The Healthy Hunger-Free Kids Act of 2010 mandates that districts raise their full pay lunch prices every year until the price of non-subsidized lunches equals the amount the federal government reimburses schools for free meals. That subsidy in 2013-2014 was $2.93. In 2015, federal reimbursement rates were $3.07 per meal for students who were income-eligible for free lunches and $2.67 for those who qualified for a reduced price. School lunch participation nationally dropped from 31.6 million students in 2012 to 30.4 million in 2014, according to the federal Department of Agriculture. Pennsylvania statistics show that school lunch participation dropped by 86,950 students in the same two years, from 1,127,444 in 2012 to 1,040,494 in 2014. In 2014, President Barack Obama ordered a prohibition of advertisements for unhealthy foods on public school campuses during the school day. The US Department of Agriculture requires that students take milk as their beverage at lunch. In accordance with this law, any student requesting water in place of milk with their lunch must present a written request signed by a doctor, documenting the need for water instead of milk. Gettysburg Area School District provides health services as mandated by the Commonwealth and the federal government. A nurse is available in the high school to conduct annual health screenings (data reported to the PDE and state Department of Health) and to dispense prescribed medications to students during the school day. Students can be excluded from school unless they comply with all the State Department of Health’s extensive immunization mandates. School nurses monitor each pupil for this compliance. Nurses also monitor each child's weight. Pennsylvania high schools have received the overdose antidote drug naloxone in a nasal spray. School nurses were also provided with educational materials and training developed by the National Association of School Nurses. The cost was covered by a grant from a private foundation. The Gettysburg Area School District offers a variety of clubs and activities, and an extensive costly, sports program. The Gettysburg Area School Board sets policies regarding eligibility to participate in these activities. The PIAA mandates that student athletes must be passing at least four full-credit subjects to participate in sports. By Pennsylvania law, all K-12 students in the district, including those who attend a private nonpublic school, cyber charter school, charter school, or home school, are eligible to participate in the extracurricular programs, including all athletics. They must meet the same eligibility rules as the students enrolled in the district's schools.