Memorandum on Preventive Health Services at the Federal Workplace

Memorandum for the Heads of Executive Departments and Agencies

Subject: Preventive Health Services at the Federal Workplace

Today, as we celebrate the enactment of the Breast and Cervical Cancer Prevention and Treatment Act that I signed into law in October of last year, I am heartened by the progress being made in expanding access to preventive care for cancer and other serious diseases. We know a great deal about screening procedures that can detect diseases early, and about behaviors, such as smoking cessation and sun avoidance, that can greatly reduce a person's risk of disease. The challenge that remains is to ensure that all Americans not only take advantage of the screening programs and other effective preventive measures that are available and appropriate, but that they make positive changes in their lifestyles before disease develops.

The workplace is a logical place to provide employees with health information and services to help them learn about preventive health. The Federal Government, the Nation's largest employer, has already developed many programs to encourage preventive health care for its employees. These measures, available to Federal employees through the Federal Employee Health Benefits Program, cover a broad range of preventive health services, including screening for prostate, cervical, colorectal, and breast cancer, and screening for sickle cell anemia, blood lead level, and blood cholesterol level. The programs also provide for all recommended childhood immunizations, well child care, and adult preventive care visits. In addition, the Federal personnel system provides employees with considerable flexibility in scheduling their hours of work and taking time off for medical needs, including routine examinations and preventive screenings. Many agencies offer creative, effective employee health programs that provide opportunities for employees to take advantage of preventive health screenings at the worksite.

There is still room for progress. Therefore, I am today directing Federal departments and agencies to review their policies and make maximum use of existing work schedule and leave flexibilities to allow Federal employees to take advantage of screening programs and other effective preventive health measures. Each department and agency should also inform its employees of the various work schedule and leave flexibilities available to them to participate in these preventive screenings and examinations. Such flexibilities include promoting alternative work schedules (flexible and compressed work schedules), which allow for a variety of working arrangements tailored to fit the needs of individual employees, granting leave under the Federal Government's sick and annual leave programs, and granting excused absence to employees to participate in agency-sponsored preventive health activities. In the case of employees with fewer than 80 hours (two weeks) of accrued sick leave, I am directing each department and agency to establish a policy that provides up to 4 hours of excused absence each year, without loss of pay or charge to leave, for participation in preventive health screenings.

I am also directing agencies to develop or expand programs offered at the worksite to help employees understand their risks for disease, obtain preventive health services, and make healthy lifestyle choices, and to share these initiatives with the Office of Personnel Management (OPM) within 120 days. The OPM will use this information to identify agency best practices. Finally, I direct the OPM to prepare guidance to assist agencies in carrying out this directive.

Agencies will carry out this policy within available appropriations, and to the extent permitted by law and consistent with the Administration's budget priorities.

I want the Federal Government to serve as a model for the rest of the country. While Federal agencies have led the way in many instances, I want to go even further in demonstrating that preventive health care for all employees is not only desirable, but also very practical and sensible.

WILLIAM J. CLINTON