II 111th CONGRESS 2d Session S. 3298 IN THE SENATE OF THE UNITED STATES May 4, 2010 Mr. Udall of Colorado (for himself and Mr. Franken) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To establish a pilot program to reduce the increasing prevalence of overweight/obesity among 0–5 year-olds in child care settings.

1.

Short title

This Act may be cited as the Healthy Kids from Day One Act.

2.

Findings and purposes

(a)

Findings

Congress makes the following findings: (1)Life-long food preferences, eating habits, and activity levels develop early in childhood. (2)Preschool years are a critical time for determining whether or not an individual will develop obesity later in life. (3)Aerobic fitness and healthy eating patterns support enhanced behavioral, emotional, and academic performance in school. (4)Recent studies indicate that children who are overweight at age 5 are more likely to be more overweight at age 9. (5)Obese preschool children already exhibit signs of cardiovascular disease and diabetes. (6)According to a 2007 Centers for Disease Control and Prevention study, 12.4 percent of children in the United States ages 2 through 6 are obese. (7)The 2001 National Household Education Survey found that 74 percent of children in the United States ages 3 through 6 are in some form of non-parental child care, and 56 percent are in center-based child care. (8)According to a 2009 analysis of child care center licensing regulations, only 12 States have a policy prohibiting or limiting foods of low nutritional value in child care centers, only 8 States require vigorous or moderate physical activity, only one of which has a policy quantifying a required number of minutes of physical activity by day or week, and only 7 States quantify a maximum amount of time for media (television and electronic) each day or week. (9)In 2009, the Centers for Disease Control and Prevention released recommended community strategies and measures to prevent obesity in the United States that includes child care specific policy and environmental initiatives to achieve healthy eating and active living among children from birth to 5 years of age. (10)In 2009, The Institute of Medicine released findings supporting local governments' ability to play a crucial role in creating environments that make it easier for children to eat healthy diets and remain active. (11)States should strive to adopt nutrition standards, practices, and policies for child care centers that are consistent with the 2005 Dietary Guidelines for Americans. (12)Child care centers and family child care homes should serve as settings where children adopt healthy eating habits, have opportunities for age appropriate physical activity, and set screen time limits. (13)Rates of obesity are higher for Black and Latino children than the overall population of children in the United States. (b)

Purposes

It is the purpose of this Act to— (1)establish a 3-year pilot program in 5 States that will focus on reducing the increasing prevalence of overweight/obesity among children between birth and 5 years of age in child care settings; (2)enhance the focus of child care centers and family child care homes serving the birth to 5 years of age population on children's healthy development through evidence-based or data-informed practices to improve healthy eating, physical activity, and screen time limits; and (3)identify emerging and expand existing evidence-based practices and understanding of healthy eating, physical activity, and screen time limits, as appropriate, as well as replicate curricula, interventions, practices, and policy changes that are most effective in promoting nutrition and physical activity among the birth to 5 years of age population in the child care setting.

3.

Healthy kids program

Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) is amended by adding at the end the following: W

Healthy kids program

399OO.

Definitions

In this part: (1)

Child care center

The term child care center means a center licensed or otherwise authorized to provide child care services for fewer than 24 hours per day per child in a non-residential setting, unless care in excess of 24 hours is due to the nature of the parents' work. (2)

Early learning council

The term early learning council means an early childhood assembly that is established to advise governors, State legislators, or State agency administrators on how best to meet the needs of young children and their families specifically through improvement of programs and services. (3)

Family child care home

The term family child care home means a private family home where home-based child care is provided for a portion of the day, unless care in excess of 24 hours is due to the nature of the parents’ work, and that is certified, registered, or licensed in the State in which it is located. (4)

Screen time limits

The term screen time limits means policies or guidelines, such as those developed by the American Academy of Pediatrics, designed to reduce the daily amount of time that children spend watching or looking at digital monitors or displays, including television sets, computer monitors, or hand-held gaming devices. (5)

Secretary

The term Secretary means the Secretary of Health and Human Services.

300OO–1.

Grants

(a)

In general

The Secretary, in consultation with appropriate entities within the Department of Health and Human Services, shall award 3-year competitive grants to 5 State health departments (or other appropriate child care licensing entities within such States) to help reduce and prevent obesity among the birth to 5 year old population of the State in child care settings outside a child's place of residence. (b)

Use of funds

State grantees shall use amounts received under a grant under this subsection to— (1)provide, or enter into contracts to provide, training (that meets the requirements of subsection (c)) to the staff of national, State, or community-based organizations with networks of child care centers, or a consortium of child care centers and family child care homes consisting of at least 10 centers, for the purpose of implementing evidence-based or data-informed healthy eating and physical activity policies and practices, including curricula and other interventions; and (2)provide grants to child care centers and family child care homes, whose staff received the training described in paragraph (1), to implement practice, curricula, and policy changes (that meet the requirements of subsection (d)) that promote healthy eating and physical activity among the birth to 5 years of age population. Preference in awarding grants shall be given to those States that demonstrate collaboration between relevant State entities related to child care and health and with key stakeholders, such as State early learning councils and other community-based organizations working with child care centers or family child care homes.(c)

Training requirements

(1)

In general

Training provided under subsection (b) shall— (A)include the provision of information concerning age-appropriate healthy eating and physical activity interventions and culturally competent curricula for the birth to 5 years of age population in the State involved, which at a minimum shall include— (i)a handbook that includes recommendations, guidelines, and best practices for child care centers and family child care homes relating to healthy eating, physical activity, and screen time reduction; (ii)information about the availability of and services provided by child care health consultants; and (iii)health and wellness resources available through the Child Care Bureau and the Maternal and Child Health Bureau; (B)identify, improve upon, and expand nutrition and physical activity best practices targeted to the birth to 5 years of age population in the State involved and identify strategies for incorporating parental education and other parental involvement; and (C)provide instruction on how to appropriately model, direct, and encourage child care staff behavior to apply the best practices and strategies identified under subparagraph (B). (2)

Training entities

A grantee may conduct the training required under this section directly, or may provide such training through a contract with— (A)an appropriate national, State, or community organization with relevant expertise; (B)a health care provider or professional organization with relevant expertise; (C)a university or research center that employs faculty with relevant expertise; or (D)any other entity determined appropriate by the State and approved by the Secretary. (3)

Requirement of contract

If a grantee elects to provide the training under this section through a contract, the grantee shall ensure that a consistent healthy eating and physical activity curriculum is being developed for all child care entities participating in the pilot program in the State. (d)

Practice, curricula, and policy changes

After training is provided as required under subsection (c), a State grantee shall ensure that the organizations and consortium involved— (1)implement, in child care settings, evidence-based or data-informed policy changes that promote healthy eating, physical activity, and appropriate screen time limits among the birth to 5 years of age population; (2)utilize an evidence-based or data-informed, culturally competent healthy eating and physical activity curriculum in child care settings focusing on such birth to age 5 population; (3)implement programs, activities, and procedures for incorporating parental education and involvement of parents in programs, including disseminating a written parental involvement policy, and coordinating and integrating parental involvement strategies under this section, to the extent feasible and appropriate, with parental involvement strategies under other programs, such as the Head Start program and the Early Head Start Program; and (4)find innovative ways to remove barriers that exist to providing opportunities for healthy eating and physical activity. All activities described in this paragraph shall be evidence-based and data-informed and be consistent with the curriculum presented through training activities described in subsection (c).

399OO–2.

Grants for the evaluation of pilot programs

The Secretary shall award competitive grants to Prevention Research Centers or universities to evaluate the programs carried out with grants under section 399OO–1, including baseline, process, and outcome measurements.

399OO–3.

Coordination

(a)

Interagency coordination

To the extent practicable, the Secretary shall coordinate activities conducted under this part with activities undertaken by the National Prevention, Health Promotion and Public Health Council established under section 4001 of the Patient Protection and Affordable Care Act (Public Law 111–148). Where practicable, such coordination shall— (1)include the sharing of current and emerging best practices concerning healthy eating, physical activity, and screen time limits that have a population-level impact in promoting nutrition and physical activity in child care settings; (2)promote the effective implementation and sustainability of such programs; and (3)avoid unnecessary duplication of effort. (b)

Pilot coordination

The Secretary shall designate an individual (directly or through contract) to provide technical assistance to States and pilot centers in the development, implementation, and evaluation of activities and dissemination of information described in paragraphs (1), (2), and (3) of subsection (a).

399OO–4.

Evaluation and reporting

(a)

Technical assistance and information

The Secretary shall— (1)provide technical assistance to grantees and other entities providing training under a grant under this part; and (2)disseminate to health departments and trainers under grants under this part information concerning evidence-based or data-informed approaches, including dissemination of existing toolkits, curricula, and existing or emerging best practices that can be expanded or improved upon through a program conducted under this part. (b)

Evaluation requirements

With respect to evaluations conducted under section 399OO–2, the Secretary shall ensure that— (1)evaluation metrics are consistent across all programs funded under this part; (2)interim outcomes are measured by the number of centers that have implemented policy and environmental strategies that support use of curricula and practices supporting healthy eating, physical activity, and screen time limits; (3)interim outcomes are measured, to the extent possible, by behavior changes in healthy eating, physical activity, and screen time; and (4)upon completion of the program, the evaluation shall include an identification of best practices relating to behavior change and reductions in the increasing prevalence of overweight and obesity that could be replicated in other settings. (c)

Dissemination of information

Upon the conclusion of the programs carried out under this part, the Secretary shall disseminate to all appropriate agencies within the Department of Health and Human Services evidence, best practices, and lessons learned from grantees. Such agencies shall encourage the adoption of the best practices. (d)

Report to Congress

Not later than 6 months after the completion of the pilot program under this part, the Secretary shall submit to Congress a report concerning the evaluation of the pilot programs, including recommendations as to how lessons learned from such programs can be incorporated into future guidance documents developed and provided by the Secretary and other Federal agencies, as appropriate.

399OO–5.

Authorization of appropriations

There is authorized to be appropriated to carry out this part, $2,500,000 for each of fiscal years 2011, 2012 and 2013.

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