S.Amdt. 2954

SA 2954. Mr. UDALL of Colorado (for himself and Mr. Udall of New
Mexico) submitted an amendment intended to be proposed to amendment SA
2786 proposed by Mr. Reid (for himself, Mr. Baucus, Mr. Dodd, and Mr.
Harkin) to the bill H.R. 3590, to amend the Internal Revenue Code of
1986 to modify the first-time homebuyers credit in the case of members
of the Armed Forces and certain other Federal employees, and for other
purposes; which was ordered to lie on the table; as follows:

On page 1265, between lines 8 and 9, insert the following:

SEC. 4307. PILOT PROGRAM TO REDUCE THE INCREASING PREVALENCE
OF OVERWEIGHT/OBESITY AMONG CHILDREN FROM BIRTH
THROUGH 5 YEARS OF AGE.

(a) Findings.--Congress makes the following findings:
(1) Life-long food preferences, eating habits, and activity
levels develop early in childhood.
(2) Preschool years are a critical time for determining
whether or not an individual will develop obesity later in
life.
(3) Aerobic fitness and healthy eating patterns support
enhanced behavioral, emotional, and academic performance in
school.
(4) Recent studies indicate that children who are
overweight at age 5 are more likely to be more overweight at
age 9.
(5) Obese preschool children already exhibit signs of
cardiovascular disease and diabetes.
(6) According to a 2007 Centers for Disease Control and
Prevention study, 12.4 percent of children in the United
States ages 2 through 6 are obese.
(7) The 2001 National Household Education Survey found that
74 percent of children in the United States ages 3 through 6
are in some form of non-parental child care, and 56 percent
are in center-based child care.
(8) According to a 2009 analysis of child care center
licensing regulations, only 12 States have a policy
prohibiting or limiting foods of low nutritional value in
child care centers, only 8 States require vigorous or
moderate physical activity, only one of which has a policy
quantifying a required number of minutes of physical activity
by day or week, and only 7 States quantify a maximum amount
of time for media (television and electronic) each day or
week.
(9) In July 2009, the Centers for Disease Control and
Prevention released recommended community strategies and
measures to prevent obesity in the United States that
includes child care specific policy and environmental
initiatives to achieve healthy eating and active living among
children from birth to 5 years of age.
(10) In September 2009, The Institute of Medicine released
findings supporting local governments' ability to play a
crucial role in creating environments that make it easier for
children to eat healthy diets and remain active.
(11) States should strive to adopt nutrition standards,
practices, and policies for childcare centers that are
consistent with the 2005 Dietary Guidelines for Americans.
(12) The Child and Adult Care Food Program is a Federal
initiative that provides States with grants to provide
children and adults in care settings with nutritious meals
and snacks.
(13) Childcare centers should serve as settings where
children adopt healthy eating habits, have opportunities for
age appropriate physical activity, and set screen time
limits.
(b) Purposes.--It is the purpose of this Act to--
(1) establish a 3-year pilot program in 5 States that will
focus on reducing the increasing prevalence of overweight/
obesity among children between birth and 5 years of age in
child care settings;
(2) enhance the focus of child care centers serving the
birth to 5 years of age population on children's healthy
development through evidence-based or data-informed policies
and practices to improve healthy eating, physical activity,
and screen time limits; and
(3) identify emerging and expand existing evidence-based
practices and understanding of healthy eating, physical
activity, and screen time limits, as appropriate, as well as
replicate curricula, interventions, practices, and policy
changes that are most effective in promoting nutrition and
physical activity among the birth to 5 years of age
population in the child care setting.
(c) Definitions.--In this section:
(1) Child care center.--The term ``child care center''
means a nonresidential facility that generally provides child
care services for fewer than 24 hours per day per child,
unless care in excess of 24 hours is due to the nature of the
parents' work, and that is certified, registered, or licensed
in the State in which it is located.
(2) Early learning council.--The term ``early learning
council'' means an early childhood assembly that is
established to advise governors, State legislators, or State
agency administrators on how best to meet the needs of young
children and their families specifically through improvement
of programs and services.
(3) Family child care home.--The term ``family child care
home'' means a private family home where home-based child
care is provided for a portion of the day, unless care in
excess of 24 hours is due to the nature of the parents' work,
and that is certified, registered, or licensed in the State
in which it is located.
(4) Screen time limits.--The term ``screen time limits''
means policies or guidelines, such as those developed by the
American Academy of Pediatrics, designed to reduce the daily
amount of time that children spend watching or looking at
digital monitors or displays, including television sets,
computer monitors, or hand-held gaming devices.
(5) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(d) Grants.--
(1) In general.--The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall
award 3-year competitive grants to 5 State health departments
(or other appropriate State agency administering the Child
and Adult Care Food Program or other child care programs) to
help reduce and prevent obesity among the birth to 5 year old
population of the State in child care centers and family
child care homes.
(2) Use of funds.--State grantees shall use amounts
received under a grant under this subsection to--
(A) provide, or enter into contracts to provide, training
(that meets the requirements of paragraph (3)) to the staff
of national, State, or community-based organizations with
networks of child care centers, or a consortium of childcare
centers and family child care homes consisting of at least 10
child care centers or family child care homes, for the
purpose of implementing evidence-based or data-informed
healthy eating and physical activity policies and practices,
including curricula and other interventions; and
(B) provide grants to child care centers and family child
care homes, whose staff received the training described in
subparagraph (A), to implement practice, curricula, and
policy changes (that meet the requirements of paragraph (4))
that promote healthy eating and physical activity among the
birth to 5 years of age population.

In determining who receives grant funds, a State shall
consider, but not be limited to, child care centers and
family child care homes that receive funds under the Child
and Adult Care Food Program administered by the Department of
Agriculture. Preference shall be given to those States that
demonstrate collaboration between relevant State entities
related to child care and health and with key stakeholders,
such as State early learning councils and other community
based organizations working with child care centers or family
child care homes.
(3) Training requirements.--
(A) In general.--Training provided under paragraph (2)
shall--
(i) include the provision of information concerning age-
appropriate healthy eating and physical activity
interventions and curricula for the birth to 5 years of age
population in the State involved;
(ii) identify, improve upon, and expand nutrition and
physical activity best practices targeted to the birth to 5
years of age population in the State involved and identify
strategies for incorporating parental education and other
parental involvement; and
(iii) provide instruction on how to appropriately model,
direct, and encourage child care staff behavior to apply the
best practices and strategies identified under clause (ii).

[[Page S12623]]

(B) Training entities.--A grantee may conduct the training
required under this subsection directly, or may provide such
training through a contract with--
(i) an appropriate national, State, or community
organization with relevant expertise;
(ii) a health care provider or professional organization
with relevant expertise;
(iii) a university or research center that employs faculty
with relevant expertise; or
(iv) any other entity determined appropriate by the State
and approved by the Secretary.
(C) Requirement of contract.--If a grantee elects to
provide the training under this subsection through a
contract, the grantee shall ensure that a consistent healthy
eating and physical activity curriculum is being developed
for all child care entities that provide care for 10 or more
children throughout the State.
(4) Practice, curricula, and policy changes.--After
training is provided as required under paragraph (3), a State
grantee shall ensure that the organizations and consortium
involved--
(A) implement, in child care settings, evidence-based or
data-informed policy changes that promote healthy eating,
physical activity, and appropriate screen time limits among
the birth to 5 years of age population;
(B) utilize an evidence-based or data-informed healthy
eating and physical activity curriculum in child care
settings focusing on such birth to 5 age population;
(C) implement programs, activities, and procedures for
incorporating parental education and involvement of parents
in programs, including disseminating a written parental
involvement policy, and coordinating and integrating parental
involvement strategies under this section, to the extent
feasible and appropriate, with parental involvement
strategies under other programs, such as the Head Start
program and the Early Head Start Program; and
(D) find innovative ways to remove barriers that exist to
providing opportunities for healthy eating and physical
activity.
All activities described in this paragraph shall be evidence-
based or data-informed and be consistent with the curriculum
presented through training activities described in paragraph
(3).
(e) Grants for the Evaluation of Pilot Programs.--The
Secretary, acting through the Director of the Centers for
Disease Control and Prevention, shall award competitive
grants to Prevention Research Centers or universities to
evaluate the programs carried out with grants under
subsection (d), including baseline, process, and outcome
measurements.
(f) Coordination.--
(1) Interagency coordination.--To the extent practicable,
the Secretary, acting through the Centers for Disease Control
and Prevention, shall coordinate activities conducted under
this section with activities undertaken by the National
Prevention, Health Promotion and Public Health Council
established under section 4001. Where possible, such
coordination should--
(A) include the sharing of current and emerging best
practices concerning healthy eating, physical activity, and
screen time limits that have a population-level impact in
promoting nutrition and physical activity in child care
settings;
(B) promote the effective implementation and sustainability
of such programs; and
(C) avoid unnecessary duplication of effort.
(2) Pilot coordination.--The Director of the Centers for
Disease Control and Prevention shall designate an individual
(directly or through contract) to provide technical
assistance to States and pilot centers in the development,
implementation, and evaluation of activities and
dissemination of information described in subparagraphs (A),
(B), and (C) of paragraph (1).
(g) Evaluation and Reporting.--
(1) Technical assistance and information.--The Secretary,
acting through the Director of the Centers for Disease
Control and Prevention, shall--
(A) provide technical assistance to grantees and other
entities providing training under a grant under this section;
and
(B) disseminate to health departments and trainers under
grants under this section information concerning evidence-
based or data-informed approaches, including dissemination of
existing toolkits, curricula, and existing or emerging best
practices that can be expanded or improved upon through a
program conducted under this section.
(2) Evaluation requirements.--With respect to evaluations
conducted under subsection (e), the Secretary, acting through
the Director of the Center for Disease Control and
Prevention, shall ensure that--
(A) evaluation metrics are consistent across all programs
funded under this section;
(B) interim outcomes are measured by the number of centers
that have implemented policy and environmental strategies
that support use of curricula and practices supporting
healthy eating, physical activity, and screen time limits;
(C) interim outcomes are measured, to the extent possible,
by behavior changes in healthy eating, physical activity, and
screen time; and
(D) upon completion of the program, the evaluation shall
include an identification of best practices relating to
behavior change and reductions in the increasing prevalence
of overweight and obesity that could be replicated in other
settings.
(3) Dissemination of information.--Upon the conclusion of
the programs carried out under this section, the Secretary,
acting through the Director of the Centers for Disease
Control and Prevention, shall disseminate evidence, best
practices, and lessons learned from grantees and shall submit
to Congress a report concerning the evaluation of such
programs, including recommendations as to how lessons learned
from such programs can be incorporated into future guidance
documents developed and provided by the Director for States
and communities funded for nutrition, physical activity, and
obesity prevention.
(h) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section, $7,500,000 for
each of fiscal years 2011, 2012 and 2013.
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