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Childhood Obesity 2012

Childhood Obesity | 2012 Update of Legislative Policy Options

group of kidsFebruary 2013

Childhood obesity remains a pressing public health concern. One-third of American children are overweight or obese and national health care spending on obesity is nearing $150 billion a year. Taxpayers fund about $60 billion of these costs through Medicare and Medicaid.  Recent research indicates that if obesity rates are reduced by as little as 5 percent, health care savings could exceed $29 billion. Yet childhood obesity rates in the United States have nearly tripled over the past three decades and today an estimated 16.9 percent of U.S. children and adolescents ages 2 to 19 are obese; 31.7 percent are either obese or overweight. In sheer numbers, more than 12 million American children and adolescents are obese and more than 23 million are either obese or overweight. The childhood obesity epidemic also poses a national security challenge, as obesity has become one of the most common disqualifiers for military service.

Obese children and teenagers are at greater risk for developing serious chronic diseases such as type 2 diabetes, heart disease, high blood pressure, cancer 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. 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, type 2 diabetes—are the first, second, third and seventh leading U.S. causes of death. Moreover, obesity is costly. Among children and adolescents, annual hospital costs related to obesity were $127 million during 1997–1999, up from $35 million during 1979–1981. From 1987 to 2001, obesity-associated diseases accounted for 27 percent of the increases in U.S. medical costs.

State legislatures continue to be active in considering policy options to make the healthy choice the easy choice and to help provide children with healthier foods and more opportunities for safe, enjoyable physical activity throughout childhood. Legislation from 2012 on school nuttrition and physical activity, and other topics related to preventing and reducing childhood obesity is summarized below. The Table of Contents below links to information to specific topics on this page. Childhood obesity legislation summaries from prior years can be accessed at links at the right.

 

 
TABLE OF CONTENTS
 

Body Mass Index (BMI) Legislation

Diabetes Screening and Management at School

Insurance Coverage for Obesity Prevention and Treatment

Joint or Cooperative Use Agreements for School Facilities

Physical Activity or Physical Education in School and Recess Legislation Raising Awareness

School Nutrition Legislation

School Wellness Policies

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

Taxes, Tax Credits, Tax Exemptions and Other Fiscal Incentives

 

50-State Legislation on Childhood Obesity Policy Options Enacted in 2012

State

School Nutrition

Physical Education, Physical Activity
 

School Wellness

Joint-Shared Use Agreements

Insurance Coverage for Obesity

Task Forces, Studies

Alabama

 X

 

 

 

 

 

Alaska

 

 

 

 

 

 

Arizona

 

 

 

 

 

 

Arkansas

 

 

 

 X

 

California

X

 X

 

 X

 

 

Colorado

 

 

 

 

 

Connecticut

 X

 

 X

 

 

 

Delaware

X

 

 

 

 

 

Florida

 

 

 

 

 

 

Georgia

 

 

 

 

 

 

Hawaii

 

 

 

 

 

Idaho

 

 

 

 

 

 

Illinois

 

 X

 

 

X

Indiana

 

 

 

 

 

 

Iowa

 

 

 

 

 

Kansas

 

 

 

 X

 

 

Kentucky

 

 

 

 

 

Louisiana

   

 X

 

 

Maine

 

 

 

 

Maryland

 

 

 

 

 

 

Massachusetts

 

 

 X

 

 

 

Michigan

 

 

 

 

 

 

Minnesota

 

 

 

 

 

 

Mississippi

 

 

 X

 

 

 

Missouri

 

 

 

 

 

 

Montana

 

 

 

 

 

 

Nebraska

 

 

 

 

 

 

Nevada

 

 

 

 

 

 

New Hampshire

 

 

 

 

 

 

New Jersey

 

 

 

 

 

 

New Mexico

 X

 

 

 

 

New York

 

 

 

 

 

 

North Carolina

 

 

 

 

 

 

North Dakota

 

 

 

 

 

 

Ohio

 

 

 

 

 

 

Oklahoma

 

 

 

 

 

 

Oregon

 

 

 

 

 

 

Pennsylvania

 X

 

 

 

 

 

Rhode Island

 

 

 

 

 

South Carolina

 

 

 

 

 

 

South Dakota

 

 

 

 

 

 

Tennessee

 X

 

 

 

 

 

Texas

 

 

 

 

 

 

Utah

 

 

 

 

 

 

Vermont

 

 

 

 

 

Virginia

 X

 

 

 

 

 

Washington

 

 

 

 

 

 

West Virginia

 

 

 

 

 

 

Wisconsin

 

 

 

 

 

Wyoming

 

 

 

 

 

 

District of Columbia

 

 

 

 

 

 

 

School Nutrition Legislation

In 2012, 11 states—Alabama, California, Colorado, Connecticut, Delaware, Ohio, Maine, New Mexico, Pennsylvania, Tennessee and Virginia—enacted some type of school nutrition legislation or adopted school nutrition resolutions. These laws help ensure students have access to healthier food and beverage options at school or encourage other community supports for child nutrition. They complement the federal Healthy, Hunger-Free Kids Act of 2010 (P.L. 111-296), which reauthorized the national School Lunch and School Breakfast programs; increased the School Lunch and School Breakfast per-meal reimbursement by 6 cents; and authorized the secretary of Agriculture, without preempting stricter state standards, to set nutrition standards for all food products sold on school grounds during the day. Continuing areas of state legislation include not only increasing healthier school meal options, but also raising the quality of beverages and foods sold or consumed outside the regular school meals program as à la carte or snack items, providing for training school personnel to implement new standards and coordinating with other school health programs. 


Summaries of Enacted 2012 School Nutrition Legislation


Alabama
AL HR 156, AL HJR 78, AL HJR 158 (2012, resolutions adopted)
– Resolutions commend Andalusia Elementary School and Geneva County Elementary School Child Nutrition managers and staff for receiving the Healthier U.S. School Challenge Gold Award of Distinction from the federal government.

California
CA AB 1464 (2012, enacted)
– Among other state budget items for FY 2012-2013, makes a one-time appropriation of $4.8 million to support statewide training of school food authorities regarding changes to the meal and nutritional standards contained in the federal Healthy, Hunger-Free Kids Act of 2010 (P.L. 111-296), as allowed by federal guidelines on the allocation of administrative funds for state costs of implementation of new meal patterns for the National School Lunch Program and School Breakfast Program.  Also makes other appropriations from the state to local school districts for school meal programs. Also provides funds for physical education instructional support.
 

Colorado
CO SB 68 (2012, enacted)
– Prohibits public and charter schools from making food items that contain any amount of industrially produced trans fat available to students on school grounds during the school day, including cafeteria food and items in vending machines, school stores, other food service entities and fundraisers.
 

Connecticut
CT SB 299 (2012, enacted)
– Allows for expansion of an in-class school breakfast pilot program to assist severe-needs schools in providing breakfast for students and for maintenance of the program within available appropriations.
 

CT SB 458 (2012, enacted) – Clarifies that school nutrition standards apply to technical high schools, including food items in vending machines, school stores and fundraising activities on school premises.
 

CT HB 6001b (2012, enacted) – Implements state budget including provisions to establish a coordinated school health pilot program in FY 2012-2013 to provide grants to two educational reform districts selected by the Commissioner of Education, for coordinating school health, education and wellness and reducing childhood obesity. Provides that the coordinated school health pilot program shall enhance student health, promote academic achievement and reduce childhood  obesity by bringing together school administrators, teachers, other school staff, students, families and community members to assess health needs, set priorities and plan, implement and evaluate school health activities, and that may include, but need not be limited to, school nutrition services, physical education, healthy school environment, staff health and wellness, family and community involvement, health education and services, and school counseling, psychological and social services.

Delaware
DE HJR 11 (2012, resolution adopted)
- Proclaims March 2012 as National Nutrition Month in Delaware.

Ohio
OH SB 316 (2012, enacted)
– Clarifies existing school beverage standards to provide that other than milk, at least 50 percent of beverages sold on in public or charters, whether through the school food service program, in vending machines or school stores, be water or other beverages that contain no more than ten calories per eight ounces.

Maine
ME HB 1373 (2012, enacted)
- Proposes changes to the Fund for a Healthy Maine, as recommended by the state’s commission to study allocations of the fund, to add prevention, education and treatment activities concerning unhealthy weight and obesity to the health promotion purposes of the fund. Requires creation of a separate state budget entry for unhealthy weight and obesity prevention activities in the state budget for 2014-2015. Continues provisions for comprehensive school health and nutrition programs, including school-based health centers.
 
New Mexico
NM  SM 8, HM 22 (2012, resolutions adopted) – Designates Jan. 26, 2012, as "School Nutrition Day" in New Mexico to recognize that school nutrition programs play an important role in helping to ensure that children start school ready to learn, because a hungry or undernourished child is less likely to be an eager and attentive student. Notes that New Mexico is ranked No. 1 in students participating in school breakfast programs in the United States; and that 203 public, private and Bureau of Indian Affairs schools in the state serve more than 266,000 lunches and 145,000 breakfasts each school day in the state.
 
Pennsylvania
PA HB 1901 (2012, enacted) – Among other school finance provisions, continues to provide a 10 cent per school meal reimbursement from the state and an additional incentive reimbursement of 2 cents per meal for schools that serve both school breakfast and lunch if less than 20 percent of students participate and 4 cents per meal if more than 20 percent of students enrolled are served by both school breakfast and lunch programs. 
 
Tennessee
TN SB 3606 (2012, enacted) – Encourages schools to work with community partners to offer parental involvement programs and parenting classes that cover, among other topics, the importance of sleep and good nutrition in school performance.
 
Virginia
VA HB 1300, HB 1301 (2012, enacted) – Prohibits disbursing state school nutrition payments to local schools that permit the sale of competitive foods in food service facilities during food service times for full school meals. Appropriates funding from the state lottery for the second year of an incentive program to maximize federal school nutrition revenues and increase student participation in the school breakfast program. Makes these funds available to reimburse schools breakfast meals served in excess of a baseline established by the state department of education and to supplement and not replace existing funding.

Body Mass Index (BMI) or Student Fitness Screening at School 

Body mass index (BMI) 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.   Body mass index is widely accepted as a reliable indicator of body fat content and a screening tool for weight categories that can lead to health problems. The ease of measuring height and weight, without use of expensive equipment, makes BMI screening convenient and has led to policies in a number of states that require such screening at school where virtually all children can participate.

Legislation that requires individual student BMI measurement has been enacted in some states to help identify individual children with weight-related health risks. Aggregate BMI data reporting requirements are in place in other states to provide a picture of community health, monitor statewide obesity trends, or evaluate the results of programs intended to reduce or prevent obesity. Individual BMI results generally are sent to parents in a confidential letter with suggestions for making healthy changes, which can help motivate families to adopt healthier habits. When screenings identify obesity-related health risks, such as type 2 diabetes, it is important to provide parents with information about how to seek further evaluation and appropriate follow-up. Including BMI measurement as an element of a broader student fitness assessment has become a recent trend in state legislation.

In 2012, Ohio enacted BMI legislation as summarized below. 

Ohio
OH SB 316 (2012, enacted)
– Allows schools to screen students for body mass index and weight status category and report aggregate data to the director of the state’s department of health. Also requires that public and charter school limit beverages other than milk sold during the regular and extended school day in the food service program, vending machines and school stores to water or other beverages that contain no more than ten calories per eight ounces.
 

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 schoolchildren. Screening for diabetes at school can help identify students at risk and, coupled with nutrition and physical activity policies, help prevent the actual onset of type 2 diabetes in children and reduce childhood obesity. There are two general types of state legislation related to diabetes in schoolchildren. Noninvasive diabetes risk screening at school has been enacted or proposed in a number of states. Although not preventive in nature, other states, responding to the needs of children already diagnosed with diabetes, are creating policies to facilitate diabetic care for students at school, such as requiring training for school personnel to provide diabetes care for students or limiting the liability of caregivers and schools that provide such care.

Student Diabetes Risk Screening: 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 was replaced by statewide distribution of diabetes risk information to students commencing July 1, 2010 (California Education Code § 49452.7).

Student Diabetes Care: Counting legislation enacted in 2012, existing law now provides for student diabetes care or self-care at school or permits medication administration by, and/or liability protections for, school personnel responding to diabetic students in Arkansas, Arizona, Connecticut, Florida, Georgia, Illinois, Indiana, Nebraska, New Jersey, Tennessee, Texas, Rhode Island, Utah, West Virginia and Virginia.  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. Alabama adopted a legislative resolution in 2012 to study training school personnel to provide care to students with diabetes.

Alabama
AL SJR 83 (2012, enacted)
– Created a legislative interim study committee to review whether it is feasible to train school personnel to whom such authority is delegated to administer insulin and glucagon in order to provide care for diabetic students at school.
 
Connecticut
CT HB 5348 (2012, enacted)
– Allows students to self-test for blood glucose levels while at school with written authorization from a parent and a physician’s order stating that the student is capable of self-testing. Allows qualified school employees to volunteer to administer glucagon to diabetic students in an emergency.
 
Georgia
GA HB 879 (2012, enacted
) – Provides for diabetes care and self-management for elementary and secondary school students. Recognizes that the school nurse is the preferred person to provide student diabetes care but allows for other school employees to become trained diabetes personnel to perform diabetes care tasks at school when a nurse or other health care professional is not available.
 
Virginia
VA HB 1291 (2012, enacted)
– Authorizes trained school employees, with parental consent, to assist in administering glucagon or insulin during the school day to students with applicable prescriptions, if a licensed nurse is not present to administer the medication to diabetic or hypoglycemic students.
 

Insurance Coverage for Obesity Prevention and Treatment

Providing insurance coverage for obesity prevention can encourage patients to seek nutrition and physical activity counseling from health care providers. Studies have shown health care providers can play an important role in promoting weight loss among their overweight patients. Guidelines recommend that physicians identify obese patients and counsel them on weight management, using a personalized approach, as physician manner and timing when discussing weight management issues are important. To increase the effectiveness of health providers in this role, the first lady’s “Let’s Move” initiative to address childhood obesity recommends that “health care providers have the necessary training and education to effectively prevent, diagnose, and treat obese and overweight children.”

State legislation in this category generally requires private insurers, public insurance programs such as Medicaid or SCHIP (State Children's Health Insurance Programs), or state employee health insurance programs to provide or strengthen obesity health insurance coverage. Some legislation specifically requires or encourages coverage for obesity prevention. State legislation does not always specifically refer to childhood obesity. Private insurance coverage for families, however, generally includes children, and some states specifically address insurance coverage for childhood obesity. In July 2004, Medicare recognized obesity as a medical condition, opening the door for greater coverage for obesity treatments.   Upon review, Medicare will now pay for anti-obesity interventions if scientific and medical evidence demonstrate their effectiveness. Medicaid and private insurers often follow Medicare coverage policy. Under Medicaid, states have flexibility to determine the scope of covered services within federal guidelines and can include obesity prevention and treatment as covered services.

In 2011, a law establishing a pilot program for health insurance coverage for morbid obesity evaluation and treatment was enacted in Arkansas, as summarized below.

Arkansas
AR SB 66 (2011, enacted)
– Establishes a pilot program for health insurance coverage for morbid obesity diagnosis and treatment requiring state and public school employee health plans to offer such coverage, including coverage for gastric bypass surgery.
 

Joint or Cooperative Use Agreements for School Facilities

A joint-use agreement is a formal agreement between two separate entities—often a school district and a city or county government—that defines the roles, responsibilities, terms and conditions for the shared use of public property. Many communities lack safe places to exercise and play near where people live and work. Opening school fields, tracks, courts, playgrounds and gymnasiums to the public, when not in use by students, is a low-cost way not only to encourage more people to be physically active, but also to achieve maximum value for funds appropriated by legislatures for school facilities. Joint-use agreements allow town, city or county governments to work with school districts to share school facilities with the community and also address liability, staffing, maintenance, hours and cost-sharing issues.

In 2012, three states—Arkansas, California, and Kansas—enacted joint-use legislation to facilitate or encourage community use of school facilities for recreation.

Arkansas
AR SB 51 (2012, enacted)
– Appropriates $500,000 for school facility joint use support.
 
California
CA AB 806 (2012, enacted)
– Among technical conforming changes to the Davis-Stirling Common Interest Development Act, notes that nothing in this section is intended to limit or discourage the joint use of school facilities.
 
Kansas
KS SB 316 (2012, enacted)
– Among other items related to a wildlife department reorganization, allows the department to contract with school boards for the joint use and improvement of school lands for park and playground purposes.  
 

Physical Activity or Physical Education in Schools and Recess Legislation

Physical Activity or Physical Education in School

The first national Physical Activity Guidelines for Americans, issued by the U.S. Department of Health and Human Services in October 2008, recommend 60 minutes of age-appropriate, enjoyable and varied daily, moderate-to-vigorous physical activity for children. Developed by experts in exercise science and public health, the Guidelines are based on research findings about the benefits of physical activity and recommended activity levels. For children, physical activity during the school day not only provides health benefits—such as strengthening the heart, muscles and bones—but studies show it can also increase academic achievement.

Before the guidelines were issued, the National Association for Sport and Physical Education (NASPE) had recommended that all children from prekindergarten through grade 12 receive daily physical education taught by certified specialists, and that schools have appropriate class sizes, facilities and equipment. NASPE recommends 150 minutes per week of physical education for elementary school students and 225 minutes per week for middle and high school students, with qualified physical education teachers providing a developmentally appropriate program and a teacher-student ratio similar to other classroom settings. Excellent physical education programs nurture enjoyment of physical activity and set the stage for an active lifestyle in all children, regardless of athletic ability.

Currently, almost 30 percent of children do not exercise even three days per week. Only 17 percent of high school students say they exercise the minimum recommended one hour daily. 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. Legislators have considered and enacted laws to support physical education programs in schools to bridge this gap. Although all 50 states have some type of statewide standards for physical education or physical activity at school, their scope varies greatly. Policy approaches to increasing physical activity at school include setting physical education time standards at all grade levels, providing for daily physical education, and preserving recess time for physical activity.

At least five states—California, Illinois, New Mexico, Rhode Island and Wisconsin—enacted legislation or adopted resolutions related to physical education or physical activity at school in 2012.

California
CA AB 1464 (2012, enacted)
– Among other state budget items for FY 2012-2013, provides funds for physical education instructional support and to support the hiring of more credentialed physical education teachers through a state incentive, conditioned in part on meeting physical education minute requirements or providing a plan to the county office of education that corrects any deficient physical education minutes for the following school year.
 
CA AJR 27 (2012, resolution adopted) – Commemorates the 40th anniversary of federal Title IX on June 23, 2012, to provide for fair treatment of female athletes.
 
Illinois
IL HB 3374 (2012, enacted)
- Establishes a multidisciplinary "Enhance Physical Education Task Force" to promote and recommend enhanced physical education programs that can be integrated within a broader wellness strategy and health curriculum in elementary and secondary schools. Defines the Task Force's purposes to include educating and promoting leadership among district and school officials, developing and utilizing metrics to measure effectiveness, promoting training and professional development, and identifying resources for enhanced physical education. Requires the task force to report to the governor and the general assembly with recommendations for updating Illinois' learning standards for physical development and health by August 31, 2013, based on neuroscience research about the relationship between physical activity and learning.

IL HB 605 (2012, enacted) - Improves Illinois school report cards to include, among other information, reporting on physical education average number of days per week per student and school wellness initiatives at individual schools. Enhanced school report cards are part of the governor's school performance improvement initiative.  

New Mexico
NM HM 3, SM 10 (2012, resolutions adopted)
– Both resolutions support outdoor opportunities for children by encouraging the state land office, the tourism department and the department of health to develop and advertise outdoor programs for children, including opportunities on New Mexico state-owned lands, activities in and around schools such as outdoor gardening and increased physical education and outdoor and natural resource job and skills training.

Rhode Island
RI HR 8196 (2012, resolution adopted)
– Proclaims May 23, 2012 as “Shape Up Rhode Island Day” while also recognizing that obesity has become epidemic in the United States.
 
Wisconsin
WI SB 95 (2011, enacted)
– Allow local school boards to grant a waiver of the .5 credit physical education requirement for students who participate in sports or another physical activity and wish to complete .5 credits in English, social studies, math or science instead of the .5 physical education credit.

Raising Awareness 

States continue to adopt legislative resolutions to raise public awareness of childhood obesity and of policy options to address it. A sample of resolutions from 2012 are summarized below.

Illinois
IL SR 624 (2012, resolution adopted)
- Designates September 2012 as Childhood Obesity Awareness Month in Illinois and recognizes multiple strategies to promote health by addressing key components such as physical education, health education, nutrition services, staff wellness, and family and community involvement; daily, quality physical education for early childhood education programs and all students in grades K-12 supplemented with additional school-based physical activity opportunities, such as recess, physical activity in the classroom, classroom breaks, intramural sports, and walk-to-school programs; and ensuring complete streets for all users including pedestrians, bicyclists and motorists.

IL HR 783 (2012, resolution adopted) – Encourages action on policies to address obesity such as increasing access healthier foods and decreasing marketing of foods and beverages of low nutritional value, particularly to youth; changing school environments to promote health through a coordinated key components such as physical education, health education, nutrition services, staff wellness, and family and community involvement; daily, quality physical education for early childhood education programs and all students in grades K-12, supplemented with additional school-based physical activity opportunities, such as recess, physical activity in the classroom, classroom breaks, intramural sports, and walk-to-school programs.

New Mexico
NM HM 3, SM 10 (2012, resolutions adopted)
– Both resolutions support outdoor opportunities for children by encouraging the state land office, the tourism department and the department of health to develop and advertise outdoor programs for children, including opportunities on New Mexico state-owned lands, activities in and around schools such as outdoor gardening and increased physical education and outdoor and natural resource job and skills training.
 

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 Breakfast programs 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 to develop wellness policies and set goals for nutrition education, physical activity, campus food provision and other school-based activities designed to promote student wellness. The act also required plans for measuring policy implementation.  Encouraged by federal efforts and a potential penalty of withholding federal school lunch reimbursement funds, a number of states enacted legislation in previous sessions to support wellness policies or related school health efforts. School wellness policies varied in strength and completeness, however, and assessments of the implementation status range from nearly complete to inconsistent. State legislation, with or without referencing the federal requirement, has helped to fill the gaps or encourage implementation.

Current legislation in this area focuses on establishing comprehensive school health and wellness policies. In 2012, Connecticut, Lousiana and Mississippi enacted legislation to pilot coordinated school-based health and wellness programs and Massachusetts provided funding for school-based health centers in both public and non-public schools that incorporate obesity prevention programs, including nutrition and wellness programs, into school curricula. Illinois added reporting on school wellness initiatives as part of school report cards, and report cards for school districts.

Connecticut
CT HB 6001b (2012, enacted) - Among other budget provisions, effective July 1, 2012, establishes a year-long coordinated school health pilot program to provide grants to two educational reform districts selected by the commissioner of Education, for coordinating school health, education and wellness and reducing childhood obesity. Provides that the pilot program should enhance student health, promote academic achievement and reduce childhood obesity by bringing together school administrators, teachers, other school staff, students, families and community members to assess health needs, set priorities and plan, implement and evaluate school health activities. Requires program components at a minimum include: school nutrition services, physical education, a healthy school environment, staff health and wellness, family and community involvement, health education and services, school counseling and school psychological and social services.
 
Illinois
IL HB 605 (2012, enacted) - Improves Illinois school and school district report cards to include, among other information, reporting on physical education average number of days per week per student and school wellness initiatives. Enhanced school report cards are part of the governor's school performance improvement initiative.

Louisiana
LA HB 867 (2012, enacted)Authorizes the University Medical Center in Lafayette to cooperate with the Lafayette Parish School System to develop a pilot program for coordinated school health and wellness centers.
 
Massachusetts
MA HB 4200 (2012, enacted)Among other funded programs, provides for school health services and school-based health centers in public and nonpublic schools that incorporate obesity prevention programs, including nutrition and wellness programs, in school curricula to address the nutrition and lifestyle habits needed for healthy development.
 
Mississippi
MS SB 2572 (2012, enacted)As part of science-based wellness programs in the state designed to address student inactivity and obesity, authorizes the State Board of Education to consult with the state health department to establish a school health pilot program in local school districts beginning with the 2012-2013 school year. 
 

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

Enacted 2012 legislation to create state task forces, commissions, studies, grants and other special programs to address childhood obesity in the states is summarized below.

Hawaii
HI SB 2778, HI HB 2516 (2012, enacted)
– Created a childhood obesity prevention task force to collect and analyze Hawaii-specific early childhood obesity data to identify children at risk, to increase awareness of childhood obesity health implications and to promote best practices through community-based initiatives to improve healthy life choices and promote exercise and nutrition best practices.

Illinois
IL HB 3374 (2012, enacted)
- Establishes a multidisciplinary "Enhance Physical Education Task Force" to promote and recommend enhanced physical education programs that can be integrated within a broader wellness strategy and health curriculum in elementary and secondary schools. Defines the Task Force's purposes to include educating and promoting leadership among district and school officials, developing and utilizing metrics to measure effectiveness, promoting training and professional development, and identifying resources for enhanced physical education. Requires the task force to report to the governor and the general assembly with recommendations for updating Illinois' learning standards for physical development and health by August 31, 2013, based on neuroscience research about the relationship between physical activity and learning.

Kentucky
KY HB 550 (2012, enacted)
– Directs the staff of the Kentucky Legislative Research Commission to conduct a comprehensive review of studies or programs that focus on nutritional habits and outcomes for the state’s population to reduce the prevalence of obesity and the risk of chronic disease.

Louisiana
LA SR 146 (2012, adopted)
– Requests state education agencies to conduct a study or survey to determine compliance with state law regarding vending machines and physical activity requirements in schools.

LA HR 138 (2012, adopted) – Requests the state’s department of health and hospitals to study the feasibility of establishing a chronic disease database in Louisiana. Recognizes that chronic diseases such as heart disease, stroke, cancer, and diabetes are among the most prevalent, costly and preventable of all health problems and that such a database could catalogue existing state risk factors and trends to more appropriately target key areas for research, better prevention, diagnosis and treatment of chronic diseases.

Maine
ME HB 1373 (2012, enacted)
-
Proposes changes to the Fund for a Healthy Maine, as recommended by the state’s commission to study allocations of the fund, to add prevention, education and treatment activities concerning unhealthy weight and obesity to the health promotion and prevention purposes of the fund. Requires creation of a separate state budget entry for unhealthy weight and obesity prevention activities in the state budget for 2014-2015.

Vermont
VT HB 202 (2012, enacted)
– As part of the creation of Vermont’s single-payer unified health system, provides for the creation of a state health improvement plan and facilitates local health improvement plans to encourage healthy community design and to promote policy initiatives that contribute to community, school and workplace wellness.
 

Taxes, Tax Credits, Tax Exemptions and Other Fiscal Incentives

States continue to consider fiscal options to encourage healthy lifestyles. This year, three states enacted legislation to provide funding mechanisms for food banks, including establishment of a farm to food banks trust in Kentucky. Other examples of state fiscal policies to incentivize healthier eating from prior years include offering tax credits for fitness or wellness choices; tax credits or other fiscal incentives for grocery store development or improvements that allow grocery retailers to offer fresh fruits and vegetables; or enacting or increasing taxes on foods and beverages that have minimal nutritional value in order to discourage their consumption or raise revenue. California, Mississippi, Rhode Island and Nebraska considered proposals to tax soft drinks or sugar sweetened beverages to provide funding for childhood obesity prevention efforts in 2012 but none were enacted. Programs such as student health and fitness assessments, school physical activity and health programs, improvements to school meals, support for school district wellness coordinators and other evidence-based obesity prevention programs would have been funded by these proposed taxes.

Kentucky
KY HB 419 (2012, enacted)
– Establishes an income tax check-off for contributions to the farms to food banks trust fund, as renamed from the surplus agricultural commodities fund. Requires an annual report by the fund on its expenditures.
 
Louisiana
LA HB 458 (2012, enacted)
– Allows individuals to check-off to donate a portion of their state income tax refund to a new Louisiana Food Bank Association Fund to be disbursed every 60 days to the Association by the state treasurer.
 
South Dakota
SD HB 1206 (2012, enacted)
– Funds emergency food assistance grants and repeals a sales tax on the food refund program.
 
Tennessee
TN HB 3761 (2012, enacted)
– Provides that retail sales of food and food ingredients shall be taxed at the rate of 5.25 percent.
 

Other links for NCSL resources on legislative and policy options to address obesity are:

NCSL's trans fat and menu labeling legislation web page

Please contact Amy Winterfeld, NCSL, Health Program, to report any comments or corrections to this document.

Support for this web page is provided in part by the Robert Wood Johnson Foundation as part of its Leadership for Healthy Communities national program. Additional support for legislative tracking is provided by the W.K. Kellogg Foundation.

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Tel: 303-364-7700 | Fax: 303-364-7800

Washington

444 North Capitol Street, N.W., Suite 515
Washington, D.C. 20001
Tel: 202-624-5400 | Fax: 202-737-1069

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