Statements on Introduced Bills and Joint Resolutions - S. 2399

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

By Mr. FITZGERALD (for himself and Mr. KENNEDY):

S. 2399. A bill to provide for the improvement of physical activity and nutrition and the prevention of obesity for all Americans; to the Committee on Health, Education, Labor, and Pensions.

Mr. FITZGERALD. Mr. President, I rise today to introduce the Healthy Lifestyles Act of 2004 with Senator KENNEDY. This bill places the crafting of the Dietary Guidelines for Americans squarely on the shoulders of the independent Institute of Medicine of the National Academies of Sciences. This bill also establishes several grant programs to help curb the obesity epidemic that plagues more than one-third of Americans.

In the United States, approximately 300,000 of our citizens die each year as a result of being overweight or obese. This information becomes even more dire when you consider that 64 percent of adults and 13 percent of children and adolescents are overweight, according to the Centers for Disease Control and Prevention. More staggering, twice as many children and three times as many adolescents are characterized as overweight today as in 1980-when the Federal Government, through the U.S. Department of Agriculture, first published the Dietary Guidelines. In 1990, Congress took a larger role in the establishment of these Guidelines and passed legislation requiring the USDA and HHS to review, and, if necessary, revise the Guidelines every 5 years.

According to the CDC, in 1985, in no State in the union were more than 14 percent of the resident's obese, but in 2001, in every State but Colorado more than 15 percent of residents were obese. My own State of Illinois dramatically demonstrates this disturbing trend. According to CDC, in 1985, less than 10 percent of Illinois residents were obese. By 2001, between 20 and 24 percent of Illinois residents were obese.

Furthermore, according to the CDC, the medical expenses of the overweight and obese accounted for 9.1 percent of total U.S. medical expenditures in 1998 and may have reached as high as $78.5 billion. Approximately half of these costs were paid by Medicaid and Medicare.

It is time to fix this dysfunctional system. By placing the IOM in charge of drafting the Dietary Guidelines, we can help to ensure that the Guidelines are based upon unbiased, sound, scientific evidence rather than which organization has the greatest influence. When dealing with the health and welfare of Americans, we can expect no less.

Additionally, this measure directs the IOM to examine nutrition programs run by the Federal Government, an important step to discern whether USDA, HHS, and other Federal agencies are properly conducting nutrition research.

While many factors contribute to this growing health crisis, the problem, in part, may be attributed to a lack of nutrition and fitness information available to the public, especially among low-income groups. This bill will help our communities to a better job of educating Americans about proper nutrition and the serious risks associated with obesity. The Federal Government can fund all the research that it wants, but that research will do no good unless it is properly communicated to the public.

This legislation empowers schools, local and State governments, and employers, through grant programs, to establish obesity-prevention initiatives. We can only limit the prevalence of obesity in America by empowering the individual through grassroots and community programs to change their eating and exercise behaviors. Obesity is not only a preventable disease, it is a curable disease. By encouraging more physical activity and better eating habits, we can help reduce the size of waistbands in America and help curb heart disease, type II diabetes rates, and other obesity-related diseases.

In communities at risk for poor nutrition, this legislation provides grant funding to help promote the consumption of foods that are consistent with the Dietary Guidelines and to promote water as the main daily drink choice for people. The measure provides grants to train health professionals and health science students in identifying, preventing, and treating obesity-related conditions.

With 64 percent of the people in our country classified as overweight or obese, it is obvious that the Dietary Guidelines and Federal nutrition monitoring programs have failed. I thank Senator KENNEDY for joining me today to introduce the Healthy Lifestyles Act of 2004. We owe it to the American people to disseminate unbiased, sound, scientific nutrition information. I urge
my colleagues to support this important piece of legislation.

I ask unanimous consent that the text of the bill be printed in the RECORD.

S. 2399

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the "Healthy Lifestyles Act of 2004".

SEC. 2. ACTIVITIES RELATING PHYSICAL ACTIVITY.

Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) is amended by adding at the end the following:

"SEC. 399O. INCREASING PHYSICAL ACTIVITY.

"(a) IN GENERAL.-The Secretary, in collaboration with the Director of the Centers for Disease Control and Prevention, the
Secretary of Education, the Secretary of Labor, and the Director of the Federal Highway Administration, shall establish and implement activities for the purpose of increasing physical activity in schools, worksites, and communities.

"(b) SCHOOLS.-The Director of the Centers for Disease Control and Prevention, in collaboration with the Secretary of Education shall award grants to public elementary and secondary schools for programs that support-

"(1) the provision of daily physical education for students in kindergarten through grade 12 through programs that are consistent with the Guidelines for Physical Activity as reported by Centers for Disease Control and Prevention and the American College of Sports Medicine and National Physical Education Standards;

"(2) the implementation of comprehensive school curricula and school-based physical activity programs that provide education about lifelong physical activity;

"(3) training for school personnel that provides the knowledge and skills needed to effectively teach lifelong physical activity; and

"(4) evaluations of school physical education programs and facilities at annual intervals to determine the extent to which national guidelines described in paragraph (1) are met.

"© WORKSITES.-The Director of the Centers for Disease Control and Prevention and the Secretary of Labor, shall award grants to eligible entities as determined by the Director, which may include labor organizations, trade associations, trade groups, and businesses for the establishment of projects that include-

"(1) the development of activity friendly worksites (which may include the provision of facilities for physical activity, accessible and attractive stairwells, walking trails, and supportive management practices) that encourage employee participation in physical activity;

"(2) the development of worksite wellness programs that improve physical activity by increasing the knowledge, attitudes, skills, and behaviors of employees; and

"(3) the development of employee incentive programs (such as cafeteria discounts, health club memberships, small cash bonuses, and time off) to increase the participation of employees in worksite health promotion programs that increase physical activity.

"(d) COMMUNITIES.-The Director of the Centers for Disease Control and Prevention, the Secretary of Transportation, and Secretary of the Interior shall award grants for the implementation and evaluation of activities that may include-

"(1) projects to design pedestrian zones and construct safe walkways and cycling paths;

"(2) projects that create greenways and open-space areas linking parks, nature preserves, and cultural or historic sites with each other and with populated areas such as residential communities and business locations;

"(3) initiatives to increase the use of walking and bicycling as a transportation mode by creating or enhancing informational outreach to parks or community recreation centers; and

"(4) community-wide campaigns designed to increase physical activity as part of multicomponent efforts that include strategies such as support of self help groups, physical activity counseling, risk factor screening and education, and environmental or policy changes such as the creation of walking trails.

"(g) EVALUATION.-Not later than 2 years after the date on which a grant is awarded under this section, the grantee shall submit to the Director of the Centers for Disease Control and Prevention a report that describes the activities carried out with funds receive under the grant and the effectiveness of such activities in increasing physical activity.

"(g) AUTHORIZATION OF APPROPRIATIONS.-There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2005 through 2009.".

SEC. 3. IMPROVING NUTRITIONAL INTAKE.

Section 301 of the The National Nutrition Monitoring and Related Research Act of 1990 (7 U.S.C. 5341) is amended to read as follows:

"SEC. 301. DIETARY GUIDELINES.

"(a) IN GENERAL.-Not later than 3 months after the date of enactment of the Healthy Lifestyles Act of 2004, and at least every
5 years thereafter, the Secretary of Health and Human Services shall enter into a contract with the Institute of Medicine for the development and publication of a report containing the 'Dietary Guidelines for Americans'.

"(b) GUIDELINES.-Each report under subsection (a) shall-

"(1) be complete within 1 year of the date on which the contract was entered into under such subsection for such report; and

"(2) contain-

"(A) an evaluation of scientific and medical knowledge relating to healthy diets and nutrition;

"(B) dietary guidelines for Americans, with specifications for different ages and other segments of the population as determined appropriate by the Institute of Medicine.

"© SUBMISSION.-The Institute of Medicine shall submit a final report under each contract under subsection (a) to the Secretary of Health and Human Services, appropriate committees of Congress, and the general public.

"(d) USE.-The Secretary of Health and Human Services shall ensure that dietary guidelines established under this section serve as the basis of any food, nutrition or health program conducted or operated by each Federal health agency.

"(e) FOOD GUIDE PYRAMID.-In accordance with the dietary guidelines published in the report under subsection (b), the Secretary shall publish revisions to the guide commonly known as the 'food guide pyramid' or any successor to such guide.".

SEC. 4. IMPROVING THE USE OF DIETARY INFORMATION AND GUIDELINES.

(a) IN GENERAL.-The Secretary of Health and Human Services shall enter into a contract with the Institute of Medicine for the conduct of a study and the making of recommendations concerning the implementation and dissemination of dietary information and nutrition guidelines.

(b) CONTENT.-The recommendations made under subsection (a) shall address the following:

(1) The implementation of nutrition guidelines and dietary information in Federal programs.

(2) The dissemination of nutrition guidelines and dietary information to the public.

(3) The coordination, collaboration, and integration of nutrition activities within and across the Federal agencies and programs.

(4) A means for ensuring scientific integrity in the implementation and dissemination of dietary information and nutrition guidelines.

(5) A means for evaluating the impact of nutrition guidelines and dietary information.

(6) Other issues determined appropriate by the Institute of Medicine.

© SUBMISSION.-Not later than 1 year after the date of enactment of this Act, the Institute of Medicine shall submit to the Secretary of Health and Human Services, the appropriate committees of Congress, and the public, a report that contains the findings of the study and recommendations under subsection (a).

(d) IMPLEMENTATION.-

(1) IN GENERAL.-Not later than 1 year after the submission of the report under subsection ©, the Secretary of Health and Human Services, in collaboration with the Secretary of Agriculture, shall prepare and publish a plan relating to the strategy of the Secretary to implement the recommendations made pursuant to subsection (a).

(2) PUBLIC COMMENT.-The Secretary of Health and Human Services shall request public review and comment during the development of the plan under paragraph (1). The final plan shall describe the comments received and how comments were incorporated into the plan.

(3) IMPLEMENTATION REPORTS.-Not later than 3 years after the date of enactment of this Act, and biennially thereafter, the Secretary of Health and Human Services shall evaluate and report to Congress on the efforts of the Department of Health and Human Services to implement the recommendations made pursuant to subsection (a).

SEC. 5. INCREASING THE INTAKE OF NUTRITIONAL FOODS.

Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.), as amended by section 2, is further amended by adding at the end the following:

"SEC. 399P. INCREASING THE INTAKE OF NUTRITIONAL FOODS.

"(a) IN GENERAL.-The Secretary, in collaboration with the Director of the Centers for Disease Control and Prevention, the Secretary of Education, and the Secretary of Agriculture, shall establish and implement activities to improve the consumption of nutritional foods (such as fruits and vegetables, and foods that are low in fat, sugar, and salt) in communities.

"(b) COMMUNITIES.-The Secretary, acting through the Director of the Centers of Disease Control and Prevention, shall award grants for projects that-

"(1) implement campaigns, in communities at risk for poor nutrition, that are designed to promote the intake of foods consistent with established dietary guidelines through the use of different types of media including television, radio, newspapers, movie theaters, billboards, and mailings;

"(2) implement campaigns, in communities at risk for poor nutrition, that promote water as the main daily drink choice through the use of different types of media including television, radio, newspapers, movie theaters, billboards, and mailings;

"(3) conduct outreach to commercial food establishments, grocery stores, and other food suppliers, to increase the availability and accessibility of healthy foods and beverages;

"(4) partner with national programs that provide parents and mentors with the skills to help guide and influence healthy meals and snack selections for children and adolescents; and

"(5) partner with national afterschool and summer programs that provide children with the education and skills needed to make healthy meal and snack selections.

"© HEALTH PROFESSIONALS.-The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall award grants to-

"(1) support the development, implementation, and evaluation of curricula to educate and train health professionals about effective nutrition education and counseling strategies for obese individuals and parents of overweight children, with emphasis on the Dietary Guidelines for Americans or other nationally accepted standards; and

"(2) use information technology to develop, implement, and evaluate the effectiveness of dietary counseling in health care settings.

"(d) EVALUATION.-Not later than 12 months after the date on which a grant is awarded under this section, the grantee shall submit to the Director of the Centers for Disease Control and Prevention a report that describes the activities carried out with funds received under the grant and the effectiveness of such activities in improving the intake of nutritional foods.

"(e) AUTHORIZATION OF APPROPRIATIONS.-There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2005 through 2009.

SEC. 6. FEDERAL OBESITY PREVENTION AND CONTROL ACTIVITIES.

Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.), as amended by section 5, is further amended by adding at the end the following:

"SEC. 399Q. FEDERAL OBESITY PREVENTION AND CONTROL ACTIVITIES.

"(a) IN GENERAL.-The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall directly or through a grant to an eligible entity, conduct, support, and promote the coordination of research, investigations, demonstrations, training, and studies relating to the prevention, control, and surveillance of obesity.

"(b) DUTIES OF THE SECRETARY.-The activities of the Secretary under subsection (a) shall include-

"(1) the collection, publication, and analysis of data on the prevalence and incidence of obesity;

"(2) the development of uniform data sets for public health surveillance and clinical quality improvement activities;
"(3) the identification of evidence-based and cost-effective best practices for the prevention, diagnosis, management, and treatment of obesity;

"(4) research, including research on behavioral interventions to prevent obesity and on other evidence-based best practices relating to obesity prevention, diagnosis, management, and care; and

"(5) demonstration projects, including community-based programs of obesity prevention and control, and similar collaborations with academic institutions, hospitals, health insurers, researchers, health professionals, and nonprofit organizations.

"© TRAINING AND TECHNICAL ASSISTANCE.-With respect to the planning, development, and operation of any activity carried out under subsection (a), the Secretary may provide training, technical assistance, supplies, equipment, or services, and may assign any officer or employee of the Department of Health and Human Services to a State or local health agency, or to any public or nonprofit entity designated by a State health agency, in lieu of providing grant funds under this section.

"(d) OBESITY PREVENTION AND CONTROL RESEARCH AT THE CENTERS FOR DISEASE CONTROL AND PREVENTION CENTERS.-The Secretary shall provide additional grant support under this section for research projects at the Centers for Prevention Research of the Centers for Disease Control and Prevention to encourage the expansion of research portfolios at the Centers for Prevention Research to include obesity specific research activities related to the prevention and control of obesity.

"(e) AUTHORIZATION OF APPROPRIATIONS.-There are authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2005 through 2009.".

SEC. 7. STATE OBESITY PREVENTION AND CONTROL ACTIVITIES.

Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.), as amended by section 6, is further amended by adding at the end the following:

"SEC. 399R. STATE OBESITY PREVENTION AND CONTROL PROGRAMS.

"(a) IN GENERAL.-The Secretary shall award grants to eligible entities to provide support for comprehensive obesity prevention
and control programs and to enable such entities to provide public health surveillance, prevention, and control activities related to obesity.

"(b) ELIGIBILITY.-To be eligible to receive a grant under this section, an entity shall-

"(1) be a State or an Indian tribe; and

"(2) submit to the Secretary an application at such time, in such manner, and containing such agreements, assurances, and information as the Secretary may require, including a comprehensive obesity control and prevention plan that-
"(A) is developed with the advice of stakeholders from the public, private, and nonprofit sectors that have expertise relating to obesity prevention, control, and treatment;

"(B) is intended to reduce the morbidity of obesity, with priority on preventing and controlling obesity in at-risk populations and reducing disparities in obesity prevention, diagnosis, management, and quality of care in underserved populations; and

"© describes the obesity-related services and activities to be undertaken or supported by the entity.

"© USE OF FUNDS.-An eligible entity shall use amounts received under a grant awarded under subsection (a) to conduct, in a manner consistent with the comprehensive obesity prevention and control plan submitted by the entity in the application under subsection (b)(2)-

"(1) public health surveillance and epidemiological activities relating to the prevalence of obesity and assessment of disparities in obesity prevention, diagnosis, management, and care; and

"(2) public information and education programs.

"(d) AUTHORIZATION OF APPROPRIATIONS.-There are authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2005 through 2009.".

SEC. 8. STATE OBESITY PREVENTION AND CONTROL ACTIVITIES.

Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.), as amended by section 7, is further amended by adding at the end the following:

"SEC. 399S. COMPREHENSIVE OBESITY PREVENTION ACTION GRANTS.

"(a) IN GENERAL.-The Secretary shall award grants on a competitive basis to eligible entities to enable such eligible entities to assist in the implementation of a national strategy for obesity prevention and control.

"(b) ELIGIBILITY.-To be eligible to receive a grant under this section, an entity shall-

"(1) be a national public or private nonprofit entity; and

"(2) submit to the Secretary an application at such time, in such manner, and containing such agreements, assurances, and information as the Secretary may require, including a description of how funds received under a grant awarded under this section will-

"(A) supplement or fulfill unmet needs identified in the comprehensive obesity prevention and control plan of a State or Indian tribe; and

"(B) otherwise help achieve the goals of an obesity prevention strategic plan designated by the Secretary.

"© PRIORITY.-In awarding grants under this section, the Secretary shall give priority to eligible entities submitting applications proposing to carry out programs for preventing and controlling obesity in at-risk populations or reducing disparities in underserved populations.

"(d) USE OF FUNDS.-An eligible entity shall use amounts received under a grant awarded under subsection (a) for 1 or more of the following purposes:

"(1) To expand the availability of physical activity programs designed specifically for people with obesity.

"(2) To provide awareness education to patients, family members, and health care providers, to help such individuals recognize risk factors for obesity, and to address the control and prevention of obesity.

"(3) To decrease the long-term consequences of obesity by making information available to individuals with regard to obesity prevention.

"(4) To provide information on nutrition education programs with regard to preventing or mitigating the impact of obesity.

"(e) EVALUATION.-An eligible entity that receives a grant under this section shall submit to the Secretary an evaluation of the operations and activities carried out under such grant that includes an analysis of increased utilization and benefit of public health programs relevant to the activities described in subsection (d).

"(f) AUTHORIZATION OF APPROPRIATIONS.-There are authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2005 through 2009.".