II 

111TH CONGRESS 

2D SESSION S. 3298 

To establish a pilot program to reduce the increasing prevalence of overweight/ 

obesity among 0–5 year-olds in child care settings. 

IN THE SENATE OF THE UNITED STATES 

MAY 4, 2010 

Mr. UDALL of Colorado (for himself and Mr. FRANKEN) introduced the following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL 

To establish a pilot program to reduce the increasing prevalence of overweight/obesity among 0–5 year-olds in child 

care settings. 

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 ‘‘Healthy Kids from 

5 Day One Act’’. 

6 SEC. 2. FINDINGS AND PURPOSES. 

7 (a) FINDINGS.—Congress makes the following find8 ings: 


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1 (1) Life-long food preferences, eating habits, 

2 and activity levels develop early in childhood. 

3 (2) Preschool years are a critical time for deter4 mining whether or not an individual will develop obe5 sity later in life. 

6 (3) Aerobic fitness and healthy eating patterns 

7 support enhanced behavioral, emotional, and aca8 demic performance in school. 

9 (4) Recent studies indicate that children who 

10 are overweight at age 5 are more likely to be more 

11 overweight at age 9. 

12 (5) Obese preschool children already exhibit 

13 signs of cardiovascular disease and diabetes. 

14 (6) According to a 2007 Centers for Disease 

15 Control and Prevention study, 12.4 percent of chil16 dren in the United States ages 2 through 6 are 

17 obese. 

18 (7) The 2001 National Household Education 

19 Survey found that 74 percent of children in the 

20 United States ages 3 through 6 are in some form of 

21 non-parental child care, and 56 percent are in cen22 ter-based child care. 

23 (8) According to a 2009 analysis of child care 

24 center licensing regulations, only 12 States have a 

25 policy prohibiting or limiting foods of low nutritional 


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1 value in child care centers, only 8 States require vig2 orous or moderate physical activity, only one of 

3 which has a policy quantifying a required number of 

4 minutes of physical activity by day or week, and only 

5 7 States quantify a maximum amount of time for 

6 media (television and electronic) each day or week. 

7 (9) In 2009, the Centers for Disease Control 

8 and Prevention released recommended community 

9 strategies and measures to prevent obesity in the 

10 United States that includes child care specific policy 

11 and environmental initiatives to achieve healthy eat12 ing and active living among children from birth to 

13 5 years of age. 

14 (10) In 2009, The Institute of Medicine re15 leased findings supporting local governments’ ability 

16 to play a crucial role in creating environments that 

17 make it easier for children to eat healthy diets and 

18 remain active. 

19 (11) States should strive to adopt nutrition 

20 standards, practices, and policies for child care cen21 ters that are consistent with the 2005 Dietary 

22 Guidelines for Americans. 

23 (12) Child care centers and family child care 

24 homes should serve as settings where children adopt 

25 healthy eating habits, have opportunities for age apVerDate Mar 15 2010 02:05 May 05, 2010 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3298.IS S3298

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1 propriate physical activity, and set screen time lim2 its. 

3 (13) Rates of obesity are higher for Black and 

4 Latino children than the overall population of chil5 dren in the United States. 

6 (b) PURPOSES.—It is the purpose of this Act to— 

7 (1) establish a 3-year pilot program in 5 States 

8 that will focus on reducing the increasing prevalence 

9 of overweight/obesity among children between birth 

10 and 5 years of age in child care settings; 

11 (2) enhance the focus of child care centers and 

12 family child care homes serving the birth to 5 years 

13 of age population on children’s healthy development 

14 through evidence-based or data-informed practices to 

15 improve healthy eating, physical activity, and screen 

16 time limits; and 

17 (3) identify emerging and expand existing evi18 dence-based practices and understanding of healthy 

19 eating, physical activity, and screen time limits, as 

20 appropriate, as well as replicate curricula, interven21 tions, practices, and policy changes that are most ef22 fective in promoting nutrition and physical activity 

23 among the birth to 5 years of age population in the 

24 child care setting. 


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1 SEC. 3. HEALTHY KIDS PROGRAM. 

2 Title III of the Public Health Service Act (42 U.S.C. 

3 241 et seq.) is amended by adding at the end the fol4 lowing: 

5 ‘‘PART W—HEALTHY KIDS PROGRAM 

6 ‘‘SEC. 399OO. DEFINITIONS. 

7 ‘‘In this part: 

8 ‘‘(1) CHILD CARE CENTER.—The term ‘child 

9 care center’ means a center licensed or otherwise au10 thorized to provide child care services for fewer than 

11 24 hours per day per child in a non-residential set12 ting, unless care in excess of 24 hours is due to the 

13 nature of the parents’ work. 

14 ‘‘(2) EARLY LEARNING COUNCIL.—The term 

15 ‘early learning council’ means an early childhood as16 sembly that is established to advise governors, State 

17 legislators, or State agency administrators on how 

18 best to meet the needs of young children and their 

19 families specifically through improvement of pro20 grams and services. 

21 ‘‘(3) FAMILY CHILD CARE HOME.—The term 

22 ‘family child care home’ means a private family 

23 home where home-based child care is provided for a 

24 portion of the day, unless care in excess of 24 hours 

25 is due to the nature of the parents’ work, and that 


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1 is certified, registered, or licensed in the State in 

2 which it is located. 

3 ‘‘(4) SCREEN TIME LIMITS.—The term ‘screen 

4 time limits’ means policies or guidelines, such as 

5 those developed by the American Academy of Pediat6 rics, designed to reduce the daily amount of time 

7 that children spend watching or looking at digital 

8 monitors or displays, including television sets, com9 puter monitors, or hand-held gaming devices. 

10 ‘‘(5) SECRETARY.—The term ‘Secretary’ means 

11 the Secretary of Health and Human Services. 

12 ‘‘SEC. 300OO–1. GRANTS. 

13 ‘‘(a) IN GENERAL.—The Secretary, in consultation 

14 with appropriate entities within the Department of Health 

15 and Human Services, shall award 3-year competitive 

16 grants to 5 State health departments (or other appro17 priate child care licensing entities within such States) to 

18 help reduce and prevent obesity among the birth to 5 year 

19 old population of the State in child care settings outside 

20 a child’s place of residence. 

21 ‘‘(b) USE OF FUNDS.—State grantees shall use 

22 amounts received under a grant under this subsection to— 

23 ‘‘(1) provide, or enter into contracts to provide, 

24 training (that meets the requirements of subsection 

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1 based organizations with networks of child care cen2 ters, or a consortium of child care centers and fam3 ily child care homes consisting of at least 10 centers, 

4 for the purpose of implementing evidence-based or 

5 data-informed healthy eating and physical activity 

6 policies and practices, including curricula and other 

7 interventions; and 

8 ‘‘(2) provide grants to child care centers and 

9 family child care homes, whose staff received the 

10 training described in paragraph (1), to implement 

11 practice, curricula, and policy changes (that meet 

12 the requirements of subsection (d)) that promote 

13 healthy eating and physical activity among the birth 

14 to 5 years of age population. 

15 Preference in awarding grants shall be given to those 

16 States that demonstrate collaboration between relevant 

17 State entities related to child care and health and with 

18 key stakeholders, such as State early learning councils and 

19 other community-based organizations working with child 

20 care centers or family child care homes. 

21 ‘‘(c) TRAINING REQUIREMENTS.— 

22 ‘‘(1) IN GENERAL.—Training provided under 

23 subsection (b) shall— 

24 ‘‘(A) include the provision of information 

25 concerning age-appropriate healthy eating and 


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1 physical activity interventions and culturally 

2 competent curricula for the birth to 5 years of 

3 age population in the State involved, which at 

4 a minimum shall include— 

5 ‘‘(i) a handbook that includes rec6 ommendations, guidelines, and best prac7 tices for child care centers and family child 

8 care homes relating to healthy eating, 

9 physical activity, and screen time reduc10 tion; 

11 ‘‘(ii) information about the availability 

12 of and services provided by child care 

13 health consultants; and 

14 ‘‘(iii) health and wellness resources 

15 available through the Child Care Bureau 

16 and the Maternal and Child Health Bu17 reau; 

18 ‘‘(B) identify, improve upon, and expand 

19 nutrition and physical activity best practices 

20 targeted to the birth to 5 years of age popu21 lation in the State involved and identify strate22 gies for incorporating parental education and 

23 other parental involvement; and 

24 ‘‘(C) provide instruction on how to appro25 priately model, direct, and encourage child care 


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1 staff behavior to apply the best practices and 

2 strategies identified under subparagraph (B). 

3 ‘‘(2) TRAINING ENTITIES.—A grantee may con4 duct the training required under this section di5 rectly, or may provide such training through a con6 tract with— 

7 ‘‘(A) an appropriate national, State, or 

8 community organization with relevant expertise; 

9 ‘‘(B) a health care provider or professional 

10 organization with relevant expertise; 

11 ‘‘(C) a university or research center that 

12 employs faculty with relevant expertise; or 

13 ‘‘(D) any other entity determined appro14 priate by the State and approved by the Sec15 retary. 

16 ‘‘(3) REQUIREMENT OF CONTRACT.—If a grant17 ee elects to provide the training under this section 

18 through a contract, the grantee shall ensure that a 

19 consistent healthy eating and physical activity cur20 riculum is being developed for all child care entities 

21 participating in the pilot program in the State. 

22 ‘‘(d) PRACTICE, CURRICULA, AND POLICY

23 CHANGES.—After training is provided as required under 

24 subsection (c), a State grantee shall ensure that the orga25 nizations and consortium involved— 


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1 ‘‘(1) implement, in child care settings, evidence2 based or data-informed policy changes that promote 

3 healthy eating, physical activity, and appropriate 

4 screen time limits among the birth to 5 years of age 

5 population; 

6 ‘‘(2) utilize an evidence-based or data-informed, 

7 culturally competent healthy eating and physical ac8 tivity curriculum in child care settings focusing on 

9 such birth to age 5 population; 

10 ‘‘(3) implement programs, activities, and proce11 dures for incorporating parental education and in12 volvement of parents in programs, including dissemi13 nating a written parental involvement policy, and co14 ordinating and integrating parental involvement 

15 strategies under this section, to the extent feasible 

16 and appropriate, with parental involvement strate17 gies under other programs, such as the Head Start 

18 program and the Early Head Start Program; and 

19 ‘‘(4) find innovative ways to remove barriers 

20 that exist to providing opportunities for healthy eat21 ing and physical activity. 

22 All activities described in this paragraph shall be evidence23 based and data-informed and be consistent with the cur24 riculum presented through training activities described in 

25 subsection (c). 


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1 ‘‘SEC. 399OO–2. GRANTS FOR THE EVALUATION OF PILOT 

2 PROGRAMS. 

3 ‘‘The Secretary shall award competitive grants to 

4 Prevention Research Centers or universities to evaluate 

5 the programs carried out with grants under section 

6 399OO–1, including baseline, process, and outcome meas7 urements. 

8 ‘‘SEC. 399OO–3. COORDINATION. 

9 ‘‘(a) INTERAGENCY COORDINATION.—To the extent 

10 practicable, the Secretary shall coordinate activities con11 ducted under this part with activities undertaken by the 

12 National Prevention, Health Promotion and Public Health 

13 Council established under section 4001 of the Patient Pro14 tection and Affordable Care Act (Public Law 111–148). 

15 Where practicable, such coordination shall— 

16 ‘‘(1) include the sharing of current and emerg17 ing best practices concerning healthy eating, physical 

18 activity, and screen time limits that have a popu19 lation-level impact in promoting nutrition and phys20 ical activity in child care settings; 

21 ‘‘(2) promote the effective implementation and 

22 sustainability of such programs; and 

23 ‘‘(3) avoid unnecessary duplication of effort. 

24 ‘‘(b) PILOT COORDINATION.—The Secretary shall 

25 designate an individual (directly or through contract) to 

26 provide technical assistance to States and pilot centers in 


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1 the development, implementation, and evaluation of activi2 ties and dissemination of information described in para3 graphs (1), (2), and (3) of subsection (a). 

4 ‘‘SEC. 399OO–4. EVALUATION AND REPORTING. 

5 ‘‘(a) TECHNICAL ASSISTANCE AND INFORMATION.— 

6 The Secretary shall— 

7 ‘‘(1) provide technical assistance to grantees 

8 and other entities providing training under a grant 

9 under this part; and 

10 ‘‘(2) disseminate to health departments and 

11 trainers under grants under this part information 

12 concerning evidence-based or data-informed ap13 proaches, including dissemination of existing tool14 kits, curricula, and existing or emerging best prac15 tices that can be expanded or improved upon 

16 through a program conducted under this part. 

17 ‘‘(b) EVALUATION REQUIREMENTS.—With respect to 

18 evaluations conducted under section 399OO–2, the Sec19 retary shall ensure that— 

20 ‘‘(1) evaluation metrics are consistent across all 

21 programs funded under this part; 

22 ‘‘(2) interim outcomes are measured by the 

23 number of centers that have implemented policy and 

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1 ricula and practices supporting healthy eating, phys2 ical activity, and screen time limits; 

3 ‘‘(3) interim outcomes are measured, to the ex4 tent possible, by behavior changes in healthy eating, 

5 physical activity, and screen time; and 

6 ‘‘(4) upon completion of the program, the eval7 uation shall include an identification of best prac8 tices relating to behavior change and reductions in 

9 the increasing prevalence of overweight and obesity 

10 that could be replicated in other settings. 

11 ‘‘(c) DISSEMINATION OF INFORMATION.—Upon the 

12 conclusion of the programs carried out under this part, 

13 the Secretary shall disseminate to all appropriate agencies 

14 within the Department of Health and Human Services evi15 dence, best practices, and lessons learned from grantees. 

16 Such agencies shall encourage the adoption of the best 

17 practices. 

18 ‘‘(d) REPORT TO CONGRESS.—Not later than 6 

19 months after the completion of the pilot program under 

20 this part, the Secretary shall submit to Congress a report 

21 concerning the evaluation of the pilot programs, including 

22 recommendations as to how lessons learned from such pro23 grams can be incorporated into future guidance docu24 ments developed and provided by the Secretary and other 

25 Federal agencies, as appropriate. 


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1 ‘‘SEC. 399OO–5. AUTHORIZATION OF APPROPRIATIONS. 

2 ‘‘There is authorized to be appropriated to carry out 

3 this part, $2,500,000 for each of fiscal years 2011, 2012 

4 and 2013.’’. 

Æ 


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