[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6666 Introduced in House (IH)]

112th CONGRESS
  2d Session
                                H. R. 6666

To provide a comprehensive approach to preventing and treating obesity.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           December 13, 2012

   Mr. Kind introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees on 
    Ways and Means, Natural Resources, Education and the Workforce, 
Transportation and Infrastructure, and Agriculture, 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''.
    (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. Requirement to expedite national Medicare coverage 
                            determinations for evidence-based treatment 
                            services.
Sec. 102. Expansion of obesity treatment services under Medicare.
Sec. 103. Chronic weight management drugs covered under Medicaid and 
                            Medicare part D.
Sec. 104. Grants to provide training for health profession students.
Sec. 105. Grants to provide training for health professionals.
Sec. 106. Preventive health services block grant.
Sec. 107. Health Empowerment for At-Risk Teens and Youth (HEARTY) 
                            program.
TITLE II--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. 201. Play assessment tools.
Sec. 202. Model communities of play implementation grants.
                   Subtitle B--Healthy Kids Outdoors

Sec. 211. Definitions.
Sec. 212. Cooperative agreements for development or implementation of 
                            healthy kids outdoors State strategies.
Sec. 213. National strategy for encouraging Americans to be active 
                            outdoors.
Sec. 214. National evaluation of health impacts.
Sec. 215. Technical assistance and best practices.
Sec. 216. Authorization of appropriations.
                      Subtitle C--Other Provisions

Sec. 221. Physical education guidelines for elementary and secondary 
                            schools.
Sec. 222. Treating physical education as a core academic subject for 
                            elementary and secondary education grants.
Sec. 223. Physical activity guidelines for preschool children.
Sec. 224. Tracking physical activity in schools.
Sec. 225. Employer-provided off-premises health club services.
Sec. 226. Certain amounts paid for physical activity, fitness, and 
                            exercise treated as amounts paid for 
                            medical care.
Sec. 227. National youth sports program revitalization.
  TITLE III--IMPROVING ACCESS TO NUTRITIONAL INFORMATION AND HEALTHY 
                                 FOODS

Sec. 301. Consumer education.
Sec. 302. Expand team nutrition training grants.
Sec. 303. Urban and Native-American Community Garden Grant Program.
  TITLE IV--REALIGNING TRANSPORTATION POLICY TO HELP PROMOTE HEALTHY 
                               LIFESTYLES

Sec. 401. Grants to promote planning decisions and policies that 
                            increase access to physical activity.
Sec. 402. Joint use agreements.
                 TITLE V--RESEARCH AND ASSESSMENT TOOLS

Sec. 501. National Center for Health Statistics.
Sec. 502. Report on obesity research.

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

SEC. 101. REQUIREMENT TO EXPEDITE NATIONAL MEDICARE COVERAGE 
              DETERMINATIONS FOR EVIDENCE-BASED TREATMENT SERVICES.

    (a) In General.--The Secretary of Health and Human Services shall--
            (1) not later than January 1, 2014, issue national Medicare 
        coverage determinations for evidence-based services to treat 
        overweight and obesity that have an Evidence Category ``A'' or 
        ``B'' designation for treating overweight and obesity as 
        defined by the ``Clinical Guidelines on the Identification, 
        Evaluation, and Treatment of Overweight and Obesity in Adults'' 
        of the National Heart, Lung, and Blood Institute; and
            (2) update such coverage determinations based on future 
        updates to such Guidelines.
    (b) Updating NHLBI Guidelines.--Not later than December 31, 2014, 
and at least once every 3 years thereafter, the Secretary of Health and 
Human Services, acting through the Director of the National Heart, 
Lung, and Blood Institute, shall update the NHLBI Guidelines referred 
to in subsection (a).

SEC. 102. EXPANSION OF OBESITY TREATMENT SERVICES UNDER MEDICARE.

    (a) Coverage.--Section 1861 of the Social Security Act (42 U.S.C. 
1395x) is 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:

                      ``Obesity Treatment Program

    ``(iii)(1) The term `obesity treatment program' means 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 for which 
                payment would not otherwise be made under this title.
                    ``(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 
        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 Clinical Guidelines on the Identification, 
        Evaluation, and Treatment of Overweight and Obesity in Adults 
        released by the National Heart Lung and Blood Institute).
    ``(2) For purposes of paragraph (1), the term `eligible individual' 
means any of the following:
            ``(A) An individual who has been diagnosed with obesity by 
        a physician or provider of services, without regard to body 
        mass index or the presence of any comorbid condition.
            ``(B) An individual who has a body mass index of at least 
        30, without regard to the presence of any comorbid condition.
            ``(C) An individual who has a body mass index of at least 
        27 with at least one weight-related comorbid condition.''.
    (b) Payment.--Section 1833(a)(1) of the Social Security Act (42 
U.S.C. 1395l(a)(1)) 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''.
    (c) Effective Date.--The amendments made by this section shall 
apply to items and services furnished on or after January 1, 2014.

SEC. 103. CHRONIC WEIGHT MANAGEMENT DRUGS COVERED UNDER MEDICAID AND 
              MEDICARE PART D.

    (a) Medicaid Coverage.--Section 1927(d)(2)(A) of the Social 
Security Act (42 U.S.C. 1396r-8(d)(2)(A)) is amended by inserting 
before the period at the end the following: ``except prescription 
agents approved by the Food and Drug Administration used for chronic 
weight management in the treatment of obesity or overweight with a 
weight related co-morbidity''.
    (b) Medicare Part D Coverage.--Section 1860D-2(e)(1) of the Social 
Security Act (42 U.S.C. 1395w-102(e)(1)) is amended by inserting before 
the period at the end the following: ``and includes prescription agents 
approved by the Food and Drug Administration used for chronic weight 
management in the treatment of obesity or overweight with a weight 
related co-morbidity''.
    (c) Effective Date.--The amendments made by this section shall 
apply to items and services furnished on or after January 1, 2014.

SEC. 104. 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. 105. 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 
        ``2018'';
            (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), such sums as may be 
        necessary for each of fiscal years 2014 through 2018.''.

SEC. 106. 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.''.

SEC. 107. HEALTH EMPOWERMENT FOR AT-RISK TEENS AND YOUTH (HEARTY) 
              PROGRAM.

    Title III of the Public Health Service Act is amended by inserting 
after section 317T of such Act (42 U.S.C. 247b-22) the following:

``SEC. 317U. HEALTHY EMPOWERMENT FOR AT-RISK TEENS AND YOUTH (HEARTY) 
              PROGRAM.

    ``(a) In General.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention, may make grants to 
eligible entities to carry out nationally-based or community-based 
qualified childhood obesity prevention initiatives.
    ``(b) Eligible Entities.--To be eligible to seek a grant under this 
section, an entity shall be--
            ``(1) a nationally-based nonprofit organization qualified 
        in childhood obesity prevention and youth mentoring proposing 
        to implement programs described in subsection (c); or
            ``(2) a community-based nonprofit organization qualified in 
        childhood obesity prevention and youth mentoring proposing to 
        implement a program described in subsection (c).
    ``(c) Qualified Childhood Obesity Prevention Initiative.--To 
qualify as a childhood obesity prevention initiative eligible for 
funding under this section, an initiative shall consist of programs 
that--
            ``(1) serve both male and female children or adolescents 
        most at risk for being overweight and obese in predominantly 
        economically disadvantaged communities;
            ``(2) serve both male and female children or adolescents 
        during after-school hours, weekends, or summer hours;
            ``(3) provide structured physical fitness activities, 
        including organized sports, which engage each participant in a 
        minimum of 60 minutes of moderate to vigorous physical activity 
        at least three days per week for a period of at least 24 weeks 
        in a given year;
            ``(4) demonstrate cost-effectiveness as defined by the 
        Secretary; and
            ``(5) demonstrate measurable results for reducing childhood 
        obesity on the part of participants, including through--
                    ``(A) measurement and study of participants' 
                moderate to vigorous physical activity (MVPA) each day, 
                both as part of the programs funded under this section 
                and on the participants' own initiative;
                    ``(B) increased knowledge of and awareness about 
                the importance of maintaining healthy, active 
                lifestyles by balancing recommended levels of physical 
                activity and caloric intakes;
                    ``(C) keeping track of and reporting increased 
                consumption of healthy items and increased levels of 
                unstructured, self-initiated physical activity outside 
                of the programs funded under this section; and
                    ``(D) measurement and study of participants' body 
                mass index (BMI) indicating that--
                            ``(i) children entering programs funded 
                        under this section with a healthy body mass 
                        index maintain it while participating in such 
                        programs; and
                            ``(ii) children participating in such 
                        programs with an unhealthy body mass index halt 
                        any negative trend lines towards obesity or 
                        begin trend lines in a positive direction.
    ``(d) Priority.--In selecting among applicants for grants under 
this section, the Secretary shall give priority to eligible entities 
proposing to carry out programs that show:
            ``(1) effectiveness in working with ethnic and racial 
        minority groups;
            ``(2) effectiveness in recruiting participants from 
        communities with substantial immigrant populations, as defined 
        by the Secretary; and
            ``(3) program evaluation by an independent, third-party 
        evaluator, of category specified by the Secretary.
    ``(e) Distribution of Funds.--Of the amount made available to carry 
out this section for a fiscal year, the Secretary shall award--
            ``(1) not less than 25 percent of such amount to 
        nationally-based nonprofit organizations described in 
        subsection (b)(1); and
            ``(2) not more than 75 percent of such amount to community-
        based nonprofit organizations described in subsection (b)(2).
    ``(f) Cost-Share Requirements.--With respect to the costs of a 
qualified childhood obesity prevention initiative to be carried out 
under this section, there shall be no non-federal match requirement.
    ``(g) Report to Congress.--Not later than one year after the first 
appropriation of Federal funds to carry out this section, the Secretary 
shall report to the Congress on the progress made in carrying out 
programs funded by grants under this section.
    ``(h) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2014 through 2018.''.

TITLE II--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. 201. PLAY ASSESSMENT TOOLS.

    (a) In General.--The Secretary of Health and Human Services (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. 202. MODEL COMMUNITIES OF PLAY IMPLEMENTATION GRANTS.

    (a) Program Authorized.--
            (1) In general.--The Secretary of Health and Human Services 
        (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 201 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 
                        and other health care professionals 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 2014 through 2019.

                   Subtitle B--Healthy Kids Outdoors

SEC. 211. DEFINITIONS.

    In this subtitle:
            (1) Eligible entity.--The term ``eligible entity'' means--
                    (A) a State; or
                    (B) a consortium from one State that may include 
                such State and municipalities, entities of local or 
                tribal governments, parks and recreation departments or 
                districts, school districts, institutions of higher 
                education, or nonprofit organizations.
            (2) Local partners.--The term ``local partners'' means a 
        municipality, entity of local or tribal government, parks and 
        recreation departments or districts, Indian tribe, school 
        district, institution of higher education, nonprofit 
        organization, or a consortium of local partners.
            (3) Secretary.--The term ``Secretary'' means the Secretary 
        of the Interior.
            (4) State.--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. 212. COOPERATIVE AGREEMENTS FOR DEVELOPMENT OR IMPLEMENTATION OF 
              HEALTHY KIDS OUTDOORS STATE STRATEGIES.

    (a) In General.--The Secretary is authorized to issue one 
cooperative agreement per State to eligible entities to develop, 
implement, and update a 5-year State strategy, to be known as a 
``Healthy Kids Outdoors State Strategy'', designed to encourage 
Americans, especially children, youth, and families, to be physically 
active outdoors.
    (b) Submission and Approval of Strategies.--
            (1) Applications.--An application for a cooperative 
        agreement under subsection (a) shall--
                    (A) be submitted not later than 120 days after the 
                Secretary publishes guidelines under subsection (f)(1); 
                and
                    (B) include a Healthy Kids Outdoors 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 Healthy Kids Outdoors State 
        Strategy, the Secretary shall, through a peer review process, 
        approve or recommend changes to the strategy.
            (3) Strategy update.--An eligible entity receiving funds 
        under this section shall update its Healthy Kids Outdoors State 
        Strategy at least once every 5 years. Continued funding under 
        this section shall be contingent upon submission of such 
        updated strategies and reports that document impact evaluation 
        methods consistent with the guidelines in subsection (f)(1) and 
        lessons learned from implementing the strategy.
    (c) Comprehensive Strategy Requirements.--The Healthy Kids Outdoors 
State Strategy under subsection (a) shall include--
            (1) a description of how the eligible entity will encourage 
        Americans, especially children, youth, and families, to be 
        physically active in the outdoors through State, local, and 
        tribal--
                    (A) public health systems;
                    (B) public parks and recreation systems;
                    (C) public transportation and city planning 
                systems; and
                    (D) other public systems that connect Americans, 
                especially children, youth, and families, to the 
                outdoors;
            (2) a description of how the eligible entity will partner 
        with nongovernmental organizations, especially those that serve 
        children, youth, and families, including those serving military 
        families and tribal agencies;
            (3) a description of how State agencies will collaborate 
        with each other to implement the strategy;
            (4) a description of how funding will be spent through 
        local planning and implementation subgrants under subsection 
        (d);
            (5) a description of how the eligible entity will evaluate 
        the effectiveness of, and measure the impact of, the strategy, 
        including an estimate of the costs associated with such 
        evaluation;
            (6) a description of how the eligible entity will provide 
        opportunities for public involvement in developing and 
        implementing the strategy;
            (7) a description of how the strategy will increase 
        visitation to Federal public lands within the state; and
            (8) a description of how the eligible entity will leverage 
        private funds to expand opportunities and further implement the 
        strategy.
    (d) Local Planning and Implementation.--
            (1) In general.--A Healthy Kids Outdoors State Strategy 
        shall provide for subgrants by the cooperative agreement 
        recipient under subsection (a) to local partners to implement 
        the strategy through one or more of the program activities 
        described in paragraph (2).
            (2) Program activities.--Program activities may include--
                    (A) implementing outdoor recreation and youth 
                mentoring programs that provide opportunities to 
                experience the outdoors, be physically active, and 
                teach skills for lifelong participation in outdoor 
                activities, including fishing, hunting, recreational 
                shooting, archery, hiking, camping, outdoor play in 
                natural environments, and wildlife watching;
                    (B) implementing programs that connect communities 
                with safe parks, green spaces, and outdoor recreation 
                areas through affordable public transportation and 
                trail systems that encourage walking, biking, and 
                increased physical activity outdoors;
                    (C) implementing school-based programs that use 
                outdoor learning environments, such as wildlife 
                habitats or gardens, and programs that use service 
                learning to restore natural areas and maintain 
                recreational assets; and
                    (D) implementing education programs for parents and 
                caregivers about the health benefits of active time 
                outdoors to fight obesity and increase the quality of 
                life for Americans, especially children, youth, and 
                families.
    (e) Priority.--In making cooperative agreements under subsection 
(a) and subgrants under subsection (d)(1), the Secretary and the 
recipient under subsection (a), respectively, shall give preference to 
entities that serve individuals who have limited opportunities to 
experience nature, including those who are socioeconomically 
disadvantaged or have a disability or suffer disproportionately from 
physical and mental health stressors.
    (f) Guidelines.--Not later than 180 days after the date of 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 and evaluation 
        methods under subsection (b); and
            (2) technical assistance and dissemination of best 
        practices under section 215.
    (g) Reporting.--Not later than 2 years after the Secretary approves 
the Healthy Kids Outdoors State Strategy of an eligible entity 
receiving funds under this section, and every year thereafter, the 
eligible 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.
    (h) Allocation of Funds.--An eligible entity receiving funding 
under subsection (a) for a fiscal year--
            (1) may use not more than 5 percent of the funding for 
        administrative expenses; and
            (2) shall use at least 95 percent of the funding for 
        subgrants to local partners under subsection (d).
    (i) Match.--An eligible entity receiving funding under subsection 
(a) for a fiscal year shall provide a 25-percent match through in-kind 
contributions or cash.

SEC. 213. NATIONAL STRATEGY FOR ENCOURAGING AMERICANS TO BE ACTIVE 
              OUTDOORS.

    (a) In General.--Not later than September 30, 2013, the President, 
in cooperation with appropriate Federal departments and agencies, shall 
develop and issue a national strategy for encouraging Americans, 
especially children, youth, and families, to be physically active 
outdoors. Such a strategy shall include--
            (1) identification of barriers to Americans, especially 
        children, youth, and families, spending healthy time outdoors 
        and specific policy solutions to address those barriers;
            (2) identification of opportunities for partnerships with 
        Federal, State, tribal, and local partners;
            (3) coordination of efforts among Federal departments and 
        agencies to address the impacts of Americans, especially 
        children, youth, and families, spending less active time 
        outdoors on--
                    (A) public health, including childhood obesity, 
                attention deficit disorders and stress;
                    (B) the future of conservation in the United 
                States; and
                    (C) the economy;
            (4) identification of ongoing research needs to document 
        the health, conservation, economic, and other outcomes of 
        implementing the national strategy and State strategies;
            (5) coordination and alignment with Healthy Kids Outdoors 
        State Strategies; and
            (6) an action plan for implementing the strategy at the 
        Federal level.
    (b) Strategy Development.--
            (1) Public participation.--Throughout the process of 
        developing the national strategy under subsection (a), the 
        President may use, incorporate, or otherwise consider existing 
        Federal plans and strategies that, in whole or in part, 
        contribute to connecting Americans, especially children, youth, 
        and families, with the outdoors and shall provide for public 
        participation, including a national summit of participants with 
        demonstrated expertise in encouraging individuals to be 
        physically active outdoors in nature.
            (2) Updating the national strategy.--The President shall 
        update the national strategy not less than 5 years after the 
        date the first national strategy is issued under subsection 
        (a), and every 5 years thereafter. In updating the strategy, 
        the President shall incorporate results of the evaluation under 
        section 214.

SEC. 214. NATIONAL EVALUATION OF HEALTH IMPACTS.

    The Secretary, in coordination with the Secretary of Health and 
Human Services, shall--
            (1) develop recommendations for appropriate evaluation 
        measures and criteria for a study of national significance on 
        the health impacts of the strategies under this subtitle; and
            (2) carry out such a study.

SEC. 215. TECHNICAL ASSISTANCE AND BEST PRACTICES.

    The Secretary shall--
            (1) provide technical assistance to grantees under section 
        212 through cooperative agreements with national organizations 
        with a proven track record of encouraging Americans, especially 
        children, youth, and families, to be physically active 
        outdoors; and
            (2) disseminate best practices that emerge from strategies 
        funded under this subtitle.

SEC. 216. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--There are authorized to be appropriated to the 
Secretary to carry out this subtitle such sums as may be necessary for 
each of fiscal years 2014 through 2018.
    (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 215.
    (c) Supplement, Not Supplant.--Funds made available under this 
subtitle shall be used to supplement, and not supplant, any other 
Federal, State, or local funds available for activities that encourage 
Americans, especially children, youth, and families to be physically 
active outdoors.

                      Subtitle C--Other Provisions

SEC. 221. 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. 222. 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. 223. 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. 224. 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 
                childcare 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. 225. 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. 226. 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. 227. 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 2014 through 2024''.

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

SEC. 301. 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. 302. 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 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).
            ``(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 this Act; 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. 303. 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).
    (e) Authorization of Appropriations.--For each of fiscal years 2014 
through 2018, there are authorized to be appropriated to the Secretary 
such sums as may be necessary to award grants under this section.

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

SEC. 401. 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. 402. JOINT USE AGREEMENTS.

    (a) Grants.--The Secretary may make a grant to any eligible school 
or other public or nonprofit 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 or nonprofit 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, the following definitions apply:
            (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 of 
        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 or nonprofit 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 of the Community 
        Services Block Grant Act (42 U.S.C. 9902).
            (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.

                 TITLE V--RESEARCH AND ASSESSMENT TOOLS

SEC. 501. 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. 502. 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>