170 
(A) knowledge of age-appropriate child de-
velopment in cognitive, language, social-emo-
tional, and motor domains; 
(B) knowledge of realistic expectations of 
age-appropriate child behaviors; 
(C) knowledge of health and wellness 
issues for children and parents; 
(D) modeling, consulting, and coaching on 
parenting practices; 
(E) skills to interact with their child to en-
hance age-appropriate development; 
(F) skills to recognize and seek help for 
issues related to health, developmental delays, 
and social, emotional, and behavioral skills; and 
(G) activities designed to help parents be-
come full partners in the education of their chil-
dren. 
(2) Ascertaining what health and developmental 
services the family receives and working with these 
providers to eliminate gaps in service by offering an-
nual health, vision, hearing, and developmental 
screening for children from birth to entry into kin-
dergarten, when not otherwise provided. 
(3) Providing referrals for participating eligible 
families with a family member in the Armed Forces, 
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as needed, to additional resources available in the 
community, such as center-based early education 
programs, child care services, health or mental 
health services, family literacy programs, employ-
ment agencies, social services, and child care re-
source and referral agencies. 
(4) Offering group meetings (at program dis-
cretion), on not less frequently than a monthly basis, 
for eligible families with a family member in the 
Armed Forces that— 
(A) further enhance the information, ac-
tivities, and skill-building addressed during 
home visitation; 
(B) offer opportunities for parents to meet 
with and support each other; and 
(C) address challenges facing eligible fami-
lies with a family member in the Armed Forces. 
(5) Providing training and technical assistance 
to early childhood home visitation staff relating to— 
(A) effective service to eligible families 
with a family member in the Armed Forces; 
(B) effective methods of implementing par-
ent education, conducting home visiting, and 
promoting quality early childhood development, 
with sensitivity to cultural variations in par-
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172 
enting norms and attitudes toward formal sup-
port services; 
(C) the relationship of health and well- 
being of pregnant women to prenatal and early 
child development; 
(D) early childhood development with re-
spect to children from birth until entry into kin-
dergarten; 
(E) methods to help parents promote 
emergent literacy in their children from birth 
until entry into kindergarten; 
(F) implementing strategies for helping eli-
gible families with a family member in the 
Armed Forces coping with crisis; 
(G) recruiting, supervising, and retaining 
qualified staff; 
(H) increasing services for underserved eli-
gible families with a family member in the 
Armed Forces; 
(I) methods to help parents effectively re-
spond to their children’s needs and behaviors; 
(J) implementation of ongoing program 
quality improvement and evaluation of activities 
and outcomes; and 
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(K) the relationship of father involvement 
to the health and well-being of pregnant women 
and to prenatal and early childhood develop-
ment. 
(6) Coordinating existing programs of early 
childhood home visitation in order to effectively and 
efficiently meet the needs of more eligible families 
with a family member in the Armed Forces. 
(f) REPORTING REQUIREMENTS.—Each applicant 
that receives a grant under this section to carry out a pro-
gram shall submit an annual report to the Secretary, and 
the lead State agency as described in section 204(c)(1), 
regarding the progress of such program in addressing the 
purposes of this subtitle. Such report shall include, at a 
minimum, a description of— 
(1) actual service delivery provided under the 
grant including— 
(A) program characteristics including de-
scriptive information on the service model used 
and actual program performance; 
(B) provider characteristics including staff 
qualifications, work experience, and demo-
graphic characteristics; 
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(C) 
recipient 
characteristics 
including 
number, demographic characteristics, and fam-
ily retention; and 
(D) an estimate of annual program imple-
mentation costs; 
(2) recipient outcomes that are consistent with 
program goals including, where appropriate given 
the program being evaluated— 
(A) parental practices; 
(B) child health and development indica-
tors; 
(C) child maltreatment indicators; 
(D) school readiness indicators; and 
(E) links to community services; 
(3) the research-based instruction, materials, 
and activities being used in the activities funded 
under the grant; and 
(4) the training and technical assistance, in-
cluding ongoing professional development, provided 
to programs supported under the grant. 
(g) SUPPLEMENT NOT SUPPLANT.—Grant funds 
provided under this section shall be used to supplement, 
and not supplant, Federal and non-Federal funds available 
for carrying out the activities described in this section. 
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(h) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$20,000,000 for fiscal year 2010 and such sums as may 
be necessary for fiscal years 2011 through 2014. 
SEC. 207. EVALUATION. 
(a) IN GENERAL.—From funds reserved under sec-
tion 204(b)(1)(A), the Secretary shall conduct, through 
grant or contract, an independent evaluation of the effec-
tiveness of home visitation programs carried out under 
this subtitle. 
(b) REPORTS.— 
(1) INTERIM REPORT.—Not later than 2 years 
after the date of enactment of this subtitle, the Sec-
retary shall submit an interim report on the evalua-
tion conducted pursuant to subsection (a) to the 
Committee on Health, Education, Labor, and Pen-
sions of the Senate and the Committee on Education 
and Labor of the House of Representatives. 
(2) FINAL REPORT.—Not later than 4 years 
after the date of enactment of this subtitle, the Sec-
retary shall submit a final report on the evaluation 
conducted pursuant to subsection (a) to the commit-
tees described in paragraph (1). 
(c) STUDY.—The independent evaluation conducted 
under this section shall examine the following: 
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(2) the service delivery models funded under 
this subtitle; 
(3) program characteristics, including— 
(A) staff qualifications and demographic 
characteristics; and 
(B) recipient characteristics including the 
number of families served, the demographic 
characteristics of the families served, and fam-
ily retention and duration of services; 
(4) program-reported outcomes; 
(5) the findings from State evaluations; 
(6) the research-based instruction, materials, 
and activities being used in the activities funded 
under the grant; 
(7) the training and technical activities, includ-
ing ongoing professional development, provided to 
programs; and 
(8) the annual program implementation costs, 
including the cost per family served under the pro-
gram. 
SEC. 209. SUPPORTING NEW PARENTS THROUGH HOSPITAL 
EDUCATION. 
(a) IN GENERAL.—The Secretary shall develop and 
implement a public information and educational campaign 
to inform the public and new parents about the impor-
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tance of proper care for infants and children under 5 years 
of age, including healthy parent-child relationships, the de-
mands and stress associated with caring for infants, posi-
tive responses to infants’ challenging behaviors including 
awareness of their social, emotional, and physical needs, 
awareness of the vulnerability of young children to abusive 
practices, and the signs and treatment of post-partum de-
pression. 
(b) ELEMENTS.— 
(1) IN
GENERAL.—The campaign developed 
under subsection (a) shall include the following ele-
ments: 
(A) The dissemination of educational and 
informational materials in print, audio, video, 
electronic, and other media. 
(B) The use of public service announce-
ments and advertisements. 
(C) The dissemination of effective child 
abuse prevention practices and techniques, in-
cluding information about research-based home 
visiting programs, respite care, crisis nurseries, 
and parent support networks, to parents, care-
givers, maternity hospitals, children’s hospitals, 
pediatricians, child care centers, organizations 
providing prenatal and postnatal care, and or-
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179 
ganizations providing parenting education and 
support services. 
(D) Connection to existing parental in-
volvement programs. 
(2) EXISTING
PROGRAMS.—The Secretary, in 
implementing and executing the public information 
and educational campaign under this section, should 
seek collaboration with and referrals to existing pa-
rental involvement programs that specialize in 
strengthening children’s cognitive skills, early lit-
eracy skills, social or emotional and physical develop-
ment and existing prenatal and early childhood home 
visitation programs. 
(3) EXISTING
STATE
REQUIREMENTS.—The 
Secretary, in implementing and executing the public 
information and educational campaign under this 
section, shall consider with pre-existing State re-
quirements to ensure that no unnecessary burdens 
are placed on hospitals, military hospitals, and birth 
centers receiving educational materials. 
(c) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for fiscal years 2010 
through 2014. 
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180 
Subtitle B—Care for Young 
Children 
SEC. 215. EXPANDING CHILD CARE FOR YOUNG CHILDREN. 
(a) GOALS.—Section 658A(b) of the Child Care and 
Development Block Grant Act of 1990 (42 U.S.C. 9801 
note) is amended— 
(1) in paragraph (4), by striking ‘‘and’’; 
(2) in paragraph (5), by striking the period and 
inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(6) to assist States in improving child care 
services for young children.’’. 
(b) AUTHORIZATION OF APPROPRIATIONS.—Section 
658B of the Child Care and Development Block Grant Act 
of 1990 (42 U.S.C. 9858) is amended— 
(1) by striking ‘‘There’’ and inserting ‘‘(a) In 
General.—There’’; and 
(2) by adding at the end the following: 
‘‘(b) CHILD CARE ACTIVITIES FOR YOUNG CHIL-
DREN.—In addition to amounts appropriated under sub-
section (a), there is authorized to be appropriated to carry 
out child care activities for young children under this sub-
chapter $500,000,000 for each of the fiscal years 2008, 
2009, and 2010.’’. 
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181 
(c) CHILD CARE ACTIVITIES
FOR YOUNG CHIL-
DREN.—The Child Care and Development Block Grant 
Act of 1990 (42 U.S.C. 9801 et seq.) is amended by in-
serting after section 658G the following: 
‘‘SEC. 658H. CHILD CARE ACTIVITIES FOR YOUNG CHIL-
DREN. 
‘‘Child care activities for young children for which 
funds under this subchapter may be used include activities 
that are designed to accomplish the following: 
‘‘(1) Increase the availability of child care serv-
ices for young children with disabilities. 
‘‘(2) Provide support services for networks of 
family child care providers. 
‘‘(3) Provide or support programs that provide 
training, services, materials, equipment, or other 
support to caregivers, eligible child care providers, 
and family child care providers that provide child 
care to young children. Such support may include 
the purchase of equipment such as cribs and high 
chairs. 
‘‘(4) Provide funds to increase compensation of-
fered and provide bonuses to caregivers, eligible 
child care providers, and family child care providers 
who provide child care to children under the age of 
3 years, especially those caregivers and providers 
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182 
who have formal education in early childhood devel-
opment. 
‘‘(5) Provide and support networks between 
health care providers and caregivers, eligible child 
care providers, and family child care providers that 
provide child care to young children. 
‘‘(6) Provide child care services for young chil-
dren who are enrolled in Head Start programs under 
the Head Start Act (42 U.S.C. 9831 et seq.).’’. 
(d) DEFINITIONS.—Section 658P of the Child Care 
and Development Block Grant Act of 1990 (42 U.S.C. 
9858n) is amended by adding at the end the following: 
‘‘(15) YOUNG
CHILDREN.—The term ‘young 
children’ means eligible children who are less than 3 
years of age.’’. 
Subtitle C—Improving Child Care 
Quality Through Teacher Incen-
tives 
SEC. 221. PURPOSE. 
The purposes of this subtitle are— 
(1) to establish the Child Care Provider Devel-
opment and Retention Grant Program, the Child 
Care Provider Scholarship Program, and a program 
of child care provider health benefits coverage; and 
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(2) to help children receive the high quality 
child care and early education the children need for 
positive cognitive and social development, by reward-
ing and promoting the retention of committed, quali-
fied child care providers and by providing financial 
assistance to improve the educational qualifications 
of child care providers. 
SEC. 222. DEFINITIONS. 
In this subtitle: 
(1) CHILD CARE PROVIDER.—The term ‘‘child 
care provider’’ means an individual who provides a 
service directly to a child on a person-to-person basis 
for compensation for— 
(A) a center-based child care provider that 
is licensed or regulated under State or local law 
and that satisfies the State and local require-
ments applicable to the child care services pro-
vided; 
(B) a licensed or regulated family child 
care provider that satisfies the State and local 
requirements applicable to the child care serv-
ices provided; or 
(C) an out-of-school time program that is 
licensed or regulated under State or local law 
and that satisfies the State and local require-
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184 
ments applicable to the child care services pro-
vided. 
(2) FAMILY CHILD CARE PROVIDER.—The term 
‘‘family child care provider’’ has the meaning given 
such term in section 658P of the Child Care and 
Development Block Grant Act of 1990 (42 U.S.C. 
9858n). 
(3) INDIAN TRIBE.—The term ‘‘Indian tribe’’ 
has the meaning given such term in section 4 of the 
Indian Self-Determination and Education Assistance 
Act (25 U.S.C. 450b). 
(4) LEAD AGENCY.—The term ‘‘lead agency’’ 
means the agency designated under section 658D of 
the Child Care and Development Block Grant Act of 
1990 (42 U.S.C. 9858b). 
(5) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(6) STATE.—The term ‘‘State’’ means any of 
the several States, the District of Columbia, the 
Commonwealth of Puerto Rico, the Virgin Islands of 
the United States, Guam, American Samoa, or the 
Commonwealth of the Northern Mariana Islands. 
(7) TRIBAL ORGANIZATION.—The term ‘‘tribal 
organization’’ has the meaning given the term in 
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section 4 of the Indian Self-Determination and Edu-
cation Assistance Act (25 U.S.C. 450b). 
SEC. 223. FUNDS FOR CHILD CARE PROVIDER DEVELOP-
MENT AND RETENTION GRANTS, SCHOLAR-
SHIPS, AND HEALTH BENEFITS COVERAGE. 
(a) IN GENERAL.—From amounts appropriated to 
carry out this subtitle, the Secretary may allot and dis-
tribute funds to eligible States, and make payments to In-
dian tribes and tribal organizations, to pay for the Federal 
share of the cost of carrying out activities under sections 
226, 227, and 228 for eligible child care providers. 
(b) ALLOTMENTS.—The funds shall be allotted and 
distributed, and the payments shall be made, by the Sec-
retary in accordance with section 224, and expended by 
the States (directly, or at the option of the States, through 
units of general purpose local government), and by Indian 
tribes and tribal organizations, in accordance with this 
subtitle. 
SEC. 224. ALLOTMENTS TO STATES. 
(a) AMOUNTS RESERVED.— 
(1) TERRITORIES AND POSSESSIONS.—The Sec-
retary shall reserve not more than 1⁄2 of 1 percent 
of the funds appropriated under section 231(a), and 
not more than 1⁄2 of 1 percent of the funds appro-
priated under section 232(b), for any fiscal year for 
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186 
payments to the Virgin Islands of the United States, 
Guam, American Samoa, and the Commonwealth of 
the Northern Mariana Islands, to be allotted in ac-
cordance with their respective needs. 
(2) INDIAN
TRIBES
AND
TRIBAL
ORGANIZA-
TIONS.—The Secretary shall reserve not more than 
3 percent of the funds appropriated under section 
231(a), and not more than 3 percent of the funds 
appropriated under section 231(b), for any fiscal 
year for payments to Indian tribes and tribal organi-
zations with applications approved under subsection 
(c). 
(b) ALLOTMENTS TO REMAINING STATES.— 
(1) GENERAL
AUTHORITY.—From the funds 
appropriated under section 231(a) for any fiscal year 
and remaining after the reservations made under 
subsection (a), and from the funds appropriated 
under section 231(b) for any fiscal year and remain-
ing after the reservations made under subsection (a), 
the Secretary shall allot to each State an amount 
equal to the sum of— 
(A) an amount that bears the same ratio 
to 50 percent of the appropriate remainder as 
the product of the young child factor of the 
State and the allotment percentage of the State 
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bears to the sum of the corresponding products 
for all States; and 
(B) an amount that bears the same ratio 
to 50 percent of such remainder as the product 
of the school lunch factor of the State and the 
allotment percentage of the State bears to the 
sum of the corresponding products for all 
States. 
(2) YOUNG CHILD FACTOR.—In this subsection, 
the term ‘‘young child factor’’ means the ratio of the 
number of children under 5 years of age in the State 
to the number of such children in all the States, as 
determined according to the most recent annual esti-
mates of population in the States, as provided by the 
Bureau of the Census. 
(3) SCHOOL
LUNCH
FACTOR.—In this sub-
section, the term ‘‘school lunch factor’’ means the 
ratio of the number of children who are receiving 
free or reduced price lunches under the school lunch 
program established under the Richard B. Russell 
National School Lunch Act (42 U.S.C. 1751 et seq.) 
in the State to the number of such children in all 
the States, as determined annually by the Depart-
ment of Agriculture. 
(4) ALLOTMENT PERCENTAGE.— 
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(A) IN GENERAL.—Except as provided in 
subparagraph (B), for purposes of this sub-
section, the allotment percentage for a State 
shall be determined by dividing the per capita 
income of all individuals in the United States, 
by the per capita income of all individuals in 
the State. 
(B) LIMITATIONS.—For purposes of this 
subsection, if an allotment percentage deter-
mined under subparagraph (A)— 
(i) is more than 1.2 percent, the allot-
ment percentage of that State shall be con-
sidered to be 1.2 percent; and 
(ii) is less than 0.8 percent, the allot-
ment percentage of the State shall be con-
sidered to be 0.8 percent. 
(C) PER CAPITA INCOME.—For purposes 
of subparagraph (A), per capita income shall 
be— 
(i) determined at 2-year intervals; 
(ii) applied for the 2-year period be-
ginning on October 1 of the first fiscal 
year beginning after the date such deter-
mination is made; and 
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(iii) equal to the average of the an-
nual per capita incomes for the most re-
cent period of 3 consecutive years for 
which satisfactory data are available from 
the Department of Commerce at the time 
such determination is made. 
(c) PAYMENTS TO INDIAN TRIBES AND TRIBAL OR-
GANIZATIONS.— 
(1) RESERVATION OF FUNDS.—From amounts 
reserved under subsection (a)(2), the Secretary may 
make grants to or enter into contracts with Indian 
tribes and tribal organizations that submit applica-
tions under this subsection, to plan and carry out 
programs and activities— 
(A) to encourage child care providers to 
improve their qualifications; 
(B) to retain qualified child care providers 
in the child care field; and 
(C) to provide health benefits coverage for 
child care providers. 
(2) APPLICATIONS
AND
REQUIREMENTS.—To 
be eligible to receive a grant or contract under this 
subsection, an Indian tribe or tribal organization 
shall submit an application to the Secretary at such 
time, in such manner, and containing such informa-
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tion as the Secretary may require. The application 
shall provide that the applicant— 
(A) will coordinate the programs and ac-
tivities involved, to the maximum extent prac-
ticable, with the lead agency in each State in 
which the applicant will carry out such pro-
grams and activities; and 
(B) will make such reports on, and conduct 
such audits of the funds made available through 
the grant or contract for, programs and activi-
ties under this subtitle as the Secretary may re-
quire. 
(d) DATA AND INFORMATION.—The Secretary shall 
obtain from each appropriate Federal agency, the most re-
cent data and information necessary to determine the al-
lotments provided for in subsection (b). 
(e) REALLOTMENTS.— 
(1) IN GENERAL.—Any portion of an allotment 
under subsection (b) to a State for a fiscal year that 
the Secretary determines will not be distributed to 
the State for such fiscal year shall be reallotted by 
the Secretary to other States in proportion to the 
original corresponding allotments made under such 
subsection to such States for such fiscal year. 
(2) LIMITATIONS.— 
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(A) REDUCTION.—The amount of any re-
allotment to which a State is entitled under this 
subsection shall be reduced to the extent that 
such amount exceeds the amount that the Sec-
retary estimates will be distributed to the State 
to carry out corresponding activities under this 
subtitle. 
(B) REALLOTMENTS.—The amount of 
such reduction shall be reallotted to States for 
which no reduction in a corresponding allot-
ment, or in a corresponding reallotment, is re-
quired by this subsection, in proportion to the 
original corresponding allotments made under 
subsection (b) to such States for such fiscal 
year. 
(3) AMOUNTS REALLOTTED.—For purposes of 
this subtitle (other than this subsection and sub-
section (b)), any amount reallotted to a State under 
this subsection shall be considered to be part of the 
corresponding allotment made under subsection (b) 
to the State. 
(4) INDIAN
TRIBES
OR
TRIBAL
ORGANIZA-
TIONS.—Any portion of a grant or contract made to 
an Indian tribe or tribal organization under sub-
section (c) that the Secretary determines is not 
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192 
being used in a manner consistent with the provi-
sions of this subtitle in the period for which the 
grant or contract is made available, shall be used by 
the Secretary to make payments to other tribes or 
organizations that have submitted applications under 
subsection (c) in accordance with their respective 
needs. 
(f) COST-SHARING.— 
(1) CHILD CARE PROVIDER DEVELOPMENT AND 
RETENTION GRANTS AND SCHOLARSHIPS.— 
(A) FEDERAL SHARE.—The Federal share 
of the cost of carrying out activities under sec-
tions 226 and 227, with funds allotted under 
this section and distributed by the Secretary to 
a State, shall be— 
(i) not more than 90 percent of the 
cost of each grant made under such sec-
tions, in the first fiscal year for which the 
State receives such funds; 
(ii) not more than 85 percent of the 
cost of each grant made under such sec-
tions, in the second fiscal year for which 
the State receives such funds; 
(iii) not more than 80 percent of the 
cost of each grant made under such sec-
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193 
tions, in the third fiscal year for which the 
State receives such funds; and 
(iv) not more than 75 percent of the 
cost of each grant made under such sec-
tions, in any subsequent fiscal year for 
which the State receives such funds. 
(B) NON-FEDERAL SHARE.— 
(i) IN GENERAL.—The State may pro-
vide the non-Federal share of the cost in 
cash or in the form of an in-kind contribu-
tion, fairly evaluated by the Secretary. 
(ii) IN-KIND CONTRIBUTION.—In this 
subparagraph, the term ‘‘in-kind contribu-
tion’’ means payment of the costs of par-
ticipation of eligible child care providers in 
health insurance programs or retirement 
programs. 
(2) CHILD CARE PROVIDER HEALTH BENEFITS 
COVERAGE.— 
(A) FEDERAL SHARE.—The Federal share 
of the cost of carrying out activities under sec-
tion 228, with funds allotted under this section 
and distributed by the Secretary to a State, 
shall be not more than 50 percent of such cost. 
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(B) NON-FEDERAL
SHARE.—The State 
may provide the non-Federal share of the cost 
in cash or in kind, fairly evaluated by the Sec-
retary, including plant, equipment, or services. 
The State shall provide the non-Federal share 
directly or through donations from public or 
private entities. Amounts provided by the Fed-
eral Government, or services assisted or sub-
sidized to any significant extent by the Federal 
Government, may not be included in deter-
mining the amount of such share. 
(g) AVAILABILITY OF ALLOTTED FUNDS DISTRIB-
UTED TO STATES.—Of the funds allotted under this sec-
tion for activities described in sections 226 and 227 and 
distributed by the Secretary to a State for a fiscal year— 
(1) not less than 67.5 percent shall be available 
to the State for grants under section 226; 
(2) not less than 22.5 percent shall be available 
to the State for grants under section 227; and 
(3) not more than 10 percent shall be available 
to pay administrative costs incurred by the State to 
carry out activities described in sections 226 and 
227. 
(h) DEFINITION.—For the purposes of subsections 
(a) through (e), the term ‘‘State’’ includes only the 50 
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States, the District of Columbia, and the Commonwealth 
of Puerto Rico. 
SEC. 225. APPLICATION AND PLAN. 
(a) APPLICATION.—To be eligible to receive a dis-
tribution of funds allotted under section 224, a State shall 
submit to the Secretary an application at such time, in 
such manner, and containing such information as the Sec-
retary may require by rule and shall include in such appli-
cation— 
(1) a State plan that satisfies the requirements 
of subsection (b); and 
(2) assurances of compliance satisfactory to the 
Secretary with respect to the requirements of section 
228. 
(b) REQUIREMENTS OF PLAN.— 
(1) LEAD AGENCY.—The State plan shall iden-
tify the lead agency to make grants under this sub-
title for the State. 
(2) RECRUITMENT AND RETENTION OF CHILD 
CARE
PROVIDERS.—The State plan shall describe 
how the lead agency will encourage both the recruit-
ment of qualified child care providers who are new 
to the child care field and the retention of qualified 
child care providers who have a demonstrated com-
mitment to the child care field. 
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(3) NOTIFICATION OF AVAILABILITY OF GRANTS 
AND BENEFITS.—The State plan shall describe how 
the lead agency will identify all eligible child care 
providers in the State and notify the providers of the 
availability of grants and benefits under this sub-
title. 
(4) DISTRIBUTION
OF
GRANTS.—The State 
plan shall describe how the lead agency will make 
grants under sections 226 and 227 to eligible child 
care providers in selected geographical areas in the 
State in compliance with the following requirements: 
(A) 
SELECTION
OF
GEOGRAPHICAL 
AREAS.—For the purpose of making such 
grants for a fiscal year, the State shall— 
(i) select a variety of geographical 
areas, determined by the State, that, col-
lectively— 
(I) include urban areas, suburban 
areas, and rural areas; and 
(II) are areas whose residents 
have diverse income levels; and 
(ii) give special consideration to geo-
graphical areas selected under this sub-
paragraph for the preceding fiscal year. 
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197 
(B) SELECTION
OF
CHILD
CARE
PRO-
VIDERS
TO
RECEIVE
GRANTS.—In making 
grants under section 226, the State may make 
grants only to eligible child care providers in 
geographical areas selected under subparagraph 
(A), but may give special consideration in such 
areas to eligible child care providers— 
(i) who have attained a higher rel-
evant educational credential; 
(ii) who provide a specific kind of 
child care services; 
(iii) who provide child care services to 
populations who meet specific economic 
characteristics; or 
(iv) who meet such other criteria as 
the State may establish. 
(C) LIMITATION.—The State shall describe 
how the State will ensure that grants made 
under section 226 to child care providers will 
not be used to offset reductions in the com-
pensation of such providers. 
(D) REPORTING REQUIREMENT.—With re-
spect to each particular geographical area se-
lected under subparagraph (A), the State shall 
provide an assurance that the State will, for 
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198 
each fiscal year for which such State receives a 
grant under section 226— 
(i) include in the report required by 
section 229, detailed information regard-
ing— 
(I) the continuity of employment 
of the grant recipients as child care 
providers with the same employer; 
(II) with respect to each em-
ployer that employed such a grant re-
cipient, whether such employer was 
accredited by a recognized national or 
State accrediting body during the pe-
riod of employment; and 
(III) to the extent practicable 
and available to the State, the rate 
and frequency of employment turnover 
of 
qualified 
child 
care 
providers 
throughout such area, 
during the 2-year period ending on the 
deadline for submission of applications for 
grants under section 226 for that fiscal 
year; and 
(ii) provide a follow-up report, not 
later than 90 days after the end of the suc-
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ceeding fiscal year that includes informa-
tion regarding— 
(I) the continuity of employment 
of the grant recipients as child care 
providers with the same employer; 
(II) with respect to each em-
ployer that employed such a grant re-
cipient, whether such employer was 
accredited by a recognized national or 
State accrediting body during the pe-
riod of employment; and 
(III) to the extent practicable 
and available to the State, detailed in-
formation regarding the rate and fre-
quency of employment turnover of 
qualified child care providers through-
out such area, 
during the 1-year period beginning on the 
date on which the grant to the State was 
made under section 226. 
(5) CHILD CARE PROVIDER DEVELOPMENT AND 
RETENTION GRANT PROGRAM.—The State plan shall 
describe how the lead agency will determine the 
amounts of grants to be made under section 226 in 
accordance with the following requirements: 
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(A) SUFFICIENT
AMOUNTS.—The State 
shall demonstrate that the amounts of indi-
vidual grants to be made under section 226 will 
be sufficient— 
(i) to encourage child care providers 
to improve their qualifications; and 
(ii) to retain qualified child care pro-
viders in the child care field. 
(B) AMOUNTS
TO
CREDENTIALED
PRO-
VIDERS.—Such grants made to eligible child 
care providers who have a child development as-
sociate credential (or equivalent) and who are 
employed full-time to provide child care services 
shall be in an amount that is not less than 
$1,000 per year. 
(C) AMOUNTS TO PROVIDERS WITH HIGH-
ER LEVELS OF EDUCATION.—The State shall 
make such grants in amounts greater than 
$1,000 per year to eligible child care providers 
who have higher levels of education than the 
education required for a credential such as a 
child development associate credential (or equiv-
alent), according to the following requirements: 
(i) PROVIDERS WITH BACCALAUREATE 
DEGREES IN RELEVANT FIELDS.—An eligi-
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201 
ble child care provider who has a bacca-
laureate degree in the area of child devel-
opment or early child education shall re-
ceive a grant under section 226 in an 
amount that is not less than twice the 
amount of the grant that is made under 
section 226 to an eligible child care pro-
vider who has an associate of the arts de-
gree in the area of child development or 
early child education. 
(ii) PROVIDERS WITH ASSOCIATE DE-
GREES.—An eligible child care provider 
who has an associate of the arts degree in 
the area of child development or early child 
education shall receive a grant under sec-
tion 226 in an amount that is not less 
than 150 percent of the amount of the 
grant that is made under section 226 to an 
eligible child care provider who has a child 
development associate credential (or equiv-
alent) and is employed full-time to provide 
child care services. 
(iii) OTHER PROVIDERS WITH BACCA-
LAUREATE DEGREES.— 
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202 
(I) IN GENERAL.—Except as pro-
vided in subclause (II), an eligible 
child care provider who has a bacca-
laureate degree in a field other than 
child development or early child edu-
cation shall receive a grant under sec-
tion 226 in an amount equal to the 
amount of the grant that is made 
under section 226 to an eligible child 
care provider who has an associate of 
the arts degree in the area of child de-
velopment or early child education. 
(II) EXCEPTION.—If an eligible 
child care provider who has such a 
baccalaureate degree obtains addi-
tional educational training in the area 
of child development or early child 
education, as specified by the State, 
such provider shall receive a grant 
under section 226 in an amount equal 
to the amount of the grant that is 
made under section 226 to an eligible 
child care provider who has a bacca-
laureate degree specified in clause (i). 
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203 
(D) 
AMOUNTS
TO
FULL-TIME
PRO-
VIDERS.—The State shall make a grant under 
section 226 to an eligible child care provider 
who works full-time in a greater amount than 
the amount of the grant that is made under 
section 226 to an eligible child care provider 
who works part-time, based on the State defini-
tions of full-time and part-time work. 
(E) AMOUNTS
TO
EXPERIENCED
PRO-
VIDERS.—The State shall make grants under 
section 226 in progressively larger amounts to 
eligible child care providers to reflect the num-
ber of years worked as child care providers. 
(6) DISTRIBUTION OF CHILD CARE PROVIDER 
SCHOLARSHIPS.—The State plan shall describe how 
the lead agency will make grants for scholarships in 
compliance with section 227 and shall specify the 
types of educational and training programs for 
which the scholarship grants made under such sec-
tion may be used, including only programs that— 
(A) are administered by institutions of 
higher education that are eligible to participate 
in student financial assistance programs under 
title IV of the Higher Education Act of 1965 
(20 U.S.C. 1070 et seq.); and 
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204 
(B) lead to a State or nationally recog-
nized credential in the area of child develop-
ment or early child education, an associate of 
the arts degree in the area of child development 
or early child education, or a baccalaureate de-
gree in the area of child development or early 
child education. 
(7) EMPLOYER
CONTRIBUTION.—The State 
plan shall describe how the lead agency will encour-
age employers of child care providers to contribute 
to the attainment of education goals by eligible child 
care providers who receive grants under section 227. 
(8) SUPPLEMENTATION.—The State plan shall 
provide assurances that amounts received by the 
State to carry out sections 226, 227, and 228 will 
be used only to supplement, and not to supplant, 
Federal, State, and local funds otherwise available to 
support existing services and activities (as of the 
date the amounts are used) that— 
(A) encourage child care providers to im-
prove their qualifications and that promote the 
retention of qualified child care providers in the 
child care field; or 
(B) provide health benefits coverage for 
child care providers. 
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205 
SEC. 226. CHILD CARE PROVIDER DEVELOPMENT AND RE-
TENTION GRANT PROGRAM. 
(a) IN GENERAL.—A State that receives funds allot-
ted under section 224 and made available to carry out this 
section shall expend such funds to pay for the Federal 
share of the cost of making grants to eligible child care 
providers in accordance with this section, to improve the 
qualifications and promote the retention of qualified child 
care providers. 
(b) ELIGIBILITY TO RECEIVE GRANTS.—To be eligi-
ble to receive a grant under this section, a child care pro-
vider shall— 
(1) have a child development associate creden-
tial (or equivalent), an associate of the arts degree 
in the area of child development or early child edu-
cation, a baccalaureate degree in the area of child 
development or early child education, or a bacca-
laureate degree in an unrelated field; and 
(2) be employed as a child care provider for not 
less than 1 calendar year, or (if the provider is em-
ployed on the date of the eligibility determination in 
a child care program that operates for less than a 
full calendar year) the program equivalent of 1 cal-
endar year, ending on the date of the application for 
such grant, except that not more than 3 months of 
education related to child development or to early 
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206 
child education obtained during the corresponding 
calendar year may be treated as employment that 
satisfies the requirements of this paragraph. 
(c) PRESERVATION OF ELIGIBILITY.—A State shall 
not take into consideration whether a child care provider 
is receiving, may receive, or may be eligible to receive any 
funds or benefits under any other provision of this subtitle 
for purposes of selecting eligible child care providers to 
receive grants under this section. 
SEC. 227. CHILD CARE PROVIDER SCHOLARSHIP PROGRAM. 
(a) IN GENERAL.—A State that receives funds allot-
ted under section 224 and made available to carry out this 
section shall expend such funds to pay for the Federal 
share of the cost of making scholarship grants to eligible 
child care providers in accordance with this section, to im-
prove their educational qualifications to provide child care 
services. 
(b) ELIGIBILITY REQUIREMENT FOR SCHOLARSHIP 
GRANTS.—To be eligible to receive a scholarship grant 
under this section, a child care provider shall be employed 
as a child care provider for not less than 1 calendar year, 
or (if the provider is employed on the date of the eligibility 
determination in a child care program that operates for 
less than a full calendar year) the program equivalent of 
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1 calendar year, ending on the date of the application for 
such grant. 
(c) SELECTION OF GRANTEES.—For purposes of se-
lecting eligible child care providers to receive scholarship 
grants under this section and determining the amounts of 
such grants, a State shall not— 
(1) take into consideration whether a child care 
provider is receiving, may receive, or may be eligible 
to receive any funds or benefits under any other pro-
vision of this subtitle, or under any other Federal or 
State law that provides funds for educational pur-
poses; or 
(2) consider as resources of such provider any 
funds such provider is receiving, may receive, or may 
be eligible to receive under any other provision of 
this subtitle, under any other Federal or State law 
that provides funds for educational purposes, or 
from a private entity. 
(d) COST-SHARING REQUIRED.—The amount of a 
scholarship grant made under this section to an eligible 
child care provider shall be less than the cost of the edu-
cational or training program for which such grant is made. 
(e) 
ANNUAL
MAXIMUM
SCHOLARSHIP
GRANT 
AMOUNT.—The maximum aggregate dollar amount of a 
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208 
scholarship grant made by a State to an eligible child care 
provider under this section in a fiscal year shall be $1,500. 
SEC. 228. CHILD CARE PROVIDER HEALTH BENEFITS COV-
ERAGE. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Healthy Early Education Workforce Grant Program 
Act’’. 
(b) DEFINITION.—In this section, the terms ‘‘depend-
ent’’, ‘‘domestic partner’’, and ‘‘spouse’’, used with respect 
to a State, have the meanings given the terms by the 
State. 
(c) GENERAL AUTHORITY.—A State that receives 
funds allotted under section 224 and made available to 
carry out this section shall expend such funds to pay for 
the Federal share of the cost of providing access to afford-
able health benefits coverage for— 
(1) eligible child care providers; and 
(2) at the discretion of the State involved, the 
spouses, domestic partners, and dependents of such 
providers. 
(d) PERMISSIBLE ACTIVITIES.—In carrying out sub-
section (c), the State may expend such funds for any of 
the following: 
(1) To reimburse an employer of an eligible 
child care provider, or the provider, for the employ-
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er’s or provider’s share (or a portion of the share) 
of the premiums or other costs for coverage under 
group or individual health plans. 
(2) To offset the cost of enrolling eligible child 
care providers in public health benefits plans, such 
as the medicaid program under title XIX of the So-
cial Security Act (42 U.S.C. 1396 et seq.), the State 
children’s health insurance program under title XXI 
of such Act (42 U.S.C. 1397aa et seq.), or public 
employee health benefit plans. 
(3) To otherwise subsidize the cost of health 
benefits coverage for eligible child care providers. 
(e) ELIGIBILITY CRITERIA FOR HEALTH BENEFITS 
COVERAGE.—The State may establish criteria to limit the 
child care providers who may receive benefits through the 
allotment. 
(f) SELECTION OF GRANTEES.—For purposes of se-
lecting eligible child care providers to receive benefits 
under this section for a fiscal year, a State shall give— 
(1) highest priority to— 
(A) providers that meet any applicable cri-
teria established in accordance with subsection 
(e) and received such assistance during the pre-
vious fiscal year; and 
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210 
(B) at the State’s discretion, the spouses, 
domestic partners, and dependents of such pro-
viders; and 
(2) second highest priority to— 
(A) providers that meet any applicable cri-
teria established in accordance with subsection 
(e) and are accredited by the National Associa-
tion for the Education of Young Children or the 
National Association for Family Child Care; 
and 
(B) at the State’s discretion, the spouses, 
domestic partners, and dependents of such pro-
viders. 
SEC. 229. ANNUAL REPORT. 
A State that receives funds appropriated to carry out 
this subtitle for a fiscal year shall submit to the Secretary, 
not later than 90 days after the end of such fiscal year, 
a report— 
(1) specifying the uses for which the State ex-
pended such funds, and the aggregate amount of 
funds (including State funds) expended for each of 
such uses; and 
(2) containing available data relating to grants 
made and benefits provided with such funds, includ-
ing— 
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(A) the number of eligible child care pro-
viders who received such grants and benefits; 
(B) the amounts of such grants and bene-
fits; 
(C) any other information that describes or 
evaluates the effectiveness of this subtitle; 
(D) the particular geographical areas se-
lected under section 225 for the purpose of 
making such grants; 
(E) with respect to grants made under sec-
tion 226— 
(i) the number of years grant recipi-
ents have been employed as child care pro-
viders; 
(ii) the level of training and education 
of grant recipients; 
(iii) to the extent practicable and 
available to the State, detailed information 
regarding the salaries and other compensa-
tion received by grant recipients to provide 
child care services before, during, and after 
receiving such grants; 
(iv) the number of children who re-
ceived child care services provided by grant 
recipients; 
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(v) information on family demo-
graphics of such children; 
(vi) the types of settings described in 
subparagraphs (A), (B), and (C) of section 
222(1) in which grant recipients are em-
ployed; and 
(vii) the ages of the children who re-
ceived child care services provided by grant 
recipients; 
(F) with respect to grants made under sec-
tion 227— 
(i) the number of years grant recipi-
ents have been employed as child care pro-
viders; 
(ii) the level of training and education 
of grant recipients; 
(iii) to the extent practicable and 
available to the State, detailed information 
regarding the salaries and other compensa-
tion received by grant recipients to provide 
child care services before, during, and after 
receiving such grants; 
(iv) the types of settings described in 
subparagraphs (A), (B), and (C) of section 
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222(1) in which grant recipients are em-
ployed; 
(v) the ages of the children who re-
ceived child care services provided by grant 
recipients; 
(vi) the number of course credits or 
credentials obtained by grant recipients; 
and 
(vii) the amount of time taken for 
completion of the educational and training 
programs for which such grants were 
made; and 
(G) such other information as the Sec-
retary may require by rule. 
SEC. 230. EVALUATION OF HEALTH BENEFITS PROGRAMS 
BY SECRETARY. 
(a) EVALUATION.—The Secretary shall conduct an 
evaluation of several State programs carried out with 
grants made under section 228, representing various ap-
proaches to raising the rate of child care providers with 
health benefits coverage. 
(b) ASSESSMENT OF IMPACTS.—In evaluating State 
programs under subsection (a), the Secretary may con-
sider any information appropriate to measure the success 
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of the programs, and shall assess the impact of the pro-
grams on the following: 
(1) The rate of child care providers with health 
benefits coverage. 
(2) The take-up rate by eligible child care pro-
viders. 
(3) The turnover rate in the child care field. 
(4) The average wages paid to a child care pro-
vider. 
(c) REPORT.—Not later than 3 years after the date 
of enactment of this subtitle, the Secretary shall prepare 
and submit a report to Congress containing the results 
of the evaluation conducted under subsection (a), together 
with recommendations for strengthening programs carried 
out with grants made under section 228. 
SEC. 231. AUTHORIZATION OF APPROPRIATIONS. 
(a) CHILD CARE PROVIDER DEVELOPMENT, RETEN-
TION, AND SCHOLARSHIPS.—There are authorized to be 
appropriated to carry out the activities described in sec-
tions 226 and 227 $500,000,000 for fiscal year 2008 and 
such sums as may be necessary for each of fiscal years 
2008 through 2012. 
(b) CHILD CARE PROVIDER HEALTH BENEFITS COV-
ERAGE.—There is authorized to be appropriated to carry 
out the activities described in section 228 $200,000,000 
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for fiscal year 2007 and such sums as may be necessary 
for each of fiscal years 2008 through 2012. 
Subtitle D—Child Care Facilities 
Financing 
SEC. 241. SHORT TITLE. 
This subtitle may be cited as the ‘‘Child Care Facili-
ties Financing Act of 2009’’. 
SEC. 
242. 
TECHNICAL 
AND 
FINANCIAL 
ASSISTANCE 
GRANTS. 
(a) GRANT AUTHORITY.—The Secretary may make 
grants on a competitive basis to eligible entities in accord-
ance with this section. 
(b) APPLICATION.— 
(1) IN GENERAL.—To be eligible to receive a 
grant under subsection (a), an eligible entity shall 
submit to the Secretary an application at such time, 
in such form, and containing such information as 
the Secretary may require by rule. 
(2) REQUIREMENTS.—The Secretary shall issue 
rules that take into account the experience and suc-
cess of eligible entities in attracting private financ-
ing and carrying out the types of activities for which 
grants under subsection (a) are made. 
(c) PRIORITY.—In making grants under subsection 
(a), the Secretary shall give priority to an applicant— 
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(1) that has demonstrated experience— 
(A) providing technical or financial assist-
ance for the acquisition, construction, or ren-
ovation of child care facilities; 
(B) providing technical, financial, or mana-
gerial assistance to eligible child care providers; 
and 
(C) securing private sources of capital fi-
nancing for child care or other low-income com-
munity development; and 
(2) whose application proposes to assist eligible 
recipients that serve— 
(A) low-income areas, including— 
(i) a community that— 
(I) is in a metropolitan area; and 
(II) has a median household in-
come that is not more than 80 percent 
of the median household income of the 
metropolitan area; or 
(ii) a community that— 
(I) is not in a metropolitan area; 
and 
(II) has a median income that is 
not more than 80 percent of the me-
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dian household income of the State in 
which the community is located; or 
(B) low-income individuals, including eligi-
ble children. 
(d) USE OF FUNDS.— 
(1) CAPITAL FUND.—Each eligible entity that 
receives a grant under subsection (a) shall deposit 
the grant amount into a child care capital fund es-
tablished by the eligible entity. 
(2) PAYMENTS FROM FUNDS.—Each eligible en-
tity shall provide technical or financial assistance (in 
the form of loans, grants, investments, guarantees, 
interest subsidies, and other appropriate forms of 
assistance) to eligible recipients from the child care 
capital fund it establishes to pay for— 
(A) the acquisition, construction, or im-
provement of child care facilities; 
(B) equipment for child care facilities; or 
(C) technical assistance to eligible child 
care providers to help them undertake facilities 
improvement and expansion projects. 
(3) LOAN REPAYMENTS AND INVESTMENT PRO-
CEEDS.—An eligible entity that receives a loan re-
payment or investment proceeds from an eligible re-
cipient shall deposit such repayment or proceeds into 
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the child care capital fund of the eligible entity for 
use in accordance with this section. 
(4) APPLICATION.—To obtain assistance from 
an eligible entity, an eligible recipient shall prepare 
and submit an application to an eligible entity at 
such time, in such form, and containing such infor-
mation as the eligible entity may require. 
SEC. 243. DEFINITIONS. 
As used in this subtitle: 
(1) CHILD CARE FACILITY.—The term ‘‘child 
care facility’’ means a structure used for the care 
and development of eligible children. 
(2) CHILD CARE SERVICES.—The term ‘‘child 
care services’’ means child care and early childhood 
education. 
(3) COMMUNITY DEVELOPMENT FINANCIAL IN-
STITUTION.—The term ‘‘community development fi-
nancial institution’’ has the meaning given such 
term in section 103(5) of the Community Develop-
ment Banking and Financial Institutions Act of 
1994 (12 U.S.C. 4702(5)). 
(4) ELIGIBLE
CHILD
CARE
PROVIDER.—The 
term ‘‘eligible child care provider’’ has the meaning 
given such term in section 658P of the Child Care 
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and Development Block Grant Act of 1990 (42 
U.S.C. 9858n). 
(5) ELIGIBLE
CHILD.—The term ‘‘eligible 
child’’ has the meaning given such term in section 
658P of the Child Care and Development Block 
Grant Act of 1990 (42 U.S.C. 9858n). 
(6) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means— 
(A) a community development financial in-
stitution certified by the Department of Treas-
ury; or 
(B) an organization that— 
(i) is described in section 501(c)(3) of 
the Internal Revenue Code of 1986; 
(ii) is exempt from taxation under 
section 501(a) of such Code; and 
(iii) has demonstrated experience in— 
(I) providing technical or finan-
cial assistance for the acquisition, con-
struction, or renovation of child care 
facilities; 
(II) providing technical, financial, 
or managerial assistance to eligible 
child care providers; and 
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(III) securing private sources of 
capital financing for child care or 
other low-income community develop-
ment. 
(7) ELIGIBLE RECIPIENT.—The term ‘‘eligible 
recipient’’ means— 
(A) an eligible child care provider that pro-
vides child care services to an eligible child; 
(B) an organization seeking to provide 
child care services to an eligible child; or 
(C) an organization providing or seeking to 
provide child care services to low-income chil-
dren as determined by the Secretary. 
(8) EQUIPMENT.—The term ‘‘equipment’’ in-
cludes— 
(A) machinery, utilities, and built-in equip-
ment, and any necessary structure to house 
them; and 
(B) any other items necessary for the func-
tioning of a child care facility, including fur-
niture, books, and program materials. 
(9) METROPOLITAN AREA.—The term ‘‘metro-
politan area’’ has the meaning given such term in 
section 102 of the Housing and Community Devel-
opment Act of 1974 (42 U.S.C. 5302). 
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(10) 
SECRETARY.—The 
term 
‘‘Secretary’’ 
means the Secretary of Health and Human Services. 
SEC. 244. AUTHORIZATION OF APPROPRIATIONS. 
There is authorized to be appropriated to carry out 
this subtitle $50,000,000 for each of the fiscal years 2010 
through 2014. 
Subtitle E—Business Child Care 
Incentive Grant Program 
SEC. 251. BUSINESS CHILD CARE INCENTIVE GRANT PRO-
GRAM. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’) shall establish a program to award grants to 
States, on a competitive basis, to assist States in providing 
funds to encourage the establishment and operation of em-
ployer operated child care programs. 
(b) APPLICATION.—To be eligible to receive a grant 
under this section, a State shall prepare and submit to 
the Secretary an application at such time, in such manner, 
and containing such information as the Secretary may re-
quire, including an assurance that the funds required 
under subsection (e) will be provided. 
(c) AMOUNT OF GRANT.—The Secretary shall deter-
mine the amount of a grant to a State under this section 
based on the population of children less than 5 years of 
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age in the State as compared to the population of all 
States receiving grants under this section. 
(d) USE OF FUNDS.— 
(1) IN GENERAL.—A State shall use amounts 
provided under a grant awarded under this section 
to provide assistance to businesses located in the 
State to enable the businesses to establish and oper-
ate child care programs. Such assistance may in-
clude— 
(A) technical assistance in the establish-
ment of a child care program; 
(B) assistance for the startup costs related 
to a child care program; 
(C) assistance for the training of child care 
providers; 
(D) scholarships for low-income wage earn-
ers; 
(E) the provision of services to care for 
sick children or to provide care to school aged 
children; 
(F) the entering into of contracts with 
local resource and referral or local health de-
partments; 
(G) assistance for care for children with 
disabilities; or 
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(H) assistance for any other activity deter-
mined appropriate by the State. 
(2) APPLICATION.—To be eligible to receive as-
sistance from a State under this section, a business 
shall prepare and submit to the State an application 
at such time, in such manner, and containing such 
information as the State may require. 
(3) PREFERENCE.— 
(A) IN GENERAL.—In providing assistance 
under this section, a State shall give priority to 
applicants that desire to form a consortium to 
provide child care in a geographic area within 
the State where such care is not generally avail-
able or accessible. 
(B) CONSORTIUM.—For purposes of sub-
paragraph (A), a consortium shall be made up 
of 2 or more entities that may include busi-
nesses, nonprofit agencies or organizations, 
local governments, or other appropriate entities. 
(4) LIMITATION.—With respect to grant funds 
received under this section, a State may not provide 
in excess of $100,000 in assistance from such funds 
to any single applicant. 
(e) MATCHING REQUIREMENT.—To be eligible to re-
ceive a grant under this section a State shall provide as-
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surances to the Secretary that, with respect to the costs 
to be incurred by an entity receiving assistance in carrying 
out activities under this section, the entity will make avail-
able (directly or through donations from public or private 
entities) non-Federal contributions to such costs in an 
amount equal to— 
(1) for the first fiscal year in which the entity 
receives such assistance, not less than 50 percent of 
such costs ($1 for each $1 of assistance provided to 
the entity under the grant); 
(2) for the second fiscal year in which the enti-
ty receives such assistance, not less than 662⁄3 per-
cent of such costs ($2 for each $1 of assistance pro-
vided to the entity under the grant); and 
(3) for the third fiscal year in which the entity 
receives such assistance, not less than 75 percent of 
such costs ($3 for each $1 of assistance provided to 
the entity under the grant). 
(f) REQUIREMENTS OF PROVIDERS.—To be eligible 
to receive assistance under a grant awarded under this 
section a child care provider shall comply with all applica-
ble State and local licensing and regulatory requirements 
and all applicable health and safety standards in effect 
in the State. 
(g) ADMINISTRATION.— 
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225 
(1) STATE
RESPONSIBILITY.—A State shall 
have responsibility for administering a grant award-
ed for the State under this section and for moni-
toring entities that receive assistance under such 
grant. 
(2) AUDITS.—A State shall require each entity 
receiving assistance under the grant awarded under 
this section to conduct an annual audit with respect 
to the activities of the entity. Such audits shall be 
submitted to the State. 
(3) MISUSE OF FUNDS.— 
(A) REPAYMENT.—If the State determines, 
through an audit or otherwise, that an entity 
receiving assistance under a grant awarded 
under this section has misused the assistance, 
the State shall notify the Secretary of the mis-
use. The Secretary, upon such a notification, 
may seek from such an entity the repayment of 
an amount equal to the amount of any such 
misused assistance plus interest. 
(B) APPEALS
PROCESS.—The Secretary 
shall by regulation provide for an appeals proc-
ess with respect to repayments under this para-
graph. 
(h) REPORTING REQUIREMENTS.— 
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226 
(1) 2-YEAR STUDY.— 
(A) IN GENERAL.—Not later than 2 years 
after the date on which the Secretary first 
awards grants under this section, the Secretary 
shall conduct a study to determine— 
(i) the capacity of entities to meet the 
child care needs of communities within 
States; 
(ii) the kinds of partnerships that are 
being formed with respect to child care at 
the local level to carry out programs fund-
ed under this section; and 
(iii) who is using the programs funded 
under this section and the income levels of 
such individuals. 
(B) REPORT.—Not later than 28 months 
after the date on which the Secretary first 
awards grants under this section, the Secretary 
shall prepare and submit to the appropriate 
committees of Congress a report on the results 
of the study conducted in accordance with sub-
paragraph (A). 
(2) 4-YEAR STUDY.— 
(A) IN GENERAL.—Not later than 4 years 
after the date on which the Secretary first 
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awards grants under this section, the Secretary 
shall conduct a study to determine the number 
of child care facilities funded through entities 
that received assistance through a grant award-
ed under this section that remain in operation 
and the extent to which such facilities are meet-
ing the child care needs of the individuals 
served by such facilities. 
(B) REPORT.—Not later than 52 months 
after the date on which the Secretary first 
awards grants under this section, the Secretary 
shall prepare and submit to the appropriate 
committees of Congress a report on the results 
of the study conducted in accordance with sub-
paragraph (A). 
(i) DEFINITION.—In this section, the term ‘‘busi-
ness’’ means an employer who employed an average of at 
least 2 employees on business days during the preceding 
calendar year. 
(j) AUTHORIZATION OF APPROPRIATIONS.— 
(1) IN GENERAL.—There is authorized to be 
appropriated to carry out this section, $60,000,000 
for the period of fiscal years 2008 through 2010. 
(2) EVALUATIONS
AND
ADMINISTRATION.— 
With respect to the total amount appropriated for 
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such period in accordance with this subsection, not 
more than $5,000,000 of that amount may be used 
for expenditures related to conducting evaluations 
required under, and the administration of, this sec-
tion. 
(k) TERMINATION OF PROGRAM.—The program es-
tablished under subsection (a) shall terminate on Sep-
tember 30, 2011. 
TITLE 
III—PRE-SCHOOL, 
IN- 
SCHOOL, AND AFTER SCHOOL 
ASSISTANCE 
Subtitle A—Universal 
Prekindergarten Act 
SEC. 301. SHORT TITLE. 
This subtitle may be cited as the ‘‘Universal Pre-
kindergarten Act’’. 
SEC. 302. PURPOSE. 
The purpose of this subtitle is to ensure that all chil-
dren 3, 4, and 5 years old have access to a high-quality 
full-day, full-calendar-year prekindergarten program by 
providing grants to States to assist in developing a uni-
versal prekindergarten program that is voluntary and free- 
of-charge. 
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SEC. 303. PREKINDERGARTEN GRANT PROGRAM AUTHOR-
IZATION. 
The Secretary of Health and Human Services, in con-
sultation with the Secretary of Education, shall provide 
grants to an agency designated by each State (hereafter 
in this subtitle referred to as the ‘‘designated State agen-
cy’’) for the development of high-quality full-day, full-cal-
endar-year universal prekindergarten programs for all 
children 3, 4, and 5 years old in the State. 
SEC. 304. STATE REQUIREMENTS. 
(a) STATE MATCHING FUNDS.—Federal funds made 
available to a designated State agency under this subtitle 
shall be matched at least 20 percent by State funds. 
(b) STATE APPLICATION.—To be eligible to receive 
funds under this subtitle, a designated State agency shall 
submit an application at such time, in such manner, and 
containing such information as the Secretary of Health 
and Human Services may require. The application shall 
include the following: 
(1) How the designated State agency, in over-
seeing the State’s universal prekindergarten pro-
gram, will coordinate with other State agencies re-
sponsible for early childhood education and health 
programs. 
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(2) A State plan to establish and implement a 
statewide universal prekindergarten program, in ac-
cordance with subsection (c). 
(c) STATE PLAN.—The State plan required under 
subsection (b)(2) shall include each of the following: 
(1) A description of the universal prekinder-
garten program that will be established and how it 
will support children’s cognitive, social, emotional, 
and physical development. 
(2) A statement of the goals for universal pre-
kindergarten programs and how program outcomes 
will be measured. 
(3) A description of— 
(A) how funding will be distributed to eli-
gible prekindergarten program providers based 
on the need for early childhood education in 
each geographical area served by such pro-
viders; and 
(B) how the designated State agency will 
involve representatives of early childhood pro-
gram providers (including child care providers, 
Head Start programs, and State and local 
agencies) that sponsor programs addressing 
children 3, 4, and 5 years old. 
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(4) A description of how the designated State 
agency will coordinate with existing State-funded 
prekindergarten programs, federally funded pro-
grams (such as Head Start programs), public school 
programs, and child care providers. 
(5) A description of how an eligible prekinder-
garten program provider may apply to the des-
ignated State agency for funding under this Act. 
(6) A plan to address the shortages of qualified 
early childhood education teachers, including how to 
increase such teachers’ compensation to be com-
parable to that of public school teachers. 
(7) How the designated State agency will pro-
vide ongoing professional development opportunities 
to help increase the number of teachers in early 
childhood programs who meet the State’s education 
or credential requirements for prekindergarten 
teachers. 
(8) A plan to address how the universal pre-
kindergarten program will meet the needs of chil-
dren with disabilities, limited English proficiency, 
and other special needs. 
(9) A plan to provide transportation to children 
to and from the universal prekindergarten program. 
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(10) A description of how the State will provide 
the 20 percent match of Federal funds. 
(d) ADMINISTRATION.—A designated State agency 
may not use more than 5 percent of a grant under this 
subtitle for costs associated with State administration of 
the program under this subtitle. 
SEC. 305. LOCAL REQUIREMENTS. 
(a) IN GENERAL.—An eligible prekindergarten pro-
gram provider receiving funding under this subtitle 
shall— 
(1) maintain a maximum class size of 20 chil-
dren; 
(2) maintain a ratio of not more than 10 chil-
dren for each member of the teaching staff; 
(3)(A) ensure that all prekindergarten teachers 
meet the requirements for teachers at a State-fund-
ed prekindergarten program under an applicable 
State law; and 
(B) document that the State is demonstrating 
significant progress in assisting prekindergarten 
teachers on working toward a bachelor of arts de-
gree with training in early childhood development or 
early childhood education; 
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(4)(A) be accredited by a national organization 
with demonstrated experience in accrediting pre-
kindergarten programs; or 
(B) provide assurances that it shall obtain such 
accreditation not later than 3 years after first re-
ceiving funding under this subtitle; and 
(5) meet applicable State and local child care li-
censing health and safety standards. 
(b) LOCAL APPLICATION.—Eligible prekindergarten 
program providers desiring to receive funding under this 
subtitle shall submit an application to the designated 
State agency overseeing funds under this subtitle con-
taining the following: 
(1) A description of the prekindergarten pro-
gram. 
(2) A statement of the demonstrated need for 
a program, or an enhanced or expanded program, in 
the area served by the eligible prekindergarten pro-
gram provider. 
(3) A description of the age-appropriate and de-
velopmentally appropriate educational curriculum to 
be provided that will help children be ready for 
school and assist them in the transition to kinder-
garten. 
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(4) A description of how the eligible prekinder-
garten program provider will collaborate with exist-
ing community-based child care providers and Head 
Start programs. 
(5) A description of how students and families 
will be assisted in obtaining supportive services 
available in their communities. 
(6) A plan to promote parental involvement in 
the prekindergarten program. 
(7) A description of how teachers will receive 
ongoing professional development in early childhood 
development and education. 
(8) An assurance that prekindergarten pro-
grams receiving funds under this subtitle provide the 
data required in section 7(c). 
SEC. 306. PROFESSIONAL DEVELOPMENT SET-ASIDE. 
(a) IN GENERAL.—A designated State agency may 
set aside up to 5 percent of a grant under this subtitle 
for ongoing professional development activities for teach-
ers and staff at prekindergarten programs that wish to 
participate in the universal prekindergarten grant pro-
gram under this subtitle. A designated State agency using 
the set-aside for professional development must include in 
its application the following: 
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235 
(1) A description of how the designated State 
agency will ensure that eligible prekindergarten pro-
gram providers in a range of settings (including 
child care providers, Head Start programs, and 
schools) will participate in the professional develop-
ment programs. 
(2) An assurance that, in developing its applica-
tion and in carrying out its program, the profes-
sional development provider has consulted, and will 
consult, with relevant agencies, early childhood orga-
nizations, early childhood education experts, and 
early childhood program providers. 
(3) A description of how the designated State 
agency will ensure that the professional development 
is ongoing and accessible to educators in all geo-
graphic areas of the State, including by the use of 
advanced educational technologies. 
(4) A description of how the designated State 
agency will ensure that such set-aside funds will be 
used to pay the cost of additional education and 
training. 
(5) A description of how the designated State 
agency will work with other agencies and institutions 
of higher education to provide scholarships and 
other financial assistance to prekindergarten staff. 
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(6) A description of how the State educational 
agency will provide a financial incentive, such as a 
financial stipend or a bonus, to educators who par-
ticipate in and complete such professional develop-
ment. 
(7) A description of how the professional devel-
opment activities will be carried out, including the 
following: 
(A) How programs and educators will be 
selected to participate. 
(B) How professional development pro-
viders will be selected, based on demonstrated 
experience in providing research-based profes-
sional development to early childhood educators. 
(C) The types of research-based profes-
sional development activities that will be carried 
out in all domains of children’s physical, cog-
nitive, social, and emotional development and 
on early childhood pedagogy. 
(D) How the program will train early 
childhood educators to meet the diverse edu-
cational needs of children in the community, es-
pecially children who have limited English pro-
ficiency, disabilities, and other special needs. 
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(E) How the program will coordinate with 
and build upon, but not supplant or duplicate, 
early childhood education professional develop-
ment activities that exist in the community. 
(b) USES OF FUNDS.—Funds set aside under this 
section may be used for ongoing professional develop-
ment— 
(1) to provide prekindergarten teachers and 
staff with the knowledge and skills for the applica-
tion of recent research on child cognitive, social, 
emotional, and physical development, including lan-
guage and literacy development, and on early child-
hood pedagogy; 
(2) to provide the cost of education needed to 
obtain a credential or degree with specific training 
in early childhood development or education; 
(3) to work with children who have limited 
English proficiency, disabilities, and other special 
needs; and 
(4) to select and use developmentally appro-
priate screening and diagnostic assessments to im-
prove teaching and learning and make appropriate 
referrals for services to support prekindergarten 
children’s development and learning. 
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SEC. 307. REPORTING. 
(a) REPORT BY SECRETARY.—For each year in which 
funding is provided under this subtitle, the Secretary of 
Health and Human Services shall submit an annual report 
to the Congress on the implementation and effectiveness 
of the universal prekindergarten program under this sub-
title. 
(b) REPORT BY DESIGNATED STATE AGENCY.—Each 
designated State agency that provides grants to eligible 
prekindergarten program providers under this subtitle 
shall submit to the Secretary an annual report on the im-
plementation and effectiveness of the programs in the 
State supported under this subtitle. Such report shall con-
tain such additional information as the Secretary may rea-
sonably require. 
(c) REPORT BY GRANT RECIPIENT.—Each eligible 
prekindergarten program provider that receives a grant 
under this subtitle shall submit to the designated State 
agency an annual report that includes, with respect to the 
program supported by such grant, the following: 
(1) A description of the type of program and a 
statement of the number and ages of children served 
by the program, as well as the number and ages of 
children with a disability or a native language other 
than English. 
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(2) A description of the qualifications of the 
program staff and the type of ongoing professional 
development provided to such staff. 
(3) A statement of all sources of Federal, State, 
local, and private funds received by the program. 
(4) A description of the curricula, materials, 
and activities used by the program to support early 
childhood development and learning. 
(5) Such other information as the designated 
State agency may reasonably require. 
SEC. 308. FEDERAL FUNDS SUPPLEMENTARY. 
Funds made available under this subtitle may not be 
used to supplant other Federal, State, local, or private 
funds that would, in the absence of such Federal funds, 
be made available for the program assisted under this sub-
title. 
SEC. 309. DEFINITIONS. 
In this subtitle: 
(1) The term ‘‘eligible prekindergarten program 
provider’’ means a prekindergarten program pro-
vider that is— 
(A) a school; 
(B) supported, sponsored, supervised, or 
carried out by a local educational agency; 
(C) a Head Start program; or 
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(D) a child care provider. 
(2) The term ‘‘prekindergarten program’’ 
means a program serving children 3, 4, and 5 years 
old that supports children’s cognitive, social, emo-
tional, and physical development and helps prepare 
those children for the transition to kindergarten. 
(3) The term ‘‘local educational agency’’ has 
the meaning given that term in the Elementary and 
Secondary Education Act of 1965 (20 U.S.C. 6301 
et seq.). 
(4) The term ‘‘prekindergarten teacher’’ means 
an individual who has received, or is working to-
ward, a bachelor of arts degree in early childhood 
education. 
SEC. 310. AUTHORIZATION OF APPROPRIATIONS. 
There are authorized to be appropriated to carry out 
this subtitle— 
(1) $10,000,000,000 for fiscal year 2009; 
(2) $20,000,000,000 for fiscal year 2010; 
(3) $30,000,000,000 for fiscal year 2011; 
(4) $40,000,000,000 for fiscal year 2012; and 
(5) $50,000,000,000 for fiscal year 2013. 
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241 
Subtitle B—Universal Free School 
Breakfast Program 
SEC. 311. UNIVERSAL FREE SCHOOL BREAKFAST PRO-
GRAM. 
(a) FREE
BREAKFAST
AND
UNIVERSAL
ELIGI-
BILITY.—Section 4 of the Child Nutrition Act of 1966 (42 
U.S.C. 1773) is amended to read as follows: 
‘‘SEC. 4. SCHOOL BREAKFAST PROGRAM AUTHORIZATION. 
‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as are nec-
essary to enable the Secretary to carry out a program to 
assist States and the Department of Defense to initiate, 
maintain, or expand nonprofit breakfast programs to pro-
vide free breakfasts to school children without regard to 
family income in all schools which make application for 
participation and agree to carry out a nonprofit free 
breakfast program in accordance with this Act. Appropria-
tions and expenditures for this Act shall be considered 
Health and Human Services functions for budget purposes 
rather than functions of Agriculture. 
‘‘(b) APPORTIONMENT TO STATES.— 
‘‘(1)(A) IN
GENERAL.—The Secretary shall 
make breakfast payments to each State educational 
agency each fiscal year, at such times as the Sec-
retary may determine, from the sums appropriated 
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for such purpose, in an amount equal to the product 
obtained by multiplying— 
‘‘(i) the number of breakfasts served free 
during such fiscal year to children in schools in 
such States which participate in the school 
breakfast program under agreements with such 
State educational agency; by 
‘‘(ii) the national breakfast payment as 
prescribed in paragraph (2) of this subsection. 
‘‘(B) AGREEMENTS.—The agreements described 
in subparagraph (A)(i) shall be permanent agree-
ments that may be amended as necessary. Nothing 
in the preceding sentence shall be construed to limit 
the ability of the State educational agency to sus-
pend or terminate any such agreement in accordance 
with regulations prescribed by the Secretary. 
‘‘(2) NATIONAL
BREAKFAST
PAYMENT.—The 
national payment for each breakfast shall be $1.40 
(as adjusted each July 1 pursuant to section 
11(a)(3)(B) of the Richard B. Russell National 
School Lunch Act (42 U.S.C. 1759a(a)(3)(B))). 
‘‘(3) LIMITATION.—No breakfast payment may 
be made under this subsection for any breakfast 
served by a school unless such breakfast consists of 
a combination of foods which meet the minimum nu-
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tritional requirements prescribed by the Secretary 
under subsection (e) of this section. 
‘‘(4) NUTRITION QUALITY ADJUSTMENT.—The 
Secretary shall increase by 6 cents the annually ad-
justed payment for each breakfast served under this 
Act and section 17 of the Richard B. Russell Na-
tional School Lunch Act. These funds shall be used 
to assist States, to the extent feasible, in improving 
the nutritional quality of the breakfasts. 
‘‘(5) AGRICULTURAL COMMODITIES.—Notwith-
standing any other provision of law, whenever stocks 
of agricultural commodities are acquired by the Sec-
retary or the Commodity Credit Corporation and are 
not likely to be sold by the Secretary or the Com-
modity Credit Corporation or otherwise used in pro-
grams of commodity sale or distribution, the Sec-
retary shall make such commodities available to 
school food authorities and eligible institutions serv-
ing breakfasts under this Act in a quantity equal in 
value to not less than 3 cents for each breakfast 
served under this Act. 
‘‘(6) EFFECT
ON
EXPENDITURES.—Expendi-
tures of funds from State and local sources for the 
maintenance of the breakfast program shall not be 
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diminished as a result of funds or commodities re-
ceived under paragraph (4) or (5). 
‘‘(c) STATE DISBURSEMENT TO SCHOOLS.—Funds 
paid to any State during any fiscal year for the purpose 
of this section shall be disbursed by the State educational 
agency, in accordance with such agreements approved by 
the Secretary as may be entered into by such State agency 
and the schools in the State, to those schools in the State 
which the State educational agency, determines are eligi-
ble to participate in the school breakfast program. 
‘‘(d) PARTICIPATION BY SCHOOLS.— 
‘‘(1) REQUIREMENTS FOR PARTICIPATION.—To 
be eligible to participate in the school breakfast pro-
gram under this section, a school food authority 
shall— 
‘‘(A) agree to serve all breakfasts at no 
charge to all students who wish to participate 
without regard to family income in all partici-
pating schools; and 
‘‘(B) meet all other requirements that the 
Secretary may reasonably establish. 
‘‘(2) START-UP ASSISTANCE.—The Secretary is 
authorized to provide additional assistance to schools 
not participating in the school breakfast program 
prior to the enactment of the Family and Workplace 
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Balancing Act of 2009 in order to assist such 
schools to begin participation in the school breakfast 
program under this section. 
‘‘(3) STATE
EDUCATIONAL
AGENCY
ASSIST-
ANCE.—Each State educational agency shall assist 
schools not participating in the school breakfast pro-
gram prior to the enactment of the Family and 
Workplace Balancing Act of 2009 to enter into 
agreements with such agencies in order to partici-
pate in the school breakfast program under this sec-
tion. 
‘‘(e) NUTRITIONAL AND OTHER PROGRAM REQUIRE-
MENTS.— 
‘‘(1) 
MINIMUM
NUTRITIONAL
REQUIRE-
MENTS.—Breakfasts served by schools participating 
in the school breakfast program under this section 
shall consist of a combination of foods and shall 
meet minimum nutritional requirements prescribed 
by the Secretary on the basis of tested nutritional 
research, except that the minimum nutritional re-
quirements shall be measured by not less than the 
weekly average of the nutrient content of school 
breakfasts. 
‘‘(2) TECHNICAL ASSISTANCE AND TRAINING.— 
The Secretary shall provide through State edu-
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cational agencies technical assistance and training, 
including technical assistance and training in the 
preparation of foods high in complex carbohydrates 
and lower-fat versions of foods commonly used in the 
school breakfast program established under this sec-
tion, to schools participating in the school breakfast 
program to assist the schools in complying with the 
nutritional requirements prescribed by the Secretary 
pursuant to paragraph (1) and in providing appro-
priate meals to children with medically certified spe-
cial dietary needs. 
‘‘(3) OPTION VERSUS SERVE.—At the option of 
a local school food authority, a student in a school 
under the authority that participates in the school 
breakfast program under this Act may be allowed to 
refuse not more than one item of a breakfast that 
the student does not intend to consume. A refusal of 
an offered food item shall not affect the amount of 
payments made under this Act to a school for the 
breakfast.’’. 
(b) TECHNICAL AMENDMENTS.— 
(1) CHILD NUTRITION ACT OF 1966.—Section 
20 of the Child Nutrition Act of 1966 (42 U.S.C. 
1789) is amended by striking subsection (b) and re-
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designating subsections (c) through (e) as sub-
sections (b) through (d), respectively. 
(2) RICHARD B. RUSSELL NATIONAL SCHOOL 
LUNCH
ACT.—The Richard B. Russell National 
School Lunch Act is amended— 
(A) in section 11(a)(1)— 
(i) in subparagraph (C), by striking 
‘‘or breakfasts’’ each place it appears; 
(ii) in subparagraph (C)(i)(I), by 
striking ‘‘or in the case of a school’’ and 
all that follows through ‘‘4 successive 
school years’’; 
(iii) in subparagraph (D)(iii), by strik-
ing ‘‘, or for free and reduced price lunches 
and breakfasts,’’; 
(iv) in subparagraph (D)(iv), by strik-
ing ‘‘or school breakfast’’; 
(v) in subparagraph (E)(i)(I), by 
striking ‘‘or in the case of a school’’ and 
all that follows through ‘‘4 successive 
school years’’; and 
(vi) in subparagraph (E)(i)(II)— 
(I) by striking ‘‘or breakfasts’’ 
both places it appears; and 
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(II) by striking ‘‘or school break-
fast’’; 
(B) in section 11(a)(3)(A)— 
(i) by striking clause (iii); and 
(ii) by redesignating clause (iv) as 
clause (iii); 
(C) in section 13(a)(1)(C), by striking ‘‘or 
breakfasts’’; 
(D) in section 17— 
(i) in subsection (c), by striking para-
graph (2), and redesignating paragraphs 
(3) through (6) as paragraphs (2) through 
(5), respectively; and 
(ii) in subsection (f)(3)(E)(ii)(I), by 
striking ‘‘meals’’ and inserting ‘‘lunches’’; 
and 
(E) in section 18, by striking subsection 
(e) and redesignating subsections (f) through 
(k) as subsections (e) through (j), respectively. 
Subtitle C—Free Lunch Eligibility 
SECTION 321. FREE LUNCH ELIGIBILITY. 
Section 9(b)(1) of the Richard B. Russell National 
School Lunch Act (42 U.S.C. 1758(b)(1)) is amended by 
adding at the end the following: 
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