BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                    THIRD READING


          Bill No:  AB 290
          Author:   Alejo (D)
          Amended:  9/3/13 in Senate
          Vote:     21

           
           SENATE HUMAN SERVICES COMMITTEE  :  6-0, 6/11/13
          AYES: Yee, Berryhill, Emmerson, Evans, Liu, Wright

           SENATE APPROPRIATIONS COMMITTEE  :  7-0, 8/30/13
          AYES:  De Le�n, Walters, Gaines, Hill, Lara, Padilla, Steinberg

           ASSEMBLY FLOOR  :  77-0, 4/29/13 (Consent) - See last page for  
            vote


           SUBJECT  :    Child day care:  childhood nutrition training

           SOURCE  :     California Food Policy Advocates


           DIGEST  :    This bill requires a teacher or director of a day  
          care center or family day care home who is licensed after  
          January 1, 2016, and receives health and safety training, to  
          also have at least one hour of childhood nutrition training,  
          including information about age-appropriate meal patterns, and  
          information about reimbursement rates for the federal Child and  
          Adult Care Food Program (CACFP), as specified. 

           ANALYSIS  :    

          Existing law:

                                                                CONTINUED





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          1. Establishes the California Child Day Care Facilities Act to  
             establish a statewide comprehensive, quality system for  
             licensing child day care facilities to ensure a quality day  
             care environment. 

          2. Establishes in federal law the CACFP and identifies  
             nutritional standards for meals in such facilities.

          3. Requires that state child care centers adhere to CACFP  
             nutrition standards, but leaves open the option to  
             participate in the reimbursement program.  Family Child Care  
             Homes are not required to adhere to CACFP standards. 

          4. States legislative intent to encourage any person who  
             provides child care in a licensed child day care facility to  
             have completed "elementary" health care training such as  
             cardiopulmonary resuscitation, pediatric first aid,  
             preventative health practices such as food preparation,  
             sanitation, and practices that reduce the spread of  
             infectious disease.

          5. Requires that at least one director or teacher at each day  
             care center, and each family day care home licensee who  
             provides care, to have at least 15 hours of health and safety  
             training, as specified, to include:


             A.    Pediatric first aid.


             B.    Pediatric cardiopulmonary resuscitation.

             C.    A preventive health practices course or courses that  
                include instruction in the recognition, management, and  
                prevention of infectious diseases, including  
                immunizations, and prevention of childhood injuries. 

          6. Establishes that training may include instruction in child  
             nutrition, food handling, caring for children with special  
             needs, and the identification and reporting of signs and  
             symptoms of child abuse.

          7. Requires that at least one staff member of a day care center  
             or family day care home who has completed the training be  







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             on-site whenever children are present on- site or during  
             off-site trips.

          8. Requires the state's Emergency Medical Services Authority  
             (EMSA) to establish training standards for child care center  
             directors and teachers and providers in licensed child care  
             homes. 

          This bill:

          1.Makes various findings and declarations about obesity in  
            children, childhood nutrition and eating habits.

          2.Makes various findings and declarations about the prevalence  
            of child care use among American families and within  
            California, and about the benefit to children of having  
            trained child care providers.

          3.Through intent language, encourages any person who provides  
            child care also receive training in childhood nutrition and  
            practices that support overall health.

          4.States legislative intent to establish an effective date for  
            the requirements of this bill that provides sufficient time  
            for the EMSA to develop and approve adequate childhood  
            nutrition training standards using existing processes and  
            procedures and to avoid excessive costs and burden on EMSA. 

          5.Adds one hour of childhood nutrition education to the required  
            15 hours of training for directors and teachers at day center  
            centers and licensed family day care homes, as specified. 

          6.Provides that the additional hour of required training applies  
            only to licenses issued after January 1, 2016, and be included  
            as part of the preventive health practices course or courses.

          7.Requires that childhood nutritional training include content  
            on age-appropriate meal patterns based on the most current  
            Dietary Guidelines for Americans.

          8.Requires the training to contain information about  
            reimbursement rates for the CACFP and that child care  
            providers be directed to the state Department of Education's  
            CACFP for information on eligibility and enrollment.







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          9.Permits the EMSA, through bulletin or similar instructions  
            from the DDS director until regulations are adopted, to  
            establish standards for the training in childhood nutrition,  
            pursuant to existing law. 

           Background
           
           Obesity among children  .  The prevalence of obesity in children  
          has more than doubled in the past 30 years among young children  
          aged two to five, according to the U.S. Department of Health and  
          Human Services.  It has tripled among youth ages 6 to 11, and  
          has more than tripled among adolescents ages 12 to 19.   
          According to the Centers for Disease Control, more than  
          one-third of children and adolescents were overweight or obese  
          in 2010.

           Child Care training requirements  .  Existing law requires that at  
          least one director or teacher at each day care center, and each  
          family day care home licensee who provides care, must have at  
          least 15 hours of health and safety training on preventative  
          health practices. 

          Included in the required training is pediatric CPR  
          (cardiopulmonary resuscitation); pediatric first aid;  
          recognition, management, and prevention of infectious diseases,  
          including immunizations; and prevention of childhood injuries.   
          State statute requires the EMSA to establish standards for the  
          training. 

          Additionally, the training may include training in sanitary food  
          handling, child nutrition, emergency preparedness and  
          evacuation, caring for children with special needs, and  
          identification and reporting of signs of child abuse.  This bill  
          changes the permissive training for child nutrition to a  
          mandate.

           CACFP  .  The U. S. Department of Agriculture's CACFP provides day  
          care providers with cash reimbursement for serving up to two  
          meals and one snack per day to enrolled children that meet  
          federal nutritional guidelines.  Program payments for day care  
          homes are based on the number of meals served to enrolled  
          children, multiplied by the appropriate reimbursement rate for  
          each breakfast, lunch, supper, or snack they are approved to  







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          serve.  
           
           Other states  .  According to research by the California Food  
          Policy Advocates, many other states have nutrition training for  
          licensed daycare centers and family day care homes.   
          Massachusetts requires two hours of training in nutrition for  
          young children.  Delaware requires that Early Childhood  
          Caregivers complete three hours of nutrition training within a  
          mandated 60-hour training course on early care and education.   
          Nevada requires child care facility employees to complete at  
          least two hours of annual training on the subject of lifelong  
          wellness, health and safety of children which includes training  
          relating to childhood obesity, nutrition and physical activity.

           Related Legislation
           
          AB 2084 (Brownley, Chapter 593, Statutes of 2010) specified the  
          amount of juice and type of milk to be served at licensed child  
          day care facility and prohibited serving sweetened beverages, as  
          specified.

          AB 1872 (Alejo, 2012) would have required child care providers  
          to adhere to federal nutritional standards and to keep a daily  
          menu of all meals and snacks available for parents to view.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Senate Appropriations Committee:

           EMSA:  Significant one-time workload to create new standards,  
            notify training providers of new requirements, and to receive  
            and review updated curriculum from those providers. 

           Regulations:  Likely minor workload for the EMSA to re-open  
            and revise regulations, with a flexible timeframe.

           SUPPORT  :   (Verified  8/31/13)

          California Food Policy Advocates (source)
          Alameda County Child Care Planning Council
          American Federation of State, County and Municipal Employees
          Asia Law Alliance
          Atkins Center for Weight and Health at UC Berkeley







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          Bay Area Family Child Care Providers Support Group 
          California Alternative Payment Program Association
          California Association for the Education of Young Children
          California Center for Public Health Advocacy
          California Childcare Health Program
          California Federation of Teachers
          California Pan-Ethnic Health Network
          California State Parent Teachers Association
          California Teachers Association
          California WIC Association
          Child Care Alliance of Los Angeles
          Child Care Food Program Roundtable
          Children Now
          Choices for Children
          Community Child Care Council 4C's of Alameda County
          Community Health Improvement Partners
          Crystal Stairs, Inc.,
          Dietetic Intern Choices for Children 
          Elaine's Family Child Care
          Family Child Care Association of San Francisco
          Family Child Care Council
          Feeding America San Diego
          First 5 San Bernardino
          First 5 Santa Clara
          First5 Fresno
          Fresno Economic Opportunity Commission
          Junior Leagues of California State Public Affairs Committee
          PACE (Professional Association for Childhood Education)
          San Francisco and Marin Food Banks
          Solano Family & Children's Services
          State Council on Developmental Disabilities
          University of California San Francisco School of Nursing  
          California Childcare Health Program

           ASSEMBLY FLOOR  :  77-0, 4/29/13
          AYES:  Achadjian, Alejo, Allen, Ammiano, Bigelow, Bloom,  
            Blumenfield, Bocanegra, Bonilla, Bonta, Bradford, Brown,  
            Buchanan, Ian Calderon, Campos, Chau, Ch�vez, Chesbro, Conway,  
            Cooley, Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox,  
            Frazier, Beth Gaines, Garcia, Gatto, Gomez, Gordon, Gorell,  
            Gray, Grove, Hagman, Hall, Harkey, Roger Hern�ndez, Holden,  
            Jones, Jones-Sawyer, Levine, Linder, Logue, Lowenthal,  
            Maienschein, Mansoor, Medina, Mitchell, Morrell, Mullin,  
            Muratsuchi, Nazarian, Nestande, Olsen, Pan, Patterson, Perea,  







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            V. Manuel P�rez, Quirk, Quirk-Silva, Rendon, Salas, Skinner,  
            Stone, Ting, Torres, Wagner, Waldron, Weber, Wieckowski, Wilk,  
            Williams, Yamada, John A. P�rez
          NO VOTE RECORDED:  Atkins, Melendez, Vacancy


          JL:d:n  9/1/13   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

                                   ****  END  ****