,i #aacth ,,congress #b;d ,session ,h4 ,r4 #dgfe ,,in ,,the ,,house ,,of ,,representatives ,may #bi1 #bjad ,ms4 ,fudge 7for herself1 ,mr4 ,ellison1 ,ms4 ,lee of ,california1 ,mr4 ,richmond1 and ,mr4 ,payne7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committees on ,agriculture1 ,education and the ,workforce1 the ,judiciary1 ,financial ,services1 and ,natural ,resources1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to address childhood obesity1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,fit for ,life ,act of #bjad4 #b4 ,table of contents ,the table of contents of this ,act is as follows3 ,sec4 #a4 ,short title4 ,sec4 #b4 ,table of contents4 ,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 ,sec4 #aja4 ,nutritious ,food ,access through mobility and ,innovation ,program4 ,sec4 #ajb4 ,expansion of the ,fresh ,fruit and ,vegetable ,program4 ,sec4 #ajc4 ,expanding ,access to the ,summer ,food ,service ,program for ,children4 ,sec4 #ajd4 ,study and report on physical activity and nutritional quality of meals and snacks served1 in juvenile justice facilities4 ,sec4 #aje4 ,local food insecurity assessments3 evaluating the unique nutritional needs of local communities4 ,sec4 #ajf4 ,weekends and holidays without hunger4 ,subtitle ,b--,ensuring a ,healthy ,start for ,children in ,underserved ,american ,communities ,sec4 #aaa4 ,improving ,healthy ,eating and ,physical ,activity ,among our ,youngest ,children4 ,sec4 #aab4 ,health and fitness school programs3 training ,america's youth to live healthy lifestyles4 ,title ,,ii--,advancing ,preventative ,measures and ,treatment of ,obesity in ,adults and ,children in ,underserved ,communities ,sec4 #bja4 ,community health and wellness navigators pilot program3 connecting ,america's health professionals with our schools4 ,sec4 #bjb4 ,coverage of evidence-based preventive services under ,medicaid and ,,schip4 ,sec4 #bjc4 ,coverage of medical nutrition therapy under ,medicaid and ,,chip4 ,sec4 #bjd4 ,clarification of ,,epsdt inclusion of prevention1 screening1 and treatment services for obesity and overweight2 ,,chip coverage4 ,sec4 #bje4 ,national commission on child obesity4 ,sec4 #bjf4 ,,gao report4 ,title ,,iii--,encouraging ,physical ,activity in ,underserved ,american ,communities ,sec4 #cja4 ,renovation of foreclosed and abandoned properties to create spaces that encourage physical activity in ,american neighborhoods4 ,sec4 #cjb4 ,national youth sports program revitalization4 ,sec4 #cjc4 ,expansion of the ,zuni ,youth ,enrichment ,project ,summer ,camp4 ,sec4 #cjd4 ,making routes to schools in underserved communities safe and accessible with public participation through the ,community ,oriented ,policing ,services program4 ,sec4 #cje4 ,school infrastructure healthier upgrades competitive grant4 ,sec4 #cjf4 ,shared use agreement expansion pilot grant program4 ,sec4 #cjg4 ,land and ,water ,conservation ,fund ,program ,grants in ,low-,income ,communities and ,expand ,tribal ,participation4 ,sec4 #cjh4 ,changing ,hearts1 ,attitudes1 and ,minds by ,participating in ,sports 7,,champs7 ,program4 ,sec4 #cji4 ,coordinated ,school ,health ,initiatives4 ,sec4 #caj4 ,rewarding elementary and secondary schools for outstanding student performance in physical fitness programs4 ,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 #aja4 ,nutritious food access through mobility and innovation program 7a7 ,administration ,the ,secretary of ,agriculture shall carry out a pilot program to make #c-year grants in accordance with this section to nonprofit organizations1 local government agencies1 and accredited colleges and universities4 7b7 ,eligibility ,to be eligible to receive a grant under this section1 a nonprofit organization1 local government agency1 for-profit business1 or accredited college or university shall submit to the ,secretary an application in such form1 and containing such information1 as the ,secretary may require by rule4 ,such application shall include an assurance that such applicant will create or expand an innovative food distribution project that-- 7#a7 serves an area in which residents have low income1 or an area that is a food desert or food swamp2 7#b7 is not a supermarket-based project2 7#c7 provides for the free or low-cost delivery of fresh fruits and vegetables to food recipients who participate in such project2 7#d7 provides for the acquisition of produce trucks to distribute food to such recipients without a delivery charge and without any other service charge2 or 7#e7 provides for the establishment of a community food market 7including a food market in a school7 at which fresh fruits and vegetables are sold to such recipients at a low cost4 7c7 ,priority ,the ,secretary shall give priority to-- 7#a7 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 obesity2 7#b7 eligible applicants that have a proven record of serving low-income or minority communities2 and 7#c7 organizations with plans for sustainability plans in place for continuing successful services after ,federal funding lapses4 7d7 ,reporting ,each recipient of a #c-year grant made under this section shall submit annually to the ,secretary a report that includes an assessment of-- 7#a7 the impact that the recipient's project has had on the community involved during the year for which such report is submitted2 and 7#b7 the prospects of continuing such project after the #c-year period for which such grant is made4 #ajb4 ,expansion of the ,fresh ,fruit and ,vegetable ,program ,section #ai of the ,richard ,b4 ,russell ,national ,school ,lunch ,act 7#db ,u4,s4,c4 #agfi;a7 is amended-- 7#a7 in subsection 7a71 by inserting 1 secondary schools1 childcare centers1 and family childcare homes after elementary schools2 7#b7 by amending subsection 7b7 to read as follows3 7b7 ,program ,a school1 childcare center1 or family childcare home participating in the program-- 7#a7 shall make free fruits and vegetables available to students throughout the school1 center1 or home day 7or at such other times as are considered appropriate by the ,secretary7 in #a or more areas designated by the school1 center1 or home2 and 7#b7 may make free fruits and vegetables in any other form 7such as fresh1 frozen1 dried1 pureed1 or canned7 available to students throughout the school1 center1 or home day 7or at such other times as are considered appropriate by the ,secretary7 in #a or more areas designated by the school only if such fruits and vegetables meet any additional nutrition specifications1 as established by the ,secretary4 2 7#c7 in subsection 7d7-- 7,a7 in the heading1 by inserting 1 centers1 or homes2 7,b7 in paragraph 7#a7-- 7i7 in the matter preceding subparagraph 7,a71 by inserting 1 centers1 or homes after schools2 7ii7 in subparagraph 7,a71 by inserting 1 center1 or home after school2 7iii7 in subparagraph 7,b71 by inserting 1 centers1 or homes after schools2 7iv7 by amending subparagraph 7,c7 to read as follows3 7,c7 ensure that each school selected is an elementary school or secondary school 7as such terms are defined in section #iaja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja771 each center selected is a childcare center 7as such term is defined in section #cii,,oo of the ,public ,health ,service ,act71 and each home selected is a family childcare home 7as such term is defined in section #cii,,oo of the ,public ,health ,service ,act74 2 and 7v7 in subparagraph 7,d7-- 7,i7 in the matter preceding clause 7i71 by inserting 1 centers1 or homes after schools2 7,,ii7 in clause 7i71 by inserting 1 center1 or home after school2 and 7,,iii7 in clause 7ii71 by inserting 1 center1 or home after as determined by the school2 7,c7 in paragraph 7#b71 by inserting 1 centers1 or homes after each place schools appears2 and 7,d7 in paragraph 7#c71 by inserting 1 centers1 or homes after each place schools appears2 and 7#d7 in subsection 7e71 by inserting 1 center1 or home after school4 #ajc4 ,expanding access to the ,summer ,food ,service ,program for ,children ,section #ac7;a7 of the ,richard ,b4 ,russell ,national ,school ,lunch ,act 7#db ,u4,s4,c4 #agfa7;a77 is amended-- 7#a7 in paragraph 7#a77;,a71 by striking #ej percent each place it appears and inserting #dj percent2 7#b7 by repealing paragraph 7#i72 and 7#c7 in paragraph 7#aj7-- 7,a7 in subparagraph 7,a7-- 7i7 by striking ,the ,secretary and inserting ,from the amounts appropriated to carry out this paragraph1 the ,secretary2 and 7ii7 by striking not more than #e2 7,b7 in subparagraph 7,c71 by striking fiscal year #bjjf and inserting fiscal year #bjae2 7,c7 in subparagraph 7,d7-- 7i7 by striking ,january #a1 #bjjh and inserting ,january #a1 #bjae2 and 7ii7 by striking ,january #a1 #bjji and inserting ,january #a1 #bjaf2 and 7,d7 by striking subparagraph 7,e74 #ajd4 ,study and report on physical activity and nutritional quality of meals and snacks served in juvenile justice facilities 7a7 ,study ,the ,administrator of the ,office of ,juvenile ,justice and ,delinquency ,prevention1 in consultation with the ,secretary of ,agriculture1 shall conduct a study on-- 7#a7 physical activity by juveniles in juvenile justice facilities1 including-- 7,a7 the amount of such physical activity2 7,b7 the types of physical activities in which such juveniles participate2 7,c7 the number of hours per day such juveniles participate in such physical activity2 7,d7 the degree of inclusiveness for juveniles with disabilities in physical activities2 7,e7 the participation rates for juveniles with disabilities2 and 7,f7 the adequacy of the amounts and types of physical activity of such juveniles2 and 7#b7 the nutritional quality of meals and snacks served in juvenile justice facilities4 7b7 ,report ,not later than two years after the date of the enactment of this ,act1 the ,administrator of the ,office of ,juvenile ,justice and ,delinquency ,prevention1 in consultation with the ,secretary of ,agriculture1 shall submit to ,congress a report on the findings of the study conducted under subsection 7a71 including an evaluation of whether the amounts and types of physical activity by juveniles1 and the nutritional quality of meals and snacks served1 in juvenile justice facilities are adequate to ensure the health and wellness of such juveniles4 #aje4 ,local food insecurity assessments3 evaluating the unique nutritional needs of local communities 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall establish a #c-year pilot program to award grants to local and tribal governments1 on a competitive basis1 to allow such local and tribal governments1 in partnership with the local community organizations under subsection 7e71 to-- 7#a7 conduct a food security assessment2 and 7#b7 make an inventory of the system in order to identify the strengths and gaps in such system4 7b7 ,data points for ,assessment ,for purposes of conducting an assessment and making an inventory under a grant under subsection 7a71 with respect to the community served by a local or tribal government1 such government shall examine the following food security and food system issues in the community3 7#a7 ,the prevalence of childhood obesity4 7#b7 ,the availability of safe routes to school for children4 7#c7 ,the quality of food served in school and childcare settings4 7#d7 ,the availability of supermarkets4 7#e7 ,the cost and availability of fresh fruits and vegetables4 7#f7 ,the concentration of convenience stores and other food vendors that sell a disproportionate amount of foods that are not fresh fruits and vegetables4 7#g7 ,the availability of products4 7#h7 ,the concentration of fast food restaurants4 7#i7 ,the availability of green space or recreation areas1 and the extent to which such space or areas encourage physical activity by adults and children4 7#aj7 ,any other issues determined to be relevant by the local or tribal government4 7#aa7 ,any other issues determined to be relevant by the ,secretary of ,health and ,human ,services4 7c7 ,number of sites ,the ,secretary of ,health and ,human ,services1 in awarding grants under subsection 7a71 shall award grants to no more than-- 7#a7 #bj local governments2 and 7#b7 #e tribal governments4 7d7 ,priority ,in awarding grants under subsection 7a71 the ,secretary of ,health and ,human ,services shall give priority to those local and tribal governments that serve communities with the highest concentrations of poverty4 7e7 ,requirement of partnerships ,in order to qualify for a grant under subsection 7a71 a local or tribal government shall demonstrate1 to the satisfaction of the ,secretary of ,health and ,human ,services1 that the local or tribal government has entered into a partnership 7for the purpose of conducting an assessment and making an inventory under subsection 7a77 with at least one of the following local community organizations3 7#a7 ,a nonprofit1 community-based organization or entity4 7#b7 ,a developer or urban planning institution4 7#c7 ,an accredited college or university4 7#d7 ,a freestanding children's hospital or center with expertise in child health and policy4 #ajf4 ,weekends and holidays without hunger ,section #ah of the ,richard ,b4 ,russell ,national ,school ,lunch ,act 7#db ,u4,s4,c4 #agfi7 is amended by adding at the end the following3 7l7 ,weekends and holidays without hunger 7#a7 ,definitions ,in this subsection3 7,a7 ,at-risk school child ,the term at-risk school child has the meaning given the term in section #ag7r77#a74 7,b7 ,eligible institution 7i7 ,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 storage1 handling1 and delivery standards established by the ,secretary4 7ii7 ,inclusions ,the term eligible institution includes-- 7,i7 an elementary or secondary school or school food service authority2 7,,ii7 a food bank or food pantry2 7,,iii7 a homeless shelter2 and 7,,iv7 such other type of emergency feeding agency as is approved by the ,secretary4 7#b7 ,establishment ,subject to the availability of appropriations provided in advance in an appropriations ,act specifically for the purpose of carrying out this subsection1 the ,secretary shall establish a program under which the ,secretary shall provide commodities1 on a competitive basis1 to eligible institutions to provide nutritious food to at-risk children on weekends and during extended school holidays during the school year4 7#c7 ,eligibility 7,a7 ,in general ,to be eligible to receive commodities under this subsection1 an eligible institution shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may determine4 7,b7 ,plan ,an application under subparagraph 7,a7 shall include the plan of the eligible institution for the distribution of nutritious foods to at-risk school children1 including-- 7i7 methods of food service delivery to at-risk school children2 7ii7 assurances that children receiving foods under the project will not be publicly separated or overtly identified2 7iii7 lists of the types of food to be provided under the project and provisions to ensure food quality and safety2 7iv7 information on the number of at-risk school children to be served and the per-child cost of providing the children with food2 and 7v7 such other information as the ,secretary determines to be necessary to assist the ,secretary in evaluating projects that receive commodities under this subsection4 7#d7 ,priority ,in selecting applications under this subsection1 the ,secretary shall give priority to eligible institutions that-- 7,a7 have on-going programs and experience serving populations with significant proportions of at-risk school children2 7,b7 have a good record of experience in food delivery and food safety systems2 7,c7 maintain high quality control1 accountability1 and recordkeeping standards2 7,d7 provide children with readily consumable food of high nutrient content and quality2 7,e7 demonstrate cost efficiencies and the potential for obtaining supplemental funding from non-,federal sources to carry out projects2 and 7,f7 demonstrate the ability to continue projects for the full approved term of the pilot project period4 7#e7 ,guidelines 7,a7 ,in general ,the ,secretary shall issue guidelines containing the criteria for projects to receive commodities under this subsection4 7,b7 ,inclusions ,the guidelines shall1 to the maximum extent practicable within the funds available and applications submitted1 take into account-- 7i7 geographical variations in project locations to include qualifying projects in rural1 urban1 and suburban areas with high proportions of families with at-risk school children2 7ii7 different types of projects that offer nutritious foods on weekends and during school holidays to at-risk school children2 and 7iii7 institutional capacity to collect1 maintain1 and provide statistically valid information necessary for the ,secretary-- 7,i7 to analyze and evaluate the results of the pilot project2 and 7,,ii7 to make recommendations to ,congress4 7#f7 ,evaluation 7,a7 ,interim evaluation ,not later than ,november #cj1 #bjaf1 the ,secretary shall complete an interim evaluation of the pilot program carried out under this subsection4 7,b7 ,final report ,not later than ,december #ca1 #bjag1 the ,secretary shall submit to ,congress a final report that contains-- 7i7 an evaluation of the pilot program carried out under this subsection2 and 7ii7 any recommendations of the ,secretary for legislative action4 7#g7 ,funding 7,a7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section such sums as are necessary1 to remain available until expended4 7,b7 ,availability of funds ,not more than #c percent of the funds made available under subparagraph 7,a7 may be used by the ,secretary for expenses associated with review of the operations and evaluation of the projects carried out under this subsection4 4 ,b ,ensuring a ,healthy ,start for ,children in ,underserved ,american ,communities #aaa4 ,improving healthy eating and physical activity among our youngest children ,title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bda et seq47 is amended by adding at the end the following3 ,w ,healthy kids program #cii,,oo4 ,definitions ,in this part3 7#a7 ,childcare center ,the term childcare center means a center licensed or otherwise authorized to provide childcare services for fewer than #bd hours per day per child in a nonresidential setting1 unless care in excess of #bd hours is due to the nature of the parents' work4 7#b7 ,early learning council ,the term early learning council means an early childhood assembly that is established to advise ,governors1 ,state legislators1 or ,state agency administrators on how best to meet the needs of young children and their families specifically through improvement of programs and services4 7#c7 ,family childcare home ,the term family childcare home means a private family home where home-based childcare is provided for a portion of the day1 unless care in excess of #bd hours is due to the nature of the parents' work1 and that is certified1 registered1 or licensed in the ,state in which it is located4 7#d7 ,screen time limits ,the term screen time limits means policies or guidelines1 such as those developed by the ,american ,academy of ,pediatrics1 designed to reduce the daily amount of time that children spend watching or looking at digital monitors or displays1 including television sets1 computer monitors1 or hand-held gaming devices4 7#e7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 #cii,,oo-#a4 ,grants 7a7 ,in general ,the ,secretary1 in consultation with appropriate entities within the ,department of ,health and ,human ,services1 shall award #c-year competitive grants to #e ,state health departments 7or other appropriate childcare licensing entities within such ,states7 to help reduce and prevent obesity among the birth to #e-year-old population of the ,state in childcare settings outside a child's place of residence4 7b7 ,use of funds ,state grantees shall use amounts received under a grant under this subsection to-- 7#a7 provide1 or enter into contracts to provide1 training 7that meets the requirements of subsection 7c77 to the staff of national1 ,state1 or community-based organizations with networks of childcare centers1 or a consortium of childcare centers and family childcare homes consisting of at least #aj centers1 for the purpose of implementing evidence-based healthy eating and physical activity policies and practices1 including curricula and other interventions2 and 7#b7 provide grants to childcare centers and family childcare homes1 whose staff received the training described in paragraph 7#a71 to implement practice1 curricula1 and policy changes 7that meet the requirements of subsection 7d77 that promote healthy eating and physical activity among the birth to #e years of age population4 ,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 stakeholders1 such as ,state early learning councils and other community-based organizations working with childcare centers or family childcare homes4 7c7 ,training requirements 7#a7 ,in general ,training provided under subsection 7b7 shall-- 7,a7 include the provision of information concerning age-appropriate healthy eating and physical activity interventions and culturally competent curricula for the birth to #e years of age population in the ,state involved1 which at a minimum shall include-- 7i7 a handbook that includes recommendations1 guidelines1 and best practices for childcare centers and family childcare homes relating to healthy eating1 physical activity1 and screen time reduction2 7ii7 information about the availability of and services provided by childcare health consultants2 and 7iii7 health and wellness resources available through the ,child ,care ,bureau and the ,maternal and ,child ,health ,bureau2 7,b7 identify1 improve upon1 and expand nutrition and physical activity best practices targeted to the birth to #e years of age population in the ,state involved and identify strategies for incorporating parental education and other parental involvement2 and 7,c7 provide instruction on how to appropriately model1 direct1 and encourage childcare staff behavior to apply the best practices and strategies identified under subparagraph 7,b74 7#b7 ,training entities ,a grantee may conduct the training required under this section directly1 or may provide such training through a contract with-- 7,a7 an appropriate national1 ,state1 or community organization with relevant expertise2 7,b7 a health care provider or professional organization with relevant expertise2 7,c7 a university or research center that employs faculty with relevant expertise2 or 7,d7 any other entity determined appropriate by the ,state and approved by the ,secretary4 7#c7 ,requirement of contract ,if a grantee elects to provide the training under this section through a contract1 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 ,state4 7d7 ,practice1 curricula1 and policy changes ,after training is provided as required under subsection 7c71 a ,state grantee shall ensure that the organizations and consortia involved-- 7#a7 implement1 in childcare settings1 evidence-based policy changes that promote healthy eating1 physical activity1 and appropriate screen time limits among the birth to #e years of age population2 7#b7 utilize an evidence-based1 culturally competent healthy eating and physical activity curriculum in childcare settings focusing on such birth to age #e population2 7#c7 implement programs1 activities1 and procedures for incorporating parental education and involvement of parents in programs1 including disseminating a written parental involvement policy1 and coordinating and integrating parental involvement strategies under this section1 to the extent feasible and appropriate1 with parental involvement strategies under other programs1 such as the ,head ,start program and the ,early ,head ,start ,program2 and 7#d7 find innovative ways to remove barriers that exist to providing opportunities for healthy eating and physical activity4 ,all activities described in this paragraph shall be evidence-based and be consistent with the curriculum presented through training activities described in subsection 7c74 #cii,,oo-#b4 ,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 #cii,,oo-#a1 including baseline1 process1 and outcome measurements4 #cii,,oo-#c4 ,coordination 7a7 ,interagency coordination ,to the extent practicable1 the ,secretary shall coordinate activities conducted under this part with activities undertaken by the ,national ,prevention1 ,health ,promotion and ,public ,health ,council established under section #djja of the ,patient ,protection and ,affordable ,care ,act 7,public ,law #aaa-adh74 ,where practicable1 such coordination shall-- 7#a7 include the sharing of current and emerging best practices concerning healthy eating1 physical activity1 and screen time limits that have a population-level impact in promoting nutrition and physical activity in childcare settings2 7#b7 promote the effective implementation and sustainability of such programs2 and 7#c7 avoid unnecessary duplication of effort4 7b7 ,pilot coordination ,the ,secretary shall designate an individual 7directly or through contract7 to provide technical assistance to ,states and pilot centers in the development1 implementation1 and evaluation of activities and dissemination of information described in paragraphs 7#a71 7#b71 and 7#c7 of subsection 7a74 #cii,,oo-#d4 ,evaluation and reporting 7a7 ,technical assistance and information ,the ,secretary shall-- 7#a7 provide technical assistance to grantees and other entities providing training under a grant under this part2 and 7#b7 disseminate to health departments and trainers under grants under this part information concerning evidence-based approaches1 including dissemination of existing toolkits1 curricula1 and existing or emerging best practices that can be expanded or improved upon through a program conducted under this part4 7b7 ,evaluation requirements ,with respect to evaluations conducted under section #cii,,oo-#b1 the ,secretary shall ensure that-- 7#a7 evaluation metrics are consistent across all programs funded under this part2 7#b7 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 eating1 physical activity1 and screen time limits2 7#c7 interim outcomes are measured1 to the extent possible1 by behavior changes in healthy eating1 physical activity1 and screen time2 and 7#d7 upon completion of the program1 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 settings4 7c7 ,dissemination of information ,upon the conclusion of the programs carried out under this part1 the ,secretary shall disseminate to all appropriate agencies within the ,department of ,health and ,human ,services evidence1 best practices1 and lessons learned from grantees4 ,such agencies shall encourage the adoption of the best practices4 7d7 ,report to ,congress ,not later than #f months after the completion of the program under this part1 the ,secretary shall submit to ,congress a report containing an evaluation of the program1 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 agencies1 as appropriate4 #cii,,oo-#e4 ,authorization of appropriations ,there is authorized to be appropriated to carry out this part1 #b1ejj1jjj for each of fiscal years #bjae1 #bjaf1 and #bjag4 4 #aab4 ,health and fitness school programs3 training ,america's youth to live healthy lifestyles 7a7 ,in general ,the ,secretaries shall carry out a #b-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 communities4 7b7 ,health and fitness program requirements ,as a condition on receipt of a grant under this section1 an eligible entity shall agree that any health and fitness program at a secondary school funded through the grant will-- 7#a7 be conducted in partnership with the secondary school1 community entities1 and tribal councils2 7#b7 ensure the services provided are inclusive of students with disabilities2 7#c7 include services by recent graduates of institutions of higher education who are interested in pursuing graduate degrees in medicine1 nursing1 nutrition science1 exercise physiology1 public health1 or a related discipline2 7#d7 use services by such graduates to supplement rather than supplant the health and fitness curriculum of the secondary school2 7#e7 include a highly effective student-mentor intervention and education program conducted by such graduates for a maximum of #b years of service in #a secondary school per graduate2 7#f7 build a healthier community through wellness activities and increased awareness about and access to healthy foods2 7#g7 provide daily health and fitness instruction to both students and faculty2 7#h7 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 foods2 7#i7 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 foods2 and 7#aj7 expose secondary school students to a variety of career choices in wellness and health-related disciplines1 including careers in medicine1 nursing1 nutrition science1 and exercise physiology4 7c7 ,non-,federal funds ,the ,secretaries shall encourage grantees under this section to contribute funds from non-,federal sources to increase-- 7#a7 the number of secondary schools at which health and fitness programs are offered2 or 7#b7 the longevity of such programs4 7d7 ,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 #bj schools4 7e7 ,assessment2 reporting ,as conditions on receipt of a grant under this section1 an eligible entity shall agree to-- 7#a7 conduct an annual assessment of health and fitness programs funded through the grant2 7#b7 on an annual basis1 report the findings of each assessment under paragraph 7#a7 to the participating school1 community partners1 local contributors of funds1 and tribal councils2 and 7#c7 not later than the end of fiscal year #bjaf1 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 obesity1 including data from each assessment under paragraph 7#a74 7f7 ,report to ,congress ,not later than the end of fiscal year #bjaf1 the ,secretaries shall submit to the ,congress a report that-- 7#a7 summarizes the results achieved through programs funded under this section2 and 7#b7 includes a summary of the reports submitted by grant recipients under subsection 7e77#c74 7g7 ,definitions ,in this section3 7#a7 ,the term secondary school has the meaning given to such term in section #iaja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7#b7 ,the term eligible entity means a nonprofit organization or entity with the ability to meet the requirements applicable to a grantee under this section1 as determined by the ,secretaries4 7#c7 ,the term low-income communities includes-- 7,a7 communities with a high percentage of children eligible for free and reduced priced lunches under the ,richard ,b4 ,russell ,national ,school ,lunch ,act 7#db ,u4,s4,c4 #agea et seq472 and 7,b7 any other communities determined by the ,secretaries to be low-income for purposes of this section4 7#d7 ,the term ,secretaries means the ,secretary of ,health and ,human ,services and the ,secretary of ,education1 acting jointly and in conjunction with the ,director of the ,centers for ,disease ,control and ,prevention4 7h7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #a1djj1jjj for the period of fiscal years #bjae through #bjaf4 ,,ii ,advancing ,preventative ,measures and ,treatment of ,obesity in ,adults and ,children in ,underserved ,communities #bja4 ,community health and wellness navigators pilot program3 connecting ,america's health professionals with our schools 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall award grants to #e or more ,states for the establishment of a community navigator program1 consisting of each such ,state making subgrants to #a or more eligible entities for a local community navigator program described in subsection 7b74 7b7 ,program description ,a local community navigator program described in this subsection shall consist of the following3 7#a7 ,an eligible entity1 in partnership with a local educational agency1 a bureau-funded school1 or a nonprofit health or education organization1 will hire and train #b or more community navigators4 7#b7 ,the community navigators will facilitate a relationship between the eligible entity and the local educational agency1 bureau-funded school1 or nonprofit health or education organization in low-income communities to ensure increased access to medical care through educating parents and school administrators4 7#c7 ,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-- 7,a7 increasing familial intake of nutritious meals2 7,b7 increasing physical activity both in and out of the school setting2 and 7,c7 increasing access to medical care4 7#d7 ,the community navigators will specifically recognize and address that there are subgroups that are shown to have particular barriers to physical activities1 such as persons with disabilities4 7c7 ,report ,not later than #b years after the date of the enactment of this ,act1 the ,secretary shall submit a report to the ,congress on the effectiveness of the program under this section4 7d7 ,definitions ,in this section3 7#a7 ,the term bureau-funded school has the meaning given such term in section #aadf of the ,education ,amendments of #aigh 7#be ,u4,s4,c4 #bjbf74 7#b7 ,the terms elementary school1 local educational agency1 and secondary school have the meanings given to such terms in section #iaja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7#c7 ,the term eligible entity includes a ,federally qualified health center 7as defined in section #ahfa7;aa7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa7771 a facility operated by the ,indian ,health ,service 7including 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 7#be ,u4,s4,c4 #dej et seq4771 a free-standing children's hospital that is described in subparagraph 7,l7 or 7,m7 of section #cdj;,b7a77#d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bef;b7a77#d771 a non-profit with demonstrated effectiveness in the area of health care and with a focus on serving low-income communities1 a rural hospital1 and a rural health clinic4 7#d7 ,the term low-income communities includes-- 7,a7 communities with a high percentage of children eligible for free and reduced priced lunches under the ,richard ,b4 ,russell ,national ,school ,lunch ,act 7#db ,u4,s4,c4 #agea et seq472 and 7,b7 any other communities determined by the ,secretaries to be low-income for purposes of this section4 7#e7 ,the term nonprofit health or education organization shall be defined by the ,secretary4 7#f7 ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#g7 ,the term ,state includes the ,district of ,columbia and any commonwealth1 territory1 or possession of the ,united ,states1 including the ,commonwealth of ,puerto ,rico1 the ,united ,states ,virgin ,islands1 ,guam1 ,american ,samoa1 and the ,commonwealth of the ,northern ,mariana ,islands4 7e7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated such sums as may be necessary for fiscal years #bjae and #bjaf4 #bjb4 ,coverage of evidence-based preventive services under ,medicaid and ,,schip 7a7 ,state ,option ,to ,provide ,medical ,assistance for ,evidence-,based ,preventive ,services 7#a7 ,in general ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7 is amended-- 7,a7 in subsection 7a7-- 7i7 in paragraph 7#bh71 by striking and at the end2 7ii7 by redesignating paragraph 7#bi7 as paragraph 7#cj72 and 7iii7 by inserting after paragraph 7#bh7 the following3 7#bi7 evidence-based preventive services described in subsection 7ee72 and 2 and 7,b7 by adding at the end the following3 7ee7 ,for purposes of subsection 7a77#bi71 evidence-based preventive services described in this subsection are-- 7#a7 any preventive services which the ,secretary has determined are reasonable and necessary for preventing obesity and comorbidities of obesity1 including diet and exercise counseling1 and healthy weight and obesity counseling2 and 7#b7 any other evidence-based1 effective1 clinical intervention for obese individuals designed to prevent comorbidities of obesity1 including pharmacological or surgical services4 4 7#b7 ,conforming amendment ,section #aijb7;a77#aj77;,c77iv7 of such ,act 7#db ,u4,s4,c4 #acif7;a77#aj77;,c77iv77 is amended by inserting 1 or 7#bi7 after 7#bd74 7b7 ,state option ,to provide child health assistance for evidence-,based preventive services ,section #baaj7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;jj7a77 is amended-- 7#a7 by redesignating paragraph 7#bh7 as paragraph 7#bi72 and 7#b7 by inserting after paragraph 7#bg7 the following3 7#bh7 ,evidence-based preventive services described in section #aije7;ee74 4 #bjc4 ,coverage of medical nutrition therapy under ,medicaid and ,,chip 7a7 ,state ,option ,to ,provide ,medical ,assistance for ,medical ,therapy ,services 7#a7 ,in general ,section #aije7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a771 as amended by section #bjb7;a77#a71 is amended-- 7,a7 in paragraph 7#bi71 by striking and at the end2 7,b7 by redesignating paragraph 7#cj7 as paragraph 7#ca72 and 7,c7 by inserting after paragraph 7#bi7 the following3 7#cj7 medical nutrition therapy services 7as defined in section #ahfa7vv77#a77 for individuals with prediabetes or obesity or who are overweight 7as defined by the ,secretary72 and 4 7#b7 ,conforming amendment ,section #aijb7;a77#aj77;,c77iv7 of such ,act 7#db ,u4,s4,c4 #acif7;a77#aj77;,c77iv771 as amended by section #bjb7;a77#b71 is amended by striking or 7#bi7 and inserting 7#bi71 or 7#cj74 7b7 ,state option ,to provide child health assistance for medical nutrition therapy services ,section #baaj7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;jj7a771 as amended by section #bjb7;b71 is amended-- 7#a7 by redesignating paragraph 7#bi7 as paragraph 7#cj72 and 7#b7 by inserting after paragraph 7#bh7 the following3 7#bi7 ,medical nutrition therapy services 7as defined in section #ahfa7vv77#a77 for individuals with prediabetes or obesity or who are overweight 7as defined by the ,secretary74 4 #bjd4 ,clarification of ,,epsdt inclusion of prevention1 screening1 and treatment services for obesity and overweight2 ,,chip coverage 7a7 ,in general ,section #aije7r7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7r77 is amended-- 7#a7 in paragraph 7#a77;,b7-- 7,a7 in clause 7iv71 by striking and at the end2 7,b7 in clause 7v71 by striking the period at the end and inserting 1 and2 and 7,c7 by adding at the end the following3 7vi7 weight and ,,bmi measurement and monitoring4 2 and 7#b7 in paragraph 7#e71 by inserting 7including treatment services related to obesity and body weight1 such as medical nutrition therapy services 7as defined in section #ahfa7vv77#a771 physical therapy1 exercise training1 behavioral health counseling1 and such other evidence-based services as recommended by the ,secretary 7taking into consideration the ,american ,academy of ,pediatrics ,expert ,committee ,guidelines ,regarding the ,prevention1 ,assessment1 and ,treatment of ,child and ,adolescent ,overweight and ,obesity and the ,national ,center on ,health1 ,physical ,activity1 and ,disability's ,physical ,activity ,guidelines for ,individuals with ,disabilities7 after screening services4 7b7 ,,chip 7#a7 ,required coverage ,section #bajc of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7 is amended-- 7,a7 in subsection 7a71 in the matter preceding paragraph 7#a71 by striking and 7#g7 and inserting 7#g71 and 7#h72 and 7,b7 in subsection 7c7-- 7i7 by redesignating paragraphs 7#g7 and 7#h7 as paragraphs 7#h7 and 7#i71 respectively2 and 7ii7 by inserting after paragraph 7#f71 the following3 7#g7 ,prevention1 screening1 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 monitoring1 as well as appropriate treatment services1 including medical nutrition therapy services 7as defined in section #ahfa7vv77#a771 physical therapy or exercise training1 including steps needed to make such therapy and training inclusive for persons with disabilities1 behavioral health counseling1 and such other evidence-based services as recommended by the ,secretary4 ,for purposes of the previous sentence the ,secretary shall take into consideration the ,american ,academy of ,pediatrics ,expert ,committee ,guidelines ,regarding the ,prevention1 ,assessment1 and ,treatment of ,child and ,adolescent ,overweight and ,obesity and the ,national ,center on ,health1 ,physical ,activity1 and ,disability's ,physical ,activity ,guidelines for ,individuals with ,disabilities4 4 7#b7 ,conforming amendment ,section #bajb7;a77#g77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;bb7c77#b77 is amended by striking section #bajc7;c77#e7 and inserting paragraphs 7#e7 and 7#g7 of section #bajc7;c74 #bje4 ,national ,commission on ,child ,obesity 7a7 ,establishment ,there is established a commission to be known as the ,national ,commission on ,child ,obesity 7in this section referred to as the ,commission74 7b7 ,duties of commission ,the ,commission shall-- 7#a7 conduct a comprehensive study that examines and assesses the needs of children relating to the prevalence1 prevention1 and treatment of childhood overweight and obesity1 including specific findings relating to-- 7,a7 best practices for the prevention and treatment of childhood overweight and obesity2 7,b7 child physical health and mental health2 7,c7 childcare in all settings2 7,d7 child welfare2 7,e7 elementary and secondary education2 7,f7 food availability in neighborhoods2 7,g7 access to health care2 7,h7 health care utilization2 7,i7 built environment2 7,j7 parent physical health and education2 7,k7 underserved communities1 including tribal communities1 health professional shortage areas designated under section #ccb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e71 medically underserved areas 7as defined in section #gii;,b of such ,act 7#db ,u4,s4,c4 #biep71 and areas in the ,appalachian region 7as defined in section #adajb7;a7 of title #dj1 ,united ,states ,code72 7,l7 relevant activities in childhood overweight and obesity2 7,m7 the availability of information on ,state and ,federal supportive nutrition programs1 such as the ,summer ,food ,service ,program1 the ,women1 ,infants1 and ,children ,program1 the ,state ,children's ,health ,insurance ,program under title ,,xxi of the ,social ,security ,act1 and the ,supplemental ,nutrition ,assistance ,program2 and 7,n7 children with disabilities2 7#b7 identify1 review1 and evaluate existing laws1 regulations1 policies1 programs1 and public health initiatives relevant to best practices for the prevalence1 prevention1 and treatment of childhood overweight and obesity2 7#c7 identify1 review1 and evaluate the lessons learned from past laws1 regulations1 policies1 programs1 and public health initiatives relevant to the prevalence1 prevention1 and treatment of childhood overweight and obesity2 7#d7 advise on the need to revise laws1 regulations1 policies1 and programs relative to addressing best practices for the prevalence1 prevention1 and treatment of childhood overweight and obesity at regular intervals as new knowledge is gained2 7#e7 include in the interim report required by subsection 7i77#a7 recommendations on-- 7,a7 the appropriate ,federal agency to establish the infrastructure for the creation of a comprehensive nationwide registry of patient data associated with children living with obesity2 7,b7 the specific criteria needed for such registry to allow the field of pediatric clinicians access to patient-level1 clinical data suitable for research and the development of best practices2 7,c7 the appropriate funding level required for the establishment and implementation of such the registry described in subparagraph 7,a72 and 7,d7 how to capture large-scale data that are currently unavailable on adolescent and child patients who are currently obese2 and 7#f7 include in the final report required by subsection 7i77#c7 the ,commission's specific findings1 conclusions1 and recommendations to address the needs of children relating to the prevention and treatment of childhood overweight and obesity1 including specific recommendations on-- 7,a7 the need for planning and establishing a national resource center for children and obesity2 and 7,b7 such coordination of resources and services1 administrative actions1 policies1 regulations1 and legislative changes as the ,commission considers appropriate4 7c7 ,composition 7#a7 ,members ,the ,commission shall be composed of #ae members1 of whom-- 7,a7 #c members1 including at least one from each major national political party1 shall be appointed by the ,president2 7,b7 #c members shall be appointed by the majority leader of the ,senate2 7,c7 #c members shall be appointed by the minority leader of the ,senate2 7,d7 #c members shall be appointed by the ,speaker of the ,house of ,representatives2 and 7,e7 #c members shall be appointed by the minority leader of the ,house of ,representatives4 7#b7 ,appointment ,members of the ,commission shall be appointed not later than #f months after the date of the enactment of this ,act4 7#c7 ,chairperson1 vice chairperson1 and meetings 7,a7 ,in general ,not later than #cj days after the date on which all members of the ,commission are appointed under paragraph 7#a71 such members shall meet to elect a ,chairperson and ,vice ,chairperson from among such members and shall determine a schedule of ,commission meetings4 7,b7 ,initial meeting ,the ,commission shall meet and begin the operations of the ,commission not later than #abj days after the appointment of members of the ,commission4 7#d7 ,governmental appointees ,an individual appointed to the ,commission may not be an official or employee of the ,federal ,government4 7#e7 ,commission representation ,the ,commission shall include at least one-- 7,a7 representative from each of a nonprofit and for-profit entity with demonstrated expertise in addressing the needs of children relating to the prevalence1 prevention1 and treatment of childhood overweight and obesity2 7,b7 ,state or local director of health2 and 7,c7 tribal health representative4 7#f7 ,qualifications ,members appointed under paragraph 7#a7 may include-- 7,a7 individuals involved with providing services to children1 including health and other social services2 7,b7 individuals involved with administering health insurance coverage to children2 7,c7 individuals with experience in public health initiatives relating to the prevention and treatment of childhood overweight and obesity1 including coordination of resources and services among ,state and local governments1 the ,federal ,government1 and nongovernmental entities2 7,d7 individuals with philanthropic experience focused on the needs of children relating to the prevalence1 prevention1 and treatment of childhood overweight and obesity2 7,e7 individuals who have conducted academic research relating to the prevalence1 prevention1 and treatment of childhood overweight and obesity2 and 7,f7 individuals with significant experience in child health and policy4 7#g7 ,quorum and ,vacancy 7,a7 ,quorum ,a majority of the members of the ,commission shall constitute a quorum1 but a lesser number of members may hold hearings4 7,b7 ,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 made4 7d7 ,powers of commission 7#a7 ,hearings ,the ,commission may hold such hearings1 meet and act at such times and places1 and receive such evidence as may be necessary to carry out the functions of the ,commission4 7#b7 ,information from ,federal agencies 7,a7 ,in general ,the ,commission may access1 to the extent authorized by law1 from any executive department1 bureau1 agency1 board1 commission1 office1 independent establishment1 or instrumentality of the ,federal ,government such information1 suggestions1 estimates1 and statistics as the ,commission considers necessary to carry out this section4 7,b7 ,provision of information ,on written request of the ,chairperson of the ,commission1 each department1 bureau1 agency1 board1 commission1 office1 independent establishment1 or instrumentality of the ,federal ,government shall1 to the extent authorized by law1 provide the requested information to the ,commission4 7,c7 ,receipt1 handling1 storage1 and dissemination ,information shall only be received1 handled1 stored1 and disseminated by members of the ,commission and its staff consistent with all applicable statutes1 regulations1 and ,executive orders4 7#c7 ,assistance from ,federal agencies 7,a7 ,general services administration ,on request of the ,chairperson of the ,commission1 the ,administrator of ,general ,services shall provide to the ,commission1 on a reimbursable basis1 administrative support and other assistance necessary for the ,commission to carry out its duties4 7,b7 ,other departments and agencies ,in addition to assistance under subparagraph 7,a71 departments and agencies of the ,united ,states may provide to the ,commission such assistance as they determine advisable and as authorized by law4 7#d7 ,contracting ,the ,commission may enter into financially reasonable contracts to enable the ,commission to discharge its duties under this section4 7#e7 ,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 ,states4 7e7 ,staff of commission 7#a7 ,in general ,the ,chairperson of the ,commission1 in consultation with the ,vice ,chairperson1 in accordance with rules agreed upon by the ,commission1 may appoint and fix the compensation of a staff director1 policy director1 and administrative assistant 7and other staff if agreed upon by a majority of ,commission members7 to enable the ,commission to carry out its functions1 in accordance with the provisions of title #e1 ,united ,states ,code1 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 #ecaf of title #e1 ,united ,states ,code4 7#b7 ,staff of ,federal agencies ,upon request of the ,chairperson of the ,commission1 the head of any executive department1 bureau1 agency1 board1 commission1 office1 independent establishment1 or instrumentality of the ,federal ,government may detail1 without reimbursement1 any of its personnel to the ,commission to assist it in carrying out its duties under this section4 ,any detail of an employee shall be without interruption or loss of civil service status or privilege4 7#c7 ,consultant services ,the ,commission is authorized to procure 7pursuant to a majority vote of the ,commission members7 the services of experts and consultants in accordance with section #caji of title #e1 ,united ,states ,code1 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 #ecae of title #e1 ,united ,states ,code4 7f7 ,travel expenses ,each member of the ,commission shall serve without compensation1 but shall receive travel expenses1 including per diem in lieu of subsistence1 in accordance with applicable provisions in the same manner as persons employed intermittently in the ,government service are allowed expenses under section #egjc of title #e1 ,united ,states ,code4 7g7 ,applicability of ,,faca ,the ,federal ,advisory ,committee ,act1 including any provisions applicable to staff1 is deemed to apply to the ,commission4 7h7 ,reports of commission2 termination 7#a7 ,interim report ,the ,commission shall1 not later than #a year after the date of its first meeting1 submit to the ,president and the ,congress an interim report containing specific findings1 conclusions1 and recommendations required under this section and agreed to by a majority of ,commission members4 7#b7 ,other reports and information 7,a7 ,reports ,the ,commission may issue additional reports as the ,commission determines necessary4 7,b7 ,information ,the ,commission may hold public hearings to collect information and shall make such information available for use by the public4 7#c7 ,final report ,the ,commission shall1 not later than #b years after the date of its first meeting1 submit to the ,president and ,congress a final report containing specific findings1 conclusions1 and recommendations required under this section and agreed to by a majority of ,commission members4 7#d7 ,termination 7,a7 ,in general ,unless reauthorized by statute1 the ,commission1 and all the authorities of this section1 shall terminate #ahj days after the date on which the final report is submitted under paragraph 7#c74 7,b7 ,records ,not later than the date of termination of the ,commission under subparagraph 7,a71 all records and papers of the ,commission shall be delivered to the ,archivist of the ,united ,states for deposit in the ,national ,archives4 7i7 ,definitions ,in this section3 7#a7 ,obesity ,the term obesity with respect to children means having a body mass index 7,,bmi7 greater than or equal to the #ieth percentile for age and sex according to the ,centers for ,disease ,control and ,prevention4 7#b7 ,child2 children ,the terms child and children mean an individual or individuals1 respectively1 who have not attained #ah years of age4 7j7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 #a1ejj1jjj for each of fiscal years #bjae and #bjaf4 #bjf4 ,,gao report ,not later than #b years after the first appropriation of ,federal funds to carry out this ,act1 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 obesity1 which shall include an analysis of the costs and the benefits of such activities4 ,,iii ,encouraging ,physical ,activity in ,underserved ,american ,communities #cja4 ,renovation of foreclosed and abandoned properties to create spaces that encourage physical activity in ,american neighborhoods ,section #ajf7;a7 of the ,housing and ,community ,development ,act of #aigd 7#db ,u4,s4,c4 #ecjf7;a77 is amended-- 7#a7 in paragraph 7#c7-- 7,a7 by striking 7#a7 and and inserting 7#a712 and 7,b7 by inserting and after reserving such amounts for units of general local government1 special district governments1 and ,indian tribes with high foreclosure rates and great infrastructure need under paragraph 7#d71 after paragraph 7#b712 7#b7 by redesignating paragraph 7#d7 as paragraph 7#e72 7#c7 in paragraph 7#e71 as redesignated by paragraph 7#b7 of this section1 by striking paragraphs 7#a71 7#b71 and 7#c7 and inserting paragraphs 7#a71 7#b71 7#c71 and 7#d72 and 7#d7 by inserting after paragraph 7#c7 the following new paragraph3 7#d7 7,a7 ,for each fiscal year1 of the amount approved in appropriation ,acts under section #ajc for grants for such fiscal year 7excluding the amounts provided for use in accordance with section #ajg71 the ,secretary shall reserve for grants to units of general local government1 special district governments1 and ,indian tribes that the ,secretary determines have both high foreclosure rates and the greatest infrastructure needs1 based on the scope of the needs1 an amount the ,secretary determines necessary4 7,b7 ,grants under this paragraph may be used by units of general local government1 special district governments1 and ,indian tribes to-- 7i7 renovate foreclosed commercial properties1 abandoned commercial properties1 or both1 to be transformed into community centers1 public recreation facilities1 swimming pools1 or any other type of facility that will encourage indoor physical activity2 7ii7 demolish foreclosed or abandoned commercial and residential properties1 or both1 to use the sites for-- 7,i7 the construction of parks1 playgrounds1 outdoor swimming pools1 tracks1 soccer fields1 baseball diamonds1 or any other type of facility that will encourage outdoor physical activity2 7,,ii7 community gardens or urban farms1 particularly in areas that are food deserts 7as such term is defined in section #gebg7;a7 of the ,food1 ,conservation1 and ,energy ,act of #bjjh 7,public ,law #aaj-bcd2 #abb ,stat4 #bjci72 or 7,,iii7 mixed-use facilities that are used for both of the purposes under subclauses 7,i7 and 7,,ii7 of this clause2 and 7iii7 reconstruct and repair dilapidated sidewalks1 bike and pedestrian trails1 and indoor and outdoor facilities that encourage physical activity4 7,c7 ,in making grants under this paragraph1 the ,secretary shall give priority among units of general local government1 special district governments1 and ,indian tribes eligible pursuant to subparagraph 7,a7-- 7i7 to units of general local government1 special district governments1 and ,indian tribes that demonstrate the ability and willingness to work with local educational agencies1 developers1 and other community-based organizations to enter into mixed-use agreements to maximize the use and efficiency of properties renovated1 constructed1 or reconstructed and repaired through the use of grant funds2 7ii7 to units of general local government1 special district governments1 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 #aiij 7#db ,u4,s4,c4 #abeja et seq47 or the ,domestic ,volunteer ,service ,act of #aigc 7#db ,u4,s4,c4 #diej et seq47 in the renovation1 construction1 or reconstruction and repair of properties through the use of grant funds2 7iii7 to projects proposed by units of general local government1 special district governments1 and ,indian tribes that are easily accessible1 on foot or by public transportation1 for persons in low-income communities2 and 7iv7 to projects proposed by units of general local government1 special district governments1 and ,indian tribes that have particular accessibility considerations for persons with disabilities4 7,d7 ,for purposes of this paragraph1 the term special district government means any organized local entity1 known by a variety of titles1 including districts1 authorities1 boards1 and commissions1 other than a unit of general local government or local educational agency1 authorized by ,state law to provide only one or a limited number of designated functions1 and with sufficient administrative and fiscal autonomy to qualify as a separate government unit1 as determined by the ,secretary4 4 #cjb4 ,national ,youth ,sports ,program revitalization ,section #fhb7;g7 of the ,community ,services ,block ,grant ,act 7#db ,u4,s4,c4 #iibc7;g77 is amended by striking #ae1jjj1jjj and all that follows through #bjjc and inserting #bj1jjj1jjj for each of the fiscal years #bjae through #bjbd4 #cjc4 ,expansion of the ,zuni ,youth ,enrichment ,project ,summer ,camp 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall establish a #b-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 7in the form of a summer camp and a year-round program7 for the purpose of-- 7#a7 reversing the epidemics of obesity1 diabetes1 and alcoholism in such areas2 and 7#b7 to mitigate other problems stemming from the formation of bad habits and the development of low self-esteem during childhood4 7b7 ,partnerships ,in order to qualify for funding under subsection 7a71 a community-based organization shall demonstrate1 to the satisfaction of the ,secretary of ,health and ,human ,services1 that the organization has entered into a partnership with community entities1 local funders1 and tribal leaders 7including1 if applicable1 the tribal council7 to plan and execute an enrichment program under subsection 7a74 7c7 ,number of sites ,the ,secretary of ,health and ,human ,services1 in providing funding under subsection 7a71 shall provide funding to no more than #bj community-based organizations4 7d7 ,model and camp requirement ,the enrichment program under subsection 7a7 shall-- 7#a7 be modeled on similar programs established by the ,zuni ,youth ,enrichment ,project2 and 7#b7 shall include a camp of at least #f weeks in duration during the summer4 7e7 ,specific camp requirements 7#a7 ,daily activities ,with respect to children attending a camp under subsection 7d77#b71 the leader of the organization that receives funds under subsection 7a7 shall1 for each day of the camp1 ensure that such children are-- 7,a7 involved in at least #fj minutes of physical activity 7with appropriate accommodations made for children with disabilities72 and 7,b7 provided with at least two meals that meet national nutritional standards4 7#b7 ,other activities ,such leader shall also ensure that-- 7,a7 a community gardening activity is included in the activities conducted at the camp2 and 7,b7 health and wellness education is provided to the children attending the camp4 7f7 ,evaluation 7#a7 ,in general ,a community-based organization that receives funding under subsection 7a71 shall1 as a condition of receiving such funding1 conduct an evaluation of the enrichment program conducted by such organization4 7#b7 ,model ,the form1 manner1 content1 and frequency of the evaluation under paragraph 7#a7 shall be modeled on the ,zuni ,youth ,enrichment ,project standard project evaluation4 7g7 ,report ,not later than #a year after the date on which a community organization first receives funding under subsection 7a7 and annually thereafter1 the organization shall-- 7#a7 submit a report to the ,secretary of ,health and ,human ,services on the outcomes of the enrichment program conducted by the organization under this section1 including-- 7,a7 the findings of the evaluation conducted under subsection 7f72 and 7,b7 the impact of such enrichment program on the rates of childhood obesity on the reservation or area of tribal land served by the organization2 and 7#b7 provide a copy of the findings under paragraph 7#a77;,a7 to community entities1 local funders1 tribal leaders 7including1 if applicable1 the tribal council71 and the families of children participating in the enrichment program4 #cjd4 ,making routes to schools in underserved communities safe and accessible with public participation through the ,community ,oriented ,policing ,services ,program ,section #agja of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#db ,u4,s4,c4 #cgif;dd7 is amended-- 7#a7 in subsection 7b7-- 7,a7 in paragraph 7#af71 by striking and after the semicolon2 7,b7 by redesignating paragraph 7#ag7 as paragraph 7#ah71 and in such paragraph 7#ah7 7as so redesignated71 by striking through 7#af7 and inserting through 7#ag72 and 7,c7 by inserting after paragraph 7#af7 the following new paragraph3 7#ag7 to award grants for ,safe ,routes to ,school-,community ,oriented ,policing ,services programs1 in accordance with subsection 7l72 and 2 and 7#b7 by adding at the end the following new subsection3 7l7 ,safe ,routes to ,school-,community ,oriented ,policing ,services programs 7#a7 ,grant program ,the ,director of the ,office of ,community ,oriented ,policing ,services1 in collaboration with the ,secretary of ,education1 shall award grants to not fewer than #aj local and tribal law enforcement agencies in low-income communities for the planning1 development1 and assessment of ,safe ,routes to ,school-,community ,oriented ,policing ,services programs in accordance with this subsection4 7#b7 ,grant period ,each grant awarded under this subsection shall be for a #c-year period beginning with the first fiscal year that begins after the date of enactment of the ,fit for ,life ,act of #bjad1 and may not be renewed4 7#c7 ,use of grants ,a grant awarded under this subsection shall be used by each grantee to-- 7,a7 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 safely2 and 7,b7 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 unsafe1 such as dangers associated with crime1 drug or gang activity1 abandoned properties1 and the presence of sexual predators4 7#d7 ,reports ,not later than one year after receiving a grant award under this subsection1 and annually thereafter1 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-- 7,a7 a description of the activities carried out with such grant during the preceding year2 7,b7 the effectiveness of such activities in ensuring safe routes to and from school for elementary and secondary school students2 7,c7 a description of the activities the grantee plans to carry out with such grant in succeeding years2 and 7,d7 best practices1 plans1 and findings for purposes of incorporation into urban planning and development in underserved communities in succeeding years4 7#e7 ,definition ,the term low-income communities includes-- 7,a7 communities with a high percentage of children eligible for free and reduced priced lunches under the ,richard ,b4 ,russell ,national ,school ,lunch ,act 7#db ,u4,s4,c4 #agea et seq472 and 7,b7 any other communities determined by the ,director of the ,office of ,community ,oriented ,policing ,services to be low-income for purposes of this section4 4 #cje4 ,school infrastructure healthier upgrades competitive grant 7a7 ,in general ,from the amounts appropriated to carry out this ,act1 the ,secretary of ,education shall award grants1 on a competitive basis1 to eligible entities to upgrade facilities specifically pertaining to healthy eating and fitness4 7b7 ,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 fitness1 which may include-- 7#a7 building or maintaining school gardens2 7#b7 renovating outdoor facilities for physical educations or activity programs2 or 7#c7 upgrading kitchen and cafeteria services to better prepare and store healthy foods4 7c7 ,priority ,in awarding grants under this section to eligible entities that are local educational agencies1 the ,secretary shall give priority to local educational agencies that-- 7#a7 serve a high-percentage of low-income students2 7#b7 serve a high-percentage of students who are minorities2 7#c7 serve a high-percentage of students with childhood obesity2 and 7#d7 serve schools that have joint use agreements for afterschool programs or community-wellness partnerships for afterschool or weekend use4 7d7 ,definitions ,in this section3 7#a7 ,eligible entity ,the term eligible entity means a local educational agency or licensed childcare centers with evidence-based wellness programs4 7#b7 ,local educational agency ,the term local educational agency has the meaning given the term in section #iaja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7#c7 ,secretary ,the term ,secretary means the ,secretary of ,education4 #cjf4 ,shared use agreement expansion pilot grant program 7a7 ,in general ,from the amounts appropriated to carry out this section1 the ,secretary of ,education shall award grants1 on a competitive basis1 to eligible entities to supplement programmatic costs1 operations1 security1 maintenance fees1 and other costs associated with out-of-school use of elementary school or secondary school buildings or facilities for physical activity1 fitness1 and wellness purposes4 7b7 ,grant terms ,each grant under this section shall be awarded for a period of not more than #c years4 7c7 ,total grants ,the ,secretary shall award not less than #ae grants under this section for each fiscal year for which funds are appropriated to carry out this section4 7d7 ,priority ,in awarding grants under this section1 the ,secretary shall give priority to each eligible entity that-- 7#a7 serves low-income and minority populations2 7#b7 serves communities with high levels of childhood obesity2 and 7#c7 is supporting a joint or shared-use agreement 7as described in subsection 7e77#b77;,a77 that-- 7,a7 was established not more than #e years before the eligible entity received a grant under this section2 and 7,b7 allows the open community use of elementary school or secondary school buildings or facilities as opposed to only fee-based sports league use4 7e7 ,definitions ,in this section3 7#a7 ,,esea terms ,the terms elementary school and secondary school have the meanings given such terms in section #iaja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7#b7 ,eligible entity ,the term eligible entity means an elementary school1 secondary school1 local government1 or community partner that has-- 7,a7 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 programs2 and 7,b7 the ability to use funds to support such community programs4 7#c7 ,secretary ,the term ,secretary means the ,secretary of ,education4 #cjg4 ,land and ,water ,conservation ,fund ,program grants in low-income communities and expand tribal participation ,section #f7;e7 of the ,land and ,water ,conservation ,act of #aife 7#af ,u4,s4,c4 #dfjl-#h7;e77 is amended by adding at the end the following3 7#c7 ,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 reservations4 4 #cjh4 ,changing ,hearts1 ,attitudes1 and ,minds by ,participating in ,sports 7,,champs7 ,program ,part ,b of title ,,iii of the ,public ,health ,service ,act is amended by inserting after section #cag,t 7#db ,u4,s4,c4 #bdg;b-#bb7 the following3 #cag,u4 ,changing ,hearts1 ,attitudes1 and ,minds by ,participating in ,sports 7,,champs7 ,program 7a7 ,in ,general ,the ,secretary1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 may make grants to eligible entities to carry out nationally based or community-based qualified childhood obesity prevention initiatives4 7b7 ,eligible entities ,to be eligible to seek a grant under this section1 an entity shall be-- 7#a7 a nationally based nonprofit organization proposing to implement programs described in subsection 7c71 each serving at least #a1jjj individuals1 at #e or more locations across the ,nation2 or 7#b7 a community-based nonprofit organization proposing to implement a program described in subsection 7c7 serving at least #a1jjj individuals4 7c7 ,qualified childhood obesity prevention initiative ,to qualify as a childhood obesity prevention initiative eligible for funding under this section1 an initiative shall consist of programs that-- 7#a7 serve children or adolescents most at risk for being overweight and obese in predominantly economically disadvantaged communities2 7#b7 serve children or adolescents during after-school hours1 weekends1 or summer hours2 7#c7 provide structured physical fitness activities1 including organized sports1 which engage each participant in a minimum of #fj minutes of moderate to vigorous physical activity at least three days per week for a period of at least #bd weeks in a given year2 7#d7 provide adult supervision and guidance or coaches who encourage and teach proper exercise techniques and skills2 7#e7 combine physical fitness activities with nutritional counseling and education2 and 7#f7 demonstrate measurable results for reducing childhood obesity on the part of participants1 including through-- 7,a7 measurement and study of participants' moderate to vigorous physical activity 7,,mvpa7 each day1 both as part of the programs funded under this section and on the participants' own initiative2 7,b7 increased knowledge of and awareness about the importance of physical activity and exercise as well as the nutritional value of food and beverage choices2 7,c7 keeping track of and reporting meaningful reductions in the consumption of food and beverages with low nutritional value1 increased consumption of healthy items1 and increased levels of unstructured1 self-initiated physical activity outside of the programs funded under this section2 and 7,d7 measurement and study of participants' body mass index 7,,bmi7 indicating that-- 7i7 children entering programs funded under this section with a healthy body mass index maintain it while participating in such programs2 and 7ii7 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 direction4 7d7 ,priority ,in selecting among applicants for grants under this section1 the ,secretary shall give priority to eligible entities proposing to carry out programs that will provide additional societal benefits1 such as-- 7#a7 effectiveness in working with programs for ethnic and racial minorities that are evaluated by independent1 third-party evaluators2 7#b7 improvements to academic performance in school2 7#c7 character building and leadership development2 7#d7 gang and juvenile delinquency prevention and reduction2 7#e7 gender equality and female empowerment2 7#f7 mentoring1 volunteerism promotion1 and service-learning opportunities2 7#g7 family and community engagement and participation2 7#h7 workforce education and career development opportunities2 or 7#i7 being inclusive of persons with disabilities4 7e7 ,distribution of funds ,of the amount made available to carry out this section for a fiscal year1 the ,secretary shall award-- 7#a7 not less than #be percent of such amount to nationally based nonprofit organizations described in subsection 7b77#a72 and 7#b7 not more than #ge percent of such amount to community-based nonprofit organizations described in subsection 7b77#b74 7f7 ,cost-,share requirements 7#a7 ,in general ,with respect to the costs of a qualified childhood obesity prevention initiative to be carried out under this section-- 7,a7 in the case of an applicant that is a nationally based nonprofit organization1 a grant under subsection 7a7 may be made only if the organization agrees to make available 7directly or through donations from public or private entities7 non-,federal contributions toward such costs in an amount that is not less than one-third of such costs 7#a for each #b of ,federal funds provided in the grant72 and 7,b7 in the case of an applicant that is a community-based nonprofit organization1 a grant under subsection 7a7 may be made only if the organization agrees to make available 7directly or through donations from public or private entities7 non-,federal contributions toward such costs in an amount that is not less than one-fourth of such costs 7#a for each #c of ,federal funds provided in the grant74 7#b7 ,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 initiative1 the organization shall require the subgrantee to make available 7directly or through donations from public or private entities7 non-,federal contributions toward the costs of such programs in an amount that is not less than one-third of such costs 7#a for each #b of ,federal funds provided in the grant74 ,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 7#a74 7#c7 ,determination of amount contributed 7,a7 ,in general ,non-,federal contributions required by paragraph 7#a7 or 7#b7-- 7i7 in the case of a nationally based nonprofit organization1 shall be made in cash2 and 7ii7 in the case of a subgrantee described in paragraph 7#b7 or a community-based nonprofit organization1 may be in cash or in kind1 fairly evaluated1 including plant1 equipment1 or services4 7,b7 ,exclusion of ,federal contributions ,amounts provided by the ,federal ,government1 or services assisted or subsidized to any significant extent by the ,federal ,government1 may not be included in determining the amount of non-,federal contributions required by paragraph 7#a7 or 7#b74 7g7 ,report to ,congress ,not later than one year after the first appropriation of ,federal funds to carry out this section1 the ,secretary shall report to the ,congress on the progress made in carrying out programs funded by grants under this section4 7h7 ,best practices guidelines ,based on the results of programs funded through grants under this section during the first two fiscal years of such funding1 the ,secretary shall develop publicly accessible best practices guidelines for obesity reduction programs4 ,the ,secretary shall update these guidelines every two years4 7i7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #ej1jjj1jjj for each of fiscal years #bjae through #bjai4 4 #cji4 ,coordinated school health initiatives 7a7 ,in general ,from the amounts appropriated to carry out this section1 the ,secretary of ,education shall carry out a pilot program to award grants to not more than #e eligible entities to carry out coordinated school health initiatives in schools4 7b7 ,amount of grant ,a grant awarded under subsection 7a7 may not exceed #ae1jjj4 7c7 ,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-- 7#a7 carry out a program1 such as a fitness program1 to assess the physical fitness 7including aerobic capacity1 muscular strength and endurance1 flexibility1 and body composition7 of each student served by the entity2 and 7#b7 evaluate such assessments to-- 7,a7 establish baselines with respect to aerobic capacity1 muscular strength and endurance1 flexibility1 and body composition that each such student should meet by a certain period2 and 7,b7 identify interventions to assist each such student1 including those with disabilities1 in meeting such baselines2 7#c7 review the interventions identified under paragraph 7#b77;,b7 to determine the best practices with respect to such interventions2 7#d7 use the determinations for best practices under paragraph 7#c7 to implement interventions in each school under the jurisdiction of the entity2 and 7#e7 not later than #a year after the implementation of the interventions1 assess the physical fitness of each student served by the entity4 7d7 ,reporting 7#a7 ,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 ,secretary1 a report on-- 7,a7 the initial physical fitness assessments carried out under subsection 7c77#a72 7,b7 the interventions implemented under subsection 7c77#d72 and 7,c7 the physical fitness assessments carried out under subsection 7c77#e7 after the interventions have been implemented4 7#b7 ,secretary ,not later than the first appropriation of ,federal funds to carry out this section1 the ,secretary shall use the reports received under paragraph 7#a7 to prepare and transmit to ,congress a report on-- 7,a7 the average physical fitness levels of students participating in the coordinated school health initiative under this section-- 7i7 prior to the interventions implemented by each eligible entity under this section2 and 7ii7 #a year after the implementation of the interventions2 7,b7 the best practices with respect to the interventions2 and 7,c7 recommendations on how schools and local educational agencies may incorporate such best practices4 7e7 ,application ,to receive a grant under this section1 an eligible entity shall submit an application to the ,secretary of ,education at such time1 in such manner1 and containing such information as the ,secretary may require4 7f7 ,supplement1 ,not ,supplant ,funds received under this section shall be used to supplement1 and not supplant1 non-,federal funds that would otherwise be used for activities authorized under this section4 7g7 ,definitions ,for purposes of this section3 7#a7 ,eligible entity ,the term eligible entity means a local educational agency-- 7,a7 that serves-- 7i7 a high percentage of students eligible for free or reduced price lunches under the ,richard ,b4 ,russell ,national ,school ,lunch ,act2 or 7ii7 a community otherwise determined by the ,secretary to be a low-income community2 and 7,b7 that forms a partnership with an institution of higher education or a nonprofit health or education organization1 as determined by the ,secretary1 for the purposes of carrying out the coordinated school health initiative described in subsection 7c74 7#b7 ,institution of higher education ,the term institution of higher education has the meaning given the term in section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja74 7#c7 ,local educational agency ,the term local educational agency has the meaning given such term in section #iaja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7#d7 ,secretary ,the term ,secretary means the ,secretary of ,agriculture4 #caj4 ,rewarding elementary and secondary schools for outstanding student performance in physical fitness programs 7a7 ,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 programs4 7b7 ,preference ,in making grants under subsection 7a71 the ,secretary shall give preference to elementary and secondary schools that-- 7#a7 have the highest percentage of students earning a ,presidential ,physical ,fitness ,award through the ,presidential ,youth ,fitness ,program2 7#b7 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 ,program2 and 7#c7 implement evidence-based physical education and physical activity policies and programs that align with the ,presidential ,youth ,fitness ,program4 7c7 ,allocation of funds for underperforming schools ,of the amounts made available for grants under this section for each fiscal year1 the ,secretary shall set aside a portion of such amounts for underperforming elementary and secondary schools that-- 7#a7 are in need of improvement2 7#b7 meet the requirements of this section2 and 7#c7 have evidence-based physical education and physical activity policies and programs4 7d7 ,use of funds ,as a condition on receipt of a grant under this section1 a school shall agree to use the grant funds for programs and activities to further improve the physical fitness of students4 7e7 ,data requirements ,as a condition on receipt of a grant1 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-- 7#a7 to improve tracking of physical fitness data across the ,united ,states2 and 7#b7 to inform efforts to strengthen local wellness policies to improve student physical activity and physical fitness4 7f7 ,application ,to seek a grant under this section1 a school shall submit an application at such time1 in such manner1 and containing such information as the ,secretary may require4 ,at a minimum1 an application under this subsection shall include-- 7#a7 a description of the school's programs and activities for improving physical fitness2 7#b7 an assurance of compliance with applicable requirements of physical fitness programs of the ,department of ,health and ,human ,services2 and 7#c7 an assessment of physical fitness levels of students in the school before1 during1 and after implementation such programs4 7g7 ,reports 7#a7 ,,hhs ,not later than #ah months after the date of the enactment of this ,act1 and annually thereafter1 the ,secretary shall submit a report to the ,congress on the program of grants under this section1 including-- 7,a7 a description of best practices by elementary and secondary schools for improving physical fitness2 and 7,b7 any recommendations for improving the program under this section4 7#b7 ,,gao ,not later than #bd months after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall complete a study and submit a report to the ,congress-- 7,a7 analyzing physical fitness levels of students in elementary and secondary schools across the ,nation2 7,b7 evaluating the ,president's ,challenge to determine whether the standards for ,presidential ,physical ,fitness ,awards1 ,national ,physical ,fitness ,awards1 and ,participant ,physical ,fitness ,awards are accurate1 up-to-date1 and appropriate2 and 7,c7 evaluating the effectiveness of the awards described in subparagraph 7,b74 7h7 ,definitions ,in this section3 7#a7 ,the term elementary and secondary schools means public or private elementary schools and secondary schools 7as defined in section #iaja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja774 7#b7 ,the term ,president's ,challenge refers to the premier program of the ,president's ,council on ,fitness1 ,sports ,nutrition1 under the ,secretary of ,health and ,human ,services1 for increasing physical activity and improving physical fitness4 7#c7 ,the term ,secretary means the ,secretary of ,health and ,human ,services4