1.This Act may be cited as the
Healthy Kids
Act
.
2.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.
3.FTC Review of
advertising and marketing of unhealthy foods and beverages
(a)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)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)Section 18(h) of the Federal Trade
Commission Act (15 U.S.C. 57a(h)) is repealed.
(d)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.
4.FCC Limits on
Advertising Unhealthy Foods and Beverages During Children’s
ProgrammingSection 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)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)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)The
Commission shall take all actions necessary to complete the proceeding required
under paragraph (1) within 120 days after the initiation of such
proceeding.
.
5.Office of
Childhood Overweight and Obesity Prevention and TreatmentTitle 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:
1711.Office of
Childhood Overweight and Obesity Prevention and Treatment
(a)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)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)
(1)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)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)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)
(A)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)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)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
appropriationsThere 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)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)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)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)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.
.
6.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;
.
7.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.
.
8.Early and
Periodic Screening, Diagnostic, and Treatment Services
(a)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)
(1)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 legislationIn 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.
9.Requiring
Coverage of EPSDT Services under SCHIP
(a)Additional
Required Services
(1)Required
coverage of EPSDT ServicesSection 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 ServicesThe 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)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)
(1)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 legislationIn 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.
10.Authorization
and availability of appropriations
(a)There
are authorized to be appropriated such sums as may be necessary to carry out
this Act.
(b)Amounts
appropriated pursuant to paragraph (1) shall remain available until
expended.