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HR 2633 IH

To improve the health of Americans and reduce health care costs by reorienting the Nation's health care system toward prevention, wellness, and self care.

June 7, 2007

Mr. UDALL of New Mexico (for himself, Mr. MORAN of Virginia, and Mr. MCGOVERN) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Labor, Oversight and Government Reform, House Administration, and Transportation and Infrastructure, 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

To improve the health of Americans and reduce health care costs by reorienting the Nation's health care system toward prevention, wellness, and self care.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title- This Act may be cited as the `Healthy Lifestyles and Prevention America Act' or the `HeLP America Act'.

(b) Table of Contents- The table of contents of this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Findings.

TITLE I--CHILDHOOD OBESITY

Sec. 101. Federal Task Force on Childhood Obesity.

TITLE II--HEALTHIER KIDS AND SCHOOLS

Sec. 201. Fresh fruit and vegetable program.

Sec. 202. Food of minimal nutritional value.

Sec. 203. School nutrition environment enhancement grants.

Sec. 204. Baby friendly hospital-center for breastfeeding excellence.

Sec. 205. Intervention to strengthen families and build children's resilience.

Sec. 206. Grants for the integration of schools and mental health systems.

Sec. 207. Grants for the promotion of university-community partnerships to increase youth competencies and reduce youth problem behaviors in communities.

Sec. 208. Reservations for Early Head Start programs.

TITLE III--HEALTHIER COMMUNITIES AND WORKPLACES

Subtitle A--Incentives for a Healthy Workforce

Sec. 301. Short title.

Sec. 302. Tax credit to employers for costs of implementing wellness programs.

Sec. 303. CDC and employer-based wellness programs.

Sec. 304. Employer-provided off-premises health club services.

Subtitle B--Healthy Communities

Chapter 1--Provisions To Improve the Health of Communities

Sec. 311. Healthy community grants.

Sec. 312. Promoting the health and wellness of individuals with disabilities through community sports programs.

Sec. 313. Safe and complete streets.

Sec. 314. National assessment of mental health needs.

Sec. 315. Preventive medicine and public health training grant program.

Sec. 316. Task force for the Promotion of Breastfeeding in the Workplace.

Sec. 317. Lactation accommodation and breastfeeding promotion at work.

Chapter 2--Promoting Lifelong Active Communities

Sec. 321. Short title.

Sec. 322. Purpose.

Sec. 323. Definition of Secretary.

subchapter a--national program promoting lifelong active communities

Sec. 331. Development of community play index.

Sec. 332. Sense of the House of Representatives regarding funding.

subchapter b--model communities of play implementation grants

Sec. 341. Model communities of play implementation grants.

TITLE IV--RESPONSIBLE MARKETING AND CONSUMER AWARENESS

Subtitle A--General Provisions

Sec. 401. Nutrition labeling of restaurant foods.

Sec. 402. Rulemaking authority for advertising to children.

Sec. 403. Food advertising in schools.

Sec. 404. Disallowance of deductions for advertising and marketing expenses relating to tobacco product use.

Sec. 405. Federal-state tobacco counter-advertising programs.

Subtitle B--Penalties for Failure To Reduce Teen Smoking

Sec. 411. Child cigarette use surveys.

Sec. 412. Cigarette use reduction goal and noncompliance.

Sec. 413. Enforcement.

Subtitle C--Food Guidance

Sec. 421. Front-label food guidance systems.

TITLE V--REIMBURSEMENT AND COVERAGE OF PREVENTIVE SERVICES

Sec. 501. Coverage of substance use (other than tobacco), diet, exercise, injury prevention, and dental health counseling.

Sec. 502. Medicare coverage of medical nutrition therapy services for people with pre-diabetes.

Sec. 503. Preventive mental health screenings.

Sec. 504. Encouragement of cessation of tobacco use.

Sec. 505. Recognition of school-based health centers as model for delivery of primary care for children under the medicaid and State children's health insurance programs.

Sec. 506. Preventive health care demonstration program.

Sec. 507. Preventive health services for women.

Sec. 508. Promoting cessation of tobacco use by pregnant women under the medicaid program.

TITLE VI--HELP (HEALTHY LIFESTYLES AND PREVENTION) AMERICA TRUST FUND

Sec. 601. HELP (Healthy Lifestyles and Prevention) America Trust Fund.

TITLE VII--RESEARCH

Sec. 701. Expansion of research regarding obesity.

Sec. 702. Incorporation of physical activity into Federal programs.

SEC. 2. FINDINGS.

Congress makes the following findings:

(1) Health care costs in the United States are rising rapidly. Per capita health spending in the United States is 56 percent higher than the median country that is a member of the Organization for Economic Cooperation and Development.

(2) According to the Centers for Medicare and Medicaid Services, total health care spending in the United States in 2004 was $1,800,000,000,000 and is expected to rise to $3,600,000,000,000 by 2014. Furthermore, chronic disease accounts for approximately 75 percent of health care costs annually.

(3) The United States spends less than 2 percent of annual health care expenditures on prevention

(4) Reducing and preventing the incidence of chronic disease is one means by which to reduce health care costs in the United States.

(5) More than 1,700,000 Americans die of a chronic disease each year, accounting for nearly 70 percent of all deaths in the United States.

(6) The economic impact of chronic disease can be seen in the annual costs associated with cardiovascular disease and stroke ($352,000,000,000), obesity ($117,000,000,000), cancer ($171,600,000,000), and diabetes ($132,000,000,000).

(7) Obesity related health conditions cost employers nearly $13,000,000,000 in health care and other indirect costs.

(8) Health promotion investments by employers on average yield a return of $3 for every $1 invested in a program.

(9) Being overweight or obese increase the risk of diabetes, heart disease, stroke, several types of cancer and other health problems.

(10) An estimated 65 percent of adults and 15 percent of children and adolescents in the United States are overweight or obese.

(11) The rates of obesity have doubled in children and tripled in teens since the 1980's.

(12) Almost 40 percent of Americans are sedentary. More than 1/3 of young people in grades 9 through 12 do not regularly engage in vigorous-intensity physical activity.

(13) Only 1 in 5 young people eat the recommended 5 daily servings of fruits and vegetables.

(14) Food and beverage advertisers collectively spend $10,000,000,000 to $12,000,000,000 a year to reach children and youth.

(15) Between 1977 and 1995, trips made by walking declined by 40 percent for adults while driving trips increased to almost 90 percent of the total.

(16) Virtually all-new users of tobacco products are under the minimum legal age to purchase such products. Every day in America, more than 4,000 kids try their first cigarette. Another 2,000 children become new daily smokers.

(17) In 2002, nearly a quarter of American adults, 46,000,000 people, smoked cigarettes, including almost 40 percent of college-aged students.

(18) Research consistently shows that smoking cessation services offered as a combination of tobacco medication therapy and counseling can be one of the most cost-effective health interventions and can reduce smoking-related health care costs.

(19) Physical and mental health are interconnected. Physical conditions often result in mental health complications and depression can manifest itself through physical symptoms.

(20) The Surgeon General reported that mental disorders collectively account for over 15 percent of the overall burden of disease from all causes, slightly more than the burden associated with all forms of cancer.

(21) One of every 2 people who need mental health treatment in the United States does not receive it. Of children and adolescents 6 to 17 years old who need mental health services, nearly 80 percent do not receive it.

(22) Early screening and prevention programs in the schools can detect high risk children that are vulnerable to developing mental illness and assist in accessing appropriate services.

(23) Children are at greater risk for mental health problems when they experience stressful family circumstances such as social or economic disadvantage, severe marital discord, divorce, family violence, parental substance abuse or other mental disorder or physical illness, and parental absence due to military service, imprisonment, or death.

(24) The 2003 President's New Freedom Commission on Mental Health urged a transformation of the approach to mental health in the United States, including improving the mental health of children and promoting resilience and prevention.

(25) People with disabilities report substantial disparities in health compared with people without disabilities. These disparities are caused by a number of factors, including less access to health care than individuals without disabilities. People with disabilities report more days of pain, depression, and anxiety and they have higher rates of obesity.

(26) Evidence shows that health promotion programs with exercise, nutrition, and wellness components targeting people with disabilities can significantly reduce the incidence of these conditions and lead to healthy outcomes for people with disabilities, as well as save money by reducing the frequency of medical visits.

TITLE I--CHILDHOOD OBESITY

SEC. 101. FEDERAL TASK FORCE ON CHILDHOOD OBESITY.

Part Q of title III of the Public Health Service Act (42 U.S.C. 280h et seq.) is amended by adding at the end the following:

`SEC. 399Z-1. FEDERAL TASK FORCE ON CHILDHOOD OBESITY.

`(a) Establishment- The Secretary shall convene a Task Force on Childhood Obesity (referred to in this section as the `Task Force') to--

`(1) establish a government-wide strategy for preventing and reducing childhood overweight and obesity;

`(2) coordinate effective inter-agency coordination and priorities for action among Federal agencies;

`(3) implement and evaluate the effectiveness of such strategy; and

`(4) direct the Secretary to designate a responsible agency to formally monitor and report, not later than January 1, 2008, to Congress on the progress of the various entities and activities related to the recommendations included in the report of Institute of Medicine entitled `Food Marketing to Children and Youth'.

`(b) Membership-

`(1) IN GENERAL- The Task Force shall be composed of employees of--

`(A) the Department of Health and Human Services;

`(B) the Department of Agriculture;

`(C) the Department of Education;

`(D) the Federal Trade Commission;

`(E) the Department of Transportation; and

`(F) any other Federal agency that the Secretary determines appropriate.

`(2) CHAIRPERSON- The chairperson of the Task Force shall be--

`(A) an individual appointed by the President; and

`(B) until the date that an individual is appointed under subparagraph (A), the Secretary.

`(c) Meetings- The Task Force shall meet at the call of the chairperson.

`(d) Report- Not later than January 1, 2008, and on annual basis thereafter through January 1, 2013, the Task Force shall submit to the President and to the relevant committees of Congress, a report that--

`(1) describes the activities and efforts to prevent and reduce childhood overweight and obesity conducted by the Task Force during the year to which the report relates; and

`(2) evaluates the effectiveness of such activities and efforts to prevent and reduce childhood overweight and obesity.'.

TITLE II--HEALTHIER KIDS AND SCHOOLS

SEC. 201. FRESH FRUIT AND VEGETABLE PROGRAM.

Section 18(g)(6)(B) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1769(g)(6)(B)) is amended--

(1) by redesignating clause (ii) as clause (iv); and

(2) by inserting after clause (i) the following:

`(ii) ADDITIONAL MANDATORY FUNDING- Out of any funds in the Treasury not otherwise appropriated, the Secretary of the Treasury shall transfer to the Secretary of Agriculture to carry out and expand the program under this subsection, to remain available until expended--

`(I) on October 1, 2007, $1,000,000,000; and

`(II) on October 1, 2007, and on each October 1 thereafter, the amount made available for the previous fiscal year, as adjusted under clause (iii).

`(iii) ADJUSTMENT- On October 1, 2007, and on each October 1 thereafter of a fiscal year the amount made available under subclause (I) of clause (ii) shall be calculated by adjusting the amount made available for the previous fiscal year to reflect changes in the Consumer Price Index of the Bureau of Labor Statistics for fresh fruits and vegetables, with the adjustment--

`(I) rounded down to the nearest dollar increment; and

`(II) based on the unrounded amounts for the preceding 12-month period.'.

SEC. 202. FOOD OF MINIMAL NUTRITIONAL VALUE.

Section 10 of the Child Nutrition Act of 1966 (42 U.S.C. 1779) is amended--

(1) by striking the section heading and all that follows through `(a) The Secretary' and inserting the following:

`SEC. 10. REGULATIONS.

`(a) In General- The Secretary'; and

(2) by striking subsections (b) and (c) and inserting the following:

`(b) Food of Minimal Nutritional Value-

`(1) PROPOSED REGULATIONS-

`(A) IN GENERAL- Not later than 180 days after the date of enactment of this paragraph, the Secretary shall promulgate proposed regulations to revise the definition of `food of minimal nutritional value' that is used to carry out this Act and the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.).

`(B) APPLICATION- The revised definition of `food of minimal nutritional value' shall apply to all foods sold--

`(i) outside the school meal programs;

`(ii) on the school campus; and

`(iii) at any time during the school day.

`(C) REQUIREMENTS- In revising the definition, the Secretary shall consider--

`(i) both the positive and negative contributions of nutrients, ingredients, and foods (including calories, portion size, saturated fat, trans fat, sodium, and added sugars) to the diets of children;

`(ii) evidence concerning the relationship between consumption of certain nutrients, ingredients, and foods to both preventing and promoting the development of overweight, obesity, and other chronic illnesses;

`(iii) recommendations made by authoritative scientific organizations concerning appropriate nutritional standards for foods sold outside of the reimbursable meal programs in schools; and

`(iv) special exemptions for school-sponsored fundraisers (other than fundraising through vending machines, school stores, snack bars, a la carte sales, and any other exclusions determined by the Secretary), if the fundraisers are approved by the school and are infrequent within the school.

`(2) IMPLEMENTATION-

`(A) EFFECTIVE DATE-

`(i) IN GENERAL- Except as provided in clause (ii), the proposed regulations shall take effect at the beginning of the school year following the date on which the regulations are finalized.

`(ii) EXCEPTION- If the regulations are finalized on a date that is not more than 60 days before the beginning of the school year, the proposed regulations shall take effect at the beginning of the following school year.

`(B) FAILURE TO PROMULGATE- If, on the date that is 1 year after the date of enactment of this paragraph, the Secretary has not promulgated final regulations, the proposed regulations shall be considered to be final regulations.'.

SEC. 203. SCHOOL NUTRITION ENVIRONMENT ENHANCEMENT GRANTS.

Section 18 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1769) is amended by adding at the end the following:

`(l) Healthy School Nutrition Environment Incentive Grants-

`(1) IN GENERAL- The Secretary may implement a grant program to follow the recommendations made by the Institute of Medicine report entitled `Nutrition Standards for Foods in Schools-Leading the Way Toward Healthier Youth' to--

`(A) provide schools with technical assistance in implementing the recommendations of the Institute of Medicine regarding appropriate school nutrition standards; and

`(B) assess the impact of implementing the recommendations on the health and well-being of children enrolled in the schools.

`(2) SELECTION OF SCHOOLS- In selecting schools to receive incentive grants under this subsection, the Secretary shall--

`(A) ensure that not less than 75 percent of schools selected to participate in the program established under this subsection are schools in which not less than 50 percent of the students enrolled in each school are eligible for free or reduced price meals under this Act;

`(B) ensure that, of the schools selected to participate in the program, there is appropriate representation of rural, urban, and suburban schools, as determined by the Secretary;

`(C) ensure that, of the schools selected to participate in the program, there is appropriate representation of elementary, middle, and secondary schools, as determined by the Secretary;

`(D) ensure that schools selected to receive a grant under this subsection meet the requirements of paragraph (3);

`(E) give priority to schools that develop comprehensive plans that include the involvement of a broad range of community stakeholders in achieving healthy school nutrition environments; and

`(F) give priority to schools that develop comprehensive plans that include a strategy for maintaining healthy school nutrition environments in the years following the fiscal years for which the schools receive grants under this subsection.

`(3) REQUIREMENTS-

`(A) CRITERIA FOR HEALTHY SCHOOL ENVIRONMENTS- The Secretary shall establish criteria, based upon the recommendations of the Institute of Medicine described in paragraph (1), under which schools may receive grants under this section.

`(B) PLAN- To be eligible to receive a grant under this subsection, a school shall--

`(i) submit to the Secretary a healthy school nutrition environment plan that describes the actions the school will take to meet the criteria established under subparagraph (A); and

`(ii) take the actions described in the plan.

`(4) GRANTS- For each of 5-fiscal years following the establishment of criteria by the Secretary under paragraph (3), the Secretary shall award a grant to each school selected under paragraph (2).

`(5) EVALUATIONS-

`(A) IN GENERAL- The Secretary, acting through the Administrator of the Food and Nutrition Service, shall conduct an evaluation of a representative sample of schools that receive grants under this subsection.

`(B) CONTENT- The evaluation shall measure, at a minimum, the effects of a healthy school nutrition environment on--

`(i) overweight children and obesity;

`(ii) dietary intake;

`(iii) nutrition education and behavior;

`(iv) parental and student attitudes and participation; and

`(v) related funding issues, including the cost of maintaining a healthy school nutrition environment.

`(C) REPORTS- The Secretary shall submit to the Committee on Education and the Workforce of the House of Representatives and the Committee on Agriculture, Nutrition, and Forestry of the Senate--

`(i) an interim report on the activities of schools evaluated under this subsection; and

`(ii) a final report on the activities of schools evaluated under this subsection.

`(6) AUTHORIZATION OF APPROPRIATIONS-

`(A) IN GENERAL- There are authorized to be appropriated such sums as are necessary to carry out this subsection for the 5-fiscal year following the establishment of criteria by the Secretary under paragraph (3), to remain available until expended.

`(B) EVALUATIONS- The Secretary may use not more than 10 percent of the total funds made available for a fiscal year under subparagraph (A) to carry out paragraph (5).'.

SEC. 204. BABY FRIENDLY HOSPITAL-CENTER FOR BREASTFEEDING EXCELLENCE.

(a) Establishment of Program- The Director of the Office on Women's Health of the Department of Health and Human Services (referred to in this section as the `Director') shall establish a program to be known as the `Baby-Friendly Hospital Initiative' (referred to in this section as the `Initiative').

(b) Certification Process- Under the Initiative, the Director shall establish a certification process under which a hospital can apply for a certification as a `baby friendly hospital/center for breastfeeding excellence'. Such certification process shall be based upon the international guidelines of the Baby-Friendly Hospital Initiative established by the World Health Organization and United Nations Children's Fund.

(c) Requirements-

(1) IN GENERAL- To be certified as a baby friendly hospital/center for breastfeeding excellence, a hospital (as defined for purposes of this section by the Director, and which may include birth centers) shall carry out the following:

(A) The hospital shall maintain a written breastfeeding policy that is routinely communicated to all of the healthcare staff of the hospital.

(B) The hospital shall provide training for all healthcare staff in the skills necessary to implement the policy described in subparagraph (A).

(C) The hospital shall ensure that all pregnant women who are patients at the hospital are informed about the benefits and management of breastfeeding.

(D) The hospital shall help mothers initiate breastfeeding within one hour of birth.

(E) The hospital shall demonstrate to mothers how to breastfeed and how to maintain lactation, even if the mother is separated from her infant.

(F) The hospital shall give infants no food or drink other than breastmilk, unless medically indicated.

(G) The hospital shall implement a `rooming in' policy by allowing mothers and infants to remain together 24 hours a day in the same hospital room.

(H) The hospital shall encourage unrestricted breastfeeding.

(I) The hospital shall provide no pacifiers or artificial nipples to breastfeeding infants.

(J) The hospital shall foster the establishment of breastfeeding support groups and refer mothers to such groups on discharge from the hospital.

(2) INSPECTION- A hospital shall be certified as a baby friendly hospital/center for breastfeeding excellence only upon the completion of an on-site assessment by the Director through which the Director has determined that the hospital is in compliance with the guidelines used for certification under subsection (b).

(3) VERIFICATION- Upon being certified as a baby friendly hospital/center for breastfeeding excellence, a hospital shall agree to permit the Director to conduct on-site assessments to verify the continued compliance of the hospital with the requirements of paragraph (1).

(d) Authority for Automatic Certification- The Director may automatically certify a hospital as a baby friendly hospital/center of breastfeeding excellence if such hospital has been designated as a baby-friendly hospital under the Baby-Friendly USA program.

(e) Limitation- A hospital shall not make any claim that such hospital is a baby friendly hospital/center of breastfeeding excellence unless such hospital has been certified by the Director in accordance with this section.

(f) Technical Assistance- The Director shall provide, at the request of a hospital seeking a certification as a baby friendly hospital/center of breastfeeding excellence, such technical assistance as appropriate to assist the requesting hospital to achieve such certification.

(g) Certification Costs- Subject to the availability of appropriations, the Director may provide to a hospital that has successfully been certified as a baby friendly hospital/center of breastfeeding excellence under this Act, a one time award of up to $20,000 to offset the cost to such hospital of being certified as a baby friendly hospital/center of breastfeeding excellence.

(h) Recommendations for Accrediting Entities- Not later than 12 months after certifying the first baby friendly hospital/center for breastfeeding excellence under this section, the Director shall provide to the appropriate organizations or entities that are engaged in the accreditation of healthcare organizations, recommendations concerning steps that such accrediting entities may take to integrate the baby friendly hospital requirements used in the Baby Friendly Hospital Initiative into healthcare organization accreditation procedures and requirements.

(i) Authorization of Appropriations- There are authorized to be appropriated such sums as may be necessary to carry out this section.

SEC. 205. INTERVENTION TO STRENGTHEN FAMILIES AND BUILD CHILDREN'S RESILIENCE.

Part B of title V of the Public Health Service Act (42 3 U.S.C. 290bb et seq.) is amended by adding at the end the following:

`SEC. 520K. INTERVENTIONS TO STRENGTHEN FAMILIES AND BUILD CHILDREN'S RESILIENCE.

`(a) In General- The Secretary shall award grants to eligible entities for the purpose of implementing programs that strengthen families of children at risk for emotional or behavioral problems due to family distress.

`(b) Eligible Entity- Entities eligible to receive funds under this section may include--

`(1) a local public entity, including a health department or local education agency;

`(2) an Indian tribal organization or agency;

`(3) a federally qualified health center;

`(4) a community-based organization; or

`(5) any other entity determined appropriate by the Secretary, including a consortia or partnership of entities eligible to receive funds under this section.

`(c) Use of Funds-

`(1) IN GENERAL- An eligible entity that receives a grant under this section shall use the funds made available through the grant to carry out home-based, school-based, and community-based activities that--

`(A) promote strong, supportive families and child resilience through parenting skills training and supports, or skill-building services with children, as well as provide other consultative services and support for family and other caregivers, such as child care providers, educators, and after-school program staff;

`(B) enhance mental health promotion activities in domains where children live, play, and learn; and

`(C) enhance community wellness, and reduce the incidence of preventable mental health problems among children.

`(2) INTERVENTION ACTIVITIES- Intervention activities funded under this section shall--

`(A) be consumer and family driven, and use strengths-based approaches;

`(B) be designed to promote social and emotional competencies and increase children's ability to successfully cope with stressful life circumstances;

`(C) be designed to strengthen children and their families by enhancing the knowledge, social, emotional, and other life or work skills, and support of, parents or other significant caregivers;

`(D) emphasize and model a positive, supportive approach to working with children;

`(E) be evidence-based and provide in-depth and ongoing training and consultation in the adoption and use of evidence-based interventions by schools, communities, and families;

`(F) include a rigorous evaluation component, including outcome measures suited to the intervention and the overall goals of the grant, as well as use of comparison groups and moderating and meditating process variables whenever possible;

`(G) involve partnerships between communities or schools and universities where possible to support effective implementation and evaluation of the intervention activities;

`(H) provide facilitated referrals for parents and other family members who need mental health, substance abuse, or social work services, and coordinate a referral network of professionals with affordable fees; and

`(I) emphasize local capacity-building to use evidence-based intervention, promote linkages among individuals and groups that serve children and families, and develop community outreach to support coalition-building.

`(3) TARGET POPULATIONS- Families targeted by these activities shall include those with children at risk for increased mental health problems due to stressful family circumstances, including--

`(A) social or economic disadvantage;

`(B) severe marital discord;

`(C) divorce;

`(D) family violence;

`(E) parental substance abuse or other mental disorder or physical illness;

`(F) parental death;

`(G) parental absence due to military service;

`(H) parental absence due to imprisonment; and

`(I) other family disruption determined appropriate by the Secretary.

`(d) Priority Funding- In awarding grants under subsection (a), the Secretary shall give priority to the following:

`(1) Entities that provide non-Federal contributions, either in cash or in kind.

`(2) Entities with demonstrated experience with community-based partnerships.

`(3) Entities with demonstrated experience and success with such interventions.

`(4) Entities with demonstrated experience working with families.

`(5) Entities that develop comprehensive plans that include a strategy for extending program activities developed under this section in the years following the fiscal years for which they receive grants under this section.

`(6) Entities that submit plans that exhibit cooperative plans that include the involvement of a broad range of stakeholders, including the following:

`(A) Community-based organizations.

`(B) Local governments.

`(C) Local educational agencies.

`(D) Local business and community associations.

`(E) Accredited colleges, universities, and community colleges.

`(F) Other entities determined appropriate by the Secretary.

`(e) Evaluation- Of the funds appropriated to carry out this section, the Secretary may reserve up to 5 percent for each fiscal year for the purpose of carrying out evaluations of the activities carried out under this section, including a national cross-site evaluation. Within 90 days of the completion of any evaluations, they shall be provided to the relevant authorizing committees and to the Committees on Appropriations of the Senate and the House of Representatives.

`(f) Duration- The Secretary shall award grants under this section for a period of not more than 5 years.

`(g) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, $25,000,000 for fiscal year 2008, and such sums as may be necessary for each of fiscal years 2008 to 2012.'.

SEC. 206. GRANTS FOR THE INTEGRATION OF SCHOOLS AND MENTAL HEALTH SYSTEMS.

Section 5541 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7269) is amended--

(1) in subsection (c), by adding at the end the following:

`(7) To support schools that work with families and appropriate community partners to implement school-wide prevention strategies, based on mental health research, that will support early and intensive interventions.

`(8) To provide necessary training and support to school personnel on how to recognize and seek needed support for children exhibiting early warning signs of behavioral and academic problems.'; and

(2) in subsection (d)--

(A) in paragraph (4)--

(i) in subparagraph (C), by striking `and' after the semicolon;

(ii) in subparagraph (D), by striking the period and inserting `; and'; and

(iii) by adding at the end the following:

`(E) mental health services provided under this section by schools will be evidence-based or promising early interventions.'; and

(B) by adding at the end the following:

`(7) An explanation of how the applicant will carry out public education programs in support of mental health promotion and prevention by collaborating with--

`(A) an institution of higher education (including a graduate program in psychology, social work, or education at an institution of higher education); and

`(B) private nonprofit community-based organizations that have experience in public education programs relating to mental health promotion and prevention.'.

SEC. 207. GRANTS FOR THE PROMOTION OF UNIVERSITY-COMMUNITY PARTNERSHIPS TO INCREASE YOUTH COMPETENCIES AND REDUCE YOUTH PROBLEM BEHAVIORS IN OUR COMMUNITIES.

(a) In General- The Secretary of Health and Human Services shall award grants to eligible entities for the implementation of programs that promote university-community partnerships to implement community-based prevention strategies that will support youth competencies and prevent youth problem behaviors.

(b) Eligibility- To be eligible to receive a grant under subsection (a), an entity shall be a partnership between--

(1) an institution of higher education (including a graduate program in psychology, social work, or education at an institution of higher education); and

(2) a private nonprofit community-based organization that has experience in prevention and interventions relating to mental health promotion and prevention.

(c) Use of Funds- An entity shall use amounts received under a grant under this section to carry out community-based activities that--

(1) are comprehensive and utilize evidence-based or promising early interventions; and

(2) include an evaluation component that includes outcomes measures related to prevention efforts as well as the overall goals of the grant.

(d) Authorization of Appropriations- There is to be authorized to be appropriated to carry out this section, $10,000,000 for fiscal year 2008, and such sums as may be necessary for each of fiscal years 2009 and 2010.

SEC. 208. RESERVATIONS FOR EARLY HEAD START PROGRAMS.

Section 640(a)(6)(A) of the Head Start Act (42 U.S.C. 9835(a)(6)(A)) is amended by striking `7.5 percent' and all that follows and inserting `12 percent for fiscal year 2008, 14 percent for fiscal year 2009, 16 percent for fiscal year 2010, 18 percent for fiscal year 2011, and 20 percent for fiscal year 2012, of the amount appropriated pursuant to section 639(a).'.

TITLE III--HEALTHIER COMMUNITIES AND WORKPLACES

Subtitle A--Incentives for a Healthy Workforce

SEC. 301. SHORT TITLE.

This subtitle may be cited as the `Healthy Workforce Act of 2007'.

SEC. 302. TAX CREDIT TO EMPLOYERS FOR COSTS OF IMPLEMENTING WELLNESS PROGRAMS.

(a) In General- Subpart D of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 (relating to business related credits) is amended by adding at the end the following:

`SEC. 45O. WELLNESS PROGRAM CREDIT.

`(a) Allowance of Credit-

`(1) IN GENERAL- For purposes of section 38, the wellness program credit determined under this section for any taxable year during the credit period with respect to an employer is an amount equal to 50 percent of the costs paid or incurred by the employer in connection with a qualified wellness program during the taxable year.

`(2) LIMITATION- The amount of credit allowed under paragraph (1) for any taxable year shall not exceed the sum of--

`(A) the product of $200 and the number of employees of the employer not in excess of 200 employees, plus

`(B) the product of $100 and the number of employees of the employer in excess of 200 employees.

`(b) Qualified Wellness Program- For purposes of this section--

`(1) QUALIFIED WELLNESS PROGRAM- The term `qualified wellness program' means a program which--

`(A) consists of any 3 of the wellness program components described in subsection (c), and

`(B) which is certified by the Secretary of Health and Human Services, in coordination with the Director of the Center for Disease Control and Prevention, as a qualified wellness program under this section.

`(2) PROGRAMS MUST BE CONSISTENT WITH RESEARCH AND BEST PRACTICES-

`(A) IN GENERAL- The Secretary of Health and Human Services shall not certify a program as a qualified wellness program unless the program--

`(i) is consistent with evidence-based research and best practices, as identified by persons with expertise in employer health promotion and wellness programs,

`(ii) includes multiple, evidence-based strategies which are based on the existing and emerging research and careful scientific reviews, including the Guide to Community Preventive Services, the Guide to Clinical Preventive Services, and the National Registry for Effective Programs, and

`(iii) includes strategies which focus on employee populations with a disproportionate burden of health problems.

`(B) PERIODIC UPDATING AND REVIEW- The Secretary of Health and Human Services shall establish procedures for periodic review and recertifications of programs under this subsection. Such procedures shall require revisions of programs if necessary to ensure compliance with the requirements of this section and require updating of the programs to the extent the Secretary, in coordination with the Director of the Centers for Disease Control and Prevention, determines necessary to reflect new scientific findings.

`(3) HEALTH LITERACY- The Secretary of Health and Human Services shall, as part of the certification process, encourage employees to make the programs culturally competent and to meet the health literacy needs of the employees covered by the programs.

`(c) Wellness Program Components- For purposes of this section, the wellness program components described in this subsection are the following:

`(1) HEALTH AWARENESS COMPONENT- A health awareness component which provides for the following:

`(A) HEALTH EDUCATION- The dissemination of health information which addresses the specific needs and health risks of employees.

`(B) HEALTH SCREENINGS- The opportunity for periodic screenings for health problems and referrals for appropriate follow up measures.

`(2) EMPLOYEE ENGAGEMENT COMPONENT- An employee engagement component which provides for--

`(A) the establishment of a committee to actively engage employees in worksite wellness programs through worksite assessments and program planning, delivery, evaluation, and improvement efforts, and

`(B) the tracking of employee participation.

`(3) BEHAVIORAL CHANGE COMPONENT- A behavioral change component which provides for altering employee lifestyles to encourage healthy living through counseling, seminars, on-line programs, or self-help materials which provide technical assistance and problem solving skills. Such component may include programs relating to--

`(A) tobacco use,

`(B) obesity,

`(C) stress management,

`(D) physical fitness,

`(E) nutrition,

`(F) substance abuse,

`(G) depression, and

`(H) mental health promotion (including anxiety).

`(4) SUPPORTIVE ENVIRONMENT COMPONENT- A supportive environment component which includes the following:

`(A) ON-SITE POLICIES- Policies and services at the worksite which promote a healthy lifestyle, including policies relating to--

`(i) tobacco use at the worksite,

`(ii) the nutrition of food available at the worksite through cafeterias and vending options,

`(iii) minimizing stress and promoting positive mental health in the workplace,

`(iv) where applicable, accessible and attractive stairs, and

`(v) the encouragement of physical activity before, during, and after work hours.

`(B) PARTICIPATION INCENTIVES-

`(i) IN GENERAL- Qualified incentive benefits for each employee who participates in the health screenings described in paragraph (1)(B) or the behavioral change programs described in paragraph (3).

`(ii) QUALIFIED INCENTIVE BENEFIT- For purposes of clause (i), the term `qualified incentive benefit' means any benefit which is approved by the Secretary of Health and Human Services, in coordination with the Director of the Centers for Disease Control and Prevention. Such benefit may include an adjustment in health insurance premiums or co-pays.

`(C) EMPLOYEE INPUT- The opportunity for employees to participate in the management of any qualified wellness program to which this section applies.

`(d) Participation Requirement-

`(1) IN GENERAL- No credit shall be allowed under subsection (a) unless the Secretary of Health and Human Services, in coordination with the Director of the Centers for Disease Control and Prevention, certifies, as a part of any certification described in subsection (b), that each wellness program component of the qualified wellness program applies to all qualified employees of the employer. The Secretary of Health and Human Services shall prescribe rules under which an employer shall not be treated as failing to meet the requirements of this subsection merely because the employer provides specialized programs for employees with specific health needs or unusual employment requirements or provides a pilot program to test new wellness strategies.

`(2) QUALIFIED EMPLOYEE- For purposes of paragraph (1), the term `qualified employee' means an employee who works an average of not less than 25 hours per week during the taxable year.

`(e) Other Definitions and Special Rules- For purposes of this section--

`(1) EMPLOYEE AND EMPLOYER-

`(A) PARTNERS AND PARTNERSHIPS- The term `employee' includes a partner and the term `employer' includes a partnership.

`(B) CERTAIN RULES TO APPLY- Rules similar to the rules of section 52 shall apply.

`(2) CERTAIN COSTS NOT INCLUDED- Costs paid or incurred by an employer for food or health insurance shall not be taken into account under subsection (a).

`(3) NO CREDIT WHERE GRANT AWARDED- No credit shall be allowable under subsection (a) with respect to any qualified wellness program of any taxpayer (other than an eligible employer described in subsection (f)(2)(A)) who receives a grant provided by the United States, a State, or a political subdivision of a State for use in connection with such program. The Secretary shall prescribe rules providing for the waiver of this paragraph with respect to any grant which does not constitute a significant portion of the funding for the qualified wellness program.

`(4) CREDIT PERIOD-

`(A) IN GENERAL- The term `credit period' means the period of 10 consecutive taxable years beginning with the taxable year in which the qualified wellness program is first certified under this section.

`(B) SPECIAL RULE FOR EXISTING PROGRAMS- In the case of an employer (or predecessor) which operates a wellness program for its employees on the date of the enactment of this section, subparagraph (A) shall be applied by substituting `3 consecutive taxable years' for `10 consecutive taxable years'. The Secretary shall prescribe rules under which this subsection shall not apply if an employer is required to make substantial modifications in the existing wellness program in order to qualify such program for certification as a qualified wellness program.

`(C) CONTROLLED GROUPS- For purposes of this paragraph, all persons treated as a single employer under subsection (b), (c), (m), or (o) of section 414 shall be treated as a single employer.

`(f) Portion of Credit Made Refundable-

`(1) IN GENERAL- In the case of an eligible employer of an employee, the aggregate credits allowed to a taxpayer under subpart C shall be increased by the lesser of--

`(A) the credit which would be allowed under this section without regard to this subsection and the limitation under section 38(c), or

`(B) the amount by which the aggregate amount of credits allowed by this subpart (determined without regard to this subsection) would increase if the limitation imposed by section 38(c) for any taxable year were increased by the amount of employer payroll taxes imposed on the taxpayer during the calendar year in which the taxable year begins.

The amount of the credit allowed under this subsection shall not be treated as a credit allowed under this subpart and shall reduce the amount of the credit otherwise allowable under subsection (a) without regard to section 38(c).

`(2) ELIGIBLE EMPLOYER- For purposes of this subsection, the term `eligible employer' means an employer which is--

`(A) a State or political subdivision thereof, the District of Columbia, a possession of the United States, or an agency or instrumentality of any of the foregoing, or

`(B) any organization described in section 501(c) of the Internal Revenue Code of 1986 which is exempt from taxation under section 501(a) of such Code.

`(3) EMPLOYER PAYROLL TAXES- For purposes of this subsection--

`(A) IN GENERAL- The term `employer payroll taxes' means the taxes imposed by--

`(i) section 3111(b), and

`(ii) sections 3211(a) and 3221(a) (determined at a rate equal to the rate under section 3111(b)).

`(B) SPECIAL RULE- A rule similar to the rule of section 24(d)(2)(C) shall apply for purposes of subparagraph (A).

`(g) Termination- This section shall not apply to any amount paid or incurred after December 31, 2017.'.

(b) Treatment as General Business Credit- Subsection (b) of section 38 of the Internal Revenue Code of 1986 (relating to general business credit) is amended by striking `plus' at the end of paragraph (30), by striking the period at the end of paragraph (31) and inserting `, plus', and by adding at the end the following:

`(32) the wellness program credit determined under section 45O.'.

(c) Denial of Double Benefit- Section 280C of the Internal Revenue Code of 1986 (relating to certain expenses for which credits are allowable) is amended by adding at the end the following new subsection:

`(f) Wellness Program Credit-

`(1) IN GENERAL- No deduction shall be allowed for that portion of the costs paid or incurred for a qualified wellness program (within the meaning of section 45O) allowable as a deduction for the taxable year which is equal to the amount of the credit allowable for the taxable year under section 45O.

`(2) SIMILAR RULE WHERE TAXPAYER CAPITALIZES RATHER THAN DEDUCTS EXPENSES- If--

`(A) the amount of the credit determined for the taxable year under section 45O, exceeds

`(B) the amount allowable as a deduction for such taxable year for a qualified wellness program,

the amount chargeable to capital account for the taxable year for such expenses shall be reduced by the amount of such excess.

`(3) CONTROLLED GROUPS- In the case of a corporation which is a member of a controlled group of corporations (within the meaning of section 41(f)(5)) or a trade or business which is treated as being under common control with other trades or business (within the meaning of section 41(f)(1)(B)), this subsection shall be applied under rules prescribed by the Secretary similar to the rules applicable under subparagraphs (A) and (B) of section 41(f)(1).'.

(d) Clerical Amendment- The table of sections for subpart D of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 is amended by adding at the end the following:

`Sec. 45O. Wellness program credit.'.

(e) Effective Date- The amendments made by this section shall apply to taxable years beginning after December 31, 2007.

(f) Outreach-

(1) IN GENERAL- The Secretary of the Treasury, in conjunction with the Director of the Centers for Disease Control and members of the business community, shall institute an outreach program to inform businesses about the availability of the wellness program credit under section 45O of the Internal Revenue Code of 1986 as well as to educate businesses on how to develop programs according to recognized and promising practices and on how to measure the success of implemented programs.

(2) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated such sums as are necessary to carry out the outreach program described in paragraph (1).

SEC. 303. CDC AND EMPLOYER-BASED WELLNESS PROGRAMS.

Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) is amended by adding at the end the following:

`PART R--CDC AND EMPLOYER-BASED WELLNESS PROGRAMS

`SEC. 399Z-1. MOTIVATING EMPLOYERS TO IMPLEMENT WORKPLACE WELLNESS PROGRAMS.

`(a) Workplace Wellness Marketing Campaign for Employers- The Director of the Centers for Disease Control and Prevention, in coordination with relevant worksite health promotion organizations, shall conduct an educational campaign to make employers, employer groups, and other interested parties aware of the benefits of employer-based wellness programs.

`(b) Employer Award Program- The Director of the Centers for Disease Control and Prevention shall develop an annual awards program for employers to encourage the development of creative and effective solutions to help employees maintain or improve their health. The awards program shall provide that small, medium, and large employers that are public or private shall be eligible for the awards

`SEC. 399Z-2. EVALUATION OF EMPLOYER-BASED WELLNESS PROGRAMS.

`The Director of the Centers for Disease Control and Prevention shall enter into contracts with entities to--

`(1) provide employers (including small, medium, and large employers, as determined by the Director) with technical assistance in evaluating such employers' employer-based wellness programs, including--

`(A) measuring the participation of employees in such programs; and

`(B) evaluating such programs as they relate to changes in the health status of employees, the absenteeism of employees, the productivity of employees, and the medical costs incurred by employees; and

`(2) train employers on how to evaluate such employers' employer-based wellness programs.

`SEC. 399Z-3. NATIONAL WORKSITE HEALTH POLICIES AND PROGRAMS STUDY.

`(a) In General- Not later than 1 year after the date of enactment of this section, and annually thereafter, the Director of the Centers for Disease Control and Prevention shall conduct a national worksite health policies and programs study to assess employer-based health policies and programs.

`(b) Report- After completing each study under subsection (a), the Director of the Centers for Disease Control and Prevention shall submit to Congress a report that includes the recommendations of the Director for the implementation of effective employer-based health policies and programs.

`SEC. 399Z-4. MISCELLANEOUS PROVISIONS.

`(a) Behavioral Risk Factor Surveillance System- The Secretary shall expand the Behavioral Risk Factor Surveillance System to include a workforce component to enable employers, researchers, and health officials to assess employee health risks, identify emerging problems associated with general employee health, prevent disease within the employee population, and improve employer-based health programs and policies.

`(b) Demonstration Projects-

`(1) IN GENERAL- The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall award grants to entities to enable such entities to carry out research demonstration projects to study the effect of the application of new worksite-based health interventions and models.

`(2) ELIGIBILITY- To be eligible to receive a grant under paragraph (1), an entity shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.

`(3) BROAD PARTICIPATION- In awarding grants under paragraph (1), the Secretary shall ensure that demonstration projects are conducted in both the public and private sectors and in small and large employer settings.

`(4) SUBMISSION OF FINDINGS- An entity shall submit to the Secretary a report on the results of the research conducted under the grant within such period as the Secretary may prescribe. Such report shall include any guidelines or recommendations developed by the entity based on such research.

`(c) Implementation of Research Results- The Secretary shall carry out activities to implement the guidelines or recommendations received by the Secretary under subsection (b)(4) if the Secretary determines that such guidelines of recommendations would result in improved employee health through worksite-based health programs or policies.'.

SEC. 304. EMPLOYER-PROVIDED OFF-PREMISES HEALTH CLUB SERVICES.

(a) Treatment as Fringe Benefit- Subparagraph (A) of section 132(j)(4) of the Internal Revenue Code of 1986 (relating to on-premises gyms and other athletic facilities) is amended to read as follows:

`(A) IN GENERAL- Gross income shall not include--

`(i) the value of any on-premises athletic facility provided by an employer to its employees, and

`(ii) so much of the fees, dues, or membership expenses paid by an employer to an athletic or fitness facility described in subparagraph (C) on behalf of its employees as does not exceed $900 per employee per year.'.

(b) Athletic Facilities Described- Paragraph (4) of section 132(j) of the Internal Revenue Code of 1986 (relating to special rules) is amended by adding at the end the following new subparagraph:

`(C) CERTAIN ATHLETIC OR FITNESS FACILITIES DESCRIBED- For purposes of subparagraph (A)(ii), an athletic or fitness facility described in this subparagraph is a facility--

`(i) which provides instruction in a program of physical exercise, offers facilities for the preservation, maintenance, encouragement, or development of physical fitness, or is the site of such a program of a State or local government,

`(ii) which is not a private club owned and operated by its members,

`(iii) which does not offer golf, hunting, sailing, or riding facilities,

`(iv) whose health or fitness facility is not incidental to its overall function and purpose, and

`(v) which is fully compliant with the State of jurisdiction and Federal anti-discrimination laws.'.

(c) Exclusion Applies to Highly Compensated Employees Only if No Discrimination- Section 132(j)(1) of the Internal Revenue Code of 1986 is amended--

(1) by striking `Paragraphs (1) and (2) of subsection (a)' and inserting `Subsections (a)(1), (a)(2), and (j)(4)', and

(2) by striking the heading thereof through `apply' and inserting `certain exclusions apply'.

(d) Employer Deduction for Dues to Certain Athletic Facilities-

(1) IN GENERAL- Paragraph (3) of section 274(a) of the Internal Revenue Code of 1986 (relating to denial of deduction for club dues) is amended by adding at the end the following new sentence: `The preceding sentence shall not apply to so much of the fees, dues, or membership expenses paid to athletic or fitness facilities (within the meaning of section 132(j)(4)(C)) as does not exceed $900 per employee per year.'.

(2) CONFORMING AMENDMENT- The last sentence of section 274(e)(4) of such Code is amended by inserting `the first sentence of' before `subsection (a)(3)'.

(e) Effective Date- The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.

Subtitle B--Healthy Communities

CHAPTER 1--PROVISIONS TO IMPROVE THE HEALTH OF COMMUNITIES

SEC. 311. HEALTHY COMMUNITY GRANTS.

Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) is amended by adding at the end the following:

`SEC. 399P. HEALTHY COMMUNITY GRANTS.

`(a) Establishment- The Secretary, acting through the Director of the Centers for Disease Control and Prevention and in coordination with the Directors of other appropriate Federal agencies, shall award competitive grants to eligible entities for the purpose of planning and implementing programs that seek to promote individual and community health and to prevent the incidence of chronic disease.

`(b) Eligibility-

`(1) IN GENERAL- To be eligible to receive a grant under this section an entity shall--

`(A) be--

`(i) a city, county, or Indian tribe;

`(ii) a local or tribal educational agency;

`(iii) an accredited university, college, or community college;

`(iv) a federally qualified health center;

`(v) a local health department;

`(vi) a health care provider;

`(vii) a community-based organization; or

`(viii) any other entity determined appropriate by the Secretary, including a consortia or partnership of entities described in any of clauses (i) through (vii);

`(B) prepare and submit an application in accordance with paragraph (2); and

`(C) provide assurances that the entity will contribute the non-Federal share as required under paragraph (3) to the cost of the activities carried out under the grant.

`(2) APPLICATION-

`(A) IN GENERAL- An entity desiring a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a plan that meets the requirements of subparagraph (B).

`(B) PLAN- A plan meets the requirements of this subparagraph if such plan, at a minimum, includes information regarding--

`(i)(I) programs or community-based activities that the applicant proposes to carry out with funds received under this section and which seek to prevent and reduce the incidence of--

`(aa) overweight and obesity, or chronic diseases associated with overweight and obesity;

`(bb) tobacco use; or

`(cc) mental illness; or

`(II) other such activities, as determined appropriate by the Secretary, that are consistent with the goals of promoting individual and community health and preventing chronic disease; and

`(ii) the manner in which the applicant will evaluate the effectiveness of the program or activities carried out under this section.

`(3) NON-FEDERAL SHARE- To be eligible to receive a grant under this section, an entity shall provide a non-Federal contribution, in cash or in kind, to the costs of activities under the grant in an amount that is equal to not less than 25 percent of the costs of such activities.

`(c) Use of Funds- An entity that receives a grant under this section shall use the amount made available under the grant to carry out community-based activities, including--

`(1) activities that seek to promote individual health and community wellness and to prevent and reduce the incidence of health problems and chronic diseases associated with--

`(A) being overweight or obese;

`(B) tobacco use; or

`(C) mental illness; or

`(2) other activities undertaken with the goals of health promotion and chronic disease prevention, as determined appropriate by the Secretary.

`(d) Priority- In awarding grants under subsection (a), the Secretary shall give priority to--

`(1) entities that demonstrate that they have previously applied successfully for funds to carry out activities that seek to promote individual and community health and to prevent the incidence of chronic disease and that can cite published and peer-reviewed research demonstrating that the activities that the entity proposes to carry out under this subsection are effective;

`(2) entities that will carry out programs or activities that seek to accomplish a goal or goals set by the State in the Healthy People 2010 plan of the State;

`(3) entities that provide non-Federal contributions, either in cash or in kind, to the costs of funding activities under the grant;

`(4) entities that develop comprehensive plans that include a strategy for extending program activities developed under this section in the years following the fiscal years for which they receive grants under this section;

`(5) entities located in communities that are medically underserved, as determined by the Secretary;

`(6) entities located in areas where the average poverty rate is 150 or higher than the average poverty rate in the State involved, as determined by the Secretary; and

`(7) entities that submit plans that exhibit multisectoral, cooperative conduct that includes the involvement of a broad range of stakeholders, including--

`(A) community-based organizations;

`(B) local governments;

`(C) local educational agencies;

`(D) the private sector;

`(E) State or local departments of health;

`(F) accredited colleges, universities, and community colleges;

`(G) health care providers;

`(H) State and local departments of transportation and city planning; and

`(I) other entities determined appropriate by the Secretary.

`(e) Technical Assistance- From amounts appropriated to carry out this section, the Secretary may reserve not more than 10 percent for each fiscal year to provide entities receiving grants under this section with technical assistance in the implementation of the plans required under subsection (b)(2)(B).

`(f) Evaluation- From amounts appropriated to carry out this section, the Secretary may reserve not to exceed 5 percent for each fiscal year for the purpose of carrying out evaluations of the activities carried out under this section. Not later than 90 days after the completion of any such evaluation, the results of such evaluation shall be submitted to the relevant authorizing committees of Congress and to the Committee on Appropriations of the Senate and the Committee on Appropriations of the House of Representatives.

`(g) Limitation on Administrative Costs- An entity may not use more than 10 percent of amounts received under a grant under this section for administrative expenses.

`(h) Supplement Not Supplant- Amounts provided under a grant under this section shall be used to supplement, and not supplant, other amounts provided for activities of the type to be carried out under this section.

`(i) Authorization of Appropriations- There is authorized to be appropriated such sums as may be necessary to carry out this section.'.

SEC. 312. PROMOTING THE HEALTH AND WELLNESS OF INDIVIDUALS WITH DISABILITIES THROUGH COMMUNITY SPORTS PROGRAMS.

Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) is amended by adding at the end the following:

`SEC. 399R. COMMUNITY SPORTS PROGRAMS FOR INDIVIDUALS WITH DISABILITIES.

`(a) In General-

`(1) INDIVIDUAL WITH A DISABILITY DEFINED- For purposes of this section, the term `individual with a disability' has the meaning given such term in section 7(20) of the Rehabilitation Act of 1973 (29 U.S.C. 705(20), for the purpose of title V of such Act (29 U.S.C. 791 et seq.).

`(2) COMMUNITY SPORTS GRANTS PROGRAM- The Secretary, in collaboration with the National Advisory Committee on Community Sports Programs for Individuals with Disabilities, may award grants on a competitive basis to public and nonprofit private entities to implement community-based, sports and athletic programs for individuals with disabilities, including youth with disabilities.

`(b) Application- To be eligible to receive a grant under subsection (a)(2), a public or nonprofit private entity shall submit to the Secretary an application at such time, in such manner, and containing such agreements, assurances, and information as the Secretary determines to be necessary to carry out this section.

`(c) Authorized Activities- Amounts awarded under a grant under subsection (a) shall be used for--

`(1) community-based sports programs, leagues, or competitions in individual or team sports for individuals with physical disabilities;

`(2) regional sports programs or competitions in individual or team sports for individuals with physical disabilities;

`(3) the development of competitive team and individual sports programs for individuals with disabilities at the high school and collegiate level; or

`(4) the development of mentoring programs to encourage participation in sports programs for individuals who are newly disabled or with newly acquired physical limitations.

`(d) Priorities-

`(1) ADVISORY COMMITTEE- The Secretary shall establish a National Advisory Committee on Community Sports Programs for Individuals with Disabilities that shall--

`(A) establish priorities for the implementation of this section, review grant proposals;

`(B) make recommendations for funding under this section; and

`(C) annually evaluate the progress of programs carried out under this section in implementing such priorities.

`(2) REPRESENTATION- The Advisory Committee established under paragraph (1) shall include representatives of--

`(A) the Department of Health and Human Services Office on Disability;

`(B) the United States Surgeon General;

`(C) the Centers for Disease Control and Prevention;

`(D) the Paralympic division of the United States Olympic Committee;

`(E) disabled sports organizations;

`(F) organizations that represent the interests of individuals with disabilities; and

`(G) individuals with disabilities (including athletes with physical disabilities) or their family members.

`(e) Dissemination of Information- The Secretary shall disseminate information about the availability of grants under this section in a manner that is designed to reach public entities and nonprofit private organizations that are dedicated to providing outreach, advocacy, or independent living services to individuals with disabilities.

`(f) Technical Assistance- The Secretary, in conjunction with the United States Olympic Committee and disabled sports organizations, shall establish a technical assistance center to provide training, support, and information to grantees under this section on establishing and operating community sports programs for individuals with disabilities.

`(g) Report to Congress- Not later than 180 days after the date of the enactment of this section, and annually thereafter, the Secretary shall submit to Congress a report summarizing activities, findings, outcomes, and recommendations resulting from the grant projects funded under this section during the year for which the report is being prepared.

`(h) Authorization of Appropriations-

`(1) IN GENERAL- To carry out this section, there are authorized to be appropriated such sums as may be necessary.

`(2) LIMITATION- Not to exceed 10 percent of the amount appropriated in each fiscal year shall be used to carry out activities under subsection (c)(4).'.

SEC. 313. SAFE AND COMPLETE STREETS.

Section 133 of title 23, United States Code, is amended by adding at the end the following:

`(g) Withholding of Funding-

`(1) IN GENERAL- Beginning with the fiscal year that begins 2 years after the date of enactment of this subsection, the Secretary of Transportation shall withhold 2 percent of the amounts allocated in such fiscal year to the highway and planning funds allotted to a Metropolitan Planning Organization or State Transportation Improvement Program under the Safe, Accountable, Flexible, Efficient Transportation Equity Act unless the State or Metropolitan Planning Organization provides the Secretary with documentation--

`(A) of the existence of an explicit statement of policy (that meets the requirements of subsection (b)) that the safety and convenience of all users of the transportation system shall be accommodated; and

`(B) that such policy has been applied to the projects contained in the Transportation Improvement Plan.

`(2) PURPOSE- The purpose of the policy statement required under paragraph (1)(A) is to ensure that all users of the transportation system, including pedestrians, bicyclists, and transit users as well as children, older individuals, and individuals with disabilities, are able to travel safely and conveniently on streets and highways within the public right of way.

`(h) Policy Statement Requirements- A policy statement under subsection (g)(1)(A) shall include the following:

`(1) An assurance that all users of the transportation system will include pedestrians (including individuals of all ages, and individuals with disabilities (including mobility, sensory, neurological or hidden disabilities)), bicyclists, transit vehicles and users, and motorists.

`(2) An assurance that the statement will apply to both new road construction and transportation improvement projects.

`(3) A clear procedure that requires approval by a senior manager of any specified exceptions from implementing the policy statement, including documentation with supporting data that indicates the basis for the exemption.

`(4) A statement directing the use of the current design standards, including those standards applying to access for individuals with disabilities.

`(5) A statement requiring that complete streets solutions be developed to fit in with the context of the community and that those solutions be flexible.

`(6) A description of the performance standards with measurable outcomes that will be developed.

`(7) A statement that accommodation shall be made for all users in all construction and improvement projects unless one or more of the following apply:

`(A) The project involved a roadway on which non-motorized users are prohibited by law from using. In such case, a greater effort shall be made to accommodate bicyclists and pedestrians elsewhere.

`(B) The cost of establishing complete facilities would be excessively disproportionate to the need or probable use.

`(C) With respect to a project area with a low population, a lack of transit service, or other documented factors indicate an absence of need now and in the future.

`(D) The policy statement may be achieved through a State or local law or ordinance, or through an agency policy directive.

`(i) Certifications- The Metropolitan Planning Organization and State Transportation Improvement Plan shall certify that each road project included in such plan has been reviewed for its compliance with any applicable policy statement under this section and that each project under such plan enhances the safety, convenience, and accessibility of the transportation system for all users to the extent that it is reasonably possible and that the project applicant addressed these concerns in the material prepared for public input with respect to such plan.

`(j) Accessibility Standards- Not later than 12 months after the date of enactment of this subsection, the United States Access Board shall issue final standards for accessibility of new construction and alterations of pedestrian facilities in the public right-of-way. Until such time as the Access Board completes a final Public Right of Way Accessibility rule, Department of Transportation Standards for Accessible Transportation Facilities (49 C.F.R. 37.9, as amended on 10/30/2006 (71 FR 63263)) shall serve as the minimum standard. If the Department Of Transportation standards are silent or inapplicable with respect to any issue, the 2005 draft Public Right Of Way Accessibility Guidelines provisions shall be consulted. A Metropolitan Planning Organization or State department of transportation that is adopting complete streets policies may consult existing Federal guidance, including the 2000 USDOT Guidance document, `Accommodating Bicycle and Pedestrian Travel'.

`(k) Inclusion of All Users- Metropolitan planning organizations shall strongly encourage local jurisdictions that are served by such organizations to maximize their efforts to include all users in their transportation planning.

`(l) Additional Provisions-

`(1) RESEARCH-

`(A) IN GENERAL- The Secretary of Transportation shall require the Federal Highway Administration to conduct complete streets research to assist States and Metropolitan Planning Organizations in developing, adopting, and implementing plans, projects, procedures, policies, and training that comply with the applicable statement of policy under subsection (g)(1)(A).

`(B) PARTICIPATION- Research under subparagraph (A) shall be conducted with the participation of the American Association of State Highway Transportation Officials, the Institute of Transportation Engineers, the American Public Transit Association, the American Planning Association, the National Association of Regional Councils, the Association of Metropolitan Planning Organizations, and representatives of the disability, motoring, bicycling, walking, transit user, aging, and other affected communities.

`(C) EXISTING NEEDS- Research under subparagraph (A) shall be based on the existing statement of complete streets research needs as outlined by the Transportation Research Board in TR Circular E110, and shall also develop new areas of inquiry.

`(2) BENCHMARKS AND GUIDANCE- The research project conducted under paragraph (1) shall be designed to result in the establishment of benchmarks and the provision of practical guidance on how to effectively implement street procedures and designs that will accommodate all types of users along the same facility or corridor including, vehicles, pedestrians, bicycles, and transit use. Such benchmarks and guidance shall focus on changing scoping, design, and construction procedures to more effectively fit the individual modes together into integrated facilities that meet the needs of each in an appropriate balance. Such benchmarks and guidance shall indicate the expected operational and safety performance of alternative approaches to facility design.

`(3) BEST PRACTICES REPORT- Not later than 2 years after the date of enactment of this subsection, the Federal Highway Administration shall publish a best practices report showing how transportation agencies have changed their procedures to routinely design safe, effective multi-modal facilities. In establishing such best practices, consideration shall be given to the following areas:

`(A) Procedures for identifying the needs of the mix of users, including primary and secondary users that need to be served on various highway functional classes.

`(B) The identification of the types and designs of facilities needed to serve each of those types of users.

`(C) The identification of barriers to implementation and identification of costs associated with implementing complete streets policies.

`(4) DATA COLLECTION- In addition to preparing the report under paragraph (3), the Federal Highway Administration shall work with the Bureau of Transportation Statistics and the Federal Transit Association and appropriate Transportation Research Board committees on data collection, including a baseline non-motorized and transit use survey that will be integrated into the National Highway Traffic Safety Administration and the development of a survey tool for use by State transportation departments in identifying the multi-modal capacity of State and local road networks.'.

SEC. 314. NATIONAL ASSESSMENT OF MENTAL HEALTH NEEDS.

Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended by inserting after section 506B (42 U.S.C. 290aa-5b) the following:

`SEC. 506C. NATIONAL ASSESSMENT OF MENTAL HEALTH NEEDS.

`(a) In General- The Secretary, acting through the Administrator, and in consultation with the Centers for Disease Control and Prevention and the Director of the National Institutes of Health, shall establish and implement public health monitoring measures to address the mental and behavioral health needs of the population of the United States and other populations served by the Administration, that include--

`(1) monitoring the mental health status of the population, including incidence and prevalence rates of mental and behavioral health problems throughout the lifespan;

`(2) monitoring mental and behavioral health risks;

`(3) enhancing existing public health monitoring systems to include data on mental and behavioral health status and risks; and

`(4) monitoring the immediate and long-term impact of environmental factors to collect data on the prevalence of mental and behavioral health problems throughout the lifespan with the aim of encouraging early intervention and treatment.

`(b) Distinguishing Among Age Groups- In designing and implementing the measures described in subsection (a) the Secretary shall ensure that methods of monitoring and reporting data distinguish among different age groups, including when identifying groups of children, and very young children under age 3, together with their parents.

`(c) Report- Not later than 1 year after the date of enactment of this section, the Secretary shall submit a report to Congress that describes the progress on the implementation of the monitoring measures described in subsection (a).

`(d) Authorization of Appropriations- There is authorized to be appropriated to carry out this section $5,000,000 for fiscal year 2008 and such sums as may be necessary for each of the following fiscal years.'.

SEC. 315. PREVENTIVE MEDICINE AND PUBLIC HEALTH TRAINING GRANT PROGRAM.

Part D of title III of the Public Health Service Act (42 U.S.C. 254b et seq.) is amended by adding at the end the following:

`Subpart XI--Preventive Medicine Training

`SEC. 340H. PREVENTIVE MEDICINE AND PUBLIC HEALTH TRAINING GRANT PROGRAM.

`(a) Grants- The Secretary, acting through the Director of the Centers for Disease Control and Prevention, may award grants to, or enter into contracts with, eligible entities to provide training to graduate medical residents in preventive medicine specialties.

`(b) Eligibility- To be eligible to receive a grant or contract under subsection (a), an entity shall--

`(1) be a school of public health, public health department, school of medicine or osteopathic medicine, public or private hospital, or public or private non-profit entity;

`(2) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require; and

`(3) maintain and adhere to a Letter of Agreement with a local community health center (if available in the local area involved) that supports practicum training of preventive medicine residents, if practicable.

`(c) Use of Funds- Amounts received under a grant or contract under this section shall be used to--

`(1) to plan, develop, and operate residency programs for preventive medicine or public health;

`(2) provide financial assistance, including tuition and stipends, to resident physicians (MD or DO) who plan to specialize in preventive medicine or public health;

`(3) defray the costs associated with the planning, development, and operation of preventive medicine or public health programs, including the development of curriculum to be used in such program; and

`(4) provide for the improvement of academic administrative units.

`(d) Duration of Award- A grant or contract under this section shall be for a term of not to exceed 5 years.

`(e) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, $43,000,000 for fiscal year 2008, and such sums as may be necessary for each succeeding fiscal year.'.

SEC. 316. TASK FORCE FOR THE PROMOTION OF BREASTFEEDING IN THE WORKPLACE.

(a) Establishment- The Secretary of Health and Human Services and the Secretary of Labor, or their designees, shall convene a task force for the purpose of promoting breastfeeding among working mothers (referred to in this section as the `Task Force').

(b) Membership- The Task Force shall be composed of members who are--

(1) expert staff from the Department of Labor with expertise in workforce issues;

(2) expert staff from the Department of Health and Human Services with expertise in the areas of breastfeeding and breastfeeding promotion;

(3) members of the United States Breastfeeding Committee;

(4) expert staff from the Department of Agriculture; and

(5) appointed by the Secretary of Health and Human Services and the Secretary of Labor, including--

(A) working mothers who have experience in working and breastfeeding; and

(B) representatives of the human resource departments of both large and small employers that have successfully promoted breastfeeding and breastmilk pumping support at work.

(c) Period of Appointment; Vacancies- Members shall be appointed for the life of the Task Force. Any vacancy in the Task Force shall not affects its powers, but shall be filled in the same manner as the original appointment.

(d) Chair- The Task Force shall be chaired jointly by the Secretary of Health and Human Services and the Secretary of Labor, or their designees.

(e) Duties of the Task Force-

(1) EXAMINATION- Consistent with the Department of Health and Human Services Blueprint for Action on Breastfeeding (2000), the Task Force shall examine the following issues:

(A) The challenges that mothers face with continuing breastfeeding when the mothers return to work after giving birth.

(B) The challenges that employers face in accommodating mothers who seek to continue to breastfeed or to express milk when the mothers re-enter the workforce, including different challenges that mothers of varying socio-economic status and in different professions may face.

(C) The benefits that accrue to mothers, babies, and to employers when mothers are able to continue to breastfeed or to express breastmilk at work after the mothers have re-entered the workforce.

(D) Federal and State statutes that may have the effect of reducing breastfeeding and breastfeeding retention rates among working mothers.

(2) REPORTS-

(A) IN GENERAL- Not later than 1 year after the date of enactment of this section, the Task Force shall issue a public report with recommendations on the following:

(i) Steps that can be taken to promote breastfeeding among working mothers and to remove barriers to breastfeeding among working mothers.

(ii) Potential ways in which the Federal Government can work with employers to promote breastfeeding among working mothers.

(iii) Areas in which changes to existing Federal, State, or local laws would likely have the effect of making it easier for working mothers to breastfeed or would remove impediments to breastfeeding that currently exist in such laws.

(iv) Whether or not increased rates of breastfeeding among working mothers would likely have the result of reducing health care costs among such mothers and their children, and, in particular, whether increased rates of breastfeeding would be likely to result in lower Federal expenditures on health care for such mothers and their children.

(v) Areas in which the Federal Government, through additional appropriations, increased efforts by Federal agencies, or changes to existing Federal law, can and should increase the Federal Government's efforts to promote breastfeeding among working mothers.

(B) COPY TO CONGRESS- Upon completion of the report described in subparagraph (A), the Task Force shall submit a copy of the report to the Committee on Health, Education, Labor, and Pensions of the Senate, the Committee on Appropriations of the Senate, the Committee on Education and the Workforce of the House of Representatives, and the Committee on Appropriations of the House of Representatives.

(f) Powers of the Task Force-

(1) HEARINGS- The Task Force may hold such hearings, sit and act at such times and places, take such testimony, and receive such evidence as the Task Force considers advisable to carry out this section.

(2) INFORMATION FROM FEDERAL AGENCIES- The Task Force may secure directly from any Federal department or agency such information as the Task Force considers necessary to carry out this section. Upon request of the Chair of the Task Force, the head of such department or agency shall furnish such information to the task Force.

(3) POSTAL SERVICES- The Task Force may use the United States mails in the same manner and under the same conditions as other departments and agencies of the Federal Government.

(4) GIFTS- The Task Force may accept, use, and dispose of gifts or donations of services or property.

(g) Operating Expenses- The operating expenses of the Task Force, including travel expenses for members of the Task Force, shall be paid for from the general operating expenses funds of the Secretary of Health and Human Services and the Secretary of Labor.

SEC. 317. LACTATION ACCOMMODATION AND BREASTFEEDING PROMOTION AT WORK.

(a) Breastfeeding at Work General Requirements- The Family and Medical Leave Act of 1993 (29 U.S.C. 2611 et seq.) is amended by inserting after title IV the following:

`TITLE V--LACTATION PERIODS AND FACILITIES

`SEC. 501. DEFINITIONS.

`In this title:

`(1) ELIGIBLE CHILD- The term `eligible child', used with respect to an eligible employee, means a son or daughter (as defined in section 101) who is a child of the employee.

`(2) ELIGIBLE EMPLOYEE- The term `eligible employee' has the meaning given the term in section 101, except that the limitations established in clauses (i) and (ii) of section 101(2)(A) shall not apply. The term `eligible employee' does not include any Federal officer or employee covered under subchapter VII of chapter 63 of title 5, United States Code, but does include a State employee described in section 304(a) of the Government Employee Rights Act of 1991 (42 U.S.C. 2000e-16c(a)).

`(3) EMPLOYER- The term `employer' has the meaning given the term in section 101, and includes an entity employing a State employee described in section 304(a) of the Government Employee Rights Act of 1991.

`(4) UNDUE HARDSHIP- The term `undue hardship' means an action requiring significant difficulty or expense.

`SEC. 502. LACTATION PERIODS.

`(a) In General- An employer shall provide an appropriate number of lactation periods, of reasonable length, for an eligible employee during each workday, to permit the employee to express milk for, or breastfeed, an eligible child.

`(b) Break Time-

`(1) UNPAID BREAK PERIODS- Except as provided in paragraph (2), the lactation periods may consist of unpaid break periods.

`(2) COMBINED BREAK PERIODS- To the extent practicable, an employer shall combine break periods by providing the lactation periods for an eligible employee at the same time as the employer provides other break periods for the employee. If the employer combines the break periods, the employee shall receive the same compensation for a combined break period as the employee would have received for an original break period.

`(c) Limitation-

`(1) UNDUE HARDSHIP- An employer shall not be required to provide a lactation period under this section if the employer demonstrates that providing the period would impose an undue hardship on the employer, subject to paragraph (2).

`(2) REASONABLE EFFORTS- An employer who maintains that an undue hardship would result from providing a lactation period to an eligible employee shall demonstrate that the employer made reasonable efforts to comply with subsections (a) and (b).

`SEC. 503. LACTATION FACILITIES.

`(a) In General- An employer shall provide an appropriate lactation facility for an eligible employee, within a reasonable distance from the employee's usual work location, to permit the employee to express milk for, or breastfeed, an eligible child.

`(b) Limitation-

`(1) UNDUE HARDSHIP- An employer shall not be required to provide a lactation facility under this section if the employer demonstrates that providing the facility would impose an undue hardship on the employer, subject to paragraph (2).

`(2) REASONABLE EFFORTS- An employer who maintains that an undue hardship would result from providing a lactation facility to an eligible employee shall demonstrate that the employer made reasonable efforts to comply with subsection (a).

`SEC. 504. ENFORCEMENT AND REMEDIES.

`(a) Enforcement Process- The Secretary of Labor shall establish or designate a process through which--

`(1) an individual may file a complaint regarding a violation of this title; and

`(2) an office designated by the Secretary in the Department of Labor shall receive, investigate, make determinations regarding, and administer remedies with respect to such complaints.

`(b) Remedies- The Secretary of Labor shall establish remedies for violations of this title.

`(c) Government Accountability Office and Library of Congress- In the case of the Government Accountability Office and the Library of Congress, the authority of the Secretary of Labor under this title shall be exercised respectively by the Comptroller General of the United States and the Librarian of Congress.

`SEC. 505. REGULATIONS.

`The Secretary of Labor shall issue regulations to carry out this title, including provisions prescribing--

`(1) an appropriate number and reasonable length of lactation periods, for purposes of section 502;

`(2) an appropriate lactation facility (which shall not be a restroom or a portion of a restroom) and a reasonable distance from a usual work location, for purposes of section 503; and

`(3) the process and remedies described in section 504.'.

(b) Breastfeeding at Work for Civil Service Employees- Chapter 63 of title 5, United States Code, is amended by adding at the end:

`SUBCHAPTER VII--LACTATION PERIODS AND FACILITIES

`Sec. 6392. Definitions

`For the purpose of this subchapter--

`(1) the term `eligible child', used with respect to an employee, means a son or daughter (as defined in section 6381) who is a child of the employee;

`(2) the term `employee' means any individual who is an `employee', as defined by section 6301(2), including any individual employed in a position referred to in clause (v) or (ix) of section 6301(2), but excluding any individual employed by the government of the District of Columbia, any individual employed on a temporary or intermittent basis, and any employee of the General Accounting Office or the Library of Congress; and

`(3) the term `undue hardship' means an action requiring significant difficulty or expense.

`Sec. 6392A. Lactation periods

`(a) An employing agency shall provide an appropriate number of lactation periods, of reasonable length, for an employee during each workday, to permit the employee to express milk for, or breastfeed, an eligible child.

`(b)(1) Except as provided in paragraph (2), the lactation periods may consist of unpaid break periods.

`(2) To the extent practicable, an employing agency shall combine break periods by providing the lactation periods for an employee at the same time as the employing agency provides other break periods for the employee. If the employing agency combines the break periods, the employee shall receive the same compensation for a combined break period as the employee would have received for an original break period.

`(c)(1) An employing agency shall not be required to provide a lactation period under this section if the employing agency demonstrates that providing the period would impose an undue hardship on the employing agency, subject to paragraph (2).

`(2) An employing agency who maintains that an undue hardship would result from providing a lactation period to an employee shall demonstrate that the employing agency made reasonable efforts to comply with subsections (a) and (b).

`Sec. 6392B. Lactation facilities

`(a) An employing agency shall provide an appropriate lactation facility for an employee, within a reasonable distance from the employee's usual work location, to permit the employee to express milk for, or breastfeed, an eligible child.

`(b)(1) An employing agency shall not be required to provide a lactation facility under this section if the employing agency demonstrates that providing the facility would impose an undue hardship on the employing agency, subject to paragraph (2).

`(2) An employing agency who maintains that an undue hardship would result from providing a lactation facility to an employee shall demonstrate that the employing agency made reasonable efforts to comply with subsection (a).

`Sec. 6392C. Remedies

`(a) The Office of Personnel Management shall establish or designate a process through which--

`(1) an individual may file a complaint regarding a violation of this subchapter; and

`(2) an office designated by the Director of the Office of Personnel Management shall receive, investigate, make determinations regarding, and administer remedies with respect to such complaints.

`(b) The Office of Personnel Management shall establish remedies for violations of this subchapter.

`Sec. 6392D. Regulations

`(a) The Office of Personnel Management shall issue regulations to carry out this subchapter, including provisions prescribing--

`(1) an appropriate number and reasonable length of lactation periods, for purposes of section 6392A;

`(2) an appropriate lactation facility (which shall not be a restroom or a portion of a restroom) and a reasonable distance from a usual work location, for purposes of section 6392B; and

`(3) the process and remedies described in section 6392C.

`(b) The regulations prescribed under this subchapter shall, to the extent appropriate, be consistent with the regulations prescribed by the Secretary of Labor to carry out title V of the Family and Medical Leave Act of 1993.'.

(c) Breastfeeding at Work for Congressional Employees-

(1) APPLICATION OF LAWS- Section 102(a) of the Congressional Accountability Act of 1995 (2 U.S.C. 1302(a)) is amended--

(A) in paragraph (5), by striking `The' and inserting `Title I of the'; and

(B) by adding at the end the following:

`(12) Title V of the Family and Medical Leave Act of 1993.'.

(2) EXTENSION OF RIGHTS AND PROTECTIONS- Part A of title II of the Congressional Accountability Act of 1995 (2 U.S.C. 1311 et seq.) is amended--

(A) in section 202 (2 U.S.C. 1312), by striking the title and inserting the following:

`SEC. 202. RIGHTS AND PROTECTIONS UNDER TITLE I OF THE FAMILY AND MEDICAL LEAVE ACT OF 1993.';

(B) by redesignating section 207 as section 208; and

(C) by inserting after section 206 the following:

`SEC. 207. RIGHTS AND PROTECTIONS UNDER TITLE V OF THE FAMILY AND MEDICAL LEAVE ACT OF 1993.

`(a) Breastfeeding Rights and Protections Provided-

`(1) IN GENERAL- The rights and protections established by sections 501 through 503 of the Family and Medical Leave Act of 1993 shall apply to covered employees.

`(2) DEFINITION- For purposes of the application described in paragraph (1)--

`(A) the term `employer' as used in the Family and Medical Leave Act of 1993 means any employing office; and

`(B) the term `eligible employee' as used in the Family and Medical Leave Act of 1993 means a covered employee who has been employed in any employing office.