BILL ANALYSIS                                                                                                                                                                                                    �






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Carol Liu, Chair


          BILL NO:       AB 1872                                     
          A
          AUTHOR:        Alejo                                       
          B
          VERSION:       June 19, 2012
          HEARING DATE:  June 26, 2012                               
          1
          FISCAL:        Yes                                         
          8
                                                                     
          7
          CONSULTANT:    Mareva Brown                                
          2
                                        
                                     SUBJECT
                                         
                      Child day care facilities: nutrition

                                     SUMMARY  

          Requires the Department of Social Services to post on its 
          Internet website information about the U.S. Department of 
          Agriculture's Child and Adult Care Food Program and 
          requires family child care home providers to post a weekly 
          menu in a visible place.

                                     ABSTRACT  

           Current law

              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. (HSC 1596.7 
               et seq)

             2.   Establishes in federal law the Child and Adult Care 
               Food Program (CACFP) and identifies nutritional 
               standards for meals in such facilities. (7 CFR 226.20)


                                                         Continued---




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             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.   Requires under state law that certain standards be 
               used when serving beverages in child care homes, and 
               exempts from those standards beverages that are deemed 
               "medical food" or those provided by a parent or legal 
               guardian. (HSC 1596.808)

           This bill
           
             1.   Requires the Department of Social Services (DSS) to 
               inform prospective and current licensed family day 
               care home providers about the USDA's Child and Adult 
               Care Food Program (CACFP) by posting information on 
               the department website, and disseminating information 
               by other means, including during orientation classes 
               for new providers.

             2.   Requires that family day care homes ensure that any 
               meals and snacks at a minimum include the amount of 
               food and components specified by the CACFP. (7 CFR 
               226.20), with specific exceptions.

             3.   Permits DSS to inform providers of any updated 
               standards in CACFP by provider bulletins or other 
               similar instructions.

             4.   Provides an exemption for children with "medical 
               food," as documented by a medical provider

             5.   Provides an exemption for meals or snacks provided 
               by a parent or legal guardian at the family day care 
               home.

             6.   Requires family day care homes to post a weekly 
               menu in an area visible to parents and guardians.

             7.   Requires the department to review the status of 
               compliance of this section only during regularly 
               scheduled, authorized monitoring inspections and not 
               through separate and independent visits based solely 





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               on complaints regarding CACFP compliance.

             8.   Requires that compliance be determined by examining 
               the posted menu or observing any meal or snacked 
               served during the monitoring visit. 

             9.   Requires that if DSS finds the provider 
               noncompliant with this section, that it recommend 
               relevant nutrition information and training 
               opportunities to the family day care home provider.

             10.  Prohibits penalties from being levied in 
               conjunction with noncompliance with this section.

             11.  Directs that these requirements are not intended to 
               replace requirements in Health and Safety code 
               1596.808, which specifies appropriate beverages to be 
               served in licensed child care facilities.

                                  FISCAL IMPACT  

          An Assembly Appropriations Committee analysis projects a 
          one-time GF costs in the range of $150,000 for the 
          Department of Social Services (DSS) to update licensing 
          forms and materials to include new nutrition requirements. 
          The analysis also projected on-going annual workload costs 
          of up to $100,000 GF for including the requirements of this 
          bill in DSS inspections and for processing an annual 
          self-certification by providers. Both the 
          self-certification requirement and the licensing 
          requirement have been removed from this version of the 
          bill, however the department still is required to review 
          compliance.

          The analysis also states that to the extent providers 
          increase participation in CACFP, it would bring additional 
          federal nutrition funding to the state. Currently more than 
          75 million free and subsidized meals per year are served to 
          children in family child care homes. If this bill increases 
          that number by one percent, it would result in an 
          additional $1.5 million in federal funding for CACFP.  In 
          addition, those meals would cost approximately $42,000 GF. 

                            BACKGROUND AND DISCUSSION  






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          Purpose of the bill

           Nearly 25 percent of children under the age of five are 
          overweight or obese, with heightened risks of developing 
          chronic diseases like diabetes and heart disease.<1> The 
          author writes that given this trend, and the fact that 37% 
          of California children are enrolled in child care centers 
          and thousands more spend time in family day care homes, 
          the child care environment represents a great opportunity 
          to promote healthy eating and an arena to battle the 
          obesity epidemic. 

          The author also states that enacting this bill would be a 
          step forward in California's effort to improve the 
          nutrition quality of meals served in the child care 
          setting, and would provide an opportunity for family day 
          care homes to get healthy food paid by an existing federal 
          program.

           Obesity among children

           The prevalence of obesity in children has more than doubled 
          in the past 30 years among young children, aged 2-5, 
          according to the U.S. Department of Health and Human 
          Services. It has tripled in among youth ages 6-11, and has 
          more than tripled among adolescents ages 12-19. The most 
          recent National Health and Nutrition Survey data shows 1 in 
          15 boys between ages 2 and 5, and nearly 1 in 10 girls, is 
          considered obese. Researchers have found that a child who 
          is overweight between the ages of two and fourandahalf is 
          five times more likely to be overweight at age twelve, when 
          compared with children who are not overweight in their 
          preschool years.

          Two national studies  the USDAs Nationwide Food Consumption 
          Survey and the Continuing Survey of Food Intakes by 
          Individuals - demonstrate changes in eating patterns among 
          American youth that illustrate the complexity that exists 
          relating food intake to the increased prevalence of 
          obesity. These include:

               ----------------------
          <1> Nutrition and Physical Activity Environments in 
          Licensed Child Care: A Statewide Assessment of California, 
          California Food Policy Advocates, et al, March 2009




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                     There has been a decline in breakfast 
                 consumption - especially for children of working 
                 mothers. 


                     Average portion sizes increased for salty 
                 snacks from 1.0 oz. to 1.6 oz. and for soft drinks 
                 from 12.2 oz. to 19.9 oz. between 1977 and 1996. 


                     Only 21 percent of young people eat the 
                 recommended five or more servings of fruits and 
                 vegetables each day.


                     Nearly half of all vegetable servings are fried 
                 potatoes. 

          Childhood obesity is a public health issue that has been 
          extensively written about and studied. 
           
          CACFP

           The USDA's Child and Adult Care Food Program (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 serve.
           
           Nineteen states require all child care facilities to follow 
          CACFP nutrition standards, including Maryland, Michigan, 
          Oregon and Virginia. Twelve states do not require the CACFP 
          standard be followed as a condition of licensure for all 
          types of child care, including California.
           
          Nutritional requirements for children in day care

           Approximately 50,000 family day care homes and child care 
          centers are licensed in California, with a combined 
          capacity of more than one million children. Approximately 
          50 percent participate in the CACFP.






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          As a condition of licensure, California's 10,850 child care 
          centers, with capacity for nearly 700,000 children, must 
          follow federally approved nutritional guidelines outlined 
          in the CACFP. About half of them fully participate in the 
          CACFP  by obtaining federal reimbursement for providing 
          nutritionally approved menus. 

          There is no state-mandated nutritional requirement for 
          providers of care in the state's approximately 39,000 
          licensed Family Child Care Homes. About half of these 
          providers - some 20,300 homes -- are approved as CACFP 
          providers.

           Comments

           This bill would require any meals and snacks provided in a 
          family day care home to contain, at a minimum, federally 
          adopted nutritional standards. It also requires these 
          providers to post weekly menus in a visible place. To 
          address concerns raised by providers about the guidelines 
          for menu posting, the author's office  has agreed to amend 
          language in the bill. In addition, staff recommends the 
          clarifying changes. Both are as follows:





          SEC. 2. Section 1597.50 is added to the Health and Safety 
          Code, to read:
            

           1597.50.  (a) Except as provided in subdivisions (c) and 
          (d), a family day care home shall  ensure,  that any meals 
          and snacks provided by the family day care home include, at 
          a minimum,  provide  the amount of food and the components  in 
          any meals and snacks served  that are specified by the 
          United States Department of Agriculture Child and Adult 
          Care Food Program (CACFP) (7 C.F.R. 226.20). The department 
          shall explain these nutritional requirements on its 
          Internet Web site, in appropriate department outreach 
          materials, and during the orientation of prospective family 
          day care home providers.

          (b) If the CACFP is amended to include new nutritional 





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          standards, the department may inform providers of these 
          updated standards by provider bulletin or other similar 
          instruction.

          (c) If a child has a medical necessity, documented in 
          writing by a medical provider, that includes the need for 
          "medical food" as defined by Section 109971, a licensed 
          family day care facility shall be exempt from complying 
          with the requirements of subdivision (a), to the extent 
          necessary to meet the medical needs of that child.

          (d) This section shall not apply to meals or snacks 
          provided by a parent or legal guardian for his or her child 
          at a family day care home.

           (e)    Family day care homes shall post, in an area open to 
          parents and guardians, a weekly menu.   

          (e) Family day care homes shall keep daily menus, available 
          for parents and guardians to see, of all meals and  snacks 
          served.  This requirement shall be interpreted in a manner 
          consistent with the Menu Records requirements of the CACFP 
          program.
            
           (f) The department shall review  the status of  compliance 
          with this section only during regularly scheduled, 
          authorized monitoring inspections, and shall not be 
          required to conduct separate and independent visits based 
          solely on complaints regarding compliance with the CACFP 
          nutritional standards  . Compliance shall be determined by 
          examining the posted menu or observing any meal or snack 
          served during the monitoring visit, if any.  If the 
          department determines that a family day care home is 
          noncompliant with this section,  based on examining the 
          daily menu or observing any meal or snack served during the 
          monitoring visit,  the department shall  recommend to   direct  
          the family day care home  to  relevant nutrition information 
          and training opportunities.  
          
           
           Related legislation  : 

          AB 2084 (Brownley), Chapter 593, Statutes of 2010, requires 
          a licensed child day care facility, as of January 1, 2012, 
          to follow specified requirements relating to the provision 





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          of beverages.

                                         


                                  PRIOR VOTES
           
          Assembly Floor:     52 - 25
          Assembly Appropriations:12 - 5
          Assembly Human Services:  4 - 2 

                                         
                                   POSITIONS  

          Support:       California Food Policy Advocates (sponsor)
                         American Academy of Pediatrics
                         American Federation of State, County and 
                         Municipal Employees 
                         American Heart Association
                         California Association for Family Child Care
                         California Center for Public Health Advocacy
                         California Child Care Resource & Referral 
                         Network
                         California Medical Association
                         California Pan-Ethnic Health Network
                         California Teachers Association
                         Central California Regional Obesity 
                         Prevention Program
                         Central Coast Hunger Coalition
                         Child Care Food Program Roundtable
                         Child Care Law Center
                         Children Now
                         Choices for Children
                         Community Bridges
                         Community Child Care Council of Santa Clara 
                         County, Inc.
                         Del Norte Child Care Council
                         Family Child Care Council
                         First 5 Shasta
                         Imperial County Children and Families First 
                         Commission
                         Los Angeles County Policy Roundtable for 
                         Child Care
                         Options Child Care and Human Service Agency
                         Shasta County Office of Education





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                         UC Berkeley, Atkins Center for Weight and 
                         Health
                         Valley Oak Children's Services


          Oppose:                                             
          California Right to Life Committee, Inc.




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