H.R. 4765 — Introduced in House

I 113th CONGRESS 2d Session H. R. 4765 IN THE HOUSE OF REPRESENTATIVES May 29, 2014 Ms. Fudge (for herself, Mr. Ellison, Ms. Lee of California, Mr. Richmond, and Mr. Payne) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Agriculture, Education and the Workforce, the Judiciary, Financial Services, and Natural Resources, 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 address childhood obesity, and for other purposes. 1. Short title This Act may be cited as the Fit for Life Act of 2014. 2. Table of contents The table of contents of this Act is as follows: Sec. 1. Short title. Sec. 2. Table of contents. Title I—Improving the Nutritional Quality of and Access to Foods in Underserved American Communities Subtitle A—Access to Nutritious and Quality Foods in Underserved American Communities Sec. 101. Nutritious Food Access through mobility and Innovation Program. Sec. 102. Expansion of the Fresh Fruit and Vegetable Program. Sec. 103. Expanding Access to the Summer Food Service Program for Children. Sec. 104. Study and report on physical activity and nutritional quality of meals and snacks served, in juvenile justice facilities. Sec. 105. Local food insecurity assessments: evaluating the unique nutritional needs of local communities. Sec. 106. Weekends and holidays without hunger. Subtitle B—Ensuring a Healthy Start for Children in Underserved American Communities Sec. 111. Improving Healthy Eating and Physical Activity Among our Youngest Children. Sec. 112. Health and fitness school programs: training America’s youth to live healthy lifestyles. Title II—Advancing Preventative Measures and Treatment of Obesity in Adults and Children in Underserved Communities Sec. 201. Community health and wellness navigators pilot program: connecting America’s health professionals with our schools. Sec. 202. Coverage of evidence-based preventive services under Medicaid and SCHIP. Sec. 203. Coverage of medical nutrition therapy under Medicaid and CHIP. Sec. 204. Clarification of EPSDT inclusion of prevention, screening, and treatment services for obesity and overweight; CHIP coverage. Sec. 205. National commission on child obesity. Sec. 206. GAO report. Title III—Encouraging Physical Activity in Underserved American Communities Sec. 301. Renovation of foreclosed and abandoned properties to create spaces that encourage physical activity in American neighborhoods. Sec. 302. National youth sports program revitalization. Sec. 303. Expansion of the Zuni Youth Enrichment Project Summer Camp. Sec. 304. Making routes to schools in underserved communities safe and accessible with public participation through the Community Oriented Policing Services program. Sec. 305. School infrastructure healthier upgrades competitive grant. Sec. 306. Shared use agreement expansion pilot grant program. Sec. 307. Land and Water Conservation Fund Program Grants in Low-Income Communities and Expand Tribal Participation. Sec. 308. Changing Hearts, Attitudes, and Minds by Participating in Sports (CHAMPS) Program. Sec. 309. Coordinated School Health Initiatives. Sec. 310. Rewarding elementary and secondary schools for outstanding student performance in physical fitness programs. I Improving the Nutritional Quality of and Access to Foods in Underserved American Communities A Access to Nutritious and Quality Foods in Underserved American Communities 101. Nutritious food access through mobility and innovation program (a) Administration The Secretary of Agriculture shall carry out a pilot program to make 3-year grants in accordance with this section to nonprofit organizations, local government agencies, and accredited colleges and universities. (b) Eligibility To be eligible to receive a grant under this section, a nonprofit organization, local government agency, for-profit business, or accredited college or university shall submit to the Secretary an application in such form, and containing such information, as the Secretary may require by rule. Such application shall include an assurance that such applicant will create or expand an innovative food distribution project that— (1) serves an area in which residents have low income, or an area that is a food desert or food swamp; (2) is not a supermarket-based project; (3) provides for the free or low-cost delivery of fresh fruits and vegetables to food recipients who participate in such project; (4) provides for the acquisition of produce trucks to distribute food to such recipients without a delivery charge and without any other service charge; or (5) provides for the establishment of a community food market (including a food market in a school) at which fresh fruits and vegetables are sold to such recipients at a low cost. (c) Priority The Secretary shall give priority to— (1) eligible applicants that propose to create or to expand a project that will operate in a geographical area in which there is a high incidence of childhood obesity; (2) eligible applicants that have a proven record of serving low-income or minority communities; and (3) organizations with plans for sustainability plans in place for continuing successful services after Federal funding lapses. (d) Reporting Each recipient of a 3-year grant made under this section shall submit annually to the Secretary a report that includes an assessment of— (1) the impact that the recipient’s project has had on the community involved during the year for which such report is submitted; and (2) the prospects of continuing such project after the 3-year period for which such grant is made. 102. Expansion of the Fresh Fruit and Vegetable Program Section 19 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1769a) is amended— (1) in subsection (a), by inserting , secondary schools, childcare centers, and family childcare homes after elementary schools; (2) by amending subsection (b) to read as follows: (b) Program A school, childcare center, or family childcare home participating in the program— (1) shall make free fruits and vegetables available to students throughout the school, center, or home day (or at such other times as are considered appropriate by the Secretary) in 1 or more areas designated by the school, center, or home; and (2) may make free fruits and vegetables in any other form (such as fresh, frozen, dried, pureed, or canned) available to students throughout the school, center, or home day (or at such other times as are considered appropriate by the Secretary) in 1 or more areas designated by the school only if such fruits and vegetables meet any additional nutrition specifications, as established by the Secretary. ; (3) in subsection (d)— (A) in the heading, by inserting , centers, or homes; (B) in paragraph (1)— (i) in the matter preceding subparagraph (A), by inserting , centers, or homes after schools; (ii) in subparagraph (A), by inserting , center, or home after school; (iii) in subparagraph (B), by inserting , centers, or homes after schools; (iv) by amending subparagraph (C) to read as follows: (C) ensure that each school selected is an elementary school or secondary school (as such terms are defined in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801)), each center selected is a childcare center (as such term is defined in section 399OO of the Public Health Service Act), and each home selected is a family childcare home (as such term is defined in section 399OO of the Public Health Service Act). ; and (v) in subparagraph (D)— (I) in the matter preceding clause (i), by inserting , centers, or homes after schools; (II) in clause (i), by inserting , center, or home after school; and (III) in clause (ii), by inserting , center, or home after as determined by the school; (C) in paragraph (2), by inserting , centers, or homes after each place schools appears; and (D) in paragraph (3), by inserting , centers, or homes after each place schools appears; and (4) in subsection (e), by inserting , center, or home after school. 103. Expanding access to the Summer Food Service Program for Children Section 13(a) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1761(a)) is amended— (1) in paragraph (1)(A), by striking 50 percent each place it appears and inserting 40 percent; (2) by repealing paragraph (9); and (3) in paragraph (10)— (A) in subparagraph (A)— (i) by striking The Secretary and inserting From the amounts appropriated to carry out this paragraph, the Secretary; and (ii) by striking not more than 5; (B) in subparagraph (C), by striking fiscal year 2006 and inserting fiscal year 2015; (C) in subparagraph (D)— (i) by striking January 1, 2008 and inserting January 1, 2015; and (ii) by striking January 1, 2009 and inserting January 1, 2016; and (D) by striking subparagraph (E). 104. Study and report on physical activity and nutritional quality of meals and snacks served in juvenile justice facilities (a) Study The Administrator of the Office of Juvenile Justice and Delinquency Prevention, in consultation with the Secretary of Agriculture, shall conduct a study on— (1) physical activity by juveniles in juvenile justice facilities, including— (A) the amount of such physical activity; (B) the types of physical activities in which such juveniles participate; (C) the number of hours per day such juveniles participate in such physical activity; (D) the degree of inclusiveness for juveniles with disabilities in physical activities; (E) the participation rates for juveniles with disabilities; and (F) the adequacy of the amounts and types of physical activity of such juveniles; and (2) the nutritional quality of meals and snacks served in juvenile justice facilities. (b) Report Not later than two years after the date of the enactment of this Act, the Administrator of the Office of Juvenile Justice and Delinquency Prevention, in consultation with the Secretary of Agriculture, shall submit to Congress a report on the findings of the study conducted under subsection (a), including an evaluation of whether the amounts and types of physical activity by juveniles, and the nutritional quality of meals and snacks served, in juvenile justice facilities are adequate to ensure the health and wellness of such juveniles. 105. Local food insecurity assessments: evaluating the unique nutritional needs of local communities (a) In general The Secretary of Health and Human Services shall establish a 3-year pilot program to award grants to local and tribal governments, on a competitive basis, to allow such local and tribal governments, in partnership with the local community organizations under subsection (e), to— (1) conduct a food security assessment; and (2) make an inventory of the system in order to identify the strengths and gaps in such system. (b) Data points for Assessment For purposes of conducting an assessment and making an inventory under a grant under subsection (a), with respect to the community served by a local or tribal government, such government shall examine the following food security and food system issues in the community: (1) The prevalence of childhood obesity. (2) The availability of safe routes to school for children. (3) The quality of food served in school and childcare settings. (4) The availability of supermarkets. (5) The cost and availability of fresh fruits and vegetables. (6) The concentration of convenience stores and other food vendors that sell a disproportionate amount of foods that are not fresh fruits and vegetables. (7) The availability of products. (8) The concentration of fast food restaurants. (9) The availability of green space or recreation areas, and the extent to which such space or areas encourage physical activity by adults and children. (10) Any other issues determined to be relevant by the local or tribal government. (11) Any other issues determined to be relevant by the Secretary of Health and Human Services. (c) Number of sites The Secretary of Health and Human Services, in awarding grants under subsection (a), shall award grants to no more than— (1) 20 local governments; and (2) 5 tribal governments. (d) Priority In awarding grants under subsection (a), the Secretary of Health and Human Services shall give priority to those local and tribal governments that serve communities with the highest concentrations of poverty. (e) Requirement of partnerships In order to qualify for a grant under subsection (a), a local or tribal government shall demonstrate, to the satisfaction of the Secretary of Health and Human Services, that the local or tribal government has entered into a partnership (for the purpose of conducting an assessment and making an inventory under subsection (a)) with at least one of the following local community organizations: (1) A nonprofit, community-based organization or entity. (2) A developer or urban planning institution. (3) An accredited college or university. (4) A freestanding children’s hospital or center with expertise in child health and policy. 106. Weekends and holidays without hunger Section 18 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1769) is amended by adding at the end the following: (l) Weekends and holidays without hunger (1) Definitions In this subsection: (A) At-risk school child The term at-risk school child has the meaning given the term in section 17(r)(1). (B) Eligible institution (i) In general The term eligible institution means a public or private nonprofit institution that is determined by the Secretary to be able to meet safe food storage, handling, and delivery standards established by the Secretary. (ii) Inclusions The term eligible institution includes— (I) an elementary or secondary school or school food service authority; (II) a food bank or food pantry; (III) a homeless shelter; and (IV) such other type of emergency feeding agency as is approved by the Secretary. (2) Establishment Subject to the availability of appropriations provided in advance in an appropriations Act specifically for the purpose of carrying out this subsection, the Secretary shall establish a program under which the Secretary shall provide commodities, on a competitive basis, to eligible institutions to provide nutritious food to at-risk children on weekends and during extended school holidays during the school year. (3) Eligibility (A) In general To be eligible to receive commodities under this subsection, an eligible institution shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may determine. (B) Plan An application under subparagraph (A) shall include the plan of the eligible institution for the distribution of nutritious foods to at-risk school children, including— (i) methods of food service delivery to at-risk school children; (ii) assurances that children receiving foods under the project will not be publicly separated or overtly identified; (iii) lists of the types of food to be provided under the project and provisions to ensure food quality and safety; (iv) information on the number of at-risk school children to be served and the per-child cost of providing the children with food; and (v) such other information as the Secretary determines to be necessary to assist the Secretary in evaluating projects that receive commodities under this subsection. (4) Priority In selecting applications under this subsection, the Secretary shall give priority to eligible institutions that— (A) have on-going programs and experience serving populations with significant proportions of at-risk school children; (B) have a good record of experience in food delivery and food safety systems; (C) maintain high quality control, accountability, and recordkeeping standards; (D) provide children with readily consumable food of high nutrient content and quality; (E) demonstrate cost efficiencies and the potential for obtaining supplemental funding from non-Federal sources to carry out projects; and (F) demonstrate the ability to continue projects for the full approved term of the pilot project period. (5) Guidelines (A) In general The Secretary shall issue guidelines containing the criteria for projects to receive commodities under this subsection. (B) Inclusions The guidelines shall, to the maximum extent practicable within the funds available and applications submitted, take into account— (i) geographical variations in project locations to include qualifying projects in rural, urban, and suburban areas with high proportions of families with at-risk school children; (ii) different types of projects that offer nutritious foods on weekends and during school holidays to at-risk school children; and (iii) institutional capacity to collect, maintain, and provide statistically valid information necessary for the Secretary— (I) to analyze and evaluate the results of the pilot project; and (II) to make recommendations to Congress. (6) Evaluation (A) Interim evaluation Not later than November 30, 2016, the Secretary shall complete an interim evaluation of the pilot program carried out under this subsection. (B) Final report Not later than December 31, 2017, the Secretary shall submit to Congress a final report that contains— (i) an evaluation of the pilot program carried out under this subsection; and (ii) any recommendations of the Secretary for legislative action. (7) Funding (A) Authorization of appropriations There is authorized to be appropriated to carry out this section such sums as are necessary, to remain available until expended. (B) Availability of funds Not more than 3 percent of the funds made available under subparagraph (A) may be used by the Secretary for expenses associated with review of the operations and evaluation of the projects carried out under this subsection. . B Ensuring a Healthy Start for Children in Underserved American Communities 111. Improving healthy eating and physical activity among our youngest children Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) is amended by adding at the end the following: W Healthy kids program 399OO. Definitions In this part: (1) Childcare center The term childcare center means a center licensed or otherwise authorized to provide childcare services for fewer than 24 hours per day per child in a nonresidential setting, unless care in excess of 24 hours is due to the nature of the parents' work. (2) Early learning council The term early learning council means an early childhood assembly that is established to advise Governors, State legislators, or State agency administrators on how best to meet the needs of young children and their families specifically through improvement of programs and services. (3) Family childcare home The term family childcare home means a private family home where home-based childcare 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. 399OO–1. Grants (a) In general The Secretary, in consultation with appropriate entities within the Department of Health and Human Services, shall award 3-year competitive grants to 5 State health departments (or other appropriate childcare licensing entities within such States) to help reduce and prevent obesity among the birth to 5-year-old population of the State in childcare settings outside a child's place of residence. (b) Use of funds State grantees shall use amounts received under a grant under this subsection to— (1) provide, or enter into contracts to provide, training (that meets the requirements of subsection (c)) to the staff of national, State, or community-based organizations with networks of childcare centers, or a consortium of childcare centers and family childcare homes consisting of at least 10 centers, for the purpose of implementing evidence-based healthy eating and physical activity policies and practices, including curricula and other interventions; and (2) provide grants to childcare centers and family childcare homes, whose staff received the training described in paragraph (1), to implement practice, curricula, and policy changes (that meet the requirements of subsection (d)) that promote healthy eating and physical activity among the birth to 5 years of age population. Preference in awarding grants shall be given to those States that demonstrate collaboration between relevant State entities related to childcare and health and with key stakeholders, such as State early learning councils and other community-based organizations working with childcare centers or family childcare homes. (c) Training requirements (1) In general Training provided under subsection (b) shall— (A) include the provision of information concerning age-appropriate healthy eating and physical activity interventions and culturally competent curricula for the birth to 5 years of age population in the State involved, which at a minimum shall include— (i) a handbook that includes recommendations, guidelines, and best practices for childcare centers and family childcare homes relating to healthy eating, physical activity, and screen time reduction; (ii) information about the availability of and services provided by childcare health consultants; and (iii) health and wellness resources available through the Child Care Bureau and the Maternal and Child Health Bureau; (B) identify, improve upon, and expand nutrition and physical activity best practices targeted to the birth to 5 years of age population in the State involved and identify strategies for incorporating parental education and other parental involvement; and (C) provide instruction on how to appropriately model, direct, and encourage childcare staff behavior to apply the best practices and strategies identified under subparagraph (B). (2) Training entities A grantee may conduct the training required under this section directly, or may provide such training through a contract with— (A) an appropriate national, State, or community organization with relevant expertise; (B) a health care provider or professional organization with relevant expertise; (C) a university or research center that employs faculty with relevant expertise; or (D) any other entity determined appropriate by the State and approved by the Secretary. (3) Requirement of contract If a grantee elects to provide the training under this section through a contract, the grantee shall ensure that a consistent healthy eating and physical activity curriculum is being developed for all childcare entities participating in the pilot program in the State. (d) Practice, curricula, and policy changes After training is provided as required under subsection (c), a State grantee shall ensure that the organizations and consortia involved— (1) implement, in childcare settings, evidence-based policy changes that promote healthy eating, physical activity, and appropriate screen time limits among the birth to 5 years of age population; (2) utilize an evidence-based, culturally competent healthy eating and physical activity curriculum in childcare settings focusing on such birth to age 5 population; (3) implement programs, activities, and procedures for incorporating parental education and involvement of parents in programs, including disseminating a written parental involvement policy, and coordinating and integrating parental involvement strategies under this section, to the extent feasible and appropriate, with parental involvement strategies under other programs, such as the Head Start program and the Early Head Start Program; and (4) find innovative ways to remove barriers that exist to providing opportunities for healthy eating and physical activity. All activities described in this paragraph shall be evidence-based and be consistent with the curriculum presented through training activities described in subsection (c). 399OO–2. Grants for the evaluation of pilot programs The Secretary shall award competitive grants to prevention research centers or universities to evaluate the programs carried out with grants under section 399OO–1, including baseline, process, and outcome measurements. 399OO–3. Coordination (a) Interagency coordination To the extent practicable, the Secretary shall coordinate activities conducted under this part with activities undertaken by the National Prevention, Health Promotion and Public Health Council established under section 4001 of the Patient Protection and Affordable Care Act (Public Law 111–148). Where practicable, such coordination shall— (1) include the sharing of current and emerging best practices concerning healthy eating, physical activity, and screen time limits that have a population-level impact in promoting nutrition and physical activity in childcare settings; (2) promote the effective implementation and sustainability of such programs; and (3) avoid unnecessary duplication of effort. (b) Pilot coordination The Secretary shall designate an individual (directly or through contract) to provide technical assistance to States and pilot centers in the development, implementation, and evaluation of activities and dissemination of information described in paragraphs (1), (2), and (3) of subsection (a). 399OO–4. Evaluation and reporting (a) Technical assistance and information The Secretary shall— (1) provide technical assistance to grantees and other entities providing training under a grant under this part; and (2) disseminate to health departments and trainers under grants under this part information concerning evidence-based approaches, including dissemination of existing toolkits, curricula, and existing or emerging best practices that can be expanded or improved upon through a program conducted under this part. (b) Evaluation requirements With respect to evaluations conducted under section 399OO–2, the Secretary shall ensure that— (1) evaluation metrics are consistent across all programs funded under this part; (2) interim outcomes are measured by the number of centers that have implemented policy and environmental strategies that support use of curricula and practices supporting healthy eating, physical activity, and screen time limits; (3) interim outcomes are measured, to the extent possible, by behavior changes in healthy eating, physical activity, and screen time; and (4) upon completion of the program, the evaluation shall include an identification of best practices relating to behavior change and reductions in the increasing prevalence of overweight and obesity that could be replicated in other settings. (c) Dissemination of information Upon the conclusion of the programs carried out under this part, the Secretary shall disseminate to all appropriate agencies within the Department of Health and Human Services evidence, best practices, and lessons learned from grantees. Such agencies shall encourage the adoption of the best practices. (d) Report to Congress Not later than 6 months after the completion of the program under this part, the Secretary shall submit to Congress a report containing an evaluation of the program, including recommendations as to how lessons learned from the program can be incorporated into future guidance documents developed and provided by the Secretary and other Federal agencies, as appropriate. 399OO–5. Authorization of appropriations There is authorized to be appropriated to carry out this part, $2,500,000 for each of fiscal years 2015, 2016, and 2017. . 112. Health and fitness school programs: training America’s youth to live healthy lifestyles (a) In general The Secretaries shall carry out a 2-year pilot program consisting of awarding grants to eligible entities for the purpose of establishing or expanding evidence-based health and fitness programs in secondary schools in low-income communities. (b) Health and fitness program requirements As a condition on receipt of a grant under this section, an eligible entity shall agree that any health and fitness program at a secondary school funded through the grant will— (1) be conducted in partnership with the secondary school, community entities, and tribal councils; (2) ensure the services provided are inclusive of students with disabilities; (3) include services by recent graduates of institutions of higher education who are interested in pursuing graduate degrees in medicine, nursing, nutrition science, exercise physiology, public health, or a related discipline; (4) use services by such graduates to supplement rather than supplant the health and fitness curriculum of the secondary school; (5) include a highly effective student-mentor intervention and education program conducted by such graduates for a maximum of 2 years of service in 1 secondary school per graduate; (6) build a healthier community through wellness activities and increased awareness about and access to healthy foods; (7) provide daily health and fitness instruction to both students and faculty; (8) conduct an annual in-school health and fitness fair using the services of secondary school students with the objective of building a healthier community through wellness activities and increased awareness about and access to healthy foods; (9) conduct an annual school-based and an annual community-based health and fitness fair using the services of secondary school students with the objective of building a healthier community through wellness activities and increased awareness about and access to healthy foods; and (10) expose secondary school students to a variety of career choices in wellness and health-related disciplines, including careers in medicine, nursing, nutrition science, and exercise physiology. (c) Non-Federal funds The Secretaries shall encourage grantees under this section to contribute funds from non-Federal sources to increase— (1) the number of secondary schools at which health and fitness programs are offered; or (2) the longevity of such programs. (d) Minimum number of schools The Secretaries shall ensure that grants under this section are used to establish or expand health and fitness programs at a total of not less than 20 schools. (e) Assessment; reporting As conditions on receipt of a grant under this section, an eligible entity shall agree to— (1) conduct an annual assessment of health and fitness programs funded through the grant; (2) on an annual basis, report the findings of each assessment under paragraph (1) to the participating school, community partners, local contributors of funds, and tribal councils; and (3) not later than the end of fiscal year 2016, submit a report to the Secretaries and an appropriate representative of the Centers for Disease Control and Prevention on the success of the programs in educating children and families and thereby preventing or reducing childhood obesity, including data from each assessment under paragraph (1). (f) Report to Congress Not later than the end of fiscal year 2016, the Secretaries shall submit to the Congress a report that— (1) summarizes the results achieved through programs funded under this section; and (2) includes a summary of the reports submitted by grant recipients under subsection (e)(3). (g) Definitions In this section: (1) The term secondary school has the meaning given to such term in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801). (2) The term eligible entity means a nonprofit organization or entity with the ability to meet the requirements applicable to a grantee under this section, as determined by the Secretaries. (3) 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. (4) The term Secretaries means the Secretary of Health and Human Services and the Secretary of Education, acting jointly and in conjunction with the Director of the Centers for Disease Control and Prevention. (h) Authorization of appropriations To carry out this section, there is authorized to be appropriated $1,400,000 for the period of fiscal years 2015 through 2016. II Advancing Preventative Measures and Treatment of Obesity in Adults and Children in Underserved Communities 201. Community health and wellness navigators pilot program: connecting America’s health professionals with our schools (a) In general The Secretary of Health and Human Services shall award grants to 5 or more States for the establishment of a community navigator program, consisting of each such State making subgrants to 1 or more eligible entities for a local community navigator program described in subsection (b). (b) Program description A local community navigator program described in this subsection shall consist of the following: (1) An eligible entity, in partnership with a local educational agency, a bureau-funded school, or a nonprofit health or education organization, will hire and train 2 or more community navigators. (2) The community navigators will facilitate a relationship between the eligible entity and the local educational agency, bureau-funded school, or nonprofit health or education organization in low-income communities to ensure increased access to medical care through educating parents and school administrators. (3) The community navigators will carry out educational activities for elementary school and secondary school students and their parents in low-income communities with the goal of— (A) increasing familial intake of nutritious meals; (B) increasing physical activity both in and out of the school setting; and (C) increasing access to medical care. (4) The community navigators will specifically recognize and address that there are subgroups that are shown to have particular barriers to physical activities, such as persons with disabilities. (c) Report Not later than 2 years after the date of the enactment of this Act, the Secretary shall submit a report to the Congress on the effectiveness of the program under this section. (d) Definitions In this section: (1) The term bureau-funded school has the meaning given such term in section 1146 of the Education Amendments of 1978 (25 U.S.C. 2026). (2) The terms elementary school, local educational agency, and secondary school have the meanings given to such terms in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801). (3) The term eligible entity includes a Federally qualified health center (as defined in section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa))), a facility operated by the Indian Health Service (including a facility operated by an Indian tribe or tribal organization through a contract or compact with the Service under the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.)), a free-standing children’s hospital that is described in subparagraph (L) or (M) of section 340B(a)(4) of the Public Health Service Act (42 U.S.C. 256b(a)(4)), a non-profit with demonstrated effectiveness in the area of health care and with a focus on serving low-income communities, a rural hospital, and a rural health clinic. (4) 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. (5) The term nonprofit health or education organization shall be defined by the Secretary. (6) The term Secretary means the Secretary of Health and Human Services. (7) The term State includes the District of Columbia and any commonwealth, territory, or possession of the United States, including the Commonwealth of Puerto Rico, the United States Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands. (e) Authorization of appropriations To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2015 and 2016. 202. Coverage of evidence-based preventive services under Medicaid and SCHIP (a) State Option To Provide Medical Assistance for Evidence-Based Preventive Services (1) In general Section 1905 of the Social Security Act (42 U.S.C. 1396d) is amended— (A) in subsection (a)— (i) in paragraph (28), by striking and at the end; (ii) by redesignating paragraph (29) as paragraph (30); and (iii) by inserting after paragraph (28) the following: (29) evidence-based preventive services described in subsection (ee); and ; and (B) by adding at the end the following: (ee) For purposes of subsection (a)(29), evidence-based preventive services described in this subsection are— (1) any preventive services which the Secretary has determined are reasonable and necessary for preventing obesity and comorbidities of obesity, including diet and exercise counseling, and healthy weight and obesity counseling; and (2) any other evidence-based, effective, clinical intervention for obese individuals designed to prevent comorbidities of obesity, including pharmacological or surgical services. . (2) Conforming amendment Section 1902(a)(10)(C)(iv) of such Act (42 U.S.C. 1396(a)(10)(C)(iv)) is amended by inserting , or (29) after (24). (b) State option To provide child health assistance for evidence-Based preventive services Section 2110(a) of the Social Security Act (42 U.S.C. 1397jj(a)) is amended— (1) by redesignating paragraph (28) as paragraph (29); and (2) by inserting after paragraph (27) the following: (28) Evidence-based preventive services described in section 1905(ee). . 203. Coverage of medical nutrition therapy under Medicaid and CHIP (a) State Option To Provide Medical Assistance for Medical Therapy Services (1) In general Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)), as amended by section 202(a)(1), is amended— (A) in paragraph (29), by striking and at the end; (B) by redesignating paragraph (30) as paragraph (31); and (C) by inserting after paragraph (29) the following: (30) medical nutrition therapy services (as defined in section 1861(vv)(1)) for individuals with prediabetes or obesity or who are overweight (as defined by the Secretary); and . (2) Conforming amendment Section 1902(a)(10)(C)(iv) of such Act (42 U.S.C. 1396(a)(10)(C)(iv)), as amended by section 202(a)(2), is amended by striking or (29) and inserting (29), or (30). (b) State option To provide child health assistance for medical nutrition therapy services Section 2110(a) of the Social Security Act (42 U.S.C. 1397jj(a)), as amended by section 202(b), is amended— (1) by redesignating paragraph (29) as paragraph (30); and (2) by inserting after paragraph (28) the following: (29) Medical nutrition therapy services (as defined in section 1861(vv)(1)) for individuals with prediabetes or obesity or who are overweight (as defined by the Secretary). . 204. Clarification of EPSDT inclusion of prevention, screening, and treatment services for obesity and overweight; CHIP coverage (a) In general Section 1905(r) of the Social Security Act (42 U.S.C. 1396d(r)) is amended— (1) in paragraph (1)(B)— (A) in clause (iv), by striking and at the end; (B) in clause (v), by striking the period at the end and inserting , and; and (C) by adding at the end the following: (vi) weight and BMI measurement and monitoring. ; and (2) in paragraph (5), by inserting (including treatment services related to obesity and body weight, such as medical nutrition therapy services (as defined in section 1861(vv)(1)), physical therapy, exercise training, behavioral health counseling, and such other evidence-based services as recommended by the Secretary (taking into consideration the American Academy of Pediatrics Expert Committee Guidelines Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity and the National Center on Health, Physical Activity, and Disability’s Physical Activity Guidelines for Individuals with Disabilities) after screening services. (b) CHIP (1) Required coverage Section 2103 of the Social Security Act (42 U.S.C. 1397cc) is amended— (A) in subsection (a), in the matter preceding paragraph (1), by striking and (7) and inserting (7), and (8); and (B) in subsection (c)— (i) by redesignating paragraphs (7) and (8) as paragraphs (8) and (9), respectively; and (ii) by inserting after paragraph (6), the following: (7) Prevention, screening, and treatment services for overweight and obese The child health assistance provided to a targeted low-income child shall include coverage of weight and BMI measurement and monitoring, as well as appropriate treatment services, including medical nutrition therapy services (as defined in section 1861(vv)(1)), physical therapy or exercise training, including steps needed to make such therapy and training inclusive for persons with disabilities, behavioral health counseling, and such other evidence-based services as recommended by the Secretary. For purposes of the previous sentence the Secretary shall take into consideration the American Academy of Pediatrics Expert Committee Guidelines Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity and the National Center on Health, Physical Activity, and Disability’s Physical Activity Guidelines for Individuals with Disabilities. . (2) Conforming amendment Section 2102(a)(7)(B) of the Social Security Act (42 U.S.C. 1397bb(c)(2)) is amended by striking section 2103(c)(5) and inserting paragraphs (5) and (7) of section 2103(c). 205. National Commission on Child Obesity (a) Establishment There is established a commission to be known as the National Commission on Child Obesity (in this section referred to as the Commission). (b) Duties of commission The Commission shall— (1) conduct a comprehensive study that examines and assesses the needs of children relating to the prevalence, prevention, and treatment of childhood overweight and obesity, including specific findings relating to— (A) best practices for the prevention and treatment of childhood overweight and obesity; (B) child physical health and mental health; (C) childcare in all settings; (D) child welfare; (E) elementary and secondary education; (F) food availability in neighborhoods; (G) access to health care; (H) health care utilization; (I) built environment; (J) parent physical health and education; (K) underserved communities, including tribal communities, health professional shortage areas designated under section 332 of the Public Health Service Act (42 U.S.C. 254e), medically underserved areas (as defined in section 799B of such Act (42 U.S.C. 295p), and areas in the Appalachian region (as defined in section 14102(a) of title 40, United States Code); (L) relevant activities in childhood overweight and obesity; (M) the availability of information on State and Federal supportive nutrition programs, such as the Summer Food Service Program, the Women, Infants, and Children Program, the State Children’s Health Insurance Program under title XXI of the Social Security Act, and the Supplemental Nutrition Assistance Program; and (N) children with disabilities; (2) identify, review, and evaluate existing laws, regulations, policies, programs, and public health initiatives relevant to best practices for the prevalence, prevention, and treatment of childhood overweight and obesity; (3) identify, review, and evaluate the lessons learned from past laws, regulations, policies, programs, and public health initiatives relevant to the prevalence, prevention, and treatment of childhood overweight and obesity; (4) advise on the need to revise laws, regulations, policies, and programs relative to addressing best practices for the prevalence, prevention, and treatment of childhood overweight and obesity at regular intervals as new knowledge is gained; (5) include in the interim report required by subsection (i)(1) recommendations on— (A) the appropriate Federal agency to establish the infrastructure for the creation of a comprehensive nationwide registry of patient data associated with children living with obesity; (B) the specific criteria needed for such registry to allow the field of pediatric clinicians access to patient-level, clinical data suitable for research and the development of best practices; (C) the appropriate funding level required for the establishment and implementation of such the registry described in subparagraph (A); and (D) how to capture large-scale data that are currently unavailable on adolescent and child patients who are currently obese; and (6) include in the final report required by subsection (i)(3) the Commission’s specific findings, conclusions, and recommendations to address the needs of children relating to the prevention and treatment of childhood overweight and obesity, including specific recommendations on— (A) the need for planning and establishing a national resource center for children and obesity; and (B) such coordination of resources and services, administrative actions, policies, regulations, and legislative changes as the Commission considers appropriate. (c) Composition (1) Members The Commission shall be composed of 15 members, of whom— (A) 3 members, including at least one from each major national political party, shall be appointed by the President; (B) 3 members shall be appointed by the majority leader of the Senate; (C) 3 members shall be appointed by the minority leader of the Senate; (D) 3 members shall be appointed by the Speaker of the House of Representatives; and (E) 3 members shall be appointed by the minority leader of the House of Representatives. (2) Appointment Members of the Commission shall be appointed not later than 6 months after the date of the enactment of this Act. (3) Chairperson, vice chairperson, and meetings (A) In general Not later than 30 days after the date on which all members of the Commission are appointed under paragraph (1), such members shall meet to elect a Chairperson and Vice Chairperson from among such members and shall determine a schedule of Commission meetings. (B) Initial meeting The Commission shall meet and begin the operations of the Commission not later than 120 days after the appointment of members of the Commission. (4) Governmental appointees An individual appointed to the Commission may not be an official or employee of the Federal Government. (5) Commission representation The Commission shall include at least one— (A) representative from each of a nonprofit and for-profit entity with demonstrated expertise in addressing the needs of children relating to the prevalence, prevention, and treatment of childhood overweight and obesity; (B) State or local director of health; and (C) tribal health representative. (6) Qualifications Members appointed under paragraph (1) may include— (A) individuals involved with providing services to children, including health and other social services; (B) individuals involved with administering health insurance coverage to children; (C) individuals with experience in public health initiatives relating to the prevention and treatment of childhood overweight and obesity, including coordination of resources and services among State and local governments, the Federal Government, and nongovernmental entities; (D) individuals with philanthropic experience focused on the needs of children relating to the prevalence, prevention, and treatment of childhood overweight and obesity; (E) individuals who have conducted academic research relating to the prevalence, prevention, and treatment of childhood overweight and obesity; and (F) individuals with significant experience in child health and policy. (7) Quorum and Vacancy (A) Quorum A majority of the members of the Commission shall constitute a quorum, but a lesser number of members may hold hearings. (B) Vacancy Any vacancy in the Commission shall not affect its powers and shall be filled in the same manner in which the original appointment was made. (d) Powers of commission (1) Hearings The Commission may hold such hearings, meet and act at such times and places, and receive such evidence as may be necessary to carry out the functions of the Commission. (2) Information from Federal agencies (A) In general The Commission may access, to the extent authorized by law, from any executive department, bureau, agency, board, commission, office, independent establishment, or instrumentality of the Federal Government such information, suggestions, estimates, and statistics as the Commission considers necessary to carry out this section. (B) Provision of information On written request of the Chairperson of the Commission, each department, bureau, agency, board, commission, office, independent establishment, or instrumentality of the Federal Government shall, to the extent authorized by law, provide the requested information to the Commission. (C) Receipt, handling, storage, and dissemination Information shall only be received, handled, stored, and disseminated by members of the Commission and its staff consistent with all applicable statutes, regulations, and Executive orders. (3) Assistance from Federal agencies (A) General services administration On request of the Chairperson of the Commission, the Administrator of General Services shall provide to the Commission, on a reimbursable basis, administrative support and other assistance necessary for the Commission to carry out its duties. (B) Other departments and agencies In addition to assistance under subparagraph (A), departments and agencies of the United States may provide to the Commission such assistance as they determine advisable and as authorized by law. (4) Contracting The Commission may enter into financially reasonable contracts to enable the Commission to discharge its duties under this section. (5) Postal services The Commission may use the United States mails in the same manner and under the same conditions as a department or agency of the United States. (e) Staff of commission (1) In general The Chairperson of the Commission, in consultation with the Vice Chairperson, in accordance with rules agreed upon by the Commission, may appoint and fix the compensation of a staff director, policy director, and administrative assistant (and other staff if agreed upon by a majority of Commission members) to enable the Commission to carry out its functions, in accordance with the provisions of title 5, United States Code, except that no rate of pay fixed under this paragraph may exceed the equivalent of that payable for a position at level V of the Executive Schedule under section 5316 of title 5, United States Code. (2) Staff of Federal agencies Upon request of the Chairperson of the Commission, the head of any executive department, bureau, agency, board, commission, office, independent establishment, or instrumentality of the Federal Government may detail, without reimbursement, any of its personnel to the Commission to assist it in carrying out its duties under this section. Any detail of an employee shall be without interruption or loss of civil service status or privilege. (3) Consultant services The Commission is authorized to procure (pursuant to a majority vote of the Commission members) the services of experts and consultants in accordance with section 3109 of title 5, United States Code, but at rates not to exceed the daily equivalent of the annual rate of basic pay for level IV of the Executive Schedule under section 5315 of title 5, United States Code. (f) Travel expenses Each member of the Commission shall serve without compensation, but shall receive travel expenses, including per diem in lieu of subsistence, in accordance with applicable provisions in the same manner as persons employed intermittently in the Government service are allowed expenses under section 5703 of title 5, United States Code. (g) Applicability of FACA The Federal Advisory Committee Act, including any provisions applicable to staff, is deemed to apply to the Commission. (h) Reports of commission; termination (1) Interim report The Commission shall, not later than 1 year after the date of its first meeting, submit to the President and the Congress an interim report containing specific findings, conclusions, and recommendations required under this section and agreed to by a majority of Commission members. (2) Other reports and information (A) Reports The Commission may issue additional reports as the Commission determines necessary. (B) Information The Commission may hold public hearings to collect information and shall make such information available for use by the public. (3) Final report The Commission shall, not later than 2 years after the date of its first meeting, submit to the President and Congress a final report containing specific findings, conclusions, and recommendations required under this section and agreed to by a majority of Commission members. (4) Termination (A) In general Unless reauthorized by statute, the Commission, and all the authorities of this section, shall terminate 180 days after the date on which the final report is submitted under paragraph (3). (B) Records Not later than the date of termination of the Commission under subparagraph (A), all records and papers of the Commission shall be delivered to the Archivist of the United States for deposit in the National Archives. (i) Definitions In this section: (1) Obesity The term obesity with respect to children means having a body mass index (BMI) greater than or equal to the 95th percentile for age and sex according to the Centers for Disease Control and Prevention. (2) Child; children The terms child and children mean an individual or individuals, respectively, who have not attained 18 years of age. (j) Authorization of appropriations There is authorized to be appropriated to carry out this section, $1,500,000 for each of fiscal years 2015 and 2016. 206. GAO report Not later than 2 years after the first appropriation of Federal funds to carry out this Act, the Comptroller General of the United States shall submit to Congress a report on the effectiveness of the activities carried out under this Act in reducing child obesity, which shall include an analysis of the costs and the benefits of such activities. III Encouraging Physical Activity in Underserved American Communities 301. Renovation of foreclosed and abandoned properties to create spaces that encourage physical activity in American neighborhoods Section 106(a) of the Housing and Community Development Act of 1974 (42 U.S.C. 5306(a)) is amended— (1) in paragraph (3)— (A) by striking (1) and and inserting (1),; and (B) by inserting and after reserving such amounts for units of general local government, special district governments, and Indian tribes with high foreclosure rates and great infrastructure need under paragraph (4), after paragraph (2),; (2) by redesignating paragraph (4) as paragraph (5); (3) in paragraph (5), as redesignated by paragraph (2) of this section, by striking paragraphs (1), (2), and (3) and inserting paragraphs (1), (2), (3), and (4); and (4) by inserting after paragraph (3) the following new paragraph: (4) (A) For each fiscal year, of the amount approved in appropriation Acts under section 103 for grants for such fiscal year (excluding the amounts provided for use in accordance with section 107), the Secretary shall reserve for grants to units of general local government, special district governments, and Indian tribes that the Secretary determines have both high foreclosure rates and the greatest infrastructure needs, based on the scope of the needs, an amount the Secretary determines necessary. (B) Grants under this paragraph may be used by units of general local government, special district governments, and Indian tribes to— (i) renovate foreclosed commercial properties, abandoned commercial properties, or both, to be transformed into community centers, public recreation facilities, swimming pools, or any other type of facility that will encourage indoor physical activity; (ii) demolish foreclosed or abandoned commercial and residential properties, or both, to use the sites for— (I) the construction of parks, playgrounds, outdoor swimming pools, tracks, soccer fields, baseball diamonds, or any other type of facility that will encourage outdoor physical activity; (II) community gardens or urban farms, particularly in areas that are food deserts (as such term is defined in section 7527(a) of the Food, Conservation, and Energy Act of 2008 (Public Law 110–234; 122 Stat. 2039); or (III) mixed-use facilities that are used for both of the purposes under subclauses (I) and (II) of this clause; and (iii) reconstruct and repair dilapidated sidewalks, bike and pedestrian trails, and indoor and outdoor facilities that encourage physical activity. (C) In making grants under this paragraph, the Secretary shall give priority among units of general local government, special district governments, and Indian tribes eligible pursuant to subparagraph (A)— (i) to units of general local government, special district governments, and Indian tribes that demonstrate the ability and willingness to work with local educational agencies, developers, and other community-based organizations to enter into mixed-use agreements to maximize the use and efficiency of properties renovated, constructed, or reconstructed and repaired through the use of grant funds; (ii) to units of general local government, special district governments, and Indian tribes that demonstrate the willingness to recognize and promote the involvement of individuals enrolled in a national service program authorized under the National and Community Service Act of 1990 (42 U.S.C. 12501 et seq.) or the Domestic Volunteer Service Act of 1973 (42 U.S.C. 4950 et seq.) in the renovation, construction, or reconstruction and repair of properties through the use of grant funds; (iii) to projects proposed by units of general local government, special district governments, and Indian tribes that are easily accessible, on foot or by public transportation, for persons in low-income communities; and (iv) to projects proposed by units of general local government, special district governments, and Indian tribes that have particular accessibility considerations for persons with disabilities. (D) For purposes of this paragraph, the term special district government means any organized local entity, known by a variety of titles, including districts, authorities, boards, and commissions, other than a unit of general local government or local educational agency, authorized by State law to provide only one or a limited number of designated functions, and with sufficient administrative and fiscal autonomy to qualify as a separate government unit, as determined by the Secretary. . 302. 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 2015 through 2024. 303. Expansion of the Zuni Youth Enrichment Project Summer Camp (a) In general The Secretary of Health and Human Services shall establish a 2-year pilot program to provide funds to community-based organizations on Indian reservations or tribal lands to plan and implement an enrichment program for children (in the form of a summer camp and a year-round program) for the purpose of— (1) reversing the epidemics of obesity, diabetes, and alcoholism in such areas; and (2) to mitigate other problems stemming from the formation of bad habits and the development of low self-esteem during childhood. (b) Partnerships In order to qualify for funding under subsection (a), a community-based organization shall demonstrate, to the satisfaction of the Secretary of Health and Human Services, that the organization has entered into a partnership with community entities, local funders, and tribal leaders (including, if applicable, the tribal council) to plan and execute an enrichment program under subsection (a). (c) Number of sites The Secretary of Health and Human Services, in providing funding under subsection (a), shall provide funding to no more than 20 community-based organizations. (d) Model and camp requirement The enrichment program under subsection (a) shall— (1) be modeled on similar programs established by the Zuni Youth Enrichment Project; and (2) shall include a camp of at least 6 weeks in duration during the summer. (e) Specific camp requirements (1) Daily activities With respect to children attending a camp under subsection (d)(2), the leader of the organization that receives funds under subsection (a) shall, for each day of the camp, ensure that such children are— (A) involved in at least 60 minutes of physical activity (with appropriate accommodations made for children with disabilities); and (B) provided with at least two meals that meet national nutritional standards. (2) Other activities Such leader shall also ensure that— (A) a community gardening activity is included in the activities conducted at the camp; and (B) health and wellness education is provided to the children attending the camp. (f) Evaluation (1) In general A community-based organization that receives funding under subsection (a), shall, as a condition of receiving such funding, conduct an evaluation of the enrichment program conducted by such organization. (2) Model The form, manner, content, and frequency of the evaluation under paragraph (1) shall be modeled on the Zuni Youth Enrichment Project standard project evaluation. (g) Report Not later than 1 year after the date on which a community organization first receives funding under subsection (a) and annually thereafter, the organization shall— (1) submit a report to the Secretary of Health and Human Services on the outcomes of the enrichment program conducted by the organization under this section, including— (A) the findings of the evaluation conducted under subsection (f); and (B) the impact of such enrichment program on the rates of childhood obesity on the reservation or area of tribal land served by the organization; and (2) provide a copy of the findings under paragraph (1)(A) to community entities, local funders, tribal leaders (including, if applicable, the tribal council), and the families of children participating in the enrichment program. 304. Making routes to schools in underserved communities safe and accessible with public participation through the Community Oriented Policing Services Program Section 1701 of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3796dd) is amended— (1) in subsection (b)— (A) in paragraph (16), by striking and after the semicolon; (B) by redesignating paragraph (17) as paragraph (18), and in such paragraph (18) (as so redesignated), by striking through (16) and inserting through (17); and (C) by inserting after paragraph (16) the following new paragraph: (17) to award grants for Safe Routes to School-Community Oriented Policing Services programs, in accordance with subsection (l); and ; and (2) by adding at the end the following new subsection: (l) Safe Routes to School-Community Oriented Policing Services programs (1) Grant program The Director of the Office of Community Oriented Policing Services, in collaboration with the Secretary of Education, shall award grants to not fewer than 10 local and tribal law enforcement agencies in low-income communities for the planning, development, and assessment of Safe Routes to School-Community Oriented Policing Services programs in accordance with this subsection. (2) Grant period Each grant awarded under this subsection shall be for a 3-year period beginning with the first fiscal year that begins after the date of enactment of the Fit for Life Act of 2014, and may not be renewed. (3) Use of grants A grant awarded under this subsection shall be used by each grantee to— (A) assess the needs of the low-income community served by the grantee with respect to the ability of elementary and secondary school students to get to and from school safely; and (B) establish and maintain a Safe Routes to School-Community Oriented Policing Services program that ensures the availability of safe routes to and from school for elementary and secondary school students in underserved communities by addressing the unique personal safety dangers to students in such communities that may cause routes to or from school to be unsafe, such as dangers associated with crime, drug or gang activity, abandoned properties, and the presence of sexual predators. (4) Reports Not later than one year after receiving a grant award under this subsection, and annually thereafter, each grantee shall submit to the Director of the Office of Community Oriented Policing Services a report on the Safe Routes to School-Community Oriented Policing Services program carried out by the grantee that includes— (A) a description of the activities carried out with such grant during the preceding year; (B) the effectiveness of such activities in ensuring safe routes to and from school for elementary and secondary school students; (C) a description of the activities the grantee plans to carry out with such grant in succeeding years; and (D) best practices, plans, and findings for purposes of incorporation into urban planning and development in underserved communities in succeeding years. (5) Definition 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 Director of the Office of Community Oriented Policing Services to be low-income for purposes of this section. . 305. School infrastructure healthier upgrades competitive grant (a) In general From the amounts appropriated to carry out this Act, the Secretary of Education shall award grants, on a competitive basis, to eligible entities to upgrade facilities specifically pertaining to healthy eating and fitness. (b) Authorized use of fund An eligible entity receiving a grant under this section shall use such grant to upgrade facilities specifically pertaining to healthy eating and fitness, which may include— (1) building or maintaining school gardens; (2) renovating outdoor facilities for physical educations or activity programs; or (3) upgrading kitchen and cafeteria services to better prepare and store healthy foods. (c) Priority In awarding grants under this section to eligible entities that are local educational agencies, the Secretary shall give priority to local educational agencies that— (1) serve a high-percentage of low-income students; (2) serve a high-percentage of students who are minorities; (3) serve a high-percentage of students with childhood obesity; and (4) serve schools that have joint use agreements for afterschool programs or community-wellness partnerships for afterschool or weekend use. (d) Definitions In this section: (1) Eligible entity The term eligible entity means a local educational agency or licensed childcare centers with evidence-based wellness programs. (2) Local educational agency The term local educational agency has the meaning given the term in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801). (3) Secretary The term Secretary means the Secretary of Education. 306. Shared use agreement expansion pilot grant program (a) In general From the amounts appropriated to carry out this section, the Secretary of Education shall award grants, on a competitive basis, to eligible entities to supplement programmatic costs, operations, security, maintenance fees, and other costs associated with out-of-school use of elementary school or secondary school buildings or facilities for physical activity, fitness, and wellness purposes. (b) Grant terms Each grant under this section shall be awarded for a period of not more than 3 years. (c) Total grants The Secretary shall award not less than 15 grants under this section for each fiscal year for which funds are appropriated to carry out this section. (d) Priority In awarding grants under this section, the Secretary shall give priority to each eligible entity that— (1) serves low-income and minority populations; (2) serves communities with high levels of childhood obesity; and (3) is supporting a joint or shared-use agreement (as described in subsection (e)(2)(A)) that— (A) was established not more than 5 years before the eligible entity received a grant under this section; and (B) allows the open community use of elementary school or secondary school buildings or facilities as opposed to only fee-based sports league use. (e) Definitions In this section: (1) ESEA terms The terms elementary school and secondary school have the meanings given such terms in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801). (2) Eligible entity The term eligible entity means an elementary school, secondary school, local government, or community partner that has— (A) adopted or entered into a joint or shared-use agreement authorizing elementary school or secondary school buildings or facilities to be used by community and nonprofit organizations for community programs; and (B) the ability to use funds to support such community programs. (3) Secretary The term Secretary means the Secretary of Education. 307. Land and Water Conservation Fund Program grants in low-income communities and expand tribal participation Section 6(e) of the Land and Water Conservation Act of 1965 (16 U.S.C. 460l–8(e)) is amended by adding at the end the following: (3) Low-income communities and Indian reservations For development of programs to increase the use of and access to parks and open space in low-income communities and on or near Indian reservations. . 308. Changing Hearts, Attitudes, and Minds by Participating in Sports (CHAMPS) Program Part B of title III of the Public Health Service Act is amended by inserting after section 317T (42 U.S.C. 247b–22) the following: 317U. Changing Hearts, Attitudes, and Minds by Participating in Sports (CHAMPS) 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 proposing to implement programs described in subsection (c), each serving at least 1,000 individuals, at 5 or more locations across the Nation; or (2) a community-based nonprofit organization proposing to implement a program described in subsection (c) serving at least 1,000 individuals. (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 children or adolescents most at risk for being overweight and obese in predominantly economically disadvantaged communities; (2) serve 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) provide adult supervision and guidance or coaches who encourage and teach proper exercise techniques and skills; (5) combine physical fitness activities with nutritional counseling and education; and (6) 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 physical activity and exercise as well as the nutritional value of food and beverage choices; (C) keeping track of and reporting meaningful reductions in the consumption of food and beverages with low nutritional value, 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 toward 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 will provide additional societal benefits, such as— (1) effectiveness in working with programs for ethnic and racial minorities that are evaluated by independent, third-party evaluators; (2) improvements to academic performance in school; (3) character building and leadership development; (4) gang and juvenile delinquency prevention and reduction; (5) gender equality and female empowerment; (6) mentoring, volunteerism promotion, and service-learning opportunities; (7) family and community engagement and participation; (8) workforce education and career development opportunities; or (9) being inclusive of persons with disabilities. (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 (1) In general With respect to the costs of a qualified childhood obesity prevention initiative to be carried out under this section— (A) in the case of an applicant that is a nationally based nonprofit organization, a grant under subsection (a) may be made only if the organization agrees to make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that is not less than one-third of such costs ($1 for each $2 of Federal funds provided in the grant); and (B) in the case of an applicant that is a community-based nonprofit organization, a grant under subsection (a) may be made only if the organization agrees to make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that is not less than one-fourth of such costs ($1 for each $3 of Federal funds provided in the grant). (2) Non-Federal contributions by subgrantees If a nationally based nonprofit organization chooses to provide grant funds received under this section to a subgrantee to carry out one or more programs as part of the organization’s qualified childhood obesity prevention initiative, the organization shall require the subgrantee to make available (directly or through donations from public or private entities) non-Federal contributions toward the costs of such programs in an amount that is not less than one-third of such costs ($1 for each $2 of Federal funds provided in the grant). The amount of non-Federal contributions by subgrantees required under this paragraph is in addition to the amount of non-Federal contributions by the nationally based nonprofit organization required under paragraph (1). (3) Determination of amount contributed (A) In general Non-Federal contributions required by paragraph (1) or (2)— (i) in the case of a nationally based nonprofit organization, shall be made in cash; and (ii) in the case of a subgrantee described in paragraph (2) or a community-based nonprofit organization, may be in cash or in kind, fairly evaluated, including plant, equipment, or services. (B) Exclusion of Federal contributions Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of non-Federal contributions required by paragraph (1) or (2). (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) Best practices guidelines Based on the results of programs funded through grants under this section during the first two fiscal years of such funding, the Secretary shall develop publicly accessible best practices guidelines for obesity reduction programs. The Secretary shall update these guidelines every two years. (i) Authorization of appropriations To carry out this section, there is authorized to be appropriated $50,000,000 for each of fiscal years 2015 through 2019. . 309. Coordinated school health initiatives (a) In general From the amounts appropriated to carry out this section, the Secretary of Education shall carry out a pilot program to award grants to not more than 5 eligible entities to carry out coordinated school health initiatives in schools. (b) Amount of grant A grant awarded under subsection (a) may not exceed $15,000. (c) Use of funds An eligible entity receiving a grant under this section shall carry out a coordinated school health initiative in each school under the jurisdiction of the entity under which the entity shall— (1) carry out a program, such as a fitness program, to assess the physical fitness (including aerobic capacity, muscular strength and endurance, flexibility, and body composition) of each student served by the entity; and (2) evaluate such assessments to— (A) establish baselines with respect to aerobic capacity, muscular strength and endurance, flexibility, and body composition that each such student should meet by a certain period; and (B) identify interventions to assist each such student, including those with disabilities, in meeting such baselines; (3) review the interventions identified under paragraph (2)(B) to determine the best practices with respect to such interventions; (4) use the determinations for best practices under paragraph (3) to implement interventions in each school under the jurisdiction of the entity; and (5) not later than 1 year after the implementation of the interventions, assess the physical fitness of each student served by the entity. (d) Reporting (1) Eligible entity Each eligible entity receiving a grant under this section shall submit to the Secretary at such time and in such manner as determined by the Secretary, a report on— (A) the initial physical fitness assessments carried out under subsection (c)(1); (B) the interventions implemented under subsection (c)(4); and (C) the physical fitness assessments carried out under subsection (c)(5) after the interventions have been implemented. (2) Secretary Not later than the first appropriation of Federal funds to carry out this section, the Secretary shall use the reports received under paragraph (1) to prepare and transmit to Congress a report on— (A) the average physical fitness levels of students participating in the coordinated school health initiative under this section— (i) prior to the interventions implemented by each eligible entity under this section; and (ii) 1 year after the implementation of the interventions; (B) the best practices with respect to the interventions; and (C) recommendations on how schools and local educational agencies may incorporate such best practices. (e) Application To receive a grant under this section, an eligible entity shall submit an application to the Secretary of Education at such time, in such manner, and containing such information as the Secretary may require. (f) Supplement, Not Supplant Funds received under this section shall be used to supplement, and not supplant, non-Federal funds that would otherwise be used for activities authorized under this section. (g) Definitions For purposes of this section: (1) Eligible entity The term eligible entity means a local educational agency— (A) that serves— (i) a high percentage of students eligible for free or reduced price lunches under the Richard B. Russell National School Lunch Act; or (ii) a community otherwise determined by the Secretary to be a low-income community; and (B) that forms a partnership with an institution of higher education or a nonprofit health or education organization, as determined by the Secretary, for the purposes of carrying out the coordinated school health initiative described in subsection (c). (2) Institution of higher education The term institution of higher education has the meaning given the term in section 101 of the Higher Education Act of 1965 (20 U.S.C. 1001). (3) Local educational agency The term local educational agency has the meaning given such term in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801). (4) Secretary The term Secretary means the Secretary of Agriculture. 310. Rewarding elementary and secondary schools for outstanding student performance in physical fitness programs (a) In general The Secretary of Health and Human Services may make grants to elementary and secondary schools as rewards for their students’ outstanding performance in the Presidential Youth Fitness Program or other federally supported physical fitness programs. (b) Preference In making grants under subsection (a), the Secretary shall give preference to elementary and secondary schools that— (1) have the highest percentage of students earning a Presidential Physical Fitness Award through the Presidential Youth Fitness Program; (2) demonstrate the greatest improvement in the number or percentage of students earning the National Physical Fitness Award and the Participant Physical Fitness Award through the Presidential Youth Fitness Program; and (3) implement evidence-based physical education and physical activity policies and programs that align with the Presidential Youth Fitness Program. (c) Allocation of funds for underperforming schools Of the amounts made available for grants under this section for each fiscal year, the Secretary shall set aside a portion of such amounts for underperforming elementary and secondary schools that— (1) are in need of improvement; (2) meet the requirements of this section; and (3) have evidence-based physical education and physical activity policies and programs. (d) Use of funds As a condition on receipt of a grant under this section, a school shall agree to use the grant funds for programs and activities to further improve the physical fitness of students. (e) Data requirements As a condition on receipt of a grant, a school shall agree to report the results achieved at the school through the Presidential Youth Fitness Program or other Federal physical fitness programs to the community and the relevant State agency— (1) to improve tracking of physical fitness data across the United States; and (2) to inform efforts to strengthen local wellness policies to improve student physical activity and physical fitness. (f) Application To seek a grant under this section, a school shall submit an application at such time, in such manner, and containing such information as the Secretary may require. At a minimum, an application under this subsection shall include— (1) a description of the school’s programs and activities for improving physical fitness; (2) an assurance of compliance with applicable requirements of physical fitness programs of the Department of Health and Human Services; and (3) an assessment of physical fitness levels of students in the school before, during, and after implementation such programs. (g) Reports (1) HHS Not later than 18 months after the date of the enactment of this Act, and annually thereafter, the Secretary shall submit a report to the Congress on the program of grants under this section, including— (A) a description of best practices by elementary and secondary schools for improving physical fitness; and (B) any recommendations for improving the program under this section. (2) GAO Not later than 24 months after the date of the enactment of this Act, the Comptroller General of the United States shall complete a study and submit a report to the Congress— (A) analyzing physical fitness levels of students in elementary and secondary schools across the Nation; (B) evaluating the President’s Challenge to determine whether the standards for Presidential Physical Fitness Awards, National Physical Fitness Awards, and Participant Physical Fitness Awards are accurate, up-to-date, and appropriate; and (C) evaluating the effectiveness of the awards described in subparagraph (B). (h) Definitions In this section: (1) The term elementary and secondary schools means public or private elementary schools and secondary schools (as defined in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801)). (2) The term President’s Challenge refers to the premier program of the President’s Council on Fitness, Sports & Nutrition, under the Secretary of Health and Human Services, for increasing physical activity and improving physical fitness. (3) The term Secretary means the Secretary of Health and Human Services.