I 

111TH CONGRESS 

2D SESSION H. R. 5209 

To provide a comprehensive approach to preventing and treating obesity. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 5, 2010 

Mr. KIND (for himself, Mrs. BONO MACK, Mr. BLUMENAUER, and Ms. 

FUDGE) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on 

Education and Labor, Ways and Means, Agriculture, Transportation and 

Infrastructure, and Natural Resources, for a period to be subsequently 

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

A BILL 

To provide a comprehensive approach to preventing and 

treating obesity. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

5 ‘‘Healthy Communities through Helping to Offer Incen6 tives and Choices to Everyone in Society Act of 2010’’. 

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

8 this Act is as follows: 


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Sec. 1. Short title; table of contents. 

TITLE I—IMPROVING PREVENTION AND TREATMENT OF 

OBESITY IN ADULTS AND CHILDREN 

Sec. 101. Reporting of Body Mass Index Information Requirement. 

Sec. 102. Grants for Body Mass Index data analysis. 

Sec. 103. Requirement to expedite national Medicare coverage determinations 

for evidence-based preventive services. 

Sec. 104. Expansion of obesity treatment services under Medicare. 

Sec. 105. Coverage of evidence-based preventive services under Medicaid and 

SCHIP. 

Sec. 106. Coverage of medical nutrition therapy under Medicaid and SCHIP. 

Sec. 107. Clarification of EPSDT inclusion of prevention, screening, and treatment services for obesity and overweight; SCHIP coverage. 

Sec. 108. Grants to increase physical activity, improve nutrition, and promote 

healthy eating behaviors. 

Sec. 109. Grants to provide training for health profession students. 

Sec. 110. Grants to provide training for health professionals. 

Sec. 111. Preventive health services block grant. 

TITLE II—IMPROVING CHILDHOOD NUTRITION 

Sec. 201. Nutrition and wellness goals for meals served through the child and 

adult care food program. 

Sec. 202. Interagency coordination to promote health and wellness in child care 

licensing. 

Sec. 203. Study on nutrition and wellness quality of child care settings. 

Sec. 204. Working group to reduce paperwork and improve program administration. 

Sec. 205. Renewal of application materials and permanent operating agreements. 

Sec. 206. Transmission of income information by sponsored family or group 

day care homes. 

Sec. 207. Simplifying and enhancing administrative payments to sponsoring organizations. 

Sec. 208. Cultivate farm-to-school partnerships. 

TITLE III—IMPROVING ACCESS TO AND OPPORTUNITY FOR 

PHYSICAL ACTIVITY FOR ADULTS AND CHILDREN 

Subtitle A—National Program Promoting Lifelong Active Youth (PLAY) and 

Implementation Grants 

Sec. 301. Play assessment tools. 

Sec. 302. Model communities of play implementation grants. 

Subtitle B—Moving Outdoors in Nature 

Sec. 311. Definitions. 

Sec. 312. Grants for development or implementation of Moving Outdoors in 

Nature Strategies. 

Sec. 313. National evaluation of health impacts. 

Sec. 314. Technical assistance and best practices. 

Sec. 315. Authorization of appropriations. 

Subtitle C—Other Provisions 


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Sec. 321. Authorization of appropriations for Carol M. White Physical Education Program. 

Sec. 322. Physical education guidelines for elementary and secondary schools. 

Sec. 323. Treating physical education as a core academic subject for elementary 

and secondary education grants. 

Sec. 324. Physical activity guidelines for preschool children. 

Sec. 325. Tracking physical activity in schools. 

Sec. 326. Employer-provided off-premises health club services. 

Sec. 327. Certain amounts paid for physical activity, fitness, and exercise treated as amounts paid for medical care. 

Sec. 328. National youth sports program revitalization. 

Sec. 329. Duplication of the Zuni Youth Enrichment Project Summer Camp on 

Indian reservations and tribal lands. 

TITLE IV—IMPROVING ACCESS TO NUTRITIONAL INFORMATION 

AND HEALTHY FOODS 

Sec. 401. Consumer education. 

Sec. 402. Expand team nutrition training grants. 

Sec. 403. Department of Agriculture program to support establishment or expansion of retail food stores offering affordable, nutritious 

foods in underserved communities and coordination with other 

Federal programs. 

Sec. 404. Virtual Farmers Market Program. 

Sec. 405. Urban and Native-American Community Garden Grant Program. 

TITLE V—REALIGNING TRANSPORTATION POLICY TO HELP 

PROMOTE HEALTHY LIFESTYLES 

Sec. 501. Grants to promote planning decisions and policies that increase access to physical activity. 

Sec. 502. Joint use agreements. 

Sec. 503. Expansion of safe routes to school program. 

Sec. 504. Active transportation infrastructure investment program. 

TITLE VI—RESEARCH AND ASSESSMENT TOOLS 

Sec. 601. National Center for Health Statistics. 

Sec. 602. Report on obesity research. 


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1 TITLE I—IMPROVING PREVEN2 TION AND TREATMENT OF 

3 OBESITY IN ADULTS AND 

4 CHILDREN 

5 SEC. 101. REPORTING OF BODY MASS INDEX INFORMATION 

6 REQUIREMENT. 

7 (a) IN GENERAL.—Subsection (a) of section 2125 of 

8 the Public Health Service Act (42 U.S.C. 300aa–25) is 

9 amended— 

10 (1) by striking ‘‘and’’ at the end of paragraph 

11 (3); 

12 (2) by striking the period and adding ‘‘, and’’ 

13 at the end of paragraph (4); and 

14 (3) by adding at the end the following new 

15 paragraph: 

16 ‘‘(5) the age, gender, height, and weight of each 

17 person vaccinated to calculate the body mass index 

18 of such person.’’. 

19 (b) REPORTING.—Subsection (b) of such section is 

20 amended— 

21 (1) in paragraph (1)— 

22 (A) by striking ‘‘and’’ at the end of sub23 paragraph (B); 

24 (B) by redesignating subparagraph (C) as 

25 subparagraph (D); and 


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1 (C) by inserting after subparagraph (B) 

2 the following new subparagraph: 

3 ‘‘(C) the information recorded under sub4 section (a)(5), and’’; and 

5 (2) by adding at the end the following new 

6 paragraph: 

7 ‘‘(4) Each health provider shall also report to 

8 the relevant department of the State in which such 

9 health care provider practices the data collected 

10 under subsection (a)(5).’’. 

11 SEC. 102. GRANTS FOR BODY MASS INDEX DATA ANALYSIS. 

12 (a) ESTABLISHMENT.—The Secretary of Health and 

13 Human Services may make grants to not more than 20 

14 eligible entities to analyze body mass index (hereinafter 

15 in this section referred to as ‘‘BMI’’) measurements of 

16 children, ages 2 through 18. 

17 (b) ELIGIBILITY.—An eligible entity for purposes of 

18 this section is a State (including the District of Columbia, 

19 the Commonwealth of Puerto Rico, and each territory of 

20 the United States) that has a statewide immunization in21 formation system that— 

22 (1) has the capacity to store basic demographic 

23 information (including date of birth, gender, and ge24 ographic area of residence), height, weight, and im25 munization data for each resident of the State; 


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1 (2) is accessible to doctors, nurses, other li2 censed medical professionals, and officials of the rel3 evant department in the State charged with main4 taining health and immunization records; and 

5 (3) has the capacity to integrate large amounts 

6 of data for the analysis of BMI measurements. 

7 (c) USE OF FUNDS.—A State that receives a grant 

8 under this section shall use the grant for the following 

9 purposes: 

10 (1) Analyzing the effectiveness of obesity pre11 vention programs and wellness policies carried out in 

12 the State. 

13 (2) Purchasing new computers, computer equip14 ment, and software to upgrade computers to be used 

15 for a statewide immunization information system. 

16 (3) The hiring and employment of personnel to 

17 maintain and analyze BMI data. 

18 (4) The development and implementation of 

19 training programs for medical professionals to aid 

20 such professionals in taking BMI measurements and 

21 discussing such measurements with patients. 

22 (5) Providing information to parents and legal 

23 guardians in accordance with subsection (e)(2). 

24 (d) SELECTION CRITERIA.—In selecting recipients of 

25 grants under this section, the Secretary shall give priority 


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1 to States in which a high percentage of public and private 

2 health care providers submit data to a statewide immuni3 zation information system that— 

4 (1) contains immunization data for not less 

5 than 20 percent of the population of such State that 

6 is under the age of 18; and 

7 (2) includes data collected from men and 

8 women who are of a wide variety of ages and who 

9 reside in a wide variety of geographic areas in a 

10 State (as determined by the Secretary). 

11 (e) CONDITIONS.—As a condition of receiving a grant 

12 under this section, a State shall— 

13 (1) ensure that BMI measurements will be re14 corded for children ages 2 through 18— 

15 (A) on an annual basis by a licensed physi16 cian, nurse, nurse practitioner, or physicians as17 sistant during an annual physical examination, 

18 wellness visit, or similar visit with a physician; 

19 and 

20 (B) in accordance with data collection pro21 tocols published by the American Academy of 

22 Pediatrics in the 2007 Expert Committee Rec23 ommendations; and 

24 (2) for each child in the State for whom such 

25 measurements indicate a BMI greater than the 95th 


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1 percentile for such child’s age and gender, provide to 

2 the parents or legal guardians of such child informa3 tion on how to lower BMI and information on State 

4 and local obesity prevention programs. 

5 (f) REPORTS.— 

6 (1) REPORTS TO THE SECRETARY.—Not later 

7 than 5 years after the receipt of a grant under this 

8 section, the State receiving such grant shall submit 

9 to the Secretary the following reports: 

10 (A) A report containing an analysis of 

11 BMI data collected using the grant, including— 

12 (i) the differences in obesity trends by 

13 gender, disability, geographic area (as de14 termined by the State), and socioeconomic 

15 status within such State; and 

16 (ii) the demographic groups and geo17 graphic areas most affected by obesity 

18 within such State. 

19 (B) A report containing an analysis of the 

20 effectiveness of obesity prevention programs 

21 and State wellness policies, including— 

22 (i) an analysis of the success of such 

23 programs and policies prior to the receipt 

24 of the grant; and 


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1 (ii) a discussion of the means to de2 termine the most effective strategies to 

3 combat obesity in the geographic areas 

4 identified under subparagraph (A). 

5 (2) REPORT TO CONGRESS AND CERTAIN EXEC6 UTIVE AGENCIES.—Not later than 1 year after the 

7 Secretary receives all the reports required pursuant 

8 to paragraph (1), the Secretary shall submit to the 

9 Secretary of Education, the Secretary of Agriculture, 

10 and to Congress a report that contains the following: 

11 (A) An analysis of trends in childhood obe12 sity, including how such trends vary across re13 gions of the United States, and how such 

14 trends vary by gender and socioeconomic status. 

15 (B) A description of any programs that— 

16 (i) the Secretary has determined sig17 nificantly lower childhood obesity rates for 

18 certain geographic areas in the United 

19 States, including urban, rural, and subur20 ban areas; and 

21 (ii) the Secretary recommends to be 

22 implemented by the States (including 

23 States that did not receive a grant under 

24 this section). 


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1 (g) AUTHORIZATION OF APPROPRIATIONS.—There is 

2 authorized to be appropriated to the Secretary such sums 

3 as may be necessary to carry out this section for each of 

4 fiscal years 2010 through 2015. 

5 SEC. 103. REQUIREMENT TO EXPEDITE NATIONAL MEDI6 CARE COVERAGE DETERMINATIONS FOR EVI7 DENCE-BASED PREVENTIVE SERVICES. 

8 (a) IN GENERAL.—Not later than January 1, 2011, 

9 the Secretary of Health and Human Services shall issue 

10 national Medicare coverage determinations for evidence11 based preventive and treatment services, including services 

12 to prevent or treat overweight and obesity that have in 

13 effect a rating of ‘‘A’’ or ‘‘B’’ (relating to a classification 

14 representing strongly recommended or recommended serv15 ices) in the current recommendations of the United States 

16 Preventive Services Task Force (in this section referred 

17 to as ‘‘USPSTF’’) and clinical services for preventing and 

18 treating overweight and obesity as defined by the National 

19 Heart, Lung and Blood Institute’s (in this section referred 

20 to as ‘‘NHLBI’’) Clinical Guidelines on the Identification, 

21 Evaluation and Treatment of Overweight and Obesity in 

22 Adults. The Secretary shall update such coverage deter23 minations based on future updates to such USPSTF and 

24 NHLBI guidelines. 


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1 (b) UPDATING RECOMMENDATIONS.—The Secretary 

2 shall instruct— 

3 (1) the Agency for Healthcare Research and 

4 Quality and the USPSTF to update, by not later 

5 than one year after the date of the enactment of this 

6 Act and at least once every 5 years thereafter, 

7 USPSTF recommendations relating to the preven8 tion of overweight and obesity that have in effect a 

9 rating of ‘‘I’’ (relating to a classification rep10 resenting insufficient evidence to make a rec11 ommendation for the service involved) to determine 

12 if such rating should be upgraded to a rating of ‘‘A’’ 

13 or ‘‘B’’; and 

14 (2) the National Heart, Lung and Blood Insti15 tute to update, by not later than December 31, 

16 2010, and at least once every 3 years thereafter, the 

17 NHLBI Clinical Guidelines described in subsection 

18 (a). 

19 SEC. 104. EXPANSION OF OBESITY TREATMENT SERVICES 

20 UNDER MEDICARE. 

21 (a) COVERAGE.—Section 1861 of the Social Security 

22 Act (42 U.S.C. 1395x), as amended by section 4103 of 

23 the Patient Protection and Affordable Care Act (Public 

24 Law 111–148), is further amended— 

25 (1) in subsection (s)(2)— 


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1 (A) in subparagraph (EE), by striking at 

2 the end ‘‘and’’; 

3 (B) in subparagraph (FF), by adding at 

4 the end ‘‘and’’; and 

5 (C) by adding at the end the following new 

6 subparagraph: 

7 ‘‘(GG) items and services furnished under 

8 an obesity treatment program (as defined in 

9 subsection (iii));’’; and 

10 (2) by adding at the end the following new sub11 section: 

12 ‘‘(iii) OBESITY TREATMENT PROGRAM.—The term 

13 ‘obesity treatment program’ means— 

14 ‘‘(1) medical services delivered to eligible indi15 viduals under a plan of care for the purpose of re16 ducing body mass index and the associated co17 morbidities of obesity, including the following: 

18 ‘‘(A) the development of an initial plan of 

19 care and subsequent revisions to that plan of 

20 care; 

21 ‘‘(B) medical and surgical interventions as 

22 determined appropriate by the Secretary; and 

23 ‘‘(C) additional services for which payment 

24 would not otherwise be made under this title 

25 that the Secretary may specify that encourage 


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1 the receipt of, or improve the effectiveness of, 

2 the services described in the preceding subpara3 graphs. 

4 In carrying out subparagraph (C), the Secretary 

5 shall consider recommendations of the United States 

6 Preventive Services Task Force; clinical practice 

7 guidelines for treatment of overweight, obesity, and 

8 severe obesity issued by professional medical soci9 eties; and consensus statements and guidelines on 

10 effective treatment of overweight, obesity, and severe 

11 obesity issued by the National Institutes of Health, 

12 professional medical societies, and other authori13 tative sources (such as those identified in the Na14 tional Heart Lung and Blood Institute’s Clinical 

15 Guidelines on the Identification, Evaluation, and 

16 Treatment of Overweight and Obesity in Adults). 

17 ‘‘(2) For purposes of this subsection, the term 

18 ‘eligible individual’ means an individual who has: 

19 ‘‘(A) been diagnosed with obesity by a phy20 sician (as defined in subsection (r)) or provider 

21 of services (as defined in subsection (u)); 

22 ‘‘(B) a body mass index of at least 30; or 

23 ‘‘(C) a body mass index of at least 27 with 

24 at least one weight-related comorbid condition. 


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1 It is not necessary for such individual be diagnosed 

2 with co-morbidities in addition to the obesity diag3 nosis or body mass index of at least 30 in order to 

4 be considered an ‘eligible individual’ under this sub5 section.’’. 

6 (b) PAYMENT.—Section 1833(a)(1) of the Social Se7 curity Act (42 U.S.C. 1395l(a)(1)), as amended by section 

8 10501(h)(3)(B) of the Patient Protection and Affordable 

9 Care Act (Public Law 111–148), is amended— 

10 (1) by striking ‘‘and’’ before ‘‘(Z)’’; and 

11 (2) by inserting before the semicolon at the end 

12 the following: ‘‘, and (AA) with respect to items and 

13 services furnished under an obesity treatment pro14 gram (as defined in section 1861(iii)), the amount 

15 paid shall be 80 percent of the lesser of the actual 

16 charge for the services or the amount determined 

17 under a fee schedule established by the Secretary for 

18 purposes of this subparagraph’’. 

19 SEC. 105. COVERAGE OF EVIDENCE-BASED PREVENTIVE 

20 SERVICES UNDER MEDICAID AND SCHIP. 

21 (a) STATE OPTION TO PROVIDE MEDICAL ASSIST22 ANCE FOR EVIDENCE-BASED PREVENTIVE SERVICES.— 

23 (1) IN GENERAL.—Section 1905 of the Social 

24 Security Act (42 U.S.C. 1396d)— 


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1 (A) in subsection (a), as amended by sec2 tion 2301(a) of the Patient Protection and Af3 fordable Care Act, is further amended— 

4 (i) in paragraph (28), by striking 

5 ‘‘and’’ at the end; 

6 (ii) by redesignating paragraph (29) 

7 as paragraph (30); and 

8 (iii) by inserting after paragraph (28) 

9 the following: 

10 ‘‘(29) evidence-based preventive services de11 scribed in subsection (dd); and’’; and 

12 (B) as amended by section 10201(c)(6) of 

13 the Patient Protection and Affordable Care Act, 

14 is further amended by adding at the end the 

15 following: 

16 ‘‘(dd) For purposes of subsection (a)(29), evidence17 based preventive services described in this subsection are 

18 any preventive services which the Secretary has deter19 mined are reasonable and necessary, including, as so de20 termined, diet and exercise counseling, healthy weight and 

21 obesity counseling, and any other evidence-based, effective 

22 clinical intervention for obese individuals, including phar23 macological or surgical services, designed to prevent 

24 comorbidities of obesity.’’. 


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1 (2) CONFORMING AMENDMENT.—Section 

2 1902(a)(10)(C)(iv) of such Act is amended by in3 serting ‘‘, and (29)’’ after ‘‘(24)’’. 

4 (b) STATE OPTION TO PROVIDE CHILD HEALTH AS5 SISTANCE FOR EVIDENCE-BASED PREVENTIVE SERV6 ICES.—Section 2110(a) of the Social Security Act (42 

7 U.S.C. 1397jj(a)) is amended— 

8 (1) by redesignating paragraph (28) as para9 graph (29); and 

10 (2) by inserting after paragraph (27) the fol11 lowing: 

12 ‘‘(28) Evidence-based preventive services de13 scribed in section 1905(dd).’’. 

14 SEC. 106. COVERAGE OF MEDICAL NUTRITION THERAPY 

15 UNDER MEDICAID AND SCHIP. 

16 (a) STATE OPTION TO PROVIDE MEDICAL ASSIST17 ANCE FOR MEDICAL THERAPY SERVICES.— 

18 (1) IN GENERAL.—Section 1905(a) of the So19 cial Security Act (42 U.S.C. 1396d), as amended by 

20 section 105(b), is amended— 

21 (A) in paragraph (29), by striking ‘‘and’’ 

22 at the end; 

23 (B) by redesignating paragraph (30) as 

24 paragraph (31); and 


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1 (C) by inserting after paragraph (29) the 

2 following: 

3 ‘‘(30) medical nutrition therapy services (as de4 fined in section 1861(vv)(1)) for individuals with 

5 pre-diabetes or obesity, or who are overweight (as 

6 defined by the Secretary); and′′.’’. 

7 (2) CONFORMING AMENDMENT.—Section 

8 1902(a)(10)(C)(iv) of such Act, as amended by sec9 tion 105(b)(2), is amended by striking ‘‘and (29)’’ 

10 and inserting ‘‘(29), and (30)’’. 

11 (b) STATE OPTION TO PROVIDE CHILD HEALTH AS12 SISTANCE FOR MEDICAL NUTRITION THERAPY SERV13 ICES.—Section 2110(a) of the Social Security Act (42 

14 U.S.C. 1397jj(a)), as amended by section 105(c), is 

15 amended— 

16 (1) by redesignating paragraph (29) as para17 graph (30); and 

18 (2) by inserting after paragraph (28) the fol19 lowing: 

20 ‘‘(29) Medical nutrition therapy services (as de21 fined in section 1861(vv)(1)) for individuals with 

22 pre-diabetes or obesity, or who are overweight (as 

23 defined by the Secretary).’’. 


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1 SEC. 107. CLARIFICATION OF EPSDT INCLUSION OF PRE2 VENTION, SCREENING, AND TREATMENT 

3 SERVICES FOR OBESITY AND OVERWEIGHT; 

4 SCHIP COVERAGE. 

5 (a) IN GENERAL.—Section 1905(r)(5) of the Social 

6 Security Act (42 U.S.C. 1396d(r)(5)) is amended by in7 serting before the period the following: ‘‘, including weight 

8 and BMI measurement and monitoring, as well as appro9 priate treatment services, including medical nutrition ther10 apy services (as defined in section 1861(vv)(1)), physical 

11 therapy or exercise training, behavioral health counseling, 

12 and such other evidence-based services as recommended 

13 by the Secretary (after taking into consideration the 

14 American Academy of Pediatrics Expert Committee 

15 Guidelines Regarding the Prevention, Assessment, and 

16 Treatment of Child and Adolescent Overweight and Obe17 sity)’’. 

18 (b) SCHIP.— 

19 (1) REQUIRED COVERAGE.—Section 2103 (42 

20 U.S.C. 1397cc) is amended— 

21 (A) in subsection (a), in the matter pre22 ceding paragraph (1), by striking ‘‘and (7)’’ 

23 and inserting ‘‘(7), and (9)’’; and 

24 (B) in subsection (c)— 

25 (i) by redesignating paragraph (7) as 

26 paragraph (9); and 


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1 (ii) by inserting after paragraph (6), 

2 the following: 

3 ‘‘(7) PREVENTION, SCREENING, AND TREAT4 MENT SERVICES FOR OBESITY AND OVERWEIGHT.— 

5 The child health assistance provided to a targeted 

6 low-income child shall include coverage of weight 

7 and BMI measurement and monitoring, as well as 

8 appropriate treatment services (including but not 

9 limited to) medical nutrition therapy services (as de10 fined in section 1861(vv)(1)), physical therapy or ex11 ercise training, behavioral health counseling, and 

12 such other evidence-based services as recommended 

13 by the Secretary. For purposes of the previous sen14 tence the Secretary shall take into consideration the 

15 American Academy of Pediatrics Expert Committee 

16 Guidelines Regarding the Prevention, Assessment, 

17 and Treatment of Child and Adolescent Overweight 

18 and Obesity.’’. 

19 (2) CONFORMING AMENDMENT.—Section 

20 2102(a)(7)(B) (42 U.S.C. 1397bb(c)(2)) is amended 

21 by striking ‘‘section 2103(c)(5)’’ and inserting 

22 ‘‘paragraphs (5) and (7) of section 2103(c)’’. 


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1 SEC. 108. GRANTS TO INCREASE PHYSICAL ACTIVITY, IM2 PROVE NUTRITION, AND PROMOTE HEALTHY 

3 EATING BEHAVIORS. 

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

5 (42 U.S.C. 280h et seq.) is amended by striking section 

6 399W and inserting the following: 

7 ‘‘SEC. 399W. GRANTS TO INCREASE PHYSICAL ACTIVITY, IM8 PROVE NUTRITION, AND PROMOTE HEALTHY 

9 EATING BEHAVIORS. 

10 ‘‘(a) ESTABLISHMENT.— 

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

12 through the Director of the Centers for Disease 

13 Control and Prevention and in coordination with the 

14 Administrator of the Health Resources and Services 

15 Administration, the Director of the Indian Health 

16 Service, the Secretary of Education, the Secretary of 

17 Agriculture, the Secretary of the Interior, the Direc18 tor of the National Institutes of Health, the Director 

19 of the Office of Women’s Health, and the heads of 

20 other appropriate agencies, shall award competitive 

21 grants to eligible entities to plan and implement pro22 grams that promote healthy eating behaviors and 

23 physical activity to prevent obesity, being overweight, 

24 and related serious and chronic medical conditions. 

25 ‘‘(2) SPECIAL PRIORITY.—In awarding grants 

26 under this section, the Secretary shall give special 


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1 priority to grant proposals that target communities 

2 or populations disproportionately at-risk from obe3 sity or being overweight, including health disparity 

4 populations (as defined in section 485E(d)), the un5 derserved, and youth. 

6 ‘‘(3) TERM.—The Secretary shall award grants 

7 under this subsection for a period not to exceed 4 

8 years. 

9 ‘‘(b) AWARD OF GRANTS.—An eligible entity desiring 

10 a grant under this section shall submit an application to 

11 the Secretary at such time, in such manner, and con12 taining such information as the Secretary may require, in13 cluding— 

14 ‘‘(1) a plan describing a comprehensive pro15 gram of approaches to encourage healthy eating be16 haviors and healthy levels of physical activity; 

17 ‘‘(2) the manner in which the eligible entity will 

18 coordinate with appropriate State and local authori19 ties and community-based organizations, including— 

20 ‘‘(A) State and local educational agencies; 

21 ‘‘(B) departments of health; 

22 ‘‘(C) chronic disease directors; 

23 ‘‘(D) State directors of programs under 

24 section 17 of the Child Nutrition Act of 1966; 


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1 ‘‘(E) governors’ councils for physical activ2 ity and good nutrition; 

3 ‘‘(F) State and local parks and recreation 

4 departments; 

5 ‘‘(G) State and local departments of trans6 portation and city planning; and 

7 ‘‘(H) community-based organizations serv8 ing youth; and 

9 ‘‘(3) the manner in which the applicant will 

10 evaluate the effectiveness of the program carried out 

11 under this section. 

12 ‘‘(c) COORDINATION.—In awarding grants under this 

13 section, the Secretary shall ensure that the proposed pro14 grams are coordinated in substance and format with pro15 grams currently funded through other Federal agencies 

16 and operating within the community including the Phys17 ical Education Program (PEP) of the Department of Edu18 cation. 

19 ‘‘(d) ELIGIBLE ENTITY.—In this section, the term 

20 ‘eligible entity’ means— 

21 ‘‘(1) a city, county, tribe, territory, or State; 

22 ‘‘(2) a State educational agency; 

23 ‘‘(3) a tribal educational agency; 

24 ‘‘(4) a local educational agency; 


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1 ‘‘(5) a federally qualified health center (as de2 fined in section 1861(aa)(4) of the Social Security 

3 Act); 

4 ‘‘(6) a rural health clinic; 

5 ‘‘(7) a health department; 

6 ‘‘(8) an Indian Health Service hospital or clinic; 

7 ‘‘(9) an Indian tribal health facility; 

8 ‘‘(10) an urban Indian facility; 

9 ‘‘(11) any health provider; 

10 ‘‘(12) an accredited university or college; 

11 ‘‘(13) a community-based organization; 

12 ‘‘(14) a local city planning agency; 

13 ‘‘(15) a State or local parks and recreation de14 partment; or 

15 ‘‘(16) any other entity determined appropriate 

16 by the Secretary. 

17 ‘‘(e) USE OF FUNDS.—An eligible entity that receives 

18 a grant under this section shall use the funds made avail19 able through the grant to— 

20 ‘‘(1) carry out community-based activities in21 cluding— 

22 ‘‘(A) city planning, transportation initia23 tives, and environmental changes that help pro24 mote physical activity, such as increasing the 


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1 use of walking or bicycling as a mode of trans2 portation; 

3 ‘‘(B) forming partnerships and activities 

4 with businesses, disability organizations, com5 munity-based organizations, and other entities 

6 to increase physical activity levels and promote 

7 healthy eating behaviors in schools and while 

8 traveling to and from schools; 

9 ‘‘(C) forming partnerships with entities, in10 cluding schools, faith-based entities, commu11 nity-based organizations, and other organiza12 tions providing recreational services, to estab13 lish programs that use their facilities or other 

14 resources for after-school, weekend, and sum15 mer community activities, especially those that 

16 promote or involve physical activity; 

17 ‘‘(D) establishing incentives for retail food 

18 stores, farmer’s markets, food co-ops, grocery 

19 stores, and other retail food outlets that offer 

20 fruits and vegetables and other nutritious foods 

21 to encourage such stores and outlets to locate 

22 in economically depressed areas; 

23 ‘‘(E) forming partnerships with senior cen24 ters, nursing facilities, retirement communities, 

25 and assisted living facilities to establish proVerDate Mar 15 2010 02:37 May 06, 2010 Jkt 089200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\H5209.IH H5209

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1 grams for older people to foster physical activ2 ity and healthy eating behaviors; 

3 ‘‘(F) forming partnerships with daycare 

4 and after-school entities to establish programs 

5 that promote healthy eating behaviors and 

6 physical activity; 

7 ‘‘(G) developing and evaluating community 

8 educational activities targeting good nutrition 

9 and promoting healthy eating behaviors; and 

10 ‘‘(H) providing, directly or in cooperation 

11 with State and local parks and recreation de12 partments, programs and other opportunities 

13 for daily physical activity; 

14 ‘‘(2) carry out age-appropriate school-based ac15 tivities including— 

16 ‘‘(A) developing and testing educational 

17 curricula and intervention programs designed to 

18 promote healthy eating behaviors and habits in 

19 youth, which may include— 

20 ‘‘(i) after hours physical activity pro21 grams; 

22 ‘‘(ii) increasing opportunities for stu23 dents to make informed choices regarding 

24 healthy eating behaviors; and 


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1 ‘‘(iii) science-based interventions with 

2 multiple components to prevent obesity and 

3 being overweight including nutritional con4 tent, understanding and responding to 

5 hunger and satiety, positive body image de6 velopment, positive self-esteem develop7 ment, and learning life skills (such as 

8 stress management, communication skills, 

9 problem-solving and decisionmaking skills), 

10 as well as consideration of cultural and de11 velopmental issues, and the role of family, 

12 school, and community; 

13 ‘‘(B) providing education and training to 

14 educational professionals regarding a healthy 

15 lifestyle and a healthy school environment; 

16 ‘‘(C) planning and implementing a healthy 

17 lifestyle curriculum or program with an empha18 sis on healthy eating behaviors and physical ac19 tivity; and 

20 ‘‘(D) planning and implementing healthy 

21 lifestyle classes or programs for parents or 

22 guardians, with an emphasis on healthy eating 

23 behaviors and physical activity; 

24 ‘‘(3) carry out activities through the local 

25 health care delivery systems including— 


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1 ‘‘(A) promoting healthy eating behaviors 

2 and physical activity services to treat or prevent 

3 obesity and being overweight; 

4 ‘‘(B) providing patient education and coun5 seling to increase physical activity and promote 

6 healthy eating behaviors; and 

7 ‘‘(C) providing community education on 

8 good nutrition and physical activity to develop 

9 a better understanding of the relationship be10 tween diet, physical activity, and obesity or 

11 being overweight; or 

12 ‘‘(4) other activities determined appropriate by 

13 the Secretary (including evaluation or identification 

14 and dissemination of outcomes and best practices). 

15 ‘‘(f) MATCHING FUNDS.—In awarding grants under 

16 subsection (a), the Secretary may give priority to eligible 

17 entities who provide matching contributions. Such non18 Federal contributions may be cash or in kind, fairly evalu19 ated, including plant, equipment, or services. 

20 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary may 

21 set aside an amount not to exceed 10 percent of the total 

22 amount appropriated for a fiscal year pursuant to sub23 section (k) to permit the Director of the Centers for Dis24 ease Control and Prevention to provide grantees with tech25 nical support in the development, implementation, and 


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1 evaluation of programs under this section and to dissemi2 nate information about effective strategies and interven3 tions in preventing and treating obesity through the pro4 motion of healthy eating behaviors and physical activity. 

5 ‘‘(h) LIMITATION ON ADMINISTRATIVE COSTS.—An 

6 eligible entity awarded a grant under this section may not 

7 use more than 10 percent of funds awarded under such 

8 grant for administrative expenses. 

9 ‘‘(i) REPORT.—Not later than 6 years after the date 

10 of enactment of the Improved Nutrition and Physical Ac11 tivity Act, the Director of the Centers for Disease Control 

12 and Prevention shall review the results of the grants 

13 awarded under this section and other related research and 

14 identify programs that have demonstrated effectiveness in 

15 promoting healthy eating behaviors and physical activity 

16 in youth. Such review shall include an identification of 

17 model curricula, best practices, and lessons learned, as 

18 well as recommendations for next steps to reduce obesity 

19 and being overweight. Information derived from such re20 view, including model program curricula, shall be dissemi21 nated to the public. 

22 ‘‘(j) DEFINITIONS.—In this section: 

23 ‘‘(1) HEALTHY EATING BEHAVIORS.—The term 

24 ‘healthy eating behaviors’ means— 


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1 ‘‘(A) eating in quantities adequate to meet, 

2 but not in excess of, daily energy needs; 

3 ‘‘(B) choosing foods to promote health and 

4 prevent disease; 

5 ‘‘(C) eating comfortably in social environ6 ments that promote healthy relationships with 

7 family, peers, and community; and 

8 ‘‘(D) eating in a manner to acknowledge 

9 internal signals of hunger and satiety. 

10 ‘‘(2) OBESE.—The term ‘obese’ refers to an 

11 adult with a Body Mass Index (BMI) of 30 kg/m2 

12 or greater, or a child or adolescent with a BMI at 

13 or above the 95th percentile on the revised Centers 

14 for Disease Control and Prevention growth charts or 

15 another appropriate childhood definition, as defined 

16 by the Secretary. 

17 ‘‘(3) OVERWEIGHT.—The term ‘overweight’ re18 fers to an adult with a Body Mass Index (BMI) of 

19 25 to 29.9 kg/m2 or a child or adolescent with a 

20 BMI at or above the 85th percentile, but below the 

21 95th percentile, on the revised Centers for Disease 

22 Control and Prevention growth charts or another ap23 propriate childhood definition, as defined by the Sec24 retary. 


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1 ‘‘(4) YOUTH.—The term ‘youth’ means individ2 uals not more than 18 years old. 

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

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

5 $60,000,000 for fiscal year 2011, and such sums as may 

6 be necessary for each of fiscal years 2012 through 2015.’’. 

7 SEC. 109. GRANTS TO PROVIDE TRAINING FOR HEALTH 

8 PROFESSION STUDENTS. 

9 Section 747 of the Public Health Service Act (42 

10 U.S.C. 293k) is amended— 

11 (1) by redesignating subsection (c) as sub12 section (d); and 

13 (2) by inserting after subsection (b) the fol14 lowing: 

15 ‘‘(c) SPECIAL CONSIDERATION.—In awarding grants 

16 or contracts under subsection (a) or (b), the Secretary 

17 shall give special consideration to qualified applicants pro18 posing a project or program which will prepare practi19 tioners to care for individuals (including children) who are 

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

21 399W(j)).’’. 

22 SEC. 110. GRANTS TO PROVIDE TRAINING FOR HEALTH 

23 PROFESSIONALS. 

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

25 U.S.C. 280h–3) is amended— 


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1 (1) in subsection (b), by striking ‘‘2005’’ and 

2 inserting ‘‘2011’’; 

3 (2) by redesignating subsection (b) as sub4 section (c); 

5 (3) by inserting after subsection (a) the fol6 lowing: 

7 ‘‘(b) GRANTS.— 

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

9 grants to eligible entities to train primary care phy10 sicians and other licensed or certified health profes11 sionals on how to treat and prevent obesity and aid 

12 individuals who are obese or overweight. 

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

14 grant under this subsection shall submit an applica15 tion at such time, in such manner, and containing 

16 such information as the Secretary may require, in17 cluding a plan for the use of funds that may be 

18 awarded and an evaluation of the training that will 

19 be provided. 

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

21 a grant under this subsection shall use the funds 

22 made available through such grant to— 

23 ‘‘(A) use evidence-based findings or rec24 ommendations that pertain to the prevention 

25 and treatment of obesity and being overweight 


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1 to conduct educational conferences, including 

2 Internet-based courses and teleconferences, 

3 on— 

4 ‘‘(i) how to treat or prevent obesity 

5 and being overweight; 

6 ‘‘(ii) the link between obesity and 

7 being overweight and related serious and 

8 chronic medical conditions; 

9 ‘‘(iii) how to discuss varied strategies 

10 with patients from at-risk and diverse pop11 ulations to promote positive behavior 

12 change and healthy lifestyles to avoid obe13 sity and being overweight; 

14 ‘‘(iv) how to identify individuals who 

15 are or are at risk for being obese or being 

16 overweight and, therefore, are at risk for 

17 related serious and chronic medical condi18 tions; and 

19 ‘‘(v) how to conduct a comprehensive 

20 assessment of individual and familial 

21 health risk factors; and 

22 ‘‘(B) evaluate the effectiveness of the 

23 training provided by such entity in increasing 

24 knowledge and changing attitudes and behav25 iors of trainees.’’; and 


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1 (4) in subsection (c) (as so redesignated)— 

2 (A) by striking ‘‘There are authorized to 

3 be appropriated to carry out this section’’ and 

4 all that follows and inserting the following: 

5 ‘‘There are authorized to be appropriated— 

6 ‘‘(1) to carry out subsection (a),’’; 

7 (B) by striking the period at the end and 

8 inserting ‘‘; and’’; and 

9 (C) by adding at the end the following: 

10 ‘‘(2) to carry out subsection (b), $10,000,000 

11 for fiscal year 2011, and such sums as may be nec12 essary for each of fiscal years 2012 through 2015.’’. 

13 SEC. 111. PREVENTIVE HEALTH SERVICES BLOCK GRANT. 

14 Section 1904(a)(1) of the Public Health Service Act 

15 (42 U.S.C. 300w–3(a)(1)) is amended by adding at the 

16 end the following: 

17 ‘‘(H) Activities and community education pro18 grams designed to address and prevent obesity and 

19 being overweight through effective programs to pro20 mote healthy eating, and exercise habits and behav21 iors.’’. 


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1 TITLE II—IMPROVING 

2 CHILDHOOD NUTRITION 

3 SEC. 201. NUTRITION AND WELLNESS GOALS FOR MEALS 

4 SERVED THROUGH THE CHILD AND ADULT 

5 CARE FOOD PROGRAM. 

6 Section 17 of the Richard B. Russell National School 

7 Lunch Act (42 U.S.C. 1766) is amended— 

8 (1) in subsection (a), by striking ‘‘(a) GRANT

9 AUTHORITY’’ and all that follows through the end of 

10 paragraph (1) and inserting the following: 

11 ‘‘(a) PROGRAM PURPOSE, GRANT AUTHORITY AND

12 INSTITUTION ELIGIBILITY.— 

13 ‘‘(1) IN GENERAL.— 

14 ‘‘(A) PROGRAM PURPOSE.— 

15 ‘‘(i) FINDINGS.—Congress finds 

16 that— 

17 ‘‘(I) eating habits and other 

18 wellness-related behavior habits are 

19 established early in life; and 

20 ‘‘(II) good nutrition and wellness 

21 are important contributors to the 

22 overall health of young children and 

23 essential to cognitive development. 

24 ‘‘(ii) PURPOSE.—The purpose of the 

25 program authorized by this section is to 


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1 provide aid to child care institutions and 

2 family or group day care homes for the 

3 provision of nutritious foods that con4 tribute to the wellness, healthy growth, and 

5 development of young children. 

6 ‘‘(B) GRANT AUTHORITY.—The Secretary 

7 may carry out a program to assist States 

8 through grants-in-aid and other means to ini9 tiate and maintain nonprofit food service pro10 grams for children in institutions providing 

11 child care.’’; 

12 (2) by striking subsection (g) and inserting the 

13 following: 

14 ‘‘(g) NUTRITIONAL REQUIREMENTS FOR MEALS AND

15 SNACKS SERVED IN INSTITUTIONS AND FAMILY OR

16 GROUP DAY CARE HOMES.— 

17 ‘‘(1) DEFINITION OF DIETARY GUIDELINES.— 

18 In this subsection, the term ‘Dietary Guidelines’ 

19 means the Dietary Guidelines for Americans pub20 lished under section 301 of the National Nutrition 

21 Monitoring and Related Research Act of 1990 (7 

22 U.S.C. 5341). 

23 ‘‘(2) NUTRITIONAL REQUIREMENTS.— 

24 ‘‘(A) IN GENERAL.—Except as provided in 

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1 plements served by institutions and family or 

2 group day care homes participating in the pro3 gram under this section shall consist of a com4 bination of foods that meet minimum nutri5 tional requirements prescribed by the Secretary 

6 on the basis of tested nutritional research. 

7 ‘‘(B) CONFORMITY WITH THE DIETARY

8 GUIDELINES AND AUTHORITATIVE SCIENCE.— 

9 ‘‘(i) IN GENERAL.—Not less fre10 quently than once every 10 years, the Sec11 retary shall review and, as appropriate, up12 date requirements for meals and supple13 ments served under the program under 

14 this section to ensure that the meals— 

15 ‘‘(I) are consistent with the goals 

16 of the most recent Dietary Guidelines; 

17 and 

18 ‘‘(II) promote the health of the 

19 population served by the program au20 thorized under this section, as indi21 cated by the most recent relevant nu22 trition science and appropriate au23 thoritative scientific agency and orga24 nization recommendations. 


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1 ‘‘(ii) COST REVIEW.—The review re2 quired under clause (i) shall include a re3 view of the cost to child care centers and 

4 group or family day care homes resulting 

5 from updated requirements for meals and 

6 snacks served under the program under 

7 this section. 

8 ‘‘(iii) REGULATIONS.—Not later than 

9 18 months after receipt of recommenda10 tions for meal pattern improvements from 

11 the Food and Nutrition Board of the Na12 tional Research Council of the National 

13 Academy of Sciences, the Secretary shall 

14 promulgate proposed regulations to update 

15 the meal patterns for meals and snacks 

16 served under the program under this sec17 tion. 

18 ‘‘(C) EXCEPTIONS.— 

19 ‘‘(i) SPECIAL DIETARY NEEDS.—The 

20 minimum nutritional requirements pre21 scribed under subparagraph (A) do not 

22 prohibit institutions and family or group 

23 day care homes from substituting foods to 

24 accommodate the medical or other special 

25 dietary needs of individual children. 


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1 ‘‘(ii) EXEMPT INSTITUTIONS.—The 

2 Secretary may elect to waive all or part of 

3 the requirements of this subsection for 

4 emergency shelters and adult day care cen5 ters participating in the program under 

6 this section. 

7 ‘‘(3) MEAL SERVICE.—Institutions and family 

8 day care homes shall ensure that reimbursable meal 

9 service contributes to the development and socializa10 tion of enrolled children by providing that food is 

11 not used as a punishment or reward. 

12 ‘‘(4) FLUID MILK.— 

13 ‘‘(A) IN GENERAL.—Each institution or 

14 family or group day care home participating in 

15 the program under this section shall provide 

16 fluid milk, in accordance with the most recent 

17 version of the Dietary Guidelines, as part of 

18 each reimbursable meal and supplement served 

19 under the program. 

20 ‘‘(B) MILK SUBSTITUTES.—In the case of 

21 children who cannot consume fluid milk due to 

22 medical or other special dietary needs other 

23 than a disability, an institution or family or 

24 group day care home may substitute for the 


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1 fluid milk required in meals and supplements 

2 served, a nondairy beverage that— 

3 ‘‘(i) is nutritionally equivalent to fluid 

4 milk; and 

5 ‘‘(ii) meets nutritional standards es6 tablished by the Secretary, including, 

7 among other requirements established by 

8 the Secretary, fortification of calcium, pro9 tein, vitamin A, and vitamin D to levels 

10 found in cow’s milk. 

11 ‘‘(C) APPROVAL.— 

12 ‘‘(i) IN GENERAL.—A substitution au13 thorized under subparagraph (B) may be 

14 made— 

15 ‘‘(I) at the discretion of and on 

16 approval by the participating day care 

17 institution; and 

18 ‘‘(II) if the substitution is re19 quested by written statement of a 

20 medical authority, or by the parent or 

21 legal guardian of the child, that iden22 tifies the medical or other special die23 tary need that restricts the diet of the 

24 child. 


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1 ‘‘(ii) EXCEPTION.—An institution or 

2 family or group day care home shall not be 

3 required under this paragraph to provide 

4 beverages other than beverages the State 

5 has identified as acceptable substitutes. 

6 ‘‘(D) EXCESS EXPENSES BORNE BY INSTI7 TUTION.—A participating institution or family 

8 or group day care home shall be responsible for 

9 any expenses that— 

10 ‘‘(i) are incurred by the institution or 

11 family or group day care home to provide 

12 substitutions under this paragraph; and 

13 ‘‘(ii) are in excess of expenses covered 

14 under reimbursements under this Act. 

15 ‘‘(5) NONDISCRIMINATION POLICY.—No phys16 ical segregation or other discrimination against any 

17 child shall be made because of the inability of the 

18 child to pay, nor shall there be any overt identifica19 tion of any such child by special tokens or tickets, 

20 different meals or meal service, announced or pub21 lished lists of names, or other means. 

22 ‘‘(6) USE OF ABUNDANT AND DONATED

23 FOODS.—To the maximum extent practicable, each 

24 institution shall use in its food service foods that 

25 are— 


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1 ‘‘(A) designated from time to time by the 

2 Secretary as being in abundance, either nation3 ally or in the food service area; or 

4 ‘‘(B) donated by the Secretary.’’; and 

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

6 ‘‘(u) PROMOTING HEALTH AND WELLNESS IN CHILD

7 CARE.— 

8 ‘‘(1) PHYSICAL ACTIVITY AND ELECTRONIC

9 MEDIA USE.—The Secretary shall encourage partici10 pating child care centers and family or group day 

11 care homes— 

12 ‘‘(A) to provide to all children under the 

13 supervision of the participating child care cen14 ters and family or group day care homes daily 

15 opportunities for structured and unstructured 

16 age-appropriate moderate-intensity to vigorous17 intensity physical activity; and 

18 ‘‘(B) to limit among children under the su19 pervision of the participating child care centers 

20 and family or group day care homes the use of 

21 electronic media to an appropriate level. 

22 ‘‘(2) WATER CONSUMPTION.—Participating 

23 child care centers and family or group day care 

24 homes shall make available to children, as nutrition25 ally appropriate, water as an acceptable fluid for 


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1 consumption throughout the day, including at meal 

2 times. 

3 ‘‘(3) TECHNICAL ASSISTANCE AND GUID4 ANCE.— 

5 ‘‘(A) IN GENERAL.—The Secretary shall 

6 provide technical assistance to institutions par7 ticipating in the program under this section to 

8 assist participating child care centers and fam9 ily or group day care homes in complying with 

10 the nutritional and wellness requirements pre11 scribed by the Secretary in accordance with this 

12 subsection and subsection (g). 

13 ‘‘(B) GUIDANCE.—Not later than January 

14 1, 2011, the Secretary shall issue guidance to 

15 States and institutions to encourage partici16 pating child care centers and family or group 

17 day care homes serving meals and snacks under 

18 this section to— 

19 ‘‘(i) include foods that are rec20 ommended for increased serving consump21 tion in amounts recommended by the most 

22 recent Dietary Guidelines for Americans 

23 published under section 301 of the Na24 tional Nutrition Monitoring and Related 

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1 cluding fresh, canned, frozen, or dried 

2 whole fruits and vegetables, whole grain 

3 products, lean meat products, and low-fat 

4 and non-fat dairy products; and 

5 ‘‘(ii) reduce sedentary activities and 

6 provide opportunities for regular physical 

7 activity in quantities recommended by the 

8 most recent Dietary Guidelines for Ameri9 cans described in clause (i). 

10 ‘‘(C) NUTRITION.—Technical assistance 

11 relating to the nutritional requirements of this 

12 subsection and subsection (g) shall include— 

13 ‘‘(i) nutrition education, including 

14 education that emphasizes the relationship 

15 between nutrition, physical activity, and 

16 health; 

17 ‘‘(ii) menu planning; 

18 ‘‘(iii) interpretation of nutrition labels; 

19 and 

20 ‘‘(iv) food preparation and purchasing 

21 guidance to produce meals and snacks that 

22 are— 

23 ‘‘(I) consistent with the goals of 

24 the most recent Dietary Guidelines; 

25 and 


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1 ‘‘(II) promote the health of the 

2 population served by the program 

3 under this section, as recommended 

4 by authoritative scientific organiza5 tions. 

6 ‘‘(D) PHYSICAL ACTIVITY.—Technical as7 sistance relating to the physical activity require8 ments of this subsection shall include— 

9 ‘‘(i) education on the importance of 

10 regular physical activity to overall health 

11 and well being; and 

12 ‘‘(ii) sharing of best practices for 

13 physical activity plans in child care centers 

14 and homes as recommended by authori15 tative scientific organizations. 

16 ‘‘(E) ELECTRONIC MEDIA USE.—Technical 

17 assistance relating to the electronic media use 

18 requirements of this subsection shall include— 

19 ‘‘(i) education on the health impacts 

20 of overuse of and overexposure to elec21 tronic media by children; and 

22 ‘‘(ii) sharing of best practices for the 

23 development of daily activity plans that 

24 limit use of electronic media. 


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1 ‘‘(F) MINIMUM ASSISTANCE.—At a min2 imum, the technical assistance required under 

3 this paragraph shall include a handbook, devel4 oped by the Secretary in coordination with the 

5 Secretary for Health and Human Services, that 

6 includes recommendations, guidelines, and best 

7 practices for participating institutions and fam8 ily or group day care homes that are consistent 

9 with the nutrition, physical activity, and 

10 wellness requirements and recommendations of 

11 this subsection. 

12 ‘‘(G) ADDITIONAL ASSISTANCE.—In addi13 tion to the requirements of this paragraph, the 

14 Secretary shall develop and provide such appro15 priate training and education materials, guid16 ance, and technical assistance as the Secretary 

17 considers to be necessary to comply with the 

18 nutritional and wellness requirements of this 

19 subsection and subsection (g). 

20 ‘‘(H) FUNDING.— 

21 ‘‘(i) IN GENERAL.—On October 1, 

22 2009, and on each October 1 thereafter 

23 through October 1, 2013, out of any funds 

24 in the Treasury not otherwise appro25 priated, the Secretary of the Treasury 


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1 shall transfer to the Secretary to provide 

2 technical assistance under this subsection 

3 $3,000,000, to remain available until ex4 pended. 

5 ‘‘(ii) RECEIPT AND ACCEPTANCE.— 

6 The Secretary shall be entitled to receive, 

7 shall accept, and shall use to carry out this 

8 subsection the funds transferred under 

9 clause (i), without further appropriation.’’. 

10 SEC. 202. INTERAGENCY COORDINATION TO PROMOTE 

11 HEALTH AND WELLNESS IN CHILD CARE LI12 CENSING. 

13 The Secretary of Agriculture shall coordinate with 

14 the Secretary of Health and Human Services to encourage 

15 State licensing agencies to include nutrition and wellness 

16 standards within State licensing standards that ensure, to 

17 the maximum extent practicable, that licensed child care 

18 centers and family or group day care homes— 

19 (1) provide to all children under the supervision 

20 of the child care centers and family or group day 

21 care homes daily opportunities for age-appropriate 

22 moderate-intensity to vigorous-intensity physical ac23 tivity; 

24 (2) limit among children under the supervision 

25 of the child care centers and family or group day 


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1 care homes the use of electronic media and the 

2 quantity of time spent in sedentary activity to an ap3 propriate level; 

4 (3) serve meals and snacks that are consistent 

5 with the child and adult care food program estab6 lished under section 17 of the Richard B. Russell 

7 National School Lunch Act (42 U.S.C. 1766); and 

8 (4) promote such other nutrition and wellness 

9 goals as the Secretaries determine to be necessary. 

10 SEC. 203. STUDY ON NUTRITION AND WELLNESS QUALITY 

11 OF CHILD CARE SETTINGS. 

12 (a) IN GENERAL.—Not less than 4 years after the 

13 date of enactment of this Act, and not less frequently than 

14 once every 5 years thereafter, the Secretary of Agriculture 

15 shall submit to Congress a report based on— 

16 (1) a nationally representative study of child 

17 care centers and family or group day care homes 

18 that— 

19 (A) is designed in consultation with the 

20 Secretary of Health and Human Services; and 

21 (B) includes an assessment of— 

22 (i) the nutritional quality of all foods 

23 provided to children in child care settings 

24 as compared to the recommendations in 

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1 cans published under section 301 of the 

2 National Nutrition Monitoring and Related 

3 Research Act of 1990 (7 U.S.C. 5341); 

4 (ii) the quantity and type of opportu5 nities for physical activity provided to chil6 dren in child care settings; and 

7 (iii) the quantity of time spent by chil8 dren in child care settings in sedentary ac9 tivities; and 

10 (2) an assessment of the barriers to and 

11 facilitators for— 

12 (A) providing foods to children in child 

13 care settings that meet the recommendations in 

14 the most recent Dietary Guidelines for Ameri15 cans published under section 301 of the Na16 tional Nutrition Monitoring and Related Re17 search Act of 1990 (7 U.S.C. 5341); 

18 (B) providing the appropriate quantity and 

19 type of opportunities for physical activity for 

20 children in child care settings; and 

21 (C) participation by child care centers and 

22 family or group day care homes in the child and 

23 adult care food program established under sec24 tion 17 of the Richard B. Russell National 

25 School Lunch Act (42 U.S.C. 1766). 


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1 (b) FUNDING.— 

2 (1) IN GENERAL.—On October 1, 2010, out of 

3 any funds in the Treasury not otherwise appro4 priated, the Secretary of the Treasury shall transfer 

5 to the Secretary of Agriculture to carry out this sec6 tion $5,000,000, to remain available until expended. 

7 (2) RECEIPT AND ACCEPTANCE.—The Sec8 retary of Agriculture shall be entitled to receive, 

9 shall accept, and shall use to carry out this section 

10 the funds transferred under paragraph (1), without 

11 further appropriation. 

12 SEC. 204. WORKING GROUP TO REDUCE PAPERWORK AND 

13 IMPROVE PROGRAM ADMINISTRATION. 

14 (a) DEFINITIONS.—In this section: 

15 (1) PROGRAM.—The term ‘‘program’’ means 

16 the child and adult care food program established 

17 under section 17 of the Richard B. Russell National 

18 School Lunch Act (42 U.S.C. 1766). 

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

20 the Secretary of Agriculture. 

21 (b) ESTABLISHMENT.—The Secretary, in conjunction 

22 with States and participating institutions, shall reconvene 

23 a working group to continue to examine the feasibility of 

24 reducing unnecessary or duplicative paperwork resulting 

25 from regulations and recordkeeping requirements for 


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1 State agencies, institutions, family and group day care 

2 homes, and sponsored centers participating in the pro3 gram. 

4 (c) DUTIES.—At a minimum, the working group 

5 shall— 

6 (1) review and evaluate the recommendations, 

7 guidance, and regulatory priorities developed and 

8 issued to comply with section 119(i) of the Child 

9 Nutrition and WIC Reauthorization Act of 2004 (42 

10 U.S.C. 1766 note; Public Law 108–265); and 

11 (2) examine additional paperwork and adminis12 trative requirements that have been established since 

13 February 23, 2007, that could be reduced or sim14 plified. 

15 (d) ADDITIONAL DUTIES.—In addition to, or oper16 ating concurrently with, the working group described in 

17 subsection (b), the Secretary may, if determined necessary 

18 by the Secretary and in conjunction with States and insti19 tutions participating in the program, establish 1 or more 

20 working groups to examine any aspect of administration 

21 of the program. 

22 (e) REPORT.—Not later than 4 years after the date 

23 of enactment of this Act, the Secretary shall submit to 

24 Congress a report that describes the actions that have 

25 been taken to carry out this section, including— 


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1 (1) actions taken to address administrative and 

2 paperwork burdens identified as a result of compli3 ance with section 119(i) of the Child Nutrition and 

4 WIC Reauthorization Act of 2004 (42 U.S.C. 1766 

5 note; Public Law 108–265); 

6 (2) administrative and paperwork burdens iden7 tified as a result of compliance with section 119(i) 

8 of that Act for which no regulatory action or policy 

9 guidance has been taken; 

10 (3) additional steps that the Secretary is taking 

11 or plans to take to address any administrative and 

12 paperwork burdens identified under subsection (c)(2) 

13 and paragraph (2), including— 

14 (A) new or updated regulations, policy, 

15 guidance, or technical assistance; and 

16 (B) a timeframe for the completion of 

17 those steps; and 

18 (4) recommendations to Congress for modifica19 tions to existing statutory authorities needed to ad20 dress identified administrative and paperwork bur21 dens. 

22 SEC. 205. RENEWAL OF APPLICATION MATERIALS AND PER23 MANENT OPERATING AGREEMENTS. 

24 (a) PERMANENT OPERATING AGREEMENTS.—Sec25 tion 17(d)(1) of the Richard B. Russell National School 


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1 Lunch Act (42 U.S.C. 1766(d)(1)) is amended by adding 

2 at the end the following: 

3 ‘‘(E) PERMANENT OPERATING AGREE4 MENTS.— 

5 ‘‘(i) IN GENERAL.—Subject to clauses 

6 (ii) and (iii), to participate in the child and 

7 adult care food program, an institution 

8 that meets the conditions of eligibility de9 scribed in this subsection shall be required 

10 to enter into a permanent agreement with 

11 the applicable State agency. 

12 ‘‘(ii) AMENDMENTS.—A permanent 

13 agreement described in clause (i) may be 

14 amended as necessary to ensure that the 

15 institution is in compliance with all re16 quirements established in this section or by 

17 the Secretary. 

18 ‘‘(iii) TERMINATION.—A permanent 

19 agreement described in clause (i)— 

20 ‘‘(I) may be terminated for con21 venience by the institution and State 

22 agency that is a party to the perma23 nent agreement; and 

24 ‘‘(II) shall be terminated— 


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1 ‘‘(aa) for cause by the appli2 cable State agency in accordance 

3 with paragraph (5); or 

4 ‘‘(bb) on termination of par5 ticipation of the institution in the 

6 child and adult care food pro7 gram.’’. 

8 (b) APPLICATIONS.—Section 17(d) of the Richard B. 

9 Russell National School Lunch Act (42 U.S.C. 1766(d)) 

10 is amended by striking paragraph (2) and inserting the 

11 following: 

12 ‘‘(2) PROGRAM APPLICATIONS.— 

13 ‘‘(A) IN GENERAL.—The Secretary shall 

14 develop a policy under which each institution 

15 providing child care that participates in the 

16 program under this section shall— 

17 ‘‘(i) submit to the State agency an ini18 tial application to participate in the pro19 gram that meets all requirements estab20 lished by the Secretary by regulation; 

21 ‘‘(ii) annually confirm to the State 

22 agency that the institution, and any facili23 ties of the institution in which the program 

24 is operated by a sponsoring organization, is 

25 in compliance with subsection (a)(5); and 


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1 ‘‘(iii) annually submit to the State 

2 agency any additional information nec3 essary to confirm that the institution is in 

4 compliance with all other requirements to 

5 participate in the program, as established 

6 by the Secretary by regulation. 

7 ‘‘(B) REVIEWS.—The Secretary shall de8 velop a policy under which each sponsoring or9 ganization participating in the program shall 

10 conduct— 

11 ‘‘(i) periodic unannounced site visits 

12 at not less than 3-year intervals to spon13 sored child care centers and family or 

14 group day care homes to identify and pre15 vent management deficiencies and fraud 

16 and abuse under the program; 

17 ‘‘(ii) at least 1 scheduled site visit at 

18 not less than 3-year intervals to sponsoring 

19 organizations and nonsponsored child care 

20 centers to identify and prevent manage21 ment deficiencies and fraud and abuse 

22 under the program and to improve pro23 gram operations; and 

24 ‘‘(iii) periodic site visits to private in25 stitutions that the State agency determines 


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1 have a high probability of program 

2 abuse.’’. 

3 (c) AGREEMENTS.—Section 17(j)(1) of the Richard 

4 B. Russell National School Lunch Act (42 U.S.C. 

5 1766(j)(1)) is amended— 

6 (1) by striking ‘‘may’’ and inserting ‘‘shall’’; 

7 (2) by striking ‘‘family or group day care’’ the 

8 first place it appears; and 

9 (3) by inserting ‘‘or sponsored day care cen10 ters’’ before ‘‘participating’’. 

11 SEC. 206. TRANSMISSION OF INCOME INFORMATION BY 

12 SPONSORED FAMILY OR GROUP DAY CARE 

13 HOMES. 

14 Section 17(f)(3)(A)(iii)(III) of the Richard B. Russell 

15 National School Lunch Act (42 U.S.C. 

16 1766(f)(3)(A)(iii)(III)) is amended by adding at the end 

17 the following: 

18 ‘‘(dd) TRANSMISSION OF IN19 COME INFORMATION BY SPON20 SORED FAMILY OR GROUP DAY

21 CARE HOMES.—If a family or 

22 group day care home elects to be 

23 provided reimbursement factors 

24 described in subclause (II), the 

25 family or group day care home 


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1 may assist in the transmission of 

2 necessary household income in3 formation to the family or group 

4 day care home sponsoring organi5 zation in accordance with the pol6 icy described in item (ee). 

7 ‘‘(ee) POLICY.—The Sec8 retary shall develop a policy 

9 under which a sponsored family 

10 or group day care home described 

11 in item (dd) may, under terms 

12 and conditions specified by the 

13 Secretary and with the written 

14 consent of the parents or guard15 ians of a child in a family or 

16 group day care home partici17 pating in the program, assist in 

18 the transmission of the income 

19 information of the family to the 

20 family or group day care home 

21 sponsoring organization.’’. 


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1 SEC. 207. SIMPLIFYING AND ENHANCING ADMINISTRATIVE 

2 PAYMENTS TO SPONSORING ORGANIZATIONS. 

3 Section 17(f)(3) of the Richard B. Russell National 

4 School Lunch Act (42 U.S.C. 1766(f)(3)) is amended by 

5 striking subparagraph (B) and inserting the following: 

6 ‘‘(B) ADMINISTRATIVE FUNDS.— 

7 ‘‘(i) IN GENERAL.—In addition to re8 imbursement factors described in subpara9 graph (A), a family or group day care 

10 home sponsoring organization shall receive 

11 reimbursement for the administrative ex12 penses of the sponsoring organization in an 

13 amount that is not less than the product 

14 obtained each month by multiplying— 

15 ‘‘(I) the number of family and 

16 group day care homes of the spon17 soring organization submitting a claim 

18 for reimbursement during the month; 

19 by 

20 ‘‘(II) the appropriate administra21 tive rate determined by the Secretary. 

22 ‘‘(ii) ANNUAL ADJUSTMENT.—The ad23 ministrative reimbursement levels specified 

24 in clause (i) shall be adjusted July 1 of 

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1 sumers published by the Bureau of Labor 

2 Statistics of the Department of Labor for 

3 the most recent 12-month period for which 

4 such data are available. 

5 ‘‘(iii) CARRYOVER FUNDS.—The Sec6 retary shall develop procedures under 

7 which not more than 10 percent of the 

8 amount made available to sponsoring orga9 nizations under this section for administra10 tive expenses for a fiscal year may remain 

11 available for obligation or expenditure in 

12 the succeeding fiscal year. 

13 ‘‘(iv) RETURN TO SECRETARY.—Any 

14 amounts appropriated that are not obli15 gated or expended during a fiscal year and 

16 are not carried over for the succeeding fis17 cal year under clause (iii) shall be returned 

18 to the Secretary.’’. 

19 SEC. 208. CULTIVATE FARM-TO-SCHOOL PARTNERSHIPS. 

20 (a) PROMOTING LOCAL FOOD.—Section 9(j)(1) of 

21 the Richard B. Russell National School Lunch Act (42 

22 U.S.C. 1758(j)(1)) is amended by inserting before the 

23 semicolon at the end, ‘‘, for use in programs under such 

24 Acts, including the commodity distribution program, the 


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1 summer food service program for children, child and adult 

2 care food program, and nutrition promotion’’. 

3 (b) GRANTS FOR FARM-TO-SCHOOL PROGRAMS.— 

4 (1) IN GENERAL.—The Richard B. Russell Na5 tional School Lunch Act (42 U.S.C. 1751 et seq.) is 

6 amended by inserting after section 19, the following: 

7 ‘‘SEC. 19A. GRANTS FOR FARM-TO-SCHOOL PROGRAMS. 

8 ‘‘(a) IN GENERAL.—The Secretary may provide as9 sistance, through competitive matching grants and tech10 nical assistance, to schools and nonprofit entities for farm11 to-school programs that— 

12 ‘‘(1) improve access to local foods in schools 

13 and institutions participating in programs under this 

14 Act and section 4 of the Child Nutrition Act of 1966 

15 (42 U.S.C. 1773) through farm-to-cafeteria activi16 ties, including school gardens, that may include the 

17 acquisition of food and appropriate equipment and 

18 the provision of training and education; 

19 ‘‘(2) are, at a minimum, designed to— 

20 ‘‘(A) procure local foods from small- and 

21 medium-sized farms for school meals; and 

22 ‘‘(B) support school garden programs; 

23 ‘‘(3) support nutrition education activities or 

24 curriculum planning that promotes healthy food edu25 cation in the school curriculum and incorporates the 


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1 participation of school children in farm-based agri2 cultural education activities, that may include school 

3 gardens; 

4 ‘‘(4) develop a sustained commitment to farm5 to-cafeteria projects in the community by linking 

6 schools, State departments of agriculture, agricul7 tural producers, parents, and other community 

8 stakeholders; 

9 ‘‘(5) require $100,000 or less in Federal con10 tributions; 

11 ‘‘(6) require a Federal share of costs not to ex12 ceed 75 percent; 

13 ‘‘(7) provide matching support in the form of 

14 cash or in-kind contributions (including facilities, 

15 equipment, or services provided by State and local 

16 governments and private sources); and 

17 ‘‘(8) cooperate in an evaluation carried out by 

18 the Secretary. 

19 ‘‘(b) ADMINISTRATION.—In providing grants under 

20 subsection (a), the Secretary shall give priority to pro21 grams that can be replicated in schools. 

22 ‘‘(c) PROGRAM FOR HIGH-POVERTY SCHOOLS.— 

23 ‘‘(1) DEFINITIONS.—In this subsection: 

24 ‘‘(A) ELIGIBLE PROGRAM.—The term ‘eli25 gible program’ means— 


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1 ‘‘(i) a school-based program with 

2 hands-on vegetable gardening and nutri3 tion education that is incorporated into the 

4 curriculum for 1 or more grades at 2 or 

5 more eligible schools; or 

6 ‘‘(ii) a community-based summer pro7 gram with hands-on vegetable gardening 

8 and nutrition education that is part of, or 

9 coordinated with, a summer enrichment 

10 program at 2 or more eligible schools. 

11 ‘‘(B) ELIGIBLE SCHOOL.—The term ‘eligi12 ble school’ means a public school, at least 50 

13 percent of the students of which are eligible for 

14 free or reduced price meals under this Act. 

15 ‘‘(2) ESTABLISHMENT.—The Secretary shall 

16 carry out a program under which the Secretary shall 

17 provide to nonprofit organizations or public entities 

18 States grants to develop and run, through eligible 

19 programs, community gardens at eligible schools in 

20 the States that would— 

21 ‘‘(A) be planted, cared for, and harvested 

22 by students at the eligible schools; and 

23 ‘‘(B) teach the students participating in 

24 the community gardens about agriculture pro25 duction practices and diet. 


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1 ‘‘(3) PRIORITY STATES.—Of the States in 

2 which grantees under this subsection are located— 

3 ‘‘(A) at least 1 State shall be among the 

4 15 largest States, as determined by the Sec5 retary; 

6 ‘‘(B) at least 1 State shall be among the 

7 16th to 30th largest States, as determined by 

8 the Secretary; and 

9 ‘‘(C) at least 1 State shall be a State that 

10 is not described in subparagraph (A) or (B). 

11 ‘‘(4) USE OF PRODUCE.—Produce from a com12 munity garden provided a grant under this sub13 section may be— 

14 ‘‘(A) used to supplement food provided at 

15 the eligible school; 

16 ‘‘(B) distributed to students to bring home 

17 to the families of the students; or 

18 ‘‘(C) donated to a local food bank or senior 

19 center nutrition program. 

20 ‘‘(5) NO COST-SHARING REQUIREMENT.—A 

21 nonprofit organization or public entity that receives 

22 a grant under this subsection shall not be required 

23 to share the cost of carrying out the activities as24 sisted under this paragraph. 


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1 ‘‘(6) EVALUATION.—A nonprofit organization 

2 or public entity that receives a grant under this sub3 section shall be required to cooperate in an evalua4 tion in accordance with subsection (a)(8). 

5 ‘‘(d) GUIDANCE FOR STATES.—Not later than 1 year 

6 after the date of the enactment of this section, the Sec7 retary shall research, evaluate, and make available to 

8 States— 

9 ‘‘(1) best practices for innovative and effective, 

10 as determined by the Secretary, farm-to-school pro11 grams described in subsection (a); 

12 ‘‘(2) an identification of the common challenges 

13 faced by schools, institutions, and local educational 

14 agencies in carrying out such farm-to-school pro15 grams; and 

16 ‘‘(3) a description of schools, institutions, and 

17 local educational agencies that are carrying out suc18 cessful farm-to-school programs. 

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

20 are authorized to be appropriated such sums as are nec21 essary to carry out this section for each of fiscal years 

22 2011 through 2016.’’. 

23 (2) CONFORMING AMENDMENTS.—Section 

24 18(g) of the Richard B. Russell National School 

25 Lunch Act (42 U.S.C. 1769(g)) is repealed. 


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1 TITLE III—IMPROVING ACCESS 

2 TO AND OPPORTUNITY FOR 

3 PHYSICAL ACTIVITY FOR 

4 ADULTS AND CHILDREN 

5 Subtitle A—National Program Pro6 moting Lifelong Active Youth 

7 (PLAY) and Implementation 

8 Grants 

9 SEC. 301. PLAY ASSESSMENT TOOLS. 

10 (a) IN GENERAL.—The Secretary of Health and 

11 Human Services (hereafter in this section referred to as 

12 the Secretary), acting through the Director of the Centers 

13 for Disease Control and Prevention, shall develop a list 

14 of well-validated assessment tools, which can measure the 

15 policy, program, or environmental barriers in communities 

16 to participating in physical activity. Tools on the Sec17 retary’s recommended list shall include— 

18 (1) cross-cutting measurements that— 

19 (A) examine barriers to physical activities 

20 across multiple settings, including homes, after21 school and child care sites, schools, the commu22 nity-at-large, and worksites; and 

23 (B) focus on the— 

24 (i) availability of adequate spaces and 

25 places for physical activity; 


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1 (ii) availability of, and access to, high2 quality physical activity and physical edu3 cation programs; and 

4 (iii) the availability of programs, ac5 tivities, and leaders to educate about the 

6 importance of physical activity for the com7 munity; and 

8 (2) additional measurements to assist economi9 cally and culturally diverse communities in exam10 ining the social determinants of health. 

11 (b) GUIDANCE AND TRAINING.—The Secretary shall 

12 provide guidelines and recommendations to develop train13 ing on utilizing such tools. 

14 SEC. 302. MODEL COMMUNITIES OF PLAY IMPLEMENTA15 TION GRANTS. 

16 (a) PROGRAM AUTHORIZED.— 

17 (1) IN GENERAL.—The Secretary of Health and 

18 Human Services (hereafter in this section referred to 

19 as the ‘‘Secretary’’), acting through the Director of 

20 the Centers for Disease Control and Prevention, 

21 shall award grants to State health departments to 

22 enable the State health departments to work in part23 nership with eligible community-based coalitions to 

24 plan and implement model communities of play that 

25 increase— 


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1 (A) the physical spaces and places avail2 able for physical activity; 

3 (B) the opportunities for children and fam4 ilies to participate in high-quality play, and the 

5 number of children and families participating in 

6 high-quality play; 

7 (C) knowledge and awareness about the 

8 importance of individuals achieving 60 minutes 

9 of recommended physical activity every day; and 

10 (D) school siting practices in which ele11 mentary and secondary schools are located 

12 within neighborhoods to increase the likelihood 

13 of students walking and biking to school. 

14 (2) AMOUNT OF GRANTS.—A grant awarded to 

15 a State health department under this subsection 

16 shall be in the amount of $250,000 to $1,000,000. 

17 (b) APPLICATION.—A State health department desir18 ing a grant under subsection (a) shall submit an applica19 tion to the Secretary at such time, in such manner, and 

20 containing such information as the Secretary may require. 

21 (c) COORDINATION.—In awarding grants under sub22 section (a), the Secretary shall ensure that the proposed 

23 programs assisted under each grant are coordinated in 

24 substance and format with programs currently funded 


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1 through other Federal departments and agencies, includ2 ing— 

3 (1) State-based nutrition and physical activity 

4 programs, comprehensive school health education 

5 programs, and community-based health and wellness 

6 programs of the Centers for Disease Control and 

7 Prevention; 

8 (2) the physical education programs under sub9 part 10 of part D of title V of the Elementary and 

10 Secondary Education Act of 1965 (20 U.S.C. 7261 

11 et seq.); 

12 (3) the safe routes to schools program under 

13 section 1404 of the Safe, Accountable, Flexible, Effi14 cient Transportation Equity Act: A Legacy for 

15 Users (23 U.S.C. 402 note); and 

16 (4) other health and wellness programs oper17 ating within the community. 

18 (d) PARTNERSHIP WITH COMMUNITY COALITIONS.— 

19 A State health department receiving a grant under sub20 section (a) shall use the majority of grant funds to carry 

21 out the activities described in subsection (e) in partnership 

22 with 1 or more community coalitions that meet all of the 

23 following requirements: 

24 (1) The community coalition is comprised of a 

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1 cluding not less than half of the following types of 

2 individuals and entities: 

3 (A) A community-based organization that 

4 focuses on children and youth, preventive 

5 health, physical activity, or physical education. 

6 (B) A local parks and recreation depart7 ment. 

8 (C) A local health department. 

9 (D) A local educational agency, as defined 

10 in section 9101 of the Elementary and Sec11 ondary Education Act of 1965 (20 U.S.C. 

12 7801). 

13 (E) A local city planning agency. 

14 (F) A local health care provider. 

15 (G) An institution of higher education, as 

16 defined in section 101 of the Higher Education 

17 Act of 1965 (20 U.S.C. 1001). 

18 (H) A tribal health facility, where applica19 ble. 

20 (I) A tribal educational agency, where ap21 plicable. 

22 (J) A federally qualified health center or 

23 rural health clinic (as such terms are defined in 

24 section 1861(aa) of the Social Security Act (42 

25 U.S.C. 1395x(aa)), where applicable. 


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1 (K) A hospital. 

2 (L) A faith-based organization. 

3 (M) A policymaker or elected official. 

4 (N) A community planning organization. 

5 (O) A business. 

6 (2) The community coalition completed and 

7 submitted to the State health department— 

8 (A) an assessment tool identified by the 

9 Secretary under section 301 for the community 

10 that identifies the gaps and barriers to physical 

11 activity in the community to children and 

12 youth; and 

13 (B) a community action plan describing 

14 the programs, policies, and environmental 

15 change strategies that will be implemented with 

16 grant funds to help children and youth in the 

17 community reach the recommended 60 minutes 

18 of physical activity every day. 

19 (3) The community coalition provided— 

20 (A) documentation to the State health de21 partment on the manner in which the coalition 

22 will coordinate with appropriate State and local 

23 authorities, including— 

24 (i) State or local health departments; 


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1 (ii) State educational agencies or local 

2 educational agencies, as defined in section 

3 9101 of the Elementary and Secondary 

4 Education Act of 1965 (20 U.S.C. 7801); 

5 (iii) State or local parks and recre6 ation departments or associations; 

7 (iv) State or local departments of 

8 transportation or city planning; 

9 (v) community foundations; and 

10 (vi) any other entities determined to 

11 be appropriate by the Secretary; and 

12 (B) a description of the manner in which 

13 the coalition will evaluate the effectiveness of 

14 the programs carried out with grant funds. 

15 (e) AUTHORIZED ACTIVITIES.—A State health de16 partment that receives a grant under subsection (a) shall 

17 use the majority of funds available through the grant to 

18 carry out the following activities: 

19 (1) Train community-based coalitions on how to 

20 utilize assessment tools to measure the program, 

21 policy, and environmental barriers to promoting life22 long physical activity for youth. 

23 (2) Work in partnership with one or more com24 munity coalitions described in subsection (d) to en25 able the coalitions to carry out the coalition’s comVerDate Mar 15 2010 02:37 May 06, 2010 Jkt 089200 PO 00000 Frm 00070 Fmt 6652 Sfmt 6201 E:\BILLS\H5209.IH H5209

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1 munity action plan and promote a model community 

2 of play, which may include the following: 

3 (A) Enabling the maximum use of, or the 

4 creation of spaces and places for, physical activ5 ity for children, families, and communities be6 fore, during, and after school or work, which 

7 may include increasing the number of— 

8 (i) programs that increase the number 

9 of safe streets and sidewalks in the com10 munity to walk and bike to school, work, 

11 or other community destinations, such as 

12 recreation sites, parks, or community cen13 ters; 

14 (ii) schools, faith-based organizations, 

15 and recreational facilities serving the com16 munity that provide programming on phys17 ical activity and physical education before, 

18 during, or after school; 

19 (iii) schools serving the community 

20 that provide recess, physical education, and 

21 physical activity for children and youth; 

22 (iv) day care, child care, and after23 school care sites in the community that 

24 provide physical activity for children and 

25 youth; 


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1 (v) venues in the community that pro2 vide co-curricular physical activity pro3 grams, including sports fields and courts, 

4 especially venues for all-inclusive intra5 mural programs and physical activity 

6 clubs; 

7 (vi) playgrounds and activity sites in 

8 the community for young children, includ9 ing sites that offer programs that provide 

10 physical activity instruction that meets the 

11 various needs and interests of all students, 

12 including those with illness, injury, and 

13 physical and developmental disabilities, as 

14 well as those who live sedentary lifestyles 

15 or have a disinterest in traditional team 

16 sports; 

17 (vii) capital improvement projects that 

18 increase opportunities for physical activity 

19 in the community; and 

20 (viii) networks of walking and cycling 

21 trails where trails do not exist in the com22 munity, that offer both a functional alter23 native to automobile travel and an oppor24 tunity for exercise, recreation, and commu25 nity connectedness. 


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1 (B) Enhancing opportunities and access 

2 for children and youth in the community to par3 ticipate in high-quality physical activity and 

4 physical education programs before, during, and 

5 after school, which may include increasing the 

6 number of— 

7 (i) school and after-school care sites 

8 in the community that implement proven 

9 health curricula, physical education (in10 cluding developing innovative approaches 

11 to teaching and staffing physical edu12 cation), and physical activity programming; 

13 (ii) children and youth in the commu14 nity who are able to participate in physical 

15 education or activity before, during, or 

16 after school, by ensuring that adequate 

17 equipment is available to such children and 

18 youth; 

19 (iii) scholarships to low-income chil20 dren and youth for physical activity pro21 grams; 

22 (iv) education and training programs 

23 for education, recreation, leisure, child 

24 care, and coaching professionals regarding 


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1 high-quality physical education and phys2 ical activity programs and policies; 

3 (v) training programs to assist physi4 cians in— 

5 (I) carefully communicating the 

6 results of body mass index (BMI) 

7 tests to parents and, in an age-appro8 priate manner, to the children and 

9 youth themselves; 

10 (II) providing information to 

11 families so they may make informed 

12 decisions about physical activity and 

13 nutrition; and 

14 (III) explaining the benefits asso15 ciated with physical activity and the 

16 risks associated with childhood over17 weight and obesity; 

18 (vi) assessment tools used to measure 

19 the quality of physical activity, sports, and 

20 intramural sports programs; 

21 (vii) guidelines and informational ma22 terials used by teachers, parents, care23 givers, and health-care professionals who 

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1 ity for infants, toddlers, and preschoolers; 

2 and 

3 (viii) guidelines and informational ma4 terials used to promote— 

5 (I) physical activity with the in6 tent of improving the current health, 

7 fitness, and wellness of preadolescent 

8 children (ages 6 through 12); and 

9 (II) lifelong physical activity. 

10 (C) Identifying, engaging, and mobilizing 

11 community leaders, decisionmakers, experts, 

12 and the media to raise awareness and educate 

13 the public about the importance of securing 60 

14 minutes of physical activity every day, which 

15 may include increasing the number of— 

16 (i) school and after-school care faculty 

17 and staff, including coaches, who serve as 

18 positive role models for students regarding 

19 regular physical activity; 

20 (ii) businesses that serve as role mod21 els by providing physical space and incen22 tives for employees to participate in phys23 ical activity; 

24 (iii) businesses that serve as role mod25 els to communities by— 


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1 (I) providing support to intra2 mural teams, clubs, sports leagues, 

3 playgrounds, trails, biking and walk4 ing paths, and fields and venues for 

5 sports, play, and physical activity; 

6 (II) incorporating built environ7 ment strategies into new construction 

8 of facilities; 

9 (III) adopting safe routes to 

10 school programs; 

11 (IV) providing bike racks at the 

12 office; and 

13 (V) encouraging the use of the 

14 stairs; 

15 (iv) insurers that cover obesity screen16 ing and prevention services in routine clin17 ical practice; 

18 (v) groups representing low-income in19 dividuals or individuals with disabilities, 

20 that can promote and secure safer and 

21 more accessible sites for activity; 

22 (vi) consumer research-driven mar23 keting strategies for ongoing initiatives 

24 and interventions that enhance physical ac25 tivity for children and youth; 


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1 (vii) products and opportunities pro2 vided or offered by leisure, entertainment, 

3 and recreation industries that promote reg4 ular physical activity and reduce sedentary 

5 behaviors; 

6 (viii) media advocacy training pro7 grams for public health and exercise sci8 entists so as to empower the scientists to 

9 disseminate their knowledge to a broad au10 dience; and 

11 (ix) campaigns to foster awareness 

12 about the health benefits of regular phys13 ical activity of not less than 60 minutes a 

14 day for all children and youth. 

15 (3) Support the evaluation of community action 

16 plans of community coalitions described in sub17 section (d) and activities carried out pursuant to 

18 this Act. 

19 (f) DEFINITION.—In this section, the term ‘‘State’’ 

20 includes the District of Columbia and any commonwealth, 

21 territory, or possession of the United States. 

22 (g) AUTHORIZATION OF APPROPRIATIONS.—To carry 

23 out this section, there are authorized to be appropriated 

24 such sums as may be necessary for fiscal years 2011 

25 through 2016. 


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1 Subtitle B—Moving Outdoors in 

2 Nature 

3 SEC. 311. DEFINITIONS. 

4 In this subtitle: 

5 (1) The term ‘‘eligible entity’’ means— 

6 (A) a State, city, county, municipality, en7 tity of local government, park and recreation 

8 department or district, school district, institu9 tion of higher education, or nonprofit organiza10 tion; or 

11 (B) a consortium of entities specified in 

12 subparagraph (A). 

13 (2) The term ‘‘Secretary’’ means the Secretary 

14 of the Interior. 

15 (3) The term ‘‘State’’ means any of the several 

16 States, the District of Columbia, the Commonwealth 

17 of Puerto Rico, the United States Virgin Islands, 

18 Guam, American Samoa, the Commonwealth of the 

19 Northern Mariana Islands, any other territory or 

20 possession of the United States, or any Indian tribe. 

21 SEC. 312. GRANTS FOR DEVELOPMENT OR IMPLEMENTA22 TION OF MOVING OUTDOORS IN NATURE 

23 STRATEGIES. 

24 (a) IN GENERAL.—The Secretary may award com25 petitive grants or cooperative agreements to States, or 


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1 other eligible entities in lieu of a State, to develop and 

2 implement a 5-year strategy, to be known as a Moving 

3 Outdoors in Nature State Strategy, for connecting chil4 dren and families with the outdoors. 

5 (b) SUBMISSION AND APPROVAL OF STRATEGIES.— 

6 (1) APPLICATIONS.—An application for a grant 

7 under subsection (a) shall— 

8 (A) be submitted not later than 120 days 

9 after the Secretary publishes guidelines under 

10 subsection (g)(1); and 

11 (B) include a Moving Outdoors in Nature 

12 State Strategy meeting the requirements of 

13 subsection (c) or a proposal for development 

14 and submission of such a strategy. 

15 (2) APPROVAL OF STRATEGY; PEER REVIEW.— 

16 Not later than 90 days after submission of a Moving 

17 Outdoors in Nature State Strategy, the Secretary 

18 shall approve or recommend changes to the strategy. 

19 The Secretary shall carry out the preceding sentence 

20 through a peer review process that includes partici21 pation from Federal, State, and local government 

22 and nongovernmental organizations. 

23 (3) STRATEGY UPDATE.—An eligible entity re24 ceiving funds under this subtitle shall update its 

25 Moving Outdoors in Nature State Strategy not less 


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1 than every 5 years to reflect any changes and modi2 fications. 

3 (c) COMPREHENSIVE STRATEGY REQUIREMENTS.— 

4 The Secretary may approve a Moving Outdoors in Nature 

5 State Strategy under subsection (b)(2) only if the strategy 

6 includes the following: 

7 (1) A description of how the eligible entity will 

8 connect children, youth, and families to the great 

9 outdoors through State and local— 

10 (A) public health systems; 

11 (B) public parks and recreation systems; 

12 (C) public transportation and city planning 

13 systems; and 

14 (D) other public systems that connect chil15 dren, youth, and families to the great outdoors. 

16 (2) A description of how the eligible entity will 

17 connect existing governmental systems to networks 

18 of nongovernmental partner organizations serving 

19 children, youth, and families. 

20 (3) A description of how State agencies, such as 

21 State departments of health, natural resources, envi22 ronmental quality, fish and wildlife, national guard, 

23 and transportation, will collaborate with each other 

24 and with nongovernmental organizations and local 

25 agencies to implement the strategy. 


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1 (4) A description of how funding will be spent 

2 through local planning and implementation grants 

3 under subsection (d). 

4 (5) A description of how the eligible entity will 

5 evaluate the effectiveness of, and measure the im6 pact of, the strategy. 

7 (6) A description of how the eligible entity will 

8 provide opportunities for public involvement in devel9 oping and implementing the strategy through a pub10 lic comment period, public hearings, or other means. 

11 (d) LOCAL PLANNING AND IMPLEMENTATION.— 

12 (1) IN GENERAL.—A Moving Outdoors in Na13 ture State Strategy shall provide for— 

14 (A) local planning; and 

15 (B) subgrants by the eligible entity receiv16 ing a grant under subsection (a) to local eligible 

17 entities to implement the strategy through one 

18 or more of the activities described in paragraph 

19 (2). 

20 (2) PROGRAM ACTIVITIES.—The activities de21 scribed in this paragraph are the following: 

22 (A) Outdoor recreation programs and ac23 tivities that engage children, youth, and families 

24 in healthy, active time outdoors through camp25 ing, hiking, hunting, fishing, archery, recVerDate Mar 15 2010 02:37 May 06, 2010 Jkt 089200 PO 00000 Frm 00081 Fmt 6652 Sfmt 6201 E:\BILLS\H5209.IH H5209

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1 reational shooting, wildlife watching, and other 

2 recreational activities that teach skills for life3 long participation in outdoor activities. 

4 (B) Public health initiatives to educate 

5 parents and caregivers about the health benefits 

6 of active time outdoors to fight obesity and in7 crease the quality of life for children, youth, 

8 and families. 

9 (C) Creation of natural play areas within 

10 communities, as defined by nationally recog11 nized guidelines, to provide opportunities for 

12 safe outdoor play in natural environments at 

13 daycare and afterschool child care sites, schools, 

14 parks, recreation centers, camps, libraries, mili15 tary installations, and other areas. 

16 (D) Development of trails and greenways 

17 to safely connect parks and outdoor recreation 

18 areas with military installations, daycare and 

19 afterschool child care sites, schools, and com20 munities through trail systems that encourage 

21 walking, biking, and increased time outdoors by 

22 children, youth, and families. 

23 (E) Creation of outdoor learning environ24 ments such as schoolyard, community, or back25 yard wildlife habitats or gardens. 


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1 (F) Environmental, sustainability, and 

2 conservation education and interpretation pro3 grams and activities that engage children, 

4 youth, and families in learning and physical ac5 tivity in the outdoors. 

6 (G) Service learning and volunteer oppor7 tunities to help restore natural areas, maintain 

8 recreational assets, and engage children, youth, 

9 and families in the outdoors. 

10 (H) Promotional activities that promote 

11 the benefits of time spent outdoors and invite 

12 children, youth, and families to enjoy the great 

13 outdoors by visiting nearby public and private 

14 lands. 

15 (I) Initiatives that engage health profes16 sionals, pediatricians, educators, daycare in17 structors, afterschool program providers, camp 

18 directors, community planners, local planning 

19 commissions, homeowners’ associations, envi20 ronmental professionals, military, law enforce21 ment, and business leaders in identifying inno22 vative solutions to connecting children, youth, 

23 and families with nature. 

24 (e) PRIORITY.—In making grants under subsection 

25 (a) and subgrants under subsection (d)(1)(B), the SecVerDate Mar 15 2010 02:37 May 06, 2010 Jkt 089200 PO 00000 Frm 00083 Fmt 6652 Sfmt 6201 E:\BILLS\H5209.IH H5209

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1 retary and the recipient of a grant under subsection (a) 

2 shall give preference to eligible entities that serve individ3 uals who have limited opportunities to experience nature, 

4 including those who are socioeconomically disadvantaged 

5 or have a disability. 

6 (f) ADMINISTRATIVE EXPENSES.—An eligible entity 

7 receiving a grant under subsection (a) may not use more 

8 than 5 percent of the grant funds for administrative ex9 penses. 

10 (g) GUIDELINES.—Not later than 180 days after the 

11 enactment of this Act, and after notice and opportunity 

12 for public comment, the Secretary shall publish in the 

13 Federal Register guidelines on the implementation of this 

14 subtitle, including guidelines for— 

15 (1) developing and submitting strategies under 

16 subsection (b); and 

17 (2) technical assistance and dissemination of 

18 best practices under section 314. 

19 (h) REPORTING.—Not later than 2 years after the 

20 Secretary approves the Moving Outdoors in Nature State 

21 Strategy of an eligible entity receiving funds under this 

22 subtitle, and every year thereafter, the entity shall submit 

23 to the Secretary a report on the implementation of the 

24 strategy based on the entity’s evaluation and assessment 

25 of meeting the goals specified in the strategy. 


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1 SEC. 313. NATIONAL EVALUATION OF HEALTH IMPACTS. 

2 The Secretary shall enter into an agreement with the 

3 Secretary of Health and Human Services and the Director 

4 of the Centers for Disease Control and Prevention for— 

5 (1) the development of recommendations for ap6 propriate evaluation measures and criteria for devel7 oping a study of national significance on the health 

8 impacts of the programs under this subtitle; and 

9 (2) the administration of such a study. 

10 SEC. 314. TECHNICAL ASSISTANCE AND BEST PRACTICES. 

11 The Secretary shall— 

12 (1) provide technical assistance to grantees 

13 under section 312, including training and technical 

14 assistance through national organizations with a 

15 proven track record of connecting children to the 

16 great outdoors; and 

17 (2) disseminate best practices that emerge from 

18 strategies funded under this subtitle. 

19 SEC. 315. AUTHORIZATION OF APPROPRIATIONS. 

20 (a) IN GENERAL.—There are authorized to be appro21 priated to the Secretary to carry out this subtitle— 

22 (1) $15,000,000 for fiscal year 2011; 

23 (2) $50,000,000 for fiscal year 2012; 

24 (3) $100,000,000 for fiscal year 2013; and 

25 (4) such sums as may be necessary for subse26 quent fiscal years. 


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1 (b) LIMITATION.—Of the amounts made available to 

2 carry out this subtitle for a fiscal year, not more than 5 

3 percent may be made available for carrying out section 

4 314. 

5 Subtitle C—Other Provisions 

6 SEC. 321. AUTHORIZATION OF APPROPRIATIONS FOR 

7 CAROL M. WHITE PHYSICAL EDUCATION PRO8 GRAM. 

9 Subpart 10 of part D of title V of the Elementary 

10 and Secondary Education Act of 1965 (20 U.S.C. 7261 

11 et seq.) is amended by adding at the end the following: 

12 ‘‘SEC. 5508. AUTHORIZATION OF APPROPRIATIONS. 

13 ‘‘There are authorized to be appropriated to carry out 

14 this subpart— 

15 ‘‘(1) $100,000,000 for fiscal year 2011; 

16 ‘‘(2) $110,000,000 for fiscal year 2012; 

17 ‘‘(3) $120,000,000 for fiscal year 2013; 

18 ‘‘(4) $130,000,000 for fiscal year 2014; 

19 ‘‘(5) $140,000,000 for fiscal year 2015; and 

20 ‘‘(6) $150,000,000 for fiscal year 2016.’’. 

21 SEC. 322. PHYSICAL EDUCATION GUIDELINES FOR ELE22 MENTARY AND SECONDARY SCHOOLS. 

23 The Secretary of Health and Human Services, acting 

24 through the Director of the Centers for Disease Control 

25 and Prevention— 


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1 (1) not later than 1 year after the date of the 

2 enactment of this Act, shall issue and make available 

3 to the public guidelines for physical education in ele4 mentary and secondary schools; and 

5 (2) not less than every 5 years thereafter, up6 date such guidelines as appropriate. 

7 SEC. 323. TREATING PHYSICAL EDUCATION AS A CORE ACA8 DEMIC SUBJECT FOR ELEMENTARY AND SEC9 ONDARY EDUCATION GRANTS. 

10 Section 9101(11) of the Elementary and Secondary 

11 Education Act of 1965 (20 U.S.C. 7801(11)) is amended 

12 by inserting ‘‘physical education,’’ after ‘‘arts,’’. 

13 SEC. 324. PHYSICAL ACTIVITY GUIDELINES FOR PRE14 SCHOOL CHILDREN. 

15 Not later than 1 year after the date of the enactment 

16 of this Act, the Secretary of Health and Human Services, 

17 acting through the Centers for Disease Control and Pre18 vention, shall— 

19 (1) issue physical activity guidelines for pre20 school children, 

21 (2) make such guidelines available to the public, 

22 and 

23 (3) make a recommendation to each Head Start 

24 agency that such agency implement such guidelines 


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1 as appropriate in the Head Start program carried 

2 out by such agency. 

3 SEC. 325. TRACKING PHYSICAL ACTIVITY IN SCHOOLS. 

4 (a) REPORT CARDS.—Section 1111(h) of the Ele5 mentary and Secondary Education Act of 1965 (20 U.S.C. 

6 6311(h)) is amended— 

7 (1) in paragraph (1)(C)— 

8 (A) in clause (vii), by striking ‘‘and’’ after 

9 the semicolon; 

10 (B) in clause (viii), by striking the period 

11 at the end and inserting a semicolon; and 

12 (C) by adding at the end the following: 

13 ‘‘(ix) the amount of time students 

14 spend in required physical education as 

15 measured against the national standards of 

16 150 minutes per week of required physical 

17 education for students in elementary school 

18 and 225 minutes per week of required 

19 physical education for students in middle 

20 school and secondary school; 

21 ‘‘(x) the percentage of local edu22 cational agencies in the State that have a 

23 required, age-appropriate physical edu24 cation curriculum for all students in ele25 mentary schools, middle schools, and secVerDate Mar 15 2010 02:37 May 06, 2010 Jkt 089200 PO 00000 Frm 00088 Fmt 6652 Sfmt 6201 E:\BILLS\H5209.IH H5209

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1 ondary schools that adheres to national 

2 guidelines adopted by the Centers for Dis3 ease Control and Prevention and State 

4 standards; 

5 ‘‘(xi) the percentage of elementary 

6 school and secondary school physical edu7 cation teachers who are State licensed or 

8 certified as physical education teachers; 

9 and 

10 ‘‘(xii) the percentage of schools that 

11 have a School Health Council that includes 

12 parents, students, representatives of the 

13 school food authority, representatives of 

14 the school board, school administrators 

15 and members of the public and that meets 

16 monthly to promote a healthy school envi17 ronment.’’; 

18 (2) in paragraph (2)(B)(i)— 

19 (A) in subclause (I), by striking ‘‘and’’ 

20 after the semicolon; 

21 (B) in subclause (II), by striking ‘‘and’’ 

22 after the semicolon; and 

23 (C) by adding at the end the following: 

24 ‘‘(III) the percentage of elemen25 tary school and secondary school 


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1 physical education teachers who are 

2 State certified as physical education 

3 teachers; and 

4 ‘‘(IV) the amount of square feet 

5 of indoor and outdoor facilities that 

6 are primarily used for physical edu7 cation and the amount of square feet 

8 of indoor and outdoor facilities that 

9 are primarily used for physical activ10 ity; and’’; and 

11 (3) in paragraph (2)(B)(ii)— 

12 (A) in subclause (I), by striking ‘‘and’’ 

13 after the semicolon; 

14 (B) in subclause (II), by striking the pe15 riod at the end and inserting a semicolon; and 

16 (C) by adding at the end the following: 

17 ‘‘(III) the percentage of elemen18 tary school and secondary school 

19 physical education teachers who are 

20 State certified as physical education 

21 teachers; and 

22 ‘‘(IV) the number of meetings of 

23 a School Health Council that includes 

24 parents, students, representatives of 

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1 tives of the school board, school ad2 ministrators and members of the pub3 lic during the school year.’’. 

4 (b) PROMOTING PHYSICAL EDUCATION AND ACTIV5 ITY IN SCHOOL PROGRAMS.— 

6 (1) ELEMENTARY AND SECONDARY SCHOOL

7 COUNSELING PROGRAMS.—Section 5421 of the Ele8 mentary and Secondary Education Act of 1965 (20 

9 U.S.C. 7245) is amended— 

10 (A) in subsection (b)(2)(H), by inserting ‘‘, 

11 which design and implementation shall take 

12 into consideration the overall emotional and 

13 physical well-being of students’’ after ‘‘the pro14 gram’’; and 

15 (B) in subsection (c)(2)(E), by inserting 

16 ‘‘health, the importance of regular physical ac17 tivity,’’ after ‘‘relationships,’’. 

18 (2) SMALLER LEARNING COMMUNITIES.—Sec19 tion 5441(b) of the Elementary and Secondary Edu20 cation Act of 1965 (20 U.S.C. 7249(b)) is amended 

21 by adding at the end the following: 

22 ‘‘(14) How the local educational agency will en23 sure that smaller learning communities support 

24 healthy lifestyles including participation in physical 


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1 education and physical activity by all students and 

2 access to nutritious food and nutrition education.’’. 

3 (3) 21ST CENTURY COMMUNITY LEARNING CEN4 TERS.— 

5 (A) PURPOSE; DEFINITIONS.—Section 

6 4201 of the Elementary and Secondary Edu7 cation Act of 1965 (20 U.S.C. 7171) is amend8 ed— 

9 (i) in subsection (a)(2), by inserting 

10 ‘‘nutrition education programs, structured 

11 physical activity programs,’’ after ‘‘recre12 ation programs,’’; and 

13 (ii) in subsection (b)(1)(A), by insert14 ing ‘‘nutrition education, structured phys15 ical activity,’’ after ‘‘recreation,’’. 

16 (B) LOCAL COMPETITIVE GRANT PRO17 GRAM.—Section 4204(b)(2) of the Elementary 

18 and Secondary Education Act of 1965 (20 

19 U.S.C. 7174(b)(2))— 

20 (i) in subparagraph (M), by striking 

21 ‘‘and’’ after the semicolon; 

22 (ii) by redesignating subparagraph 

23 (N) as subparagraph (O); and 

24 (iii) by inserting after subparagraph 

25 (M) the following: 


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1 ‘‘(N) an assurance that the proposed pro2 gram is coordinated with the physical education 

3 and health education programs offered during 

4 the school day; and’’. 

5 (C) LOCAL ACTIVITIES.—Section 4205(a) 

6 of the Elementary and Secondary Education 

7 Act of 1965 (20 U.S.C. 7175(a))— 

8 (i) in paragraph (11), by striking 

9 ‘‘and’’ after the semicolon; 

10 (ii) in paragraph (12), by striking the 

11 period at the end and inserting ‘‘; and’’; 

12 and 

13 (iii) by adding at the end the fol14 lowing: 

15 ‘‘(13) programs that support a healthy, active 

16 lifestyle, including nutritional education and regular, 

17 structured physical activity programs.’’. 

18 (4) PARENTAL INVOLVEMENT.—Section 1118 

19 of the Elementary and Secondary Education Act of 

20 1965 is amended— 

21 (A) in subsection (a)(2)— 

22 (i) in subparagraph (E), by striking 

23 ‘‘and’’ at the end; 

24 (ii) by redesignating subparagraph 

25 (F) as subparagraph (G); and 


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1 (iii) by inserting after subparagraph 

2 (E) the following: 

3 ‘‘(F) involve and train parents in encour4 aging and supporting a healthy and active life5 style, including increased physical activity dur6 ing and outside the school day, and nutritional 

7 eating habits in the home and at school; and’’; 

8 (B) in subsection (d)— 

9 (i) in the subsection heading, by in10 serting after ‘‘ACHIEVEMENT’’ the fol11 lowing: ‘‘BY HEALTHY, ACTIVE STU12 DENTS’’; 

13 (ii) in the matter preceding paragraph 

14 (1), by striking ‘‘standards.’’ and inserting 

15 ‘‘standards and to ensure that the children 

16 lead healthy, active lives.’’; and 

17 (iii) in paragraph (1)— 

18 (I) by inserting after ‘‘sup19 portive’’ the following: ‘‘, healthy,’’; 

20 (II) by striking ‘‘; and partici21 pating’’ and inserting ‘‘; partici22 pating’’; and 

23 (III) by inserting after ‘‘extra24 curricular time’’ the following: ‘‘and 

25 supporting their children in leading a 


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1 healthy and active life, such as by 

2 providing healthy meals and snacks, 

3 encouraging participation in physical 

4 education, and sharing in physical ac5 tivity outside the school day’’; and 

6 (C) in subsection (e)— 

7 (i) by redesignating paragraphs (6) 

8 through (14) as paragraphs (7) through 

9 (15), respectively; and 

10 (ii) by inserting after paragraph (5) 

11 the following: 

12 ‘‘(6)(A) shall ensure that parents and teachers 

13 have information about the importance of a healthy 

14 lifestyle, including nutritional eating habits, physical 

15 education, and physical activity, to an effective 

16 learning environment; and 

17 ‘‘(B) shall coordinate activities with parents 

18 and teachers to ensure that children are provided 

19 with nutritious meals and snacks, and have ample 

20 opportunities for physical education and physical ac21 tivity during and outside the school day;’’. 

22 (c) PROFESSIONAL DEVELOPMENT FOR TEACHERS

23 AND PRINCIPALS.— 

24 (1) STATE APPLICATIONS.—Section 2112(b) of 

25 the Elementary and Secondary Education Act of 


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1 1965 (20 U.S.C. 6612(b)) is amended by adding at 

2 the end the following: 

3 ‘‘(13) A description of how the State edu4 cational agency will use funds under this part to 

5 provide professional development that is directly re6 lated to the fields of physical education and health 

7 education to physical education teachers and health 

8 education teachers to ensure that children are lead9 ing healthy, active lifestyles that are conducive to ef10 fective learning.’’. 

11 (2) STATE USE OF FUNDS.—Section 2113(c)(6) 

12 of the Elementary and Secondary Education Act of 

13 1965 (20 U.S.C. 6613(c)(6)) is amended— 

14 (A) by striking ‘‘, in cases in which a State 

15 educational agency determines support to be 

16 appropriate,’’; and 

17 (B) by inserting ‘‘, physical education 

18 teachers, and health education teachers’’ after 

19 ‘‘pupil services personnel’’. 

20 (3) LOCAL APPLICATIONS AND NEEDS ASSESS21 MENT.—Section 2122(b)(9) of the Elementary and 

22 Secondary Education Act of 1965 (20 U.S.C. 

23 6622(b)(9)) is amended— 

24 (A) in subparagraph (C), by striking 

25 ‘‘and’’ after the semicolon; 


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1 (B) in subparagraph (D), by striking the 

2 period at the end and inserting ‘‘; and’’; and 

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

4 ‘‘(E) improve the health and eating habits 

5 of students and increase rates of physical activ6 ity of students.’’. 

7 (4) LOCAL USE OF FUNDS.—Section 2123(a)(3) 

8 of the Elementary and Secondary Education Act of 

9 1965 (20 U.S.C. 6623(a)(3)) is amended— 

10 (A) in subparagraph (A)— 

11 (i) in clause (i), by striking ‘‘and’’ 

12 after the semicolon; and 

13 (ii) by adding at the end the fol14 lowing: 

15 ‘‘(iii) effective strategies for improving 

16 the healthy habits of students and the 

17 rates of physical activity by students that 

18 result in the ability to learn more effec19 tively; and’’; and 

20 (B) in subparagraph (B)— 

21 (i) in clause (iv), by striking ‘‘and’’ 

22 after the semicolon; 

23 (ii) in clause (v), by striking the pe24 riod at the end and inserting ‘‘; and’’; and 


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1 (iii) by adding at the end the fol2 lowing: 

3 ‘‘(vi) provide training, with curricula 

4 that is evidence-based, in how to teach 

5 physical education and health education 

6 that results in the ability of students to 

7 learn more effectively.’’. 

8 (d) NATIONAL RESEARCH COUNCIL STUDY.—Not 

9 later than 180 days after the date of enactment of this 

10 Act, the Secretary of Education shall enter into a contract 

11 with the National Research Council of the National Acad12 emy of Sciences to— 

13 (1) examine and make recommendations re14 garding— 

15 (A) various means that may be employed 

16 to incorporate physical activity into Head Start 

17 and child care settings, elementary, middle, and 

18 high school settings, and before- and after19 school programs; and 

20 (B) innovative and effective ways to in21 crease physical activity for all students; 

22 (2) study the impact of health, level of physical 

23 activity, and amount of physical education on stu24 dents’ ability to learn and maximize performance in 

25 school; and 


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1 (3) study and provide specific recommendations 

2 for— 

3 (A) effectively measuring the progress of 

4 students, at the school level, in improving their 

5 health and well-being, including improving 

6 their— 

7 (i) knowledge, awareness, and behav8 ior changes, related to nutrition and phys9 ical activity; 

10 (ii) cognitive development, and fitness 

11 improvement, in physical education; 

12 (iii) knowledge of lifetime physical ac13 tivity and health promotion; 

14 (iv) decrease in obesity; and 

15 (v) levels on overall health indicators; 

16 and 

17 (B) effectively measuring the progress of 

18 students, at the school level, in increasing phys19 ical activity. 

20 SEC. 326. EMPLOYER-PROVIDED OFF-PREMISES HEALTH 

21 CLUB SERVICES. 

22 (a) TREATMENT AS FRINGE BENEFIT.—Subpara23 graph (A) of section 132(j)(4) of the Internal Revenue 

24 Code of 1986 (relating to on-premises gyms and other ath25 letic facilities) is amended to read as follows: 


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1 ‘‘(A) IN GENERAL.—Gross income shall 

2 not include— 

3 ‘‘(i) the value of any on-premises ath4 letic facility provided by an employer to the 

5 employer’s employees, and 

6 ‘‘(ii) so much of the fees, dues, or 

7 membership expenses paid by an employer 

8 to an athletic or fitness facility described 

9 in subparagraph (C) on behalf of the em10 ployer’s employees as does not exceed $900 

11 per employer per year.’’. 

12 (b) ATHLETIC FACILITIES DESCRIBED.—Paragraph 

13 (4) of section 132(j) of such Code is amended by adding 

14 at the end the following new subparagraph: 

15 ‘‘(C) CERTAIN ATHLETIC OR FITNESS FA16 CILITIES DESCRIBED.—For purposes of sub17 paragraph (A)(ii), an athletic or fitness facility 

18 described in this subparagraph is a facility— 

19 ‘‘(i) providing instruction in a pro20 gram of physical exercise, offering facilities 

21 for the preservation, maintenance, encour22 agement, or development of physical fit23 ness, or serving as the site of such a pro24 gram of a State or local government, 


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1 ‘‘(ii) which is not a private club owned 

2 and operated by its members, 

3 ‘‘(iii) which does not offer golf, hunt4 ing, sailing, or riding facilities, 

5 ‘‘(iv) whose health or fitness facility is 

6 not incidental to its overall function and 

7 purpose, and 

8 ‘‘(v) which is fully compliant with the 

9 State of jurisdiction and Federal anti-dis10 crimination laws.’’. 

11 (c) EXCLUSION APPLIES TO HIGHLY COMPENSATED

12 EMPLOYEES ONLY IF NO DISCRIMINATION.—Paragraph 

13 (1) of section 132(j) of such Code is amended— 

14 (1) by striking ‘‘Paragraphs (1) and (2) of sub15 section (a)’’ and inserting ‘‘Paragraphs (1) and (2) 

16 of subsection (a) and paragraph (4) of this sub17 section’’, and 

18 (2) in the heading by striking ‘‘EXCLUSIONS

19 UNDER SUBSECTION (A)(1) AND (2)’’ and inserting 

20 ‘‘CERTAIN EXCLUSIONS’’. 

21 (d) EMPLOYER DEDUCTION FOR DUES TO CERTAIN

22 ATHLETIC FACILITIES.— 

23 (1) IN GENERAL.—Paragraph (3) of section 

24 274(a) of such Code (relating to denial of deduction 

25 for club dues) is amended by adding at the end the 


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1 following new sentence: ‘‘The preceding sentence 

2 shall not apply to so much of the fees, dues, or 

3 membership expenses paid to athletic or fitness fa4 cilities (within the meaning of section 132(j)(4)(C)) 

5 as does not exceed $900 per employee per year.’’. 

6 (2) CONFORMING AMENDMENT.—Section 

7 274(e)(4) of such Code is amended by inserting ‘‘the 

8 first sentence of’’ before ‘‘subsection (a)(3)’’. 

9 (e) EFFECTIVE DATE.—The amendments made by 

10 this section shall apply to taxable years beginning after 

11 the date of the enactment of this Act. 

12 SEC. 327. CERTAIN AMOUNTS PAID FOR PHYSICAL ACTIV13 ITY, FITNESS, AND EXERCISE TREATED AS 

14 AMOUNTS PAID FOR MEDICAL CARE. 

15 (a) IN GENERAL.—Paragraph (1) of section 213(d) 

16 of the Internal Revenue Code of 1986 is amended by strik17 ing ‘‘or’’ at the end of subparagraph (C), by striking the 

18 period at the end of subparagraph (D) and inserting ‘‘, 

19 or’’, and by adding at the end the following new subpara20 graph: 

21 ‘‘(E) for qualified sports and fitness ex22 penses.’’. 

23 (b) QUALIFIED SPORTS AND FITNESS EXPENSES.— 

24 Subsection (d) of section 213 of such Code is amended 

25 by adding at the end the following paragraph: 


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1 ‘‘(12) QUALIFIED SPORTS AND FITNESS EX2 PENSES.— 

3 ‘‘(A) IN GENERAL.—The term ‘qualified 

4 sports and fitness expenses’ means amounts 

5 paid— 

6 ‘‘(i) for membership at a fitness cen7 ter, 

8 ‘‘(ii) for participation or instruction in 

9 a program of physical exercise or physical 

10 activity, and 

11 ‘‘(iii) for equipment for use in a pro12 gram (including a self-directed program) of 

13 physical exercise or physical activity. 

14 ‘‘(B) OVERALL DOLLAR LIMITATION.—The 

15 aggregate amount treated as qualified sports 

16 and fitness expenses with respect to any tax17 payer for any taxable year shall not exceed 

18 $1,000 ($2,000 in the case of a joint return or 

19 a head of household (as defined in section 

20 2(b))). 

21 ‘‘(C) FITNESS FACILITY DEFINED.—For 

22 purposes of subparagraph (A)(i), the term ‘fit23 ness facility’ means a facility— 

24 ‘‘(i) providing instruction in a pro25 gram of physical exercise, offering facilities 


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1 for the preservation, maintenance, encour2 agement, or development of physical fit3 ness, or serving as the site of such a pro4 gram of a State or local government, 

5 ‘‘(ii) which is not a private club owned 

6 and operated by its members, 

7 ‘‘(iii) which does not offer golf, hunt8 ing, sailing, or riding facilities, 

9 ‘‘(iv) whose health or fitness facility is 

10 not incidental to its overall function and 

11 purpose, and 

12 ‘‘(v) which is fully compliant with the 

13 State of jurisdiction and Federal anti-dis14 crimination laws. 

15 ‘‘(D) LIMITATIONS RELATED TO SPORTS

16 AND FITNESS EQUIPMENT.—Amounts paid for 

17 equipment described in subparagraph (A)(iii) 

18 shall be treated as a qualified sports and fitness 

19 expense only— 

20 ‘‘(i) if such equipment is utilized ex21 clusively for participation in fitness, exer22 cise, sport, or other physical activity pro23 grams, 

24 ‘‘(ii) if such equipment is not apparel 

25 or footwear, and 


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1 ‘‘(iii) in the case of any item of sports 

2 equipment (other than exercise equip3 ment), with respect to so much of the 

4 amount paid for such item as does not ex5 ceed $250. 

6 ‘‘(E) PROGRAMS WHICH INCLUDE COMPO7 NENTS OTHER THAN PHYSICAL EXERCISE AND

8 PHYSICAL ACTIVITY.—Rules similar to the rules 

9 of section 213(d)(6) shall apply in the case of 

10 any program that includes physical exercise or 

11 physical activity and also other components. 

12 For purposes of the preceding sentence, travel 

13 and accommodations shall be treated as an 

14 other component.’’. 

15 (c) EXCEPTION FOR HEALTH SAVINGS ACCOUNTS.— 

16 Subparagraph (A) of section 223(d)(2) of such Code is 

17 amended by inserting ‘‘, determined without regard to 

18 paragraph (1)(E) thereof’’ after ‘‘section 213(d)’’. 

19 (d) EFFECTIVE DATE.—The amendment made by 

20 this section shall apply to taxable years beginning after 

21 the date of the enactment of this Act. 

22 SEC. 328. NATIONAL YOUTH SPORTS PROGRAM REVITAL23 IZATION. 

24 Section 682(g) of the Community Services Block 

25 Grant Act (42 U.S.C. 9923(g)) is amended by striking 


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1 ‘‘$15,000,000’’ and all that follows through ‘‘2003’’, and 

2 inserting ‘‘$20,000,000 for each of the fiscal years 2011 

3 through 2021’’. 

4 SEC. 329. DUPLICATION OF THE ZUNI YOUTH ENRICHMENT 

5 PROJECT SUMMER CAMP ON INDIAN RES6 ERVATIONS AND TRIBAL LANDS. 

7 (a) IN GENERAL.—The Secretary of Health and 

8 Human Services shall establish a 2-year pilot program to 

9 provide funds to community-based organizations on Indian 

10 reservations or tribal lands to plan and implement an en11 richment program for children (in the form of a summer 

12 camp and a year-round program) for the purpose of— 

13 (1) reversing the epidemics of obesity, diabetes, 

14 and alcoholism in such areas; and 

15 (2) to mitigate other problems stemming from 

16 the formation of bad habits and the development of 

17 low self esteem during childhood. 

18 (b) PARTNERSHIPS.—In order to qualify for funding 

19 under subsection (a), a community-based organization 

20 shall demonstrate, to the satisfaction of the Secretary of 

21 Health and Human Services, that the community-based 

22 organization has entered into a partnership with commu23 nity entities, local funders, and tribal leaders (including, 

24 if applicable, the tribal council) to plan and execute an 

25 enrichment program under subsection (a). 


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1 (c) NUMBER OF SITES.—The Secretary of Health 

2 and Human Services, in providing funding under sub3 section (a), shall provide funding to no more than 20 com4 munity-based organizations. 

5 (d) MODEL AND CAMP REQUIREMENT.—The enrich6 ment program under subsection (a) shall— 

7 (1) be modeled on similar programs established 

8 by the Zuni Youth Enrichment Project; and 

9 (2) shall include a camp of at least 6 weeks in 

10 duration during the summer. 

11 (e) SPECIFIC CAMP REQUIREMENTS.— 

12 (1) DAILY ACTIVITIES.—With respect to chil13 dren attending a camp under subsection (d)(2), the 

14 leader of the organization that receives funds under 

15 subsection (a) shall, for each day of the camp, en16 sure that, such children are— 

17 (A) involved in at least 60 minutes of 

18 physical activity (with appropriate accommoda19 tions made for children with disabilities); and 

20 (B) provided with at least two meals that 

21 meet national nutritional standards that are 

22 aligned with dietary guidelines. 

23 (2) OTHER ACTIVITIES.—Such leader shall also 

24 ensure that— 


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1 (A) a community gardening activity is in2 cluded in the activities conducted at the camp; 

3 and 

4 (B) health and wellness education is pro5 vided to the children attending the camp. 

6 (f) EVALUATION.— 

7 (1) IN GENERAL.—A community-based organi8 zation that receives funding under subsection (a), 

9 shall, as a condition of receiving such funding, con10 duct an evaluation of the enrichment program con11 ducted by such organization. 

12 (2) MODEL.—The form, manner, content, and 

13 frequency of the evaluation under paragraph (1) 

14 shall be modeled on the Zuni Youth Enrichment 

15 Project standard project evaluation. 

16 (g) REPORT.—Not later than 1 year after the date 

17 on which a community organization first receives funding 

18 under subsection (a) and annually thereafter, the organi19 zation shall— 

20 (1) submit a report to the to the Secretary of 

21 Health and Human Services on the outcomes of the 

22 enrichment program conducted by the organization 

23 under this section, including— 

24 (A) the findings of the evaluation con25 ducted under subsection (f); and 


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1 (B) the impact of such enrichment pro2 gram on the rates of childhood obesity on the 

3 reservation or area of tribal land served by the 

4 organization; and 

5 (2) provide a copy of the findings under para6 graph (1)(A) to community entities, local funders, 

7 tribal leaders (including, if applicable, the tribal 

8 council), and the families of children participating in 

9 the enrichment program. 

10 TITLE IV—IMPROVING ACCESS 

11 TO NUTRITIONAL INFORMA12 TION AND HEALTHY FOODS 

13 SEC. 401. CONSUMER EDUCATION. 

14 Subsection (c) of section 2 of the Nutrition Labeling 

15 and Education Act of 1990 (Pub. L. 101–535; 104 Stat. 

16 2353, 2357; 21 U.S.C. 343 note) is amended to read as 

17 follows: 

18 ‘‘(c) CONSUMER EDUCATION.— 

19 ‘‘(1) IN GENERAL.—The Secretary of Health 

20 and Human Services shall carry out activities which 

21 educate consumers about— 

22 ‘‘(A) the availability of nutrition informa23 tion in the label or labeling of food; 

24 ‘‘(B) the importance of that information in 

25 maintaining healthy dietary practices; 


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1 ‘‘(C) the importance of physical activity 

2 and healthy lifestyles; and 

3 ‘‘(D) the importance of maintaining an en4 ergy balance in consumption and activity. 

5 ‘‘(2) CERTAIN ACTIVITIES.—Activities under 

6 paragraph (1) shall include the use of public edu7 cation campaigns, public statements, and other re8 sources designed to educate consumers about the 

9 subjects described in subparagraphs (A) through (D) 

10 of such paragraph.’’. 

11 SEC. 402. EXPAND TEAM NUTRITION TRAINING GRANTS. 

12 Section 19 of the Child Nutrition Act of 1966 (20 

13 U.S.C. 1788) is amended— 

14 (1) by redesignating subsection (l) as subsection 

15 (m); and 

16 (2) by inserting after subsection (k), the fol17 lowing: 

18 ‘‘(l) INFRASTRUCTURE IMPROVEMENT GRANTS.— 

19 ‘‘(1) IN GENERAL.—Subject to the availability 

20 of funds to carry out this subsection, the Secretary 

21 shall award one-time grants, on a competitive basis, 

22 to eligible State agencies to assist such State agen23 cies in carrying out infrastructure improvements for 

24 the purpose of improving children’s lifelong eating 

25 and physical habits, consistent with the Dietary 


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1 Guidelines for Americans published under section 

2 301 of the National Nutrition Monitoring and Re3 lated Research Act of 1990 (7 U.S.C. 5341). 

4 ‘‘(2) ELIGIBLE STATE AGENCY.—For purposes 

5 of this subsection, an ‘eligible State agency’ 

6 means— 

7 ‘‘(A) a State agency that participates in— 

8 ‘‘(i) the school lunch program under 

9 the Richard B. Russell National School 

10 Lunch Act (42 U.S.C. 1751 et seq.); 

11 ‘‘(ii) the school breakfast program 

12 under section 4 of the Child Nutrition Act 

13 of 1966 (42 U.S.C. 1773); or 

14 ‘‘(iii) the child and adult care food 

15 program under the Richard B. Russell Na16 tional School Lunch Act (42 U.S.C. 1766); 

17 or 

18 ‘‘(B) a consortium of 2 or more such State 

19 agencies— 

20 ‘‘(i) located in the same State; or 

21 ‘‘(ii) located in different States. 

22 ‘‘(3) APPLICATION.—To receive a grant under 

23 this subsection, an eligible State agency shall submit 

24 to the Secretary an application at such time, in such 


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1 manner, and containing such information as the Sec2 retary may require 

3 ‘‘(4) USES OF FUNDS.— 

4 ‘‘(A) REQUIRED USES.—An eligible State 

5 agency that receives a grant under this sub6 section shall use such funds to cover the costs 

7 of infrastructure improvements related to the 

8 school lunch program, school breakfast pro9 gram, or the child and adult food care program, 

10 including improvements in kitchen equipment 

11 and other foodservice equipment used to serve 

12 or store food offered to children under any such 

13 program. 

14 ‘‘(B) AUTHORIZED USES.—An eligible 

15 State agency that receives a grant under this 

16 subsection may use such funds to award sub17 grants to local educational agencies to carry out 

18 the activities described in subparagraph (A). 

19 ‘‘(5) RECORDKEEPING.—An eligible State agen20 cy receiving a grant under this subsection shall keep 

21 a record of the use of the grant funds.’’. 


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1 SEC. 403. DEPARTMENT OF AGRICULTURE PROGRAM TO 

2 SUPPORT ESTABLISHMENT OR EXPANSION 

3 OF RETAIL FOOD STORES OFFERING AF4 FORDABLE, NUTRITIOUS FOODS IN UNDER5 SERVED COMMUNITIES AND COORDINATION 

6 WITH OTHER FEDERAL PROGRAMS. 

7 The Food and Nutrition Act of 2008 (7 U.S.C. 2011 

8 et seq.) is amended by adding at the end the following 

9 new section: 

10 ‘‘SEC. 28. LOANS, LOAN GUARANTEES, AND GRANTS TO SUP11 PORT ESTABLISHMENT OR EXPANSION OF 

12 RETAIL FOOD STORES OFFERING AFFORD13 ABLE, NUTRITIOUS FOODS IN UNDERSERVED 

14 COMMUNITIES AND INTER-DEPARTMENTAL 

15 COORDINATION. 

16 ‘‘(a) DEFINITIONS.—In this section: 

17 ‘‘(1) AFFORDABLE, NUTRITIOUS FOODS.—The 

18 term ‘affordable, nutritious foods’ means fruits and 

19 vegetables, meat, fish, grains, dairy, and poultry. 

20 ‘‘(2) RETAIL FOOD STORE.—The term ‘retail 

21 food store’ includes a supermarket, grocery store, 

22 farmers market, or other food retail outlet that oper23 ates on a self-service basis primarily selling gro24 ceries, produce, meat, baked goods, dairy products 

25 and other nutritious foods. 


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1 ‘‘(3) UNDERSERVED COMMUNITY.—The term 

2 ‘underserved community’ has the meaning given that 

3 term in section 25(a)(3). 

4 ‘‘(b) PROGRAM AUTHORIZED.—The Secretary may 

5 provide a loan or loan guarantee or make a grant to sup6 port the establishment or expansion of a retail food store 

7 that will offer affordable, nutritious foods in an under8 served community. 

9 ‘‘(c) ELIGIBILITY.—For an entity to be eligible for 

10 a loan, loan guarantee, or grant under this section, the 

11 entity must— 

12 ‘‘(1) demonstrate to the satisfaction of the Sec13 retary the economic viability of the project to estab14 lish or expand a retail food store in an underserved 

15 community; and 

16 ‘‘(2) provide a guarantee satisfactory to the 

17 Secretary that the retail food store established or ex18 panded in an underserved community using the pro19 ceeds of the loan or the grant funds will make af20 fordable, nutritious foods readily available among 

21 the food products offered by the retail food store. 

22 ‘‘(d) LOAN TERMS.— 

23 ‘‘(1) DURATION.—A loan made by the Sec24 retary under this section shall be for a term not to 

25 exceed 15 years. 


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1 ‘‘(2) INTEREST.—The loan shall bear interest 

2 at a reduced annual interest rate to be set by the 

3 Secretary. 

4 ‘‘(3) DEFERRAL OF INTEREST AND PRIN5 CIPAL.—The Secretary may permit the deferral of 

6 payments on principal and interest due on the loan 

7 for a two-year period beginning on the date the loan 

8 is made. 

9 ‘‘(e) LIMITATION ON AMOUNT OF LOAN GUARAN10 TEES.—The portion of a loan that the Secretary may 

11 guarantee under this section shall be not more than 85 

12 percent of the principal amount of the loan. 

13 ‘‘(f) GRANT COST SHARING REQUIREMENTS.— 

14 ‘‘(1) MATCHING REQUIREMENT.—As a condi15 tion of any grant made under this section, the Sec16 retary shall require the grant recipient to match not 

17 less than 50 percent of the total amount of the 

18 grant. 

19 ‘‘(2) FORM OF NON-FEDERAL SHARE.—The 

20 matching requirement may be satisfied through the 

21 provision of— 

22 ‘‘(A) cash (including through fees, grants 

23 (including community development block 

24 grants), and gifts); or 


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1 ‘‘(B) in-kind contributions acceptable to 

2 the Secretary. 

3 ‘‘(g) COORDINATION WITH OTHER FEDERAL PRO4 GRAMS IN UNDERSERVED COMMUNITIES.—The Secretary 

5 of Agriculture shall coordinate with the Secretary of 

6 Health and Human Services and the Secretary of Treas7 ury to identify and target existing tax incentives, loans, 

8 grants, and other financial and technical assistance avail9 able to each Secretary that can be used to improve access 

10 to affordable, nutritious foods in underserved commu11 nities. 

12 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For 

13 each of fiscal years 2011 through 2015, there are author14 ized to be appropriated $10,000,000 to the Secretary to 

15 provide loans and loan guarantees and to make grants 

16 under this section.’’. 

17 SEC. 404. VIRTUAL FARMERS MARKET PROGRAM. 

18 (a) ESTABLISHMENT OF GRANT PROGRAM.—From 

19 the amounts appropriated to carry out this section, the 

20 Secretary of Agriculture, in collaboration with the Sec21 retary of Education, shall award grants, on a competitive 

22 basis, to eligible entities to enable such entities to carry 

23 out a program that provides access to virtual farmers mar24 kets and distribution centers to individuals residing in, 


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1 and organizations located in, communities that are food 

2 deserts. 

3 (b) ELIGIBLE ENTITIES.—For purposes of this sec4 tion, an ‘‘eligible entity’’ means an entity that predomi5 nantly serves communities that are food deserts, includ6 ing— 

7 (1) a local educational agency or bureau-funded 

8 school; 

9 (2) a non-profit, community-based organization 

10 (including a recreation center, child care facility, or 

11 senior center); or 

12 (3) an entity that the Secretaries deem to be an 

13 eligible entity. 

14 (c) USE OF FUNDS.—An eligible entity receiving a 

15 grant under this section shall use such funds for the fol16 lowing: 

17 (1) Purchasing virtual farmers market software 

18 (including computer kiosks and swipe card stations), 

19 or entering into a contract with an eligible organiza20 tion to develop and maintain the technology nec21 essary, to carry out a virtual farmers market pro22 gram to enable individuals residing in, and organiza23 tions located in, communities that are food deserts 

24 to order and purchase fruits and vegetables and 

25 other healthy food items using such technology. 


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1 (2) Training staff to— 

2 (A) assist individuals residing in, and orga3 nizations located in, communities that are food 

4 deserts to order and purchase food products 

5 under the program described in paragraph (1); 

6 and 

7 (B) purchase and order food products 

8 under the program for the eligible entity. 

9 (3) Packaging food products purchased under 

10 the program in manner that makes transportation of 

11 the products possible by foot. 

12 (4) Paying staff to manage the program, and 

13 package and assist in the distribution and delivery 

14 of food products purchased under the program. 

15 (5) Raising public awareness about the pro16 gram. 

17 (6) Developing simple food preparation strate18 gies and menus for customers of the program. 

19 (7) Coordinating with the Secretary of Agri20 culture to develop mechanisms to enable reimburse21 ment under the supplemental nutrition assistance 

22 program established under the Food and Nutrition 

23 Act of 2008 (7 U.S.C. 2011 et seq.) for purchases 

24 made under the virtual farmers market program es25 tablished by the eligible entity under this section. 


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1 (d) APPLICATION.—In order to receive a grant under 

2 this section, an eligible entity shall submit an applicable 

3 to the Secretary at such time, in such manner, and con4 taining such information as the Secretary may require. 

5 (e) LIMITATIONS ON FOOD PURCHASED.—To the ex6 tent practicable, the majority of food under a virtual farm7 ers market program carried out by an eligible entity under 

8 this section shall be purchased from farmers located with9 in a 50 mile radius of the site where the food is ordered 

10 and delivered, except in the case where the eligible entity 

11 demonstrates to the Secretaries that no such farmers exist 

12 or that the farmers are not able to provide a sufficient 

13 variety or amount of food for the purposes of the program. 

14 (f) REPORT.—Not later than a year after funds are 

15 appropriated to carry out this section, the Secretary shall 

16 report to Congress on the progress made in carrying out 

17 programs funded by grants under this section, including— 

18 (1) the number of individuals served by such 

19 programs and the barriers and opportunities for ad20 ditional such programs; and 

21 (2) how such programs have increased access or 

22 encouraged permanent farmers markets to be estab23 lished near communities that are food deserts. 

24 (g) DEFINITIONS.—In this section— 


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1 (1) BUREAU-FUNDED SCHOOL.—The term ‘‘bu2 reau-funded school’’ has the meaning given such 

3 term in section 1146 of the Education Amendments 

4 of 1978 (25 U.S.C. 2026). 

5 (2) ELIGIBLE ORGANIZATION.—The term ‘‘eligi6 ble organization’’ means an organization with exper7 tise in developing and maintaining a virtual farmers 

8 market. 

9 (3) LOCAL EDUCATIONAL AGENCY.—The term 

10 ‘‘local educational agency’’ has the meaning given 

11 such term in section 9101 of the Elementary and 

12 Secondary Education Act of 1965 (20 U.S.C. 7801). 

13 (4) FOOD DESERT.—The term ‘‘food desert’’ 

14 has the meaning given such term in section 7527(a) 

15 of the Food, Conservation, and Energy Act of 2008 

16 (Public law 110–234). 

17 (5) SECRETARY.—The term ‘‘Secretary’’ means 

18 the Secretary of Agriculture. 

19 (6) SECRETARIES.—The term ‘‘Secretaries’’ 

20 means the Secretary of Agriculture and the Sec21 retary of Education, acting jointly. 

22 (7) SWIPE CARD STATIONS.—The term ‘‘swipe 

23 card stations’’ may include support for the use of 

24 electronic benefit transfer cards. 


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1 (8) VIRTUAL FARMERS MARKET.—The term 

2 ‘‘virtual farmers market’’ means an online grocery 

3 store that enables individuals to purchase foods from 

4 local farms and distributors. 

5 SEC. 405. URBAN AND NATIVE-AMERICAN COMMUNITY GAR6 DEN GRANT PROGRAM. 

7 (a) PROGRAM ESTABLISHED.—From the amounts 

8 appropriated to carry out this section, the Secretary of 

9 Agriculture shall award grants to eligible entities to ex10 pand, establish, or maintain urban community gardens. 

11 (b) ELIGIBLE ENTITY.—For purposes of this section, 

12 an eligible entity means— 

13 (1) a private or for-profit organization; or 

14 (2) a unit of general local government, or tribal 

15 government, located on tribal land or in a low-in16 come community. 

17 (c) APPLICATION.—In order to receive a grant under 

18 this section, an eligible entity shall submit to the Secretary 

19 an application at such time, in such manner, and con20 taining such information as the Secretary may require, in21 cluding— 

22 (1) an assurance that priority for hiring for 

23 jobs created by the expansion, establishment, or 

24 maintenance of an urban community garden funded 

25 with a grant received under this section will be given 


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1 to individuals who reside in the community where 

2 the garden is located; and 

3 (2) a demonstration that the eligible entity is 

4 committed to providing non-Federal financial or in5 kind support (such as providing a water supply) for 

6 the urban community garden for which the entity re7 ceives funds under this section. 

8 (d) DEFINITIONS.—In this section: 

9 (1) LOW-INCOME COMMUNITY.—The term ‘‘low10 income communities’’ includes— 

11 (A) communities with a high percentage of 

12 children eligible for free and reduced priced 

13 lunches under the Richard B. Russell National 

14 School Lunch Act (42 U.S.C. 1751 et seq.); 

15 and 

16 (B) any other communities determined by 

17 the Secretaries to be low-income for purposes of 

18 this section. 

19 (2) UNIT OF GENERAL LOCAL GOVERNMENT.— 

20 The term ‘‘unit of general local government’’ has the 

21 meaning given such term in section 102 of the 

22 Housing and Community Development Act of 1974 

23 (42 U.S.C. 5302). 


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1 TITLE V—REALIGNING TRANS2 PORTATION POLICY TO HELP 

3 PROMOTE HEALTHY LIFE4 STYLES 

5 SEC. 501. GRANTS TO PROMOTE PLANNING DECISIONS AND 

6 POLICIES THAT INCREASE ACCESS TO PHYS7 ICAL ACTIVITY. 

8 (a) GRANTS.—The Secretary of Transportation may 

9 make grants to eligible entities for the purpose of assisting 

10 local planning decisions and policies that increase the ac11 cess of individuals to physical activity. 

12 (b) ACTIVITIES UNDER GRANTS.—The activities of 

13 eligible entities that may be funded by a grant under sub14 section (a) include the following: 

15 (1) The coordination of activities carried out by 

16 local government officials (including planning, public 

17 works, housing, and transportation officials), school 

18 boards, and others to increase the access of individ19 uals to physical activity through— 

20 (A) improved integration of land use, hous21 ing, transportation, and infrastructure plan22 ning; and 

23 (B) consideration of impacts on physical 

24 activity levels during such planning. 


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1 (2) The formulation of strategies to establish 

2 and implement— 

3 (A) plans and policies that increase infra4 structure for pedestrians and bicyclists to con5 nect such individuals to schools, recreation op6 portunities, jobs, and retail opportunities, in7 cluding policies requiring developers to build 

8 sidewalks and bicycle lanes; or 

9 (B) plans and policies that place schools 

10 within neighborhoods and provide bike paths, 

11 sidewalks, trails, and other infrastructure to en12 courage and make possible the walking and bi13 cycling to school of students and staff. 

14 (3) The carrying out of health impact assess15 ments with respect to proposals for the placement or 

16 construction of buildings, sidewalks, roads, trails, 

17 schools, or other aspects of the built environment. 

18 (c) REPORTING.— 

19 (1) IN GENERAL.—An eligible entity that re20 ceives a grant under subsection (a) shall submit to 

21 Congress and the Secretary of Transportation a re22 port on the extent to which such grant has— 

23 (A) led to planning decisions and policies 

24 that increase the access of individuals to phys25 ical activity; and 


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1 (B) led to an improvement in the health of 

2 individuals. 

3 (2) TIMING.—A report under paragraph (1) 

4 shall be made not less than 3 years and not more 

5 than 5 years after the date on which such grant is 

6 received. 

7 (d) DEFINITIONS.—In this section, the following defi8 nitions apply: 

9 (1) BUILT ENVIRONMENT.—The term ‘‘built 

10 environment’’ means any buildings or spaces that 

11 are created or modified by individuals, including 

12 homes, schools, workplaces, parks and other recre13 ation areas, greenways, business areas, and trans14 portation areas. 

15 (2) ELIGIBLE ENTITY.—The term ‘‘eligible enti16 ty’’ means a local government agency or group of 

17 such agencies with jurisdiction over planning or land 

18 use decisions. 

19 (3) HEALTH IMPACT ASSESSMENT.—The term 

20 ‘‘health impact assessment’’ means, in relation to a 

21 proposal, an assessment of the impact that the pro22 posal will have on the health of individuals if imple23 mented. 


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1 SEC. 502. JOINT USE AGREEMENTS. 

2 (a) GRANTS.—The Secretary may make a grant to 

3 any eligible school or other public entity for the purposes 

4 of meeting either or both of the following: 

5 (1) Costs incurred by the school or other entity 

6 in negotiating or entering into a joint use agree7 ment. 

8 (2) Costs payable under a joint use agreement 

9 during the first year in which the joint use agree10 ment is in force. 

11 (b) PRIORITY.—In making grants under subsection 

12 (a), the Secretary shall give priority to schools or other 

13 public entities in areas— 

14 (1) where obesity rates are above the national 

15 average; 

16 (2) where at least 50 percent of the residents 

17 are below the poverty line; or 

18 (3) that lack safe, accessible, and affordable fit19 ness and recreational facilities. 

20 (c) DEFINITIONS.—In this section: 

21 (1) ELIGIBLE SCHOOL.—The term ‘‘eligible 

22 school’’ means any elementary school or secondary 

23 school within the meaning of section 9101 of the El24 ementary and Secondary Education Act 1965 (20 

25 U.S.C. 7801). 


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1 (2) JOINT USE AGREEMENT.—The term ‘‘joint 

2 use agreement’’ means an agreement between an eli3 gible school and another public entity relating to the 

4 use of a school’s facilities or equipment by people 

5 other than the school’s students or staff. 

6 (3) POVERTY LINE.—The term ‘‘poverty line’’ 

7 has the meaning given such term in section 673(2) 

8 of the Community Services Block Grant Act (42 

9 U.S.C. 9902(2)). 

10 (4) SECRETARY.—The term ‘‘Secretary’’ means 

11 the Secretary of Health and Human Services acting 

12 through the Director of the Centers for Disease 

13 Control and Prevention. 

14 SEC. 503. EXPANSION OF SAFE ROUTES TO SCHOOL PRO15 GRAM. 

16 (a) HIGH SCHOOLS STUDENTS INCLUDED.—Section 

17 1404(a) of SAFETEA–LU (23 U.S.C. 402 note; 119 

18 Stat. 1228) is amended by striking ‘‘in primary and mid19 dle schools’’ and inserting the following: ‘‘and adolescents 

20 in primary, middle, and high schools’’. 

21 (b) PURPOSES.— 

22 (1) IN GENERAL.—Sections 1404(b)(1) of 

23 SAFETEA–LU (119 Stat. 1228) is amended by in24 serting ‘‘and adolescents’’ after ‘‘children’’. 


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1 (2) SAFETY.—Section 1404(b)(2) of 

2 SAFETEA–LU (119 Stat. 1228) is amended by in3 serting ‘‘and throughout adolescence’’ after ‘‘early 

4 age’’ 

5 (c) APPORTIONMENT.—Section 1404(c)(1) of 

6 SAFETEA–LU (119 Stat. 1228) is amended in subpara7 graphs (A) and (B) by striking ‘‘and middle schools’’ and 

8 inserting ‘‘, middle, and high schools’’. 

9 (d) ELIGIBLE PROJECTS AND ACTIVITIES.—Section 

10 1404(f) of SAFETEA–LU (119 Stat. 1229) is amended 

11 by adding at the end the following: 

12 ‘‘(4) PREFERENCE.—From the amounts appor13 tioned to a State under this section, the State shall 

14 give priority to projects for primary and middle 

15 schools and to projects that propose to serve a com16 bination of at least one primary, middle, and high 

17 school within the same school district.’’. 

18 (e) DEFINITIONS.—Section 1404(k)(2) of 

19 SAFETEA–LU (119 Stat. 1230) is amended— 

20 (1) in the paragraph heading by striking ‘‘AND

21 MIDDLE’’ and inserting ‘‘, MIDDLE, AND HIGH

22 SCHOOLS’’; 

23 (2) by striking ‘‘and middle’’ and inserting ‘‘, 

24 middle, and high schools’’; and 


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1 (3) by striking ‘‘eighth’’ and inserting 

2 ‘‘twelfth’’. 

3 SEC. 504. ACTIVE TRANSPORTATION INFRASTRUCTURE IN4 VESTMENT PROGRAM. 

5 (a) IN GENERAL.—The Secretary of Transportation 

6 shall carry out an active transportation investment pro7 gram in accordance with the requirements of this section. 

8 (b) PURPOSE.—The purpose of the program shall be 

9 to encourage a mode shift to active transportation within 

10 selected communities by providing safe and convenient op11 portunities to bicycle and walk for routine travel. 

12 (c) SELECTION OF COMMUNITIES.— 

13 (1) APPLICATIONS.—A community seeking to 

14 participate in the program shall submit to the Sec15 retary an application that is in such form and con16 tains such information as the Secretary may require. 

17 (2) INITIAL AND ADDITIONAL SELECTIONS.— 

18 (A) INITIAL SELECTIONS.—The Secretary 

19 shall select initial communities to participate in 

20 the program. Such communities shall partici21 pate in the program in each of fiscal years 

22 2011 through 2015. 

23 (B) ADDITIONAL SELECTIONS.—Following 

24 the initial selections under subparagraph (A), 

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1 nities to participate in the program. Such com2 munities shall participate in the program in 

3 each of fiscal years 2013 through 2015. 

4 (3) CRITERIA.— 

5 (A) IN GENERAL.—In selecting commu6 nities to participate in the program, the Sec7 retary shall consider, at a minimum, the extent 

8 to which a community— 

9 (i) provides a plan for development of 

10 walking and bicycling infrastructure that is 

11 likely to contribute to a significant trans12 portation mode shift to walking and bicy13 cling; 

14 (ii) demonstrates broad community 

15 support that will facilitate successful and 

16 expeditious implementation; 

17 (iii) demonstrates a cohesive plan in 

18 which noninfrastructure elements, where 

19 proposed, reinforce achievement of the pur20 pose of the program; 

21 (iv) provides evidence of regulatory or 

22 financial incentives or community design 

23 policies that facilitate significant increases 

24 in bicycling or walking; and 


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1 (v) commits State, local, or eligible 

2 Federal matching funds, in addition to 

3 Federal funds made available under this 

4 section, to projects eligible for assistance 

5 under this section. 

6 (B) STRATEGIC PRIORITIES THAT FACILI7 TATE SUCCESS.—For purposes of subparagraph 

8 (A)(i), strategic priorities that facilitate success 

9 in increasing walking and bicycling include ef10 fective plans— 

11 (i) to create a network of active trans12 portation facilities connecting neighbor13 hoods with destinations such as work14 places, schools, residences, businesses, 

15 recreation areas, and other community ac16 tivity centers; 

17 (ii) to integrate active transportation 

18 facilities with transit services, where avail19 able, to improve access to public transpor20 tation; and 

21 (iii) to deliver safe, convenient, cost22 effective mobility via walking and bicycling. 

23 (C) INDICATORS OF COMMUNITY SUP24 PORT.—For purposes of subparagraph (A)(ii), 

25 indicators of community support include— 


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1 (i) the use of public input in the de2 velopment of transportation plans; and 

3 (ii) the commitment of community 

4 leaders to the success and timely imple5 mentation of projects eligible for assistance 

6 under this section. 

7 (d) GRANTS.— 

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

9 grants to each community selected to participate in 

10 the program. 

11 (2) RECIPIENTS.—A recipient of a grant rep12 resenting a community under the program shall be 

13 a local or regional governmental organization, multi14 county special district, or Indian tribe that the Sec15 retary determines is suitably equipped and organized 

16 to carry out the objectives and requirements of this 

17 section. Such organizations include metropolitan 

18 planning organizations and other regional planning 

19 organizations. 

20 (3) SUBRECIPIENTS.—A recipient of a grant 

21 under the program may suballocate funds from the 

22 grant to a nonprofit organization to carry out the 

23 purposes of the program. 

24 (4) INCLUSION OF CERTAIN COMMUNITIES.—To 

25 fulfill the Nation’s need to achieve and document 


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1 mode shift to bicycling and walking over time, the 

2 4 communities that received pilot funding under sec3 tion 1807 of SAFETEA–LU (119 Stat. 1460) may 

4 be among the communities selected by the Secretary 

5 under subsection (c). 

6 (5) GRANTS AMOUNTS.— 

7 (A) IN GENERAL.—The Secretary may 

8 make a grant as low as $5,000,000 and as high 

9 as $15,000,000 per fiscal year for a community 

10 participating in the program. The Secretary 

11 shall ensure that grant awards under the pro12 gram are sufficiently high to enable a mode 

13 shift to active transportation. 

14 (B) JUSTIFICATION FOR LARGER

15 GRANTS.—Subject to the $15,000,000 per fiscal 

16 year limit set forth in subparagraph (A), the 

17 Secretary may justify a grant in a higher 

18 amount for a community under the program 

19 based on the population served, greater oppor20 tunities to shift trips to bicycling and walking, 

21 or use of innovative design features. 

22 (e) ELIGIBLE PROJECTS.—Grants made to commu23 nities under this section shall be used for one or more of 

24 the following purposes: 


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1 (1) To carry out projects to construct networks 

2 of active transportation infrastructure facilities, in3 cluding sidewalks, bikeways, and pedestrian and bi4 cycle trails, that connect people with public transpor5 tation, workplaces, schools, residences, businesses, 

6 recreation areas, and other community activity cen7 ters. 

8 (2) To carry out projects to provide for bicycle 

9 boxes, cycle tracks, bicycle boulevards, dual traffic 

10 signals, and bicycle sharing stations. 

11 (3) To carry out projects to restore and up12 grade current active transportation infrastructure 

13 facilities. 

14 (4) To carry out projects to support educational 

15 activities, safety-oriented activities, and technical as16 sistance to further the purpose of the program. 

17 (f) PROGRAM MEASURES.—In carrying out the pro18 gram, the Secretary shall develop statistical information 

19 on changes in motor vehicle, active transportation, and 

20 public transportation usage in communities participating 

21 in the program and assess how the changes impact conges22 tion and energy usage, impact the frequency of bicycling 

23 and walking, and impact health, safety, and the environ24 ment. In addition, the Secretary shall develop interim 

25 measures of progress, which may include indicators of 


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1 public engagement, educational outcomes, and project ad2 vancement into planning and development. 

3 (g) DEADLINES.— 

4 (1) REQUEST FOR APPLICATIONS.—Not later 

5 than 60 days after the date of enactment of this 

6 Act, the Secretary shall publish in the Federal Reg7 ister a request for applications pursuant to sub8 section (c)(1). 

9 (2) SELECTION OF INITIAL COMMUNITIES.— 

10 Not later than 180 days after such date of enact11 ment, the Secretary shall select initial communities 

12 to participate in the program under subsection 

13 (c)(2)(A). 

14 (3) SELECTION OF ADDITIONAL COMMU15 NITIES.—Not later than September 30, 2012, the 

16 Secretary shall select additional communities to par17 ticipate in the program under subsection (c)(2)(B). 

18 (4) GRANTS.—The Secretary shall make grants 

19 to communities selected to participate in the pro20 gram under subsection (c)— 

21 (A) for fiscal year 2011, not later than the 

22 later of— 

23 (i) the 60th day after the date of the 

24 selection of communities under subsection 

25 (c)(2)(A); and 


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1 (ii) the 30th day of the fiscal year; 

2 and 

3 (B) for each of fiscal years 2012 through 

4 2015, not later than 30th day of the fiscal year. 

5 (h) REPORTS.— 

6 (1) IN GENERAL.—The Secretary shall submit 

7 to Congress— 

8 (A) an interim report on progress made 

9 under the program not later than September 

10 30, 2014; and 

11 (B) a final report on progress made under 

12 the program not later than September 30, 

13 2016. 

14 (2) CONTENTS.—Each report submitted under 

15 paragraph (1) shall include the Secretary’s findings 

16 concerning the best practices of communities partici17 pating in the program and the impediments experi18 enced by such communities relating to program de19 velopment and achieving a mode shift to active 

20 transportation. 

21 (i) FUNDING.— 

22 (1) AUTHORIZATION OF APPROPRIATIONS.— 

23 There is authorized to be appropriated out of the 

24 Highway Trust Fund (other than the Mass Transit 

25 Account) to carry out this section— 


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1 (A) $300,000,000 for fiscal year 2011; 

2 (B) $300,000,000 for fiscal year 2012; 

3 (C) $466,666,666 for fiscal year 2013; 

4 (D) $466,666,666 for fiscal year 2014; 

5 and 

6 (E) $466,666,668 for fiscal year 2015. 

7 (2) CONTRACT AUTHORITY.—Funds authorized 

8 to be appropriated by this section shall be available 

9 for obligation and administered in the same manner 

10 as if the funds were apportioned under chapter 1 of 

11 title 23, United States Code, except that the Federal 

12 share of the cost of a project carried out using the 

13 funds shall be 100 percent, and the funds shall re14 main available until expended and shall not be trans15 ferable. 

16 (3) ADMINISTRATIVE COSTS.— 

17 (A) SET ASIDE.—Each fiscal year, the Sec18 retary shall set aside not more than 1.5 percent 

19 of the funds made available to carry out this 

20 section to cover the costs of administrative, re21 search, technical assistance, communications, 

22 and training activities under the program. 

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1 tracts, partnerships, or cooperative agreements 

2 with other government agencies, institutions of 

3 higher learning, or nonprofit organizations, to 

4 perform activities with amounts set aside under 

5 subparagraph (A). The Federal share of the 

6 cost of such activities may be up to 100 per7 cent. 

8 (C) LIMITATION ON STATUTORY CON9 STRUCTION.—Nothing in this paragraph may 

10 be construed to prohibit a community from re11 ceiving research or other funds under title 23 or 

12 49, United States Code. 

13 (j) TREATMENT OF PROJECTS.— 

14 (1) NONINFRASTRUCTURE PROJECTS.—Non15 infrastructure projects and infrastructure projects 

16 that do not involve or lead directly to construction 

17 assisted under this subsection shall not be treated as 

18 projects on a Federal-aid system under chapter 1 of 

19 title 23, United States Code. 

20 (2) INFRASTRUCTURE PROJECTS.—Not later 

21 than one year after the date of enactment of this 

22 Act, the Secretary shall develop regulations or guid23 ance (or both) for Federal-aid projects under this 

24 section that encourages the use of the programmatic 

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1 niques, and other best practices to facilitate produc2 tive and timely expenditure for projects that are 

3 small, low impact, and constructed within an exist4 ing built environment. 

5 (3) STATE PROCESSES.—The Secretary shall 

6 work with State departments of transportation to 

7 ensure that any guidance or regulation developed 

8 under paragraph (2) is being implemented by States 

9 and the Federal Highway Administration consist10 ently to avoid unnecessary delays in implementing 

11 projects and to ensure the effective use of Federal 

12 dollars. 

13 (k) ASSISTANCE TO INDIAN TRIBES.—Notwith14 standing any other provision of law, the Secretary may 

15 enter into grants agreements, self-determination con16 tracts, and self-governance compacts under the authority 

17 of the Indian Self-Determination and Education Assist18 ance Act (25 U.S.C. 450 et seq.) with eligible Indian tribes 

19 to carry out the purposes of this Act, and such grant 

20 agreements, self-determination contracts, and self-govern21 ance compacts shall be administered in accordance with 

22 that Act. 

23 (l) DEFINITIONS.—In this section, the following defi24 nitions apply: 


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1 (1) ACTIVE TRANSPORTATION.—The term ‘‘ac2 tive transportation’’ means mobility options powered 

3 solely by human energy, such as bicycling and walk4 ing. 

5 (2) INDIAN TRIBE.—The term ‘‘Indian tribe’’ 

6 has the meaning given that term in section 4(e) of 

7 Indian Self-Determination and Education Assistance 

8 Act (25 U.S.C. 450b(e)). 

9 (3) PROGRAM.—The term ‘‘program’’ means 

10 the active transportation investment program estab11 lished under this section. 

12 TITLE VI—RESEARCH AND 

13 ASSESSMENT TOOLS 

14 SEC. 601. NATIONAL CENTER FOR HEALTH STATISTICS. 

15 Section 306 of the Public Health Service Act (42 

16 U.S.C. 242k) is amended— 

17 (1) in subsection (m)(4)(B), by striking ‘‘sub18 section (n)’’ each place it appears and inserting 

19 ‘‘subsection (o)’’; 

20 (2) by redesignating subsection (n) as sub21 section (o); and 

22 (3) by inserting after subsection (m) the fol23 lowing: 

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

25 may provide for the— 


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1 ‘‘(A) collection of data for determining the fit2 ness levels and energy expenditure of children and 

3 youth; and 

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

5 National Health and Nutrition Examination Survey 

6 and other data sources. 

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

8 acting through the Center, may make grants to States, 

9 public entities, and nonprofit entities. 

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

11 provide technical assistance, standards, and methodologies 

12 to grantees supported by this subsection in order to maxi13 mize the data quality and comparability with other stud14 ies.’’. 

15 SEC. 602. REPORT ON OBESITY RESEARCH. 

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

17 date of enactment of this Act, the Secretary of Health and 

18 Human Services shall submit to the Committee on Health, 

19 Education, Labor, and Pensions of the Senate and the 

20 Committee on Energy and Commerce of the House of 

21 Representatives a report on research conducted on causes 

22 and health implications (including mental health implica23 tions) of obesity and being overweight. 

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

25 (a) shall contain— 


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1 (1) descriptions on the status of relevant, cur2 rent, ongoing research being conducted in the De3 partment of Health and Human Services including 

4 research at the National Institutes of Health, the 

5 Centers for Disease Control and Prevention, the 

6 Agency for Healthcare Research and Quality, the 

7 Health Resources and Services Administration, and 

8 other offices and agencies; 

9 (2) information about what these studies have 

10 shown regarding the causes, prevention, and treat11 ment of, obesity and being overweight; and 

12 (3) recommendations on further research that 

13 is needed, including research among diverse popu14 lations, the plan of the Department of Health and 

15 Human Services for conducting such research, and 

16 how current knowledge can be disseminated. 

Æ 


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