BILL ANALYSIS SB 19 Page 1 Date of Hearing: August 21, 2001 ASSEMBLY COMMITTEE ON HEALTH Helen Thomson, Chair SB 19 (Escutia) - As Amended: July 20, 2001 SENATE VOTE : 22-15 POLICY QUESTIONS : 1)Should the reimbursement a school receives for free and reduced-price meals sold or served to pupils in elementary or middle schools be required to be increased to twenty-six cents? 2)Should various limitations and prohibitions on the sale of beverages and foods to pupils in elementary and middle schools be established? 3)Should the Department of Education be required to establish a pilot program in which not less than 10 high schools voluntarily adopt the provisions of this bill relating to various limitations and prohibitions on the sale of beverages and foods to pupils in school? 4)Should a school district maintaining at least one elementary school or secondary school be permitted to convene a Child Nutrition and Physical Activity Advisory Committee (Committee)? 5)Should the Committee be required to develop and recommend to the governing board of the school district for its adoption, school district policies on nutrition and physical activity? SUBJECT : Pupil health. SUMMARY : Requires the reimbursement a school receives for free and reduced-price meals sold or served to pupils in elementary or middle schools to be increased to twenty-six cents. Requires the sale of all foods on school grounds at elementary schools and middle schools, and in those schools participating in the pilot program created pursuant to this bill to be approved by the principal of the school or, by the principal's designee, for compliance with the nutrition standards specified by this bill. Establishes various limitations and prohibitions on the sale of SB 19 Page 2 beverages and foods to pupils in elementary and middle schools. Requires the Department of Education (DOE) to establish a pilot program in which not less than 10 high schools voluntarily adopt the provisions of this bill relating to various limitations and prohibitions on the sale of beverages and foods to pupils in school. Permits a school district maintaining at least one elementary school or secondary school to convene a Child Nutrition and Physical Activity Advisory Committee (Committee). Requires the Committee to develop and recommend to the governing board of the school district for its adoption, school district policies on nutrition and physical activity. Requires a school district that develops and adopts policies pursuant to the Committees established by this bill, to receive a grant from DOE on the basis of an equal amount per unit of average daily attendance of the participating school districts. Specifically, this bill : 1)Requires the reimbursement a school receives for free and reduced-price meals sold or served to pupils in elementary or middle schools to be increased to twenty-six cents. 2)Requires each elementary and middle school to receive a reimbursement of thirteen cents for meals sold at full price. 3)Defines "middle school" to mean any public school that maintains grades 7 and 8 and no grade lower than grade 6. Defines "elementary school" to mean a public school that maintains any grade below grade 6. Defines "high school" to mean any school maintaining grades 10 to 12 inclusive. 4)Requires a school to follow the United States Department of Agriculture's Enhanced Food Based Meal Pattern, the United States Department of Agriculture's Nutrient Standard Meal Planning, or California's SHAPE Menu Patterns in order to qualify for the increased reimbursement for free and reduced-price meals and for the reimbursement for meals sold at full price. 5)Requires the reimbursement rates set forth in #1 and #2 above to be adjusted annually for increases in cost of living in the same manner set forth in current law relating to the inflation adjustment established by the Superintendent of Public Instruction. 6)Requires #1 through #5 to become operative on January 1, 2004. SB 19 Page 3 7)Requires the sale of all foods on school grounds at elementary schools and middle schools, and in those schools participating in the pilot program created pursuant to this bill, to be approved by the principal of the school or, by the principal's designee, for compliance with the nutrition standards specified by this bill. 8)Requires the only food that may be sold to pupils at elementary schools during breakfast and lunch periods to be sold as a full meal, which is defined as any combination of food items that meet a USDA-approved meal pattern. Exempts the sale of fruits, vegetables, or beverages from this requirement. 9)Requires individual food items sold to pupils during morning or afternoon breaks at elementary schools to meet the standards for foods sold to pupils at middle schools, as set forth in #11 through #15 below. 10)Limits the types of beverages that may be sold to pupils at an elementary school to water, milk, and 100% fruit juices regardless of the time of day. 11)Limits the types of beverages that may be sold to pupils at middle schools from one-half hour before the start of the schoolday until after the end of the last lunch period to: a) Fruit-based drinks that do not contain additional sweeteners; b) Water; c) Milk, including, but not limited to, chocolate milk, soy milk, rice milk, and other similar nondairy milk; and, d) Sports drinks, defined as any electrolyte replacement beverage that contains no more than 25 grams of sweetener per 12 ounce serving. 12)Prohibits any beverage permitted to be sold pursuant to #11 above from being carbonated. 13)Requires in middle schools, all snacks, sweets, and side dishes sold to pupils outside the federal meal program before the end of the last lunch period to meet the following standards: SB 19 Page 4 a) Have 35 percent or less of its total calories from fat and exempts the sale of nuts and seeds from this requirement; b) Have 10 percent or less of its total calories from saturated fat; c) Have 35 percent or less of its total weight composed of sugar and exempts the sale of fruits and vegetables from this requirement; and, d) Be limited to 20 ounces for sports drinks, and 12 ounces for other beverages, and exempts water and milk from this requirement. 14)Prohibits in middle schools, entree items and side dishes, from being larger than the portions of those foods served as part of the federal school meal program. 15)Requires fruits and vegetables to be offered for sale at any location on the schoolsite where competitive foods are sold. 16)Requires vending machines that contain food or beverage items that do not meet the nutritional standards of this bill to remain locked or be rendered inoperable until after the end of the last lunch period. 17)Permits on no more than four days per year, a school to permit organizations consisting solely of pupils of that school to sell food items that do not meet the standards of this bill as part of a schoolwide fundraising event. Requires these sales to be held on the same four days for any or all organizations. 18)Prohibits #7 through #17 above from being waived pursuant to current law which permits the governing board of a school district or a county board of education, on a districtwide or countywide basis or on behalf of one or more of its schools or programs to waive any section of the Education Code or any regulation adopted by the Board of Education (BOE) that implements a section of the Education Code, after a public hearing on the matter. 19)Requires #7 through #17 above to become operative on January 1, 2004. 20)Requires, by January 1, 2004, every school to post a summary SB 19 Page 5 of nutrition and physical activity laws and regulations, and to post the school district's nutrition and physical activity policies, in public view within all school cafeterias or other central eating areas. Requires the DOE to develop the summary of state law and regulations. 21)Requires #20 above to become operative only if funds are appropriated in the Budget Act for the 2003-04 fiscal year for purposes of #27 and #28 below. 22)Permits a school district maintaining at least one elementary school or secondary school to convene a Child Nutrition and Physical Activity Advisory Committee (Committee) to develop and recommend to the governing board of the school district for its adoption, school district policies on nutrition and physical activity. 23)Requires the Committee to include, but not be limited to, food service directors, food service staff, staff, parents, pupils, physical and health education teachers, dietitians, health care professionals, and interested community members. 24)Requires the Committee to hold at least one public hearing, in developing the policies on nutrition and physical activity. Requires the policies on nutrition and physical activity to address issues and goals, including, but not limited to, all of the following: a) Implementing the nutritional standards set forth in #7 through #17 above; b) Encouraging fundraisers that promote good health habits and discouraging fundraisers that promote unhealthy foods; c) Ensuring that no pupil is hungry; d) Improving nutritional standards; e) Increasing the availability of fresh fruits and vegetables; f) Ensuring, to the extent possible, that the food served is fresh; g) Encouraging eligible pupils to participate in the school lunch program; h) Integrating nutrition and physical activity into the overall curriculum; i) Ensuring regular professional development for food services staff; SB 19 Page 6 j) Ensuring pupils a minimum of 30 minutes to eat lunch and 20 minutes to eat breakfast , when provided; aa) Ensuring pupils engage in healthful levels of vigorous physical activity; bb) Ensuring pupils receive nutrition education; cc) Improving the quality of physical education curricula and increasing training of physical education teachers; dd) Enforcing existing physical education requirements; ee) Altering the economic structures in place to encourage healthy eating by pupils and reduce dependency on generating profits for the school from the sale of unhealthy foods; and, ff) Developing a financing plan to implement the policies. 25)Permits a school district maintaining at least one elementary or middle school to apply to DOE for a grant to offset the costs of developing and adopting policies pursuant to #22 through #24 above. Requires these grants to be available to applicant school districts by January 1, 2002. 26)Requires a school district that develops and adopts policies pursuant to #22 through #24 above, by January 1, 2003, to receive a grant from DOE on the basis of an equal amount per unit of average daily attendance of the participating school districts, with no participating school district receiving less $4,000 per grant, and no participating school district receiving more than $25,000 per grant, to offset the costs of developing the policies. 27)Appropriates the sum of $9 million from the GF to DOE, for allocation as follows: a) $1 million in each of the fiscal years 2001-02 and 2002-03, for the purpose of providing technical support to school districts to assist in implementing #22 through #24 above. Requires activities carried out by DOE to include, but not be limited to, highlighting model nutrition programs, disseminating information to assist in the financial management of school food service programs, and identifying fundraising mechanisms that encourage health habits among pupils; and b) $8 million for providing grants to applicant school districts, on the basis of average daily attendance of the participating school districts, for the purposes of developing policies as set forth in #25 above. SB 19 Page 7 1)Requires of the $8 million appropriated by #27 b) above, the amount of $5 million to be allocated in the 2001-02 fiscal year, and $5 million to be allocated in the 2002-03 fiscal year. 2)Requires DOE to establish a pilot program in which not less than 10 high schools voluntarily adopt the provisions of #7 through #21 above. Requires participating districts to be eligible to receive a grant pursuant to #25. Requires school districts to be eligible for an increased reimbursement rate for free and reduced priced meals served at participating high schools. 3)Requires, annually, the Superintendent of Public Instruction (Superintendent) to randomly select not less than 10% of the school districts of the state to report compliance with this bill as set forth in #31 below. Requires the group selected to be sufficient to provide a statistically random and accurate sampling of the state as a whole. 4)Requires each school district selected pursuant to #30 above to report to the Superintendent in the coordinated compliance review regarding the extent to which it has complied with this bill. 5)Requires the Superintendent to issue a notice of noncompliance for any school district that the Superintendent finds is not in compliance with the mandatory provisions of this bill. 6)Requires the noncomplying school district to adopt, and provide to the Superintendent, a corrective plan. Requires the corrective plan to set forth the actions to be taken by the school district in order to ensure that the school district will be in full compliance within one year from the issuance of the noncompliance notification. 7)Requires DOE, with advice from the Child Nutrition Advisory Council, to design and implement a financial incentive grant program to help and encourage schools to implement the school district policies and meet the goals described in #24 above. 8)Requires the Department of Health Services (DHS) to monitor the implementation of #7 through #17 and to annually report to the Legislature regarding all of the following: SB 19 Page 8 a) The effectiveness of the policies and standards developed by school districts; b) The effect of this bill upon school districts and pupils, including, but not limited to, an assessment of pupil responses and related findings; and c) Recommendations for improvements or additions. 9)Requires DHS to report to the Legislature by June 1, 2004, regarding the initial implementation of #7 through #17 above. 10)Makes various legislative findings and declarations, including childhood obesity has reached epidemic levels in California and throughout the nation. EXISTING LAW : 1)Provides approximately $0.12 for the state's share of the reimbursable meal program. 2)Requires the governing board of a school district to give diligent care to the health and physical development of pupils. 3)Requires the Superintendent to reimburse school districts for certain costs associated with free and reduced-price meals. 4)Prohibits the sale of competitive foods in the school food service area, as defined in federal law. 5)Requires that 50% of the items, other than foods reimbursed under federal law, offered for sale each schoolday at any school-site by any entity or organization during regular school hours be selected from a prescribed list of nutritious foods. 6)Requires all public school districts and county superintendents of schools to make available, free or at a reduced price, one nutritionally adequate meal to each needy student every school day. FISCAL EFFECT : This bill would cost $4.5 million, for 2001-02 SB 19 Page 9 and $4.5 million for 2003-04 fiscal years from GF. $1 million of the appropriation would be available in the 2001-02 and 2002-03 fiscal years for the purpose of providing technical support to school districts. The remaining $8 million would be for providing grants to school districts on the basis of average daily attendance in the 2001-02 and 2002-03 fiscal years. COMMENTS : 1)PURPOSE OF THIS BILL . According to the author, the percentage of overweight children and youth in the U.S. has doubled in the past 30 years. 91 percent of children ages 6 to 11 are not eating the recommended amounts of fruits and vegetables. Many experts believe this is due, at least in part, to an increased consumption of convenience foods. The author argues that overweight and obese children are at a higher risk than other children for long-term health problems including diabetes, hypertension, cardiovascular disease, high blood pressure, gallbladder disease, asthma and certain cancers. The link between good nutrition and student achievement is clear: children who eat poorly tend to have high rates of sickness and absence from school, low energy, low test scores and difficulty concentrating. The author argues that this bill encourages students to adopt healthy eating habits and supports them in this endeavor at school by guaranteeing nutritious options for meals and snacks. 2)SUPPORT . According to the sponsors of this bill, the California Center for Public Health Advocacy (CCPHA), throughout California, as many as 1/3 of students are overweight. Poor nutrition and physical inactivity are responsible for 28% of preventable deaths in the U.S.. CCPHA argues that schools are part of the problem because there are no standards for foods sold a la carte, or in vending machines. According to the American Cancer Society (ACS), a significant contribution to youth obesity comes from the sale of unregulated foods and sodas at schools. This bill is directed at improving the choice of foods offered at schools as well as encouraging fruit and vegetable consumption. ACS adds that this bill will ensure that the eating habits promoted at our schools is consistent with the nutrition education students receive in the classroom. According to the American Heart Association (AHA), poor diet and physical inactivity contribute to an estimated 35,000 deaths and $15 billion in excess of health care costs every year in SB 19 Page 10 California. AHA argues that this bill takes long overdue and important steps to ensure that the eating habits promoted through the sale of food and beverages at our schools are aligned with nutrition education students receive in the classroom. According to the California Adolescent Nutrition and Fitness Program (CANFIT), schools greatly influence what youth eat, how active they are, and whether they become obese. Schools are increasingly offering unhealthy meals and foods in vending machines such as chips, candy, and soda. CANFIT states that this trend not only threatens student health, but also performance. The Sharp HealthCare Center for Health Promotion (SHARP) states that there is currently a huge dissonance in what is being taught in schools about nutrition and what is being sold to students through competitive food sales, school stores and fundraising efforts. SHARP argues that the role of schools should be to create a "safe haven" where youth are not bombarded daily with messages and opportunities to eat unhealthy foods that are high in fat and sugar. The California Parent Teachers Association (PTA) states that this bill includes all of what its members adopted as sound nutritional guidelines 10 years ago. PTA adds that this bill provides individual school districts local control and needed input in adopting district policies through the local Child Nutrition and Physical Advisory Committees. 3)OPPOSITION . The California School Food Service Association (CSFSA), is concerned about the impact this bill will have on the nutrition programs their school food service authorities are mandated to provide to California students. CSFSA states that it opposes this bill because the funding in the bill is not linked to the implementation of the standards, and a la carte sales would be severely restricted and the financial stability of school food service programs will be at stake. CSFSA states that they support the concept of improved nutrition access for students, but that, this bill falls short in addressing the true issue and will do more harm than good. The Association of California School Administrators (ACSA) states that although the bill has been significantly amended, ACSA continues to have strong concerns regarding operational and fiscal impacts the bill will have on school districts. These concerns are focused primarily on the potential impacts SB 19 Page 11 the bill will have on middle schools and student activities at those grade levels. ACSA supports the position that this bill should be piloted across all grade levels. If the Legislature is interested in changing school nutrition standards, then an across-the-board pilot program would provide evidence as to whether this bill or other similar proposals will work. The Jelly Belly Candy Company argues that candy is only a small percentage of calories consumed by children and all food can be eaten in moderation. Nutrition education and the need for physical activity should instead by fully addressed. The Dairy Institute argues that contrary to the implications of this bill, child health and nutrition is a concern for parents, school nutritionists and food manufacturers. As partners with families, local school food service programs make positive efforts to both educate and feed California's school children. The California Association of Directors of Activities (CADA), states that this bill provides no financial compensation to the hundreds of student clubs, organizations, publications, classes, activity programs, athletics, or performance groups that now rely on monies generated by the sale of food and beverages whether during the school day, or immediately after school in student run snack bars. CADA adds that this bill does not address the real problem of obesity or student activity. The Grocery Manufacturers of America argues that this bill will only serve to limit choice and restrict the authority of local schools and school districts to exercise discretion over whether and under what conditions various food products should be available in schools. The Riverside County Schools Advocacy Association argues that an unintended consequence of this bill would be a significant increase in secondary students leaving campus for lunch, undermining the nutritional goals of this bill and further reducing funding for this state mandated program. 4)SUPPORT IF AMENDED . (This bill was recently amended. It is unclear to what extent recent amendments have addressed these concerns.) The California School Boards Association, and the President of the Woodland School Board would support this bill if it was amended to instead create a pilot program in order to test the feasibility of implementing the suggested standards and their economic feasibility. The California Nutrition Council (CNC) would prefer to see less prescriptive language that could be used to teach children to manage their SB 19 Page 12 environment so that they can live productive healthy lives after their school careers. CNC states that it would prefer to see language that would allow schools some flexibility in meeting the demands of their students while providing a nutrition environment that does not flood food choices with foods of minimal nutritional value. 5)USDA REGULATIONS . Under the United States Department of Agriculture (USDA) regulations, the nutrient content of meals sold under the reimbursable meal program is based on (a) the recommended daily allowance (RDA); (b) children's energy expenditure; and (c) dietary guidelines for Americans. Each meal is based on a specific standard put out by the USDA. Such standards provide that each meal limit total fat content, meet 1/3 of RDA, and provide a variety of foods moderate in sugar and salt and high in fruits, vegetables, and whole grains. 6)COMPETITIVE FOOD SALES . Current law prohibits the sale of Foods of Minimal Nutritional Value or "competitive foods" in the "school food service area" as defined by federal law. The School Food Service Program (the federal, not-for-profit program) is authorized to sell nutritious school meals to pupils (within the specified federal guidelines). Current law authorizes school districts to contract with private vendors for the sale of competitive foods, so long as they meet a one-to-one requirement standard for these "competitive foods." 7)FREE AND REDUCED MEAL PROGRAMS . Currently, 74% of California school children receive free or reduced-price school meals. This is a reimbursable meal program where 96% percent of the reimbursement comes from federal funds. The state's share of this reimbursement equals around $0.12 and has remained constant since 1981. 8)CRB STUDY . A study by the California Research Bureau (CRB), entitled "Overweight Kids: Why Should We Care?" stated that childhood obesity in the United States has doubled in the last 10 years. There is much finger-pointing at the specific reasons as to why this has occurred. The CRB study found that the most apparent reasons for the increase in childhood obesity are that children are eating more calories and exercising less. The CRB study added that according to a Centers for Disease Control and Prevention national survey, SB 19 Page 13 one third of high school students did not participate regularly in vigorous physical activity, and more than half were not enrolled in physical education classes. According to the CRB study, students typically opt to take physical education during their first two years of high school, however, there may be no room if a student wanted to take additional physical activity classes. The CRB study listed the following potential policy options regarding addressing the problem of obesity: a) Providing accessible and affordable physical activity space and equipment; b) Providing physical activity instruction; c) Sharing programs that work by increasing networking between various programs; d) Providing affordable fruits and vegetables and instructing how to cook them; and, e) Developing a cost-effective preventive health campaign to better education Californians about the risks of eating fatty foods and not exercising. 9)COMMENT . This bill defines a "high school" to mean any school maintaining grades 10 to 12 inclusive, and a "middle school" to mean any public school that maintains grades 7 and 8 and no grade lower than grade 6. However, many schools contain grades 7 through 12 or some similar combination of grades. It is unclear whether a school that maintains grades 7 through 12, would be considered a "middle school", or a "high school" since it would satisfy both of the definitions in this bill. 10)DRAFTING CONCERN . On two occasions, this bill references Section 49430, which contains the definitions for this bill. It appears that the author intended to reference Section 49430.5 which relates to increasing the reimbursement a school receives for free and reduced-price meals. 11)RELATED LEGISLATION . SB 292 (Ortiz) requires DHS to expand the activities provided under the Physical Activity and Health Initiative (PAHI) and requires PAHI to work in conjunction with the California Project Leaders Encouraging Activity and Nutrition to promote health education, health activities, and health awareness to the public regarding the need to increase physical activity to prevent major chronic disease. SB 665 SB 19 Page 14 (Peace) prohibits any food offered for sale at any school-site during the regular schoolday from being junk food, as defined, and requires all milk offered to be skim or nonfat, or 1% fat. AB 287 (Wesson) appropriate up to $1 million from the General Fund to DOE for the purpose of contracting with a recognized testing company to perform various services related to making available a physical fitness test to school districts. AB 367 (Migden) requires DOE to issue a notice of noncompliance to each school district that fails to comply with specified requirements, including requirements regarding the number of hours of physical instruction offered to pupils in grades 1 to 12, inclusive. 12)PRIOR LEGISLATION . SB 1320 (Escutia) of 2000 contained similar provisions to this bill including the establishment of a Child Nutrition and Physical Activity Advisory Committee and prohibitions relating to the sale of foods and beverages at schools. SB 1320 was amended to focus on students with diabetes and included a provision requiring every school to permit any pupil with diabetes to test his or her blood glucose levels either in classrooms or very close to classrooms. SB 1320 was vetoed by the Governor. The Governor's veto message stated that currently, the governing boards of local educational agencies have a clear statutory responsibility to give diligent care to the health and physical development of pupils and have the authority to determine their staffing needs consistent with fulfilling this obligation. School health staffing needs are determined at the local level based on local priorities and should remain so. 13)DOUBLE REFERRAL . Should this bill pass out of this committee, it will be referred to the Assembly Committee on Education. REGISTERED SUPPORT / OPPOSITION : Support California Center for Public Health Advocacy (sponsor) African Americans Building a Legacy of Health Project (prior version) American Academy of Pediatrics (prior version) American Cancer Society (prior version) American Diabetes Association (prior version) American Federation of State, County, and Municipal Employees, SB 19 Page 15 AFL-CIO (prior version) American Heart Association (prior version) Bay Area Partnership (prior version) Beach Cities Health District (current version) California Adolescent Nutrition and Fitness Program (prior version) California Association for Health, Physical Education, Recreation and Dance (prior version) California Citizens For Health Freedom (prior version) California Conference of Local Health Department Nutritionists (prior version) California Conference of Local Health Officers (prior version) California Dental Association (prior version) California Federation of Teachers (prior version) California Food Policy Advocates (prior version) California Public Health Association-North (prior version) California State Parent Teachers Association (prior version) California Teachers Association (prior version) California WIC Association (prior version) Children's Advocacy Institute (current version) City of Norwalk (prior version) Community Health Councils, Inc. (prior version) Diabetes Coalition of California (prior version) Imperial County Public Health Department (prior version) Junior Leagues of California State Public Affairs Committee (prior version) Kaiser Permanente (current version) Prevention Institute (prior version) Project Harmony (prior version) Project LEAN in the Gold Coast Region (prior version) Samuels and Associates (prior version) Santa Barbara County (prior version) Sharp HealthCare Center for Health Promotion (prior version) Southern California Public Health Association (prior version) Strategic Alliance to Prevent Childhood Obesity (prior version) University of Southern California Mobile Dental Clinic (prior version) Western Growers Association (prior version) Several individuals Opposition A&R Wholesale Distributors, Inc. (prior version) Association of California School Administrators (current SB 19 Page 16 version) California Association of Directors of Activities (prior version) California Association of School Business Officials (current version) California Automatic Vendors Council (prior version) California Distributors Association (prior version) California Nevada Soft Drink Association (prior version) Californians for Sensible School Nutrition Policy (prior version) California School Food Service Association (prior version) Chocolate Manufacturers Association (prior version) Colusa Unified School District (prior version) Covina-Valley Unified School District (prior version) Dairy Institute (prior version) Glendale Unified School District (prior version) Grocery Manufacturers of America (prior version) Hershey Foods Corporations (prior version) Jelly Belly Candy Company (prior version) Lawndale Elementary School District (prior version) Long Beach Unified School District (prior version) Los Angeles Area Chamber of Commerce (prior version) Manteca Unified School District (prior version) National Automatic Merchandising Association (prior version) National Confectioners Association (prior version) Ontario-Montclair School District (current version) Pepsi-Cola Company (prior version) Quaker Oats Company (prior version) Quality Vending Systems (prior version) Redondo Beach Unified School District (prior version) Riverside County Schools Advocacy Association (current version) Santa Clarita Valley School Food Services Agency (prior version) Santa Maria-Bonita School District (prior version) Snack Foods Association (prior version) Tom's Foods, Inc. (prior version) Total Vending Services Inc. (prior version) Whittier City School District (prior version) Several Food Service Directors from: Alta Loma School District Capistrano Unified School District Central Unified School District Conejo Valley Unified School District El Monte Union High School District SB 19 Page 17 Fairfield-Suisun Unified School District Kingsburg Elementary Charter School District Los Banos Unified School District Manhattan Beach Unified School District Manteca Unified School District Merced City School District Modesto City Schools Pomona Unified School District Redondo Beach Unified School District Visalia Unified School District Several individuals Analysis Prepared by : David Gonzalez / HEALTH / (916) 319-2097