BILL ANALYSIS SENATE HEALTH COMMITTEE ANALYSIS Senator Elaine K. Alquist, Chair BILL NO: AB 2084 A AUTHOR: Brownley B AMENDED: June 15, 2010 HEARING DATE: June 23, 2010 2 CONSULTANT: 0 Orr/cjt 8 4 SUBJECT Child day care facilities: nutrition SUMMARY Requires a licensed child day care facility to follow specified requirements relating to the provision of beverages, with specified exceptions. CHANGES TO EXISTING LAW Existing federal law: Establishes the Child and Adult Care Food Program (CACFP), authorized by the National School Lunch Act which subsidizes meals and snacks for specified populations with the purpose of ensuring adequate nutrition while in care. Existing state law: Authorizes the state Department of Education to administer the federal Child Care and Adult Food Program in California. Bans the sale of soda in schools and imposes caloric restrictions on entr?e items sold to pupils in elementary, Continued--- STAFF ANALYSIS OF ASSEMBLY BILL 2084 (Brownley) Page 2 middle, junior, or high schools, except for food served as part of a United States Department of Agriculture meal program. Under the California Child Day Care Facilities Act (Act), authorizes the state Department of Social Services to license and regulate child day care facilities, including child care centers and homes, as defined, and requires that persons or organizations offering child day care must comply with specified licensure requirements. This bill: Places the following requirements on beverages served by providers to children in licensed child day care facilities: Only low fat (1 percent) or nonfat milk to children 2 years of age or older. No more than one serving per day of 100 percent juice. No beverages with added sweeteners, either natural or artificial, excluding infant formula or children's complete balanced nutrition products. Clean and safe drinking water must be readily available throughout the day. Specifies that beverages provided by parents or legal guardians, and medical foods when documented by a physician, are exempt from complying with these requirements. Makes findings and declarations about unhealthy taste preferences in early childhood and obesity. FISCAL IMPACT According to the Assembly Appropriations Committee analysis, one-time General Fund (GF) costs, likely less than $75,000, for the Department of Social Services (DSS) to update licensing forms and materials to include new nutrition requirements, and ongoing annual workload costs of approximately $100,000 GF for increased workload associated with DSS including the requirements of this bill in their annual inspections. STAFF ANALYSIS OF ASSEMBLY BILL 2084 (Brownley) Page 3 BACKGROUND AND DISCUSSION The purpose of this bill is to create standards for beverages served in licensed child care settings in an effort to help prevent childhood obesity. According to the author, this bill would encourage healthy beverages in child care settings by establishing modest, no-cost, easy-to-implement nutrition standards in child care licensing. With over 4 million children between birth and 12 years of age in California having one or two working parents who rely on child care services, child care settings, including center and home-based care, play an important role in influencing good eating habits and teaching the importance of physical activities. Research increasingly points to sugary beverages, such as soda, sports drinks, and juice drinks as a major factor in rising rates of obesity. With recommendations supported by the scientific community and consistent with the Dietary Guidelines for Americans and the American Academy of Pediatrics, this bill will ensure that only the healthiest beverages are served in licensed child care settings. Impact of beverage consumption on obesity In a September 2009 report titled, "Bubbling Over: Soda Consumption and its Link to Obesity in California," the UCLA Center for Health Policy Research found that 24 percent of California adults, 62 percent of adolescents ages 12 to17, and 41 percent of children ages 2 to11 drink at least one soda or other sugar-sweetened beverage every day. The report cites findings that between 1977 and 2002, Americans have increased their calorie intake from soft drinks by 228 percent. Also, according to the report, over the past three decades the prevalence rate for overweight and obesity nationwide has nearly doubled for adults, has tripled among 12 to19 year olds and has more than quadrupled among 6 to11 year olds. In California, 21 percent of adults and 14 percent of adolescents are obese, according to the report. Thirty-five percent of adults and 16 percent of adolescents are overweight. Most importantly, the report concludes that the rates of overweight and obesity are 18 percent higher among those who drink soda daily compared to those who do not. On November 5, 2009, the Senate convened a joint hearing with the Committee on Health the Select Committee on STAFF ANALYSIS OF ASSEMBLY BILL 2084 (Brownley) Page 4 Obesity and Diabetes titled, "Exploring the Link Between Sugar Sweetened Drinks and Obesity." At the hearing, leading nutrition and obesity researchers from across the nation gave testimony that sweetened beverage consumption: 1) adds unnecessary calories to an individual's daily intake due to lack of nutritional value; and, 2) parallels the rise in obesity in the nation. Researchers affirmed that reducing the consumption of sweetened beverages is an important strategy to reverse obesity trends in the United States. Obesity trends and scholastic achievement According to the Centers for Disease Control and Prevention, approximately one out of every four children between the ages of two and five has a high body mass index, putting these children at risk for obesity. According to data from the 2007 California Health Interview Survey, 11.2 percent of children in California are classified as overweight for their age. Being overweight or obese can lead to developing type II diabetes, hypertension, sleep apnea, and several other adverse health conditions. These conditions can translate into millions of dollars in health care costs down the road, further burdening an already overstretched health care system. Research supports the assertion that healthy eating and physical activity play an important role in learning and cognitive development. Poor diet and physical inactivity have been found to adversely influence the ability to learn and decrease motivation and attentiveness. Such findings indicate that young people will not be ready to learn and achieve their full potential unless they are well nourished and healthy. Child and Adult Care Food Program (CACFP) CACFP serves meals and snacks to 2.9 million eligible children and 86,000 adults who are enrolled for care at participating child care centers, day care homes, and nonresidential adult day care centers. CACFP also provides meals to children residing in emergency shelters, and snacks to youths participating in afterschool care programs. The USDA Food and Nutrition Service (FNS) administers CACFP through grants to states. In California, CACFP is administered by the Department of Education. Independent centers and sponsoring STAFF ANALYSIS OF ASSEMBLY BILL 2084 (Brownley) Page 5 organizations receive cash reimbursement for serving meals to enrolled children and adults that meet federal nutritional guidelines. Care providers participating in this program are required to observe the USDA nutrition standards for children ages one through twelve by providing meals as follows: Breakfast Fluid milk; Vegetable, fruit, or 100 percent juice; and, Bread, or rolls/muffins, or cold dry cereal, or cooked cereal/pasta/noodle products (whole grain or enriched). Lunch or Dinner Fluid milk; Vegetable and/or fruit (two or more); Bread, or rolls/muffins, or cold dry cereal, or cooked cereal/pasta/noodle products (whole grain or enriched); and, Lean meat/fish/poultry, or cheese, or cottage cheese/cheese spread substitute, or large egg, or cooked dried beans/peas, or peanut butter/other nut or seed butter, or peanuts/tree nuts/roasted seeds, or yogurt, or an equivalent quantity of any combination of the above meat/meat alternatives. Snack Fluid milk; Vegetable, fruit, or 100 percent juice; Bread, or rolls/muffins, or cold dry cereal, or cooked cereal/pasta/noodle products (whole grain or enriched); and Lean meat/fish/poultry, or cheese, or cottage cheese/cheese spread substitute, or large egg, or yogurt, or cooked dried beans/peas, or peanut butter/other nut or seed butter, or peanuts/tree nuts/roasted seeds, or an equivalent quantity of any combination of the above meat/meat alternatives. The CACFP serving size varies according to age and types of meal served. Juice cannot be served when milk is served as the only other component. Under the CACF, the federal government provides $1.7 billion to California for licensed child care centers, STAFF ANALYSIS OF ASSEMBLY BILL 2084 (Brownley) Page 6 adult day care centers, and organizations that sponsor day care homes to provide nutritionally adequate meals and snacks. The federal government provides a maximum of $1.17 for breakfast, $2.18 for lunch, and $0.65 for snacks, under the Act. California provides $0.16 for breakfast and $0.16 for lunch to licensed child care centers, and $0.16 for 75 percent of the breakfast and lunches served to children enrolled in licensed child care homes. Centers and day care homes may be approved to claim up to two reimbursable meals (breakfast, lunch or supper) and one snack, or two snacks and one meal, to each eligible participant, each day. Child care facilities There are currently 15,140 licensed center-based sites and 42,907 family home sites in California. Collectively, these sites have the capacity to care for 1.2 million children from birth to 12 years of age. Day care homes must be licensed or approved to provide day care services to participate in CACFP. Reimbursement for meals served in day care homes is based upon eligibility for tier I rates (which targets higher levels of reimbursement to low-income areas, providers, or children) or lower tier II rates. Tier I day care homes are those that are located in low-income areas, or those in which the provider's household income is at or below 185 percent of the federal income poverty guidelines. Tier II homes are those family day care homes which do not meet the location or provider income criteria for a tier I home. Eligible public or private nonprofit child care centers, outside-school-hours care centers, Head Start programs, and other institutions which are licensed or approved to provide day care services may also participate in CACFP, independently or as sponsored centers. For-profit centers must receive specified federal funding for at least 25 percent of enrolled children or licensed capacity (whichever is less) or at least 25 percent of the children in care must be eligible for free and reduced-price meals. Meals served to children are reimbursed at rates that are based upon a child's eligibility for free, reduced price, or paid meals. Related bills SB 1210 (Florez) would impose a tax upon every sweetened STAFF ANALYSIS OF ASSEMBLY BILL 2084 (Brownley) Page 7 beverage manufacturer, concentrate manufacturer, or other person who makes the first sale in this state of a sweetened beverage or concentrate of a rate of one cent per teaspoon of sugar placed into the sweetened beverage or equivalent amount of concentrate. The revenues collected from this tax would be deposited in the Childhood Obesity Fund, which the bill would create, for appropriation by the Legislature. Pending in Senate Revenue and Taxation Committee. SB 1413 (Leno) would require a school district to provide access to free, fresh drinking water in school food service areas by January 1, 2012. Pending in Assembly Education Committee. AB 2100 (Coto) would impose a tax on every distributor or retailer at the rate of one cent per teaspoon of added caloric sweetener in a bottled beverage or concentrate offered for sale in this state. The bill would require all taxes be deposited into the Pediatric Obesity Fund, created by this bill. Upon appropriation by the Legislature, the Fund would be allocated to the Department of Education for distribution of grants to school districts for the purpose of employing school nurses or for other health-related needs at schools. Pending in Assembly Revenue and Taxation Committee. Prior legislation AB 95 (Torlakson) would have specified that, if the Superintendent of Public Instruction determines that the appropriation set forth in the Budget Act of 2008-09 is insufficient to fully fund all free and reduced price meal reimbursement claims, the state Department of Education to notify the Legislature of the statutory funding amount necessary to reimburse school districts at the prescribed rate. The bill would have appropriated $19,500,000 to reimburse claims pursuant to those provisions. Held in the Assembly Education Committee. AB 627 (Brownley) of 2009 would have required the Superintendent of Public Instruction to establish a pilot program under which licensed child care centers and child day care homes selected by the department that participate in the federal Child and Adult Care Food Program would implement certain nutrition and STAFF ANALYSIS OF ASSEMBLY BILL 2084 (Brownley) Page 8 physical activity standards in exchange for a higher state meal reimbursement. Vetoed. SB 20 (Torlakson) of 2007 would have required schools, and encouraged child development programs, to follow specified nutritional guidelines and prohibit the sale or serving of food that is deep fried, par fried, or flash fried, or food that contains trans fat, as specified, beginning with fiscal year 2007-08, in order to get reimbursement for meals and food items sold as part of the free- and reduced-price meal program. These provisions were amended out of the bill. SB 490 (Alquist) Chapter 648, Statutes of 2007, prohibits beginning July 1, 2009, a school district from making available to pupils enrolled in kindergarten or grades 1 through 12 a food containing artificial trans fat, and prohibits the use of artificial trans fat in the preparation of a food item served to those pupils. Exempts from these requirements food provided as part of a USDA meal program. SB 965 (Escutia) Chapter 237, Statues of 2005, modified the list of beverages that may be sold to pupils at an elementary, middle or junior high school, in effect banning the sale of sodas in schools. SB 677 (Ortiz) Chapter 415, Statutes of 2003, prohibited the sale of certain beverages to pupils in elementary, middle, or junior high schools commencing July 1, 2004. In addition, the bill exempted the sale of certain beverages at specified school events from those prohibitions. SB 56 (Escutia) Chapter 361, Statutes of 2002, required schools that are selected to participate in the pilot program prescribed by the Pupil Nutrition, Health and Achievement Act of 2001 to comply with specified food sale requirements, and made various technical and clarifying changes in related provisions. SB 19 (Escutia) Chapter 913, Statutes of 2001, established the Pupil Nutrition, Health and Achievement Act of 2001. It established, as of January 1, 2004, various prohibitions on the sale of beverages in elementary and middle schools and placed nutritional standards on the type of foods that may STAFF ANALYSIS OF ASSEMBLY BILL 2084 (Brownley) Page 9 be sold to pupils during school breaks and through vending machines. The bill increased the reimbursement a school receives for free and reduced-price meals, permits school districts to convene a Child Nutrition and Physical Activity Advisory Committee, and required the Department of Education to establish a pilot program in which high schools voluntarily adopt food sale requirements, in exchange for eligibility for an increased reimbursement rate for free and reduced price meals served. Arguments in support California Food Policy Advocates (CFPA) is co-sponsoring this bill, and supports policies that improve the health and well-being of Californians through increasing consumption of nutritious foods and beverages. Child care represents a great, and largely untapped, opportunity for improving nutrition and shaping lifelong, healthy habits. AB 2084 would take California's successful school nutrition changes and bring these to child care. Given the increasingly important role child care plays for millions of working families in California and the significant amount of time children spend in child care, CFPA believes California must ensure that these children enjoy healthy nutrition environments while in care. PRIOR ACTIONS Assembly Floor: 44-26 Assembly Appropriations: 11-5 Assembly Human Services: 4-2 POSITIONS Support: California Food Policy Advocates (co-sponsor) California Center for Public Health Advocacy (co-sponsor) American Academy of Pediatrics American Cancer Society American Federation of State, County and Municipal Employees American Heart Association STAFF ANALYSIS OF ASSEMBLY BILL 2084 (Brownley) Page 10 California Alternative Payment Program Association California Chiropractic Association California Dental Association (CDA) California Medical Association California Park & Recreation Society California State PTA California Teachers Association California WIC Association Central Coast Hunger Coalition Dental Health Foundation First 5 LA Fresno Metro Ministry Grupo de la Comida Latino Coalition for a Healthy California Plowshares Second Harvest Food Bank, Santa Cruz State Superintendent of Public Instruction An individual Oppose: None received -- END --