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Harkin Bill Outlines Critical Public Health and Prevention Initiatives

Legislation Includes Provisions to Fight Chronic Disease, Encourage Healthier Communities, Schools and Workplaces, and Improve Opportunities for Individuals with Disabilities

WASHINGTON, D.C.  — Legislation introduced today by Senator Tom Harkin (D-IA), Chairman of the Senate Health, Education, Labor, and Pensions (HELP) Committee, outlines critical public health and prevention initiatives to fight chronic disease, encourage healthier schools, communities and workplaces, and improve physical activity opportunities for individuals with disabilities. The Healthier Lifestyles and Prevention America (HeLP America) Act includes wellness provisions in a broad range of areas, including expanded access to fresh fruits and vegetables for all low-income elementary schools, tax incentives for businesses that offer comprehensive workplace wellness programs to their employees, improved physical activity and athletic opportunities for individuals with disabilities, and greater oversight with regard to food and tobacco marketing.

“Improving public health starts with prevention. Taking steps to improve access to healthier options, exercise opportunities, food labeling, and tobacco cessation will not only help stave off chronic disease—it will also save consumers and taxpayers money in the long run,” Harkin said. “By making health and wellness a key priority in our schools, workplaces, and communities—and by educating people to make informed choices—the HeLP America Act can open the door for more Americans to live longer and more productive lives free from chronic disease.”

Chronic diseases such as heart disease, cancer, and diabetes are among the leading causes of death and disability in the United States, and the economic impact is staggering. More than seventy-five percent of the $2.5 trillion the United States spends on health care annually is due to chronic disease.

Harkin has championed preventive healthcare initiatives throughout his career, including increased access to screenings for breast cancer and other diseases, the school fruit and vegetable pilot program, and tobacco control.  Most recently, as HELP Committee Chairman, Harkin championed the prevention and wellness measures that are included in the Affordable Care Act.  Preventive initiatives in doctors’ offices and the community help rein in costs across the full health care spectrum. The Prevention and Public Health title of the health reform law creates incentives to prevent chronic disease, and requires health insurance companies to cover recommended preventive screenings with no copays or deductibles. The bill introduced today builds upon the prevention and wellness measures contained in the health reform law and includes several new sections that further expand public health and prevention efforts, including encouraging healthier food offerings in our National Parks and increasing opportunities for physical activity in school settings.

Harkin’s legislation has been endorsed by the American Heart Association, the YMCA of the USA, the Center for Science in the Public Interest, Campaign for Tobacco-Free Kids, and Trust for America's Health. A full summary of the HeLP America Act of 2013 is below: 

Title I.  Healthier Kids and Schools

Nutrition and Physical Activity in Child Care Quality Improvement:  Supports State efforts to provide resources to child care providers to help them meet high-quality health, mental health, nutrition, physical activity and physical development standards; highlights nutrition standards and physical activity as a possible component of State Child Care and Development Block Grant plans. 

Access to Local Foods and School Gardens at Preschools and Child Care Centers:  Enables child care providers to participate in the USDA’s farm-to-school initiatives. 

Fruit and Vegetable Program:  Expands the Harkin Fresh Fruit and Vegetable Program to all low income elementary schools nationwide. 

Equal Physical Activity Opportunities for Students with Disabilities:  Directs the Department of Education to provide oversight, guidance, and technical assistance to ensure that schools provide equal opportunities for students with disabilities for Physical Education (PE) and extracurricular athletics. 

Physical Activity in School Settings:  Includes in annual state report cards a set of indicators describing the physical activity environment in schools including measures of the time, quality, teachers, and facilities devoted to PE. Adds PE to the existing set of “core subjects,” bolsters nutrition and physical activity in community learning centers, and engages parents and teachers in physical activity and healthy eating opportunities. 

Title II.  Healthier Communities and Workplaces

Joint/Shared Use Agreements:  Directs HHS, in coordination with Department of Education, to develop and disseminate guidelines and model joint use agreements to facilitate community access to spaces for physical activity.

Community Sports for Individuals with Disabilities:  Establishes competitive grants to public entities and nonprofit private entities to implement community-based sports and athletic programs for people with disabilities, including youth with disabilities. 

Community Gardens:  Establishes grants from the USDA to establish, expand, or maintain community gardens.

Physical Activity Guidelines for Americans:  Requires HHS to issue and update physical activity guidelines for all ages every 10 years while compiling intermediate reports highlighting specific groups, issues, concerns, or practices.

Tobacco Taxes Parity:  Increases the excise tax on small cigarettes; equalizes excise taxes for pipe tobacco, roll-your-own tobacco, and smokeless tobacco; clarifies the definition of small cigars; and closes an existing loophole to end mislabeling of tobacco products. 

Health in All Policies:  Requires HHS to conduct a health impact assessment of major non-health legislative proposals and to detail staff to other departments to assist them with consideration of health impacts of their activities.

Healthy Workforce:  Provides tax credits to businesses that offer comprehensive workplace wellness

programs to their employees to improve health and wellbeing.

Workforce Health Improvement:  Allows employers to deduct the cost of athletic facility memberships for their employees and exempts this benefit as taxable income for employees.

Workplace Breastfeeding Taskforce:  Establishes a federal taskforce for the promotion of breastfeeding among working mothers.

Healthy Federal Workplaces:  Requires menu labeling in federal food facilities; the development of nutritional guidelines for food procurement and vending machines on federal property; the development of guidelines for stair placement and signage; and bicycle parking in federal properties. Calls on Federal Agencies to consider accessibility and attractiveness of stairs in designing new or remodeled buildings

Healthier National Parks:  Ensures the availability of healthy food and beverages in National Parks; directs the Secretary of the Interior to issue a report assessing the state of food and beverage offerings and proposing healthy food guidelines for food and beverages sold in National Parks; and calls on the Departments of Health and Human Services and the Interior to coordinate and create a long range action plan to advance efforts for the National Park System to enhance opportunities for people to engage in physical activity.

Title III.  Responsible Marketing and Consumer Awareness

Reducing Sodium Consumption:  Directs the FDA to develop two year targets for sodium reduction in packaged and restaurant foods.

Improved Food Labeling:  Removes nutrition labeling exemption for foods sold exclusively to restaurants.

Healthy Symbols:  Instructs the FDA to develop uniform guidelines for the use of nutrient labeling symbols or systems on the front of food packages.

Protect Kids from Unfair Junk Food Advertising:  Restores the rulemaking authority of the Federal Trade Commission (FTC) to issue restrictions on unfair advertising with respect to children, and gives the FTC APA rulemaking authority.

Health Literacy:  Strengthens federal initiatives to improve the health literacy of consumers by making health information more understandable and health care systems easier to navigate through continued research and dissemination of effective interventions.

Tobacco Marketing:  Eliminates tax deductibility of tobacco advertising and funds counter-advertising.

Incentives to Reduce Youth Tobacco Use:  Requires HHS to carry out an annual youth tobacco use survey and creates a penalty for tobacco manufacturers if youth use their tobacco products does not decrease.

Voluntary Guidelines on Food Marketing to Children:  Requires the FTC, FDA, CDC, and the Department of Agriculture to issue recommendations for standards for food marketing to children.

Title IV:  Expanded Coverage of Preventive Services

Preventive Services in Medicaid:  Requires coverage of preventive services recommended by the U.S. Preventive Services Task Force (USPSTF) and the CDC without cost-sharing for Medicaid beneficiaries.

Preventive Services for Federal Employees:  Requires coverage of preventive services recommended by the USPSTF, CDC, the Health Resources and Services Administration (HRSA) for children, and workplace wellness program in the Federal Employee Health Benefits (FEHB) Program.

Health Professional Education on Healthy Eating:  Establishes a program administered by CDC and HRSA to train health professionals to better identify and treat patients who may be, or are at-risk of being overweight or obese, or have an eating disorder.

Integrative Medicine Training Program:  Establishes a National Coordinating Center for Training in Integrative Medicine designed to integrate alternative treatment, diagnostic and prevention systems with the practice of conventional medicine as a complement to such medicine; and provides grants to develop such training programs for medical residents.

Title V:  Research and Surveillance

National Consortium on Breastfeeding Research:  Establishes a group at NIH to help breastfeeding researchers overcome current limitations, identify key research priorities, enable expanded and advanced research, and promote the translation of research to practice. 

National Assessment of Mental Health Needs:  Requires the Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA) to build on existing monitoring systems, or create new ones, to better assess mental health and substance use disorder status and risks.