I 

111TH CONGRESS 

2D SESSION H. R. 5431 

To amend section 17 of the Richard B. Russell National School Lunch 

Act to promote health and wellness in child care, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 27, 2010 

Mrs. MCCARTHY of New York (for herself and Mr. WU) introduced the 

following bill; which was referred to the Committee on Education and Labor 

A BILL 

To amend section 17 of the Richard B. Russell National 

School Lunch Act to promote health and wellness in 

child care, and for other purposes. 

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. 

4 This Act may be cited as the ‘‘Start Healthy Habits 

5 Early Act’’. 

6 SEC. 2. CHILD AND ADULT CARE FOOD PROGRAM. 

7 Section 17 of the Richard B. Russell National School 

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

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

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

3 paragraph (1) and inserting the following: 

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

5 INSTITUTION ELIGIBILITY.— 

6 ‘‘(1) IN GENERAL.— 

7 ‘‘(A) PROGRAM PURPOSE.—The purpose of 

8 the program authorized under this section is to 

9 provide aid to child and adult care institutions 

10 for the provision of nutritious foods that con11 tribute to the wellness, healthy growth, and de12 velopment of young children, and the health 

13 and wellness of older adults and chronically im14 paired disabled persons. 

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

16 may carry out a program to assist States 

17 through grants-in-aid and other means to ini18 tiate and maintain nonprofit food service pro19 grams for children in institutions providing 

20 child care.’’; 

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

22 following: 

23 ‘‘(g) NUTRITIONAL REQUIREMENTS FOR MEALS AND

24 SNACKS SERVED IN INSTITUTIONS AND FAMILY OR

25 GROUP DAY CARE HOMES.— 

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

2 In this subsection, the term ‘Dietary Guidelines’ 

3 means the Dietary Guidelines for Americans pub4 lished under section 301 of the National Nutrition 

5 Monitoring and Related Research Act of 1990 (7 

6 U.S.C. 5341). 

7 ‘‘(2) NUTRITIONAL REQUIREMENTS.— 

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

9 subparagraph (C), reimbursable meals and 

10 snacks served by institutions, family or group 

11 day care homes, and sponsored centers partici12 pating in the program under this section shall 

13 consist of a combination of foods that meet 

14 minimum nutritional requirements prescribed 

15 by the Secretary on the basis of tested nutri16 tional research. 

17 ‘‘(B) CONFORMITY WITH THE DIETARY

18 GUIDELINES AND AUTHORITATIVE SCIENCE.— 

19 ‘‘(i) IN GENERAL.—Not less fre20 quently than once every 10 years, the Sec21 retary shall review and, as appropriate, up22 date nutritional requirements for meals 

23 and snacks served under the program 

24 under this section to ensure that the meals 

25 and snacks— 

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1 ‘‘(I) are consistent with the goals 

2 of the most recent Dietary Guidelines; 

3 and 

4 ‘‘(II) promote the health of the 

5 population served by the program au6 thorized under this section, as indi7 cated by the most recent relevant nu8 trition science and appropriate au9 thoritative scientific recommendations. 

10 ‘‘(ii) COST REVIEW.—The review re11 quired under clause (i) shall include a re12 view of the cost to institutions, family or 

13 group day care homes, and sponsored cen14 ters, resulting from the updated nutritional 

15 requirements under this subparagraph for 

16 meals and snacks served under the pro17 gram under this section. 

18 ‘‘(iii) REGULATIONS.— 

19 ‘‘(I) PROPOSED RULE.—Not later 

20 than 18 months after the completion 

21 of the review of the nutritional re22 quirements under clause (i), the Sec23 retary shall promulgate proposed reg24 ulations to update the nutritional re25 quirements for meals and snacks 

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1 served under the program under this 

2 section. 

3 ‘‘(II) CONSIDERATION.—In pro4 mulgating proposed regulations under 

5 subclause (I), the Secretary shall dem6 onstrate consideration for the finan7 cial and administrative impact to in8 stitutions, family or group day care 

9 homes, and sponsored centers result10 ing from any proposed changes to the 

11 nutritional requirements for meals 

12 and snacks in the regulations. 

13 ‘‘(C) EXCEPTIONS.— 

14 ‘‘(i) SPECIAL DIETARY NEEDS.—The 

15 minimum nutritional requirements pre16 scribed under subparagraph (A) shall not 

17 prohibit institutions, family or group day 

18 care homes, and sponsored centers from 

19 substituting foods to accommodate the 

20 medical or other special dietary needs of 

21 individual participants. 

22 ‘‘(ii) EXEMPT INSTITUTIONS.—The 

23 Secretary may elect to waive all or part of 

24 the requirements of this subsection for 

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1 emergency shelters participating in the 

2 program under this section. 

3 ‘‘(3) MEAL SERVICE.—Institutions, family or 

4 group day care homes, and sponsored centers shall 

5 ensure that reimbursable meal service is not used as 

6 a punishment or reward. 

7 ‘‘(4) FLUID MILK.— 

8 ‘‘(A) IN GENERAL.—If an institution, fam9 ily or group day care home, or sponsored center 

10 provides fluid milk as part of a reimbursable 

11 meal or supplement, the institution, family or 

12 group day care home, or sponsored center shall 

13 provide the milk in accordance with the most 

14 recent version of the Dietary Guidelines and ap15 propriate authoritative scientific recommenda16 tions for young children. 

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

18 children who cannot consume fluid milk due to 

19 medical or other special dietary needs other 

20 than a disability, an institution, family or group 

21 day care home, or sponsored center may sub22 stitute for the fluid milk served as part of a re23 imbursable meal or supplement, a nondairy bev24 erage that— 

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1 ‘‘(i) is nutritionally equivalent to fluid 

2 milk; and 

3 ‘‘(ii) meets nutritional standards es4 tablished by the Secretary, including, 

5 among other requirements established by 

6 the Secretary, fortification of calcium, pro7 tein, vitamin A, and vitamin D to levels 

8 found in cow’s milk. 

9 ‘‘(C) APPROVAL.— 

10 ‘‘(i) IN GENERAL.—A substitution au11 thorized under subparagraph (B) may be 

12 made— 

13 ‘‘(I) at the discretion of, and on 

14 approval by, the participating institu15 tion, family or group day care home, 

16 or sponsored center; and 

17 ‘‘(II) if the substitution is re18 quested— 

19 ‘‘(aa) by a medical author20 ity; or 

21 ‘‘(bb) by the parent or legal 

22 guardian of a participating child. 

23 ‘‘(ii) EXCEPTION.—An institution, 

24 family or group day care home, or spon25 sored center that elects to make a substimstockstill on DSKH9S0YB1PROD with BILLS

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1 tution authorized under this paragraph 

2 shall not provide beverages other than bev3 erages the State has identified as accept4 able substitutes. 

5 ‘‘(D) EXCESS EXPENSES BORNE BY INSTI6 TUTION.—A participating institution, family or 

7 group day care home, or sponsored center shall 

8 be responsible for any expenses that— 

9 ‘‘(i) are incurred by the institution, 

10 family or group day care home, or spon11 sored center to provide substitutions under 

12 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; 

5 ‘‘(7) WATER.—Participating institutions, family 

6 or group day care homes, and sponsored centers 

7 shall make available to children, as nutritionally ap8 propriate, potable water throughout the day, includ9 ing at meal times.’’; and 

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

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

12 CARE.— 

13 ‘‘(1) IN GENERAL.—The Secretary shall assist 

14 participating institutions, family or group day care 

15 homes, and sponsored centers through technical as16 sistance and guidance, and competitive grants for 

17 the purpose of promoting the health and nutrition of 

18 children in child care settings. 

19 ‘‘(2) TECHNICAL ASSISTANCE AND GUID20 ANCE.— 

21 ‘‘(A) NUTRITION.—From funds made 

22 available under subparagraph (C), the Sec23 retary shall provide technical assistance and 

24 guidance to institutions, family or group day 

25 care homes, and sponsored centers, particimstockstill on DSKH9S0YB1PROD with BILLS

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1 pating in the program under this section to 

2 support compliance with the nutrition require3 ments described in subsection (g), which shall 

4 include technical assistance and guidance with 

5 respect to— 

6 ‘‘(i) menu planning; 

7 ‘‘(ii) interpretation of nutrition labels; 

8 and 

9 ‘‘(iii) food preparation and purchasing 

10 guidance to produce meals and snacks 

11 that— 

12 ‘‘(I) are consistent with the goals 

13 of the most recent Dietary Guidelines 

14 for Americans published under section 

15 301 of the National Nutrition Moni16 toring and Related Research Act of 

17 1990 (7 U.S.C. 5341) (in this sub18 section referred to as the ‘Dietary 

19 Guidelines’); and 

20 ‘‘(II) promote the health of the 

21 population served by the program 

22 under this section, as recommended 

23 by authoritative scientific recommen24 dations. 

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1 ‘‘(B) WELLNESS PROMOTION.—Not later 

2 than January 1, 2012, in consultation with the 

3 Secretary of Health and Human Services, the 

4 Secretary shall provide technical assistance and 

5 guidance, such as a handbook, to assist State 

6 agencies and institutions, family and group day 

7 care homes, and sponsored centers, partici8 pating in the program under this section to— 

9 ‘‘(i) promote access to foods that are 

10 recommended for consumption by the most 

11 recent Dietary Guidelines; 

12 ‘‘(ii) encourage opportunities for age13 appropriate physical activity in quantities 

14 and at levels recommended by the most re15 cent Dietary Guidelines and the Secretary 

16 of Health and Human Services and provide 

17 information on— 

18 ‘‘(I) the importance of regular 

19 age-appropriate physical activity for 

20 health and well-being based on au21 thoritative scientific recommendations; 

22 and 

23 ‘‘(II) best practices for physical 

24 activity plans in child care settings; 

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1 ‘‘(iii) encourage age-appropriate elec2 tronic media use by children based on au3 thoritative scientific recommendations and 

4 provide information on— 

5 ‘‘(I) the importance of age-appro6 priate use, including limitations, of 

7 electronic media; and 

8 ‘‘(II) best practices for imple9 mentation of such recommendations in 

10 child care settings; and 

11 ‘‘(iv) encourage the involvement of 

12 parents in nutrition and wellness initiatives 

13 for children. 

14 ‘‘(C) ADDITIONAL INFORMATION.—In con15 sultation with the Secretary of Health and 

16 Human Services, the Secretary shall provide 

17 educational materials (such as pamphlets, or 

18 other printed materials) to State agencies and 

19 institutions, family and group day care homes, 

20 and sponsored centers participating in the pro21 gram under this section regarding common 

22 food-related choking hazards and guidance on 

23 avoiding food choking in young children. 

24 ‘‘(D) FUNDING.— 

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1 ‘‘(i) IN GENERAL.—On October 1, 

2 2010, out of any funds in the Treasury not 

3 otherwise appropriated, the Secretary of 

4 the Treasury shall transfer to the Sec5 retary to carry out this paragraph 

6 $10,000,000, to remain available until ex7 pended. 

8 ‘‘(ii) RECEIPT AND ACCEPTANCE.— 

9 The Secretary shall be entitled to receive, 

10 shall accept, and shall use to carry out this 

11 subsection the funds transferred under 

12 clause (i), without further appropriation. 

13 ‘‘(3) COMPETITIVE GRANTS.— 

14 ‘‘(A) GRANTS TO STATE AGENCIES.—From 

15 the funds made available under subparagraph 

16 (G), the Secretary shall award grants, on a 

17 competitive basis, to State agencies partici18 pating in the program under this section for the 

19 purpose of promoting health and nutrition in 

20 child care settings. 

21 ‘‘(B) PRIORITY.—In awarding grants 

22 under this paragraph, the Secretary shall give 

23 priority to State agencies administering projects 

24 under the program that carry out each of the 

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1 authorized uses of funds described in subpara2 graph (C)(ii). 

3 ‘‘(C) USES OF FUNDS.— 

4 ‘‘(i) REQUIRED USES.—A State agen5 cy receiving a grant under this paragraph 

6 shall use not less than 50 percent of such 

7 grant funds to award subgrants to institu8 tions, including sponsoring organizations, 

9 for the purpose of carrying out the activi10 ties described in clause (ii). 

11 ‘‘(ii) AUTHORIZED USES.—In addition 

12 to such other activities as the Secretary de13 termines to be appropriate, State agencies 

14 and institutions may use funds received 

15 under this paragraph for activities that— 

16 ‘‘(I) promote nutrition and phys17 ical activity in child care settings that 

18 reflect— 

19 ‘‘(aa) the recommendations 

20 of the most recent version of the 

21 Dietary Guidelines; and 

22 ‘‘(bb) authoritative scientific 

23 recommendations; 

24 ‘‘(II) provide technical assistance 

25 and training to sponsors and promstockstill on DSKH9S0YB1PROD with BILLS

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1 viders of child care centers and family 

2 or group day care homes in imple3 menting State or local initiatives de4 signed to improve the health and nu5 trition of children in child care set6 tings; 

7 ‘‘(III) perform outreach cam8 paigns on the State or local level that 

9 are designed to increase access to the 

10 program in underserved areas and 

11 populations, including subsidized child 

12 care providers; and 

13 ‘‘(IV) make innovative use of 

14 technology to provide training and 

15 education to promote the nutrition, 

16 physical activity, and health of chil17 dren. 

18 ‘‘(D) APPLICATION.—To be eligible to re19 ceive a grant under this paragraph, a State 

20 agency shall submit an application to the Sec21 retary at such time, in such manner, and con22 taining such information as the Secretary may 

23 require, which shall include— 

24 ‘‘(i) a plan to promote child care set25 tings that encourage healthful behaviors, 

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1 including improvements to the quality of 

2 meals and snacks provided in institutions, 

3 family or group day care homes, and spon4 sored centers; and 

5 ‘‘(ii) a description of— 

6 ‘‘(I) the procedures by which the 

7 State agency will use the grant to 

8 award subgrants to institutions; and 

9 ‘‘(II) the criteria that the State 

10 agency will use in awarding such sub11 grants. 

12 ‘‘(E) REPORTING.—Any State agency re13 ceiving a grant under this paragraph shall sub14 mit a report to the Secretary at such time, in 

15 such manner, and containing such information 

16 as the Secretary may require that, at a min17 imum, shall include— 

18 ‘‘(i) a description of the activities sup19 ported with funds under this paragraph; 

20 ‘‘(ii) the progress of implementing the 

21 activities; and 

22 ‘‘(iii) the outcome of the activities. 

23 ‘‘(F) BEST PRACTICES.—The Secretary 

24 shall provide to State agencies and institutions 

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1 tion and wellness initiatives, including best 

2 practices for implementing the activities sup3 ported with funds under this paragraph. 

4 ‘‘(G) FUNDING.— 

5 ‘‘(i) IN GENERAL.—On October 1, 

6 2010, out of any funds in the Treasury not 

7 otherwise appropriated, the Secretary of 

8 the Treasury shall transfer to the Sec9 retary to carry out this paragraph 

10 $25,000,000 to remain available until ex11 pended to carry out this paragraph to re12 main available until expended. 

13 ‘‘(ii) RECEIPT AND ACCEPTANCE.— 

14 The Secretary shall be entitled to receive, 

15 shall accept, and shall use to carry out this 

16 paragraph the funds transferred under 

17 clause (i) without further appropriation.’’. 

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