Reducing Obesity in Youth Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 8918 To amend the Public Health Service Act to promote healthy eating and physical activity among children. IN THE HOUSE OF REPRESENTATIVES DECEMBER 9, 2020 Mr. COHEN (for himself, Ms. NORTON, Mr. PAYNE, Mr. RUSH, and Ms. BLUNT ROCHESTER) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend the Public Health Service Act to promote healthy eating and physical activity among children. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Reducing Obesity in 4 Youth Act of 2020’’. 5 SEC. 2. FINDINGS AND PURPOSES. 6 (a) FINDINGS.—Congress makes the following find- 7 ings: 8 VerDate Sep 11 2014 23:18 Dec 21, 2020 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H8918.IH H8918 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 8918 IH (1) The COVID–19 pandemic has had serious 1 impacts on the health and well-being of children and 2 families. 3 (2) Unemployment and poverty, likely exacer- 4 bated by business, school, and childcare closures, 5 have all contributed to elevated levels of food insecu- 6 rity, with an estimated 14,000,000 children in the 7 United States not getting enough to eat. 8 (3) Millions of children receive free or reduced- 9 price meals through early childhood education pro- 10 grams, including school and early care and education 11 programs such as childcare, Head Start, pre-kinder- 12 garten, and family childcare, making early childhood 13 education an important setting for addressing food 14 insecurity. 15 (4) More than 30,000,000 children receive free 16 or reduced-price meals on a daily basis, and access 17 to both breakfast and lunch can provide some chil- 18 dren with more than half of their daily caloric in- 19 take. 20 (5) Due to financial instability during the 21 COVID–19 pandemic, there is an increased likeli- 22 hood of unhealthy weight gain among children as 23 families shift to less costly, calorically-dense, shelf- 24 stable foods, rather than fresh foods. 25 VerDate Sep 11 2014 23:18 Dec 21, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H8918.IH H8918 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 8918 IH (6) Research has shown that early childhood is 1 an important time for developing dietary and phys- 2 ical activity behaviors that support health and well- 3 being and that may help prevent obesity. 4 (7) Children who are exposed to healthy foods 5 early are more likely develop eating habits that pro- 6 mote healthy growth that can continue throughout 7 childhood, and healthy eating can improve a child’s 8 learning ability, potentially lead to higher academic 9 performance, improve mental, social, and physical 10 well-being, and contribute to increased self-esteem. 11 (8) Research underscores the importance of 12 physical activity in early childhood. It is not only es- 13 sential for healthy weight maintenance, but also for 14 practicing and learning fundamental gross motor 15 skills and improving academic achievement. Further- 16 more, when children have the opportunity for ade- 17 quate physical activity, they benefit physically, psy- 18 chologically, and socially. 19 (9) Nearly 20 percent (1 in 5) of 2-year-olds 20 spend more than 2 hours of a typical day watching 21 television or videos, and the Journal of the American 22 Medical Association Pediatrics found that each in- 23 cremental hour of watching television at age 2 is as- 24 sociated with corresponding declines in school en- 25 VerDate Sep 11 2014 23:18 Dec 21, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H8918.IH H8918 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 8918 IH gagement, math achievement, and weekend physical 1 activity, and with increases in bullying by class- 2 mates, consumption of soft drinks and snacks, and 3 body mass index at age 10. 4 (10) A study published in the New England 5 Journal of Medicine in 2014 found that a third of 6 children with overweight in kindergarten had obesity 7 by eighth grade. Almost every child with severe obe- 8 sity remained that way, suggesting that efforts must 9 start much earlier and focus more on the children at 10 greatest risk. 11 (11) A study published in the New England 12 Journal of Medicine in 2017 estimates that over 50 13 percent of 2-year-olds today will be obese by 35 14 years of age. 15 (12) A study examining the National Health 16 and Nutrition Examination Survey published in 17 2018 found an increase in prevalence of childhood 18 obesity in 2015 and 2016. Childhood obesity for 19 children between 2 and 5 years of age increased 20 from 9 percent to 14 percent, the highest increase 21 since 1999. 22 (13) In 2016, about 82 percent of United 23 States preschool-aged children were in childcare, and 24 most of their day was spent in sedentary activities. 25 VerDate Sep 11 2014 23:18 Dec 21, 2020 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H8918.IH H8918 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 8918 IH (14) Early care and education centers serve ap- 1 proximately 7,500,000 children birth through age 5 2 years but not yet in kindergarten, making the early 3 childhood care and education setting an important 4 one for promoting healthful habits. 5 (15) More than 122,000 children in 12 States 6 have benefitted from efforts to support healthier 7 early care and education programs. This includes 8 the provision of training and coaching for childcare 9 providers and technical assistance to State agencies 10 to integrate nutrition and physical activity best prac- 11 tices into existing State and local systems. 12 (b) PURPOSES.—The purposes of this Act are to— 13 (1) establish a program that will enhance the 14 training and knowledge of early care and education 15 providers and influence practices, policies, and envi- 16 ronments in early care and education settings to 17 support healthy eating and physical activity for chil- 18 dren ages birth through 5, including by addressing 19 the growing threat of food insecurity; 20 (2) provide support to States on ways to link 21 early care and education programs to nutrition sup- 22 ports; 23 VerDate Sep 11 2014 23:18 Dec 21, 2020 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H8918.IH H8918 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 8918 IH (3) monitor progress of healthy eating and 1 physical activity promotion in early care and edu- 2 cation settings; and 3 (4) identify emerging, and expand existing, ap- 4 proaches to engaging families and parents of chil- 5 dren ages birth to 5 in healthy eating and physical 6 activity. 7 SEC. 3. HEALTHY KIDS PROGRAM. 8 Title III of the Public Health Service Act (42 U.S.C. 9 241 et seq.) is amended by adding at the end the fol- 10 lowing: 11 ‘‘PART W—HEALTHY KIDS PROGRAM 12 ‘‘SEC. 399OO. DEFINITIONS. 13 ‘‘In this part: 14 ‘‘(1) DIRECTOR.—The term ‘Director’ means 15 the Director of the Centers for Disease Control and 16 Prevention. 17 ‘‘(2) EARLY CARE AND EDUCATION.—The term 18 ‘early care and education’ means programs and ac- 19 tivities that serve children ages birth through 5 20 years either through in-home or out-of-home set- 21 tings, including childcare programs, Head Start pro- 22 grams, family childcare, and pre-kindergarten pro- 23 grams. 24 VerDate Sep 11 2014 23:18 Dec 21, 2020 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H8918.IH H8918 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 8918 IH ‘‘SEC. 399OO–1. GRANTS. 1 ‘‘(a) IN GENERAL.—The Secretary, acting through 2 the Director of the Centers for Disease Control and Pre- 3 vention and in coordination with the Assistant Secretary 4 for the Administration for Children and Families, shall 5 award 5-year competitive grants to eligible entities to im- 6 prove healthy eating and physical activity among children 7 ages birth through 5 years in early care and education 8 settings. 9 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 10 under subsection (a), an entity shall— 11 ‘‘(1) be— 12 ‘‘(A) a nonprofit organization with exper- 13 tise in early childhood health and childhood obe- 14 sity prevention; 15 ‘‘(B) an institution of higher education or 16 research center that employs faculty with rel- 17 evant expertise and has expertise in training 18 early care and education providers; or 19 ‘‘(C) a consortium of entities described in 20 subparagraphs (A) and (B) that submit a single 21 application to carry out activities under the 22 grant jointly; and 23 ‘‘(2) submit to the Director an application at 24 such time, in such manner, and containing such in- 25 formation as the Director may require. 26 VerDate Sep 11 2014 23:18 Dec 21, 2020 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H8918.IH H8918 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 8918 IH ‘‘(c) USE OF FUNDS.— 1 ‘‘(1) IN GENERAL.—An entity shall use 2 amounts received under a grant under this section to 3 work directly with implementing partners, which 4 may include States, territories, Indian Tribes, mu- 5 nicipalities, and nonprofit organizations, to— 6 ‘‘(A) create sustainable programs to train 7 early care and education providers through di- 8 rect coaching and peer-learning, access to qual- 9 ity technical assistance, and professional devel- 10 opment opportunities that are focused on 11 healthy eating, physical activity, and addressing 12 food insecurity; 13 ‘‘(B) build State capacity through training, 14 technical assistance, and resources to integrate 15 the promotion of healthy eating and physical 16 activity into existing early care and education 17 programs, systems, and initiatives, including 18 helping to link early care and education pro- 19 grams with existing resources for nutrition sup- 20 ports; and 21 ‘‘(C) test innovative or evidence-informed 22 approaches to engage families of children ages 23 birth to 5 years served in early care and edu- 24 cation programs participating in this grant. 25 VerDate Sep 11 2014 23:18 Dec 21, 2020 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H8918.IH H8918 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 8918 IH ‘‘(2) IMPLEMENTING PARTNERS.—In selecting 1 States, territories, Indian tribes, municipalities, or 2 nonprofit organizations to be implementing partners 3 under a grant under this section, a grantee shall en- 4 sure that such partners— 5 ‘‘(A) serve populations that are racially, 6 ethnically, socioeconomically, and geographically 7 diverse; and 8 ‘‘(B) represent a mix of rural and urban 9 settings. 10 ‘‘(3) NATIONAL INDEPENDENT EVALUATOR.— 11 From the amounts appropriated to carry out this 12 section, and prior to awarding any grants under 13 paragraph (1), the Director shall enter into a con- 14 tract with an external entity to create a single, uni- 15 form process to— 16 ‘‘(A) ensure that entities that receive 17 grants under paragraph (1) comply with the re- 18 quirements of this section; and 19 ‘‘(B) evaluate the outcomes of the grant 20 activities carried out by each participating enti- 21 ty. 22 ‘‘(d) TRACKING STATE PROGRESS.—The Director 23 may use amounts appropriated under subsection (f)(2) to 24 enter into contracts with, or award grants to, institutions 25 VerDate Sep 11 2014 23:18 Dec 21, 2020 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H8918.IH H8918 kjohnson on DSK79L0C42PROD with BILLS 10 •HR 8918 IH of higher education, nonprofit organizations, or other enti- 1 ties with relevant monitoring and surveillance expertise, 2 for purposes of— 3 ‘‘(1) tracking State progress in obesity preven- 4 tion policies and practices of early care and edu- 5 cation programs in States where grantees are 6 present; and 7 ‘‘(2) measuring changes in food security within 8 exposed groups. 9 ‘‘(e) REPORT.—Not later than 1 year after the com- 10 pletion of the programs and activities funded under grants 11 awarded under this section, the Secretary shall submit to 12 Congress, and all appropriate agencies, a report con- 13 cerning an evaluation of the results of such programs, ac- 14 tivities, and surveillance, including best practices, and les- 15 sons derived from the experiences of grantees with respect 16 to reducing and preventing food insecurity and obesity and 17 overweight among children ages birth through 5 years in 18 the early care and education settings. 19 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 20 is authorized to be appropriated to carry out this section— 21 ‘‘(1) $4,500,000 for each of fiscal years 2022 22 through 2026; and 23 ‘‘(2) $1,700,000 for fiscal year 2022, to be 24 used to track State progress in obesity prevention 25 VerDate Sep 11 2014 23:18 Dec 21, 2020 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H8918.IH H8918 kjohnson on DSK79L0C42PROD with BILLS 11 •HR 8918 IH policies and practices of early care and education 1 programs in a sentinel set of States as provided for 2 in subsection (d).’’. 3 Æ VerDate Sep 11 2014 23:18 Dec 21, 2020 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\H8918.IH H8918 kjohnson on DSK79L0C42PROD with BILLS