BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: SB 949
AUTHOR: Jackson
INTRODUCED: February 6, 2014
HEARING DATE: April 2, 2014
CONSULTANT: Diaz
SUBJECT : Nutrition: Distinguished After School Health
Recognition Program.
SUMMARY : Establishes the Distinguished After School Health
(DASH) Recognition Program within the Department of Public
Health in consultation with the Department of Education, as
appropriate. Allows after-school programs, as defined, to apply
for DASH certification by self-certifying to meeting the
requirements of the program. Requires DASH-certified programs to
recertify every year. Requires DPH to maintain and update a list
of DASH-certified programs on its Internet Web site.
Existing law:
1.Establishes the California Nutrition Monitoring Development
Act to determine the availability and types of nutrition
monitoring information currently available in specified
federal, state, and local government programs. Requires the
Department of Public Health (DPH) to assess the availability
and adequacy of existing state and local food and nutrition
data systems and to require other state entities to provide
existing nutrition-related data. Encourages programs in local
government and the private sector to provide available
nutrition monitoring information to DPH. Requires DPH to
outline a process for developing a prototype state-local
nutrition monitoring system.
2.Establishes the "5 A Day-For Better Health" program in DPH, to
the extent funds are available, for the purpose of promoting
public awareness of the need to increase the consumption of
fruits and vegetables as part of a low-fat, high fiber diet in
order to improve health and prevent major chronic diseases,
including diet-related cancers. Allows the promotion of the
program to the public through channels including, but not
limited to, print and electronic media, retail, grocers,
schools, and other government programs, specifically to the
general adult population, adults with lower educational
attainment, school-age children and youth, and high-risk
Continued---
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groups determined by DPH.
3.Establishes the California Healthy Food Financing Initiative
(CHFFI) Council within the office of the Treasurer to expand
access to nutritious foods in underserved, urban, and rural
communities and to eliminate food deserts in the state.
Requires the Council to establish and maintain an Internet Web
site. Requires the Secretary of the California Department of
Food and Agriculture (CDFA) to prepare recommendations
regarding actions that need to be taken to promote food access
in the state. Establishes the CHFFI Fund in the State Treasury
to be used, to the extent practicable, to leverage other
funding, including, but not limited to, federal, state, and
private funds.
This bill:
1.Establishes the Distinguished After School Health (DASH)
Recognition Program to be administered by DPH in consultation
with the Department of Education (CDE), as appropriate.
2.Defines an after-school program as the After School Education
and Safety Program (ASES), the 21st Century High School After
School Safety and Enrichment for Teens (High School ASSETs)
Program, and other qualified out-of-school time and licensed
childcare programs, as specified, that are outside of regular
school hours, including before school and on weekends.
3.Requires DPH to provide on its Web site an application form
for a program to apply for DASH certification as well as
resources and links that a program may utilize to meet the
requirements of certification. Requires a program with
multiple sites to apply for certification for each site.
4.Allows after-school programs to apply to DPH for DASH
certification. Requires DPH to provide DASH certification, for
a period of one year, to a program that self-certifies to
meeting the criteria. Requires the application to include a
description of the manner in which the program meets the
following:
a. Each staff member of the program has received
training on standards in accordance with the YMCA of
the USA, the Center for Collaborative Solutions, A
World Fit For Kids!, the National Institute on
Out-of-School Time, or other similar programs, as well
as training on the importance of modeling healthy
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eating and physical activity;
b. The program provides regular and ongoing
nutrition education to each program attendee to help
in developing and practicing healthy habits;
c. The program ensures that each attendee
participates daily in an average of 30 to 60 minutes
of moderate to vigorous physical activity, consistent
with Guidelines 7 and 8 of the CDE California After
School Physical Activity Guidelines (CASPAG), while
the program is in session;
d. Screen time, as defined, is limited during
program hours and is only allowed in connection with
homework or an activity that engages attendees in a
physical activity or educational experience consistent
with the CASPAG;
e. Healthy foods, including, but not limited to,
fruits and vegetables, without added sugar, shall be
served to attendees as snacks daily. Fried foods,
candy, or foods that are primarily sugar-based or high
in sodium and that include trans-fats shall not be
served to attendees or consumed by staff during
program hours. Snacks or meals provided pursuant to
the ASES, High School ASSETs, and the Child and Adult
Care Food Program meal guidelines shall be deemed to
meet this standard;
f. Program attendees shall be served water,
low-fat or nonfat milk, or 100 percent fruit juice,
with a preference for water. Milk and fruit juices
shall not be served in quantities exceeding six ounces
per day. Sugar-sweetened beverages shall not be served
to program attendees or consumed by staff while at the
program site;
g. If located on a school site, the program
communicates with the school regarding nutrition
education and physical activity, as appropriate, to
provide attendees with a complete educational
experience;
h. The program has implemented an educational
program for parents of attendees that provides them
with nutrition and physical activity information
relevant to the after-school program and the health of
their children; and,
i. Information about the implementation of the
requirements is available for review by a parent both
at the physical location of the program and on the
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program's Internet Web site, if there is one.
5.Requires DPH to maintain and update a list of programs that
receive DASH certification and to post the list on its Web
site, including the date of a program's self-certification for
each program site.
6.Allows DPH to consider developing gold, silver, and bronze
levels of distinction.
FISCAL EFFECT : This bill has not been analyzed by a fiscal
committee.
COMMENTS :
1.Author's statement. According to the author, childhood obesity
rates remain at dangerously high levels. One in three
California children and nearly 40 percent of Latino children
are overweight or obese. In California, after-school programs
provide services to over 1.5 million children. Over 4,400
publicly funded after-school programs exist in California,
including the ASES and 21st Century Community Learning
Centers, which serve over 450,000 low-income K-12 students
statewide and 600,000 school-age children in licensed
childcare settings. This bill encourages healthy foods,
beverages, physical activity, and promotes healthy living
standards in after-school programs and licensed childcare
settings and incentivizes providers to adopt these standards
through state certification. This bill would allow
after-school programs to apply to be a California DASH
program. Those programs that meet healthy eating and physical
activity standards will be recognized with DASH Program
certification. Parents searching for a healthy after-school
program will be able to find a list of DASH-certified programs
on a state Web site. DASH programs will be able to display
their certification on-site and on their program's Web site
and printed materials.
2.Obesity and other chronic diseases. DPH issued a study, The
Burden of Chronic Disease and Injury, in 2013 that highlights
some of the leading causes of death, such as heart disease,
cancer, stroke, and respiratory disease, all of which have a
strong connection to obesity. Diabetes is another serious
chronic disease stemming from obesity that adversely affects
quality of life and results in serious medical costs. The last
decade has witnessed a 32 percent rise in diabetes prevalence,
affecting some 3.9 million people and costing upwards of $24
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billion per year. According to the CDC, more than one-third of
U.S. adults are obese, and approximately 12.5 million children
and adolescents ages 2 to 19 years are obese. Research
indicates a tripling in the youth obesity rate over the past
three decades. While this increase has stabilized between the
years 2005 and 2010, in 2010, 38 percent of public school
children were overweight and obese. Overweight youth face
increased risks for many serious detrimental health conditions
that do not commonly occur during childhood, including high
cholesterol and type-2 diabetes. Additionally, more than 80
percent of obese adolescents remain obese as adults.
3.YMCA of the USA. According to the YMCA of the USA, the Y is
one of the nation's largest providers of childcare and
after-school programs. The Y is adopting a set of healthy
eating and physical activity standards that will be
disseminated through early childhood and after-school programs
nationwide. According to the Y, the standards are based on
years of research supported by collaborations with the Harvard
School of Public Health, University of Massachusetts at
Boston, the Healthy Out of School Time Coalition, and the
National Institute for Out of School Time. As part of the
implementation, the Y states that it will leverage the
existing national training system for childcare and
after-school program staff to develop, test, and implement new
trainings to educate staff about the new health promoting
standards and practices, as well as leverage the Y's preferred
vendor program to strengthen partnerships with companies that
help advance their efforts by providing healthful products and
services to early childhood and after-school programs. The Y
states that it made this commitment in November 2011 to the
Partnership for a Healthier America, which was created in
conjunction with Let's Move, First Lady Michelle Obama's
campaign to reduce childhood obesity.
4.School Health Index (SHI). The SHI was developed by the
Centers for Disease Control and Prevention (CDC) in
partnership with school administrators and staff, school
health experts, parents, and national nongovernmental health
and education agencies to enable schools to identify strengths
and weaknesses of health and safety policies; enable schools
to develop an action plan for improving student health; and
engage teachers, parents, students, and the community in
promoting health-enhancing behaviors and better health. The
SHI addresses six health topic areas: physical activity;
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healthy eating; tobacco-use prevention; unintentional injury
and violence prevention (safety); asthma; and sexual health,
including HIV, other sexually transmitted diseases, and
pregnancy prevention. The CDC states that completing the SHI
is an important first step toward improving a school's health
promotion policies and practices and can help a school include
health promotion activities in its overall School Improvement
Plan.
5.CHFFI. The CHFFI was established in October 2011 as a
public-private partnership to increase access to healthy foods
in underserved, urban, and rural communities and to inspire
innovation in healthy food retailing. The CHFFI Fund within
the State Treasurer's Office is comprised of federal, state,
philanthropic, and private funds. When the Treasurer's Office
secures funding, these funds will provide financing for
grocery stores and other forms of healthy food retail and
distribution by providing capital to eligible applicants.
The CHFFI Council includes the State Treasurer, the CDFA
Secretary, the Secretary of the California Health and Human
Services Agency, and the Secretary of the California Labor and
Workforce Development Agency. The Council's duties are to
develop financing options using public or private moneys and
resources; develop program parameters, such as establish
minimum and maximum levels of financial assistance; and
partner with federal, state, or local government agencies,
nonprofit organizations, and philanthropic programs.
6.Double referral. This bill is double referred. Should it pass
out of this committee, it will be referred to the Senate
Committee on Education.
7.Prior legislation. AB 626 (Skinner and Lowenthal), Chapter
706, Statutes of 2013, made numerous changes to law related to
school nutrition, mostly to conform to the federal Healthy,
Hunger-Free Kids Act of 2010.
SB 464 (Jackson) of 2013 would have established the Healthy
Eating and Physical Activity Act within the Child Care and
Development Services Act (CCDSA) to establish standards for
nutrition and physical activity for early childhood education
programs, infant care programs, and after-school programs
conducted under the CCDSA. The bill would have expressed
legislative intent to encourage all child care providers to
implement educational programs for parents to provide them
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with physical activity and nutritional information relevant to
the health of their children. This bill failed in the Senate
Education Committee without being heard.
AB 1178 (Bocanegra) of 2013 would have established the
California Promise Neighborhood Initiative to provide funding
to schools that have formalized partnerships with local
agencies and community organizations to provide a network of
services to improve the health, safety, education, and
economic development of a defined area. This bill was held in
suspense in the Assembly Appropriations Committee.
AB 70 (Monning) of 2011 would have allowed DPH to apply, in
conjunction with another eligible applicant as specified, for
federal community transformation grants under the Patient
Protection and Affordable Care Act and the Healthy,
Hunger-Free Kids Act of 2010, as specified. This bill failed
in the Senate Health Committee without being heard.
AB 581 (John A. Pérez), Chapter 505, Statutes of 2011, created
the CHFFI, the CHFFI Fund, and the CHFFI Council for the
purpose of expanding access to healthy foods in underserved
communities. The bill also required the Secretary of CDFA, by
July 1, 2012, to prepare recommended actions to be taken to
promote food access within California. This authority remains
in effect until January 1, 2017.
AB 152 (Fuentes), Chapter 503, Statutes of 2011, established
the State Emergency Food Assistance Program (SEFAP) in statute
and allows for federal contributions to SEFAP for the purchase
of California-grown fresh fruits or vegetables; provided a tax
credit to California growers for the costs of fresh fruits or
vegetables donated to California food banks; and directed DPH
to apply for specified federal funding for obesity prevention
and promotion of healthy eating.
AB 2720 (John A. Pérez) of 2010 was substantially similar to
AB 581. AB 2720 was vetoed by Governor Schwarzenegger, who
stated that while his Administration shares the same goals as
the author when it comes to promoting healthy and affordable
food access for low-income communities in California, the
federal Healthy Food Financing Initiative had not yet been
acted on by Congress, and unless and until those important
federal funding details were known, AB 2720 was both premature
and unnecessary.
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AB 2726 (Leno), Chapter 466, Statutes of 2008, extended the
repeal date of the Healthy Food Purchase pilot program from
January 1, 2011, to January 1, 2013.
AB 2384 (Leno), Chapter 236, Statutes of 2006, required DPH,
in consultation with CDFA to develop a Healthy Food Purchase
pilot program to increase the sale and purchase of fresh
fruits and vegetables in low-income communities, as specified,
until January 1, 2011.
8.Support. The sponsor and other supporters of the bill argue
that SB 949 encourages after-school program operators to
provide healthy foods, snacks and beverages, physical
activity, limited screen time, healthy living standards, and
educational programs to improve the health and well-being of
California's 1.5 million children who attend these programs.
They also note that more than 4,400 publicly funded
after-school programs exist in the state, which serve more
than 450,000 low-income K-12 students.
The Association of California Healthcare Districts writes in
support that efforts to promote healthy eating, after-school
programs, and physical activity for children result in a
healthier community overall and support innovative methods in
creating a healthy community.
The California Food Policy Advocates (CFPA) writes in support
that the DASH Recognition Program would include evidence-based
standards, which CFPA believes should be encouraged and
incorporated in all after-school programming that serves
low-income children.
9.Policy comments.
a. Monitoring of DASH certification. Because the DASH
certification process allows programs to self-certify to
meeting the criteria, it is unclear how DPH will ensure
compliance with DASH criteria; what the process will be
for revoking certificates due to noncompliance; and how
noncompliant programs will be screened out from the
program.
b. Levels of distinction. This bill permits DPH to
consider developing gold, silver, or bronze levels of
distinction but does not specify any criteria for those
separate distinctions. The author may wish to clarify the
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criteria for the different levels.
c. Administration of the DASH program. The author
states that the DASH program is best suited under DPH
because of its scope of work related to public health and
chronic diseases and because of its current work under a
CDC grant to address obesity in school-age populations.
However, it is unclear if DPH is the appropriate
department to administer DASH certification when
after-school programs are not currently under its
purview.
SUPPORT AND OPPOSITION :
Support: California State Alliance of YMCAs (sponsor)
Armed Services YMCA of the USA Twentynine Palms
Association of California Healthcare Districts
California Center for Public Health Advocacy
California Collaboration for Youth
California Food Policy Advocates
California Primary Care Association
Center for Collaborative Solutions
Ecological Farming Association
Family YMCA of the Desert
Santa Barbara Food Alliance
School Food Initiative
Southeast Ventura Country YMCA
Oppose: None received.
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