[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4053 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 4053

To establish the Office of Childhood Overweight and Obesity Prevention 
  and Treatment within the Office of Public Health and Science of the 
    Department of Health and Human Services, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            November 6, 2009

  Mr. Moran of Virginia (for himself and Mr. Pascrell) introduced the 
   following bill; which was referred to the Committee on Energy and 
Commerce, and in addition to the Committee on Education and Labor, for 
a period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
To establish the Office of Childhood Overweight and Obesity Prevention 
  and Treatment within the Office of Public Health and Science of the 
    Department of Health and Human Services, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Healthy Kids Act''.

SEC. 2. FINDINGS.

    The Congress finds the following:
            (1) Over the past 3 decades, the rate of obesity has more 
        than doubled for children aged 2 to 11 years and more than 
        tripled for adolescents aged 12 to 19 years according to the 
        Centers for Disease Control and Prevention.
            (2) Current data from the Centers for Disease Control and 
        Prevention shows that 32 percent of children are overweight, 16 
        percent are obese, and 11 percent are extremely obese.
            (3) In low-income populations, some racial and ethnic 
        groups, and among recent immigrants, the rates of obesity among 
        children and youth are alarmingly high.
            (4) Overweight and obese children are at much greater risk 
        of developing diabetes, heart disease, high blood pressure, 
        asthma, and other diseases than their non-obese peers, and many 
        are subjected to ridicule and bullying that damages their 
        emotional well-being.
            (5) Overweight and obese children are at risk of growing 
        into adults who do not participate fully in the workforce 
        because of employment discrimination, lost productivity due to 
        illness and disability, and premature death.
            (6) In 2008, national health care expenditures associated 
        with adult overweight and obesity exceeded $100,000,000,000.
            (7) Many factors contribute to the childhood obesity 
        epidemic, including eating patterns, family dynamics, economic 
        situations, levels of physical activity, and the influence of 
        media messages.
            (8) Research shows that current food and beverage marketing 
        practices influence children and youth to make choices that are 
        not in keeping with healthful diets, and agreement on effective 
        voluntary industry standards has not been reached.
            (9) Family plays an important role in society and is widely 
        recognized as important in shaping and establishing children's 
        attitudes and behaviors about nutrition.
            (10) Family and consumer sciences education programs can 
        address nutrition, fitness, and positive lifestyle choices as 
        an integral part of the curriculum. Positive health attitudes 
        and habits are the foundation for successful management of 
        daily living and therefore prepare young people to manage the 
        multiple roles of family member, wage earner, and community 
        leader.
            (11) Existing State immunization and health registries 
        present a unique opportunity to create State and national 
        childhood body mass index surveillance systems. Because all 50 
        States currently maintain childhood immunization tracking 
        systems, using such systems to track childhood obesity data is 
        an effective, efficient basis for building a national childhood 
        obesity surveillance system.
            (12) Health screenings under the Medicaid and SCHIP 
        programs are important tools for preventing overweight and 
        obesity, and follow-up counseling and treatment must be 
        available to children suffering from or at risk for these 
        conditions.
            (13) Childhood obesity is a public health crisis that will 
        not be solved without the full support of the Government.
            (14) To address this crisis, it is necessary to coordinate 
        the budgets, policies, programs, and research efforts of 
        Federal agencies and to establish effective interdepartmental 
        collaboration and priorities for action, paying particular 
        attention to the unique needs of diverse groups and high-risk 
        populations.

SEC. 3. FTC REVIEW OF ADVERTISING AND MARKETING OF UNHEALTHY FOODS AND 
              BEVERAGES.

    (a) Determination.--Not later than 3 years after the issuance of 
guidelines by the Office of Childhood Overweight and Obesity Prevention 
and Treatment described in section 1711(b)(7) of the Public Health 
Service Act, the Federal Trade Commission shall--
            (1) promulgate rules that define advertising, promoting, 
        and marketing directed at children and youth including--
                    (A) the age of the intended audience; and
                    (B) the medium used to convey such advertising, 
                promoting, or marketing; and
            (2) promulgate rules under section 553 of title 5, United 
        States Code, consistent with the guidelines issued by the 
        Office of Childhood Overweight and Obesity Prevention and 
        Treatment described in section 1711(b)(7) of the Public Health 
        Service Act, specifying categories of foods and beverages for 
        or about which any advertisement, promotion, or marketing 
        directed at children and youth shall be an abusive, unfair, or 
        deceptive act or practice in or affecting commerce.
    (b) Violation.--A violation of a rule promulgated under subsection 
(a)(2) shall be treated as a violation of a rule defining an unfair or 
deceptive act or practice prescribed under section 18(a)(1)(B) of the 
Federal Trade Commission Act (15 U.S.C. 57a(a)(1)(B)). The Federal 
Trade Commission shall enforce this section in the same manner, by the 
same means, and with the same jurisdiction as though all applicable 
terms and provisions of the Federal Trade Commission Act were 
incorporated into and made a part of this section.
    (c) Repeal.--Section 18(h) of the Federal Trade Commission Act (15 
U.S.C. 57a(h)) is repealed.
    (d) Conforming Amendments.--Subsections (i) and (j) of section 18 
of the Federal Trade Commission Act (15 U.S.C. 57a) are redesignated as 
subsections (h) and (i), respectively.

SEC. 4. FCC LIMITS ON ADVERTISING UNHEALTHY FOODS AND BEVERAGES DURING 
              CHILDREN'S PROGRAMMING.

    Section 102 of the Children's Television Act of 1990 (47 U.S.C. 
303a) is amended--
            (1) by redesignating subsection (d) as subsection (e); and
            (2) by inserting after subsection (c) the following new 
        subsection:
    ``(d) Limitation on Advertising Foods and Beverages of Low 
Nutritional Value to Children.--
            ``(1) In general.--Not later than 30 days after the 
        issuance of guidelines by the Office of Childhood Overweight 
        and Obesity Prevention and Treatment as required by section 
        1711(b)(7) of the Public Health Service Act, the Commission 
        shall initiate a proceeding to revise its regulations with 
        respect to commercial matter in children's television 
        programming for the purpose of limiting the amount of time 
        devoted to advertising foods and beverages of low nutritional 
        value.
            ``(2) Rule contents.--In carrying out the proceeding under 
        paragraph (1), the Commission shall, at a minimum--
                    ``(A) prohibit the showing of any advertisements 
                during or adjacent to children's television programming 
                for foods or beverages classified as Tier 3 under 
                guidelines issued under such section;
                    ``(B) limit the amount of time devoted to 
                advertisements during or adjacent to children's 
                television programming for foods or beverages 
                classified as Tier 2 under such guidelines to 2 minutes 
                per hour on weekends and 3 minutes per hour on 
                weekdays; and
                    ``(C) apply such prohibitions and limitations to 
                commercial television broadcast licensees and to direct 
                broadcast satellite (DBS) providers, as defined in 
                section 25.701(a) of the Commission's rules (47 CFR 
                25.701(a)).
            ``(3) Deadline.--The Commission shall take all actions 
        necessary to complete the proceeding required under paragraph 
        (1) within 120 days after the initiation of such proceeding.''.

SEC. 5. OFFICE OF CHILDHOOD OVERWEIGHT AND OBESITY PREVENTION AND 
              TREATMENT.

    Title XVII of the Public Health Service Act (42 U.S.C. 300u et 
seq.) is amended by adding at the end the following new section:

``SEC. 1711. OFFICE OF CHILDHOOD OVERWEIGHT AND OBESITY PREVENTION AND 
              TREATMENT.

    ``(a) Establishment.--There is established within the Office of 
Public Health and Science of the Department of Health and Human 
Services an office to be known as the Office of Childhood Overweight 
and Obesity Prevention and Treatment (in this section referred to as 
the `Office'), which shall be headed by a director appointed by the 
Secretary (in this section referred to as the `Director').
    ``(b) Duties.--The Secretary, acting through the Director, shall 
carry out the following:
            ``(1) Evaluate the policies, programs, and actions of each 
        Federal agency to identify--
                    ``(A) existing evidence-based policies, programs, 
                and actions that are effective in preventing childhood 
                obesity; and
                    ``(B) opportunities for each Federal agency to 
                develop new age- and developmentally-appropriate 
                evidence-based policies, programs, and actions to 
                prevent childhood obesity.
            ``(2) Expand Federal data collection and surveillance 
        systems to monitor--
                    ``(A) the prevalence of childhood obesity and co-
                morbidities;
                    ``(B) dietary behaviors, physical activity levels, 
                and sedentary behaviors of children and youth; and
                    ``(C) the effectiveness of existing public and 
                private sector policies, programs, and actions in 
                preventing childhood obesity, including local wellness 
                policies under section 204 of the Child Nutrition and 
                WIC Reauthorization Act of 2004 (42 U.S.C. 1751 note).
            ``(3) Implement Federal support measures, including grants, 
        to increase the capacity of State, tribal, and territorial 
        health departments to--
                    ``(A) provide leadership and technical assistance 
                in preventing and treating childhood obesity;
                    ``(B) enhance surveillance efforts, including 
                support for the development of health registries, 
                immunization information systems, or other child health 
                information systems that may be used to monitor local 
                rates of childhood obesity and co-morbidities; and
                    ``(C) implement obesity prevention and treatment 
                programs and evaluate such programs to establish best 
                practices.
            ``(4) Implement a coordinated, comprehensive, long-term, 
        and national multimedia public education campaign focused on 
        preventing childhood obesity and evaluate the effectiveness of 
        such public education campaign.
            ``(5) Promote the adoption of and describe and evaluate 
        barriers to the implementation of Federal standards and 
        guidelines for age-appropriate nutrition and wellness practices 
        and physical activity programs for all students.
            ``(6) Evaluate the effectiveness of Federal agricultural 
        policies (including agricultural subsidies, commodity programs, 
        and programs to promote farmers markets and community food 
        projects in areas with limited access to affordable and 
        nutritious food) at making a diet consistent with the Dietary 
        Guidelines for Americans published jointly by the Department of 
        Health and Human Services and the Department of Agriculture 
        affordable and available to Americans at all economic levels.
            ``(7) Within 2 years after the date of the enactment of 
        this section, for purposes of encouraging healthful eating 
        patterns in children and adolescents and improving children's 
        and adolescents' understanding of their nutritional needs--
                    ``(A) in consultation with the Secretary of 
                Agriculture, and with reference to recommendations by 
                the Institute of Medicine of the National Academies, 
                identify the following categories of foods and 
                beverages--
                            ``(i) Tier 1 foods and beverages, which are 
                        healthful for children and adolescents and the 
                        consumption of which is encouraged;
                            ``(ii) Tier 2 foods and beverages, which do 
                        not exceed levels of total, saturated, and 
                        trans fat, sugars, and sodium that are 
                        acceptable in a healthful diet for children and 
                        adolescents; and
                            ``(iii) Tier 3 foods and beverages, which 
                        do not contribute to a healthful diet for 
                        children and adolescents and the consumption of 
                        which is discouraged; and
                    ``(B) in consultation with the Chairman of the 
                Federal Trade Commission and the Chairman of the 
                Federal Communications Commission, for each category of 
                foods and beverages described in subparagraph (A), 
                develop and publish guidelines applicable to the 
                marketing, advertising, or promoting of such foods and 
                beverages to children and adolescents that support the 
                purposes of this paragraph, taking into account--
                            ``(i) the emotional vulnerability of 
                        children and adolescents and their cognitive 
                        ability to distinguish between commercial and 
                        non-commercial content; and
                            ``(ii) society's interest in protecting the 
                        health and well-being of its children and the 
                        long-term health and well-being of its 
                        population.
            ``(8) In consultation with the National Institutes of 
        Health, evaluate existing research and identify and initiate 
        further research as necessary in pediatric obesity prevention 
        by examining--
                    ``(A) factors involved in changing dietary 
                behaviors, physical activity levels, and sedentary 
                behaviors, including factors to motivate changes in 
                behavior;
                    ``(B) factors that influence nutrition and wellness 
                practices across an individual's life span;
                    ``(C) strategies to reinforce and sustain improved 
                behavior;
                    ``(D) barriers to behavioral change;
                    ``(E) specific ethnic and cultural influences on 
                behavioral change;
                    ``(F) policy, environmental, social, clinical, and 
                behavioral interventions that focus on--
                            ``(i) reducing and preventing an increase 
                        in obesity prevalence;
                            ``(ii) improving dietary behaviors;
                            ``(iii) increasing the accessibility of 
                        healthy, affordable foods in communities;
                            ``(iv) increasing physical activity levels, 
                        including an assessment of the impact of 
                        changes to the built environment (the man-made 
                        physical structures and infrastructure of 
                        communities) on the levels of physical activity 
                        in communities and populations; and
                            ``(v) reducing sedentary behaviors;
                    ``(G) the feasibility, efficacy, effectiveness, and 
                sustainability of intervention approaches;
                    ``(H) the ways in which the marketing of foods, 
                beverages, and sedentary entertainment influence the 
                attitudes and behaviors of children and youth;
                    ``(I) whether taxation and pricing strategies can 
                be used to promote improved dietary behaviors, more 
                physical activity, or reduced sedentary behaviors; and
                    ``(J) the effect of exposure to endocrine-
                disrupting chemicals, including exposure in utero, on 
                the initiation or exacerbation of obesity.
            ``(9) Make available to local educational agencies, school 
        food authorities, and State educational agencies information 
        and technical assistance for use as described in section 204 of 
        the Child Nutrition and WIC Reauthorization Act of 2004 (42 
        U.S.C. 1751 note), as amended by section 6 of the Healthy Kids 
        Act.
            ``(10) Subject to the availability of appropriations 
        provided for such purpose, establish and carry out the grant 
        program under subsection (c).
    ``(c) Grant Program.--
            ``(1) In general.--The Secretary, acting through the 
        Director, may establish and carry out a matching grant program 
        to make grants to eligible entities to--
                    ``(A) assist the Office--
                            ``(i) in gathering data regarding childhood 
                        obesity; and
                            ``(ii) in implementing a coordinated, 
                        comprehensive, long-term, and national 
                        multimedia public education campaign focused on 
                        preventing childhood obesity; and
                            ``(iii) in evaluating the effectiveness of 
                        such public education campaign; and
                    ``(B) carry out demonstration programs to reduce 
                the incidence of childhood obesity.
            ``(2) Eligible entities.--For purposes of this subsection, 
        an `eligible entity' means a--
                    ``(A) State;
                    ``(B) unit of general local government;
                    ``(C) nonprofit organization with demonstrated 
                experience and focus in childhood obesity issues, as 
                determined by the Director;
                    ``(D) a partnership between any combination of 
                subparagraphs (A) through (C).
            ``(3) Matching requirement.--An eligible entity that 
        receives a grant under this subsection shall provide, from non-
        Federal sources, an amount equal to 25 percent of such grant 
        award to carry out the activities under this subsection. Such 
        non-Federal share may be provided in the form of in-kind 
        contributions of services or materials.
            ``(4) Reports.--
                    ``(A) Reports to the director.--Not later than 1 
                year after receipt of funds from a grant awarded under 
                this subsection, and for each fiscal year an entity 
                receives such funding thereafter, such entity shall 
                submit to the Director a report on its use of grant 
                funds received and such other information as the 
                Director may require.
                    ``(B) Reports to congress.--Not later than 2 years 
                after the first disbursement of funds for a grant 
                awarded under this subsection, and annually thereafter, 
                the Secretary, acting through the Director, shall 
                submit to Congress a report on the status of the grant 
                program under this subsection.
            ``(5) Limitation on funds.--Of the amounts provided through 
        a grant under this subsection, an eligible entity may use not 
        more than 10 percent for administrative expenses.
            ``(6) Authorization of appropriations.--There are 
        authorized to be appropriated to carry out the grant program 
        under this subsection $15,000,000 for each of fiscal years 2011 
        to 2015.
    ``(d) Existing Programs.--The Secretary, acting through the 
Director, shall carry out the duties under subsection (b) in a manner 
that enhances existing programs that the Secretary determines are 
effective.
    ``(e) Consultation.--In order to carry out the duties of the 
Office, the Secretary, acting through the Director, shall consult 
with--
            ``(1) experts from the public sector, including--
                    ``(A) the Director of the Centers for Disease 
                Control and Prevention;
                    ``(B) the Secretary of Agriculture;
                    ``(C) the Secretary of Education;
                    ``(D) the Secretary of Defense;
                    ``(E) the Secretary of Interior;
                    ``(F) the Secretary of Transportation;
                    ``(G) the Secretary of Housing and Urban 
                Development;
                    ``(H) the Chairman of the Federal Communications 
                Commission; and
                    ``(I) the Chairman of the Federal Trade Commission; 
                and
            ``(2) experts from the private sector, including experts in 
        pediatrics, public health, psychology, nutrition, sports 
        medicine, or related fields, such as family and consumer 
        services education.
    ``(f) Annual Report.--Not later than one year after the date of the 
enactment of this section, and annually thereafter, the Secretary, 
acting through the Director, shall submit to Congress a report on the 
activities of the Office carried out under this section and any 
findings, conclusions, and recommendations based on such activities.
    ``(g) Considerations.--In carrying out this section, the Secretary, 
acting through the Director, shall consider the unique needs of 
racially and ethnically diverse groups and high-risk populations, 
including low-income populations and communities.''.

SEC. 6. LOCAL WELLNESS POLICY.

    Subsection (b) of section 204 of the Child Nutrition and WIC 
Reauthorization Act of 2004 (42 U.S.C. 1751 note) is amended--
            (1) in paragraph (1), by inserting ``and the Office of 
        Childhood Overweight and Obesity Prevention and Treatment'' 
        after ``the Centers for Disease Control and Prevention''; and
            (2) in paragraph (2)--
                    (A) by redesignating subparagraphs (B), (C), and 
                (D) as subparagraphs (C), (D), and (E), respectively; 
                and
                    (B) by adding after subparagraph (A) the following 
                new subparagraph:
                    ``(B) support schools and local educational 
                agencies in--
                            ``(i) communicating with parents on how 
                        nutrition, wellness, and physical activity 
                        affect the health of their child;
                            ``(ii) implementing nutrition, wellness 
                        practices, and physical activity guidelines;
                            ``(iii) integrating nutrition and wellness, 
                        family and consumer sciences education 
                        programs, and physical activity into the 
                        overall curriculum;
                            ``(iv) offering professional development 
                        for faculty and staff that includes information 
                        on nutrition and wellness and physical activity 
                        issues;
                            ``(v) improving the quality of physical 
                        education curricula and increasing the training 
                        of physical education teachers; and
                            ``(vi) encouraging healthy eating and 
                        reducing school dependence on profits from the 
                        sale of foods with minimal nutritional 
                        value;''.

SEC. 7. REGULATIONS.

    Section 10 of the Child Nutrition Act of 1966 (42 U.S.C. 1779) is 
amended--
            (1) in subsection (a), by striking ``, including 
        regulations'' and all that follows through ``School Lunch 
        Act''; and
            (2) in subsection (b)--
                    (A) by striking ``The regulations'' and all that 
                follows through ``if'' and inserting ``The Secretary 
                shall prescribe regulations relating to the service of 
                foods and beverages in participating schools and 
                service institutions in competition with the programs 
                authorized under this Act and the Richard B. Russell 
                National School Lunch Act (42 U.S.C. 1751 et seq.). 
                Such regulations shall require that''; and
                    (B) by striking the period at the end and inserting 
                the following: ``and shall, based on the categories 
                identified pursuant to section 1711(b)(7)(A) of the 
                Public Health Service Act--
            ``(1) identify Tier 1 foods and beverages, which are 
        healthful for children and the consumption of which is 
        encouraged, and provide that such foods and beverages may be 
        offered throughout the school day at all school levels;
            ``(2) identify Tier 2 foods and beverages, which do not 
        exceed an acceptable level of total, saturated, and trans fat, 
        sugars, and sodium, and provide that such foods and beverages 
        may be made available only at limited times of the day at 
        specified school levels; and
            ``(3) identify Tier 3 foods and beverages, which do not 
        contribute to a healthful diet for children and adolescents, 
        and provide that such foods and beverages may not be made 
        available during the school day or at after-school activities 
        for students, except that the local wellness policy required by 
        section 204 of the Child Nutrition and WIC Reauthorization Act 
        of 2004 (42 U.S.C. 1751 note) may allow such foods and 
        beverages to be offered at occasional events authorized by the 
        school, such as celebrations, special fundraising events, and 
        after school activities.''.

SEC. 8. EARLY AND PERIODIC SCREENING, DIAGNOSTIC, AND TREATMENT 
              SERVICES.

    (a) In General.--Section 1905(r) of the Social Security Act (42 
U.S.C. 1396d) is amended--
            (1) by redesignating paragraph (5) as paragraph (6); and
            (2) by adding after paragraph (4) the following new 
        paragraph:
            ``(5) Obesity prevention, nutritional counseling, and other 
        services for obesity--
                    ``(A) which are provided--
                            ``(i) at intervals which meet reasonable 
                        standards of medical practice, as determined by 
                        the State after consultation with recognized 
                        medical organizations involved in child health 
                        care; and
                            ``(ii) at such other intervals indicated as 
                        medically necessary; and
                    ``(B) which shall at a minimum include nutritional 
                counseling and treatment for obesity.''.
    (b) Effective Date.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendment made by subsection (a)(2) shall apply to medical 
        assistance furnished on or after January 1, 2010.
            (2) Exception for state legislation.--In the case of a 
        State plan under title XIX of the Social Security Act, which 
        the Secretary of Health and Human Services determines requires 
        State legislation in order for the plan to meet the additional 
        requirement imposed by the amendment made by subsection (a)(2), 
        the State plan shall not be regarded as failing to comply with 
        the requirement of such title solely on the basis of its 
        failure to meet such additional requirement before the first 
        day of the first calendar quarter beginning after the close of 
        the first regular session of the State legislature that begins 
        after the date of enactment of this Act. For purposes of the 
        previous sentence, in the case of a State that has a 2-year 
        legislative session, each year of the session shall be 
        considered to be a separate regular session of the State 
        legislature.

SEC. 9. REQUIRING COVERAGE OF EPSDT SERVICES UNDER SCHIP.

    (a) Additional Required Services.--
            (1) Required coverage of epsdt services.--Section 2103(c) 
        of the Social Security Act (42 U.S.C. 1397cc(c)) is amended--
                    (A) by redesignating paragraphs (7) and (8) as 
                paragraphs (8) and (9), respectively; and
                    (B) by inserting after paragraph (6), the 
                following:
            ``(7) EPSDT obesity treatment services.--The child health 
        assistance provided to a targeted low-income child shall 
        include coverage of early and periodic screening, diagnostic, 
        and treatment services described in section 1905(r)(5) and 
        provided in accordance with section 1902(a)(43).''.
            (2) Conforming amendment.--Section 2103(a) (42 U.S.C. 
        1397cc(a)) is amended, in the matter preceding paragraph (1), 
        by striking ``paragraphs (5), (6), and (7)'' and inserting 
        ``paragraphs (5), (6), (7), and (8)''.
    (b) Effective Date.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendment made by subsection (a)(1)(B) shall apply to child 
        health assistance furnished on or after January 1, 2010.
            (2) Exception for state legislation.--In the case of a 
        State child health plan under title XXI of the Social Security 
        Act, which the Secretary of Health and Human Services 
        determines requires State legislation in order for the plan to 
        meet the additional requirement imposed by the amendment made 
        by subsection (a)(1)(B), the State child health plan shall not 
        be regarded as failing to comply with the requirements of such 
        title solely on the basis of its failure to meet such 
        additional requirement before the first day of the first 
        calendar quarter beginning after the close of the first regular 
        session of the State legislature that begins after the date of 
        enactment of this Act. For purposes of the previous sentence, 
        in the case of a State that has a 2-year legislative session, 
        each year of the session shall be considered to be a separate 
        regular session of the State legislature.

SEC. 10. AUTHORIZATION AND AVAILABILITY OF APPROPRIATIONS.

    (a) Authorization.--There are authorized to be appropriated such 
sums as may be necessary to carry out this Act.
    (b) Availability.--Amounts appropriated pursuant to paragraph (1) 
shall remain available until expended.
                                 <all>