BILL ANALYSIS
SENATE HEALTH
COMMITTEE ANALYSIS
Senator Elaine K. Alquist, Chair
BILL NO: AB 627
A
AUTHOR: Brownley
B
AMENDED: June 24, 2009
HEARING DATE: July 15, 2009
6
CONSULTANT:
2
Orr/
7
SUBJECT
Child care: nutritional requirements
SUMMARY
Establishes specified nutritional requirements as a
condition of child care facility licensure, and establishes
an 18-month pilot program to implement certain nutrition
and physical activity standards in exchange for a higher
state meal reimbursement.
CHANGES TO EXISTING LAW
Existing federal law:
Establishes the Child and Adult Care Food Program (CACFP),
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 & 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,
middle, junior, or high schools, except for food served as
part of a United States Department of Agriculture meal
Continued---
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program.
Under the California Child Day Care Facilities 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:
Requires licensed child care facilities to comply with
specified health requirements for food and beverages served
by the provider to children while in their care.
Specifically, this bill:
Requires meals to include at least the minimum food
items, as described in the CACFP;
Eliminates whole milk from being served to children over
two years of age;
Eliminates any juice from being served unless it is
deemed 100 percent juice, and restricts juice to one
serving per day;
Requires at least one vegetable to be served at lunch and
supper;
Prohibits the deep fat frying of foods onsite;
Limits the amount of sugar to six grams per serving for
hot and cold cereals; and,
Requires water to be available and accessible throughout
the day.
Allows a child care facility to exclude children with
documented medical necessities from these nutritional
standards.
Stipulates that facilities must comply with these
requirements by January 1, 2011, and must self-certify
their compliance annually with the department, but
specifies that noncompliance will not be punishable by
penalties or loss of licensure.
Requires the Superintendent of Public Instruction to
establish a pilot program in certain child care centers and
day care homes to implement certain nutrition and physical
activity standards in exchange for a higher state meal
reimbursement. Requires the pilot be implemented only to
the extent that non-General Fund funding sources are
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available, and remain in effect only until January 1, 2015.
Requires the California Department of Education (CDE) to
design and implement this pilot and authorizes the
department to contract with an independent agency to
evaluate outcomes, as described. Also authorizes the
department to convene a stakeholder group to advise the
design, implementation, and evaluation of the program.
FISCAL IMPACT
For the nutritional standards portion of the bill, the
Assembly Appropriations Committee estimates one-time costs
of less than $75,000 from the General Fund for the
Department of Social Services (DSS) to update licensing
forms and materials to include new nutrition requirements.
The bill stipulates that funding for the pilot will need to
come from outside sources; however, CDE staff time to
research these outside sources, plus CDE staff time related
to designing the necessary provisions of the pilot will
likely cause upfront costs to the department.
BACKGROUND AND DISCUSSION
The purpose of this bill is to apply nutritional standards
in licensed child care facilities, similar to the state's
recent efforts to promote improved nutrition in primary and
secondary school settings. The author is concerned about
the growing obesity trend in young children, and cites that
almost 20 percent of children in California between the
ages of two and five years old are overweight or obese. The
author cites research that shows how difficult it is to
reverse obesity in both adolescence and in adulthood, which
could lead to many adverse health outcomes later in life.
The State of California has a strong policy interest and
financial involvement in the licensed child care system and
in the health and safety of children while they are engaged
in that system. By establishing minimal nutritional
standards as a condition of licensure, and by establishing
a pilot project to determine how higher nutritional
standards can best be implemented in child care settings,
the author claims this bill is the first step toward
putting good eating habits into practice that will decrease
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the likelihood of childhood obesity and prevent adverse
health conditions. The author claims the bill was
specifically designed to be easy and cost-neutral to
implement in child care centers and day dare homes, in
order to ensure compliance.
Obesity trends
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.
In August 2007, CDE and the Health and Human Services
Agency convened a stakeholder group to develop
recommendations for reducing childhood obesity in childcare
settings. The group developed a number of recommendations,
including adding nutrition and activity standards in
licensing requirements, and strengthening nutrition
standards under CACFP. In August of 2008, CDE and the
Department of Public Health (DPH) convened an advisory
committee to develop nutrition standards in child care
settings. This bill seeks to implement the tentative
recommendations of that group.
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
organizations receive cash reimbursement for serving meals
to enrolled children and adults that meet federal
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nutritional guidelines. Care providers participating in
this program are required to observe the USDA nutrition
standards for children age one through twelve, 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.
The federal government provides $1.7 billion to California
for licensed child care centers, adult day care centers,
and organizations that sponsor day care homes to provide
nutritionally adequate meals and snacks. The federal
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government gives a maximum of $1.17 for breakfast, $2.18
for lunch, and $0.65 for snacks. 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 (which
ever 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 based upon
a child's eligibility for free, reduced price, or paid
meals.
Provisions of the pilot
The purpose of the pilot proposed in AB 627 is to implement
and evaluate enhanced nutrition standards and an improved
nutrition environment using a representative mix of eight
child care centers and two day care home sponsors (serving
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1,150 family day care providers). Participating agencies
will receive an increased state meal reimbursement
(approximately $0.12 per free and reduced-price meal
served) for 18 months. Staff serving the children will
receive training and technical assistance from CDE on the
development and implementation of the enhanced nutrition
standards and the implementation of nutrition policies.
Children will receive more servings of healthful foods such
as fruits and vegetables and whole grains. A comprehensive
evaluation will be conducted by the UC Berkeley Center for
Weight and Health.
Related Bills
AB 95 (Torlakson) would specify 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 shall notify the
Legislature of the statutory funding amount necessary to
reimburse school districts at the prescribed rate. The bill
would appropriate $19,500,000 to reimburse claims pursuant
to those provisions. Held in the Assembly Education
Committee.
Prior Legislation
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, by the
school, 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.
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 1-12
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.
AB 1503 (Fuller) of 2007 would have revised the
requirements for schools to receive the $0.21 state
reimbursement rate for free and reduced-price meals,
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including not selling or serving any food item that is
fried in any manner, and initiating the process of
eliminating foods containing manufactured trans fats. Would
have reduced the statutory reimbursement rate for free and
reduced-price meals from $0.21 to $0.1563. These provisions
were amended out of the bill.
SB 12 (Escutia) Chapter 235, Statutes of 2005, implemented
nutrition standards at elementary schools, and prohibited
the sale of certain beverages and food items, as specified,
at all middle, junior high, and high schools, commencing
July 1, 2007.
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, and restricted
the sale of beverages to pupils at a high school at
specified times, to certain specified beverages.
SB 19 (Escutia), Chapter 913, Statutes of 2001,
established, as of January 1, 2004, various prohibitions on
the sale of beverages in elementary and middle schools and
places nutritional standards on the type of foods that may
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 and permits
school districts to convene a Child
Nutrition and Physical Activity Advisory Committee. The
bill also 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
According to the sponsor, California Food Policy Advocates,
CACFP meal patterns were devised in the 1960's and have not
yet been revised. Unlike the National School Lunch Program,
the CACFP standards are not an obesity-prevention program
and are not consistent with the Dietary Guidelines. They
claim that while it is possible to serve health food based
on USDA guidelines, the meals can still be high in fats,
saturated fats, and sugar.
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The California Center for Health Policy Advocacy cites that
the reforms outlined in this bill will be consistent with
the new Women, Infants, and Children (WIC) food package,
which will soon be implemented in the state. WIC now serves
over 700,000 children between the ages of one and five,
many of whom attend child care homes and facilities.
Ensuring that child care programs and WIC convey consistent
nutrition messages through the provision of similar foods
is important to combating the epidemic of obesity.
The California Hunger Action Coalition cites that with
nearly 25 percent of children aged two to five overweight
or obese, and the significant amount of time many children
of working families spend in child care settings, this
represents a largely untapped opportunity for improving
nutrition for children and shaping lifelong healthy habits.
They claim that there are adverse consequences resulting
from poor nutrition and obesity on health, academic
performance, and economic costs and productivity. Ensuring
that young children establish healthy taste preferences at
an early age can prevent many of the adverse health
consequences they may experience years down the road.
Arguments in opposition:
The Department of Finance estimates no costs to the state,
based on the April 13, 2009 version of the bill, but
believe this bill is likely to put cost pressure on the
state to add Proposition 98 General Fund resources to
CACFP. They claim it is difficult to quantify the exact
fiscal impact to all providers in this state, since each
provider's food service is unique. They believe this bill
might lead to higher food and commodity costs for private
and public child care centers and providers, and assume
that the centers will expect to see a corresponding
increase in funding from the state.
PRIOR ACTIONS
Assembly Floor: 49-28
Assembly Appropriations:12-5
Assembly Human Services:4-2
POSITIONS
Support: California Food Policy Advocates (sponsor)
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American Academy of Pediatrics
California Association for the Education of Young
Children
California Center for Public Health Advocacy
California Hunger Action Coalition
California Teachers Association
California State PTA
California WIC Coalition
Child Care Food Program Roundtable
Child Nutrition Program of Southern California
Fresno Metro Ministry
Food Bank of Contra Costa and Solano
FRAMAX
Latino Coalition for a Healthy California
Public Health Foundation Enterprise WIC Program
Public Health Institute
Santa Clara County Board of Supervisors
Urban and Environmental Policy Institute, Center for
Food and Justice
One individual
Oppose: Department of Finance
Grocery Manufacturers Association (unless amended)
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