progress made in carrying out programs funded by grants 
under this section, including— 
(1) the number of individuals served by such 
programs and the barriers and opportunities for ad-
ditional such programs; and 
(2) how such programs have increased access or 
encouraged permanent farmers markets to be estab-
lished near communities that are food deserts. 
(g) DEFINITIONS.—In this section— 
(1) BUREAU-FUNDED SCHOOL.—The term ‘‘bu-
reau-funded school’’ has the meaning given such 
term in section 1146 of the Education Amendments 
of 1978 (25 U.S.C. 2026). 
(2) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means an entity that predominantly serves com-
munities that are food deserts, including— 
(A) a local educational agency or bureau- 
funded school; 
(B) a nonprofit, community-based organi-
zation or entity (including a park and recre-
ation department, recreation center, child care 
facility, or senior center); 
(C) a convenience store; or 
(D) other entity that the Secretaries deem 
to be an eligible entity. 
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(3) ELIGIBLE ORGANIZATION.—The term ‘‘eligi-
ble organization’’ means an organization with exper-
tise in developing and maintaining a virtual farmers 
market. 
(4) LOCAL EDUCATIONAL AGENCY.—The term 
‘‘local educational agency’’ has the meaning given 
such term in section 9101 of the Elementary and 
Secondary Education Act of 1965 (20 U.S.C. 7801). 
(5) FOOD DESERT.—The term ‘‘food desert’’ 
has the meaning given such term in section 7527(a) 
of the Food, Conservation, and Energy Act of 2008 
(Public Law 110–234). 
(6) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Agriculture. 
(7) SWIPE CARD STATIONS.—The term ‘‘swipe 
card stations’’ shall include support for the use of 
electronic benefit transfer cards. 
(8) VIRTUAL
FARMERS
MARKET.—The term 
‘‘virtual farmers market’’ means an online grocery 
store that enables individuals to purchase foods from 
local farms and distributors. 
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SEC. 103. COMMUNITY GARDENING GRANT PROGRAM: 
FRESH FOODS GROWN IN OUR COMMUNITIES 
BY RESIDENTS. 
(a) PROGRAM ESTABLISHED.—From the amounts 
appropriated to carry out this section, the Secretary of 
Agriculture shall award grants to eligible entities to ex-
pand, establish, or maintain urban and Native American 
community gardens. 
(b) APPLICATION.—In order to receive a grant under 
this section, an eligible entity shall submit to the Secretary 
an application at such time, in such manner, and con-
taining such information as the Secretary may require, in-
cluding— 
(1) an assurance that priority for hiring for 
jobs created by the expansion, establishment, or 
maintenance of an urban community garden funded 
with a grant received under this section will be given 
to individuals who reside in the community where 
the garden is located; and 
(2) a demonstration that the eligible entity is 
committed to providing non-Federal financial or in- 
kind support (such as, but not limited to, providing 
a water supply) for the community garden for which 
the entity receives funds under this section. 
(c) DEFINITIONS.—In this section: 
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(1) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means— 
(A) a for profit or nonprofit organization; 
or 
(B) a unit of general local government, or 
tribal government, located on tribal land or in 
a low-income community. 
(2) LOW-INCOME COMMUNITY.—The term ‘‘low- 
income community’’ has the meaning given such 
term by the Secretary of Agriculture. 
(3) 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. 
(4) 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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SEC. 104. STUDY TO CERTIFY THE ADEQUACY OF CAFE-
TERIA EQUIPMENT FOR THE PREPARATION 
AND STORAGE OF FOODS WITHIN THE DIE-
TARY GUIDELINES. 
Not later than 4 years after the date of the enact-
ment of this Act or the Improving Nutrition for America’s 
Children Act, whichever occurs first, from the amounts ap-
propriated to carry out this section, the Secretary of Agri-
culture shall— 
(1) conduct a study— 
(A) on the adequacy of cafeteria equipment 
used by schools participating in the school 
lunch program established under the Richard 
B. Russell National School Lunch Act (42 
U.S.C. 1751 et seq.) to store and prepare fruits 
and vegetables and other foods that are within 
the Dietary Guidelines for Americans published 
under section 301 of the National Nutrition 
Monitoring and Related Research Act of 1990 
(7 U.S.C. 5341); and 
(B) on the barriers of the schools in ac-
quiring cafeteria equipment that adequately 
stores and prepares such foods; and 
(2) transmit a report to Congress on— 
(A) the findings of the study; and 
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(B) any recommendations based on the 
study, including whether any cafeteria equip-
ments should be updated or exchanged. 
Subtitle B—Access to Nutritious 
and Quality Foods in Under-
served American Communities 
SEC. 111. 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 supermarkets that sell fresh fruits 
and produce in low-income communities 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 a su-
permarket in a low-income community located in a food 
desert and assist the supermarket in carrying out the fol-
lowing activities: 
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(1) Selling fresh fruit and produce at a price 
comparable to the price of fresh fruits and produce 
sold at supermarkets in nearby suburban commu-
nities. 
(2) Making the supermarket available for 
youth-centered, hands-on educational instruction and 
information on healthy cooking and nutrition. 
(3) Providing community outreach services to 
the low-income community that encourage health 
and wellness. 
(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) 
of the Food, Conservation, and Energy Act of 2008 
(Public Law 110–234). 
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(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 public or private organization. 
(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. 
(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 
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any city, county, town, township, parish, village, or 
other general purpose political subdivision of a 
State. 
SEC. 112. EXPANSION OF THE CHILD CARE AND ADULT 
FOOD CARE PROGRAM TO INCREASE AVAIL-
ABILITY OF AFTER SCHOOL SNACKS. 
Section 17(r)(5) of the Richard B. Russell National 
School Lunch Act (42 U.S.C. 1766(r)(5)) is amended— 
(1) by striking ‘‘The Secretary’’ and inserting 
the following: 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), the Secretary’’; and 
(2) by adding at the end the following: 
‘‘(B) PROGRAM
EXPANSION.—Beginning 
with the first full school year after the date of 
enactment of the Fit for LIFE Act of 2010, the 
Secretary shall expand reimbursement under 
this subsection for meals served under a pro-
gram to institutions located in any State that 
elects to participate under this subsection.’’. 
SEC. 113. 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— 
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(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’’; 
(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 
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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’’; 
(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. 114. 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— 
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(1) in paragraph (1)(C), by striking ‘‘50 per-
cent’’ and inserting ‘‘40 percent’’; 
(2) by repealing paragraph (9); 
(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’’; 
(B) in subparagraph (C), by striking ‘‘fis-
cal year 2006’’ and inserting ‘‘fiscal year 
2011’’; 
(C) in subparagraph (D)— 
(i) by striking ‘‘January 1, 2008’’ and 
inserting ‘‘January 1, 2011’’; and 
(ii) by striking ‘‘January 1, 2009’’ 
and inserting ‘‘January 1, 2012’’; and 
(D) by striking subparagraph (E); and 
(4) by adding at the end the following: 
‘‘(11) START-UP
AND
EXPANSION
GRANTS.— 
From the amounts appropriated to carry out this 
paragraph, the Secretary shall award grants to eligi-
ble service institutions in high-poverty districts, as 
defined by the Secretary, to assist such institutions 
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in participating, or expanding the participation of 
such institutions, in the program under this section, 
for the purpose of serving additional children under 
the program.’’. 
SEC. 115. GRANTS FOR EXPANSION OF SCHOOL BREAKFAST 
PROGRAMS TO IMPROVE THE HEALTH AND 
EDUCATION OF CHILDREN. 
The Child Nutrition Act of 1966 (42 U.S.C. 1771 
et seq.) is amended by adding at the end the following: 
‘‘SEC. 23. GRANTS FOR EXPANSION OF SCHOOL BREAKFAST 
PROGRAMS TO IMPROVE THE HEALTH AND 
EDUCATION OF CHILDREN. 
‘‘(a) DEFINITION OF QUALIFYING SCHOOL.—In this 
section, the term ‘qualifying school’ means— 
‘‘(1) a school providing elementary or secondary 
education where at least 65 percent of the enrolled 
students are eligible for free or reduced-price school 
lunches under the school lunch program established 
under the Richard B. Russell National School Lunch 
Act (42 U.S.C. 1751 et seq.); or 
‘‘(2) an after-school program operating on 
school grounds. 
‘‘(b) ESTABLISHMENT.—The Secretary shall estab-
lish a program under which the Secretary shall provide 
grants, on a competitive basis, to local educational agen-
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cies or bureau-funded schools for use in accordance with 
this section. 
‘‘(c) GRANTS TO LOCAL EDUCATIONAL AGENCIES OR 
BUREAU-FUNDED SCHOOLS.—The amount of grants pro-
vided by the Secretary to local educational agencies or bu-
reau-funded schools for a fiscal year under this section 
shall not exceed the lesser of— 
‘‘(1) the product obtained by multiplying— 
‘‘(A) the number of qualifying schools re-
ceiving subgrants or other benefits under sub-
section (d) for the fiscal year; and 
‘‘(B) the maximum amount of a subgrant 
provided to a qualifying school under subsection 
(d)(3)(B); or 
‘‘(2) $2,000,000. 
‘‘(d) SUBGRANTS TO QUALIFYING SCHOOLS.— 
‘‘(1) IN GENERAL.—A local educational agency 
or a bureau-funded school receiving a grant under 
this section shall use funds made available under the 
grant to award subgrants to individual or groups of 
qualifying schools to carry out activities in accord-
ance with this section. 
‘‘(2) STATE AND DISTRICT SUPPORT.—A local 
educational agency or a bureau-funded school may 
allocate a portion of each subgrant to support State 
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or local educational agency or a bureau-funded 
school activities in support of qualified schools for 
which it is more efficient or appropriate to support 
the activities in a centralized manner. 
‘‘(3) AMOUNT; TERM.— 
‘‘(A) IN GENERAL.—Except as otherwise 
provided in this paragraph, a subgrant provided 
by a local educational agency or a bureau-fund-
ed school to a qualifying school under this sec-
tion shall be in such amount, and shall be pro-
vided for such term, as the local educational 
agency or a bureau-funded school determines 
appropriate. 
‘‘(B) MAXIMUM AMOUNT.—The amount of 
a subgrant provided by a local educational 
agency or a bureau-funded school to a quali-
fying school under this subsection shall not ex-
ceed— 
‘‘(i) $50,000 for a single fiscal year; 
or 
‘‘(ii) $100,000 for all fiscal years. 
‘‘(C) MAXIMUM
GRANT
TERM.—A local 
educational agency or a bureau-funded school 
shall not provide subgrants to a qualifying 
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school under this subsection for more than 5 
fiscal years. 
‘‘(e) PREFERENCE.—In providing subgrants under 
this section, a local educational agency or a bureau-funded 
school shall give priority to qualifying schools— 
‘‘(1) in which 75 percent or more of the stu-
dents enrolled in such schools are eligible for free or 
reduced-price school lunches under the school lunch 
program established under the Richard B. Russell 
National School Lunch Act (42 U.S.C. 1751 et 
seq.); and 
‘‘(2) that demonstrate— 
‘‘(A) an intent to use the grants or sub-
grants to establish or support connections be-
tween the qualifying schools and local agricul-
tural producers and food providers; 
‘‘(B) that the qualifying schools have es-
tablished, or intend to establish, a universal 
free breakfast program; or 
‘‘(C) that the qualifying schools have con-
sidered, or intend to establish, service methods 
that make breakfast a part of the school day. 
‘‘(f) BEST PRACTICES.—Prior to awarding grants 
under this section, the Secretary shall make available to 
State educational agencies and local educational agencies 
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or bureau-funded schools information regarding the most 
effective mechanisms by which to increase school breakfast 
participation among eligible children at qualifying schools, 
including best practices of schools who have increased 
breakfast participation.. 
‘‘(g) APPLICATION.— 
‘‘(1) IN GENERAL.—To be eligible to receive a 
grant under this section, a local educational agency 
or a bureau-funded school shall submit to the Sec-
retary an application at such time, in such manner, 
and containing such information as the Secretary 
may require. 
‘‘(2) ADMINISTRATION.—In carrying out this 
section, the Secretary shall— 
‘‘(A) develop an appropriate application 
process; and 
‘‘(B) advertise the availability of funds 
under this section to qualified schools, local 
educational agencies or bureau-funded schools, 
and State educational agencies. 
‘‘(h) USE OF FUNDS.— 
‘‘(1) IN
GENERAL.—A qualifying school may 
use a grant provided under this section— 
‘‘(A) to establish, promote, or expand a 
school breakfast program of the qualifying 
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school under this section, which shall include a 
nutritional education component; 
‘‘(B) to increase the quantity of local or 
fresh food available under the school breakfast 
program of the qualifying school under this sec-
tion; 
‘‘(C) to provide school breakfast to stu-
dents of the qualifying school during the school 
day; and 
‘‘(D) to increase participation in the school 
breakfast program, including through a uni-
versal free breakfast program. 
‘‘(2) REQUIREMENT.—Each activity of a quali-
fying school under this subsection shall be carried 
out in accordance with applicable nutritional guide-
lines and regulations issued by the Secretary. 
‘‘(i) MAINTENANCE
OF
EFFORT.—Grants made 
available under this section shall not diminish or otherwise 
affect the expenditure of funds from State and local 
sources for the maintenance of the school breakfast pro-
gram. 
‘‘(j) REPORTS.— 
‘‘(1) IN GENERAL.—The Secretary, in consulta-
tion with local educational agencies or bureau-fund-
ed schools and qualifying schools that receive grants 
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and subgrants under this section, shall submit to 
Congress an annual report describing the impact of 
the school breakfast programs of the qualifying 
schools on classroom performance and environment. 
‘‘(2) DATA COLLECTION.—The Secretary shall 
provide guidance and minimum standards for data 
collection to grant recipients and any collaborating 
local institutions of higher education or research en-
tities as necessary to ensure that annual reports 
under this section are able to provide an adequate 
qualitative and quantitative evaluation of the grant 
impacts. 
‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as are necessary for each of fiscal years 2011 
through 2015.’’. 
SEC. 116. 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— 
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(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 
amount and type of physical activity of such juve-
niles; and 
(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 amount and type of physical activity by juve-
niles, 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. 117. 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-
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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. 
(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. 
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(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. 
(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 
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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. 
Subtitle C—Ensuring a Healthy 
Start for Children in Under-
served American Communities 
SEC. 121. 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: 
‘‘(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-
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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 
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 
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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 
‘‘(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. 
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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 
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 
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‘‘(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— 
‘‘(A) an appropriate national, State, or 
community organization with relevant expertise; 
‘‘(B) a health care provider or professional 
organization with relevant expertise; 
‘‘(C) a university or research center that 
employs faculty with relevant expertise; or 
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‘‘(D) any other entity determined appro-
priate by the State and approved by the Sec-
retary. 
‘‘(3) REQUIREMENT OF CONTRACT.—If a grant-
ee elects to provide the training under this section 
through a contract, the grantee shall ensure that a 
consistent healthy eating and physical activity cur-
riculum is being developed for all child care entities 
participating in the pilot program in the State. 
‘‘(d) 
PRACTICE, 
CURRICULA, 
AND
POLICY 
CHANGES.—After training is provided as required under 
subsection (c), a State grantee shall ensure that the orga-
nizations and consortium involved— 
‘‘(1) implement, in child care settings, evidence- 
based or data-informed policy changes that promote 
healthy eating, physical activity, and appropriate 
screen time limits among the birth to 5 years of age 
population; 
‘‘(2) utilize an evidence-based or data-informed, 
culturally competent healthy eating and physical ac-
tivity curriculum in child care settings focusing on 
such birth to age 5 population; 
‘‘(3) implement programs, activities, and proce-
dures for incorporating parental education and in-
volvement of parents in programs, including dissemi-
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nating a written parental involvement policy, and co-
ordinating and integrating parental involvement 
strategies under this section, to the extent feasible 
and appropriate, with parental involvement strate-
gies under other programs, such as the Head Start 
program and the Early Head Start Program; and 
‘‘(4) find innovative ways to remove barriers 
that exist to providing opportunities for healthy eat-
ing and physical activity. 
All activities described in this paragraph shall be evidence- 
based and data-informed and be consistent with the cur-
riculum presented through training activities described in 
subsection (c). 
‘‘SEC. 399OO–2. GRANTS FOR THE EVALUATION OF PILOT 
PROGRAMS. 
‘‘The Secretary shall award competitive grants to 
Prevention Research Centers or universities to evaluate 
the programs carried out with grants under section 
399OO–1, including baseline, process, and outcome meas-
urements. 
‘‘SEC. 399OO–3. COORDINATION. 
‘‘(a) INTERAGENCY COORDINATION.—To the extent 
practicable, the Secretary shall coordinate activities con-
ducted under this part with activities undertaken by the 
National Prevention, Health Promotion and Public Health 
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Council established under section 4001 of the Patient Pro-
tection and Affordable Care Act (Public Law 111–148). 
Where practicable, such coordination shall— 
‘‘(1) include the sharing of current and emerg-
ing best practices concerning healthy eating, physical 
activity, and screen time limits that have a popu-
lation-level impact in promoting nutrition and phys-
ical activity in child care settings; 
‘‘(2) promote the effective implementation and 
sustainability of such programs; and 
‘‘(3) avoid unnecessary duplication of effort. 
‘‘(b) PILOT COORDINATION.—The Secretary shall 
designate an individual (directly or through contract) to 
provide technical assistance to States and pilot centers in 
the development, implementation, and evaluation of activi-
ties and dissemination of information described in para-
graphs (1), (2), and (3) of subsection (a). 
‘‘SEC. 399OO–4. EVALUATION AND REPORTING. 
‘‘(a) TECHNICAL ASSISTANCE AND INFORMATION.— 
The Secretary shall— 
‘‘(1) provide technical assistance to grantees 
and other entities providing training under a grant 
under this part; and 
‘‘(2) disseminate to health departments and 
trainers under grants under this part information 
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concerning evidence-based or data-informed ap-
proaches, including dissemination of existing tool-
kits, curricula, and existing or emerging best prac-
tices that can be expanded or improved upon 
through a program conducted under this part. 
‘‘(b) EVALUATION REQUIREMENTS.—With respect to 
evaluations conducted under section 399OO–2, the Sec-
retary shall ensure that— 
‘‘(1) evaluation metrics are consistent across all 
programs funded under this part; 
‘‘(2) interim outcomes are measured by the 
number of centers that have implemented policy and 
environmental strategies that support use of cur-
ricula and practices supporting healthy eating, phys-
ical activity, and screen time limits; 
‘‘(3) interim outcomes are measured, to the ex-
tent possible, by behavior changes in healthy eating, 
physical activity, and screen time; and 
‘‘(4) upon completion of the program, the eval-
uation shall include an identification of best prac-
tices relating to behavior change and reductions in 
the increasing prevalence of overweight and obesity 
that could be replicated in other settings. 
‘‘(c) DISSEMINATION OF INFORMATION.—Upon the 
conclusion of the programs carried out under this part, 
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the Secretary shall disseminate to all appropriate agencies 
within the Department of Health and Human Services evi-
dence, best practices, and lessons learned from grantees. 
Such agencies shall encourage the adoption of the best 
practices. 
‘‘(d) REPORT
TO CONGRESS.—Not later than 6 
months after the completion of the pilot program under 
this part, the Secretary shall submit to Congress a report 
concerning the evaluation of the pilot programs, including 
recommendations as to how lessons learned from such pro-
grams can be incorporated into future guidance docu-
ments developed and provided by the Secretary and other 
Federal agencies, as appropriate. 
‘‘SEC. 399OO–5. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There is authorized to be appropriated to carry out 
this part, $2,500,000 for each of fiscal years 2011, 2012 
and 2013.’’. 
SEC. 122. HEALTH AND FITNESS SCHOOL PROGRAMS: 
TRAINING 
AMERICA’S 
YOUTH 
TO 
LIVE 
HEALTHY LIFESTYLES. 
(a) IN GENERAL.—The Secretaries shall carry out a 
2-year pilot program consisting of awarding grants to eli-
gible entities for the purpose of establishing or expanding 
evidence-informed health and fitness programs in sec-
ondary schools in low-income communities. 
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(b) HEALTH
AND FITNESS PROGRAM REQUIRE-
MENTS.—As a condition on receipt of a grant under this 
section, an eligible entity shall agree that any health and 
fitness program at a secondary school funded through the 
grant will— 
(1) be conducted in partnership with the sec-
ondary school, community entities, local contributors 
of funds, and tribal councils; 
(2) include services by recent graduates of insti-
tutions of higher education who are interested in 
pursuing graduate degrees in medicine, nursing, nu-
trition science, exercise physiology, public health, or 
a related discipline; 
(3) use services by such graduates to supple-
ment rather than supplant the health and fitness 
curriculum of the secondary school; 
(4) include a highly effective student-mentor 
intervention and education program conducted by 
such graduates for a maximum of 2 years of service 
in 1 secondary school per graduate; 
(5) build a healthier community through 
wellness activities and increased awareness about 
and access to healthy foods; 
(6) provide daily health and fitness instruction 
to both students and faculty; 
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(7) conduct an annual in-school health fair 
using the services of secondary school students with 
the objective of building a healthier community 
through wellness activities and increased awareness 
about and access to healthy foods; 
(8) conduct an annual school-based and an an-
nual community-based health fair using the services 
of secondary school students with the objective of 
building a healthier community through wellness ac-
tivities and increased awareness about and access to 
healthy foods; and 
(9) expose secondary school students to a vari-
ety of career choices in wellness and health-related 
disciplines, including careers in medicine, nursing, 
nutrition science, and exercise physiology. 
(c) NON-FEDERAL FUNDS.—The Secretaries shall 
encourage grantees under this section to contribute funds 
from non-Federal sources to increase— 
(1) the number of secondary schools at which 
health and fitness programs are offered; or 
(2) the longevity of such programs. 
(d) MINIMUM NUMBER OF SCHOOLS.—The Secre-
taries shall ensure that grants under this section are used 
to establish or expand health and fitness programs at a 
total of not less than 20 schools. 
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(e) ASSESSMENT; REPORTING.—As conditions on re-
ceipt of a grant under this section, an eligible entity shall 
agree to— 
(1) conduct an annual assessment of health and 
fitness programs funded through the grant using the 
Centers for Disease Control and Prevention’s School 
Health Index; 
(2) on an annual basis, report the findings of 
each assessment under paragraph (1) to the partici-
pating school, community partners, local contribu-
tors of funds, and tribal councils; and 
(3) not later than the end of fiscal year 2012, 
submit a report to the Secretaries and an appro-
priate representative of the Centers for Disease Con-
trol and Prevention on the success of the programs 
in educating children and families and thereby pre-
venting or reducing childhood obesity, including data 
from each assessment under paragraph (1). 
(f) DEFINITIONS.—In this section: 
(1) The term ‘‘secondary school’’ has the mean-
ing given to such term in section 9101 of the Ele-
mentary and Secondary Education Act of 1965 (20 
U.S.C. 7801). 
(2) The term ‘‘eligible entity’’ means a non-
profit organization or entity with the ability to meet 
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the requirements applicable to a grantee under this 
section, as determined by the Secretaries. 
(3) The term ‘‘low-income communities’’ in-
cludes— 
(A) communities with a high percentage of 
children eligible for free and reduced priced 
lunches under the Richard B. Russell National 
School Lunch Act (42 U.S.C. 1751 et seq.); 
and 
(B) any other communities determined by 
the Secretaries to be low-income for purposes of 
this section. 
(4) The term ‘‘Secretaries’’ means the Sec-
retary of Health and Human Services and the Sec-
retary of Education, acting jointly and in conjunc-
tion with the Director of the Centers for Disease 
Control and Prevention. 
(g) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$1,400,000 for the period of fiscal years 2011 through 
2012. 
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TITLE II—ADVANCING PREVENT-
ATIVE 
MEASURES 
AND 
TREATMENT OF OBESITY IN 
ADULTS AND CHILDREN IN 
UNDERSERVED 
COMMU-
NITIES 
SEC. 201. COMMUNITY HEALTH AND WELLNESS NAVIGA-
TORS PILOT PROGRAM: CONNECTING AMER-
ICA’S HEALTH PROFESSIONAL WITH OUR 
SCHOOLS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall award grants to 5 or more States 
for the establishment of a community navigator program, 
consisting of each such State making subgrants to 1 or 
more eligible entities for a local community navigator pro-
gram described in subsection (b). 
(b) PROGRAM DESCRIPTION.—A local community 
navigator program described in this subsection shall con-
sist of the following: 
(1) An eligible entity, in partnership with a 
local educational agency, a bureau-funded school, or 
a nonprofit health or education organization, will 
hire and train 2 or more community navigators. 
(2) The community navigators will facilitate a 
relationship between the eligible entity and the local 
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educational agency, bureau-funded school, or non-
profit health or education organization in low-income 
communities to ensure increased access to medical 
care through educating parents and school adminis-
trators. 
(3) The community navigators will carry out 
educational activities for elementary school and sec-
ondary school students and their parents in low-in-
come communities with the goal of— 
(A) increasing familial intake of nutritious 
meals; 
(B) increasing physical activity both in and 
out of the school setting; and 
(C) increasing access to medical care. 
(c) REPORT.—Not later than 2 years after the date 
of the enactment of this Act, the Secretary shall submit 
a report to the Congress on the effectiveness of the pro-
gram under this section. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘bureau-funded school’’ has the 
meaning given such term in section 1146 of the 
Education Amendments of 1978 (25 U.S.C. 2026). 
(2) The terms ‘‘elementary school’’, ‘‘local edu-
cational agency’’, and ‘‘secondary school’’ have the 
meanings given to such terms in section 9101 of the 
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Elementary and Secondary Education Act of 1965 
(20 U.S.C. 7801). 
(3) The term ‘‘eligible entity’’ includes a Feder-
ally qualified health center (as defined in section 
1861(aa) of the Social Security Act (42 U.S.C. 
1395x(aa))), a facility operated by the Indian 
Health Service (including a facility operated by an 
Indian tribe or tribal organization through a con-
tract or compact with the Service under the Indian 
Self-Determination and Education Assistance Act 
(25 U.S.C. 450 et seq.)), a free-standing children’s 
hospital that is described in subparagraph (L) or 
(M) of section 340B(a)(4) of the Public Health 
Service Act (42 U.S.C. 256b(a)(4)), a non-profit 
with demonstrated effectiveness in the area of 
healthcare and with a focus on serving low-income 
communities, a rural hospital, and a rural health 
clinic. 
(4) The term ‘‘low-income communities’’ in-
cludes— 
(A) communities with a high percentage of 
children eligible for free and reduced priced 
lunches under the Richard B. Russell National 
School Lunch Act (42 U.S.C. 1751 et seq.); 
and 
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(B) any other communities determined by 
the Secretaries to be low-income for purposes of 
this section. 
(5) The term ‘‘nonprofit health or education or-
ganization’’ shall be defined by the Secretary. 
(6) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
(7) The term ‘‘State’’ includes the District of 
Columbia and any commonwealth, territory, or pos-
session of the United States, including the Common-
wealth of Puerto Rico, the Virgin Islands, Guam, 
American Samoa, and the Commonwealth of the 
Northern Mariana Islands. 
(e) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
such sums as may be necessary for fiscal years 2011 and 
2012. 
SEC. 202. REQUIREMENT TO EXPEDITE NATIONAL MEDI-
CARE COVERAGE DETERMINATIONS FOR EVI-
DENCE-BASED PREVENTIVE SERVICES. 
(a) IN GENERAL.—Not later than January 1, 2011, 
the Secretary of Health and Human Services shall issue 
national Medicare coverage determinations for evidence- 
based preventive and treatment services, including services 
to prevent or treat overweight and obesity that have in 
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effect a rating of ‘A’ or ‘B’ (relating to a classification 
representing strongly recommended or recommended serv-
ices) in the current recommendations of the United States 
Preventive Services Task Force (in this section referred 
to as ‘‘USPSTF’’) and clinical services for preventing and 
treating overweight and obesity as defined by the National 
Heart, Lung and Blood Institute’s (in this section referred 
to as ‘‘NHLBI’’) Clinical Guidelines on the Identification, 
Evaluation and Treatment of Overweight and Obesity in 
Adults. The Secretary shall update such coverage deter-
minations based on future updates to such USPSTF and 
NHLBI guidelines. 
(b) UPDATING RECOMMENDATIONS.—The Secretary 
shall instruct— 
(1) the Agency for Healthcare Research and 
Quality and the USPSTF to update, by not later 
than one year after the date of the enactment of this 
Act and at least once every 5 years thereafter, 
USPSTF recommendations relating to the preven-
tion of overweight and obesity that have in effect a 
rating of ‘I’ (relating to a classification representing 
insufficient evidence to make a recommendation for 
the service involved) to determine if such rating 
should be upgraded to a rating of ‘‘A’’ or ‘‘B’’; and 
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(2) the National Heart, Lung and Blood Insti-
tute to update, by not later than December 31, 
2010, and at least once every 3 years thereafter, the 
NHLBI Clinical Guidelines described in subsection 
(a). 
SEC. 203. EXPANSION OF OBESITY TREATMENT SERVICES 
UNDER MEDICARE. 
(a) COVERAGE.—Section 1861 of the Social Security 
Act (42 U.S.C. 1395x), as amended by section 4103 of 
the Patient Protection and Affordable Care Act (Public 
Law 111–148), is further amended— 
(1) in subsection (s)(2)— 
(A) in subparagraph (EE), by striking at 
the end ‘‘and’’; 
(B) in subparagraph (FF), by adding at 
the end ‘‘and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(GG) items and services furnished under 
an obesity treatment program (as defined in 
subsection (iii));’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(iii) OBESITY TREATMENT PROGRAM.—The term 
‘obesity treatment program’ means— 
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‘‘(1) medical services delivered to eligible indi-
viduals under a plan of care for the purpose of re-
ducing body mass index and the associated co- 
morbidities of obesity, including the following: 
‘‘(A) the development of an initial plan of 
care and subsequent revisions to that plan of 
care; 
‘‘(B) medical and surgical interventions as 
determined appropriate by the Secretary; and 
‘‘(C) additional services for which payment 
would not otherwise be made under this title 
that the Secretary may specify that encourage 
the receipt of, or improve the effectiveness of, 
the services described in the preceding subpara-
graphs. 
In carrying out subparagraph (C), the Secretary 
shall consider recommendations of the United States 
Preventive Services Task Force; clinical practice 
guidelines for treatment of overweight, obesity, and 
severe obesity issued by professional medical soci-
eties; and consensus statements and guidelines on 
effective treatment of overweight, obesity, and severe 
obesity issued by the National Institutes of Health, 
professional medical societies, and other authori-
tative sources (such as those identified in the Na-
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tional Heart Lung and Blood Institute’s Clinical 
Guidelines on the Identification, Evaluation, and 
Treatment of Overweight and Obesity in Adults). 
‘‘(2) For purposes of this subsection, the term 
‘eligible individual’ means an individual who has— 
‘‘(A) been diagnosed with obesity by a phy-
sician (as defined in subsection (r)) or provider 
of services (as defined in subsection (u)); 
‘‘(B) a body mass index of at least 30; or 
‘‘(C) a body mass index of at least 27 with 
at least one weight-related comorbid condition. 
It is not necessary for such individual to be diag-
nosed with co-morbidities in addition to the obesity 
diagnosis or body mass index of at least 30 in order 
to be considered an ‘eligible individual’ under this 
subsection.’’. 
(b) PAYMENT.—Section 1833(a)(1) of the Social Se-
curity Act (42 U.S.C. 1395l(a)(1)), as amended by section 
10501(h)(3)(B) of the Patient Protection and Affordable 
Care Act (Public Law 111–148), is amended— 
(1) by striking ‘‘and’’ before ‘‘(Z)’’; and 
(2) by inserting before the semicolon at the end 
the following: ‘‘, and (AA) with respect to items and 
services furnished under an obesity treatment pro-
gram (as defined in section 1861(iii)), the amount 
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paid shall be 80 percent of the lesser of the actual 
charge for the services or the amount determined 
under a fee schedule established by the Secretary for 
purposes of this subparagraph’’. 
SEC. 204. COVERAGE OF EVIDENCE-BASED PREVENTIVE 
SERVICES UNDER MEDICAID AND SCHIP. 
(a) STATE OPTION TO PROVIDE MEDICAL ASSIST-
ANCE FOR EVIDENCE-BASED PREVENTIVE SERVICES.— 
(1) IN GENERAL.—Section 1905 of the Social 
Security Act (42 U.S.C. 1396d)— 
(A) in subsection (a), as amended by sec-
tion 2301(a) of the Patient Protection and Af-
fordable Care Act, is further amended— 
(i) in paragraph (28), by striking 
‘‘and’’ at the end; 
(ii) by redesignating paragraph (29) 
as paragraph (30); and 
(iii) by inserting after paragraph (28) 
the following: 
‘‘(29) evidence-based preventive services de-
scribed in subsection (dd); and’’; and 
(B) as amended by section 10201(c)(6) of 
the Patient Protection and Affordable Care Act, 
is further amended by adding at the end the 
following: 
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‘‘(dd) For purposes of subsection (a)(29), evidence- 
based preventive services described in this subsection are 
any preventive services which the Secretary has deter-
mined are reasonable and necessary, including, as so de-
termined, diet and exercise counseling, healthy weight and 
obesity counseling, and any other evidence-based, effective 
clinical intervention for obese individuals, including phar-
macological or surgical services, designed to prevent 
comorbidities of obesity.’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
1902(a)(10)(C)(iv) of such Act is amended by in-
serting ‘‘, and (29)’’ after ‘‘(24)’’. 
(b) STATE OPTION TO PROVIDE CHILD HEALTH AS-
SISTANCE
FOR EVIDENCE-BASED PREVENTIVE SERV-
ICES.—Section 2110(a) of the Social Security Act (42 
U.S.C. 1397jj(a)) is amended— 
(1) by redesignating paragraph (28) as para-
graph (29); and 
(2) by inserting after paragraph (27) the fol-
lowing: 
‘‘(28) Evidence-based preventive services de-
scribed in section 1905(dd).’’. 
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SEC. 205. COVERAGE OF MEDICAL NUTRITION THERAPY 
UNDER MEDICAID AND SCHIP. 
(a) STATE OPTION TO PROVIDE MEDICAL ASSIST-
ANCE FOR MEDICAL THERAPY SERVICES.— 
(1) IN GENERAL.—Section 1905(a) of the So-
cial Security Act (42 U.S.C. 1396d), as amended by 
section 204(a), is amended— 
(A) in paragraph (29), by striking ‘‘and’’ 
at the end; 
(B) by redesignating paragraph (30) as 
paragraph (31); and 
(C) by inserting after paragraph (29) the 
following: 
‘‘(30) medical nutrition therapy services (as de-
fined in section 1861(vv)(1)) for individuals with 
pre-diabetes or obesity, or who are overweight (as 
defined by the Secretary); and’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
1902(a)(10)(C)(iv) of such Act, as amended by sec-
tion 204(a)(2), is amended by striking ‘‘and (29)’’ 
and inserting ‘‘(29), and (30)’’. 
(b) STATE OPTION TO PROVIDE CHILD HEALTH AS-
SISTANCE
FOR MEDICAL NUTRITION THERAPY SERV-
ICES.—Section 2110(a) of the Social Security Act (42 
U.S.C. 1397jj(a)), as amended by section 204(b), is 
amended— 
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(1) by redesignating paragraph (29) as para-
graph (30); and 
(2) by inserting after paragraph (28) the fol-
lowing: 
‘‘(29) Medical nutrition therapy services (as de-
fined in section 1861(vv)(1)) for individuals with 
pre-diabetes or obesity, or who are overweight (as 
defined by the Secretary).’’. 
SEC. 206. CLARIFICATION OF EPSDT INCLUSION OF PRE-
VENTION, 
SCREENING, 
AND 
TREATMENT 
SERVICES FOR OBESITY AND OVERWEIGHT; 
SCHIP COVERAGE. 
(a) IN GENERAL.—Section 1905(r)(5) of the Social 
Security Act (42 U.S.C. 1396d(r)(5)) is amended by in-
serting before the period the following: ‘‘, including weight 
and BMI measurement and monitoring, as well as appro-
priate treatment services, including medical nutrition ther-
apy services (as defined in section 1861(vv)(1)), physical 
therapy or exercise training, behavioral health counseling, 
and such other evidence based services as recommended 
by the Secretary (after taking into consideration the 
American Academy of Pediatrics Expert Committee 
Guidelines Regarding the Prevention, Assessment, and 
Treatment of Child and Adolescent Overweight and Obe-
sity)’’. 
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(b) SCHIP.— 
(1) REQUIRED COVERAGE.—Section 2103 (42 
U.S.C. 1397cc) is amended— 
(A) in subsection (a), in the matter pre-
ceding paragraph (1), by striking ‘‘and (7)’’ 
and inserting ‘‘(7), and (9)’’; and 
(B) in subsection (c)— 
(i) by redesignating paragraph (7) as 
paragraph (9); and 
(ii) by inserting after paragraph (6), 
the following: 
‘‘(7) PREVENTION, SCREENING, AND
TREAT-
MENT SERVICES FOR OBESITY AND OVERWEIGHT.— 
The child health assistance provided to a targeted 
low-income child shall include coverage of weight 
and BMI measurement and monitoring, as well as 
appropriate treatment services (including but not 
limited to) medical nutrition therapy services (as de-
fined in section 1861(vv)(1)), physical therapy or ex-
ercise training, behavioral health counseling, and 
such other evidence based services as recommended 
by the Secretary. For purposes of the previous sen-
tence the Secretary shall take into consideration the 
American Academy of Pediatrics Expert Committee 
Guidelines Regarding the Prevention, Assessment, 
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and Treatment of Child and Adolescent Overweight 
and Obesity.’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
2102(a)(7)(B) (42 U.S.C. 1397bb(c)(2)) is amended 
by striking ‘‘section 2103(c)(5)’’ and inserting 
‘‘paragraphs (5) and (7) of section 2103(c)’’. 
SEC. 207. NATIONAL COMMISSION ON CHILD OBESITY. 
(a) ESTABLISHMENT.—There is established a com-
mission to be known as the National Commission on Child 
Obesity (in this section referred to as the ‘‘Commission’’). 
(b) DUTIES
OF
COMMISSION.—The Commission 
shall— 
(1) conduct a comprehensive study that exam-
ines and assesses the needs of children relating to 
the prevalence, prevention, and treatment of child-
hood overweight and obesity, including specific find-
ings relating to— 
(A) best practices for the prevention and 
treatment of childhood overweight and obesity; 
(B) child physical health and mental 
health; 
(C) child care in all settings; 
(D) child welfare; 
(E) elementary and secondary education; 
(F) food availability in neighborhoods; 
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(G) access to health care; 
(H) health care utilization; 
(I) built environment; 
(J) parent physical health and education; 
(K) underserved communities, including 
tribal communities, health professional shortage 
areas designated under section 332 of the Pub-
lic Health Service Act (42 U.S.C. 254e), medi-
cally underserved areas (as defined in section 
799B of such Act (42 U.S.C. 295p), and areas 
in the Appalachian region (as defined in section 
14102(a) of title 40, United States Code); 
(L) relevant activities in childhood over-
weight and obesity; and 
(M) the availability of information on State 
and Federal supportive nutrition programs, 
such as the Summer Food Service Program, the 
Women, Infants, and Children Program, the 
State Children’s Health Insurance Program 
under title XXI of the Social Security Act, and 
the Supplemental Nutrition Assistance Pro-
gram; 
(2) identify, review, and evaluate existing laws, 
regulations, policies, programs, and public health ini-
tiatives relevant to best practices for the prevalence, 
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prevention, and treatment of childhood overweight 
and obesity; 
(3) identify, review, and evaluate the lessons 
learned from past laws, regulations, policies, pro-
grams, and public health initiatives relevant to the 
prevalence, prevention, and treatment of childhood 
overweight and obesity; 
(4) advise on the need to revise laws, regula-
tions, policies, and programs relative to addressing 
best practices for the prevalence, prevention, and 
treatment of childhood overweight and obesity at 
regular intervals as new knowledge is gained; 
(5) include in the interim report required by 
subsection (i)(1) recommendations on— 
(A) the appropriate Federal agency to es-
tablish the infrastructure for the creation of a 
comprehensive nationwide registry of patient 
data associated with children living with obe-
sity; 
(B) the specific criteria needed for such 
registry to allow the field of pediatric clinicians 
access to patient-level, clinical data suitable for 
research and the development of best practices; 
(C) the appropriate funding level required 
for the establishment and implementation of 
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such the registry described in subparagraph 
(A); and 
(D) how to capture large-scale data that 
are currently unavailable on adolescent and 
child patients who are currently obese; and 
(6) include in the final report required by sub-
section (i)(3) the Commission’s specific findings, 
conclusions, and recommendations to address the 
needs of children relating to the prevention and 
treatment of childhood overweight and obesity, in-
cluding specific recommendations on— 
(A) the need for planning and establishing 
a national resource center for children and obe-
sity; and 
(B) such coordination of resources and 
services, administrative actions, policies, regula-
tions, and legislative changes as the Commis-
sion considers appropriate. 
(c) COMPOSITION.— 
(1) MEMBERS.—The Commission shall be com-
posed of 15 members, of whom— 
(A) 3 members, each of a different political 
party, shall be appointed by the President; 
(B) 3 members shall be appointed by the 
majority leader of the Senate; 
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(C) 3 members shall be appointed by the 
minority leader of the Senate; 
(D) 3 members shall be appointed by the 
Speaker of the House of Representatives; and 
(E) 3 members shall be appointed by the 
minority leader of the House of Representa-
tives. 
(2) APPOINTMENT.—Members of the Commis-
sion shall be appointed not later than 6 months after 
the date of the enactment of this Act. 
(3) CHAIRPERSON, VICE
CHAIRPERSON, AND 
MEETINGS.— 
(A) IN GENERAL.—Not later than 30 days 
after the date on which all members of the 
Commission are appointed under paragraph (1), 
such members shall meet to elect a Chairperson 
and Vice Chairperson from among such mem-
bers and shall determine a schedule of Commis-
sion meetings. 
(B) INITIAL MEETING.—The Commission 
shall meet and begin the operations of the Com-
mission not later than 120 days after the ap-
pointment of members of the Commission. 
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(4) GOVERNMENTAL
APPOINTEES.—An indi-
vidual appointed to the Commission may not be an 
official or employee of the Federal Government. 
(5) COMMISSION REPRESENTATION.—The Com-
mission shall include at least one— 
(A) representative from each of a nonprofit 
and for-profit entity with demonstrated exper-
tise in addressing the needs of children relating 
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; 
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(D) individuals with philanthropic experi-
ence focused on the needs of children relating 
to the prevalence, prevention, and treatment of 
childhood overweight and obesity; and 
(E) individuals who have conducted aca-
demic research relating to the prevalence, pre-
vention, and treatment of childhood overweight 
and obesity. 
(7) QUORUM AND VACANCY.— 
(A) QUORUM.—A majority of the members 
of the Commission shall constitute a quorum, 
but a lesser number of members may hold hear-
ings. 
(B) VACANCY.—Any vacancy in the Com-
mission shall not affect its powers and shall be 
filled in the same manner in which the original 
appointment was made. 
(d) POWERS OF COMMISSION.— 
(1) HEARINGS.—The Commission may hold 
such hearings, meet and act at such times and 
places, and receive such evidence as may be nec-
essary to carry out the functions of the Commission. 
(2) INFORMATION FROM FEDERAL AGENCIES.— 
(A) IN GENERAL.—The Commission may 
access, to the extent authorized by law, from 
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any executive department, bureau, agency, 
board, commission, office, independent estab-
lishment, or instrumentality of the Federal Gov-
ernment such information, suggestions, esti-
mates, and statistics as the Commission con-
siders necessary to carry out this section. 
(B) PROVISION
OF
INFORMATION.—On 
written request of the Chairperson of the Com-
mission, each department, bureau, agency, 
board, commission, office, independent estab-
lishment, or instrumentality of the Federal Gov-
ernment shall, to the extent authorized by law, 
provide the requested information to the Com-
mission. 
(C) RECEIPT, HANDLING, STORAGE, AND 
DISSEMINATION.—Information shall only be re-
ceived, handled, stored, and disseminated by 
members of the Commission and its staff con-
sistent with all applicable statutes, regulations, 
and Executive orders. 
(3) ASSISTANCE FROM FEDERAL AGENCIES.— 
(A) 
GENERAL
SERVICES
ADMINISTRA-
TION.—On request of the Chairperson of the 
Commission, the Administrator of General 
Services shall provide to the Commission, on a 
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reimbursable basis, administrative support and 
other assistance necessary for the Commission 
to carry out its duties. 
(B) OTHER
DEPARTMENTS
AND
AGEN-
CIES.—In addition to assistance under subpara-
graph (A), departments and agencies of the 
United States may provide to the Commission 
such assistance as they determine advisable and 
as authorized by law. 
(4) 
CONTRACTING.—The 
Commission 
may 
enter into financially reasonable contracts to enable 
the Commission to discharge its duties under this 
section. 
(5) POSTAL SERVICES.—The Commission may 
use the United States mails in the same manner and 
under the same conditions as a department or agen-
cy of the United States. 
(e) STAFF OF COMMISSION.— 
(1) IN
GENERAL.—The Chairperson of the 
Commission, in consultation with the Vice Chair-
person, in accordance with rules agreed upon by the 
Commission, may appoint and fix the compensation 
of a staff director, policy director, and administra-
tive assistant (and other staff if agreed upon by a 
majority of Commission members) to enable the 
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Commission to carry out its functions, in accordance 
with the provisions of title 5, United States Code, 
except that no rate of pay fixed under this para-
graph may exceed the equivalent of that payable for 
a position at level V of the Executive Schedule under 
section 5316 of title 5, United States Code. 
(2) STAFF OF FEDERAL AGENCIES.—Upon re-
quest of the Chairperson of the Commission, the 
head of any executive department, bureau, agency, 
board, commission, office, independent establish-
ment, or instrumentality of the Federal Government 
may detail, without reimbursement, any of its per-
sonnel to the Commission to assist it in carrying out 
its duties under this section. Any detail of an em-
ployee shall be without interruption or loss of civil 
service status or privilege. 
(3) CONSULTANT SERVICES.—The Commission 
is authorized to procure (pursuant to a majority vote 
of the Commission members) the services of experts 
and consultants in accordance with section 3109 of 
title 5, United States Code, but at rates not to ex-
ceed the daily equivalent of the annual rate of basic 
pay for level IV of the Executive Schedule under sec-
tion 5315 of title 5, United States Code. 
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(f) TRAVEL EXPENSES.—Each member of the Com-
mission shall serve without compensation, but shall receive 
travel expenses, including per diem in lieu of subsistence, 
in accordance with applicable provisions in the same man-
ner as persons employed intermittently in the Government 
service are allowed expenses under section 5703 of title 
5, United States Code. 
(g) APPLICABILITY OF FACA.—The Federal Advi-
sory Committee Act, including any provisions applicable 
to staff, is deemed to apply to the Commission. 
(h) REPORTS OF COMMISSION; TERMINATION.— 
(1) INTERIM REPORT.—The Commission shall, 
not later than 1 year after the date of its first meet-
ing, submit to the President and the Congress an in-
terim report containing specific findings, conclu-
sions, and recommendations required under this sec-
tion and agreed to by a majority of Commission 
members. 
(2) OTHER REPORTS AND INFORMATION.— 
(A) 
REPORTS.—The 
Commission 
may 
issue additional reports as the Commission de-
termines necessary. 
(B) INFORMATION.—The Commission may 
hold public hearings to collect information and 
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shall make such information available for use 
by the public. 
(3) FINAL
REPORT.—The Commission shall, 
not later than 2 years after the date of its first 
meeting, submit to the President and Congress a 
final report containing specific findings, conclusions, 
and recommendations required under this section 
and agreed to by a majority of Commission mem-
bers. 
(4) TERMINATION.— 
(A) IN GENERAL.—Unless reauthorized by 
statute, the Commission, and all the authorities 
of this section, shall terminate 180 days after 
the date on which the final report is submitted 
under paragraph (3). 
(B) RECORDS.—Not later than the date of 
termination of the Commission under subpara-
graph (A), all records and papers of the Com-
mission shall be delivered to the Archivist of the 
United States for deposit in the National Ar-
chives. 
(i) DEFINITIONS.—In this section: 
(1) OBESITY.—The term ‘‘obesity’’ with respect 
to children means having a body mass index (BMI) 
greater than or equal to the 95th percentile for age 
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and sex according to the Centers for Disease Control 
and Prevention. 
(2) CHILD; CHILDREN.—The terms ‘‘child’’ and 
‘‘children’’ mean an individual or individuals, respec-
tively, who have not attained 18 years of age. 
(j) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
$1,500,000 for each of fiscal years 2011 and 2012. 
SEC. 208. GAO REPORT. 
Not later than 2 years after the first appropriation 
of Federal funds to carry out this Act, the Comptroller 
General of the United States shall submit to Congress a 
report on the effectiveness of the activities carried out 
under this Act in reducing child obesity, which shall in-
clude an analysis of the costs and the benefits of such ac-
tivities. 
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TITLE III—ENCOURAGING PHYS-
ICAL 
ACTIVITY 
IN 
UNDER-
SERVED AMERICAN COMMU-
NITIES 
SEC. 301. RENOVATION OF FORECLOSED AND ABANDONED 
PROPERTIES TO CREATE SPACES THAT EN-
COURAGE PHYSICAL ACTIVITY IN AMERICAN 
NEIGHBORHOODS. 
Section 106(a) of the Housing and Community De-
velopment Act of 1974 (42 U.S.C. 5306(a)) is amended— 
(1) in paragraph (3)— 
(A) by striking ‘‘(1) and’’ and inserting 
‘‘(1),’’; and 
(B) by inserting ‘‘and after reserving such 
amounts for units of general local government, 
special district governments, and Indian tribes 
with high foreclosure rates and great infrastruc-
ture need under paragraph (4),’’ after ‘‘para-
graph (2),’’; 
(2) by redesignating paragraph (4) as para-
graph (5); 
(3) in paragraph (5), as redesignated by para-
graph (2) of this section, by striking ‘‘paragraphs 
(1), (2), and (3)’’ and inserting ‘‘paragraphs (1), 
(2), (3), and (4)’’; and 
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(4) by inserting after paragraph (3) the fol-
lowing new paragraph: 
‘‘(4)(A) For each fiscal year, of the amount ap-
proved in appropriation Acts under section 103 for 
grants for such fiscal year (excluding the amounts 
provided for use in accordance with section 107), the 
Secretary shall reserve for grants to units of general 
local government, special district governments, and 
Indian tribes that the Secretary determines have 
both high foreclosure rates and the greatest infra-
structure needs, based on the scope of the needs, an 
amount the Secretary determines necessary. 
‘‘(B) Grants under this paragraph may be used 
by units of general local government, special district 
governments, and Indian tribes to— 
‘‘(i) renovate foreclosed commercial prop-
erties, abandoned commercial properties, or 
both, to be transformed in community centers, 
public recreation facilities, swimming pools, or 
any other type of facility that will encourage in-
door physical activity; 
‘‘(ii) demolish foreclosed or abandoned 
commercial and residential properties, or both, 
to use the sites for— 
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‘‘(I) the construction of parks, play-
grounds, outdoor swimming pools, tracks, 
soccer fields, baseball diamonds, or any 
other type of facility that will encourage 
outdoor physical activity; 
‘‘(II) community gardens or urban 
farms, particularly in areas that are food 
deserts (as such term is defined in section 
7527(a) of the Food, Conservation, and 
Energy Act of 2008 (Public Law 110– 
234); or 
‘‘(III) mixed used facilities that are 
used for both of the purposes under sub-
clauses (I) and (II) of this clause; and 
‘‘(iii) reconstruct and repair dilapidated 
sidewalks, bike and pedestrian trails, and in-
door and outdoor facilities that encourage phys-
ical activity. 
‘‘(C) In making grants under this paragraph, 
the Secretary shall give priority among units of gen-
eral local government, special district governments, 
and Indian tribes eligible pursuant to subparagraph 
(A)— 
‘‘(i) to units of general local government, 
special district governments, and Indian tribes 
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that demonstrate the ability and willingness to 
work with local educational agencies, devel-
opers, and other community-based organizations 
to enter into mixed-use agreements to maximize 
the use and efficiency of properties renovated, 
constructed, or reconstructed and repaired 
through the use of grant funds; 
‘‘(ii) to units of general local government, 
special district governments, and Indian tribes 
that demonstrate the willingness to recognize 
and promote the involvement of individuals en-
rolled in a national service program authorized 
under the National and Community Service Act 
of 1990 (42 U.S.C. 12501 et seq.) or the Do-
mestic Volunteer Service Act of 1973 (42 
U.S.C. 4950 et seq.) in the renovation, con-
struction, or reconstruction and repair of prop-
erties through the use of grant funds; and 
‘‘(iii) to projects proposed by units of gen-
eral local government, special district govern-
ments, and Indian tribes that are easily acces-
sible, on foot or by public transportation, for 
persons in low-income communities. 
‘‘(D) For purposes of this paragraph, the term 
‘special district government’ means any organized 
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local entity, known by a variety of titles, including 
districts, authorities, boards, and commissions, other 
than a unit of general local government or local edu-
cational agency, authorized by State law to provide 
only one or a limited number of designated func-
tions, and with sufficient administrative and fiscal 
autonomy to qualify as a separate government unit, 
as determined by the Secretary.’’. 
SEC. 302. NATIONAL YOUTH SPORTS PROGRAM REVITAL-
IZATION. 
Section 682(g) of the Community Services Block 
Grant Act (42 U.S.C. 9923(g)) is amended by striking 
‘‘$15,000,000’’ and all that follows through ‘‘2003’’, and 
inserting ‘‘$20,000,000 for each of the fiscal years 2011 
through 2021’’. 
SEC. 303. EXPANSION OF THE ZUNI YOUTH ENRICHMENT 
PROJECT SUMMER CAMP. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall establish a 2-year pilot program to 
provide funds to community-based organizations on Indian 
reservations or tribal lands to plan and implement an en-
richment program for children (in the form of a summer 
camp and a year-round program) for the purpose of— 
(1) reversing the epidemics of obesity, diabetes, 
and alcoholism in such areas; and 
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(2) to mitigate other problems stemming from 
the formation of bad habits and the development of 
low self esteem during childhood. 
(b) PARTNERSHIPS.—In order to qualify for funding 
under subsection (a), a community-based organization 
shall demonstrate, to the satisfaction of the Secretary of 
Health and Human Services, that the community-based 
organization has entered into a partnership with commu-
nity entities, local funders, and tribal leaders (including, 
if applicable, the tribal council) to plan and execute an 
enrichment program under subsection (a). 
(c) NUMBER OF SITES.—The Secretary of Health 
and Human Services, in providing funding under sub-
section (a), shall provide funding to no more than 20 com-
munity-based organizations. 
(d) MODEL AND CAMP REQUIREMENT.—The enrich-
ment program under subsection (a) shall— 
(1) be modeled on similar programs established 
by the Zuni Youth Enrichment Project; and 
(2) shall include a camp of at least 6 weeks in 
duration during the summer. 
(e) SPECIFIC CAMP REQUIREMENTS.— 
(1) DAILY ACTIVITIES.—With respect to chil-
dren attending a camp under subsection (d)(2), the 
leader of the organization that receives funds under 
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subsection (a) shall, for each day of the camp, en-
sure that, such children are— 
(A) involved in at least 60 minutes of 
physical activity (with appropriate accommoda-
tions made for children with disabilities); and 
(B) provided with at least two meals that 
meet national nutritional standards. 
(2) OTHER ACTIVITIES.—Such leader shall also 
ensure that— 
(A) a community gardening activity is in-
cluded in the activities conducted at the camp; 
and 
(B) health and wellness education is pro-
vided to the children attending the camp. 
(f) EVALUATION.— 
(1) IN GENERAL.—A community-based organi-
zation that receives funding under subsection (a), 
shall, as a condition of receiving such funding, con-
duct an evaluation of the enrichment program con-
ducted by such organization. 
(2) MODEL.—The form, manner, content, and 
frequency of the evaluation under paragraph (1) 
shall be modeled on the Zuni Youth Enrichment 
Project standard project evaluation. 
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(g) REPORT.—Not later than 1 year after the date 
on which a community organization first receives funding 
under subsection (a) and annually thereafter, the organi-
zation shall— 
(1) submit a report to the to the Secretary of 
Health and Human Services on the outcomes of the 
enrichment program conducted by the organization 
under this section, including— 
(A) the findings of the evaluation con-
ducted under subsection (f); and 
(B) the impact of such enrichment pro-
gram on the rates of childhood obesity on the 
reservation or area of tribal land served by the 
organization; and 
(2) provide a copy of the findings under para-
graph (1)(A) to community entities, local funders, 
tribal leaders (including, if applicable, the tribal 
council), and the families of children participating in 
the enrichment program. 
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school health initiative in each school under the jurisdic-
tion of the entity under which the entity shall— 
(1) carry out a program, such as a fitnessgram, 
to assess the physical fitness (including aerobic ca-
pacity, muscular strength and endurance, flexibility, 
and body composition) of each student served by the 
entity; and 
(2) evaluate such assessments to— 
(A) establish baselines with respect to aer-
obic capacity, muscular strength and endur-
ance, flexibility, and body composition that each 
such student should meet by a certain period; 
and 
(B) identify interventions to assist each 
such student in meeting such baselines; 
(3) review the interventions identified under 
paragraph (2)(B) to determine the best practices 
with respect to such interventions; 
(4) use the determinations for best practices 
under paragraph (3) to implement interventions in 
each school under the jurisdiction of the entity; and 
(5) not later than 1 year after the implementa-
tion of the interventions, assess the physical fitness 
of each student served by the entity. 
(d) REPORTING.— 
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(1) ELIGIBLE ENTITY.—Each eligible entity re-
ceiving a grant under this section shall submit to the 
Secretary at such time and in such manner as deter-
mined by the Secretary, a report on— 
(A) the initial physical fitness assessments 
carried out under subsection (c)(1); 
(B) the interventions implemented under 
subsection (c)(4); and 
(C) the physical fitness assessments car-
ried out under subsection (c)(5) after the inter-
ventions have been implemented. 
(2) SECRETARY.—Not later than the first ap-
propriation of Federal funds to carry out this sec-
tion, the Secretary shall use the reports received 
under paragraph (1) to prepare and transmit to 
Congress a report on— 
(A) the average physical fitness levels of 
students participating in the coordinated school 
health initiative under this section— 
(i) prior to the interventions imple-
mented by each eligible entity under this 
section; and 
(ii) 1 year after the implementation of 
the interventions; 
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