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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Start Healthy Habits 
Early Act’’. 
SEC. 2. CHILD AND ADULT CARE FOOD PROGRAM. 
Section 17 of the Richard B. Russell National School 
Lunch Act (42 U.S.C. 1766) is amended— 
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(1) in subsection (a), by striking ‘‘(a) GRANT 
AUTHORITY’’ and all that follows through the end of 
paragraph (1) and inserting the following: 
‘‘(a) PROGRAM PURPOSE, GRANT AUTHORITY, AND 
INSTITUTION ELIGIBILITY.— 
‘‘(1) IN GENERAL.— 
‘‘(A) PROGRAM PURPOSE.—The purpose of 
the program authorized under this section is to 
provide aid to child and adult care institutions 
for the provision of nutritious foods that con-
tribute to the wellness, healthy growth, and de-
velopment of young children, and the health 
and wellness of older adults and chronically im-
paired disabled persons. 
‘‘(B) GRANT AUTHORITY.—The Secretary 
may carry out a program to assist States 
through grants-in-aid and other means to ini-
tiate and maintain nonprofit food service pro-
grams for children in institutions providing 
child care.’’; 
(2) by striking subsection (g) and inserting the 
following: 
‘‘(g) NUTRITIONAL REQUIREMENTS FOR MEALS AND 
SNACKS SERVED
IN INSTITUTIONS
AND FAMILY
OR 
GROUP DAY CARE HOMES.— 
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‘‘(1) DEFINITION OF DIETARY GUIDELINES.— 
In this subsection, the term ‘Dietary Guidelines’ 
means the Dietary Guidelines for Americans pub-
lished under section 301 of the National Nutrition 
Monitoring and Related Research Act of 1990 (7 
U.S.C. 5341). 
‘‘(2) NUTRITIONAL REQUIREMENTS.— 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (C), reimbursable meals and 
snacks served by institutions, family or group 
day care homes, and sponsored centers partici-
pating in the program under this section shall 
consist of a combination of foods that meet 
minimum nutritional requirements prescribed 
by the Secretary on the basis of tested nutri-
tional research. 
‘‘(B) CONFORMITY
WITH
THE
DIETARY 
GUIDELINES AND AUTHORITATIVE SCIENCE.— 
‘‘(i) IN
GENERAL.—Not less fre-
quently than once every 10 years, the Sec-
retary shall review and, as appropriate, up-
date nutritional requirements for meals 
and snacks served under the program 
under this section to ensure that the meals 
and snacks— 
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served under the program under this 
section. 
‘‘(II) CONSIDERATION.—In pro-
mulgating proposed regulations under 
subclause (I), the Secretary shall dem-
onstrate consideration for the finan-
cial and administrative impact to in-
stitutions, family or group day care 
homes, and sponsored centers result-
ing from any proposed changes to the 
nutritional requirements for meals 
and snacks in the regulations. 
‘‘(C) EXCEPTIONS.— 
‘‘(i) SPECIAL DIETARY NEEDS.—The 
minimum nutritional requirements pre-
scribed under subparagraph (A) shall not 
prohibit institutions, family or group day 
care homes, and sponsored centers from 
substituting foods to accommodate the 
medical or other special dietary needs of 
individual participants. 
‘‘(ii) EXEMPT
INSTITUTIONS.—The 
Secretary may elect to waive all or part of 
the requirements of this subsection for 
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emergency shelters participating in the 
program under this section. 
‘‘(3) MEAL
SERVICE.—Institutions, family or 
group day care homes, and sponsored centers shall 
ensure that reimbursable meal service is not used as 
a punishment or reward. 
‘‘(4) FLUID MILK.— 
‘‘(A) IN GENERAL.—If an institution, fam-
ily or group day care home, or sponsored center 
provides fluid milk as part of a reimbursable 
meal or supplement, the institution, family or 
group day care home, or sponsored center shall 
provide the milk in accordance with the most 
recent version of the Dietary Guidelines and ap-
propriate authoritative scientific recommenda-
tions for young children. 
‘‘(B) MILK SUBSTITUTES.—In the case of 
children who cannot consume fluid milk due to 
medical or other special dietary needs other 
than a disability, an institution, family or group 
day care home, or sponsored center may sub-
stitute for the fluid milk served as part of a re-
imbursable meal or supplement, a nondairy bev-
erage that— 
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‘‘(i) is nutritionally equivalent to fluid 
milk; and 
‘‘(ii) meets nutritional standards es-
tablished by the Secretary, including, 
among other requirements established by 
the Secretary, fortification of calcium, pro-
tein, vitamin A, and vitamin D to levels 
found in cow’s milk. 
‘‘(C) APPROVAL.— 
‘‘(i) IN GENERAL.—A substitution au-
thorized under subparagraph (B) may be 
made— 
‘‘(I) at the discretion of, and on 
approval by, the participating institu-
tion, family or group day care home, 
or sponsored center; and 
‘‘(II) if the substitution is re-
quested— 
‘‘(aa) by a medical author-
ity; or 
‘‘(bb) by the parent or legal 
guardian of a participating child. 
‘‘(ii) 
EXCEPTION.—An 
institution, 
family or group day care home, or spon-
sored center that elects to make a substi-
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tution authorized under this paragraph 
shall not provide beverages other than bev-
erages the State has identified as accept-
able substitutes. 
‘‘(D) EXCESS EXPENSES BORNE BY INSTI-
TUTION.—A participating institution, family or 
group day care home, or sponsored center shall 
be responsible for any expenses that— 
‘‘(i) are incurred by the institution, 
family or group day care home, or spon-
sored center to provide substitutions under 
this paragraph; and 
‘‘(ii) are in excess of expenses covered 
under reimbursements under this Act. 
‘‘(5) NONDISCRIMINATION
POLICY.—No phys-
ical segregation or other discrimination against any 
child shall be made because of the inability of the 
child to pay, nor shall there be any overt identifica-
tion of any such child by special tokens or tickets, 
different meals or meal service, announced or pub-
lished lists of names, or other means. 
‘‘(6) USE
OF
ABUNDANT
AND
DONATED 
FOODS.—To the maximum extent practicable, each 
institution shall use in its food service foods that 
are— 
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‘‘(A) designated from time to time by the 
Secretary as being in abundance, either nation-
ally or in the food service area; or 
‘‘(B) donated by the Secretary; 
‘‘(7) WATER.—Participating institutions, family 
or group day care homes, and sponsored centers 
shall make available to children, as nutritionally ap-
propriate, potable water throughout the day, includ-
ing at meal times.’’; and 
(3) by adding at the end the following: 
‘‘(u) PROMOTING HEALTH AND WELLNESS IN CHILD 
CARE.— 
‘‘(1) IN GENERAL.—The Secretary shall assist 
participating institutions, family or group day care 
homes, and sponsored centers through technical as-
sistance and guidance, and competitive grants for 
the purpose of promoting the health and nutrition of 
children in child care settings. 
‘‘(2) 
TECHNICAL
ASSISTANCE
AND
GUID-
ANCE.— 
‘‘(A) 
NUTRITION.—From 
funds 
made 
available under subparagraph (C), the Sec-
retary shall provide technical assistance and 
guidance to institutions, family or group day 
care homes, and sponsored centers, partici-
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pating in the program under this section to 
support compliance with the nutrition require-
ments described in subsection (g), which shall 
include technical assistance and guidance with 
respect to— 
‘‘(i) menu planning; 
‘‘(ii) interpretation of nutrition labels; 
and 
‘‘(iii) food preparation and purchasing 
guidance to produce meals and snacks 
that— 
‘‘(I) are consistent with the goals 
of the most recent Dietary Guidelines 
for Americans published under section 
301 of the National Nutrition Moni-
toring and Related Research Act of 
1990 (7 U.S.C. 5341) (in this sub-
section referred to as the ‘Dietary 
Guidelines’); and 
‘‘(II) promote the health of the 
population served by the program 
under this section, as recommended 
by authoritative scientific recommen-
dations. 
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‘‘(B) WELLNESS
PROMOTION.—Not later 
than January 1, 2012, in consultation with the 
Secretary of Health and Human Services, the 
Secretary shall provide technical assistance and 
guidance, such as a handbook, to assist State 
agencies and institutions, family and group day 
care homes, and sponsored centers, partici-
pating in the program under this section to— 
‘‘(i) promote access to foods that are 
recommended for consumption by the most 
recent Dietary Guidelines; 
‘‘(ii) encourage opportunities for age- 
appropriate physical activity in quantities 
and at levels recommended by the most re-
cent Dietary Guidelines and the Secretary 
of Health and Human Services and provide 
information on— 
‘‘(I) the importance of regular 
age-appropriate physical activity for 
health and well-being based on au-
thoritative scientific recommendations; 
and 
‘‘(II) best practices for physical 
activity plans in child care settings; 
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‘‘(iii) encourage age-appropriate elec-
tronic media use by children based on au-
thoritative scientific recommendations and 
provide information on— 
‘‘(I) the importance of age-appro-
priate use, including limitations, of 
electronic media; and 
‘‘(II) best practices for imple-
mentation of such recommendations in 
child care settings; and 
‘‘(iv) encourage the involvement of 
parents in nutrition and wellness initiatives 
for children. 
‘‘(C) ADDITIONAL INFORMATION.—In con-
sultation with the Secretary of Health and 
Human Services, the Secretary shall provide 
educational materials (such as pamphlets, or 
other printed materials) to State agencies and 
institutions, family and group day care homes, 
and sponsored centers participating in the pro-
gram under this section regarding common 
food-related choking hazards and guidance on 
avoiding food choking in young children. 
‘‘(D) FUNDING.— 
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‘‘(i) IN
GENERAL.—On October 1, 
2010, out of any funds in the Treasury not 
otherwise appropriated, the Secretary of 
the Treasury shall transfer to the Sec-
retary 
to 
carry 
out 
this 
paragraph 
$10,000,000, to remain available until ex-
pended. 
‘‘(ii) RECEIPT
AND
ACCEPTANCE.— 
The Secretary shall be entitled to receive, 
shall accept, and shall use to carry out this 
subsection the funds transferred under 
clause (i), without further appropriation. 
‘‘(3) COMPETITIVE GRANTS.— 
‘‘(A) GRANTS TO STATE AGENCIES.—From 
the funds made available under subparagraph 
(G), the Secretary shall award grants, on a 
competitive basis, to State agencies partici-
pating in the program under this section for the 
purpose of promoting health and nutrition in 
child care settings. 
‘‘(B) 
PRIORITY.—In 
awarding 
grants 
under this paragraph, the Secretary shall give 
priority to State agencies administering projects 
under the program that carry out each of the 
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authorized uses of funds described in subpara-
graph (C)(ii). 
‘‘(C) USES OF FUNDS.— 
‘‘(i) REQUIRED USES.—A State agen-
cy receiving a grant under this paragraph 
shall use not less than 50 percent of such 
grant funds to award subgrants to institu-
tions, including sponsoring organizations, 
for the purpose of carrying out the activi-
ties described in clause (ii). 
‘‘(ii) AUTHORIZED USES.—In addition 
to such other activities as the Secretary de-
termines to be appropriate, State agencies 
and institutions may use funds received 
under this paragraph for activities that— 
‘‘(I) promote nutrition and phys-
ical activity in child care settings that 
reflect— 
‘‘(aa) the recommendations 
of the most recent version of the 
Dietary Guidelines; and 
‘‘(bb) authoritative scientific 
recommendations; 
‘‘(II) provide technical assistance 
and training to sponsors and pro-
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viders of child care centers and family 
or group day care homes in imple-
menting State or local initiatives de-
signed to improve the health and nu-
trition of children in child care set-
tings; 
‘‘(III) perform outreach cam-
paigns on the State or local level that 
are designed to increase access to the 
program in underserved areas and 
populations, including subsidized child 
care providers; and 
‘‘(IV) make innovative use of 
technology to provide training and 
education to promote the nutrition, 
physical activity, and health of chil-
dren. 
‘‘(D) APPLICATION.—To be eligible to re-
ceive a grant under this paragraph, a State 
agency shall submit an application to the Sec-
retary at such time, in such manner, and con-
taining such information as the Secretary may 
require, which shall include— 
‘‘(i) a plan to promote child care set-
tings that encourage healthful behaviors, 
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including improvements to the quality of 
meals and snacks provided in institutions, 
family or group day care homes, and spon-
sored centers; and 
‘‘(ii) a description of— 
‘‘(I) the procedures by which the 
State agency will use the grant to 
award subgrants to institutions; and 
‘‘(II) the criteria that the State 
agency will use in awarding such sub-
grants. 
‘‘(E) REPORTING.—Any State agency re-
ceiving a grant under this paragraph shall sub-
mit a report to the Secretary at such time, in 
such manner, and containing such information 
as the Secretary may require that, at a min-
imum, shall include— 
‘‘(i) a description of the activities sup-
ported with funds under this paragraph; 
‘‘(ii) the progress of implementing the 
activities; and 
‘‘(iii) the outcome of the activities. 
‘‘(F) BEST
PRACTICES.—The Secretary 
shall provide to State agencies and institutions 
best practices for implementing effective nutri-
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