[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 2741 Introduced in Senate (IS)]


  1st Session
                                S. 2741

 To amend the Public Health Service Act to promote healthy eating and 
                   physical activity among children.



                           September 14, 2021

  Mr. Booker (for himself and Ms. Klobuchar) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions


                                 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 Representatives of the 
United States of America in Congress assembled,


    This Act may be cited as the ``Reducing Obesity in Youth Act of 


    (a) Findings.--Congress makes the following findings:
            (1) The COVID-19 pandemic has had serious impacts on the 
        health and well-being of children and families.
            (2) Unemployment and poverty, as well as lengthy business, 
        school, and child care closures, have all contributed to 
        elevated levels of food insecurity, with an estimated 
        14,000,000 children in the United States not getting enough to 
            (3) Millions of children receive free or reduced-price 
        meals through early childhood education programs, including 
        school and early care and education programs such as childcare, 
        Head Start, pre-kindergarten, and family childcare, making 
        early childhood education an important setting for addressing 
        food insecurity.
            (4) More than 30,000,000 children receive free or reduced-
        price meals on a daily basis, and access to both breakfast and 
        lunch can provide some children with more than half of their 
        daily caloric intake.
            (5) Due to financial instability during the COVID-19 
        pandemic, there is an increased likelihood of unhealthy weight 
        gain among children as families shift to less costly, 
        calorically dense, shelf-stable foods, rather than fresh foods.
            (6) Research has shown that early childhood is an important 
        time for developing dietary and physical activity behaviors 
        that support health and well-being and that may help prevent 
            (7) Children who are exposed to healthy foods early are 
        more likely develop eating habits that promote healthy growth 
        that can continue throughout childhood, and healthy eating can 
        improve a child's learning ability, potentially lead to higher 
        academic performance, improve mental, social, and physical 
        well-being, and contribute to increased self-esteem.
            (8) Research underscores the importance of physical 
        activity in early childhood. It is not only essential for 
        healthy weight maintenance, but also for practicing and 
        learning fundamental gross motor skills and improving academic 
        achievement. Furthermore, when children have the opportunity 
        for adequate physical activity, they benefit physically, 
        psychologically and socially.
            (9) Nearly 20 percent (1 in 5) of 2-year-olds spend more 
        than 2 hours of a typical day watching television or videos, 
        and the Journal of the American Medical Association Pediatrics 
        found that each incremental hour of watching television at age 
        2 is associated with corresponding declines in school 
        engagement, math achievement, and weekend physical activity, 
        and with increases in bullying by classmates, consumption of 
        soft drinks and snacks, and body mass index at age 10.
            (10) A study published in the New England Journal of 
        Medicine in 2014 found that a third of children with overweight 
        in kindergarten had obesity by the eighth grade. Almost every 
        child with severe obesity remained that way, suggesting that 
        efforts must start much earlier and focus more on the children 
        at greatest risk.
            (11) A study published in the New England Journal of 
        Medicine in 2017 estimates that over 50 percent of 2-year-olds 
        today will be obese by 35 years of age.
            (12) A study examining the National Health and Nutrition 
        Examination Survey published in 2018 found an increase in 
        prevalence of childhood obesity in 2015 and 2016. Childhood 
        obesity for children between 2 and 5 years of age increased 
        from 9 percent to 14 percent, the highest increase since 1999.
            (13) In 2016, about 82 percent of United States preschool-
        aged children were in childcare, and most of their day was 
        spent in sedentary activities.
            (14) Early care and education centers serve approximately 
        7,500,000 children birth through age 5 years but not yet in 
        kindergarten, making the early childhood care and education 
        setting an important one for promoting healthful habits.
            (15) More than 122,000 children in 12 States have 
        benefitted from efforts to support healthier early care and 
        education programs. This includes the provision of training and 
        coaching for childcare providers and technical assistance to 
        State agencies to integrate nutrition and physical activity 
        best practices into existing State and local systems.
    (b) Purposes.--The purposes of this Act are to--
            (1) establish a program that will enhance the training and 
        knowledge of early care and education providers and influence 
        practices, policies, and environments in early care and 
        education settings to support healthy eating and physical 
        activity for children ages birth through 5, including by 
        addressing the growing threat of food insecurity;
            (2) provide support to States on ways to link early care 
        and education programs to nutrition supports;
            (3) monitor progress of healthy eating and physical 
        activity promotion in early care and education settings; and
            (4) identify emerging, and expand existing, approaches to 
        engaging families and parents of children ages birth to 5 in 
        healthy eating and physical activity.


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

                     ``PART W--HEALTHY KIDS PROGRAM


    ``In this part:
            ``(1) Director.--The term `Director' means the Director of 
        the Centers for Disease Control and Prevention.
            ``(2) Early care and education.--The term `early care and 
        education' means programs and activities that serve children 
        ages birth through 5 years either through in-home or out-of-
        home settings, including childcare programs, Head Start 
        programs, family childcare, and pre-kindergarten programs.

``SEC. 399OO-1. GRANTS.

    ``(a) In General.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention and in coordination with 
the Assistant Secretary for the Administration for Children and 
Families, shall award 5-year competitive grants to one or more eligible 
entities to improve healthy eating and physical activity and to address 
food insecurity among children ages birth through 5 years in early care 
and education settings.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            ``(1) be--
                    ``(A) a nonprofit organization with expertise in 
                early childhood health and childhood obesity 
                    ``(B) an institution of higher education or 
                research center that employs faculty with relevant 
                expertise and has expertise in training early care and 
                education providers; or
                    ``(C) a consortium of entities described in 
                subparagraphs (A) and (B) that submit a single 
                application to carry out activities under the grant 
                jointly; and
            ``(2) submit to the Director an application at such time, 
        in such manner, and containing such information as the Director 
        may require.
    ``(c) Use of Funds.--
            ``(1) In general.--An entity shall use amounts received 
        under a grant under this section to work directly with 
        implementing partners, which may include States, territories, 
        Indian Tribes, municipalities, and nonprofit organizations, 
                    ``(A) create sustainable programs to train early 
                care and education providers through direct coaching 
                and peer-learning, access to quality technical 
                assistance, and professional development opportunities 
                that are focused on healthy eating, physical activity, 
                addressing food insecurity, and other topics that 
                support children's healthy development, as determined 
                by the Director;
                    ``(B) build State capacity through training, 
                technical assistance, and resources to integrate the 
                promotion of healthy eating and physical activity into 
                existing early care and education programs, systems, 
                and initiatives, including linking early care and 
                education programs to new and existing resources for 
                nutrition supports, with a focus on promoting equity;
                    ``(C) test innovative or evidence-informed 
                approaches to promoting healthy habits and healthy 
                child development in early care and education settings, 
                which may include linking early care and education and 
                health care providers, enhancing early care and 
                education staff wellness, enhancing access to quality 
                foods in the early care and education settings, and 
                engaging families of children ages birth to 5 years 
                served in the early care and education programs 
                supported by a grant under this section.
            ``(2) Implementing partners.--In selecting States, 
        territories, Indian tribes, municipalities, or nonprofit 
        organizations to be implementing partners under a grant under 
        this section, a grantee shall ensure that such partners--
                    ``(A) serve populations that are racially, 
                ethnically, socioeconomically, and geographically 
                diverse; and
                    ``(B) represent a mix of rural and urban settings.
            ``(3) National independent evaluator.--From the amounts 
        appropriated to carry out this section, and prior to awarding 
        any grants under paragraph (1), the Director shall enter into a 
        contract with an external entity to create a single, uniform 
        process to--
                    ``(A) ensure that entities that receive grants 
                under paragraph (1) comply with the requirements of 
                this section; and
                    ``(B) evaluate the outcomes of the grant activities 
                carried out by each participating entity.
    ``(d) Tracking State Progress.--The Director may use amounts 
appropriated under subsection (f)(2) to enter into contracts with, or 
award grants to, institutions of higher education, nonprofit 
organizations, or other entities with relevant monitoring and 
surveillance expertise, for purposes of--
            ``(1) tracking State progress in obesity prevention 
        policies and practices of early care and education programs in 
        States where grantees are present; and
            ``(2) measuring changes in food security within exposed 
    ``(e) Report.--Not later than 1 year after the completion of the 
programs and activities funded under grants awarded under this section, 
the Secretary shall submit to Congress, and all appropriate agencies, a 
report concerning an evaluation of the results of such programs, 
activities, and surveillance, including best practices, and lessons 
derived from the experiences of grantees with respect to reducing and 
preventing food insecurity and obesity and overweight among children 
ages birth through 5 years in the early care and education settings.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section--
            ``(1) $5,000,000 for each of fiscal years 2022 through 
        2026; and
            ``(2) $1,700,000 for fiscal year 2022, to be used to track 
        State progress in obesity prevention and food security policies 
        and practices of early care and education programs in a 
        sentinel set of States as provided for in subsection (d).''.