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Childhood Obesity 2008

Childhood Obesity | 2008 Update of Legislative Policy Options

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Updated December 2008

Childhood obesity remains a pressing public health concern. Currently, 66 million Americans are overweight or obese. Over the past three decades, obesity rates have nearly tripled for children ages 2 to 5 (from 5 percent to 14 percent), more than tripled for youth ages 12 to 19 (from 5 percent to 17 percent), and more than quadrupled for children ages 6 to 11 (from 4 percent to 19 percent). Currently, approximately 12 million children and adolescents are obese, and almost 30 percent do not exercise three or more days per week.    

Being overweight puts children and teenagers at greater risk for developing type 2 diabetes, risk factors for heart disease at an earlier age, and other health conditions including asthma, sleep apnea, and psychosocial effects such as decreased self-esteem. In one large study, 61 percent of overweight 5- to 10-year-olds already had at least one risk factor for heart disease, and 26 percent had two or more risk factors for the disease. There is a 70 percent chance that an overweight adolescent will be overweight or obese as an adult. By adulthood, obesity-associated chronic diseases – heart disease, some cancers, stroke, diabetes – are the first, second, third, and sixth leading U.S. causes of death.

Moreover, obesity is costly.  Annual obesity-attributable U.S. medical expenses were estimated at $75 billion for 2003. Taxpayers fund about half of this through Medicare and Medicaid.  Fortunately, healthy eating and a physically active lifestyle can help children and adults achieve and maintain a healthy weight and reduce obesity-related chronic diseases.

In 2008, legislatures continued to be active in considering policy options to address the obesity epidemic. Aiming to start early to prevent the onset of chronic conditions, legislators considered a variety of policy approaches to facilitate opportunities for a healthier diet and more exercise beginning in childhood.

The table below provides an overview links to information on this page.  Detailed information and bill summaries for the variety of policy approaches considered in 2008 follows below the 50-state chart.

 

Body Mass Index (BMI) Legislation Diabetes Screening and Management Insurance Coverage for Obesity Prevention and Treatment Nutrition Education
Physical Activity or Physical Education in Schools Raising Awareness Recess at School School Nutrition Legislation
School Wellness Policies Task Forces, Commissions, or Studies Taxes and Tax Credits Trans Fat in School Foods
Other links for NCSL resources on legislative and policy options to address obesity      
 

 

 

 

 

50-State Legislation on Childhood Obesity Policy Options 2008

State

School Nutrition 

 

Nutrition Education

Body Mass Index (BMI) 

Physical Education, Physical Activity or Recess

Trans Fat in School Foods

Alabama

 Considered

Considered

 

Considered

 

Alaska

 

 

 

 

 

Arizona

 

 

 

Considered

 

Arkansas

 

 

 

 

 

California

Considered

 

 

 

Considered

 

Colorado

Enacted

 

Enacted

 

Enacted

 

Connecticut

Considered

 

 

 

 

Delaware

 

 

 

 

 

Florida

Considered

Considered

 

Enacted

 

Georgia

 

 

 

 

 

Hawaii

Considered

Considered

 

Considered

 

Idaho

Considered

 

 

 

 

Illinois

 

 

 

 

 

Indiana

 

 

 

 

 

Iowa

Considered

 

 

 

 

Kansas

 

 

 

Considered

 

Kentucky

 

 

 

Considered

 

Louisiana

 

 

 

 

Resolution adopted

Maine

Considered

 

 

 

 

Maryland

 

 

 

Enacted

 

Massachusetts

Enacted

Considered

 

Considered

 

Michigan

Enacted

 

 

Considered

 

Minnesota

Considered

 

 

Considered

 

Mississippi

 

 

 

 

Considered

 

Missouri

Considered

Considered

 

Considered, includes recess

 

Montana

 

 

 

 

 

Nebraska

 

 

 

 

 

Nevada

 

 

 

 

 

New Hampshire

Enacted

 

 

 

 

New Jersey

* Considered

 

 

Considered - Recess

 

New Mexico

Considered

 

 

 

Enacted

 

New York

 

 

Enacted

Considered

 

North Carolina

 

Considered

 

 

Considered

 

North Dakota

 

 

 

 

 

Ohio

Considered

 

Considered

 

Oklahoma

 

Enacted

Enacted

 

Enacted,

includes Recess

 

Oregon

 

 

 

 

 

Pennsylvania

 

 

 

 

 

Rhode Island

Considered

 

 

Considered

 

South Carolina

Considered

 

 

 

 

South Dakota

 

 

 

 

 

Tennessee

Enacted

 

 

 

Considered

Texas

*

Considered

 

 

 

Utah

 

 

 

 

 

Vermont

 

 

Enacted

 

 

Virginia

Enacted

 

 

Enacted

 

Washington

Considered

 

 

Considered

 

West Virginia

Considered

 

 

 

 

Wisconsin

 

 

 

 

 

Wyoming

                         

Data Source: National Conference of State Legislatures, 2008    *Standards also implemented by state's agriculture department

School Nutrition Legislation

In 2008, at least 23 states considered some type of school nutrition legislation: Alabama, California, Colorado, Connecticut, Florida, Hawaii, Idaho, Iowa, Maine, Massachusetts, Michigan, Minnesota, Missouri, New Hampshire, New Jersey, New Mexico, North Carolina, Rhode Island, South Carolina, Tennessee, Virginia, Washington and West Virginia.  Of those states, at least six enacted new or additional policies or studies designed to help ensure that students have access to healthier food and beverage options at school.  Enacting states were Colorado, Massachusetts, Michigan, New Hampshire, Tennessee and Virginia.  Enacted legislation is summarized below.

Summaries of Enacted 2008 School Nutrition Legislation:

Colorado
SB 129 (2008, Enacted) - Requires each school district board and the State Charter Institute by Sept. 1, 2008, to adopt and implement a beverage policy that prohibits the sale of certain beverages to students without first establishing nutritional guidelines; creates an exception for beverages sold during specified school events; and specifies maximum portion sizes for beverages sold at elementary, middle and high schools.
 
Massachusetts
HB 4900 (2008, Enacted) - Appropriates $150,000 for the Childhood Obesity School Nutrition Project to initiate or maintain school lunch programs that can help diminish the epidemic of childhood obesity. Allows food service providers working with public schools to institute or maintain a school nutrition program designed to reduce childhood obesity to submit an application to the department indicating the nutritional and educational steps the school plans to implement with the grant, not to exceed $10,000 per school per year.

Other school nutrition policy actions: 

  • Farm-to-school Policies - Policies that make it easier for school food services to purchase local fresh foods for students are a new approach that is gaining momentum in many states. Statewide farm-to-school programs provide students with fresh food, increase their knowledge of nutrition and agriculture, and offer new markets for local agriculture.  Most of the statewide farm-to-school programs in 17 states were created legislatively with overwhelming bipartisan support. In addition, more than 2,000 local farm-to-school programs operate in 39 states. In 2008, 13 states introduced farm-to-school legislation, as updated on NCSL's database for healthy community design and access to healthy foods.
  • School Wellness Policies - Beginning with the 2006-2007 school year, federal law requires all schools participating in federal school meals programs--nearly every school district in the country--to develop a local school wellness policy.  Policies must include nutrition guidelines for all foods available on school campuses during the school day, with the goal of promoting student health and reducing childhood obesity. (The federal law is the Child Nutrition and WIC Reauthorization Act of 2004, Public Law 108 - 265.)  See below for a summary of state legislation on school wellness policies.
  • Regulatory Action - New Jersey implemented school nutrition standards through its department of agriculture under the governor’s direction in 2005, effective for the 2007-2008 school year.  In January 2007, the legislature codified the nutrition standards into law, effective September 1, 2007. In Texas, a public school nutrition policy became effective August 1, 2004 under the auspices of the state’s agriculture commissioner, who was authorized by the governor to administer the state’s National School Lunch Program, School Breakfast Program, and After School Snack Program. 

Additional policy approaches that states have considered to address childhood obesity in 2008 include nutrition education or wellness initiatives in schools, body mass index measurement and reporting the information confidentially to parents, enchancing physical education programs or providing opportunities for physical activity or recess during the school day, providing information on the nutrition content of school foods, and addressing the needs of diabetic students.  

The listing of bills below may not be comprehensive, but provides an overview of other policy approaches considered during the 2008 legislative session.  Bill numbers are included, allowing for retrieval of the full bills for further information. The proposed legislation has not become law, unless otherwise noted.  This document is not intended as an endorsement or recommendation of any specific legislation.  

 
Michigan
HB 6365 (2008, Enacted) - Relates to school district and public school academy purchases. Increases the sum that can be expended in a single transaction for purchasing food without requiring competitive bidding, and specifies a sum that can be expended on food in a single transaction without requiring a competitive bid.
 
HB 6366 (2008, Enacted) - Relates to intermediate school district purchases. Increases the sum that can be expended in a single transaction for purchasing food without competitive bidding; specifies the sum that can be expended on food in a single transaction without requiring a competitive bid.
 
HB 6368 (2008, Enacted) - Requires the State Department of Education to investigate the potential of various procurement procedures and tools for school authorities to purchase local farm products; educate food service directors on the small purchase threshold and other such procedures and promote their use for farm to school initiatives; implement food preparation training for food service staff workers; and encourage inclusion of local farmers, processors and suppliers when taking bids for farm products.
 
New Hampshire
HB 1422 (2008, Enacted) - Establishes the multi-disciplinary Commission on the Prevention of Childhood Obesity. Requires the commission to identify and consider legislative and policy strategies that can be effective in preventing childhood obesity in New Hampshire, including, among others, developing recommendations to help schools adopt and implement school nutrition standards.
 
Tennessee
SB 3341 (2008, Enacted) - Relates to nutritional breakfast and lunch programs. Provides that each local school board submit a plan for compliance that considers the availability and cost of local agriculture products; allows a flexible bidding process to help farmers bid on portions of a nutrition plan; and requires that the food meet or exceed food safety standards for commercial food
operations.
 
Virginia
HB 246 (2008, Enacted) - Requires the state Department of Education to develop and maintain a nutrition and physical activity best practices database that contains the results of any wellness-related fitness testing conducted by local school divisions and information on successful programs and policies implemented by local school divisions to improve nutrition and physical activity in the public schools. This information may include 1) program or policy description; 2) advice on implementation; 3) any program or policy assessment; 4) a local school division contact; and 5) other appropriate information. Database must be readily accessible to all local school divisions and the state Department of Health. Local school divisions are encouraged, but not required, to submit information to the database.

Body Mass Index (BMI) Legislation and Student Fitness Screening 

Among the proposed approaches to address obesity is student body mass index measurement. Body mass index is a measure of whether a person’s weight is healthy in proportion to height. For children, the calculations also take into consideration age and gender to account for “baby fat.” Body mass index is widely accepted as a reliable indicator of body fat content and a screening tool for weight categories that may lead to health problems. The ease of measuring height and weight, without using expensive equipment, makes body mass index screening convenient. Schools provide a convenient screening site because virtually all children can participate. Screenings at schools can help motivate families to adopt healthier habits that can reduce childhood obesity, especially when results are clearly explained to parents and suggestions for making healthy changes are communicated. When obesity-related health risks are identified, screening reports also should provide parents with information about how to seek further evaluation and appropriate follow-up.

In 2008, at least 8 states considered legislation related to student body mass index or fitness screening including Florida, Georgia (fitness screening), Maryland, Minnesota, New Jersey, New York, Oklahoma and Vermont. Of those states, New York made an appropriation of $1,980,000 for expenses related to reporting body mass index on school physical forms, and two states, Oklahoma and Vermont, passed legislation in 2008 that will require the development of student body mass index (BMI) screening tools.  Oklahoma's requirement is part of a more comprehensive student fitness assessment. In addition, in 2008, Maryland legislators established a multi-disciplinary committee on childhood obesity to provide recommendations to the governor and the General Assembly on topics including methods to increase the rate of obesity screening for children.  

As of December 2008, states that have required some type of student BMI reporting are Arkansas, California (pilot program for diabetes risk assessment that included BMI measurement was replaced by statewide distribution of diabetes risk information in 2008), Delaware (piloting BMI as part of student fitness testing), Florida, Illinois, Iowa (pilot program to track student height and weight), Missouri (required aggregate screening results), New York (requires school entry health certificates to include information about the student's body mass index), Pennsylvania, South Carolina (phasing in student fitness testing), Tennessee, Texas (screening as part of a student risk assessment program for Type 2 diabetes in selected regions of the state) and West Virginia.  Some of these state requirements are aggregate BMI data reporting requirements, rather than requirements for individual BMI reports to parents. The Arkansas, California, Delaware, Missouri, South Carolina, Tennessee and West Virginia requirements were enacted legislatively. In Pennsylvania and Florida, state health departments require measuring BMI as part of annual student growth screenings. In Arkansas, the first state to enact BMI legislation in Act 1220 of 2003, legislation was enacted in 2007 to change the frequency of BMI screening from annual to every other year and to allow parents to submit a written refusal for their child to participate in BMI screening to the child's school. California enacted legislation in 2003 (AB 766, Cal. Ed. Code §49452.6) that required non-invasive screening of 7th grade (female) and 8th grade (male) students for type 2 diabetes risk including measurement of body mass index as one of four diabetes risk factors and the pilot program was renewed to 2008 when it was replaced by statewide distribution of diabetes risk information. 

Existing BMI requirements as of December 2008 - The following states currently have some type of student BMI reporting or fitness screening in effect:

Arkansas 
AR HB 1173 (2007, enacted) - Changes student BMI screenings to every other year, beginning in kindergarten and then in even numbered grades. Permits any parent to refuse to have their child's body mass index percentile for age assessed and reported, by providing a written refusal to the school.  Exempts students in grades 11 and 12 from BMI requirements. (Arkansas Act 1220 of 2003 required annual body mass index (BMI) screenings for all public school students, with the results reported to parents confidentially by letter via U.S. mail, as part of a more comprehensive approach that halted the increase of childhood obesity in the state.)  Assigns all community health nurses under its supervision to work with schools to assure that body mass index for age assessment protocols are followed by school employees or their designees who conduct body mass index for age assessments and other student health screenings.

California- Commencing July 1, 2010, statewide distribution of diabetes risk information to school children (California Education Code § 49452.7) will replace individual student BMI reports to parents via confidential letter as part of a non-invasive diabetes screening pilot program for 7th and 8th graders (California Education Code § 49452.6).

Delaware 
DE HB 372 (2006, enacted, Volume Chapter 75:409) -
The state is piloting a new law that requires physical fitness testing for students and includes measuring BMI as part of the testing in some local school districts.  The law requires the Department of Education to develop a regulation requiring each local school district and charter school to assess the physical fitness of each student at least once at the elementary, middle and high school level and outlining the grades at which the assessment will be given.  The assessment results are to be provided to the parent, guardian or relative caregiver.  The intent is to provide baseline and periodic updates for each student and his or her parent, guardian or relative caregiver sharing in the knowledge of obesity and other chronic illnesses.

Florida - Florida Statute § 381.0056(5) requires school health services programs administered jointly by the Department of Health and the Department of Education to administer growth and development screening for students.  BMI is encouraged as part of these screenings for all students in 1st, 3rd, 6th and, optionally, 9th grades.

Illinois - Illinois Administrative Code, Title 77, Subchapter i, Part 665, §665.710 and §665.720 requires that the results of a diabetes screening, including body mass index as one indicator of whether a child is overweight, be documented on the certificate of child health examination form for the required school health examination.  

Iowa
IA SB 2124 (2006, enacted, Chapter 135, §135.27) - Establishes a nutrition and physical activity community obesity prevention grant program, contingent upon the receipt of public health funding.  Funding has been allocated as of July 2006.  Pilot program activities in six locations selected to receive grants must include measurement, reporting, and tracking of the height and weight of students in elementary schools.

Missouri - The state's legislatively established Model School Wellness Program, funded by Child Nutrition and WIC Reauthorization federal grant money, created pilot programs in school districts encouraging students to avoid tobacco use, balance their diets, get regular exercise, and become familiar with chronic conditions resulting from being overweight. A required evaluation after the 2005-2006 school year was to include aggregate data on changes in body mass index and measurement of changing behaviors related to nutrition, physical activity and tobacco use. MO HB 568T, enacted 2005.

New York 
NY AB 4308 (2007, enacted, same as SB 2108 C) - Among other provisions in this budget bill, requires school entry health certificates to include the student's body mass index (weight in kilograms divided by the square of height in meters or weight in pounds divided by the square of height in inches multiplied by a conversion factor of 703) and weight status category as defined by the commissioner of health.

NY SB 6804 (2008, enacted, Chapter 54) - Among other provisions, makes an appropriation of $1,980,000 to pay for expenses related to reporting body mass index on school entry physical forms.

Oklahoma  
OK SB 519 (2008, enacted, Chapter 342) - Directs the state's departments of education and health to facilitate development of a physical fitness assessment software program customized for public schools with the capability to track the five components of student health-related physical fitness, including: 1. aerobic capacity; 2. muscular strength; 3. muscular endurance; 4. flexibility; and 5. a weight status assessment that includes measurement of height and weight, calculation of body mass index (BMI) for age, and plotting of these measures on standard growth charts. Requires the software program to have the capability of creating a confidential individual student report for parents that includes an explanation of the data. In addition, requires the software program to be developed and made accessible to school districts at no cost.

Pennsylvania - The state's health department requires school nurses to compute body mass index - height-to-weight ratio - for students in grades one through eight during annual growth screenings. BMI measurement will be required for students in all grades the 2007-2008 school year. Parents receive letters about the BMI results that encourage them to share the information with their family physician.

South Carolina
SC HB 3499 (2005, enacted) - South Carolina's legislature passed the Student Health and Fitness Act in the spring of 2005.  Among other provisions related to student health, nutrition, physical education and fitness, the law requires all K-12 schools in the state to participate in the South Carolina Physical Education Assessment and requires that fitness reports be sent home to parents in the 5th and 8th grades and high school.  Body mass index screening is not specifically mentioned in the legislation.

Tennessee - The state requires reporting student BMI to parents as part of a confidential health report card and providing parents with basic information about what BMI means and what they can do with this information. TN HB 445, enacted 2005, now Public Chapter 194.

Texas 
SB 415 (2007, enacted, Chapter 95, HB1363-identical companion bill) - Establishes a student risk assessment program for type 2 diabetes in certain regions of the state that includes screening of body mass index for students identified by a noninvasive screening as at risk for type 2 diabetes.

Vermont  
VT HB 887 (2008, enacted, Act 203) - Requires the commissioner of health, among other items, to develop a plan for promoting measurement and tracking of body mass index (BMI) percentile for children and adolescents, such as through the collection of data relating to BMI, lack of physical exercise, and inappropriate diet and eating habits using the ICD-9-DM V-codes in the ninth edition of International Classification of Disease Codes.

West Virginia
WV SB 785 (2006, enacted, Chapter 73) - Changes the state's current BMI measurement policy by requiring that only a scientifically valid sample of students be assessed. Student confidentiality is protected and all body mass index data is reported in aggregate to the governor, the State Board of Education, the Healthy Lifestyles Coalition and the Legislative Oversight Commission on Health and Human Resource Accountability. 

Diabetes Screening and Management at School 

As the number of obese and overweight children continues to rise, Type 2 diabetes (formerly called adult-onset diabetes) is increasingly being diagnosed in children and adolescents. As a result, states are beginning to grapple with the health implications of diabetes in children attending school.  Some have passed legislation to require risk screening for the disease for school children.  Others have created policies to facilitate responding to diabetic students while limiting the liability of caregivers and schools.

Risk Screening - In 2008, at least 2 states considered legislation to require non-invasive screening, risk analysis or testing of school children for diabetes, including Missouri and New York. Student diabetes risk screening legislation was enacted in 2007 in Texas and proposed in Massachusetts and Pennsylvania.  Existing law requires non-invasive student diabetes risk screening as a regional pilot program in Texas and statewide in Illinois.  California legislation that required non-invasive screening of students in specific pilot locations for risk of type 2 diabetes was in effect 2003-2008 (California Education Code § 49452.6); the law expired in 2008 but will be replaced by statewide distribution of diabetes risk information to students commencing July 1, 2010 (California Education Code § 49452.7).

Student Diabetes Care - Legislation providing for student diabetes care or self-care at school or permitting medication administration by, and/or liability protections for, school personnel responding to diabetic students was considered in at least 9 states in 2008, including Arizona, California, Illinois, Michigan, New Jersey, Pennsylvania, Rhode Island, South Dakota and Virginia; enacted in at least 3 of those states including Arizona, Rhode Island and Virginia; and remains pending in New Jersey. In 2007, Indiana enacted legislation related to school diabetes care. Laws enacted in 2005 and 2006 in Nebraska, Tennessee, Texas, Utah, and West Virginia also facilitate at-school care for children with type 2 diabetes.  A California lawsuit settled in August 2007 interprets federal laws that guarantee equal educational opportunities for children with disabilities to require schools to have personnel trained and available to assist diabetic students. State legislation for student diabetes care enacted in 2006 through 2008 is summarized below.

Arizona
AZ SB 1229, (2008, enacted, Chapter 31) - Relates to policies and procedures adopted by a school district or charter school for diabetes management and administration of glucagon to diabetic pupils in school classrooms, on school grounds, and at school sponsored activities; relates to designation by a school district or charter school of school employees as voluntary diabetes care assistants and specifies that those employees shall be a properly trained school nurse or licensed health care professional; provides for immunity from liability.

Indiana 
IN HB 1116, (2007, enacted, P.L. 166-2007, Indiana Code 20-34-5 et. seq.) - Requires that a diabetes management and treatment plan be prepared and implemented for a student with diabetes for use during school hours or at a school related activity. The plan must be developed by: (1) the licensed health care practitioner responsible for the student's diabetes treatment; and (2) the student's parent or legal guardian. It must (1) identify the health care services or procedures the student should receive at school; (2) evaluate the student's ability to manage and level of understanding of the student's diabetes; and (3) be signed by the student's parent or legal guardian and the licensed health care practitioner responsible for the student's diabetes treatment.  Establishes a training program for school nurses and for school employees who volunteer to assist students with diabetes in managing and treating the diabetes.

Nebraska
NE LB 1107, (2006, enacted, Section 79-225) - Relates to schools; provides for student self-management of diabetes at school and school-related activities; requires a written request from a parent or guardian; limits school liability.

New Jersey
NJ AB 267, SB 2426 (2008-2009, identical, pending) - Relates to diabetes care at school and on school buses. Would authorize parents or guardians to request use of individualized health care plan and emergency health care plan for students with diabetes and provide for the emergency administration of glucagon for certain students. Would provide libability protections for school personnel who act in a reasonably prudent manner to care for diabetic students.

Rhode Island 
RI HB 7014a, (2008 enacted, Chapter 2008-243) - Requires school departments to develop policies and procedures for administering glucagon injections to diabetic students in the event of an emergency, includes parent authorization and training of school personnel.

Tennessee
TN SB 2658, HB 3870 (2006 enacted, Public Act, Chapter 542)
- Allows for students with diabetes to perform blood glucose checks, administer insulin, treat hypoglycemia and hyperglycemia, and otherwise attend to the care and management of the student's diabetes in any area of the school or school grounds and at any school- related activity. Clarifies that students are permitted to possess on the student's person at all times all necessary diabetes monitoring and treatment supplies.
 

Texas 
SB 415 (2007, enacted, Chapter 95, HB1363-identical companion bill) - Establishes a student risk assessment program for type 2 diabetes in certain regions of the state that includes screening of body mass index for students identified by a noninvasive screening as at risk for type 2 diabetes.

Utah
UT SB 8 (2006 enacted, Session Law Chapter 215) - For the care of students with diabetes in school, directs public schools to train school personnel who volunteer to be trained in the administration of glucagon in an emergency and permits a student to possess or possess and self-administer diabetes medication, when requested by parents.

Virginia 
VA HB 1445, SB 271 (2008 enacted, Chapter 85; identical SB 271, 2008 enacted, Chapter 694) - Both authorize the administration of prescription drugs by a person who has completed an approved training program to a resident of a private children's residential facility and licensed by the Department of Social Services, Department of Education, or Department of Mental Health, Mental Retardation and Substance abuse Services, or a student in a school for students with disabilities and license by the Board of Education; provided that the person administering the drugs (i) has satisfactorily completed a training program for this purpose approved by the Board of Nursing; (ii) administers such drugs in accordance with the physician’s instructions pertaining to dosage, frequency, and manner of administration; and (iii) complies with regulations promulgated by the Board of Pharmacy relating to security and record keeping.

West Virginia
WV HB 2548 (2006 enacted, Chapter 66) - Relates to the establishment of individual diabetes care plans for students with diabetes by county boards of education; requires the State Board of Education to adopt guidelines for the development and implementation of such plans; requires each county board of education to adopt such a plan meeting those guidelines; requires the state board to report to the Legislature regarding the adoption of the guidelines and the establishment of such plans by county boards.

 Insurance Coverage for Obesity Prevention and Treatment

Maryland requires insurers to cover morbid obesity treatment including surgery, while Georgia, Indiana and Virginia require private insurers to offer general coverage for morbid obesity as an option.  No additional laws requiring insurance coverage for obesity prevention or treatment were enacted in 2008, although legislation regarding obesity and insurance coverage was considered in 2008 in at least three states including Kansas, Louisiana and Missouri, and in 2007 in at least seven states including Illinois, Missouri, New Jersey, Oregon, Pennsylvania, Tennessee and Utah. Most of this legislation would have provided or strengthened private insurance coverage for obesity prevention or treatment, especially for the morbidly obese (those with a body mass index of 40 or higher), without specific reference to childhood obesity treatment. However, Louisiana legislation proposed in 2008 would have required Medicaid coverage for the treatment of obesity in children, while Illinois legislation proposed in 2007 would have established a weight loss and management pilot program in partnership with a private entity specializing in weight loss and weight control for individuals enrolled in the state's Covering ALL KIDS health insurance program or the Medicaid program.  Tennessee's proposed law would have required insurers to provide non-obese premium discounts to insureds. Information summaries for those three unique bills are reported below. As of July 2004, Medicare began to recognize obesity as a medical condition, opening the door to greater coverage for obesity treatments demonstrated as scientifically effective.

Louisiana
LA HB  12 41 (2008, proposed)
- Would have required Medicaid coverage for the treatment of obesity in children.

Illinois
IL SB 468 (2007, proposed)
- Would have amended the Covering ALL KIDS Health Insurance Act and the Illinois Public Aid Code to require the Department of Healthcare and Family Services to establish a weight loss and management pilot program in partnership with a private entity that specializes in weight loss and weight control for morbidly individuals enrolled in the Covering ALL KIDS health insurance program or the Medicaid program who demonstrated a commitment to weight loss.

Tennessee
TN HB 2220, SB 2315 (2007, proposed, bills identical, HB 2220 carried over to 2008) - Would have required insurers to provide non-smoking and non-obese premium discounts to insureds and mandated such discounts for state employees.

 Nutrition Education

Many states have school health education requirements, but in recent years legislators have considered or enacted bills specifically requiring nutrition education aimed at preventing childhood obesity as a component of school health curriculum or to train school personnel about child nutritionCalifornia, Colorado, Indiana, Louisiana, Maine, New Hampshire, South Carolina, Texas, Vermont and West Virginia currently have laws requiring some form of nutrition education in schools. Colorado enacted school wellness program legislation in 2008 that encourages expanded health education and nutrition services, while Oklahoma enacted an afterschool initiative to reduce childhood obesity to include evidence-based nutrition education. Other states that considered nutrition education legislation in 2008 include Alabama, California, Florida, Hawaii, Massachusetts, Missouri, Ohio and Texas; all as summarized below. 

Alabama
AL HB 767 (2008, proposed)
- Would have provided for the employment of a service center nutritionist in each of the 11 child nutrition service centers of the state to provide assistance and suggestions for improvement to local child nutrition program directors in menu development, food preparation, financial management, and the analysis of nutritional content based upon state and federal requirements. This bill would also require service center nutritionists to participate in inservice training for child nutrition program directors, child nutrition program staff, school administrators, and teachers.

California
CA AB 898 (2008, proposed)
- Would have required the state department of public health, until January 1, 2015, to establish and administer a pilot grant program to award 3-year grants to at least 3 but not more than 5 school health centers, as defined, that utilize the "Promotores de Salud" model, as defined, to administer a nutrition education and diabetes and obesity prevention program.

Colorado
CO HB 1224 (2008, enacted, Chapter 185)
- Encourages school districts to expand their local wellness policies to adopt goals for several areas emphasizing healthy choices and lifestyles, including increasing health education and nutrition services, as well as physical education and mental health counseling. Expands the Colorado Comprehensive Health Education Act to include local student wellness programs. Allows funding for local student wellness programs.

Florida
FL SB 1708 (2008, proposed)
- Would have enacted the "Florida Healthier Child Care and School Nutrition Act," to provide requirements for foods served in child care facilities and school food service programs. Would have required a school district's health education curriculum to include nutrition education. Would also have required a study by the Department of Agriculture and Consumer Services and the Department of Education of the fiscal impact of establishing a statewide Farm-to-School Program. 

Hawaii
HI HB 539, SB 1178 (2008, proposed, identical)
- Would have established public school nutrition standards and food service manager nutrition training requirements. Would have required the department of education to encourage schools to provide culturally appropriate nutrition education and farm-to-table education programs.

Massachusetts
MA HB 483 (2008, proposed)
- Would have directed the State Board of Education, in collaboration with the Department of Public Health to require school districts to convene a School Wellness Advisory Committee to develop and recommend a policy addressing school nutrition, nutrition education and physical activity, to be reviewed every three years.

Missouri
M0 HB 1834 (2008, proposed)
- Would have established the Missouri Commission on Prevention and Management of Obesity within the Department of Health and Senior Services, with duties including: (1) Collecting and analyzing data on the extent to which Missourians suffer from obesity and about the economic impact on the state for the failure to treat obesity; (2) Listing programs and services available to address the needs of overweight children and adults and identifying moneys. 

Ohio
OH HB341, SB 288 (2008, proposed, identical) -
Would have established the healthy farms and healthy school grant program for the purpose of providing grants to schools to establish nutrition education and agricultural education programs for kindergarteners.

Oklahoma
OK SB 1612 (2008, enacted) -
Noting that evidence-based nutrition education and increased physical activity are well-established means of addressing obesity, but that not all Oklahoma families are able to take advantage of opportunities to provide these benefits for their children; this bill creates the Oklahoma Quality Afterschool Opportunities Initiative to Reduce Childhood Obesity and Improve Academic Performance, to establish and maintain a program to award grants to comprehensive, community-based afterschool programs that include evidence-based obesity reduction components.

Texas 
TX SB 282 (2008, prefiled 11-12-08 for 2009) - Would direct the state's department of agriculture to award grants to public school campuses for best practices in nutrition education. Would allow the Department of Agriculture to solicit and accept gifts, grants, and donations from any public or private source for this purpose.

Physical Activity or Physical Education in Schools and Recess Legislation

Forty-nine states require physical education in schools, but the scope of the requirement varies greatly.  At least 23 states considered or enacted physical education or physical activity legislation or resolutions in 2008. Enacting states included Colorado, Florida, Maryland, New Mexico, Oklahoma and Virginia.  States that considered, but did not enact, new or additional legislation regarding physical education or physical activity in 2008 included Alabama, Arizona (governor vetoed a bill that would have prohibited eliminating physical education), California, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New York, North Carolina, Ohio, Rhode Island and Washington.

States also have considered legislation to preserve time for physical activity during the school day through recess.  Both the cost of physical education programs and an emphasis on academics have sometimes been considered barriers to increasing physical education in schools but recognition is growing that physical activity during the school day can increase student achievement.  Physical education and physical activity legislation that was enacted in 2008 is summarized below. Recess legislation is reported separately below
 

Arizona
AZ HB 2557 (2008, passed legislature, governor vetoed) -
 Would have prohibited school districts from eliminating or reducing instruction in physical education, the arts, music, career and technical or vocational education, unless necessary for budgetary reasons.       

Colorado
CO HB 1224 (2008, enacted, Chapter 185)
- Encourages school districts to expand their local wellness policies to adopt goals for, among other items, increasing the availability of courses in physical education and ensuring that, in school districts enrolling more than 1500 students, physical education classes are taught by persons licensed and endorsed to teach physical education.

Florida
FL SB 610 (2008, enacted, Chapter 94) -
Requires physical education in grades 6 through 8 beginning with the 2009-2010 school year at the equivalent of one class period per day of physical education for one semester each year.  For students in grade 6 who are enrolled in a school that contains one or more elementary grades, requires at least 30 consecutive minutes per day of physical education on any day during which physical education instruction is conducted.  Provides for waivers under certain circumstances and requires schools to notify parents of waiver options.

Maryland
MD HB 1411 (2008, enacted, Chapter 465)
- Requires schools to provide student with disabilities an equal opportunity to be included in mainstream physical education and mainstream athletic programs.

MD SB 955 (2008, enacted, Chapter 473) - Establishes a task force on student physical fitness in state public schools and provides that the task force shall study the advisability of requiring all public schools to provide a minimum amount of physical activity or education to students, the effects on childhood obesity and related health issues of such requirements, the costs of such requirements and how they may be minimized, and results obtained by local school systems in the state or other state that have such requirements.

New Mexico
NM H2 (2008, enacted, Chapter 3) -
Appropriates $8 million for the second year implementation of elementary physical education for students in kindergarten through sixth grade. 

NM S460 (2008, enacted, Chapter 21) - Adds a requirement for graduation for students entering the ninth grade beginning in the 2009-2010 school year of one unit in physical education. 

Oklahoma
OK HB 1186 (2007, enacted, Chapter 118) - Beginning with the 2008-2009 school year, requires school boards, as a condition of accreditation for public elementary schools, to provide students in full-day kindergarten and grades one through five an average of sixty (60) minutes each week of physical activity, which may include, but not be limited to, physical education, exercise programs, fitness breaks, recess, and classroom activities, and wellness and nutrition education. Each school district board of education shall determine the specific activities and means of compliance with the requirements, giving consideration to the recommendations of each school's Healthy and Fit Schools Advisory Committee to the school principal.

Virginia
VA HB 242 (2008, enacted, Chapter 661)
- Requires local school boards to provide a physical fitness program with a goal of 150 minutes per week for all students.

Recess Legislation Enacted in 2005-2008 

In 2008, state legislation regarding recess was enacted in Oklahoma and recess legislation or resolutions were considered in Missouri and New Jersey.  All recess legislation enacted from 2005 through 2008 is summarized below.  Legislation proposed in 2008, that remains pending in 2009, to establish a recess task force in New Jersey is also summarized below.

Arkansas
AR HR 1023 (2007, resolution adopted)
- Urges school districts to provide a mid-morning and mid-afternoon recess of at least ten minutes to all students in kindergarten through grade six.  Recognizes that recess creates a supportive environment for children and allows them to incorporate regular physical activity into their daily lives; recess provides children with discretionary time and opportunities to engage in physical activities that lead to healthy bodies and enjoyment of movement; recess results in enhanced cognitive abilities and facilitates improved attention in the classroom; recess is an essential component in the development of interpersonal communication skills, as it provides an unstructured environment in which children can interact with one another; and recess is an avenue for creativity which in turn leads to the ability to think "outside the box" and develop stronger thinking skills.

Connecticut
CT Senate Substitute Bill 204, (2006, enacted, Public Act 06-44)
- Requires the Connecticut department of education to develop guidelines for addressing the physical health needs of students that include, among other things, plans for engaging students in daily physical exercise during regular school hours.  (Note - the bill doesn't use the word "recess" or specify a certain number of minutes.)
 

Indiana
IN SB 111 (2006, enacted, Public Law 54)
- Beginning with the 2006-2007 school year, requires the governing body of each school corporation to provide daily physical activity for students in elementary school. The physical activity must be consistent with the curriculum and programs developed under IC 20-19-3-6 and may include the use of recess. On a day when there is inclement weather or unplanned circumstances have shortened the school day, the school corporation may provide physical activity alternatives or elect not to provide physical activity.

New Jersey
NJ AB 1601, SB 226 (2008-2009, pending, identical) -
Both bills would establish a task force to study the benefits of student recess and make recommendations on the advisability of mandatory recess in school districts.

Oklahoma
OK HB 1186 (2008, enacted, Chapter 118)
- Beginning with the 2008-2009 school year, requires school boards, as a condition of accreditation for public elementary schools, to provide students in full-day kindergarten and grades one through five an average of 60 minutes each week of physical activity. Allows for this physical activity to include, but not be limited to, physical education, exercise programs, fitness breaks, recess, and classroom activities, and wellness and nutrition education. Each school district board of education shall determine the specific activities and means of compliance with the requirements, giving consideration to the recommendations of each school's Healthy and Fit Schools Advisory Committee to the school principal.

OK HB 1601 (2007, enacted - OS 70-11-103.9) - Creates the "Fit Kids Physical Education Task Force" regarding school physical education. Also strongly encourages school districts to incorporate physical activity into the school day by providing to students in full-day kindergarten and grades one through five at least a twenty-minute daily recess, which shall be in addition to the 60 minutes of required physical education, and by allowing all students brief physical activity breaks throughout the day, physical activity clubs, and special events.

South Carolina
HB 3499 (2005, enacted, Act 102) - As part of bill phasing in physical education standards statewide, provides that each elementary school shall designate a physical education teacher to serve as its physical education activity director. The physical education activity director shall plan and coordinate opportunities for additional physical activity for students that exceed the designated weekly student physical education instruction times that may include, but not be limited to, before, during, and after school dance instruction, fitness trail programs, intramural programs, bicycling programs, walking programs, recess, and activities designed to promote physical activity opportunities in the classroom.

Texas
SB 42 (2005, enacted) - Encourages school districts to promote physical activity for children through classroom curricula for health and physical education.  Allows the state board of education, by rule, to require students in kindergarten to grade nine to participate in up to 30 minutes of daily physical activity as part of a school district's physical education curriculum, through structured activity or during a school's daily recess. Provides for consultation with educators, parents, and medical professionals to develop physical activity requirements.

 School Wellness Policies

 

The federal Child Nutrition and WIC Reauthorization Act of 2004 (Public Law 108 - 265) required each local school district participating in the National School Lunch and/or Breakfast Program to establish a local wellness policy by the beginning of the 2006-2007 school year. School districts were required to involve a broad group of stakeholders in developing wellness policies and set goals for nutrition education, physical activity, campus food provision, and other school-based activities designed to promote student wellness. Plans for measuring policy implementation were required to be included. In 2008, statewide legislation in support of wellness policies or related school health efforts was enacted in Colorado and considered in at least 10 other states including Florida, Georgia, Kansas, Maryland, Massachusetts, Missouri, New York, Ohio, Virginia and Washington.   Previously, in 2007, Mississippi enacted comprehensive school wellness legislation.  Colorado's enacted 2008 legislation and Mississippi's enacted 2007 legislation is summarized below. In 2006, at least eight states, Delaware, Florida, Indiana, Kentucky, Mississippi, Oklahoma, Pennsylvania and Tennessee enacted state-level legislation related to wellness policies as reported on NCSL's 2006 Childhood Obesity Policy Options web page. Legislators also have acted on individual policies that are part of school wellness goals, such as improving the nutritional quality of school foods, providing greater opportunities for physical activity, and ensuring that adequate nutrition education is part of the school curriculum, as reported separately on this web page. Additional information about federal wellness policy requirements can be found on the U.S. Department of Agriculture web site at:

http://www.fns.usda.gov/tn/Healthy/wellnesspolicy.html
 
Colorado
CO HB 1224 (2008, enacted, Chapter 185)
- Encourages school districts to expand their local wellness policies to adopt goals for several areas emphasizing healthy choices and lifestyles, including increasing health education and nutrition services, as well as physical education and mental health counseling. Expands the Colorado Comprehensive Health Education Act to include local student wellness programs. Allows funding for local student wellness programs

Mississippi
MS SB 2369 (2007, enacted) - Enacts the Mississippi Healthy Students Act in support of school wellness policies. Provides that beginning with the 2008-2009 school year, local school wellness plans shall promote increased physical activity, healthy eating habits and abstinence from use of tobacco or illegal drugs.  Directs the state board of education to adopt regulations addressing healthy food and beverage choices, healthy food preparation, marketing of healthy food choices to students and staff; food preparation ingredients and products, availability of food items during lunch and breakfast periods, minimum and maximum time allotments for student and staff lunch and breakfast periods, and methods to increase participation in the child nutrition and school breakfast and lunch programs.  Requires the appropriation of sufficient state-source funds for the state department of education to employ a physical activity coordinator to assist school districts in the implementation of physical education programs. Changes the statutory duties of local school health councils from permissive to mandatory. 
 

Raising Awareness

Again in 2008, many states sought to raise public awareness of childhood obesity, related health conditions such as diabetes, and efforts to respond to the problem with wellness, nutrition, and physical activity initiatives.  Enacted bills and resolutions from California, Florida, Georgia, Louisiana, Michigan, New Jersey, Oklahoma, Utah and Vermont are listed below.  This list is meant to provide a sampling of state legislative efforts to raise awareness and may not be completely comprehensive.

California
CA SCR 76 (2008, resolution adopted, Resolution Chapter 22) - Proclaims the month of May 2008, as California Fitness Month.

Colorado
CO SJR 1004 (2008, resolution adopted) -
Resolves that Colorado legislators will be leaders in encouraging health and wellness in their communities by challenging both themselves and their colleagues across the country to participate in the "Legislators Step to Health" program, a partnership among the American Diabetes Association, AstraZeneca, America On the Move, the Colorado Department of Public Health and Environment, Kaiser Permanente, and Thrive.

Florida
FL HB 9101 (2008, resolution adopted)
- Recognizes April 10, 2008, as Obesity Awareness Day.

Georgia
GA SR 930 (2007-2008, resolution adopted)
- Recognizes Monday, February 25, 2008 as the kickoff for the 2008 Legislative Fitness Challenge.

GA SR 1044 (2007-2008, resolution adopted) - Recognizes Thursday February 28, 2008 as the kickoff for the 2008 Legislative Fitness Challenge.

GA SR 1092 (2007-2008, resolution adopted) - Recognizes March 6, 2008 as Diabetes Awareness Day.

Louisiana
LA SCR 29 (2008, resolution adopted)
- Designates May 12, 2008, as "Obesity Awareness Day" at the legislature.

LA SR 53 (2008, resolution adopted) - Commends the efforts of various organizations and recognizes May 6, 2008, as "Legislative Wellness Day" at the Louisiana Senate.

LA HR 43 (2008, resolution adopted) - Designates May 6, 2008, as "Legislative Wellness Day" at the Louisiana House of Representatives.

LA HR 42 (2008, resolution adopted) - Community weight loss resolution commends the citizens of House District No. 29 for striving to lose 2,900 pounds collectively and extends to them best wishes for success.

Maryland
MD HB 1311 (2008, enacted, Chapter 401, cross-filed with SB437)
- Designates walking as the State exercise.

MD SB 437 (2008, enacted, Chapter 400, cross-filed with HB1311) - Designates walking as the State exercise.

Michigan
MI HR 327 (2008, resolution adopted)
- Observes April 16, 2008, as Michigan Kidney Disease and Diabetes Awareness Day.

New Jersey
NJ AR 86 (2008, resolution adopted) - Recognizes November 2008 as American Diabetes Month.

Oklahoma
OK SR 52 (2008, resolution adopted)
- Encourages local and state elected officials and government agencies to educate and create infrastructures and incentives through parks and schools to lead awareness campaigns to build a healthier state.

Utah 
UT SCR 1 (2008, resolution adopted) - Designates April 2008 as Obesity Awareness Month in Utah and urges healthcare suppliers, communities, businesses, and schools throughout the state to develop awareness campaigns and voluntary programs that focus on obesity and its prevention.

Vermont 
HR 34, SR 27 (2008, identical resolutionsadopted) - Designates April 30 as Walk at Lunch Day, recognizing that getting simply 30 minutes of moderate physical activity such as a brisk walk at least five times a week can result in significant health benefits.

 

Task Forces, Commissions, Studies, Grants and Other Special Programs

Legislation or resolutions to create obesity-related task forces, commissions, studies, strategic plans or other special programs were introduced in at least 11 states in 2008. Enacted legislation or resolutions for 2008 are reported below, including actions by legislatures in California, Illinois, Iowa, Louisiana, Maryland, Minnesota and New Mexico.  This list is meant to provide a sampling of state legislative efforts and may not be completely comprehensive.

California
CA ACR 134 (2008, resolution adopted, Resolution Chapter 157)
- Establishes the Legislative Task Force on Summer and Intersession Enrichment. Requires the task force to take various actions related to studying ways to provide summer enrichment and wellness programs to low-income children and to promote good health and to combat obesity by increasing the awareness of the benefits of good nutrition and regular physical exercise and activity.

Illinois
IL SB 2012 (2008, enacted, Public Act 95-900)
- Amends the Department of Public Health Powers and Duties Law to create the Chronic Disease Prevention and Health Promotion Task Force and membership. Requires hearings. Relates to chronic diseases such as cancer, diabetes, cardiovascular disease, arthritis and other preventable non-communicable diseases associated with risk factors such as poor nutrition, physical inactivity, tobacco or alcohol abuse as well as other social determinants of chronic illness. Relates to a racial and socioeconomic disparity.

Iowa
IA HB 2539 (2008, enacted)
- Establishes a governor's council on physical fitness and nutrition consisting of twelve members appointed by the governor who have expertise in physical activity, physical fitness, nutrition, and promoting healthy behaviors.

Louisiana
LA HCR 68 (2008, resolution adopted)
- Requests the House Committee on Health and Welfare and the Senate Committee on Health and Welfare to function as a joint committee to study childhood obesity in the state.

LA SR 160, HR 169 (2008, similar resolutions adopted) - Requests the Office of Group Benefits to study the bariatric surgery demonstration program initiated in 2004 and to report the results of the study to the Senate Committee on Health and Welfare no later than January 5, 2009.

LA SCR 98 (2008, resolution adopted) - Creates the Healthy People of Louisiana Task Force to make recommendations concerning the current and future impact of those chronic diseases which have the greatest impact on the citizens, commerce, workforce, social fabric and insurance costs and to study innovative methods with which to combat those diseases across all age groups and socioeconomic classes.

Maryland
MD HB 1176 (2008, enacted, Chapter 535)
- Creates a Committee on Childhood Obesity to provide certain recommendations to the governor and the General Assembly; specifies the membership, chair, and staff of the committee; requires the committee to issue a report.

MD SB 955 (2008, enacted, Chapter 473) - Establishes a Task Force on Student Physical Fitness in State Public Schools; requires the task force to study the advisability of requiring all public schools to provide a minimum amount of physical activity or education to students, the effects on childhood obesity and related health issues of such requirements, the costs of such requirements and how they may be minimized, and results obtained by local school systems in the state or other states that have such requirements.

Minnesota
MN SB 3780 (2008, enacted, Chapter 358)
- Creates a Statewide Health Improvement Program and grants to local communities. Among other provisions, establishes health care homes and reporting requirements, payment restructuring and care coordination payments, payment reform, health care workforce shortage study, free and reduced school lunch program data sharing, automation and coordination for state health care programs.

New Hampshire
NH HB 1422 (2008, enacted, Chapter 219)
- Establishes a multi-disciplinary commission on the prevention of childhood obesity. Requires the commission to identify and consider legislative and policy strategies that may be effective in the prevention of childhood obesity in New Hampshire, including but not limited to: (a) The efficacy of current laws, regulations, education and certification standards, and clinical protocols in promoting physical activity and healthy eating; (b) An examination of evidenced-based or promising practices from other states and jurisdictions relative to statewide policy, local ordinance, and educational programming strategies; (c) The health consequences and economic impact of childhood obesity in the state and the economic impact of any prevention policies or strategies; (d) Strategies to address the needs of particular regions of the state or certain populations within the state most impacted by childhood obesity; and (e) Developing recommendations to assist schools in adopting and implementing school nutrition standards.

New Mexico
NM SB 129 (2008, enacted, Chapter 86)
- Relates to health care reform; establishes a healthy New Mexico task force to devise a strategic plan for implementing disease prevention and chronic condition and chronic disease management measures and to reduce overall demand for high-cost medical and behavioral health treatments, thereby reducing or moderating the increase in health care costs; makes an appropriation.

NM SB 165 (2008, enacted, Chapter 6) - This appropriations bill includes $50,000 for a preventive health pilot program in rural areas of northwestern New Mexico that works to identify and improve the health of persons suffering from diabetes, heart disease, obesity or other preventable health conditions. 

Taxes and Tax Credits

States continue to consider a variety of fiscal options to encourage healthy lifestyles.  In 2008, states considered tax credits for fitness or wellness choices as well as the controversial approach of taxing foods and beverages with minimal nutritional value and, in a few states, directing the revenues to fund obesity or health-related services or programs.  In Maine, a law enacted in April 2008 that imposed a tax on syrup used to make soda in restaurants, bottled soft drinks, beer and wine, and on claims paid by insurance companies, and directed the tax revenues to pay for the Dirigo Health Choices program, a government-sponsored health insurance program, was overturned by Maine voters in a November referendum. A number of proposed healthy lifestyles fiscal bills for 2008 are reported below to give an overview of state efforts, but this listing is not intended to be comprehensive.

Hawaii
HI SB 1822
(2007-2008, proposed) - Would have established a food tax credit for Hawaii residents earning less than $30,000 per year; in order to provide tax relief while still allowing residents to retain their local diet.

Illinois
IL HB 1722
(2007-2008, proposed) - Would have created the Illinois Junk Food Tax Act.

Idaho
ID HB 588
(2008, enacted, Chapter 316) -  Incrementally increases Idaho's "Food Tax Credit" for foods consumed at home, starting with an increase to $50 for the poorest Idahoans, $30 for all other Idahoans, and an additional $20 for seniors, for tax year 2008.  The credit continues to increase each tax year by $10 until reaching $100, eventually offsetting, on average, the state sales tax on qualified foods. Also helps the poorest Idahoans by allowing virtually all citizens fo file for the credit, even if their income is too low to incur an income tax liability.

Maine
ME LD 2247 (2008, enacted, Chapter 629 - April 2008; repealed by voter referendum 1 - November 2008)
- Imposed a tax on syrup used to make soda in restaurants, bottled soft drinks, beer and wine, and on claims paid by insurance companies; and directed the tax revenues to pay for the Dirigo Health Choices program, a government-sponsored health insurance program.  Voters repealed the tax in November 2008 in Referendum 1.

New Mexico
NM SB 148, HB 148 (2008, proposed, similar) - Both bills would have provided an income tax credit for employers for a portion of the costs of providing wellness programs for employees. Wellness programs could have included self-help behavioral change components for altering employee lifestyles to encourage healthy living through counseling, seminars, on-line programs or self-help materials addressing, among other topics, obesity, nutrition, and physical fitness, as well as policies and services at work places to promote a healthy lifestyles, including those relating to: 1) tobacco use at the workplace; 2) the nutrition of food available at the workplace through cafeterias and vending machines; 3) minimizing stress and promoting positive mental health in the workplace; 4) where applicable, the provision of accessible and attractive stairs; or 5) the encouragement of physical activity before, during and after work.

West Virginia
WV HB 3123 (2008, proposed) -
Would have abolished the food tax, but increased the tax on nonintoxicating beer per barrel from $5.50 to $6.35, increased the tax on cigarettes to $1.35, increased the tax on noncigarette tobacco products from 7 to 14 percent, and dedicated the first $5 million of revenue to the state department of agriculture's crop transition program.

Wisconsin
WI SB 117, AB 237 (2007-2008, proposed, identical) -
Both bills would have imposed a tax on the sale at wholesale of soft drinks, and deposited the revenue generated by the tax into a dental access trust fund from which they could be appropriated to supplement reimbursements for dentists's services provided under the state's Medical Assistance Program, and to create grants for dental public health and dental education projects.

Trans Fat in School Foods 

 

A number of states have recently considered or enacted legislation to restrict or prohibit school foods that contain trans fat or to otherwise specify the nutritional composition of school foods.  In 2008, at least one state, Louisiana, passed a legislative resolution calling for a study of the feasibility and advisability of prohibiting trans fat in school foods.  Previously, in 2007, four states, California, New Jersey, North Carolina and Oregon, enacted bills to limit or ban the use of trans fat in school foods. At least one additional state, Tennessee, considered, but did not enact, legislation in 2008 regarding trans fat in school foods. To provide an overview of recent legislation, bills enacted or legislative resolutions adopted from 2006 through 2008 regarding trans fat in school foods is summarized below. This listing does not include legislation to require nutrition labeling or menu information for food and drink items in all chain restaurants or retail food establishments or to restrict or ban trans fat in restaurant foods, which can be found on NCSL's trans fat and menu labeling legislation web page.                           

California
CA SB 80
(2007, enacted, Chapter 174) - Requires schools and school districts, commencing with the 2007–08 fiscal year, for meals and food items sold or served as part of a free or reduced-price meal program, to comply with specified nutrition-related prohibitions and requirements. Prohibits food items containing artificial trans fats and items that have been deep fried, flash fried or par fried. Encourages schools to meet developmentally and programmatically appropriate meal pattern and meal planning requirements developed by the USDA or menu planning options of Shaping Health as Partners in Education developed by the state (SHAPE California network).

CA SB 132 (2007, enacted, Chapter 730) - As a condition of receipt of funds pursuant to Section 49430.5, commencing with the 2007-08 fiscal year, for meals and food items sold as part of the free and reduced-price meal programs, a school or school district shall not sell or serve a food item artificial trans fats or items that have been deep fried, flash fried or par fried. Prohibited oils and fats include, but are not limited to, palm, coconut, palm kernel, lard, typically solid at room temperature and are known to negatively impact cardiovascular health. Oils permitted by this provision include, but are not limited to, canola, safflower, sunflower, corn, olive, soybean, peanut, or a blend of these oils, typically liquid at room temperature and are known for their positive cardiovascular benefit.

CA SB 490 (2007, enacted, Chapter 648) - Prohibits K-12 schools from making food containing artificial trans fat available to pupils in vending machines or school food service establishments. Prohibits the use of artificial trans fat in the preparation of a food item served to pupils. Excludes food provided as part of a USDA meal program.

Indiana
IN SB 111 (2006, enacted, Public Law 54)
- Requires at least 50 percent of food items sold in schools to qualify as "better food choices" and, among other definitions, specifies that better food choices are those in which (A) Not more than 30 percent of their total calories are from fat. (B) Not more than 10 percent of their total calories are from saturated and trans fat. (C) Not more than 35 percent of their weight is from sugars that do not occur naturally in fruits, vegetables, or dairy products.

Louisiana
LA HCR 200 (2008, resolution adopted) -
Requests the state's Department of Health and Hospitals and the Board of Elementary and Secondary Education jointly to study the feasibility and advisability of prohibiting public schools from serving foods containing trans fat to students.

New Jersey
NJ SB 1218, AB 883 - (2006-2007, enacted, identical, Public Law 2007, Chapter 45)
- Establishes certain nutritional restrictions on foods and beverages served, sold or given away to pupils in public and certain nonpublic schools. Requires that based on manufacturers' nutritional data or nutrient facts labels, school foods contain no more than eight grams of total fat per serving, with the exception of nuts and seeds, and no more than two grams of saturated fat per serving.  Among its provisions, the new law states: "Schools shall reduce the purchase of any products containing trans fats beginning September 1, 2007."

North Carolina
NC HB 1473 (2007, enacted) -
A child nutrition program standards provision in this appropriations bill requires the state board of education, in consultation with a cross section of local directors of child nutrition services, to establish statewide nutrition standards for school meals, a la carte foods and beverages, and items served in the after school snack program administered by the Department of Public Instruction and child nutrition programs of local school administrative units. The nutrition standards are to promote gradual changes to increase fruits and vegetables, increase whole grain products, and decrease foods high in total fat, trans fat, saturated fat, and sugar. Standards are to be implemented initially in elementary schools, with all elementary schools required to achieve a basic level by the end of the 2008-2009 school year, followed by middle schools and then high schools.

Oregon
OR HB 2650 (2007, enacted, Chapter 455) -
 Among other provisions specifying school food standards, prohibits the sale of snack items at school that contain more than 0.5 grams of trans fat per serving.

Other links for NCSL resources on legislative and policy options to address obesity are:
NCSL healthy community design legislative database
 
Please contact Amy Winterfeld, NCSL, Health Program, to report any comments or corrections to this document.

 

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