 4703, except that section 4703(c)(1) shall not

9 apply to such a waiver.

10 ‘‘(f)(1) There are authorized to be appropriated to

11 carry out this section $400,000,000 for fiscal year 2004

12 and such sums as may be necessary for each subsequent

13 fiscal year.

14 ‘‘(2) Funds appropriated under paragraph (1) may

15 be allocated as described in section 4704.’’.

16 SEC. 543. TECHNICAL AND CONFORMING AMENDMENTS.

17 (a) IN GENERAL.—Section 6382 of title 5, United

18 States Code, is amended by adding at the end the fol19 lowing:

20 ‘‘(f)(1) If an employing agency provides an amount

21 of full paid leave to an employee for a period under section

22 6387, the employing agency shall count an amount of

23 leave, equal to that period, against the total amount of

24 leave (if any) to which the employee is entitled under sub25 section (a)(1).
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1 ‘‘(2) If an employing agency provides an amount of

2 partial paid leave to an employee for a period under sec3 tion 6387, the employing agency shall—

4 ‘‘(A) total the amount of partial paid leave

5 provided for that period;

6 ‘‘(B) convert the total into a corresponding

7 amount of full paid leave provided for a propor8 tionately reduced period; and

9 ‘‘(C) count an amount of leave, equal to

10 the period described in subparagraph (B),

11 against the total amount of leave (if any) to

12 which the employee is entitled under subsection

13 (a)(1).’’.

14 (b) TECHNICAL AND CONFORMING AMENDMENTS.—

15 Section 6382 of title 5, United States Code, is amended—

16 (1) in subsection (c), by striking ‘‘(d),’’ and in17 serting ‘‘(d) or section 6387,’’; and

18 (2) in subsection (d), by inserting ‘‘any unpaid’’

19 after ‘‘substitute for’’.

20 (c) TABLE OF SECTIONS.—The table of sections for

21 chapter 63 of title 5, United States Code, is amended by

22 striking the item relating to section 6387 and inserting

23 the following:

‘‘6387. Paid leave demonstration project.

‘‘6388. Regulations.’’.
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1 SEC. 544. EFFECTIVE DATE.

2 The amendments made by this subtitle shall not be

3 effective with respect to any birth or placement occurring

4 before the end of the 6-month period beginning on the

5 date of enactment of this Act.

6 Subtitle E—Time for Schools

7 SEC. 551. SHORT TITLE.

8 This subtitle may be cited as the ‘‘Time for Schools

9 Act of 2003’’.

10 SEC. 552. GENERAL REQUIREMENTS FOR LEAVE.

11 (a) ENTITLEMENT TO LEAVE.—Section 102(a) of the

12 Family and Medical Leave Act of 1993 (29 U.S.C.

13 2612(a)) is amended by adding at the end the following:

14 ‘‘(3) ENTITLEMENT TO SCHOOL INVOLVEMENT

15 LEAVE.—

16 ‘‘(A) IN GENERAL.—Subject to section

17 103(h), an eligible employee shall be entitled to

18 a total of 24 hours of leave during any 12-

19 month period to participate in an academic ac20 tivity of a school of a son or daughter of the

21 employee, such as a parent-teacher conference

22 or an interview for a school, or to participate in

23 literacy training under a family literacy pro24 gram.

25 ‘‘(B) DEFINITIONS.—In this paragraph:
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1 ‘‘(i) FAMILY LITERACY PROGRAM.—

2 The term ‘family literacy program’ means

3 a program of services that are of sufficient

4 intensity in terms of hours, and of suffi5 cient duration, to make sustainable

6 changes in a family and that integrate all

7 of the following activities:

8 ‘‘(I) Interactive literacy activities

9 between parents and their sons and

10 daughters.

11 ‘‘(II) Training for parents on

12 how to be the primary teacher for

13 their sons and daughters and full

14 partners in the education of their sons

15 and daughters.

16 ‘‘(III) Parent literacy training.

17 ‘‘(IV) An age-appropriate edu18 cation program for sons and daugh19 ters.

20 ‘‘(ii) LITERACY.—The term ‘literacy’,

21 used with respect to an individual, means

22 the ability of the individual to speak, read,

23 and write English, and compute and solve

24 problems, at levels of proficiency

25 necessary—
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1 ‘‘(I) to function on the job, in the

2 family of the individual, and in soci3 ety;

4 ‘‘(II) to achieve the goals of the

5 individual; and

6 ‘‘(III) to develop the knowledge

7 potential of the individual.

8 ‘‘(iii) SCHOOL.—The term ‘school’

9 means an elementary school or secondary

10 school (as such terms are defined in sec11 tion 9101 of the Elementary and Sec12 ondary Education Act of 1965 (20 U.S.C.

13 7801)), a Head Start program assisted

14 under the Head Start Act (42 U.S.C. 9831

15 et seq.), and a child care facility operated

16 by a provider who meets the applicable

17 State or local government licensing, certifi18 cation, approval, or registration require19 ments, if any.

20 ‘‘(4) LIMITATION.—No employee may take

21 more than a total of 12 workweeks of leave under

22 paragraphs (1) and (3) during any 12-month pe23 riod.’’.

24 (b) SCHEDULE.—Section 102(b)(1) of such Act (29

25 U.S.C. 2612(b)(1)) is amended by inserting after the sec-
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1 ond sentence the following: ‘‘Leave under subsection

2 (a)(3) may be taken intermittently or on a reduced leave

3 schedule.’’.

4 (c) SUBSTITUTION OF PAID LEAVE.—Section

5 102(d)(2)(A) of such Act (29 U.S.C. 2612(d)(2)(A)) is

6 amended by inserting before the period the following: ‘‘,

7 or for leave provided under subsection (a)(3) for any part

8 of the 24-hour period of such leave under such sub9 section’’.

10 (d) NOTICE.—Section 102(e) of such Act (29 U.S.C.

11 2612(e)) is amended by adding at the end the following:

12 ‘‘(3) NOTICE FOR SCHOOL INVOLVEMENT

13 LEAVE.—In any case in which the necessity for leave

14 under subsection (a)(3) is foreseeable, the employee

15 shall provide the employer with not less than 7 days’

16 notice, before the date the leave is to begin, of the

17 employee’s intention to take leave under such sub18 section. If the necessity for the leave is not foresee19 able, the employee shall provide such notice as is

20 practicable.’’.

21 (e) CERTIFICATION.—Section 103 of such Act (29

22 U.S.C. 2613), as amended by section 531(c), is further

23 amended by adding at the end the following:

24 ‘‘(h) CERTIFICATION FOR SCHOOL INVOLVEMENT

25 LEAVE.—An employer may require that a request for
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1 leave under section 102(a)(3) be supported by a certifi2 cation issued at such time and in such manner as the Sec3 retary may by regulation prescribe.’’.

4 SEC. 553. SCHOOL INVOLVEMENT LEAVE FOR CIVIL SERV5 ICE EMPLOYEES.

6 (a) ENTITLEMENT TO LEAVE.—Section 6382(a) of

7 title 5, United States Code, is amended by adding at the

8 end the following:

9 ‘‘(3)(A) Subject to section 6383(h), an employee shall

10 be entitled to a total of 24 hours of leave during any 12-

11 month period to participate in an academic activity of a

12 school of a son or daughter of the employee, such as a

13 parent-teacher conference or an interview for a school, or

14 to participate in literacy training under a family literacy

15 program.

16 ‘‘(B) In this paragraph:

17 ‘‘(i) The term ‘family literacy program’ means

18 a program of services that are of sufficient intensity

19 in terms of hours, and of sufficient duration, to

20 make sustainable changes in a family and that inte21 grate all of the following activities:

22 ‘‘(I) Interactive literacy activities between

23 parents and their sons and daughters.

24 ‘‘(II) Training for parents on how to be

25 the primary teacher for their sons and daugh-
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1 ters and full partners in the education of their

2 sons and daughters.

3 ‘‘(III) Parent literacy training.

4 ‘‘(IV) An age-appropriate education pro5 gram for sons and daughters.

6 ‘‘(ii) The term ‘literacy’, used with respect to

7 an individual, means the ability of the individual to

8 speak, read, and write English, and compute and

9 solve problems, at levels of proficiency necessary—

10 ‘‘(I) to function on the job, in the family

11 of the individual, and in society;

12 ‘‘(II) to achieve the goals of the individual;

13 and

14 ‘‘(III) to develop the knowledge potential

15 of the individual.

16 ‘‘(iii) The term ‘school’ means an elementary

17 school or secondary school (as such terms are de18 fined in section 9101 of the Elementary and Sec19 ondary Education Act of 1965 (20 U.S.C. 7801)), a

20 Head Start program assisted under the Head Start

21 Act (42 U.S.C. 9831 et seq.), and a child care facil22 ity operated by a provider who meets the applicable

23 State or local government licensing, certification, ap24 proval, or registration requirements, if any.
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1 ‘‘(4) No employee may take more than a total of 12

2 workweeks of leave under paragraphs (1) and (3) during

3 any 12-month period.’’.

4 (b) SCHEDULE.—Section 6382(b)(1) of such title is

5 amended by inserting after the second sentence the fol6 lowing: ‘‘Leave under subsection (a)(3) may be taken

7 intermittently or on a reduced leave schedule.’’.

8 (c) SUBSTITUTION OF PAID LEAVE.—Section

9 6382(d) of such title is amended by inserting before ‘‘,

10 except’’ the following: ‘‘, or for leave provided under sub11 section (a)(3) any of the employee’s accrued or accumu12 lated annual leave under subchapter I for any part of the

13 24-hour period of such leave under such subsection’’.

14 (d) NOTICE.—Section 6382(e) of such title is amend15 ed by adding at the end the following:

16 ‘‘(3) In any case in which the necessity for leave

17 under subsection (a)(3) is foreseeable, the employee shall

18 provide the employing agency with not less than 7 days’

19 notice, before the date the leave is to begin, of the employ20 ee’s intention to take leave under such subsection. If the

21 necessity for the leave is not foreseeable, the employee

22 shall provide such notice as is practicable.’’.

23 (e) CERTIFICATION.—Section 6383 of such title, as

24 amended by section 532(c), is further amended by adding

25 at the end the following:
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1 ‘‘(h) An employing agency may require that a request

2 for leave under section 6382(a)(3) be supported by a cer3 tification issued at such time and in such manner as the

4 Office of Personnel Management may by regulation pre5 scribe.’’.

6 SEC. 554. EFFECTIVE DATE.

7 This subtitle takes effect 120 days after the date of

8 enactment of this Act.

Æ