Joint Legislative Council prefatory note: This bill was prepared for the Joint
Legislative Council's Special Committee on Performance-Based Disease Management
for Large Populations. Subsequent to the committee's approval of the preliminary drafts
upon which this bill is based, the 2009-11 biennial budget act, 2009 Wisconsin Act 28, was
enacted. This bill, in addition to compiling those drafts, reconciles the provisions of those
drafts with current law, as affected by the biennial budget act.

The Department of Public Instruction (DPI) and the University of Wisconsin (UW)
received a three-year grant, which ends in 2010, to administer the FitnessGram physical
fitness test in middle schools that volunteer to participate. The FitnessGram is a
software program which is comprised of four tests: body mass index measurement, a
quasi-situps abdominal strength test, a flexibility test, and the Progressive Aerobic

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Cardiovascular Endurance Run (PACER). For all elements of the FitnessGram, age and
gender norms have been developed and individual scores are measured against these
norms. The PACER is a 20-meter shuttle run (back and forth) which is conducted in a
class-based setting in which 20-50 children can run at a time. The PACER is designed
to measure aerobic capacity. The UW has found that the PACER test is a good measure
of fitness and a good indicator of diabetes risk.

This bill directs public schools, charter schools, and private schools to ensure that
the physical fitness of pupils in grades 3 through 12 is assessed annually and specifies
that the assessment must include an evaluation of pupils' aerobic capacity. These schools
are not required to assess pupils who have a disability or other condition as specified by
DPI administrative rule. The results must be kept confidential but schools are required
to send results to DPI and provide an individual child's results to their parent or
guardian.

The national school lunch and school breakfast programs provide federal funding
to schools to serve free and reduced-priced meals and snacks. In exchange for receiving
federal funds, schools must serve meals and snacks that adhere to federal nutritional
requirements set by the U.S. Department of Agriculture (USDA). USDA requires that
school lunches must meet the applicable recommendations of the 1995 Dietary
Guidelines for Americans, which recommend that no more than 30% of an individual's
calories come from fat and less than 10% from saturated fat. Federal guidelines do not
apply to or limit the sale of a la carte or vending machine foods sold in addition to federally
funded meals and snacks.

The Department of Children and Families (DCF) licenses day care centers.
Current law requires anyone caring for four or more children under age seven who are
unrelated to the provider to be licensed. The two types of licensed day care centers are:
1) family day care centers (up to eight children in care at any given time); and 2) group
day care centers (nine or more children at any given time). Current law, as created by
the 2009-11 biennial budget act, 2009 Wisconsin Act 28, requires DCF to provide a child
care quality rating system that rates the quality of the child care provided by a licensed
day care center that receives reimbursement under the Wisconsin Works Program or that
volunteers for rating under the system and to make the rating information provided
under that system available to the parents, guardians, and legal custodians of children
who are recipients, or prospective recipients, of care and supervision from a day care
center that is rated under the system. Current licensing requirements specify that meals
and snacks provided at a licensed day care center must comply with the U.S. Department
of Agriculture Child and Adult Care Food Program minimum meal requirements. Also

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under current licensing requirements, licensed day care centers must provide children
with experiences that promote large and small muscle development and children must
go outside daily unless the weather prohibits doing so. Current licensing requirements
do not specifically direct licensed day care centers to provide nutrition education to
children.

The bill requires the child care quality rating system to rate the quality of the child
care provided by all licensed day care centers. The bill also requires the quality rating
system to include indicators regarding the quality of the nutrition education provided by
the day care center, including the developmental appropriateness of that education, the
physical activity included in the day care center's program, including the developmental
appropriateness of that activity, the nutritional value of the food and beverages served
at the day care center, and any other nutritional policies implemented by the day care
center. In addition, the bill requires DCF to consult with the Department of Health
Services in establishing the indicators used to evaluate the quality of care provided at a
licensed day care center. Finally, the bill requires DCF to seek funding to provide
financial assistance to licensed day care centers that wish to improve their rating under
the quality rating system.