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[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2726 Introduced in Senate (IS)]

<DOC>

115th CONGRESS
  2d Session
                                S. 2726

 To amend the Public Health Service Act to promote healthy eating and 
                   physical activity among children.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             April 23, 2018

    Mr. Booker (for himself, Mr. Nelson, Mr. Coons, and Mr. Carper) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL

 
 To amend the Public Health Service Act to promote healthy eating and 
                   physical activity among children.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Reducing Obesity in Youth Act of 
2018''.

SEC. 2. FINDINGS AND PURPOSES.

    (a) Findings.--Congress makes the following findings:
            (1) Research has shown that early childhood is an important 
        time for developing dietary and physical activity behaviors 
        that support health and well-being and may help prevent 
        obesity.
            (2) Infants as young as 7 months have shown eating patterns 
        that are similar to older children and adults.
            (3) For children under 1 year of age, promoting 
        opportunities for movement (such as reaching, crawling, and 
        creeping) may be the most effective way to increase physical 
        activity and improve children's motor skills.
            (4) Children who are exposed to healthy foods early are 
        more likely to prefer and eat healthy foods and to develop 
        eating habits that promote healthy growth that can continue 
        throughout childhood.
            (5) Healthy eating can improve a child's learning ability 
        and potentially lead to higher academic performance, along with 
        his or her mental, social, and physical well-being and can 
        contribute to increased self-esteem.
            (6) A 2010 study indicated that daily physical activity is 
        not only essential for healthy weight maintenance, but also for 
        practicing and learning fundamental gross motor skills and 
        socioemotional and cognitive skills. Furthermore, when children 
        have the opportunity for adequate physical activity, they 
        benefit physically, psychologically and socially.
            (7) Nearly 20 percent (1 in 5) of 2-year-olds spend more 
        than 2 hours of a typical day watching television or videos.
            (8) The Journal of the American Medical Association 
        Pediatrics found that each incremental hour of watching 
        television at age 2 is associated with corresponding declines 
        in school engagement, math achievement, and weekend physical 
        activity, and with increases in bullying by classmates, 
        consumption of soft drinks and snacks, and BMI at age 10.
            (9) About 20 percent of children between 2 and 5 years of 
        age are overweight or obese.
            (10) A study published in the New England Journal of 
        Medicine in 2014 found that a third of children who were 
        overweight in kindergarten were obese by eighth grade. Almost 
        every child who was very obese remained that way, suggesting 
        that efforts must start much earlier and focus more on the 
        children at greatest risk.
            (11) A study published in the New England Journal of 
        Medicine in 2017 estimates that over 50 percent of 2-year-olds 
        today will be obese by 35 years of age.
            (12) A study examining the National Health and Nutrition 
        Examination Survey published in 2018 found an increase in 
        prevalence of childhood obesity in 2015 and 2016. Childhood 
        obesity for children between 2 and 5 years of age increased 
        from 9 percent to 14 percent, the highest increase since 1999.
            (13) In 2012, three-fourths of United States preschool-aged 
        children were in child care, and most of their day was spent in 
        sedentary activities.
            (14) Center-based programs serve approximately 6,980,000 
        children birth through age 5 years but not yet in kindergarten, 
        making the early childhood care and education setting an 
        important one for promoting healthful habits.
            (15) Early care and education learning collaboratives in 9 
        States have reached nearly 156,000 children and improved early 
        childhood care and education provider practices for nutrition 
        and physical activity.
    (b) Purposes.--It is the purpose of this Act to--
            (1) establish a program that will influence practices, 
        policies, and environments in early care and education settings 
        to support healthy eating, physical activity, and screen time 
        reduction for children ages birth through 5;
            (2) enhance the training and knowledge of early care and 
        education providers on strategies for promoting healthy eating 
        (including early feeding best practices), physical activity, 
        and screen time reduction in early care and education settings;
            (3) monitor progress of healthy eating and physical 
        activity promotion in early care and education settings; and
            (4) identify emerging, and expand existing, approaches to 
        engaging families and parents of children ages birth to 5 in 
        healthy eating, physical activity, and screen time reduction.

SEC. 3. HEALTHY KIDS PROGRAM.

    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 W--HEALTHY KIDS PROGRAM

``SEC. 399OO. DEFINITIONS.

    ``In this part:
            ``(1) Director.--The term `Director' means the Director of 
        the Centers for Disease Control and Prevention.
            ``(2) Early care and education.--The term `early care and 
        education' means programs and activities that serve children 
        ages birth through 5 years either through in-home or out-of-
        home settings, including child care programs, Head Start 
        programs, and pre-kindergarten programs.
            ``(3) Screen time reduction.--The term `screen time 
        reduction' means policies or guidelines designed to reduce the 
        daily amount of time that children spend watching or looking at 
        digital monitors or displays, including television sets, 
        computer monitors, or hand-held gaming devices.

``SEC. 399OO-1. GRANTS.

    ``(a) In General.--The Secretary, in coordination with the Centers 
for Disease Control and Prevention and the Administration for Children 
and Families shall, subject to the availability of appropriations, 
award 5-year competitive grants to eligible entities to assist in the 
development of healthier early care and education environments to 
improve healthy eating and physical activity among children ages birth 
through 5 years in early care and education settings. Training provided 
under such grants shall be consistent with the best practices from 
existing health and wellness resources endorsed by the Secretary, in 
consultation with the National Academy of Medicine, the Office of Child 
Care and Office of Head Start of the Administration for Children and 
Families, the Division of Nutrition, Physical Activity, and Obesity of 
the Centers for Disease Control and Prevention, the Maternal and Child 
Health Bureau of the Health Resources and Services Administration, and 
the Food and Nutrition Service of the Department of Agriculture.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            ``(1) be--
                    ``(A) a nonprofit organization with expertise in 
                early childhood health and obesity prevention;
                    ``(B) an institution of higher education or 
                research center that employs faculty with relevant 
                expertise; or
                    ``(C) a consortium of entities described in 
                subparagraphs (A) and (B) that submit a single 
                application to carry out activities under the grant 
                jointly; and
            ``(2) submit to the Director an application at such time, 
        in such manner, and containing such information as the Director 
        may require.
    ``(c) Use of Funds.--
            ``(1) Identification of areas of opportunities and goals.--
        An entity that receives a grant under this section shall, using 
        Department of Health and Human Services guidance and tools 
        (such as the Spectrum of Opportunities for Obesity Prevention 
        in the Early Care and Education Setting developed by the 
        Centers for Disease Control and Prevention), identify areas of 
        opportunity and set goals and carry out activities to promote 
        healthy eating, physical activity, and screen time reduction 
        strategies among children ages birth through 5 years in early 
        care and education settings.
            ``(2) Activities.--An entity shall use amounts received 
        under a grant under this section to carry out each of the 
        following activities:
                    ``(A) Provide training, technical assistance, and 
                resources to implementing partners, which may include 
                States, territories, Indian tribes, municipalities, and 
                nonprofit organizations to integrate the promotion of 
                healthy eating (including early feeding best 
                practices), physical activity, and screen time 
                reduction into existing early care and education State 
                programs and initiatives to create and spread 
                sustainable change within the State or territory 
                involved.
                    ``(B) Work directly with implementing partners to 
                create sustainable programs to train early care and 
                education providers through train-the-trainer models, 
                learning collaboratives, or other approaches approved 
                by the Secretary.
                    ``(C) Enter into a contract with a nonprofit 
                organization or other entity with relevant expertise 
                that is approved by the Secretary, to evaluate the 
                programs carried out under the grant, including 
                baseline, process, and outcome measurements.
            ``(3) Dissemination of best practices.--Upon the conclusion 
        of programs and activities carried out under the grants under 
        this section, the Secretary shall disseminate to all 
        appropriate agencies within the Department of Health and Human 
        Services evidence, best practices, and lessons derived from the 
        experiences of grantees with respect to reducing and preventing 
        obesity and overweight among children ages birth through 5 
        years in the early care and education settings. Such agencies 
        shall encourage the adoption of such best practices.
    ``(d) Preference.--
            ``(1) Grantees.--In awarding grants under this section, the 
        Secretary shall give preference to eligible entities that 
        demonstrate--
                    ``(A) a history of working with early care and 
                education providers and States in obesity prevention in 
                the early care and education setting;
                    ``(B) a history of, and capacity to, leverage 
                private dollars to amplify obesity prevention efforts 
                in early care and education settings;
                    ``(C) a history of working successfully with an 
                evaluator to determine program effectiveness;
                    ``(D) a history of, and capacity to, collaborate 
                with the health sector on obesity prevention 
                initiatives;
                    ``(E) a history of, and capacity to, spread and 
                sustain health initiatives; and
                    ``(F) the ability to conduct at least 3 pilot 
                programs to test innovative or evidence-informed 
                approaches to engage families, including families of 
                children ages birth to 5 years, or to pursue other 
                innovative approaches in the promotion of healthy 
                eating and physical activity.
            ``(2) Implementing partners.--In selecting States, 
        territories, Indian tribes, municipalities, or nonprofit 
        organizations under a grant under this section, a grantee shall 
        ensure that such partners--
                    ``(A) serve populations that are racially, 
                ethnically, socioeconomically, and geographically 
                diverse;
                    ``(B) represent a mix of rural and urban settings;
                    ``(C) have a varied level of existing 
                infrastructure, capacity, and other programmatic 
                initiatives to address obesity prevention in early care 
                and education systems; and
                    ``(D) possess expertise in early care and education 
                or children's health and the ability to implement 
                evidence-informed interventions to promote healthy 
                eating, physical activity, and screen time reduction 
                strategies in early care and education settings for 
                children ages birth through 5 years, including 
                strategies targeted to addressing the needs of children 
                ages birth through 2 years and strategies to engage 
                parents in healthy eating and physical activity 
                promotion.
    ``(e) Tracking State Progress.--The Secretary shall use amounts 
appropriated under subsection (g)(2) to enter into contracts with, or 
award grants to, institutions of higher education, nonprofit 
organizations, or other entities with relevant monitoring and 
surveillance expertise that are approved by the Secretary, to track 
State progress in obesity prevention policies and practices of early 
care and education programs through a sentinel set of States.
    ``(f) Report to Congress.--Not later than 12 months after the 
completion of the programs and activities funded under grants awarded 
under this section, the Secretary shall submit to Congress a report 
concerning an evaluation of the results of such programs and activities 
and sentinel surveillance, including recommendations on how lessons 
learned from such programs can be incorporated into future guidance 
documents developed and provided by the Secretary or Director and other 
Federal agencies as appropriate.
    ``(g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section--
            ``(1) $4,000,000 for each of fiscal years 2019 through 
        2023; and
            ``(2) $1,700,000 for fiscal year 2019, to be used to track 
        State progress in obesity prevention policies and practices of 
        early care and education programs in a sentinel set of States 
        as provided for in subsection (e).''.
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