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 --