BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 627
                                                                  Page  1

          Date of Hearing:   April 14, 2009

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES
                                Jim Beall, Jr., Chair
                   AB 627 (Brownley) - As Amended:  April 13, 2009
           
          SUBJECT  :  Child care nutrition and exercise.

           SUMMARY  :  Requires that child day care facilities meet specified  
          health and nutritional requirements, as specified.   
          Specifically,  this bill  :

          1)Adds the following additional licensure requirements for child  
            day care facilities unless exempted in writing by a physician:

             a)   Water shall be available and accessible throughout the  
               day;

             b)   Meals and snacks shall include food amounts specified  
               under the meal patterns outlined under federal law;

             c)   Only low fat or nonfat milk shall be served to children  
               that are two years or older;

             d)   Only 100% juice shall be served and limited to one  
               serving per day;

             e)   At least one serving of a vegetable at lunch and dinner  
               shall be served;

             f)   No deep fat fried food shall be served;

             g)   Sugar is limited to 6 grams per serving of hot and cold  
               cereals; and

             h)   For children in full day care, television, computer, and  
               video games shall be limited to no more than one hour and  
               must be of quality.  For children in less than full time,  
               these activities shall be reduced proportionately.

          2)Requires that the additional nutrition standards below be met  
            if increased funding for the Child and Adult Care Food Program  
            (CACFP) comes available and a child care facility participates  
            in that increased funding unless exempted in writing by a  
            physician:








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             a)   Comply with the additional licensing requirements above;

             b)   Limit fried potatoes to one serving per week;

             c)   Limit the servings of specified sweet grains to no more  
               than two times per week, and

             d)   Provide at least one serving of a whole grain product  
               per day;

             e)   Limit serving hot dogs, SPAM, luncheon meats, and other  
               processed meat products to a maximum of three times per  
               week;

             f)   Do not serve sugar-sweetened or artificially sweetened  
               beverages; and

             g)   Limit canned fruits and vegetables to those with no  
               added sweeteners other than 100% juice.

          3)Makes findings and declarations relative to child obesity and  
            recent research that shows that changes in the nutrition  
            offered in child care facilities can be improved with low-fat  
            dairy, fresh fruits and vegetables, and whole grains.
           
          EXISTING LAW  

          1)States that the State Department of Education administers the  
            federal Child Care & Adult Food Program that provides  
            subsidized meals and snacks for these populations with the  
            purpose of ensuring adequate nutrition while in care.

          2)States, under the California Child Day Care Facilities Act,  
            that the state Department of Social Services licenses and  
            regulates child day care facilities, and that persons or  
            organizations offering child day care must comply with  
            specified licensure requirements

          3)Defines a child day care facility as a facility that provides  
            non-medical, supervisory care to children under 18 years of  
            age.  These facilities include: day care centers,  
            employer-sponsored child care centers, and family day care  
            homes.









                                                                  AB 627
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           FISCAL EFFECT  :  Unknown

           COMMENTS  :  This bill addresses nutritional standards in licensed  
          child care settings.

          Under the state Child Day Care Facilities Act, child day care  
          centers are required to provide safe and healthy environments  
          for children.  Generally, these facilities must comply with  
          state mandated licensure requirements in the following areas:   
          Fire clearance, capacity determination, teacher to child ratio,  
          indoor/outdoor space requirements, staffing for water  
          activities, administrator qualifications, director  
          qualifications, teacher and teacher aide qualifications, and  
          food service.  According to the author, there are 15,140  
          licensed center-based sites and 42,907 family home sites in  
          California, with capacity for 1.2 million children from birth to  
          12 years of age.

          Under the federal CACFP meals and snacks are subsidized by the  
          state and federal government to ensure healthy outcomes for  
          children at participating child care facilities.  CACFP serves  
          more than 3 million children in child care centers and homes  
          nationwide, with over 350,000 these children in California.

           Child health problems  :  According to the author, the Centers for  
          Disease Control and Prevention (CDC) states that approximately  
          one of every four children between the ages of two to five has a  
          high body mass index (BMI).  A high BMI puts these children at  
          risk of obesity, a condition that can lead to type-two diabetes,  
          hypertension, sleep apnea, and other adverse health conditions.   
          Childhood obesity can lead to obese adults with chronic health  
          conditions resulting in increased health costs.  

          Good nutrition, physical activity and limiting media exposures  
          (i.e. television) help to prevent childhood obesity.  With over  
          four 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.  

          The federal CACFP provides $1.7 billion to California for  
          licensed child care centers, adult day care centers, and  
          organizations that sponsor day care homes to provide  








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          nutritionally adequate meals and snacks.  All CACFP recipients  
          and all licensed child care centers in the state must observe  
          the USDA nutrition standards (i.e., Food Pyramid).  According to  
          the sponsor of the bill, the California Food Policy Advocates,  
          the CACFP employs meal patterns that were devised in the 1960s  
          and have not been revised since.  Unlike the National School  
          Lunch Program, the CACFP standards are not an obesity-prevention  
          program.  While it is possible to serve healthy food based on  
          USDA guidelines, the meals can be high in fats, saturated fats  
          and sugar.

           Recent studies  :  CFPA recently conducted a comprehensive study  
          of nutritional quality in licensed child care settings in  
          California.  The study was carried out by CFPA, researchers, and  
          child care sponsors and providers through surveys, interviews,  
          and observations.  Some of the key findings were:

             1)   CACFP sites served more healthful foods and more  
               frequently adhered to recommended food practices than  
               non-CACFP sites;

             2)   Lunches brought from home, almost exclusively reported  
               in non-CACFP centers, were of even lower quality than  
               lunches provided by child care sites; and

             3)   Meals and snacks served in CACFP-participating child  
               care sites often fell short of the goals articulated in the  
               2005 Dietary Guidelines for Americans.

          In a recent CDC peer reviewed research article on Child Care as  
          an Untapped Setting for Obesity Prevention among states, it was  
          found that opportunities exist for strengthening state licensing  
          regulations to prevent childhood obesity.  Overall, Child Care  
          Centers (CCCs) were the most heavily regulated and had the most  
          specific regulations, followed by Large Family or Group Child  
          Care Homes, and Small Family Child Care Homes (SFHs) had the  
          fewest and most general regulations.  Amongst the 50 states,  
          variability in regulations was found as follows:

             1)   Eight states set quantified time limits on screen time  
               per day or per week in small family child care homes;

             2)   Thirty-six states required that children have daily  
               outdoor activity in CCCs;









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             3)   Only 12 states had regulations that limited foods of low  
               nutritional value in child care centers; and

             4)   Two states, Michigan and West Virginia, specified that  
               CCC menus should be consistent with the Dietary Guidelines  
               for Americans.

          The article concluded that the increasing prevalence of  
          childhood obesity underscores the urgency for state policy  
          efforts to create child care environments that foster healthful  
          eating and participation in physical activity.

           Purpose and Solution  :  Two years ago, the California Department  
          of Education (CDE) and the Health and Human Services Agency  
          convened a stakeholder group to come up with key recommendations  
          for reducing childhood overweight/obesity in child care  
          settings.  This group came up with a number of recommendations,  
          including adding nutrition and activity standards in child care  
          licensing and strengthening nutrition standards in the CACFP in  
          California. 

          One year ago, CDE, in coordination with the Department of Public  
          Health (DPH), convened an advisory committee to develop  
          nutrition standards in child care.  The provisions in AB 627 are  
          consistent with the tentative recommendations of this group by  
          doing two things:

             1)   Establishing basic nutrition and activity requirements  
               as a condition of child care licensure; and

             2)   Linking additional state reimbursement for the CACFP to  
               stronger nutrition standards.  Currently, the State of  
               California supplements the federal reimbursement for CACFP  
               with approximately 16 cents per federal dollar.  The CDE  
               has requested an approximate six-cent reimbursement rate  
               increase from 16 to 22 cents to bring the state meal  
               reimbursement for CACFP in line with that for school meals.  
                If this rate increase is appropriated, the author would  
               like to see these stronger nutrition standards attached.

          By establishing nutritional standards as a condition of  
          licensure and as a condition for receipt of increase of CACFP  
          funds, the author believes that this bill will put into practice  
          good eating habits that will decrease the likelihood of  
          childhood obesity and prevent adverse health conditions.








                                                                  AB 627
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           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          California Food Policy Advocates (sponsor)
          California Hunger Action Coalition (CHAC)
          California Teachers Association
          Child Care Food Program Roundtable
          Child Nutrition Program of Southern California
          Congregation Emanu-El
          Dr. Lorrene D. Ritchie, Director of Research, 
          Food Bank of Contra Costa and Solano
          FRAMAX
          Public Health Foundation Enterprises WIC Program
          Public Health Institute
          The Robert C. & Veronica Atkins, Center for Weight & Health

           Opposition 
           
          None on file
           
          Analysis Prepared by  :    Frances Chacon / HUM. S. / (916)  
          319-2089