I 
112TH CONGRESS 
1ST SESSION H. R. 2795 
To address childhood obesity, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
AUGUST 5, 2011 
Ms. FUDGE (for herself, Mrs. CHRISTENSEN, Ms. LEE of California, and Mr. 
PAYNE) introduced the following bill 
SEPTEMBER 6, 2011 
Referred to the Committee on Energy and Commerce, and in addition to the 
Committees on Education and the Workforce, Ways and Means, Natural 
Resources, the Judiciary, Financial Services, and Agriculture, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To address childhood obesity, 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 ‘‘Fit for Life Act of 
2011’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents of this Act is as follows: 
Sec. 1. Short title. 
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Sec. 2. Table of contents. 
TITLE I—IMPROVING THE NUTRITIONAL QUALITY OF AND 
ACCESS TO FOODS IN UNDERSERVED AMERICAN COMMUNITIES 
Subtitle A—Access to Nutritious and Quality Foods in Underserved American 
Communities 
Sec. 101. Food deserts: Addressing the Lack of Supermarkets in Underserved 
Communities. 
Sec. 102. Expansion of the Fresh Fruit and Vegetable Program. 
Sec. 103. Expanding Access to the Summer Food Service Program for Chil-
dren. 
Sec. 104. Study and report on physical activity and nutritional quality of meals 
and snacks served, in juvenile justice facilities. 
Sec. 105. Local food insecurity assessments: assessing the unique nutritional 
needs of local communities. 
Sec. 106. Weekends and holidays without hunger. 
Subtitle B—Ensuring a Healthy Start for Children in Underserved American 
Communities 
Sec. 111. Improving Healthy Eating and Physical Activity Among our Young-
est Children. 
Sec. 112. Health and fitness school programs: training America’s youth to live 
healthy lifestyles. 
TITLE II—ADVANCING PREVENTATIVE MEASURES AND TREAT-
MENT OF OBESITY IN ADULTS AND CHILDREN IN UNDER-
SERVED COMMUNITIES 
Sec. 201. Community health and wellness navigators pilot program: connecting 
America’s health professional with our schools. 
Sec. 202. Requirement to expedite national Medicare coverage determinations 
for evidence-based preventive services. 
Sec. 203. Expansion of obesity treatment services under Medicare. 
Sec. 204. Coverage of evidence-based preventive services under Medicaid and 
SCHIP. 
Sec. 205. Coverage of medical nutrition therapy under Medicaid and SCHIP. 
Sec. 206. Clarification of EPSDT inclusion of prevention, screening, and treat-
ment services for obesity and overweight; SCHIP coverage. 
Sec. 207. National commission on child obesity. 
Sec. 208. GAO report. 
TITLE III—ENCOURAGING PHYSICAL ACTIVITY IN UNDERSERVED 
AMERICAN COMMUNITIES 
Sec. 301. Renovation of foreclosed and abandoned properties to create spaces 
that encourage physical activity in American neighborhoods. 
Sec. 302. National youth sports program revitalization. 
Sec. 303. Expansion of the Zuni Youth Enrichment Project Summer Camp. 
Sec. 304. Making routes to schools in underserved communities safe and acces-
sible with public participation through the Community Oriented 
Policing Services program. 
Sec. 305. Land and Water Conservation Fund Program Grants in Low-Income 
Communities and Expand Tribal Participation. 
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Sec. 306. Changing Hearts, Attitudes, and Minds by Participating in Sports 
(CHAMPS) Program. 
Sec. 307. Coordinated School Health Initiatives. 
Sec. 308. Rewarding elementary and secondary schools for outstanding student 
performance in physical fitness programs. 
TITLE I—IMPROVING THE NU-
TRITIONAL QUALITY OF AND 
ACCESS TO FOODS IN UNDER-
SERVED AMERICAN COMMU-
NITIES 
Subtitle A—Access to Nutritious 
and Quality Foods in Under-
served American Communities 
SEC. 101. FOOD DESERTS: ADDRESSING THE LACK OF SU-
PERMARKETS 
IN 
UNDERSERVED 
COMMU-
NITIES. 
(a) ESTABLISHMENT OF GRANT PROGRAM.—From 
the amounts appropriated to carry out this section, the 
Secretary of Agriculture shall award grants to local part-
nerships to establish, or enhance existing, supermarkets 
that sell fresh fruits and produce in low-income commu-
nities located in food deserts. 
(b) APPLICATION.—In order to receive a grant under 
this section, a local partnership shall submit an applica-
tion to the Secretary at such time, in such manner, and 
containing such information as the Secretary may require. 
(c) USES OF FUNDS.—A local partnership shall use 
grant funds received under this section to establish, or en-
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hance an existing, a supermarket in a low-income commu-
nity located in a food desert and assist the supermarket 
in carrying out the following activities: 
(1) Selling fresh fruit and produce at prices 
that, to the maximum extent practicable, are afford-
able for most individuals in the low-income commu-
nity. 
(2) Making the supermarket available for 
youth-centered, hands-on educational instruction and 
information on healthy cooking and nutrition. 
(3) Providing community outreach services that 
encourage health and wellness to individuals in the 
low-income community. 
(d) REPORTING.— 
(1) LOCAL PARTNERSHIPS.—Not later than 2 
years after receiving a grant under this section, a 
local partnership shall submit a report to the Sec-
retary on the success of the supermarket established 
using such funds. 
(2) SECRETARY.—Upon receipt of a report 
under paragraph (1), the Secretary shall transmit 
such report to Congress. 
(e) DEFINITIONS.—In this section: 
(1) FOOD DESERT.—The term ‘‘food desert’’ 
has the meaning given such term in section 7527(a) 
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of the Food, Conservation, and Energy Act of 2008 
(Public Law 110–234). 
(2) LOCAL
PARTNERSHIP.—The term ‘‘local 
partnership’’ means a partnership between— 
(A) a unit of general local government, a 
State, or a tribal government; and 
(B) a— 
(i) public or private organization; or 
(ii) not-for profit entity. 
(3) LOW-INCOME COMMUNITY.—The term ‘‘low- 
income community’’ includes a low-income commu-
nity (as such term is defined by the Secretary) lo-
cated in an urban area. 
(4) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Agriculture. 
(5) SUBURBAN COMMUNITY.—The term ‘‘sub-
urban community’’ has the meaning given such term 
by the Secretary. 
(6) STATE.—The term ‘‘State’’ includes, in ad-
dition to the several States of the United States, the 
Commonwealth of Puerto Rico, the District of Co-
lumbia, the Virgin Islands, Guam, American Samoa, 
and the Commonwealth of the Northern Mariana Is-
lands. 
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(7) SUPERMARKET.—The term ‘‘supermarket’’ 
means any establishment under Code 445110 of the 
North American Industry Classification System. 
(8) UNIT OF GENERAL LOCAL GOVERNMENT.— 
The term ‘‘unit of general local government’’ means 
any city, county, town, township, parish, village, or 
other general purpose political subdivision of a 
State. 
SEC. 102. EXPANSION OF THE FRESH FRUIT AND VEGE-
TABLE PROGRAM. 
Section 19 of the Richard B. Russell National School 
Lunch Act (42 U.S.C. 1769a) is amended— 
(1) in subsection (a), by inserting ‘‘, secondary 
schools, child care centers, and family child care 
homes’’ after ‘‘elementary schools’’; 
(2) in subsection (b), by inserting ‘‘, center, or 
home’’ after each place ‘‘school’’ appears; 
(3) in subsection (d)— 
(A) in the heading, by inserting ‘‘, CEN-
TERS, OR HOMES’’; 
(B) in paragraph (1)— 
(i) in the matter preceding subpara-
graph (A), by inserting ‘‘, centers, or 
homes’’ after ‘‘schools’’; 
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(ii) in subparagraph (A), by inserting 
‘‘, center, or home’’ after ‘‘school’’; 
(iii) in subparagraph (B), by inserting 
‘‘, centers, or homes’’ after ‘‘schools’’; 
(iv) by amending subparagraph (C) to 
read as follows: 
‘‘(C) ensure that each school selected is an 
elementary school or secondary school (as such 
terms are defined in section 9101 of the Ele-
mentary and Secondary Education Act of 1965 
(20 U.S.C. 7801)), each center selected is a 
child care center (as such term is defined in 
section 399OO of the Public Health Service 
Act), and each home selected is a family child 
care home (as such term is defined in section 
399OO of the Public Health Service Act).’’; and 
(v) in subparagraph (D)— 
(I) in the matter preceding clause 
(i), by inserting ‘‘, centers, or homes’’ 
after ‘‘schools’’; 
(II) in clause (i), by inserting ‘‘, 
center, or home’’ after ‘‘school’’; and 
(III) in clause (ii), by inserting ‘‘, 
center, or home’’ after ‘‘as determined 
by the school’’; 
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(C) in paragraph (2), by inserting ‘‘, cen-
ters, or homes’’ after each place ‘‘schools’’ ap-
pears; and 
(D) in paragraph (3), by inserting ‘‘, cen-
ters, or homes’’ after each place ‘‘schools’’ ap-
pears; and 
(4) in subsection (e), by inserting ‘‘, center, or 
home’’ after ‘‘school’’. 
SEC. 103. EXPANDING ACCESS TO THE SUMMER FOOD 
SERVICE PROGRAM FOR CHILDREN. 
Section 13(a) of the Richard B. Russell National 
School Lunch (42 U.S.C. 1761(a)) is amended— 
(1) in paragraph (1)(A), by striking ‘‘50 per-
cent’’ each place it appears and inserting ‘‘40 per-
cent’’; 
(2) by repealing paragraph (9); and 
(3) in paragraph (10)— 
(A) in subparagraph (A)— 
(i) by striking ‘‘The Secretary’’ and 
inserting ‘‘From the amounts appropriated 
to carry out this paragraph, the Sec-
retary’’; and 
(ii) by striking ‘‘not more than 5’’; 
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(B) in subparagraph (C), by striking ‘‘fis-
cal year 2006’’ and inserting ‘‘fiscal year 
2012’’; 
(C) in subparagraph (D)— 
(i) by striking ‘‘January 1, 2008’’ and 
inserting ‘‘January 1, 2012’’; and 
(ii) by striking ‘‘January 1, 2009’’ 
and inserting ‘‘January 1, 2013’’; and 
(D) by striking subparagraph (E). 
SEC. 104. STUDY AND REPORT ON PHYSICAL ACTIVITY AND 
NUTRITIONAL 
QUALITY 
OF 
MEALS 
AND 
SNACKS SERVED, IN JUVENILE JUSTICE FA-
CILITIES. 
(a) STUDY.—The Administrator of the Office of Ju-
venile Justice and Delinquency Prevention, in consultation 
with the Secretary of Agriculture, shall conduct a study 
on— 
(1) the amount of physical activity by juveniles 
in juvenile justice facilities, including the types of 
physical activities in which such juveniles partici-
pate, how many hours per day such juveniles partici-
pate in physical activities, and the adequacy of the 
amounts and types of physical activity of such juve-
niles; and 
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(2) the nutritional quality of meals and snacks 
served in juvenile justice facilities. 
(b) REPORT.—Not later than 2 years after the date 
of enactment of this Act, the Administrator of the Office 
of Juvenile Justice and Delinquency Prevention, in con-
sultation with the Secretary of Agriculture, shall submit 
to Congress a report on the findings of the study con-
ducted under subsection (a), including an evaluation of 
whether the amounts and types of physical activity by ju-
veniles, and the nutritional quality of meals and snacks 
served, in juvenile justice facilities are adequate to ensure 
the health and wellness of such juveniles. 
SEC. 105. LOCAL FOOD INSECURITY ASSESSMENTS: ASSESS-
ING THE UNIQUE NUTRITIONAL NEEDS OF 
LOCAL COMMUNITIES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall establish a 3-year pilot program to 
award grants to local and tribal governments, on a com-
petitive basis, to allow such local and tribal governments, 
in partnership with the local community organizations 
under subsection (e), to— 
(1) conduct a food security assessment; and 
(2) make an inventory of the system in order to 
identify the strengths and gaps in such system. 
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(b) DATA POINTS FOR ASSESSMENT.—For purposes 
of conducting an Assessment and making an inventory 
under a grant under subsection (a), with respect to the 
community served by a local or tribal government, such 
government shall examine the following food security and 
food system issues in the community: 
(1) The prevalence of childhood obesity. 
(2) The availability of safe routes to school for 
children. 
(3) The quality of food served in school and 
child care settings. 
(4) The availability of supermarkets. 
(5) The cost and availability of fresh fruits and 
vegetables. 
(6) The concentration of convenience stores, 
and other food vendors that sell a disproportionate 
amount of foods that are not fresh fruits and vegeta-
bles. 
(7) The availability of products. 
(8) The concentration of fast food restaurants. 
(9) The availability of green space or recreation 
areas, and the extent to which such space or areas 
encourage physical activity by adults and children. 
(10) Any other issues determined to be relevant 
by the local or tribal government. 
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(11) Any other issues determined to be relevant 
by the Secretary of Health and Human Services. 
(c) NUMBER OF SITES.—The Secretary of Health 
and Human Services, in awarding grants under subsection 
(a), shall award grants to no more than— 
(1) 20 local governments; and 
(2) 5 tribal governments. 
(d) PRIORITY.—In awarding grants under subsection 
(a), the Secretary of Health and Human Services shall 
give priority to those local and tribal governments that 
serve communities with the highest concentrations of pov-
erty. 
(e) REQUIREMENT OF PARTNERSHIPS.—In order to 
qualify for a grant under subsection (a), a local or tribal 
government shall demonstrate, to the satisfaction of the 
Secretary of Health and Human Services, that the local 
or tribal government has entered into a partnership (for 
the purpose of conducting an assessment and making an 
inventory under subsection (a)) with at least one of the 
following local community organizations: 
(1) A nonprofit community-based organization 
or entity. 
(2) A developer or urban planning institution. 
(3) An accredited college or university. 
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(4) A freestanding children’s hospital or center 
with expertise in child health and policy. 
SEC. 106. WEEKENDS AND HOLIDAYS WITHOUT HUNGER. 
Section 18 of the Richard B. Russell National School 
Lunch Act (42 U.S.C. 1769) is amended by adding at the 
end the following: 
‘‘(l) WEEKENDS
AND HOLIDAYS WITHOUT HUN-
GER.— 
‘‘(1) DEFINITIONS.—In this subsection: 
‘‘(A) AT-RISK SCHOOL CHILD.—The term 
‘at-risk school child’ has the meaning given the 
term in section 17(r)(1). 
‘‘(B) ELIGIBLE INSTITUTION.— 
‘‘(i) IN GENERAL.—The term ‘eligible 
institution’ means a public or private non-
profit institution that is determined by the 
Secretary to be able to meet safe food stor-
age, handling, and delivery standards es-
tablished by the Secretary. 
‘‘(ii) INCLUSIONS.—The term ‘eligible 
institution’ includes— 
‘‘(I) an elementary or secondary 
school or school food service authority; 
‘‘(II) a food bank or food pantry; 
‘‘(III) a homeless shelter; and 
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‘‘(IV) such other type of emer-
gency feeding agency as is approved 
by the Secretary. 
‘‘(2) ESTABLISHMENT.—Subject to the avail-
ability of appropriations provided in advance in an 
appropriations Act specifically for the purpose of 
carrying out this subsection, the Secretary shall es-
tablish a program under which the Secretary shall 
provide commodities, on a competitive basis, to eligi-
ble institutions to provide nutritious food to at-risk 
children on weekends and during extended school 
holidays during the school year. 
‘‘(3) ELIGIBILITY.— 
‘‘(A) IN GENERAL.—To be eligible to re-
ceive commodities under this subsection, an eli-
gible institution shall submit an application to 
the Secretary at such time, in such manner, 
and containing such information as the Sec-
retary may determine. 
‘‘(B) PLAN.—An application under sub-
paragraph (A) shall include the plan of the eli-
gible institution for the distribution of nutri-
tious foods to at-risk school children, includ-
ing— 
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‘‘(i) methods of food service delivery 
to at-risk school children; 
‘‘(ii) assurances that children receiv-
ing foods under the project will not be pub-
licly separated or overtly identified; 
‘‘(iii) lists of the types of food to be 
provided under the project and provisions 
to ensure food quality and safety; 
‘‘(iv) information on the number of 
at-risk school children to be served and the 
per-child cost of providing the children 
with food; and 
‘‘(v) such other information as the 
Secretary determines to be necessary to as-
sist the Secretary in evaluating projects 
that receive commodities under this sub-
section. 
‘‘(4) PRIORITY.—In selecting applications under 
this subsection, the Secretary shall give priority to 
eligible institutions that— 
‘‘(A) have on-going programs and experi-
ence serving populations with significant pro-
portions of at-risk school children; 
‘‘(B) have a good record of experience in 
food delivery and food safety systems; 
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‘‘(C) maintain high quality control, ac-
countability, and recordkeeping standards; 
‘‘(D) 
provide 
children 
with 
readily 
consumable food of high nutrient content and 
quality; 
‘‘(E) demonstrate cost efficiencies and the 
potential for obtaining supplemental funding 
from non-Federal sources to carry out projects; 
and 
‘‘(F) demonstrate the ability to continue 
projects for the full approved term of the pilot 
project period. 
‘‘(5) GUIDELINES.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
issue guidelines containing the criteria for 
projects to receive commodities under this sec-
tion. 
‘‘(B) INCLUSIONS.—The guidelines shall, 
to the maximum extent practicable within the 
funds available and applications submitted, take 
into account— 
‘‘(i) geographical variations in project 
locations to include qualifying projects in 
rural, urban, and suburban areas with high 
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proportions of families with at-risk school 
children; 
‘‘(ii) different types of projects that 
offer nutritious foods on weekends and 
during school holidays to at-risk school 
children; and 
‘‘(iii) institutional capacity to collect, 
maintain, and provide statistically valid in-
formation necessary for the Secretary— 
‘‘(I) to analyze and evaluate the 
results of the pilot project; and 
‘‘(II) to make recommendations 
to Congress. 
‘‘(6) EVALUATION.— 
‘‘(A) INTERIM
EVALUATION.—Not later 
than November 30, 2013, the Secretary shall 
complete an interim evaluation of the pilot pro-
gram carried out under this subsection. 
‘‘(B) FINAL REPORT.—Not later than De-
cember 31, 2015, the Secretary shall submit to 
Congress a final report that contains— 
‘‘(i) an evaluation of the pilot pro-
gram carried out under this subsection; 
and 
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‘‘(ii) any recommendations of the Sec-
retary for legislative action. 
‘‘(7) FUNDING.— 
‘‘(A) 
AUTHORIZATION
OF
APPROPRIA-
TIONS.—There is authorized to be appropriated 
to carry out this section such sums as are nec-
essary, to remain available until expended. 
‘‘(B) AVAILABILITY OF FUNDS.—Not more 
than 3 percent of the funds made available 
under subparagraph (A) may be used by the 
Secretary for expenses associated with review of 
the operations and evaluation of the projects 
carried out under this subsection.’’. 
Subtitle B—Ensuring a Healthy 
Start for Children in Under-
served American Communities 
SEC. 111. IMPROVING HEALTHY EATING AND PHYSICAL AC-
TIVITY AMONG OUR YOUNGEST CHILDREN. 
Title III of the Public Health Service Act (42 U.S.C. 
241 et seq.) is amended by adding at the end the fol-
lowing: 
‘‘PART W—HEALTHY KIDS PROGRAM 
‘‘SEC. 399OO. DEFINITIONS. 
‘‘In this part: 
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‘‘(1) CHILD CARE CENTER.—The term ‘child 
care center’ means a center licensed or otherwise au-
thorized to provide child care services for fewer than 
24 hours per day per child in a non-residential set-
ting, unless care in excess of 24 hours is due to the 
nature of the parents’ work. 
‘‘(2) EARLY
LEARNING
COUNCIL.—The term 
‘early learning council’ means an early childhood as-
sembly that is established to advise governors, State 
legislators, or State agency administrators on how 
best to meet the needs of young children and their 
families specifically through improvement of pro-
grams and services. 
‘‘(3) FAMILY CHILD CARE HOME.—The term 
‘family child care home’ means a private family 
home where home-based child care is provided for a 
portion of the day, unless care in excess of 24 hours 
is due to the nature of the parents’ work, and that 
is certified, registered, or licensed in the State in 
which it is located. 
‘‘(4) SCREEN TIME LIMITS.—The term ‘screen 
time limits’ means policies or guidelines, such as 
those developed by the American Academy of Pediat-
rics, designed to reduce the daily amount of time 
that children spend watching or looking at digital 
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monitors or displays, including television sets, com-
puter monitors, or hand-held gaming devices. 
‘‘(5) SECRETARY.—The term ‘Secretary’ means 
the Secretary of Health and Human Services. 
‘‘SEC. 399OO–1. GRANTS. 
‘‘(a) IN GENERAL.—The Secretary, in consultation 
with appropriate entities within the Department of Health 
and Human Services, shall award 3-year competitive 
grants to 5 State health departments (or other appro-
priate child care licensing entities within such States) to 
help reduce and prevent obesity among the birth to 5 year 
old population of the State in child care settings outside 
a child’s place of residence. 
‘‘(b) USE
OF FUNDS.—State grantees shall use 
amounts received under a grant under this subsection to— 
‘‘(1) provide, or enter into contracts to provide, 
training (that meets the requirements of subsection 
(c)) to the staff of national, State, or community- 
based organizations with networks of child care cen-
ters, or a consortium of child care centers and fam-
ily child care homes consisting of at least 10 centers, 
for the purpose of implementing evidence-based or 
data-informed healthy eating and physical activity 
policies and practices, including curricula and other 
interventions; and 
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‘‘(2) provide grants to child care centers and 
family child care homes, whose staff received the 
training described in paragraph (1), to implement 
practice, curricula, and policy changes (that meet 
the requirements of subsection (d)) that promote 
healthy eating and physical activity among the birth 
to 5 years of age population. 
Preference in awarding grants shall be given to those 
States that demonstrate collaboration between relevant 
State entities related to child care and health and with 
key stakeholders, such as State early learning councils and 
other community-based organizations working with child 
care centers or family child care homes. 
‘‘(c) TRAINING REQUIREMENTS.— 
‘‘(1) IN
GENERAL.—Training provided under 
subsection (b) shall— 
‘‘(A) include the provision of information 
concerning age-appropriate healthy eating and 
physical activity interventions and culturally 
competent curricula for the birth to 5 years of 
age population in the State involved, which at 
a minimum shall include— 
‘‘(i) a handbook that includes rec-
ommendations, guidelines, and best prac-
tices for child care centers and family child 
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care homes relating to healthy eating, 
physical activity, and screen time reduc-
tion; 
‘‘(ii) information about the availability 
of and services provided by child care 
health consultants; and 
‘‘(iii) health and wellness resources 
available through the Child Care Bureau 
and the Maternal and Child Health Bu-
reau; 
‘‘(B) identify, improve upon, and expand 
nutrition and physical activity best practices 
targeted to the birth to 5 years of age popu-
lation in the State involved and identify strate-
gies for incorporating parental education and 
other parental involvement; and 
‘‘(C) provide instruction on how to appro-
priately model, direct, and encourage child care 
staff behavior to apply the best practices and 
strategies identified under subparagraph (B). 
‘‘(2) TRAINING ENTITIES.—A grantee may con-
duct the training required under this section di-
rectly, or may provide such training through a con-
tract with— 
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to the prevalence, prevention, and treatment of 
childhood overweight and obesity; 
(B) State or local director of health; and 
(C) tribal health representative. 
(6) 
QUALIFICATIONS.—Members 
appointed 
under paragraph (1) may include— 
(A) individuals involved with providing 
services to children, including health and other 
social services; 
(B) individuals involved with administering 
health insurance coverage to children; 
(C) individuals with experience in public 
health initiatives relating to the prevention and 
treatment of childhood overweight and obesity, 
including coordination of resources and services 
among State and local governments, the Fed-
eral Government, and nongovernmental entities; 
(D) individuals with philanthropic experi-
ence focused on the needs of children relating 
to the prevalence, prevention, and treatment of 
childhood overweight and obesity; 
(E) individuals who have conducted aca-
demic research relating to the prevalence, pre-
vention, and treatment of childhood overweight 
and obesity; and 
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