BILL ANALYSIS �
AB 290
Page 1
Date of Hearing: April 2, 2013
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Mark Stone, Chair
AB 290 (Alejo) - As Introduced: February 11, 2013
SUBJECT : Child Day Care: childhood nutrition training
SUMMARY : Requires training for child development programs to
include one hour of childhood nutrition training. Specifically,
this bill :
1)States findings and declarations as follows:
a) Nearly 25% of California's preschool age children are
overweight or obese and are at risk of developing chronic
diseases, contributing to increased health care costs, and
at the same time are participating in child development
programs in higher numbers;
b) Research demonstrates that taste preferences and
lifelong nutrition habits are developed during the early
childhood years and that most diets of young children do
not meet the Dietary Guidelines for Americans, as they tend
to be low in healthy foods and high in sugar and fat;
c) Research supports that training for child development
providers can improve the quality of child development
programs; and
d) The state has a history of policy and fiscal investment
in the development of licensed child development programs
and providing for the health and safety of children
enrolled in those programs.
2)Amends the California Child Day Care Facilities Act (CDCFA) to
require any child day care facility seeking to be licensed
under this act, on or after January 1, 2015, to include
elementary training in childhood nutrition and practices that
support the overall health of children.
3)As a condition of meeting this additional elementary training,
at least one director or teacher employed by a child
development agency shall have at least one hour of childhood
nutrition training in addition to the 15 hours of training
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already required under law.
4)Requires the training to include content on age-appropriate
meal patterns, based upon Dietary Guidelines for Americans,
and inform providers on the eligibility, enrollment and
reimbursement for participation in the United States
Department of Agriculture (USDA) Child and Adult Care Food
Program.
EXISTING LAW
1)The CDCFA provides for the licensing and regulation of child
development homes and facilities by the California Department
of Social Services (DSS) Community Care Licensing Division.
Specifically, it:
a) Requires licensed child care agencies to have at least
one director or teacher at the agency to be have at least
15 hours of health and safety training, which includes the
following components:
i) elementary health care training, including
cardiopulmonary resuscitation and pediatric first aid;
and
ii) a preventative practices course for the recognition
and prevention of infectious diseases and injury.
b) Allows the training to include instruction on sanitary
food handling, child nutrition, emergency preparedness,
caring for children with special needs and reporting signs
and symptoms of child abuse.
c) Prohibits children from being served beverages with
added sweeteners, either natural or artificial, unless the
child has a medical necessity or if the beverage is
provided by the child's parent.
d) Allows DSS to adapt provisions of the Dietary Guidelines
for Americans, published jointly by the US Departments of
Health and Human Services and Agriculture to continue to
reflect the most recent relevant nutrition science to
improve the health of children in child care.
2)Education Code authorizes the State Superintendent of Public
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Instruction (SSPI) to implement standards for the operation of
quality early childhood education programs, which includes
providing for the nutritional needs of children. Pursuant to
this authority, under Title 5 regulations adopted by the
California Department of Education (CDE), early childhood
programs contracted with the CDE are required to include in
their programs:
a) a nutrition component that ensures that the children
have nutritious meals and snacks during the time in which
they are in the program; and
b) meals and snacks that are culturally and developmentally
appropriate for the children being served, which meet the
nutritional requirements specified by the federal Child
Care Food or the National School Lunch program.
FISCAL EFFECT : Unknown
COMMENTS :
Background
There are generally two types of child development providers in
the state; commonly referred to as either Title 22 or Title 5
programs. Title 22 refers to Division 2 of Title 22 of the
California Code of Regulations (CCR), which is governed by DSS,
and Title 5 refers to Divisions 19 and 19.5 of the CCR, which is
governed by the CDE.
Title 22 establishes general health and safety requirements,
staff to child ratios, and basic provider training
qualifications. In order for any person to operate a child
development program, the program must first become a licensed
provider under Title 22. Title 22 providers set their own rates
and may voluntarily accept child development subsidy vouchers,
along with statutorily established family fees, provided through
the California Work Opportunity and Responsibility to Kids
(CalWORKs) program or other state-funded child care subsidy
programs. Voucher rates are set by the Regional Market Rate
(RMR), which is generally intended to reflect the true regional
cost of care in the private child care market. As established
in AB 1497 of 2012, the education budget trailer bill (Chapter
29, Statutes of 2012), the RMR is currently set at the 85th
percentile of the 2005 RMR Survey, and the license-exempt child
care providers ceiling at 60% of the Family Child Care Home
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ceilings, effective July 1, 2012.
According to DSS, as of February 6, 2013, there were
approximately 47,477 child care agencies with a licensed
capacity to serve up to 1,095,672 children in California.
Title 5 governs the state's subsidized child development
programs, which are overseen by the CDE. These programs must be
licensed by DSS under Title 22 regulations and must meet higher
quality standards established under Title 5 regulations. These
requirements include:
A developmentally- and age-appropriate educational
program for enrolled children;
Staff development opportunities to improve program
quality;
Parental involvement and education, including a parent
survey;
Nutritional standards that comply with federal child
nutrition program requirements, such as the National School
Lunch Program;
A health and social services component to identify and
refer eligible children and their families to community or
public health and social services, such as CalFresh;
A self-evaluation process to continually improve and
enhance their program; and
An environment rating scale that measures education
quality, parental involvement, and staff development and
education.
It is important to note that Title 5 programs, as a condition of
being contracted with the CDE, must accept and serve needy and
eligible subsidized children. Title 5 programs are funded
through the receipt of the Standard Reimbursement Rate (SRR)
based upon the number of children enrolled and the number of
hours of care, as well as statutorily established family fees.
Whereas a Title 22 program accepting a voucher would be
reimbursed by the RMR, which is generally higher than the SRR
because of its association with the regional private provider
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market, a Title 5 program is reimbursed using the SRR.
The SRR is statutorily set and is supposed to be increased
annually with a cost of living adjustment (COLA), however, a
COLA has not been provided since the 2007-08 fiscal year. The
SRR currently stands at $34.38 for one full-day of enrolled
care, which is defined by regulation as six and one half hours
of care. There are "adjustment factors" that are applied to the
SRR to reflect the increased cost of care for the varying ages
and needs of children, i.e. infants and toddlers, special needs,
etc. However, the adjustment factors have also not changed
since they were established in AB 2311 (Chu,) Chapter 435,
Statutes of 2002.
Title 5 programs earn their SRR reimbursement based upon child
days of enrollment, meaning they are reimbursed at the rate of
$34.38 per day for each day the needy or eligible child receives
care. This creates challenges for Title 5 programs, as they
budget based upon the total number of days and children they
anticipate having to serve in a fiscal year. Add into this the
uncertainty of a child's regular and continuous enrollment, a
family being deemed as no longer eligible or in need of care,
and fluctuating statewide budgets, it becomes a formidable
challenge for a Title 5 program to fully earn their contract's
maximum reimbursable amount (MRA). The goal set by CDE for
Title 5 programs is to annually earn no less than 98% of their
MRA.
According to CDE, as of the 2009-10 fiscal year, there were
approximately 1,420 service contracts with nearly 770 public and
private agencies supporting and providing services to 489,200
children. Title 5 providers contract with the CDE and include
school districts, county offices of education, cities, local
park and recreation districts, county welfare departments, other
public entities, community-based organizations, and private
agencies.
Need for the bill
According to the Centers for Disease Control (CDC), obesity
rates among children and adolescents have almost tripled since
1980. Approximately 17%, or 12.5 million children and
adolescents nationwide, aged two to 19 years of age are
considered obese. Further, it is estimated that one in three
children are obese or considered overweight by their fifth
birthday.
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The health risks of obesity in young children are substantial,
which places their overall health at greater risk. Obesity can
lead to Type 2 diabetes, hypertension, sleep apnea, and other
adverse health conditions. Longitudinal studies have also
demonstrated that eating habits learned at an early age are more
likely to be practiced throughout a person's lifetime.
Current law allows DSS to utilize existing federal Dietary
Guidelines for Americans, developed by the US Departments of
Health and Human Services and Agriculture. It additionally
permits DSS to include childhood nutrition in its training
regimen for child care agencies. However, because the training
is permitted but not required, there is no assurance that
licensed child care agencies have knowledge of or are providing
good quality and healthy, nutritious meals to the children they
serve.
AB 290 would add one hour of specific childhood nutrition
training to the state's existing 15-hour training requirement
for licensure under the CDCFA. Although all Title 5 programs
must already provide nutritional standards development
opportunities in order to meet their childhood nutritional
requirements, it is unknown whether some or all Title 22
programs do the same.
This measure appears to be a follow-up to AB 1872 (Alejo) from
2012, which passed the Legislature but was vetoed by the
Governor. According to the Governor, he vetoed AB 1872 because:
"The bill would require family child care homes to serve
food in conformance with the federal Child and Adult Care
Food Program, which offers reimbursement for meals that
meet certain criteria.
"I can support a measure that helps family child care
providers learn about nutrition and serve healthier foods
at a lower cost, but this bill goes beyond that. Small
businesses such as family day care providers don't need
another confusing mandate that adds to their struggles to
stay afloat. "
By limiting this measure to adding one hour of training related
to childhood nutrition, it appears to be responsive to the
Governor's message to help "family child care providers learn
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about nutrition and serve healthier foods at a lower cost? "
In explaining the need for this legislation, the author states
that:
Research indicates child care provider training has the
greatest impact on the quality of child care programs. Yet
California's licensing laws do not require providers to
undergo any nutrition training. With nearly 25% of
preschool-aged children overweight or obese, thousands of
California's youngest residents face a lifetime of health
challenges (e.g., diabetes, heart disease, cancer) related
to poor nutrition. Conversely, children who practice
healthy eating habits during the first five years of life
are more likely to extend those healthy habits into
adulthood. With more than 45,000 licensed child care
facilities in California serving over one-million children,
child care providers are uniquely positioned to help ensure
young children are exposed to good nutrition during the
early years.
According to the sponsor:
Requiring providers to take one hour of early childhood
nutrition as a part of the licensing process ensures that
all incoming licensed child care providers learn about the
importance of healthy meals and snacks, cost-effective
strategies, and age-appropriate meal patterns and serving
sizes. This idea is in line with the First Lady's Let's
Move! Child Care campaign and supports complimentary
efforts to improve the nutritional quality of school meals.
Dietary Guidelines for Americans
According to the US Department of Agriculture, "the Dietary
Guidelines for Americans are the cornerstone of Federal
nutrition policy and nutrition education activities." Updated
and jointly issued with the US Department of Health and Human
Services every five years, it provides authoritative advice
about consuming fewer calories, making informed food choices,
and being physically active to attain and maintain a healthy
weight, reduce risk of chronic disease, and promote overall
health.
Last revised in 2010, the guidelines are intended for persons
two years of age and over, including those who are at increased
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risk of chronic disease. They encourage individuals to focus on
eating a healthy diet; "one that focuses on foods and beverages
that help achieve and maintain a healthy weight, promote health,
and prevent disease."
Additionally, it is estimated that nearly 15% of American
households do not have access to nutritionally adequate food due
to insufficient income or other available resources for food.
As a result, the 2010 edition of the guidelines places an
increased emphasis on how families can maximize the nutritional
content of their meals within their financial constraints.
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REGISTERED SUPPORT / OPPOSITION :
Support
American Federation of State, County and Municipal Employees
(AFSCME), AFL-CIO
Bay Area Family Child Care Providers' Support Group
California Federation of Teachers
California Food Policy Advocates (CFPA)
California Pan-Ethnic Health Network (CPEHN)
California WIC Association
Child Care Food Program Roundtable
Children and Families Commission - First 5 San Bernardino
Choices for Children
Community Child Care Council (RC's) of Alameda County
First 5 Fresno County
State Public Affairs Committee (SPAC)
Opposition
None on file
Analysis Prepared by : Chris Reefe / HUM. S. / (916) 319-2089