[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5209 Introduced in House (IH)]

111th CONGRESS
  2d Session
                                H. R. 5209

To provide a comprehensive approach to preventing and treating obesity.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 5, 2010

 Mr. Kind (for himself, Mrs. Bono Mack, Mr. Blumenauer, and Ms. Fudge) 
 introduced the following bill; which was referred to the Committee on 
Energy and Commerce, and in addition to the Committees on Education and 
Labor, Ways and Means, Agriculture, Transportation and Infrastructure, 
 and Natural Resources, 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 provide a comprehensive approach to preventing and treating obesity.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Healthy 
Communities through Helping to Offer Incentives and Choices to Everyone 
in Society Act of 2010''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
 TITLE I--IMPROVING PREVENTION AND TREATMENT OF OBESITY IN ADULTS AND 
                                CHILDREN

Sec. 101. Reporting of Body Mass Index Information Requirement.
Sec. 102. Grants for Body Mass Index data analysis.
Sec. 103. Requirement to expedite national Medicare coverage 
                            determinations for evidence-based 
                            preventive services.
Sec. 104. Expansion of obesity treatment services under Medicare.
Sec. 105. Coverage of evidence-based preventive services under Medicaid 
                            and SCHIP.
Sec. 106. Coverage of medical nutrition therapy under Medicaid and 
                            SCHIP.
Sec. 107. Clarification of EPSDT inclusion of prevention, screening, 
                            and treatment services for obesity and 
                            overweight; SCHIP coverage.
Sec. 108. Grants to increase physical activity, improve nutrition, and 
                            promote healthy eating behaviors.
Sec. 109. Grants to provide training for health profession students.
Sec. 110. Grants to provide training for health professionals.
Sec. 111. Preventive health services block grant.
                TITLE II--IMPROVING CHILDHOOD NUTRITION

Sec. 201. Nutrition and wellness goals for meals served through the 
                            child and adult care food program.
Sec. 202. Interagency coordination to promote health and wellness in 
                            child care licensing.
Sec. 203. Study on nutrition and wellness quality of child care 
                            settings.
Sec. 204. Working group to reduce paperwork and improve program 
                            administration.
Sec. 205. Renewal of application materials and permanent operating 
                            agreements.
Sec. 206. Transmission of income information by sponsored family or 
                            group day care homes.
Sec. 207. Simplifying and enhancing administrative payments to 
                            sponsoring organizations.
Sec. 208. Cultivate farm-to-school partnerships.
 TITLE III--IMPROVING ACCESS TO AND OPPORTUNITY FOR PHYSICAL ACTIVITY 
                        FOR ADULTS AND CHILDREN

Subtitle A--National Program Promoting Lifelong Active Youth (PLAY) and 
                         Implementation Grants

Sec. 301. Play assessment tools.
Sec. 302. Model communities of play implementation grants.
                 Subtitle B--Moving Outdoors in Nature

Sec. 311. Definitions.
Sec. 312. Grants for development or implementation of Moving Outdoors 
                            in Nature Strategies.
Sec. 313. National evaluation of health impacts.
Sec. 314. Technical assistance and best practices.
Sec. 315. Authorization of appropriations.
                      Subtitle C--Other Provisions

Sec. 321. Authorization of appropriations for Carol M. White Physical 
                            Education Program.
Sec. 322. Physical education guidelines for elementary and secondary 
                            schools.
Sec. 323. Treating physical education as a core academic subject for 
                            elementary and secondary education grants.
Sec. 324. Physical activity guidelines for preschool children.
Sec. 325. Tracking physical activity in schools.
Sec. 326. Employer-provided off-premises health club services.
Sec. 327. Certain amounts paid for physical activity, fitness, and 
                            exercise treated as amounts paid for 
                            medical care.
Sec. 328. National youth sports program revitalization.
Sec. 329. Duplication of the Zuni Youth Enrichment Project Summer Camp 
                            on Indian reservations and tribal lands.
TITLE IV--IMPROVING ACCESS TO NUTRITIONAL INFORMATION AND HEALTHY FOODS

Sec. 401. Consumer education.
Sec. 402. Expand team nutrition training grants.
Sec. 403. Department of Agriculture program to support establishment or 
                            expansion of retail food stores offering 
                            affordable, nutritious foods in underserved 
                            communities and coordination with other 
                            Federal programs.
Sec. 404. Virtual Farmers Market Program.
Sec. 405. Urban and Native-American Community Garden Grant Program.
   TITLE V--REALIGNING TRANSPORTATION POLICY TO HELP PROMOTE HEALTHY 
                               LIFESTYLES

Sec. 501. Grants to promote planning decisions and policies that 
                            increase access to physical activity.
Sec. 502. Joint use agreements.
Sec. 503. Expansion of safe routes to school program.
Sec. 504. Active transportation infrastructure investment program.
                TITLE VI--RESEARCH AND ASSESSMENT TOOLS

Sec. 601. National Center for Health Statistics.
Sec. 602. Report on obesity research.

 TITLE I--IMPROVING PREVENTION AND TREATMENT OF OBESITY IN ADULTS AND 
                                CHILDREN

SEC. 101. REPORTING OF BODY MASS INDEX INFORMATION REQUIREMENT.

    (a) In General.--Subsection (a) of section 2125 of the Public 
Health Service Act (42 U.S.C. 300aa-25) is amended--
            (1) by striking ``and'' at the end of paragraph (3);
            (2) by striking the period and adding ``, and'' at the end 
        of paragraph (4); and
            (3) by adding at the end the following new paragraph:
            ``(5) the age, gender, height, and weight of each person 
        vaccinated to calculate the body mass index of such person.''.
    (b) Reporting.--Subsection (b) of such section is amended--
            (1) in paragraph (1)--
                    (A) by striking ``and'' at the end of subparagraph 
                (B);
                    (B) by redesignating subparagraph (C) as 
                subparagraph (D); and
                    (C) by inserting after subparagraph (B) the 
                following new subparagraph:
                    ``(C) the information recorded under subsection 
                (a)(5), and''; and
            (2) by adding at the end the following new paragraph:
            ``(4) Each health provider shall also report to the 
        relevant department of the State in which such health care 
        provider practices the data collected under subsection 
        (a)(5).''.

SEC. 102. GRANTS FOR BODY MASS INDEX DATA ANALYSIS.

    (a) Establishment.--The Secretary of Health and Human Services may 
make grants to not more than 20 eligible entities to analyze body mass 
index (hereinafter in this section referred to as ``BMI'') measurements 
of children, ages 2 through 18.
    (b) Eligibility.--An eligible entity for purposes of this section 
is a State (including the District of Columbia, the Commonwealth of 
Puerto Rico, and each territory of the United States) that has a 
statewide immunization information system that--
            (1) has the capacity to store basic demographic information 
        (including date of birth, gender, and geographic area of 
        residence), height, weight, and immunization data for each 
        resident of the State;
            (2) is accessible to doctors, nurses, other licensed 
        medical professionals, and officials of the relevant department 
        in the State charged with maintaining health and immunization 
        records; and
            (3) has the capacity to integrate large amounts of data for 
        the analysis of BMI measurements.
    (c) Use of Funds.--A State that receives a grant under this section 
shall use the grant for the following purposes:
            (1) Analyzing the effectiveness of obesity prevention 
        programs and wellness policies carried out in the State.
            (2) Purchasing new computers, computer equipment, and 
        software to upgrade computers to be used for a statewide 
        immunization information system.
            (3) The hiring and employment of personnel to maintain and 
        analyze BMI data.
            (4) The development and implementation of training programs 
        for medical professionals to aid such professionals in taking 
        BMI measurements and discussing such measurements with 
        patients.
            (5) Providing information to parents and legal guardians in 
        accordance with subsection (e)(2).
    (d) Selection Criteria.--In selecting recipients of grants under 
this section, the Secretary shall give priority to States in which a 
high percentage of public and private health care providers submit data 
to a statewide immunization information system that--
            (1) contains immunization data for not less than 20 percent 
        of the population of such State that is under the age of 18; 
        and
            (2) includes data collected from men and women who are of a 
        wide variety of ages and who reside in a wide variety of 
        geographic areas in a State (as determined by the Secretary).
    (e) Conditions.--As a condition of receiving a grant under this 
section, a State shall--
            (1) ensure that BMI measurements will be recorded for 
        children ages 2 through 18--
                    (A) on an annual basis by a licensed physician, 
                nurse, nurse practitioner, or physicians assistant 
                during an annual physical examination, wellness visit, 
                or similar visit with a physician; and
                    (B) in accordance with data collection protocols 
                published by the American Academy of Pediatrics in the 
                2007 Expert Committee Recommendations; and
            (2) for each child in the State for whom such measurements 
        indicate a BMI greater than the 95th percentile for such 
        child's age and gender, provide to the parents or legal 
        guardians of such child information on how to lower BMI and 
        information on State and local obesity prevention programs.
    (f) Reports.--
            (1) Reports to the secretary.--Not later than 5 years after 
        the receipt of a grant under this section, the State receiving 
        such grant shall submit to the Secretary the following reports:
                    (A) A report containing an analysis of BMI data 
                collected using the grant, including--
                            (i) the differences in obesity trends by 
                        gender, disability, geographic area (as 
                        determined by the State), and socioeconomic 
                        status within such State; and
                            (ii) the demographic groups and geographic 
                        areas most affected by obesity within such 
                        State.
                    (B) A report containing an analysis of the 
                effectiveness of obesity prevention programs and State 
                wellness policies, including--
                            (i) an analysis of the success of such 
                        programs and policies prior to the receipt of 
                        the grant; and
                            (ii) a discussion of the means to determine 
                        the most effective strategies to combat obesity 
                        in the geographic areas identified under 
                        subparagraph (A).
            (2) Report to congress and certain executive agencies.--Not 
        later than 1 year after the Secretary receives all the reports 
        required pursuant to paragraph (1), the Secretary shall submit 
        to the Secretary of Education, the Secretary of Agriculture, 
        and to Congress a report that contains the following:
                    (A) An analysis of trends in childhood obesity, 
                including how such trends vary across regions of the 
                United States, and how such trends vary by gender and 
                socioeconomic status.
                    (B) A description of any programs that--
                            (i) the Secretary has determined 
                        significantly lower childhood obesity rates for 
                        certain geographic areas in the United States, 
                        including urban, rural, and suburban areas; and
                            (ii) the Secretary recommends to be 
                        implemented by the States (including States 
                        that did not receive a grant under this 
                        section).
    (g) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary such sums as may be necessary to carry 
out this section for each of fiscal years 2010 through 2015.

SEC. 103. REQUIREMENT TO EXPEDITE NATIONAL MEDICARE COVERAGE 
              DETERMINATIONS FOR EVIDENCE-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 effect a rating of ``A'' or ``B'' (relating to a classification 
representing strongly recommended or recommended services) 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 determinations 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 prevention 
        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
            (2) the National Heart, Lung and Blood Institute 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. 104. 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 subsection:
    ``(iii) Obesity Treatment Program.--The term `obesity treatment 
program' means--
            ``(1) medical services delivered to eligible individuals 
        under a plan of care for the purpose of reducing 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 subparagraphs.
        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 societies; 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 authoritative sources (such as 
        those identified in the National 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 physician 
                (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 be diagnosed 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 Security 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 program (as defined in 
        section 1861(iii)), the amount 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. 105. COVERAGE OF EVIDENCE-BASED PREVENTIVE SERVICES UNDER MEDICAID 
              AND SCHIP.

    (a) State Option To Provide Medical Assistance 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 section 
                2301(a) of the Patient Protection and Affordable 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 described 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:
    ``(dd) For purposes of subsection (a)(29), evidence-based 
preventive services described in this subsection are any preventive 
services which the Secretary has determined are reasonable and 
necessary, including, as so determined, diet and exercise counseling, 
healthy weight and obesity counseling, and any other evidence-based, 
effective clinical intervention for obese individuals, including 
pharmacological or surgical services, designed to prevent comorbidities 
of obesity.''.
            (2) Conforming amendment.--Section 1902(a)(10)(C)(iv) of 
        such Act is amended by inserting ``, and (29)'' after ``(24)''.
    (b) State Option To Provide Child Health Assistance for Evidence-
Based Preventive Services.--Section 2110(a) of the Social Security Act 
(42 U.S.C. 1397jj(a)) is amended--
            (1) by redesignating paragraph (28) as paragraph (29); and
            (2) by inserting after paragraph (27) the following:
            ``(28) Evidence-based preventive services described in 
        section 1905(dd).''.

SEC. 106. COVERAGE OF MEDICAL NUTRITION THERAPY UNDER MEDICAID AND 
              SCHIP.

    (a) State Option To Provide Medical Assistance for Medical Therapy 
Services.--
            (1) In general.--Section 1905(a) of the Social Security Act 
        (42 U.S.C. 1396d), as amended by section 105(b), 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 defined 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 section 105(b)(2), is amended by 
        striking ``and (29)'' and inserting ``(29), and (30)''.
    (b) State Option To Provide Child Health Assistance for Medical 
Nutrition Therapy Services.--Section 2110(a) of the Social Security Act 
(42 U.S.C. 1397jj(a)), as amended by section 105(c), is amended--
            (1) by redesignating paragraph (29) as paragraph (30); and
            (2) by inserting after paragraph (28) the following:
            ``(29) Medical nutrition therapy services (as defined in 
        section 1861(vv)(1)) for individuals with pre-diabetes or 
        obesity, or who are overweight (as defined by the 
        Secretary).''.

SEC. 107. CLARIFICATION OF EPSDT INCLUSION OF PREVENTION, 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 inserting before the period the 
following: ``, including weight and BMI measurement and monitoring, as 
well as appropriate treatment services, including medical nutrition 
therapy 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 Obesity)''.
    (b) SCHIP.--
            (1) Required coverage.--Section 2103 (42 U.S.C. 1397cc) is 
        amended--
                    (A) in subsection (a), in the matter preceding 
                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 treatment 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 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. For purposes of the previous 
        sentence the Secretary shall take into consideration the 
        American Academy of Pediatrics Expert Committee Guidelines 
        Regarding the Prevention, Assessment, 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. 108. GRANTS TO INCREASE PHYSICAL ACTIVITY, IMPROVE NUTRITION, AND 
              PROMOTE HEALTHY EATING BEHAVIORS.

    Part Q of title III of the Public Health Service Act (42 U.S.C. 
280h et seq.) is amended by striking section 399W and inserting the 
following:

``SEC. 399W. GRANTS TO INCREASE PHYSICAL ACTIVITY, IMPROVE NUTRITION, 
              AND PROMOTE HEALTHY EATING BEHAVIORS.

    ``(a) Establishment.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention and 
        in coordination with the Administrator of the Health Resources 
        and Services Administration, the Director of the Indian Health 
        Service, the Secretary of Education, the Secretary of 
        Agriculture, the Secretary of the Interior, the Director of the 
        National Institutes of Health, the Director of the Office of 
        Women's Health, and the heads of other appropriate agencies, 
        shall award competitive grants to eligible entities to plan and 
        implement programs that promote healthy eating behaviors and 
        physical activity to prevent obesity, being overweight, and 
        related serious and chronic medical conditions.
            ``(2) Special priority.--In awarding grants under this 
        section, the Secretary shall give special priority to grant 
        proposals that target communities or populations 
        disproportionately at-risk from obesity or being overweight, 
        including health disparity populations (as defined in section 
        485E(d)), the underserved, and youth.
            ``(3) Term.--The Secretary shall award grants under this 
        subsection for a period not to exceed 4 years.
    ``(b) Award of Grants.--An eligible entity desiring a grant under 
this section shall submit an application to the Secretary at such time, 
in such manner, and containing such information as the Secretary may 
require, including--
            ``(1) a plan describing a comprehensive program of 
        approaches to encourage healthy eating behaviors and healthy 
        levels of physical activity;
            ``(2) the manner in which the eligible entity will 
        coordinate with appropriate State and local authorities and 
        community-based organizations, including--
                    ``(A) State and local educational agencies;
                    ``(B) departments of health;
                    ``(C) chronic disease directors;
                    ``(D) State directors of programs under section 17 
                of the Child Nutrition Act of 1966;
                    ``(E) governors' councils for physical activity and 
                good nutrition;
                    ``(F) State and local parks and recreation 
                departments;
                    ``(G) State and local departments of transportation 
                and city planning; and
                    ``(H) community-based organizations serving youth; 
                and
            ``(3) the manner in which the applicant will evaluate the 
        effectiveness of the program carried out under this section.
    ``(c) Coordination.--In awarding grants under this section, the 
Secretary shall ensure that the proposed programs are coordinated in 
substance and format with programs currently funded through other 
Federal agencies and operating within the community including the 
Physical Education Program (PEP) of the Department of Education.
    ``(d) Eligible Entity.--In this section, the term `eligible entity' 
means--
            ``(1) a city, county, tribe, territory, or State;
            ``(2) a State educational agency;
            ``(3) a tribal educational agency;
            ``(4) a local educational agency;
            ``(5) a federally qualified health center (as defined in 
        section 1861(aa)(4) of the Social Security Act);
            ``(6) a rural health clinic;
            ``(7) a health department;
            ``(8) an Indian Health Service hospital or clinic;
            ``(9) an Indian tribal health facility;
            ``(10) an urban Indian facility;
            ``(11) any health provider;
            ``(12) an accredited university or college;
            ``(13) a community-based organization;
            ``(14) a local city planning agency;
            ``(15) a State or local parks and recreation department; or
            ``(16) any other entity determined appropriate by the 
        Secretary.
    ``(e) Use of Funds.--An eligible entity that receives a grant under 
this section shall use the funds made available through the grant to--
            ``(1) carry out community-based activities including--
                    ``(A) city planning, transportation initiatives, 
                and environmental changes that help promote physical 
                activity, such as increasing the use of walking or 
                bicycling as a mode of transportation;
                    ``(B) forming partnerships and activities with 
                businesses, disability organizations, community-based 
                organizations, and other entities to increase physical 
                activity levels and promote healthy eating behaviors in 
                schools and while traveling to and from schools;
                    ``(C) forming partnerships with entities, including 
                schools, faith-based entities, community-based 
                organizations, and other organizations providing 
                recreational services, to establish programs that use 
                their facilities or other resources for after-school, 
                weekend, and summer community activities, especially 
                those that promote or involve physical activity;
                    ``(D) establishing incentives for retail food 
                stores, farmer's markets, food co-ops, grocery stores, 
                and other retail food outlets that offer fruits and 
                vegetables and other nutritious foods to encourage such 
                stores and outlets to locate in economically depressed 
                areas;
                    ``(E) forming partnerships with senior centers, 
                nursing facilities, retirement communities, and 
                assisted living facilities to establish programs for 
                older people to foster physical activity and healthy 
                eating behaviors;
                    ``(F) forming partnerships with daycare and after-
                school entities to establish programs that promote 
                healthy eating behaviors and physical activity;
                    ``(G) developing and evaluating community 
                educational activities targeting good nutrition and 
                promoting healthy eating behaviors; and
                    ``(H) providing, directly or in cooperation with 
                State and local parks and recreation departments, 
                programs and other opportunities for daily physical 
                activity;
            ``(2) carry out age-appropriate school-based activities 
        including--
                    ``(A) developing and testing educational curricula 
                and intervention programs designed to promote healthy 
                eating behaviors and habits in youth, which may 
                include--
                            ``(i) after hours physical activity 
                        programs;
                            ``(ii) increasing opportunities for 
                        students to make informed choices regarding 
                        healthy eating behaviors; and
                            ``(iii) science-based interventions with 
                        multiple components to prevent obesity and 
                        being overweight including nutritional content, 
                        understanding and responding to hunger and 
                        satiety, positive body image development, 
                        positive self-esteem development, and learning 
                        life skills (such as stress management, 
                        communication skills, problem-solving and 
                        decisionmaking skills), as well as 
                        consideration of cultural and developmental 
                        issues, and the role of family, school, and 
                        community;
                    ``(B) providing education and training to 
                educational professionals regarding a healthy lifestyle 
                and a healthy school environment;
                    ``(C) planning and implementing a healthy lifestyle 
                curriculum or program with an emphasis on healthy 
                eating behaviors and physical activity; and
                    ``(D) planning and implementing healthy lifestyle 
                classes or programs for parents or guardians, with an 
                emphasis on healthy eating behaviors and physical 
                activity;
            ``(3) carry out activities through the local health care 
        delivery systems including--
                    ``(A) promoting healthy eating behaviors and 
                physical activity services to treat or prevent obesity 
                and being overweight;
                    ``(B) providing patient education and counseling to 
                increase physical activity and promote healthy eating 
                behaviors; and
                    ``(C) providing community education on good 
                nutrition and physical activity to develop a better 
                understanding of the relationship between diet, 
                physical activity, and obesity or being overweight; or
            ``(4) other activities determined appropriate by the 
        Secretary (including evaluation or identification and 
        dissemination of outcomes and best practices).
    ``(f) Matching Funds.--In awarding grants under subsection (a), the 
Secretary may give priority to eligible entities who provide matching 
contributions. Such non-Federal contributions may be cash or in kind, 
fairly evaluated, including plant, equipment, or services.
    ``(g) Technical Assistance.--The Secretary may set aside an amount 
not to exceed 10 percent of the total amount appropriated for a fiscal 
year pursuant to subsection (k) to permit the Director of the Centers 
for Disease Control and Prevention to provide grantees with technical 
support in the development, implementation, and evaluation of programs 
under this section and to disseminate information about effective 
strategies and interventions in preventing and treating obesity through 
the promotion of healthy eating behaviors and physical activity.
    ``(h) Limitation on Administrative Costs.--An eligible entity 
awarded a grant under this section may not use more than 10 percent of 
funds awarded under such grant for administrative expenses.
    ``(i) Report.--Not later than 6 years after the date of enactment 
of the Improved Nutrition and Physical Activity Act, the Director of 
the Centers for Disease Control and Prevention shall review the results 
of the grants awarded under this section and other related research and 
identify programs that have demonstrated effectiveness in promoting 
healthy eating behaviors and physical activity in youth. Such review 
shall include an identification of model curricula, best practices, and 
lessons learned, as well as recommendations for next steps to reduce 
obesity and being overweight. Information derived from such review, 
including model program curricula, shall be disseminated to the public.
    ``(j) Definitions.--In this section:
            ``(1) Healthy eating behaviors.--The term `healthy eating 
        behaviors' means--
                    ``(A) eating in quantities adequate to meet, but 
                not in excess of, daily energy needs;
                    ``(B) choosing foods to promote health and prevent 
                disease;
                    ``(C) eating comfortably in social environments 
                that promote healthy relationships with family, peers, 
                and community; and
                    ``(D) eating in a manner to acknowledge internal 
                signals of hunger and satiety.
            ``(2) Obese.--The term `obese' refers to an adult with a 
        Body Mass Index (BMI) of 30 kg/m2 or greater, or a child or 
        adolescent with a BMI at or above the 95th percentile on the 
        revised Centers for Disease Control and Prevention growth 
        charts or another appropriate childhood definition, as defined 
        by the Secretary.
            ``(3) Overweight.--The term `overweight' refers to an adult 
        with a Body Mass Index (BMI) of 25 to 29.9 kg/m2 or a child or 
        adolescent with a BMI at or above the 85th percentile, but 
        below the 95th percentile, on the revised Centers for Disease 
        Control and Prevention growth charts or another appropriate 
        childhood definition, as defined by the Secretary.
            ``(4) Youth.--The term `youth' means individuals not more 
        than 18 years old.
    ``(k) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $60,000,000 for fiscal year 
2011, and such sums as may be necessary for each of fiscal years 2012 
through 2015.''.

SEC. 109. GRANTS TO PROVIDE TRAINING FOR HEALTH PROFESSION STUDENTS.

    Section 747 of the Public Health Service Act (42 U.S.C. 293k) is 
amended--
            (1) by redesignating subsection (c) as subsection (d); and
            (2) by inserting after subsection (b) the following:
    ``(c) Special Consideration.--In awarding grants or contracts under 
subsection (a) or (b), the Secretary shall give special consideration 
to qualified applicants proposing a project or program which will 
prepare practitioners to care for individuals (including children) who 
are overweight or obese (as such terms are defined in section 
399W(j)).''.

SEC. 110. GRANTS TO PROVIDE TRAINING FOR HEALTH PROFESSIONALS.

    Section 399Z of the Public Health Service Act (42 U.S.C. 280h-3) is 
amended--
            (1) in subsection (b), by striking ``2005'' and inserting 
        ``2011'';
            (2) by redesignating subsection (b) as subsection (c);
            (3) by inserting after subsection (a) the following:
    ``(b) Grants.--
            ``(1) In general.--The Secretary may award grants to 
        eligible entities to train primary care physicians and other 
        licensed or certified health professionals on how to treat and 
        prevent obesity and aid individuals who are obese or 
        overweight.
            ``(2) Application.--An entity that desires a grant under 
        this subsection shall submit an application at such time, in 
        such manner, and containing such information as the Secretary 
        may require, including a plan for the use of funds that may be 
        awarded and an evaluation of the training that will be 
        provided.
            ``(3) Use of funds.--An entity that receives a grant under 
        this subsection shall use the funds made available through such 
        grant to--
                    ``(A) use evidence-based findings or 
                recommendations that pertain to the prevention and 
                treatment of obesity and being overweight to conduct 
                educational conferences, including Internet-based 
                courses and teleconferences, on--
                            ``(i) how to treat or prevent obesity and 
                        being overweight;
                            ``(ii) the link between obesity and being 
                        overweight and related serious and chronic 
                        medical conditions;
                            ``(iii) how to discuss varied strategies 
                        with patients from at-risk and diverse 
                        populations to promote positive behavior change 
                        and healthy lifestyles to avoid obesity and 
                        being overweight;
                            ``(iv) how to identify individuals who are 
                        or are at risk for being obese or being 
                        overweight and, therefore, are at risk for 
                        related serious and chronic medical conditions; 
                        and
                            ``(v) how to conduct a comprehensive 
                        assessment of individual and familial health 
                        risk factors; and
                    ``(B) evaluate the effectiveness of the training 
                provided by such entity in increasing knowledge and 
                changing attitudes and behaviors of trainees.''; and
            (4) in subsection (c) (as so redesignated)--
                    (A) by striking ``There are authorized to be 
                appropriated to carry out this section'' and all that 
                follows and inserting the following: ``There are 
                authorized to be appropriated--
            ``(1) to carry out subsection (a),'';
                    (B) by striking the period at the end and inserting 
                ``; and''; and
                    (C) by adding at the end the following:
            ``(2) to carry out subsection (b), $10,000,000 for fiscal 
        year 2011, and such sums as may be necessary for each of fiscal 
        years 2012 through 2015.''.

SEC. 111. PREVENTIVE HEALTH SERVICES BLOCK GRANT.

    Section 1904(a)(1) of the Public Health Service Act (42 U.S.C. 
300w-3(a)(1)) is amended by adding at the end the following:
            ``(H) Activities and community education programs designed 
        to address and prevent obesity and being overweight through 
        effective programs to promote healthy eating, and exercise 
        habits and behaviors.''.

                TITLE II--IMPROVING CHILDHOOD NUTRITION

SEC. 201. NUTRITION AND WELLNESS GOALS FOR MEALS SERVED THROUGH THE 
              CHILD AND ADULT CARE FOOD PROGRAM.

    Section 17 of the Richard B. Russell National School Lunch Act (42 
U.S.C. 1766) is amended--
            (1) in subsection (a), by striking ``(a) Grant Authority'' 
        and all that follows through the end of paragraph (1) and 
        inserting the following:
    ``(a) Program Purpose, Grant Authority and Institution 
Eligibility.--
            ``(1) In general.--
                    ``(A) Program purpose.--
                            ``(i) Findings.--Congress finds that--
                                    ``(I) eating habits and other 
                                wellness-related behavior habits are 
                                established early in life; and
                                    ``(II) good nutrition and wellness 
                                are important contributors to the 
                                overall health of young children and 
                                essential to cognitive development.
                            ``(ii) Purpose.--The purpose of the program 
                        authorized by this section is to provide aid to 
                        child care institutions and family or group day 
                        care homes for the provision of nutritious 
                        foods that contribute to the wellness, healthy 
                        growth, and development of young children.
                    ``(B) Grant authority.--The Secretary may carry out 
                a program to assist States through grants-in-aid and 
                other means to initiate and maintain nonprofit food 
                service programs for children in institutions providing 
                child care.'';
            (2) by striking subsection (g) and inserting the following:
    ``(g) Nutritional Requirements for Meals and Snacks Served in 
Institutions and Family or Group Day Care Homes.--
            ``(1) Definition of dietary guidelines.--In this 
        subsection, the term `Dietary Guidelines' means 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).
            ``(2) Nutritional requirements.--
                    ``(A) In general.--Except as provided in 
                subparagraph (C), reimbursable meals and supplements 
                served by institutions and family or group day care 
                homes participating in the program under this section 
                shall consist of a combination of foods that meet 
                minimum nutritional requirements prescribed by the 
                Secretary on the basis of tested nutritional research.
                    ``(B) Conformity with the dietary guidelines and 
                authoritative science.--
                            ``(i) In general.--Not less frequently than 
                        once every 10 years, the Secretary shall review 
                        and, as appropriate, update requirements for 
                        meals and supplements served under the program 
                        under this section to ensure that the meals--
                                    ``(I) are consistent with the goals 
                                of the most recent Dietary Guidelines; 
                                and
                                    ``(II) promote the health of the 
                                population served by the program 
                                authorized under this section, as 
                                indicated by the most recent relevant 
                                nutrition science and appropriate 
                                authoritative scientific agency and 
                                organization recommendations.
                            ``(ii) Cost review.--The review required 
                        under clause (i) shall include a review of the 
                        cost to child care centers and group or family 
                        day care homes resulting from updated 
                        requirements for meals and snacks served under 
                        the program under this section.
                            ``(iii) Regulations.--Not later than 18 
                        months after receipt of recommendations for 
                        meal pattern improvements from the Food and 
                        Nutrition Board of the National Research 
                        Council of the National Academy of Sciences, 
                        the Secretary shall promulgate proposed 
                        regulations to update the meal patterns for 
                        meals and snacks served under the program under 
                        this section.
                    ``(C) Exceptions.--
                            ``(i) Special dietary needs.--The minimum 
                        nutritional requirements prescribed under 
                        subparagraph (A) do not prohibit institutions 
                        and family or group day care homes from 
                        substituting foods to accommodate the medical 
                        or other special dietary needs of individual 
                        children.
                            ``(ii) Exempt institutions.--The Secretary 
                        may elect to waive all or part of the 
                        requirements of this subsection for emergency 
                        shelters and adult day care centers 
                        participating in the program under this 
                        section.
            ``(3) Meal service.--Institutions and family day care homes 
        shall ensure that reimbursable meal service contributes to the 
        development and socialization of enrolled children by providing 
        that food is not used as a punishment or reward.
            ``(4) Fluid milk.--
                    ``(A) In general.--Each institution or family or 
                group day care home participating in the program under 
                this section shall provide fluid milk, in accordance 
                with the most recent version of the Dietary Guidelines, 
                as part of each reimbursable meal and supplement served 
                under the program.
                    ``(B) Milk substitutes.--In the case of children 
                who cannot consume fluid milk due to medical or other 
                special dietary needs other than a disability, an 
                institution or family or group day care home may 
                substitute for the fluid milk required in meals and 
                supplements served, a nondairy beverage that--
                            ``(i) is nutritionally equivalent to fluid 
                        milk; and
                            ``(ii) meets nutritional standards 
                        established by the Secretary, including, among 
                        other requirements established by the 
                        Secretary, fortification of calcium, protein, 
                        vitamin A, and vitamin D to levels found in 
                        cow's milk.
                    ``(C) Approval.--
                            ``(i) In general.--A substitution 
                        authorized under subparagraph (B) may be made--
                                    ``(I) at the discretion of and on 
                                approval by the participating day care 
                                institution; and
                                    ``(II) if the substitution is 
                                requested by written statement of a 
                                medical authority, or by the parent or 
                                legal guardian of the child, that 
                                identifies the medical or other special 
                                dietary need that restricts the diet of 
                                the child.
                            ``(ii) Exception.--An institution or family 
                        or group day care home shall not be required 
                        under this paragraph to provide beverages other 
                        than beverages the State has identified as 
                        acceptable substitutes.
                    ``(D) Excess expenses borne by institution.--A 
                participating institution or family or group day care 
                home shall be responsible for any expenses that--
                            ``(i) are incurred by the institution or 
                        family or group day care home to provide 
                        substitutions under this paragraph; and
                            ``(ii) are in excess of expenses covered 
                        under reimbursements under this Act.
            ``(5) Nondiscrimination policy.--No physical segregation or 
        other discrimination against any child shall be made because of 
        the inability of the child to pay, nor shall there be any overt 
        identification of any such child by special tokens or tickets, 
        different meals or meal service, announced or published lists 
        of names, or other means.
            ``(6) Use of abundant and donated foods.--To the maximum 
        extent practicable, each institution shall use in its food 
        service foods that are--
                    ``(A) designated from time to time by the Secretary 
                as being in abundance, either nationally or in the food 
                service area; or
                    ``(B) donated by the Secretary.''; and
            (3) by adding at the end the following:
    ``(u) Promoting Health and Wellness in Child Care.--
            ``(1) Physical activity and electronic media use.--The 
        Secretary shall encourage participating child care centers and 
        family or group day care homes--
                    ``(A) to provide to all children under the 
                supervision of the participating child care centers and 
                family or group day care homes daily opportunities for 
                structured and unstructured age-appropriate moderate-
                intensity to vigorous-intensity physical activity; and
                    ``(B) to limit among children under the supervision 
                of the participating child care centers and family or 
                group day care homes the use of electronic media to an 
                appropriate level.
            ``(2) Water consumption.--Participating child care centers 
        and family or group day care homes shall make available to 
        children, as nutritionally appropriate, water as an acceptable 
        fluid for consumption throughout the day, including at meal 
        times.
            ``(3) Technical assistance and guidance.--
                    ``(A) In general.--The Secretary shall provide 
                technical assistance to institutions participating in 
                the program under this section to assist participating 
                child care centers and family or group day care homes 
                in complying with the nutritional and wellness 
                requirements prescribed by the Secretary in accordance 
                with this subsection and subsection (g).
                    ``(B) Guidance.--Not later than January 1, 2011, 
                the Secretary shall issue guidance to States and 
                institutions to encourage participating child care 
                centers and family or group day care homes serving 
                meals and snacks under this section to--
                            ``(i) include foods that are recommended 
                        for increased serving consumption in amounts 
                        recommended by the most recent Dietary 
                        Guidelines for Americans published under 
                        section 301 of the National Nutrition 
                        Monitoring and Related Research Act of 1990 (7 
                        U.S.C. 5341), including fresh, canned, frozen, 
                        or dried whole fruits and vegetables, whole 
                        grain products, lean meat products, and low-fat 
                        and non-fat dairy products; and
                            ``(ii) reduce sedentary activities and 
                        provide opportunities for regular physical 
                        activity in quantities recommended by the most 
                        recent Dietary Guidelines for Americans 
                        described in clause (i).
                    ``(C) Nutrition.--Technical assistance relating to 
                the nutritional requirements of this subsection and 
                subsection (g) shall include--
                            ``(i) nutrition education, including 
                        education that emphasizes the relationship 
                        between nutrition, physical activity, and 
                        health;
                            ``(ii) menu planning;
                            ``(iii) interpretation of nutrition labels; 
                        and
                            ``(iv) food preparation and purchasing 
                        guidance to produce meals and snacks that are--
                                    ``(I) consistent with the goals of 
                                the most recent Dietary Guidelines; and
                                    ``(II) promote the health of the 
                                population served by the program under 
                                this section, as recommended by 
                                authoritative scientific organizations.
                    ``(D) Physical activity.--Technical assistance 
                relating to the physical activity requirements of this 
                subsection shall include--
                            ``(i) education on the importance of 
                        regular physical activity to overall health and 
                        well being; and
                            ``(ii) sharing of best practices for 
                        physical activity plans in child care centers 
                        and homes as recommended by authoritative 
                        scientific organizations.
                    ``(E) Electronic media use.--Technical assistance 
                relating to the electronic media use requirements of 
                this subsection shall include--
                            ``(i) education on the health impacts of 
                        overuse of and overexposure to electronic media 
                        by children; and
                            ``(ii) sharing of best practices for the 
                        development of daily activity plans that limit 
                        use of electronic media.
                    ``(F) Minimum assistance.--At a minimum, the 
                technical assistance required under this paragraph 
                shall include a handbook, developed by the Secretary in 
                coordination with the Secretary for Health and Human 
                Services, that includes recommendations, guidelines, 
                and best practices for participating institutions and 
                family or group day care homes that are consistent with 
                the nutrition, physical activity, and wellness 
                requirements and recommendations of this subsection.
                    ``(G) Additional assistance.--In addition to the 
                requirements of this paragraph, the Secretary shall 
                develop and provide such appropriate training and 
                education materials, guidance, and technical assistance 
                as the Secretary considers to be necessary to comply 
                with the nutritional and wellness requirements of this 
                subsection and subsection (g).
                    ``(H) Funding.--
                            ``(i) In general.--On October 1, 2009, and 
                        on each October 1 thereafter through October 1, 
                        2013, out of any funds in the Treasury not 
                        otherwise appropriated, the Secretary of the 
                        Treasury shall transfer to the Secretary to 
                        provide technical assistance under this 
                        subsection $3,000,000, to remain available 
                        until expended.
                            ``(ii) Receipt and acceptance.--The 
                        Secretary shall be entitled to receive, shall 
                        accept, and shall use to carry out this 
                        subsection the funds transferred under clause 
                        (i), without further appropriation.''.

SEC. 202. INTERAGENCY COORDINATION TO PROMOTE HEALTH AND WELLNESS IN 
              CHILD CARE LICENSING.

    The Secretary of Agriculture shall coordinate with the Secretary of 
Health and Human Services to encourage State licensing agencies to 
include nutrition and wellness standards within State licensing 
standards that ensure, to the maximum extent practicable, that licensed 
child care centers and family or group day care homes--
            (1) provide to all children under the supervision of the 
        child care centers and family or group day care homes daily 
        opportunities for age-appropriate moderate-intensity to 
        vigorous-intensity physical activity;
            (2) limit among children under the supervision of the child 
        care centers and family or group day care homes the use of 
        electronic media and the quantity of time spent in sedentary 
        activity to an appropriate level;
            (3) serve meals and snacks that are consistent with the 
        child and adult care food program established under section 17 
        of the Richard B. Russell National School Lunch Act (42 U.S.C. 
        1766); and
            (4) promote such other nutrition and wellness goals as the 
        Secretaries determine to be necessary.

SEC. 203. STUDY ON NUTRITION AND WELLNESS QUALITY OF CHILD CARE 
              SETTINGS.

    (a) In General.--Not less than 4 years after the date of enactment 
of this Act, and not less frequently than once every 5 years 
thereafter, the Secretary of Agriculture shall submit to Congress a 
report based on--
            (1) a nationally representative study of child care centers 
        and family or group day care homes that--
                    (A) is designed in consultation with the Secretary 
                of Health and Human Services; and
                    (B) includes an assessment of--
                            (i) the nutritional quality of all foods 
                        provided to children in child care settings as 
                        compared to the recommendations in most recent 
                        Dietary Guidelines for Americans published 
                        under section 301 of the National Nutrition 
                        Monitoring and Related Research Act of 1990 (7 
                        U.S.C. 5341);
                            (ii) the quantity and type of opportunities 
                        for physical activity provided to children in 
                        child care settings; and
                            (iii) the quantity of time spent by 
                        children in child care settings in sedentary 
                        activities; and
            (2) an assessment of the barriers to and facilitators for--
                    (A) providing foods to children in child care 
                settings that meet the recommendations in the most 
                recent Dietary Guidelines for Americans published under 
                section 301 of the National Nutrition Monitoring and 
                Related Research Act of 1990 (7 U.S.C. 5341);
                    (B) providing the appropriate quantity and type of 
                opportunities for physical activity for children in 
                child care settings; and
                    (C) participation by child care centers and family 
                or group day care homes in the child and adult care 
                food program established under section 17 of the 
                Richard B. Russell National School Lunch Act (42 U.S.C. 
                1766).
    (b) Funding.--
            (1) In general.--On October 1, 2010, out of any funds in 
        the Treasury not otherwise appropriated, the Secretary of the 
        Treasury shall transfer to the Secretary of Agriculture to 
        carry out this section $5,000,000, to remain available until 
        expended.
            (2) Receipt and acceptance.--The Secretary of Agriculture 
        shall be entitled to receive, shall accept, and shall use to 
        carry out this section the funds transferred under paragraph 
        (1), without further appropriation. 

SEC. 204. WORKING GROUP TO REDUCE PAPERWORK AND IMPROVE PROGRAM 
              ADMINISTRATION.

    (a) Definitions.--In this section:
            (1) Program.--The term ``program'' means the child and 
        adult care food program established under section 17 of the 
        Richard B. Russell National School Lunch Act (42 U.S.C. 1766).
            (2) Secretary.--The term ``Secretary'' means the Secretary 
        of Agriculture.
    (b) Establishment.--The Secretary, in conjunction with States and 
participating institutions, shall reconvene a working group to continue 
to examine the feasibility of reducing unnecessary or duplicative 
paperwork resulting from regulations and recordkeeping requirements for 
State agencies, institutions, family and group day care homes, and 
sponsored centers participating in the program.
    (c) Duties.--At a minimum, the working group shall--
            (1) review and evaluate the recommendations, guidance, and 
        regulatory priorities developed and issued to comply with 
        section 119(i) of the Child Nutrition and WIC Reauthorization 
        Act of 2004 (42 U.S.C. 1766 note; Public Law 108-265); and
            (2) examine additional paperwork and administrative 
        requirements that have been established since February 23, 
        2007, that could be reduced or simplified.
    (d) Additional Duties.--In addition to, or operating concurrently 
with, the working group described in subsection (b), the Secretary may, 
if determined necessary by the Secretary and in conjunction with States 
and institutions participating in the program, establish 1 or more 
working groups to examine any aspect of administration of the program.
    (e) Report.--Not later than 4 years after the date of enactment of 
this Act, the Secretary shall submit to Congress a report that 
describes the actions that have been taken to carry out this section, 
including--
            (1) actions taken to address administrative and paperwork 
        burdens identified as a result of compliance with section 
        119(i) of the Child Nutrition and WIC Reauthorization Act of 
        2004 (42 U.S.C. 1766 note; Public Law 108-265);
            (2) administrative and paperwork burdens identified as a 
        result of compliance with section 119(i) of that Act for which 
        no regulatory action or policy guidance has been taken;
            (3) additional steps that the Secretary is taking or plans 
        to take to address any administrative and paperwork burdens 
        identified under subsection (c)(2) and paragraph (2), 
        including--
                    (A) new or updated regulations, policy, guidance, 
                or technical assistance; and
                    (B) a timeframe for the completion of those steps; 
                and
            (4) recommendations to Congress for modifications to 
        existing statutory authorities needed to address identified 
        administrative and paperwork burdens.

SEC. 205. RENEWAL OF APPLICATION MATERIALS AND PERMANENT OPERATING 
              AGREEMENTS.

    (a) Permanent Operating Agreements.--Section 17(d)(1) of the 
Richard B. Russell National School Lunch Act (42 U.S.C. 1766(d)(1)) is 
amended by adding at the end the following:
                    ``(E) Permanent operating agreements.--
                            ``(i) In general.--Subject to clauses (ii) 
                        and (iii), to participate in the child and 
                        adult care food program, an institution that 
                        meets the conditions of eligibility described 
                        in this subsection shall be required to enter 
                        into a permanent agreement with the applicable 
                        State agency.
                            ``(ii) Amendments.--A permanent agreement 
                        described in clause (i) may be amended as 
                        necessary to ensure that the institution is in 
                        compliance with all requirements established in 
                        this section or by the Secretary.
                            ``(iii) Termination.--A permanent agreement 
                        described in clause (i)--
                                    ``(I) may be terminated for 
                                convenience by the institution and 
                                State agency that is a party to the 
                                permanent agreement; and
                                    ``(II) shall be terminated--
                                            ``(aa) for cause by the 
                                        applicable State agency in 
                                        accordance with paragraph (5); 
                                        or
                                            ``(bb) on termination of 
                                        participation of the 
                                        institution in the child and 
                                        adult care food program.''.
    (b) Applications.--Section 17(d) of the Richard B. Russell National 
School Lunch Act (42 U.S.C. 1766(d)) is amended by striking paragraph 
(2) and inserting the following:
            ``(2) Program applications.--
                    ``(A) In general.--The Secretary shall develop a 
                policy under which each institution providing child 
                care that participates in the program under this 
                section shall--
                            ``(i) submit to the State agency an initial 
                        application to participate in the program that 
                        meets all requirements established by the 
                        Secretary by regulation;
                            ``(ii) annually confirm to the State agency 
                        that the institution, and any facilities of the 
                        institution in which the program is operated by 
                        a sponsoring organization, is in compliance 
                        with subsection (a)(5); and
                            ``(iii) annually submit to the State agency 
                        any additional information necessary to confirm 
                        that the institution is in compliance with all 
                        other requirements to participate in the 
                        program, as established by the Secretary by 
                        regulation.
                    ``(B) Reviews.--The Secretary shall develop a 
                policy under which each sponsoring organization 
                participating in the program shall conduct--
                            ``(i) periodic unannounced site visits at 
                        not less than 3-year intervals to sponsored 
                        child care centers and family or group day care 
                        homes to identify and prevent management 
                        deficiencies and fraud and abuse under the 
                        program;
                            ``(ii) at least 1 scheduled site visit at 
                        not less than 3-year intervals to sponsoring 
                        organizations and nonsponsored child care 
                        centers to identify and prevent management 
                        deficiencies and fraud and abuse under the 
                        program and to improve program operations; and
                            ``(iii) periodic site visits to private 
                        institutions that the State agency determines 
                        have a high probability of program abuse.''.
    (c) Agreements.--Section 17(j)(1) of the Richard B. Russell 
National School Lunch Act (42 U.S.C. 1766(j)(1)) is amended--
            (1) by striking ``may'' and inserting ``shall'';
            (2) by striking ``family or group day care'' the first 
        place it appears; and
            (3) by inserting ``or sponsored day care centers'' before 
        ``participating''.

SEC. 206. TRANSMISSION OF INCOME INFORMATION BY SPONSORED FAMILY OR 
              GROUP DAY CARE HOMES.

    Section 17(f)(3)(A)(iii)(III) of the Richard B. Russell National 
School Lunch Act (42 U.S.C. 1766(f)(3)(A)(iii)(III)) is amended by 
adding at the end the following:
                                            ``(dd) Transmission of 
                                        income information by sponsored 
                                        family or group day care 
                                        homes.--If a family or group 
                                        day care home elects to be 
                                        provided reimbursement factors 
                                        described in subclause (II), 
                                        the family or group day care 
                                        home may assist in the 
                                        transmission of necessary 
                                        household income information to 
                                        the family or group day care 
                                        home sponsoring organization in 
                                        accordance with the policy 
                                        described in item (ee).
                                            ``(ee) Policy.--The 
                                        Secretary shall develop a 
                                        policy under which a sponsored 
                                        family or group day care home 
                                        described in item (dd) may, 
                                        under terms and conditions 
                                        specified by the Secretary and 
                                        with the written consent of the 
                                        parents or guardians of a child 
                                        in a family or group day care 
                                        home participating in the 
                                        program, assist in the 
                                        transmission of the income 
                                        information of the family to 
                                        the family or group day care 
                                        home sponsoring 
                                        organization.''.

SEC. 207. SIMPLIFYING AND ENHANCING ADMINISTRATIVE PAYMENTS TO 
              SPONSORING ORGANIZATIONS.

    Section 17(f)(3) of the Richard B. Russell National School Lunch 
Act (42 U.S.C. 1766(f)(3)) is amended by striking subparagraph (B) and 
inserting the following:
                    ``(B) Administrative funds.--
                            ``(i) In general.--In addition to 
                        reimbursement factors described in subparagraph 
                        (A), a family or group day care home sponsoring 
                        organization shall receive reimbursement for 
                        the administrative expenses of the sponsoring 
                        organization in an amount that is not less than 
                        the product obtained each month by 
                        multiplying--
                                    ``(I) the number of family and 
                                group day care homes of the sponsoring 
                                organization submitting a claim for 
                                reimbursement during the month; by
                                    ``(II) the appropriate 
                                administrative rate determined by the 
                                Secretary.
                            ``(ii) Annual adjustment.--The 
                        administrative reimbursement levels specified 
                        in clause (i) shall be adjusted July 1 of each 
                        year to reflect changes in the Consumer Price 
                        Index for All Urban Consumers published by the 
                        Bureau of Labor Statistics of the Department of 
                        Labor for the most recent 12-month period for 
                        which such data are available.
                            ``(iii) Carryover funds.--The Secretary 
                        shall develop procedures under which not more 
                        than 10 percent of the amount made available to 
                        sponsoring organizations under this section for 
                        administrative expenses for a fiscal year may 
                        remain available for obligation or expenditure 
                        in the succeeding fiscal year.
                            ``(iv) Return to secretary.--Any amounts 
                        appropriated that are not obligated or expended 
                        during a fiscal year and are not carried over 
                        for the succeeding fiscal year under clause 
                        (iii) shall be returned to the Secretary.''.

SEC. 208. CULTIVATE FARM-TO-SCHOOL PARTNERSHIPS.

    (a) Promoting Local Food.--Section 9(j)(1) of the Richard B. 
Russell National School Lunch Act (42 U.S.C. 1758(j)(1)) is amended by 
inserting before the semicolon at the end, ``, for use in programs 
under such Acts, including the commodity distribution program, the 
summer food service program for children, child and adult care food 
program, and nutrition promotion''.
    (b) Grants for Farm-to-School Programs.--
            (1) In general.--The Richard B. Russell National School 
        Lunch Act (42 U.S.C. 1751 et seq.) is amended by inserting 
        after section 19, the following:

``SEC. 19A. GRANTS FOR FARM-TO-SCHOOL PROGRAMS.

    ``(a) In General.--The Secretary may provide assistance, through 
competitive matching grants and technical assistance, to schools and 
nonprofit entities for farm-to-school programs that--
            ``(1) improve access to local foods in schools and 
        institutions participating in programs under this Act and 
        section 4 of the Child Nutrition Act of 1966 (42 U.S.C. 1773) 
        through farm-to-cafeteria activities, including school gardens, 
        that may include the acquisition of food and appropriate 
        equipment and the provision of training and education;
            ``(2) are, at a minimum, designed to--
                    ``(A) procure local foods from small- and medium-
                sized farms for school meals; and
                    ``(B) support school garden programs;
            ``(3) support nutrition education activities or curriculum 
        planning that promotes healthy food education in the school 
        curriculum and incorporates the participation of school 
        children in farm-based agricultural education activities, that 
        may include school gardens;
            ``(4) develop a sustained commitment to farm-to-cafeteria 
        projects in the community by linking schools, State departments 
        of agriculture, agricultural producers, parents, and other 
        community stakeholders;
            ``(5) require $100,000 or less in Federal contributions;
            ``(6) require a Federal share of costs not to exceed 75 
        percent;
            ``(7) provide matching support in the form of cash or in-
        kind contributions (including facilities, equipment, or 
        services provided by State and local governments and private 
        sources); and
            ``(8) cooperate in an evaluation carried out by the 
        Secretary.
    ``(b) Administration.--In providing grants under subsection (a), 
the Secretary shall give priority to programs that can be replicated in 
schools.
    ``(c)  Program for High-Poverty Schools.--
            ``(1) Definitions.--In this subsection:
                    ``(A) Eligible program.--The term `eligible 
                program' means--
                            ``(i) a school-based program with hands-on 
                        vegetable gardening and nutrition education 
                        that is incorporated into the curriculum for 1 
                        or more grades at 2 or more eligible schools; 
                        or
                            ``(ii) a community-based summer program 
                        with hands-on vegetable gardening and nutrition 
                        education that is part of, or coordinated with, 
                        a summer enrichment program at 2 or more 
                        eligible schools.
                    ``(B) Eligible school.--The term `eligible school' 
                means a public school, at least 50 percent of the 
                students of which are eligible for free or reduced 
                price meals under this Act.
            ``(2) Establishment.--The Secretary shall carry out a 
        program under which the Secretary shall provide to nonprofit 
        organizations or public entities States grants to develop and 
        run, through eligible programs, community gardens at eligible 
        schools in the States that would--
                    ``(A) be planted, cared for, and harvested by 
                students at the eligible schools; and
                    ``(B) teach the students participating in the 
                community gardens about agriculture production 
                practices and diet.
            ``(3) Priority states.--Of the States in which grantees 
        under this subsection are located--
                    ``(A) at least 1 State shall be among the 15 
                largest States, as determined by the Secretary;
                    ``(B) at least 1 State shall be among the 16th to 
                30th largest States, as determined by the Secretary; 
                and
                    ``(C) at least 1 State shall be a State that is not 
                described in subparagraph (A) or (B).
            ``(4) Use of produce.--Produce from a community garden 
        provided a grant under this subsection may be--
                    ``(A) used to supplement food provided at the 
                eligible school;
                    ``(B) distributed to students to bring home to the 
                families of the students; or
                    ``(C) donated to a local food bank or senior center 
                nutrition program.
            ``(5) No cost-sharing requirement.--A nonprofit 
        organization or public entity that receives a grant under this 
        subsection shall not be required to share the cost of carrying 
        out the activities assisted under this paragraph.
            ``(6) Evaluation.--A nonprofit organization or public 
        entity that receives a grant under this subsection shall be 
        required to cooperate in an evaluation in accordance with 
        subsection (a)(8).
    ``(d) Guidance for States.--Not later than 1 year after the date of 
the enactment of this section, the Secretary shall research, evaluate, 
and make available to States--
            ``(1) best practices for innovative and effective, as 
        determined by the Secretary, farm-to-school programs described 
        in subsection (a);
            ``(2) an identification of the common challenges faced by 
        schools, institutions, and local educational agencies in 
        carrying out such farm-to-school programs; and
            ``(3) a description of schools, institutions, and local 
        educational agencies that are carrying out successful farm-to-
        school programs.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as are necessary to carry out this section for 
each of fiscal years 2011 through 2016.''.
            (2) Conforming amendments.--Section 18(g) of the Richard B. 
        Russell National School Lunch Act (42 U.S.C. 1769(g)) is 
        repealed.

 TITLE III--IMPROVING ACCESS TO AND OPPORTUNITY FOR PHYSICAL ACTIVITY 
                        FOR ADULTS AND CHILDREN

Subtitle A--National Program Promoting Lifelong Active Youth (PLAY) and 
                         Implementation Grants

SEC. 301. PLAY ASSESSMENT TOOLS.

    (a) In General.--The Secretary of Health and Human Services 
(hereafter in this section referred to as the Secretary), acting 
through the Director of the Centers for Disease Control and Prevention, 
shall develop a list of well-validated assessment tools, which can 
measure the policy, program, or environmental barriers in communities 
to participating in physical activity. Tools on the Secretary's 
recommended list shall include--
            (1) cross-cutting measurements that--
                    (A) examine barriers to physical activities across 
                multiple settings, including homes, after-school and 
                child care sites, schools, the community-at-large, and 
                worksites; and
                    (B) focus on the--
                            (i) availability of adequate spaces and 
                        places for physical activity;
                            (ii) availability of, and access to, high-
                        quality physical activity and physical 
                        education programs; and
                            (iii) the availability of programs, 
                        activities, and leaders to educate about the 
                        importance of physical activity for the 
                        community; and
            (2) additional measurements to assist economically and 
        culturally diverse communities in examining the social 
        determinants of health.
    (b) Guidance and Training.--The Secretary shall provide guidelines 
and recommendations to develop training on utilizing such tools.

SEC. 302. MODEL COMMUNITIES OF PLAY IMPLEMENTATION GRANTS.

    (a) Program Authorized.--
            (1) In general.--The Secretary of Health and Human Services 
        (hereafter in this section referred to as the ``Secretary''), 
        acting through the Director of the Centers for Disease Control 
        and Prevention, shall award grants to State health departments 
        to enable the State health departments to work in partnership 
        with eligible community-based coalitions to plan and implement 
        model communities of play that increase--
                    (A) the physical spaces and places available for 
                physical activity;
                    (B) the opportunities for children and families to 
                participate in high-quality play, and the number of 
                children and families participating in high-quality 
                play;
                    (C) knowledge and awareness about the importance of 
                individuals achieving 60 minutes of recommended 
                physical activity every day; and
                    (D) school siting practices in which elementary and 
                secondary schools are located within neighborhoods to 
                increase the likelihood of students walking and biking 
                to school.
            (2) Amount of grants.--A grant awarded to a State health 
        department under this subsection shall be in the amount of 
        $250,000 to $1,000,000.
    (b) Application.--A State health department desiring a grant under 
subsection (a) shall submit an application to the Secretary at such 
time, in such manner, and containing such information as the Secretary 
may require.
    (c) Coordination.--In awarding grants under subsection (a), the 
Secretary shall ensure that the proposed programs assisted under each 
grant are coordinated in substance and format with programs currently 
funded through other Federal departments and agencies, including--
            (1) State-based nutrition and physical activity programs, 
        comprehensive school health education programs, and community-
        based health and wellness programs of the Centers for Disease 
        Control and Prevention;
            (2) the physical education programs under subpart 10 of 
        part D of title V of the Elementary and Secondary Education Act 
        of 1965 (20 U.S.C. 7261 et seq.);
            (3) the safe routes to schools program under section 1404 
        of the Safe, Accountable, Flexible, Efficient Transportation 
        Equity Act: A Legacy for Users (23 U.S.C. 402 note); and
            (4) other health and wellness programs operating within the 
        community.
    (d) Partnership With Community Coalitions.--A State health 
department receiving a grant under subsection (a) shall use the 
majority of grant funds to carry out the activities described in 
subsection (e) in partnership with 1 or more community coalitions that 
meet all of the following requirements:
            (1) The community coalition is comprised of a 
        representative sampling of community partners, including not 
        less than half of the following types of individuals and 
        entities:
                    (A) A community-based organization that focuses on 
                children and youth, preventive health, physical 
                activity, or physical education.
                    (B) A local parks and recreation department.
                    (C) A local health department.
                    (D) A local educational agency, as defined in 
                section 9101 of the Elementary and Secondary Education 
                Act of 1965 (20 U.S.C. 7801).
                    (E) A local city planning agency.
                    (F) A local health care provider.
                    (G) An institution of higher education, as defined 
                in section 101 of the Higher Education Act of 1965 (20 
                U.S.C. 1001).
                    (H) A tribal health facility, where applicable.
                    (I) A tribal educational agency, where applicable.
                    (J) A federally qualified health center or rural 
                health clinic (as such terms are defined in section 
                1861(aa) of the Social Security Act (42 U.S.C. 
                1395x(aa)), where applicable.
                    (K) A hospital.
                    (L) A faith-based organization.
                    (M) A policymaker or elected official.
                    (N) A community planning organization.
                    (O) A business.
            (2) The community coalition completed and submitted to the 
        State health department--
                    (A) an assessment tool identified by the Secretary 
                under section 301 for the community that identifies the 
                gaps and barriers to physical activity in the community 
                to children and youth; and
                    (B) a community action plan describing the 
                programs, policies, and environmental change strategies 
                that will be implemented with grant funds to help 
                children and youth in the community reach the 
                recommended 60 minutes of physical activity every day.
            (3) The community coalition provided--
                    (A) documentation to the State health department on 
                the manner in which the coalition will coordinate with 
                appropriate State and local authorities, including--
                            (i) State or local health departments;
                            (ii) State educational agencies or local 
                        educational agencies, as defined in section 
                        9101 of the Elementary and Secondary Education 
                        Act of 1965 (20 U.S.C. 7801);
                            (iii) State or local parks and recreation 
                        departments or associations;
                            (iv) State or local departments of 
                        transportation or city planning;
                            (v) community foundations; and
                            (vi) any other entities determined to be 
                        appropriate by the Secretary; and
                    (B) a description of the manner in which the 
                coalition will evaluate the effectiveness of the 
                programs carried out with grant funds.
    (e) Authorized Activities.--A State health department that receives 
a grant under subsection (a) shall use the majority of funds available 
through the grant to carry out the following activities:
            (1) Train community-based coalitions on how to utilize 
        assessment tools to measure the program, policy, and 
        environmental barriers to promoting lifelong physical activity 
        for youth.
            (2) Work in partnership with one or more community 
        coalitions described in subsection (d) to enable the coalitions 
        to carry out the coalition's community action plan and promote 
        a model community of play, which may include the following:
                    (A) Enabling the maximum use of, or the creation of 
                spaces and places for, physical activity for children, 
                families, and communities before, during, and after 
                school or work, which may include increasing the number 
                of--
                            (i) programs that increase the number of 
                        safe streets and sidewalks in the community to 
                        walk and bike to school, work, or other 
                        community destinations, such as recreation 
                        sites, parks, or community centers;
                            (ii) schools, faith-based organizations, 
                        and recreational facilities serving the 
                        community that provide programming on physical 
                        activity and physical education before, during, 
                        or after school;
                            (iii) schools serving the community that 
                        provide recess, physical education, and 
                        physical activity for children and youth;
                            (iv) day care, child care, and after-school 
                        care sites in the community that provide 
                        physical activity for children and youth;
                            (v) venues in the community that provide 
                        co-curricular physical activity programs, 
                        including sports fields and courts, especially 
                        venues for all-inclusive intramural programs 
                        and physical activity clubs;
                            (vi) playgrounds and activity sites in the 
                        community for young children, including sites 
                        that offer programs that provide physical 
                        activity instruction that meets the various 
                        needs and interests of all students, including 
                        those with illness, injury, and physical and 
                        developmental disabilities, as well as those 
                        who live sedentary lifestyles or have a 
                        disinterest in traditional team sports;
                            (vii) capital improvement projects that 
                        increase opportunities for physical activity in 
                        the community; and
                            (viii) networks of walking and cycling 
                        trails where trails do not exist in the 
                        community, that offer both a functional 
                        alternative to automobile travel and an 
                        opportunity for exercise, recreation, and 
                        community connectedness.
                    (B) Enhancing opportunities and access for children 
                and youth in the community to participate in high-
                quality physical activity and physical education 
                programs before, during, and after school, which may 
                include increasing the number of--
                            (i) school and after-school care sites in 
                        the community that implement proven health 
                        curricula, physical education (including 
                        developing innovative approaches to teaching 
                        and staffing physical education), and physical 
                        activity programming;
                            (ii) children and youth in the community 
                        who are able to participate in physical 
                        education or activity before, during, or after 
                        school, by ensuring that adequate equipment is 
                        available to such children and youth;
                            (iii) scholarships to low-income children 
                        and youth for physical activity programs;
                            (iv) education and training programs for 
                        education, recreation, leisure, child care, and 
                        coaching professionals regarding high-quality 
                        physical education and physical activity 
                        programs and policies;
                            (v) training programs to assist physicians 
                        in--
                                    (I) carefully communicating the 
                                results of body mass index (BMI) tests 
                                to parents and, in an age-appropriate 
                                manner, to the children and youth 
                                themselves;
                                    (II) providing information to 
                                families so they may make informed 
                                decisions about physical activity and 
                                nutrition; and
                                    (III) explaining the benefits 
                                associated with physical activity and 
                                the risks associated with childhood 
                                overweight and obesity;
                            (vi) assessment tools used to measure the 
                        quality of physical activity, sports, and 
                        intramural sports programs;
                            (vii) guidelines and informational 
                        materials used by teachers, parents, 
                        caregivers, and health-care professionals who 
                        are interested in promoting physical activity 
                        for infants, toddlers, and preschoolers; and
                            (viii) guidelines and informational 
                        materials used to promote--
                                    (I) physical activity with the 
                                intent of improving the current health, 
                                fitness, and wellness of preadolescent 
                                children (ages 6 through 12); and
                                    (II) lifelong physical activity.
                    (C) Identifying, engaging, and mobilizing community 
                leaders, decisionmakers, experts, and the media to 
                raise awareness and educate the public about the 
                importance of securing 60 minutes of physical activity 
                every day, which may include increasing the number of--
                            (i) school and after-school care faculty 
                        and staff, including coaches, who serve as 
                        positive role models for students regarding 
                        regular physical activity;
                            (ii) businesses that serve as role models 
                        by providing physical space and incentives for 
                        employees to participate in physical activity;
                            (iii) businesses that serve as role models 
                        to communities by--
                                    (I) providing support to intramural 
                                teams, clubs, sports leagues, 
                                playgrounds, trails, biking and walking 
                                paths, and fields and venues for 
                                sports, play, and physical activity;
                                    (II) incorporating built 
                                environment strategies into new 
                                construction of facilities;
                                    (III) adopting safe routes to 
                                school programs;
                                    (IV) providing bike racks at the 
                                office; and
                                    (V) encouraging the use of the 
                                stairs;
                            (iv) insurers that cover obesity screening 
                        and prevention services in routine clinical 
                        practice;
                            (v) groups representing low-income 
                        individuals or individuals with disabilities, 
                        that can promote and secure safer and more 
                        accessible sites for activity;
                            (vi) consumer research-driven marketing 
                        strategies for ongoing initiatives and 
                        interventions that enhance physical activity 
                        for children and youth;
                            (vii) products and opportunities provided 
                        or offered by leisure, entertainment, and 
                        recreation industries that promote regular 
                        physical activity and reduce sedentary 
                        behaviors;
                            (viii) media advocacy training programs for 
                        public health and exercise scientists so as to 
                        empower the scientists to disseminate their 
                        knowledge to a broad audience; and
                            (ix) campaigns to foster awareness about 
                        the health benefits of regular physical 
                        activity of not less than 60 minutes a day for 
                        all children and youth.
            (3) Support the evaluation of community action plans of 
        community coalitions described in subsection (d) and activities 
        carried out pursuant to this Act.
    (f) Definition.--In this section, the term ``State'' includes the 
District of Columbia and any commonwealth, territory, or possession of 
the United States.
    (g) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2011 through 2016.

                 Subtitle B--Moving Outdoors in Nature

SEC. 311. DEFINITIONS.

    In this subtitle:
            (1) The term ``eligible entity'' means--
                    (A) a State, city, county, municipality, entity of 
                local government, park and recreation department or 
                district, school district, institution of higher 
                education, or nonprofit organization; or
                    (B) a consortium of entities specified in 
                subparagraph (A).
            (2) The term ``Secretary'' means the Secretary of the 
        Interior.
            (3) The term ``State'' means any of the several States, the 
        District of Columbia, the Commonwealth of Puerto Rico, the 
        United States Virgin Islands, Guam, American Samoa, the 
        Commonwealth of the Northern Mariana Islands, any other 
        territory or possession of the United States, or any Indian 
        tribe.

SEC. 312. GRANTS FOR DEVELOPMENT OR IMPLEMENTATION OF MOVING OUTDOORS 
              IN NATURE STRATEGIES.

    (a) In General.--The Secretary may award competitive grants or 
cooperative agreements to States, or other eligible entities in lieu of 
a State, to develop and implement a 5-year strategy, to be known as a 
Moving Outdoors in Nature State Strategy, for connecting children and 
families with the outdoors.
    (b) Submission and Approval of Strategies.--
            (1) Applications.--An application for a grant under 
        subsection (a) shall--
                    (A) be submitted not later than 120 days after the 
                Secretary publishes guidelines under subsection (g)(1); 
                and
                    (B) include a Moving Outdoors in Nature State 
                Strategy meeting the requirements of subsection (c) or 
                a proposal for development and submission of such a 
                strategy.
            (2) Approval of strategy; peer review.--Not later than 90 
        days after submission of a Moving Outdoors in Nature State 
        Strategy, the Secretary shall approve or recommend changes to 
        the strategy. The Secretary shall carry out the preceding 
        sentence through a peer review process that includes 
        participation from Federal, State, and local government and 
        nongovernmental organizations.
            (3) Strategy update.--An eligible entity receiving funds 
        under this subtitle shall update its Moving Outdoors in Nature 
        State Strategy not less than every 5 years to reflect any 
        changes and modifications.
    (c) Comprehensive Strategy Requirements.--The Secretary may approve 
a Moving Outdoors in Nature State Strategy under subsection (b)(2) only 
if the strategy includes the following:
            (1) A description of how the eligible entity will connect 
        children, youth, and families to the great outdoors through 
        State and local--
                    (A) public health systems;
                    (B) public parks and recreation systems;
                    (C) public transportation and city planning 
                systems; and
                    (D) other public systems that connect children, 
                youth, and families to the great outdoors.
            (2) A description of how the eligible entity will connect 
        existing governmental systems to networks of nongovernmental 
        partner organizations serving children, youth, and families.
            (3) A description of how State agencies, such as State 
        departments of health, natural resources, environmental 
        quality, fish and wildlife, national guard, and transportation, 
        will collaborate with each other and with nongovernmental 
        organizations and local agencies to implement the strategy.
            (4) A description of how funding will be spent through 
        local planning and implementation grants under subsection (d).
            (5) A description of how the eligible entity will evaluate 
        the effectiveness of, and measure the impact of, the strategy.
            (6) A description of how the eligible entity will provide 
        opportunities for public involvement in developing and 
        implementing the strategy through a public comment period, 
        public hearings, or other means.
    (d) Local Planning and Implementation.--
            (1) In general.--A Moving Outdoors in Nature State Strategy 
        shall provide for--
                    (A) local planning; and
                    (B) subgrants by the eligible entity receiving a 
                grant under subsection (a) to local eligible entities 
                to implement the strategy through one or more of the 
                activities described in paragraph (2).
            (2) Program activities.--The activities described in this 
        paragraph are the following:
                    (A) Outdoor recreation programs and activities that 
                engage children, youth, and families in healthy, active 
                time outdoors through camping, hiking, hunting, 
                fishing, archery, recreational shooting, wildlife 
                watching, and other recreational activities that teach 
                skills for lifelong participation in outdoor 
                activities.
                    (B) Public health initiatives to educate parents 
                and caregivers about the health benefits of active time 
                outdoors to fight obesity and increase the quality of 
                life for children, youth, and families.
                    (C) Creation of natural play areas within 
                communities, as defined by nationally recognized 
                guidelines, to provide opportunities for safe outdoor 
                play in natural environments at daycare and afterschool 
                child care sites, schools, parks, recreation centers, 
                camps, libraries, military installations, and other 
                areas.
                    (D) Development of trails and greenways to safely 
                connect parks and outdoor recreation areas with 
                military installations, daycare and afterschool child 
                care sites, schools, and communities through trail 
                systems that encourage walking, biking, and increased 
                time outdoors by children, youth, and families.
                    (E) Creation of outdoor learning environments such 
                as schoolyard, community, or backyard wildlife habitats 
                or gardens.
                    (F) Environmental, sustainability, and conservation 
                education and interpretation programs and activities 
                that engage children, youth, and families in learning 
                and physical activity in the outdoors.
                    (G) Service learning and volunteer opportunities to 
                help restore natural areas, maintain recreational 
                assets, and engage children, youth, and families in the 
                outdoors.
                    (H) Promotional activities that promote the 
                benefits of time spent outdoors and invite children, 
                youth, and families to enjoy the great outdoors by 
                visiting nearby public and private lands.
                    (I) Initiatives that engage health professionals, 
                pediatricians, educators, daycare instructors, 
                afterschool program providers, camp directors, 
                community planners, local planning commissions, 
                homeowners' associations, environmental professionals, 
                military, law enforcement, and business leaders in 
                identifying innovative solutions to connecting 
                children, youth, and families with nature.
    (e) Priority.--In making grants under subsection (a) and subgrants 
under subsection (d)(1)(B), the Secretary and the recipient of a grant 
under subsection (a) shall give preference to eligible entities that 
serve individuals who have limited opportunities to experience nature, 
including those who are socioeconomically disadvantaged or have a 
disability.
    (f) Administrative Expenses.--An eligible entity receiving a grant 
under subsection (a) may not use more than 5 percent of the grant funds 
for administrative expenses.
    (g) Guidelines.--Not later than 180 days after the enactment of 
this Act, and after notice and opportunity for public comment, the 
Secretary shall publish in the Federal Register guidelines on the 
implementation of this subtitle, including guidelines for--
            (1) developing and submitting strategies under subsection 
        (b); and
            (2) technical assistance and dissemination of best 
        practices under section 314.
    (h) Reporting.--Not later than 2 years after the Secretary approves 
the Moving Outdoors in Nature State Strategy of an eligible entity 
receiving funds under this subtitle, and every year thereafter, the 
entity shall submit to the Secretary a report on the implementation of 
the strategy based on the entity's evaluation and assessment of meeting 
the goals specified in the strategy.

SEC. 313. NATIONAL EVALUATION OF HEALTH IMPACTS.

    The Secretary shall enter into an agreement with the Secretary of 
Health and Human Services and the Director of the Centers for Disease 
Control and Prevention for--
            (1) the development of recommendations for appropriate 
        evaluation measures and criteria for developing a study of 
        national significance on the health impacts of the programs 
        under this subtitle; and
            (2) the administration of such a study.

SEC. 314. TECHNICAL ASSISTANCE AND BEST PRACTICES.

    The Secretary shall--
            (1) provide technical assistance to grantees under section 
        312, including training and technical assistance through 
        national organizations with a proven track record of connecting 
        children to the great outdoors; and
            (2) disseminate best practices that emerge from strategies 
        funded under this subtitle.

SEC. 315. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--There are authorized to be appropriated to the 
Secretary to carry out this subtitle--
            (1) $15,000,000 for fiscal year 2011;
            (2) $50,000,000 for fiscal year 2012;
            (3) $100,000,000 for fiscal year 2013; and
            (4) such sums as may be necessary for subsequent fiscal 
        years.
    (b) Limitation.--Of the amounts made available to carry out this 
subtitle for a fiscal year, not more than 5 percent may be made 
available for carrying out section 314.

                      Subtitle C--Other Provisions

SEC. 321. AUTHORIZATION OF APPROPRIATIONS FOR CAROL M. WHITE PHYSICAL 
              EDUCATION PROGRAM.

    Subpart 10 of part D of title V of the Elementary and Secondary 
Education Act of 1965 (20 U.S.C. 7261 et seq.) is amended by adding at 
the end the following:

``SEC. 5508. AUTHORIZATION OF APPROPRIATIONS.

    ``There are authorized to be appropriated to carry out this 
subpart--
            ``(1) $100,000,000 for fiscal year 2011;
            ``(2) $110,000,000 for fiscal year 2012;
            ``(3) $120,000,000 for fiscal year 2013;
            ``(4) $130,000,000 for fiscal year 2014;
            ``(5) $140,000,000 for fiscal year 2015; and
            ``(6) $150,000,000 for fiscal year 2016.''.

SEC. 322. PHYSICAL EDUCATION GUIDELINES FOR ELEMENTARY AND SECONDARY 
              SCHOOLS.

    The Secretary of Health and Human Services, acting through the 
Director of the Centers for Disease Control and Prevention--
            (1) not later than 1 year after the date of the enactment 
        of this Act, shall issue and make available to the public 
        guidelines for physical education in elementary and secondary 
        schools; and
            (2) not less than every 5 years thereafter, update such 
        guidelines as appropriate.

SEC. 323. TREATING PHYSICAL EDUCATION AS A CORE ACADEMIC SUBJECT FOR 
              ELEMENTARY AND SECONDARY EDUCATION GRANTS.

    Section 9101(11) of the Elementary and Secondary Education Act of 
1965 (20 U.S.C. 7801(11)) is amended by inserting ``physical 
education,'' after ``arts,''.

SEC. 324. PHYSICAL ACTIVITY GUIDELINES FOR PRESCHOOL CHILDREN.

    Not later than 1 year after the date of the enactment of this Act, 
the Secretary of Health and Human Services, acting through the Centers 
for Disease Control and Prevention, shall--
            (1) issue physical activity guidelines for preschool 
        children,
            (2) make such guidelines available to the public, and
            (3) make a recommendation to each Head Start agency that 
        such agency implement such guidelines as appropriate in the 
        Head Start program carried out by such agency.

SEC. 325. TRACKING PHYSICAL ACTIVITY IN SCHOOLS.

    (a) Report Cards.--Section 1111(h) of the Elementary and Secondary 
Education Act of 1965 (20 U.S.C. 6311(h)) is amended--
            (1) in paragraph (1)(C)--
                    (A) in clause (vii), by striking ``and'' after the 
                semicolon;
                    (B) in clause (viii), by striking the period at the 
                end and inserting a semicolon; and
                    (C) by adding at the end the following:
                            ``(ix) the amount of time students spend in 
                        required physical education as measured against 
                        the national standards of 150 minutes per week 
                        of required physical education for students in 
                        elementary school and 225 minutes per week of 
                        required physical education for students in 
                        middle school and secondary school;
                            ``(x) the percentage of local educational 
                        agencies in the State that have a required, 
                        age-appropriate physical education curriculum 
                        for all students in elementary schools, middle 
                        schools, and secondary schools that adheres to 
                        national guidelines adopted by the Centers for 
                        Disease Control and Prevention and State 
                        standards;
                            ``(xi) the percentage of elementary school 
                        and secondary school physical education 
                        teachers who are State licensed or certified as 
                        physical education teachers; and
                            ``(xii) the percentage of schools that have 
                        a School Health Council that includes parents, 
                        students, representatives of the school food 
                        authority, representatives of the school board, 
                        school administrators and members of the public 
                        and that meets monthly to promote a healthy 
                        school environment.'';
            (2) in paragraph (2)(B)(i)--
                    (A) in subclause (I), by striking ``and'' after the 
                semicolon;
                    (B) in subclause (II), by striking ``and'' after 
                the semicolon; and
                    (C) by adding at the end the following:
                                    ``(III) the percentage of 
                                elementary school and secondary school 
                                physical education teachers who are 
                                State certified as physical education 
                                teachers; and
                                    ``(IV) the amount of square feet of 
                                indoor and outdoor facilities that are 
                                primarily used for physical education 
                                and the amount of square feet of indoor 
                                and outdoor facilities that are 
                                primarily used for physical activity; 
                                and''; and
            (3) in paragraph (2)(B)(ii)--
                    (A) in subclause (I), by striking ``and'' after the 
                semicolon;
                    (B) in subclause (II), by striking the period at 
                the end and inserting a semicolon; and
                    (C) by adding at the end the following:
                                    ``(III) the percentage of 
                                elementary school and secondary school 
                                physical education teachers who are 
                                State certified as physical education 
                                teachers; and
                                    ``(IV) the number of meetings of a 
                                School Health Council that includes 
                                parents, students, representatives of 
                                the school food authority, 
                                representatives of the school board, 
                                school administrators and members of 
                                the public during the school year.''.
    (b) Promoting Physical Education and Activity in School Programs.--
            (1) Elementary and secondary school counseling programs.--
        Section 5421 of the Elementary and Secondary Education Act of 
        1965 (20 U.S.C. 7245) is amended--
                    (A) in subsection (b)(2)(H), by inserting ``, which 
                design and implementation shall take into consideration 
                the overall emotional and physical well-being of 
                students'' after ``the program''; and
                    (B) in subsection (c)(2)(E), by inserting ``health, 
                the importance of regular physical activity,'' after 
                ``relationships,''.
            (2) Smaller learning communities.--Section 5441(b) of the 
        Elementary and Secondary Education Act of 1965 (20 U.S.C. 
        7249(b)) is amended by adding at the end the following:
            ``(14) How the local educational agency will ensure that 
        smaller learning communities support healthy lifestyles 
        including participation in physical education and physical 
        activity by all students and access to nutritious food and 
        nutrition education.''.
            (3) 21st century community learning centers.--
                    (A) Purpose; definitions.--Section 4201 of the 
                Elementary and Secondary Education Act of 1965 (20 
                U.S.C. 7171) is amended--
                            (i) in subsection (a)(2), by inserting 
                        ``nutrition education programs, structured 
                        physical activity programs,'' after 
                        ``recreation programs,''; and
                            (ii) in subsection (b)(1)(A), by inserting 
                        ``nutrition education, structured physical 
                        activity,'' after ``recreation,''.
                    (B) Local competitive grant program.--Section 
                4204(b)(2) of the Elementary and Secondary Education 
                Act of 1965 (20 U.S.C. 7174(b)(2))--
                            (i) in subparagraph (M), by striking 
                        ``and'' after the semicolon;
                            (ii) by redesignating subparagraph (N) as 
                        subparagraph (O); and
                            (iii) by inserting after subparagraph (M) 
                        the following:
                    ``(N) an assurance that the proposed program is 
                coordinated with the physical education and health 
                education programs offered during the school day; 
                and''.
                    (C) Local activities.--Section 4205(a) of the 
                Elementary and Secondary Education Act of 1965 (20 
                U.S.C. 7175(a))--
                            (i) in paragraph (11), by striking ``and'' 
                        after the semicolon;
                            (ii) in paragraph (12), by striking the 
                        period at the end and inserting ``; and''; and
                            (iii) by adding at the end the following:
            ``(13) programs that support a healthy, active lifestyle, 
        including nutritional education and regular, structured 
        physical activity programs.''.
            (4) Parental involvement.--Section 1118 of the Elementary 
        and Secondary Education Act of 1965 is amended--
                    (A) in subsection (a)(2)--
                            (i) in subparagraph (E), by striking 
                        ``and'' at the end;
                            (ii) by redesignating subparagraph (F) as 
                        subparagraph (G); and
                            (iii) by inserting after subparagraph (E) 
                        the following:
                    ``(F) involve and train parents in encouraging and 
                supporting a healthy and active lifestyle, including 
                increased physical activity during and outside the 
                school day, and nutritional eating habits in the home 
                and at school; and'';
                    (B) in subsection (d)--
                            (i) in the subsection heading, by inserting 
                        after ``Achievement'' the following: ``by 
                        Healthy, Active Students'';
                            (ii) in the matter preceding paragraph (1), 
                        by striking ``standards.'' and inserting 
                        ``standards and to ensure that the children 
                        lead healthy, active lives.''; and
                            (iii) in paragraph (1)--
                                    (I) by inserting after 
                                ``supportive'' the following: ``, 
                                healthy,'';
                                    (II) by striking ``; and 
                                participating'' and inserting ``; 
                                participating''; and
                                    (III) by inserting after 
                                ``extracurricular time'' the following: 
                                ``and supporting their children in 
                                leading a healthy and active life, such 
                                as by providing healthy meals and 
                                snacks, encouraging participation in 
                                physical education, and sharing in 
                                physical activity outside the school 
                                day''; and
                    (C) in subsection (e)--
                            (i) by redesignating paragraphs (6) through 
                        (14) as paragraphs (7) through (15), 
                        respectively; and
                            (ii) by inserting after paragraph (5) the 
                        following:
            ``(6)(A) shall ensure that parents and teachers have 
        information about the importance of a healthy lifestyle, 
        including nutritional eating habits, physical education, and 
        physical activity, to an effective learning environment; and
            ``(B) shall coordinate activities with parents and teachers 
        to ensure that children are provided with nutritious meals and 
        snacks, and have ample opportunities for physical education and 
        physical activity during and outside the school day;''.
    (c) Professional Development for Teachers and Principals.--
            (1) State applications.--Section 2112(b) of the Elementary 
        and Secondary Education Act of 1965 (20 U.S.C. 6612(b)) is 
        amended by adding at the end the following:
            ``(13) A description of how the State educational agency 
        will use funds under this part to provide professional 
        development that is directly related to the fields of physical 
        education and health education to physical education teachers 
        and health education teachers to ensure that children are 
        leading healthy, active lifestyles that are conducive to 
        effective learning.''.
            (2) State use of funds.--Section 2113(c)(6) of the 
        Elementary and Secondary Education Act of 1965 (20 U.S.C. 
        6613(c)(6)) is amended--
                    (A) by striking ``, in cases in which a State 
                educational agency determines support to be 
                appropriate,''; and
                    (B) by inserting ``, physical education teachers, 
                and health education teachers'' after ``pupil services 
                personnel''.
            (3) Local applications and needs assessment.--Section 
        2122(b)(9) of the Elementary and Secondary Education Act of 
        1965 (20 U.S.C. 6622(b)(9)) is amended--
                    (A) in subparagraph (C), by striking ``and'' after 
                the semicolon;
                    (B) in subparagraph (D), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by adding at the end the following:
                    ``(E) improve the health and eating habits of 
                students and increase rates of physical activity of 
                students.''.
            (4) Local use of funds.--Section 2123(a)(3) of the 
        Elementary and Secondary Education Act of 1965 (20 U.S.C. 
        6623(a)(3)) is amended--
                    (A) in subparagraph (A)--
                            (i) in clause (i), by striking ``and'' 
                        after the semicolon; and
                            (ii) by adding at the end the following:
                            ``(iii) effective strategies for improving 
                        the healthy habits of students and the rates of 
                        physical activity by students that result in 
                        the ability to learn more effectively; and''; 
                        and
                    (B) in subparagraph (B)--
                            (i) in clause (iv), by striking ``and'' 
                        after the semicolon;
                            (ii) in clause (v), by striking the period 
                        at the end and inserting ``; and''; and
                            (iii) by adding at the end the following:
                            ``(vi) provide training, with curricula 
                        that is evidence-based, in how to teach 
                        physical education and health education that 
                        results in the ability of students to learn 
                        more effectively.''.
    (d) National Research Council Study.--Not later than 180 days after 
the date of enactment of this Act, the Secretary of Education shall 
enter into a contract with the National Research Council of the 
National Academy of Sciences to--
            (1) examine and make recommendations regarding--
                    (A) various means that may be employed to 
                incorporate physical activity into Head Start and child 
                care settings, elementary, middle, and high school 
                settings, and before- and after-school programs; and
                    (B) innovative and effective ways to increase 
                physical activity for all students;
            (2) study the impact of health, level of physical activity, 
        and amount of physical education on students' ability to learn 
        and maximize performance in school; and
            (3) study and provide specific recommendations for--
                    (A) effectively measuring the progress of students, 
                at the school level, in improving their health and 
                well-being, including improving their--
                            (i) knowledge, awareness, and behavior 
                        changes, related to nutrition and physical 
                        activity;
                            (ii) cognitive development, and fitness 
                        improvement, in physical education;
                            (iii) knowledge of lifetime physical 
                        activity and health promotion;
                            (iv) decrease in obesity; and
                            (v) levels on overall health indicators; 
                        and
                    (B) effectively measuring the progress of students, 
                at the school level, in increasing physical activity.

SEC. 326. EMPLOYER-PROVIDED OFF-PREMISES HEALTH CLUB SERVICES.

    (a) Treatment as Fringe Benefit.--Subparagraph (A) of section 
132(j)(4) of the Internal Revenue Code of 1986 (relating to on-premises 
gyms and other athletic facilities) is amended to read as follows:
                    ``(A) In general.--Gross income shall not include--
                            ``(i) the value of any on-premises athletic 
                        facility provided by an employer to the 
                        employer's employees, and
                            ``(ii) so much of the fees, dues, or 
                        membership expenses paid by an employer to an 
                        athletic or fitness facility described in 
                        subparagraph (C) on behalf of the employer's 
                        employees as does not exceed $900 per employer 
                        per year.''.
    (b) Athletic Facilities Described.--Paragraph (4) of section 132(j) 
of such Code is amended by adding at the end the following new 
subparagraph:
                    ``(C) Certain athletic or fitness facilities 
                described.--For purposes of subparagraph (A)(ii), an 
                athletic or fitness facility described in this 
                subparagraph is a facility--
                            ``(i) providing instruction in a program of 
                        physical exercise, offering facilities for the 
                        preservation, maintenance, encouragement, or 
                        development of physical fitness, or serving as 
                        the site of such a program of a State or local 
                        government,
                            ``(ii) which is not a private club owned 
                        and operated by its members,
                            ``(iii) which does not offer golf, hunting, 
                        sailing, or riding facilities,
                            ``(iv) whose health or fitness facility is 
                        not incidental to its overall function and 
                        purpose, and
                            ``(v) which is fully compliant with the 
                        State of jurisdiction and Federal anti-
                        discrimination laws.''.
    (c) Exclusion Applies to Highly Compensated Employees Only if No 
Discrimination.--Paragraph (1) of section 132(j) of such Code is 
amended--
            (1) by striking ``Paragraphs (1) and (2) of subsection 
        (a)'' and inserting ``Paragraphs (1) and (2) of subsection (a) 
        and paragraph (4) of this subsection'', and
            (2) in the heading by striking ``Exclusions under 
        subsection (a)(1) and (2)'' and inserting ``Certain 
        exclusions''.
    (d) Employer Deduction for Dues to Certain Athletic Facilities.--
            (1) In general.--Paragraph (3) of section 274(a) of such 
        Code (relating to denial of deduction for club dues) is amended 
        by adding at the end the following new sentence: ``The 
        preceding sentence shall not apply to so much of the fees, 
        dues, or membership expenses paid to athletic or fitness 
        facilities (within the meaning of section 132(j)(4)(C)) as does 
        not exceed $900 per employee per year.''.
            (2) Conforming amendment.--Section 274(e)(4) of such Code 
        is amended by inserting ``the first sentence of'' before 
        ``subsection (a)(3)''.
    (e) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after the date of the enactment of 
this Act.

SEC. 327. CERTAIN AMOUNTS PAID FOR PHYSICAL ACTIVITY, FITNESS, AND 
              EXERCISE TREATED AS AMOUNTS PAID FOR MEDICAL CARE.

    (a) In General.--Paragraph (1) of section 213(d) of the Internal 
Revenue Code of 1986 is amended by striking ``or'' at the end of 
subparagraph (C), by striking the period at the end of subparagraph (D) 
and inserting ``, or'', and by adding at the end the following new 
subparagraph:
                    ``(E) for qualified sports and fitness expenses.''.
    (b) Qualified Sports and Fitness Expenses.--Subsection (d) of 
section 213 of such Code is amended by adding at the end the following 
paragraph:
            ``(12) Qualified sports and fitness expenses.--
                    ``(A) In general.--The term `qualified sports and 
                fitness expenses' means amounts paid--
                            ``(i) for membership at a fitness center,
                            ``(ii) for participation or instruction in 
                        a program of physical exercise or physical 
                        activity, and
                            ``(iii) for equipment for use in a program 
                        (including a self-directed program) of physical 
                        exercise or physical activity.
                    ``(B) Overall dollar limitation.--The aggregate 
                amount treated as qualified sports and fitness expenses 
                with respect to any taxpayer for any taxable year shall 
                not exceed $1,000 ($2,000 in the case of a joint return 
                or a head of household (as defined in section 2(b))).
                    ``(C) Fitness facility defined.--For purposes of 
                subparagraph (A)(i), the term `fitness facility' means 
                a facility--
                            ``(i) providing instruction in a program of 
                        physical exercise, offering facilities for the 
                        preservation, maintenance, encouragement, or 
                        development of physical fitness, or serving as 
                        the site of such a program of a State or local 
                        government,
                            ``(ii) which is not a private club owned 
                        and operated by its members,
                            ``(iii) which does not offer golf, hunting, 
                        sailing, or riding facilities,
                            ``(iv) whose health or fitness facility is 
                        not incidental to its overall function and 
                        purpose, and
                            ``(v) which is fully compliant with the 
                        State of jurisdiction and Federal anti-
                        discrimination laws.
                    ``(D) Limitations related to sports and fitness 
                equipment.--Amounts paid for equipment described in 
                subparagraph (A)(iii) shall be treated as a qualified 
                sports and fitness expense only--
                            ``(i) if such equipment is utilized 
                        exclusively for participation in fitness, 
                        exercise, sport, or other physical activity 
                        programs,
                            ``(ii) if such equipment is not apparel or 
                        footwear, and
                            ``(iii) in the case of any item of sports 
                        equipment (other than exercise equipment), with 
                        respect to so much of the amount paid for such 
                        item as does not exceed $250.
                    ``(E) Programs which include components other than 
                physical exercise and physical activity.--Rules similar 
                to the rules of section 213(d)(6) shall apply in the 
                case of any program that includes physical exercise or 
                physical activity and also other components. For 
                purposes of the preceding sentence, travel and 
                accommodations shall be treated as an other 
                component.''.
    (c) Exception for Health Savings Accounts.--Subparagraph (A) of 
section 223(d)(2) of such Code is amended by inserting ``, determined 
without regard to paragraph (1)(E) thereof'' after ``section 213(d)''.
    (d) Effective Date.--The amendment made by this section shall apply 
to taxable years beginning after the date of the enactment of this Act.

SEC. 328. NATIONAL YOUTH SPORTS PROGRAM REVITALIZATION.

    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. 329. DUPLICATION OF THE ZUNI YOUTH ENRICHMENT PROJECT SUMMER CAMP 
              ON INDIAN RESERVATIONS AND TRIBAL LANDS.

    (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 enrichment 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
            (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 
community 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 subsection (a), shall provide funding to no 
more than 20 community-based organizations.
    (d) Model and Camp Requirement.--The enrichment 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 children attending a 
        camp under subsection (d)(2), the leader of the organization 
        that receives funds under subsection (a) shall, for each day of 
        the camp, ensure that, such children are--
                    (A) involved in at least 60 minutes of physical 
                activity (with appropriate accommodations made for 
                children with disabilities); and
                    (B) provided with at least two meals that meet 
                national nutritional standards that are aligned with 
                dietary guidelines.
            (2) Other activities.--Such leader shall also ensure that--
                    (A) a community gardening activity is included in 
                the activities conducted at the camp; and
                    (B) health and wellness education is provided to 
                the children attending the camp.
    (f) Evaluation.--
            (1) In general.--A community-based organization that 
        receives funding under subsection (a), shall, as a condition of 
        receiving such funding, conduct an evaluation of the enrichment 
        program conducted 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.
    (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 organization 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 conducted under 
                subsection (f); and
                    (B) the impact of such enrichment program 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 paragraph (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.

TITLE IV--IMPROVING ACCESS TO NUTRITIONAL INFORMATION AND HEALTHY FOODS

SEC. 401. CONSUMER EDUCATION.

    Subsection (c) of section 2 of the Nutrition Labeling and Education 
Act of 1990 (Pub. L. 101-535; 104 Stat. 2353, 2357; 21 U.S.C. 343 note) 
is amended to read as follows:
    ``(c) Consumer Education.--
            ``(1) In general.--The Secretary of Health and Human 
        Services shall carry out activities which educate consumers 
        about--
                    ``(A) the availability of nutrition information in 
                the label or labeling of food;
                    ``(B) the importance of that information in 
                maintaining healthy dietary practices;
                    ``(C) the importance of physical activity and 
                healthy lifestyles; and
                    ``(D) the importance of maintaining an energy 
                balance in consumption and activity.
            ``(2) Certain activities.--Activities under paragraph (1) 
        shall include the use of public education campaigns, public 
        statements, and other resources designed to educate consumers 
        about the subjects described in subparagraphs (A) through (D) 
        of such paragraph.''.

SEC. 402. EXPAND TEAM NUTRITION TRAINING GRANTS.

    Section 19 of the Child Nutrition Act of 1966 (20 U.S.C. 1788) is 
amended--
            (1) by redesignating subsection (l) as subsection (m); and
            (2) by inserting after subsection (k), the following:
    ``(l) Infrastructure Improvement Grants.--
            ``(1) In general.--Subject to the availability of funds to 
        carry out this subsection, the Secretary shall award one-time 
        grants, on a competitive basis, to eligible State agencies to 
        assist such State agencies in carrying out infrastructure 
        improvements for the purpose of improving children's lifelong 
        eating and physical habits, consistent with 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).
            ``(2) Eligible state agency.--For purposes of this 
        subsection, an `eligible State agency' means--
                    ``(A) a State agency that participates in--
                            ``(i) the school lunch program under the 
                        Richard B. Russell National School Lunch Act 
                        (42 U.S.C. 1751 et seq.);
                            ``(ii) the school breakfast program under 
                        section 4 of the Child Nutrition Act of 1966 
                        (42 U.S.C. 1773); or
                            ``(iii) the child and adult care food 
                        program under the Richard B. Russell National 
                        School Lunch Act (42 U.S.C. 1766); or
                    ``(B) a consortium of 2 or more such State 
                agencies--
                            ``(i) located in the same State; or
                            ``(ii) located in different States.
            ``(3) Application.--To receive a grant under this 
        subsection, an eligible State agency shall submit to the 
        Secretary an application at such time, in such manner, and 
        containing such information as the Secretary may require
            ``(4) Uses of funds.--
                    ``(A) Required uses.--An eligible State agency that 
                receives a grant under this subsection shall use such 
                funds to cover the costs of infrastructure improvements 
                related to the school lunch program, school breakfast 
                program, or the child and adult food care program, 
                including improvements in kitchen equipment and other 
                foodservice equipment used to serve or store food 
                offered to children under any such program.
                    ``(B) Authorized uses.--An eligible State agency 
                that receives a grant under this subsection may use 
                such funds to award subgrants to local educational 
                agencies to carry out the activities described in 
                subparagraph (A).
            ``(5) Recordkeeping.--An eligible State agency receiving a 
        grant under this subsection shall keep a record of the use of 
        the grant funds.''.

SEC. 403. DEPARTMENT OF AGRICULTURE PROGRAM TO SUPPORT ESTABLISHMENT OR 
              EXPANSION OF RETAIL FOOD STORES OFFERING AFFORDABLE, 
              NUTRITIOUS FOODS IN UNDERSERVED COMMUNITIES AND 
              COORDINATION WITH OTHER FEDERAL PROGRAMS.

    The Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) is 
amended by adding at the end the following new section:

``SEC. 28. LOANS, LOAN GUARANTEES, AND GRANTS TO SUPPORT ESTABLISHMENT 
              OR EXPANSION OF RETAIL FOOD STORES OFFERING AFFORDABLE, 
              NUTRITIOUS FOODS IN UNDERSERVED COMMUNITIES AND INTER-
              DEPARTMENTAL COORDINATION.

    ``(a) Definitions.--In this section:
            ``(1) Affordable, nutritious foods.--The term `affordable, 
        nutritious foods' means fruits and vegetables, meat, fish, 
        grains, dairy, and poultry.
            ``(2) Retail food store.--The term `retail food store' 
        includes a supermarket, grocery store, farmers market, or other 
        food retail outlet that operates on a self-service basis 
        primarily selling groceries, produce, meat, baked goods, dairy 
        products and other nutritious foods.
            ``(3) Underserved community.--The term `underserved 
        community' has the meaning given that term in section 25(a)(3).
    ``(b) Program Authorized.--The Secretary may provide a loan or loan 
guarantee or make a grant to support the establishment or expansion of 
a retail food store that will offer affordable, nutritious foods in an 
underserved community.
    ``(c) Eligibility.--For an entity to be eligible for a loan, loan 
guarantee, or grant under this section, the entity must--
            ``(1) demonstrate to the satisfaction of the Secretary the 
        economic viability of the project to establish or expand a 
        retail food store in an underserved community; and
            ``(2) provide a guarantee satisfactory to the Secretary 
        that the retail food store established or expanded in an 
        underserved community using the proceeds of the loan or the 
        grant funds will make affordable, nutritious foods readily 
        available among the food products offered by the retail food 
        store.
    ``(d) Loan Terms.--
            ``(1) Duration.--A loan made by the Secretary under this 
        section shall be for a term not to exceed 15 years.
            ``(2) Interest.--The loan shall bear interest at a reduced 
        annual interest rate to be set by the Secretary.
            ``(3) Deferral of interest and principal.--The Secretary 
        may permit the deferral of payments on principal and interest 
        due on the loan for a two-year period beginning on the date the 
        loan is made.
    ``(e) Limitation on Amount of Loan Guarantees.--The portion of a 
loan that the Secretary may guarantee under this section shall be not 
more than 85 percent of the principal amount of the loan.
    ``(f) Grant Cost Sharing Requirements.--
            ``(1) Matching requirement.--As a condition of any grant 
        made under this section, the Secretary shall require the grant 
        recipient to match not less than 50 percent of the total amount 
        of the grant.
            ``(2) Form of non-federal share.--The matching requirement 
        may be satisfied through the provision of--
                    ``(A) cash (including through fees, grants 
                (including community development block grants), and 
                gifts); or
                    ``(B) in-kind contributions acceptable to the 
                Secretary.
    ``(g) Coordination With Other Federal Programs in Underserved 
Communities.--The Secretary of Agriculture shall coordinate with the 
Secretary of Health and Human Services and the Secretary of Treasury to 
identify and target existing tax incentives, loans, grants, and other 
financial and technical assistance available to each Secretary that can 
be used to improve access to affordable, nutritious foods in 
underserved communities.
    ``(h) Authorization of Appropriations.--For each of fiscal years 
2011 through 2015, there are authorized to be appropriated $10,000,000 
to the Secretary to provide loans and loan guarantees and to make 
grants under this section.''.

SEC. 404. VIRTUAL FARMERS MARKET PROGRAM.

    (a) Establishment of Grant Program.--From the amounts appropriated 
to carry out this section, the Secretary of Agriculture, in 
collaboration with the Secretary of Education, shall award grants, on a 
competitive basis, to eligible entities to enable such entities to 
carry out a program that provides access to virtual farmers markets and 
distribution centers to individuals residing in, and organizations 
located in, communities that are food deserts.
    (b) Eligible Entities.--For purposes of this section, an ``eligible 
entity'' means an entity that predominantly serves communities that are 
food deserts, including--
            (1) a local educational agency or bureau-funded school;
            (2) a non-profit, community-based organization (including a 
        recreation center, child care facility, or senior center); or
            (3) an entity that the Secretaries deem to be an eligible 
        entity.
    (c) Use of Funds.--An eligible entity receiving a grant under this 
section shall use such funds for the following:
            (1) Purchasing virtual farmers market software (including 
        computer kiosks and swipe card stations), or entering into a 
        contract with an eligible organization to develop and maintain 
        the technology necessary, to carry out a virtual farmers market 
        program to enable individuals residing in, and organizations 
        located in, communities that are food deserts to order and 
        purchase fruits and vegetables and other healthy food items 
        using such technology.
            (2) Training staff to--
                    (A) assist individuals residing in, and 
                organizations located in, communities that are food 
                deserts to order and purchase food products under the 
                program described in paragraph (1); and
                    (B) purchase and order food products under the 
                program for the eligible entity.
            (3) Packaging food products purchased under the program in 
        manner that makes transportation of the products possible by 
        foot.
            (4) Paying staff to manage the program, and package and 
        assist in the distribution and delivery of food products 
        purchased under the program.
            (5) Raising public awareness about the program.
            (6) Developing simple food preparation strategies and menus 
        for customers of the program.
            (7) Coordinating with the Secretary of Agriculture to 
        develop mechanisms to enable reimbursement under the 
        supplemental nutrition assistance program established under the 
        Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) for 
        purchases made under the virtual farmers market program 
        established by the eligible entity under this section.
    (d) Application.--In order to receive a grant under this section, 
an eligible entity shall submit an applicable to the Secretary at such 
time, in such manner, and containing such information as the Secretary 
may require.
    (e) Limitations on Food Purchased.--To the extent practicable, the 
majority of food under a virtual farmers market program carried out by 
an eligible entity under this section shall be purchased from farmers 
located within a 50 mile radius of the site where the food is ordered 
and delivered, except in the case where the eligible entity 
demonstrates to the Secretaries that no such farmers exist or that the 
farmers are not able to provide a sufficient variety or amount of food 
for the purposes of the program.
    (f) Report.--Not later than a year after funds are appropriated to 
carry out this section, the Secretary shall report to Congress on the 
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 additional such programs; 
        and
            (2) how such programs have increased access or encouraged 
        permanent farmers markets to be established near communities 
        that are food deserts.
    (g) Definitions.--In this section--
            (1) Bureau-funded school.--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) Eligible organization.--The term ``eligible 
        organization'' means an organization with expertise in 
        developing and maintaining a virtual farmers market.
            (3) 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).
            (4) 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).
            (5) Secretary.--The term ``Secretary'' means the Secretary 
        of Agriculture.
            (6) Secretaries.--The term ``Secretaries'' means the 
        Secretary of Agriculture and the Secretary of Education, acting 
        jointly.
            (7) Swipe card stations.--The term ``swipe card stations'' 
        may 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.

SEC. 405. URBAN AND NATIVE-AMERICAN COMMUNITY GARDEN GRANT PROGRAM.

    (a) Program Established.--From the amounts appropriated to carry 
out this section, the Secretary of Agriculture shall award grants to 
eligible entities to expand, establish, or maintain urban community 
gardens.
    (b) Eligible Entity.--For purposes of this section, an eligible 
entity means--
            (1) a private or for-profit organization; or
            (2) a unit of general local government, or tribal 
        government, located on tribal land or in a low-income 
        community.
    (c) 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 containing such information as the Secretary 
may require, including--
            (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 
        providing a water supply) for the urban community garden for 
        which the entity receives funds under this section.
    (d) Definitions.--In this section:
            (1) Low-income community.--The term ``low-income 
        communities'' includes--
                    (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.
            (2) Unit of general local government.--The term ``unit of 
        general local government'' has the meaning given such term in 
        section 102 of the Housing and Community Development Act of 
        1974 (42 U.S.C. 5302).

   TITLE V--REALIGNING TRANSPORTATION POLICY TO HELP PROMOTE HEALTHY 
                               LIFESTYLES

SEC. 501. GRANTS TO PROMOTE PLANNING DECISIONS AND POLICIES THAT 
              INCREASE ACCESS TO PHYSICAL ACTIVITY.

    (a) Grants.--The Secretary of Transportation may make grants to 
eligible entities for the purpose of assisting local planning decisions 
and policies that increase the access of individuals to physical 
activity.
    (b) Activities Under Grants.--The activities of eligible entities 
that may be funded by a grant under subsection (a) include the 
following:
            (1) The coordination of activities carried out by local 
        government officials (including planning, public works, 
        housing, and transportation officials), school boards, and 
        others to increase the access of individuals to physical 
        activity through--
                    (A) improved integration of land use, housing, 
                transportation, and infrastructure planning; and
                    (B) consideration of impacts on physical activity 
                levels during such planning.
            (2) The formulation of strategies to establish and 
        implement--
                    (A) plans and policies that increase infrastructure 
                for pedestrians and bicyclists to connect such 
                individuals to schools, recreation opportunities, jobs, 
                and retail opportunities, including policies requiring 
                developers to build sidewalks and bicycle lanes; or
                    (B) plans and policies that place schools within 
                neighborhoods and provide bike paths, sidewalks, 
                trails, and other infrastructure to encourage and make 
                possible the walking and bicycling to school of 
                students and staff.
            (3) The carrying out of health impact assessments with 
        respect to proposals for the placement or construction of 
        buildings, sidewalks, roads, trails, schools, or other aspects 
        of the built environment.
    (c) Reporting.--
            (1) In general.--An eligible entity that receives a grant 
        under subsection (a) shall submit to Congress and the Secretary 
        of Transportation a report on the extent to which such grant 
        has--
                    (A) led to planning decisions and policies that 
                increase the access of individuals to physical 
                activity; and
                    (B) led to an improvement in the health of 
                individuals.
            (2) Timing.--A report under paragraph (1) shall be made not 
        less than 3 years and not more than 5 years after the date on 
        which such grant is received.
    (d) Definitions.--In this section, the following definitions apply:
            (1) Built environment.--The term ``built environment'' 
        means any buildings or spaces that are created or modified by 
        individuals, including homes, schools, workplaces, parks and 
        other recreation areas, greenways, business areas, and 
        transportation areas.
            (2) Eligible entity.--The term ``eligible entity'' means a 
        local government agency or group of such agencies with 
        jurisdiction over planning or land use decisions.
            (3) Health impact assessment.--The term ``health impact 
        assessment'' means, in relation to a proposal, an assessment of 
        the impact that the proposal will have on the health of 
        individuals if implemented.

SEC. 502. JOINT USE AGREEMENTS.

    (a) Grants.--The Secretary may make a grant to any eligible school 
or other public entity for the purposes of meeting either or both of 
the following:
            (1) Costs incurred by the school or other entity in 
        negotiating or entering into a joint use agreement.
            (2) Costs payable under a joint use agreement during the 
        first year in which the joint use agreement is in force.
    (b) Priority.--In making grants under subsection (a), the Secretary 
shall give priority to schools or other public entities in areas--
            (1) where obesity rates are above the national average;
            (2) where at least 50 percent of the residents are below 
        the poverty line; or
            (3) that lack safe, accessible, and affordable fitness and 
        recreational facilities.
    (c) Definitions.--In this section:
            (1) Eligible school.--The term ``eligible school'' means 
        any elementary school or secondary school within the meaning of 
        section 9101 of the Elementary and Secondary Education Act 1965 
        (20 U.S.C. 7801).
            (2) Joint use agreement.--The term ``joint use agreement'' 
        means an agreement between an eligible school and another 
        public entity relating to the use of a school's facilities or 
        equipment by people other than the school's students or staff.
            (3) Poverty line.--The term ``poverty line'' has the 
        meaning given such term in section 673(2) of the Community 
        Services Block Grant Act (42 U.S.C. 9902(2)).
            (4) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services acting through the Director of the 
        Centers for Disease Control and Prevention.

SEC. 503. EXPANSION OF SAFE ROUTES TO SCHOOL PROGRAM.

    (a) High Schools Students Included.--Section 1404(a) of SAFETEA-LU 
(23 U.S.C. 402 note; 119 Stat. 1228) is amended by striking ``in 
primary and middle schools'' and inserting the following: ``and 
adolescents in primary, middle, and high schools''.
    (b) Purposes.--
            (1) In general.--Sections 1404(b)(1) of SAFETEA-LU (119 
        Stat. 1228) is amended by inserting ``and adolescents'' after 
        ``children''.
            (2) Safety.--Section 1404(b)(2) of SAFETEA-LU (119 Stat. 
        1228) is amended by inserting ``and throughout adolescence'' 
        after ``early age''
    (c) Apportionment.--Section 1404(c)(1) of SAFETEA-LU (119 Stat. 
1228) is amended in subparagraphs (A) and (B) by striking ``and middle 
schools'' and inserting ``, middle, and high schools''.
    (d) Eligible Projects and Activities.--Section 1404(f) of SAFETEA-
LU (119 Stat. 1229) is amended by adding at the end the following:
            ``(4) Preference.--From the amounts apportioned to a State 
        under this section, the State shall give priority to projects 
        for primary and middle schools and to projects that propose to 
        serve a combination of at least one primary, middle, and high 
        school within the same school district.''.
    (e) Definitions.--Section 1404(k)(2) of SAFETEA-LU (119 Stat. 1230) 
is amended--
            (1) in the paragraph heading by striking ``and middle'' and 
        inserting ``, middle, and high schools'';
            (2) by striking ``and middle'' and inserting ``, middle, 
        and high schools''; and
            (3) by striking ``eighth'' and inserting ``twelfth''.

SEC. 504. ACTIVE TRANSPORTATION INFRASTRUCTURE INVESTMENT PROGRAM.

    (a) In General.--The Secretary of Transportation shall carry out an 
active transportation investment program in accordance with the 
requirements of this section.
    (b) Purpose.--The purpose of the program shall be to encourage a 
mode shift to active transportation within selected communities by 
providing safe and convenient opportunities to bicycle and walk for 
routine travel.
    (c) Selection of Communities.--
            (1) Applications.--A community seeking to participate in 
        the program shall submit to the Secretary an application that 
        is in such form and contains such information as the Secretary 
        may require.
            (2) Initial and additional selections.--
                    (A) Initial selections.--The Secretary shall select 
                initial communities to participate in the program. Such 
                communities shall participate in the program in each of 
                fiscal years 2011 through 2015.
                    (B) Additional selections.--Following the initial 
                selections under subparagraph (A), the Secretary shall 
                select additional communities to participate in the 
                program. Such communities shall participate in the 
                program in each of fiscal years 2013 through 2015.
            (3) Criteria.--
                    (A) In general.--In selecting communities to 
                participate in the program, the Secretary shall 
                consider, at a minimum, the extent to which a 
                community--
                            (i) provides a plan for development of 
                        walking and bicycling infrastructure that is 
                        likely to contribute to a significant 
                        transportation mode shift to walking and 
                        bicycling;
                            (ii) demonstrates broad community support 
                        that will facilitate successful and expeditious 
                        implementation;
                            (iii) demonstrates a cohesive plan in which 
                        noninfrastructure elements, where proposed, 
                        reinforce achievement of the purpose of the 
                        program;
                            (iv) provides evidence of regulatory or 
                        financial incentives or community design 
                        policies that facilitate significant increases 
                        in bicycling or walking; and
                            (v) commits State, local, or eligible 
                        Federal matching funds, in addition to Federal 
                        funds made available under this section, to 
                        projects eligible for assistance under this 
                        section.
                    (B) Strategic priorities that facilitate success.--
                For purposes of subparagraph (A)(i), strategic 
                priorities that facilitate success in increasing 
                walking and bicycling include effective plans--
                            (i) to create a network of active 
                        transportation facilities connecting 
                        neighborhoods with destinations such as 
                        workplaces, schools, residences, businesses, 
                        recreation areas, and other community activity 
                        centers;
                            (ii) to integrate active transportation 
                        facilities with transit services, where 
                        available, to improve access to public 
                        transportation; and
                            (iii) to deliver safe, convenient, cost-
                        effective mobility via walking and bicycling.
                    (C) Indicators of community support.--For purposes 
                of subparagraph (A)(ii), indicators of community 
                support include--
                            (i) the use of public input in the 
                        development of transportation plans; and
                            (ii) the commitment of community leaders to 
                        the success and timely implementation of 
                        projects eligible for assistance under this 
                        section.
    (d) Grants.--
            (1) In general.--The Secretary shall make grants to each 
        community selected to participate in the program.
            (2) Recipients.--A recipient of a grant representing a 
        community under the program shall be a local or regional 
        governmental organization, multi-county special district, or 
        Indian tribe that the Secretary determines is suitably equipped 
        and organized to carry out the objectives and requirements of 
        this section. Such organizations include metropolitan planning 
        organizations and other regional planning organizations.
            (3) Subrecipients.--A recipient of a grant under the 
        program may suballocate funds from the grant to a nonprofit 
        organization to carry out the purposes of the program.
            (4) Inclusion of certain communities.--To fulfill the 
        Nation's need to achieve and document mode shift to bicycling 
        and walking over time, the 4 communities that received pilot 
        funding under section 1807 of SAFETEA-LU (119 Stat. 1460) may 
        be among the communities selected by the Secretary under 
        subsection (c).
            (5) Grants amounts.--
                    (A) In general.--The Secretary may make a grant as 
                low as $5,000,000 and as high as $15,000,000 per fiscal 
                year for a community participating in the program. The 
                Secretary shall ensure that grant awards under the 
                program are sufficiently high to enable a mode shift to 
                active transportation.
                    (B) Justification for larger grants.--Subject to 
                the $15,000,000 per fiscal year limit set forth in 
                subparagraph (A), the Secretary may justify a grant in 
                a higher amount for a community under the program based 
                on the population served, greater opportunities to 
                shift trips to bicycling and walking, or use of 
                innovative design features.
    (e) Eligible Projects.--Grants made to communities under this 
section shall be used for one or more of the following purposes:
            (1) To carry out projects to construct networks of active 
        transportation infrastructure facilities, including sidewalks, 
        bikeways, and pedestrian and bicycle trails, that connect 
        people with public transportation, workplaces, schools, 
        residences, businesses, recreation areas, and other community 
        activity centers.
            (2) To carry out projects to provide for bicycle boxes, 
        cycle tracks, bicycle boulevards, dual traffic signals, and 
        bicycle sharing stations.
            (3) To carry out projects to restore and upgrade current 
        active transportation infrastructure facilities.
            (4) To carry out projects to support educational 
        activities, safety-oriented activities, and technical 
        assistance to further the purpose of the program.
    (f) Program Measures.--In carrying out the program, the Secretary 
shall develop statistical information on changes in motor vehicle, 
active transportation, and public transportation usage in communities 
participating in the program and assess how the changes impact 
congestion and energy usage, impact the frequency of bicycling and 
walking, and impact health, safety, and the environment. In addition, 
the Secretary shall develop interim measures of progress, which may 
include indicators of public engagement, educational outcomes, and 
project advancement into planning and development.
    (g) Deadlines.--
            (1) Request for applications.--Not later than 60 days after 
        the date of enactment of this Act, the Secretary shall publish 
        in the Federal Register a request for applications pursuant to 
        subsection (c)(1).
            (2) Selection of initial communities.--Not later than 180 
        days after such date of enactment, the Secretary shall select 
        initial communities to participate in the program under 
        subsection (c)(2)(A).
            (3) Selection of additional communities.--Not later than 
        September 30, 2012, the Secretary shall select additional 
        communities to participate in the program under subsection 
        (c)(2)(B).
            (4) Grants.--The Secretary shall make grants to communities 
        selected to participate in the program under subsection (c)--
                    (A) for fiscal year 2011, not later than the later 
                of--
                            (i) the 60th day after the date of the 
                        selection of communities under subsection 
                        (c)(2)(A); and
                            (ii) the 30th day of the fiscal year; and
                    (B) for each of fiscal years 2012 through 2015, not 
                later than 30th day of the fiscal year.
    (h) Reports.--
            (1) In general.--The Secretary shall submit to Congress--
                    (A) an interim report on progress made under the 
                program not later than September 30, 2014; and
                    (B) a final report on progress made under the 
                program not later than September 30, 2016.
            (2) Contents.--Each report submitted under paragraph (1) 
        shall include the Secretary's findings concerning the best 
        practices of communities participating in the program and the 
        impediments experienced by such communities relating to program 
        development and achieving a mode shift to active 
        transportation.
    (i) Funding.--
            (1) Authorization of appropriations.--There is authorized 
        to be appropriated out of the Highway Trust Fund (other than 
        the Mass Transit Account) to carry out this section--
                    (A) $300,000,000 for fiscal year 2011;
                    (B) $300,000,000 for fiscal year 2012;
                    (C) $466,666,666 for fiscal year 2013;
                    (D) $466,666,666 for fiscal year 2014; and
                    (E) $466,666,668 for fiscal year 2015.
            (2) Contract authority.--Funds authorized to be 
        appropriated by this section shall be available for obligation 
        and administered in the same manner as if the funds were 
        apportioned under chapter 1 of title 23, United States Code, 
        except that the Federal share of the cost of a project carried 
        out using the funds shall be 100 percent, and the funds shall 
        remain available until expended and shall not be transferable.
            (3) Administrative costs.--
                    (A) Set aside.--Each fiscal year, the Secretary 
                shall set aside not more than 1.5 percent of the funds 
                made available to carry out this section to cover the 
                costs of administrative, research, technical 
                assistance, communications, and training activities 
                under the program.
                    (B) Contracts and other agreements.--The Secretary 
                may enter into contracts with for-profit organizations, 
                or contracts, partnerships, or cooperative agreements 
                with other government agencies, institutions of higher 
                learning, or nonprofit organizations, to perform 
                activities with amounts set aside under subparagraph 
                (A). The Federal share of the cost of such activities 
                may be up to 100 percent.
                    (C) Limitation on statutory construction.--Nothing 
                in this paragraph may be construed to prohibit a 
                community from receiving research or other funds under 
                title 23 or 49, United States Code.
    (j) Treatment of Projects.--
            (1) Noninfrastructure projects.--Noninfrastructure projects 
        and infrastructure projects that do not involve or lead 
        directly to construction assisted under this subsection shall 
        not be treated as projects on a Federal-aid system under 
        chapter 1 of title 23, United States Code.
            (2) Infrastructure projects.--Not later than one year after 
        the date of enactment of this Act, the Secretary shall develop 
        regulations or guidance (or both) for Federal-aid projects 
        under this section that encourages the use of the programmatic 
        categorical exclusion, expedited procurement techniques, and 
        other best practices to facilitate productive and timely 
        expenditure for projects that are small, low impact, and 
        constructed within an existing built environment.
            (3) State processes.--The Secretary shall work with State 
        departments of transportation to ensure that any guidance or 
        regulation developed under paragraph (2) is being implemented 
        by States and the Federal Highway Administration consistently 
        to avoid unnecessary delays in implementing projects and to 
        ensure the effective use of Federal dollars.
    (k) Assistance to Indian Tribes.--Notwithstanding any other 
provision of law, the Secretary may enter into grants agreements, self-
determination contracts, and self-governance compacts under the 
authority of the Indian Self-Determination and Education Assistance Act 
(25 U.S.C. 450 et seq.) with eligible Indian tribes to carry out the 
purposes of this Act, and such grant agreements, self-determination 
contracts, and self-governance compacts shall be administered in 
accordance with that Act.
    (l) Definitions.--In this section, the following definitions apply:
            (1) Active transportation.--The term ``active 
        transportation'' means mobility options powered solely by human 
        energy, such as bicycling and walking.
            (2) Indian tribe.--The term ``Indian tribe'' has the 
        meaning given that term in section 4(e) of Indian Self-
        Determination and Education Assistance Act (25 U.S.C. 450b(e)).
            (3) Program.--The term ``program'' means the active 
        transportation investment program established under this 
        section.

                TITLE VI--RESEARCH AND ASSESSMENT TOOLS

SEC. 601. NATIONAL CENTER FOR HEALTH STATISTICS.

    Section 306 of the Public Health Service Act (42 U.S.C. 242k) is 
amended--
            (1) in subsection (m)(4)(B), by striking ``subsection (n)'' 
        each place it appears and inserting ``subsection (o)'';
            (2) by redesignating subsection (n) as subsection (o); and
            (3) by inserting after subsection (m) the following:
    ``(n)(1) The Secretary, acting through the Center, may provide for 
the--
            ``(A) collection of data for determining the fitness levels 
        and energy expenditure of children and youth; and
            ``(B) analysis of data collected as part of the National 
        Health and Nutrition Examination Survey and other data sources.
    ``(2) In carrying out paragraph (1), the Secretary, acting through 
the Center, may make grants to States, public entities, and nonprofit 
entities.
    ``(3) The Secretary, acting through the Center, may provide 
technical assistance, standards, and methodologies to grantees 
supported by this subsection in order to maximize the data quality and 
comparability with other studies.''.

SEC. 602. REPORT ON OBESITY RESEARCH.

    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Secretary of Health and Human Services shall submit to 
the Committee on Health, Education, Labor, and Pensions of the Senate 
and the Committee on Energy and Commerce of the House of 
Representatives a report on research conducted on causes and health 
implications (including mental health implications) of obesity and 
being overweight.
    (b) Content.--The report described in subsection (a) shall 
contain--
            (1) descriptions on the status of relevant, current, 
        ongoing research being conducted in the Department of Health 
        and Human Services including research at the National 
        Institutes of Health, the Centers for Disease Control and 
        Prevention, the Agency for Healthcare Research and Quality, the 
        Health Resources and Services Administration, and other offices 
        and agencies;
            (2) information about what these studies have shown 
        regarding the causes, prevention, and treatment of, obesity and 
        being overweight; and
            (3) recommendations on further research that is needed, 
        including research among diverse populations, the plan of the 
        Department of Health and Human Services for conducting such 
        research, and how current knowledge can be disseminated.
                                 <all>