BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2287
                                                                  Page 1 

          Date of Hearing:   April 9, 2014

                           ASSEMBLY COMMITTEE ON EDUCATION
                                Joan Buchanan, Chair
                      AB 2287 (Pan) - As Amended:  April 3, 2014
           
          SUBJECT  :   Free and reduced-price meals: gluten-free meals.

           SUMMARY :   Permits, but does not require, a school district or  
          county superintendent of schools to include, in the free or  
          reduced price meal application packet or notification of  
          eligibility for the free and reduced price meal program,  
          information on the availability of gluten-free meals for  
          specified students.  Specifically,  this bill  :  

             1)   Makes findings and declaration as follows:
               a)     Defines and describes celiac disease;


               b)     Cites a National Institutes of Health (NIH) report  
                 that concludes 1 in 133 people with no genetic risk  
                 factors have celiac disease, up to 1 in 22 people with  
                 genetic risk factors have celiac disease, and even more  
                 common are gluten intolerance and wheat allergy;


               c)     Restates existing federal regulations that require  
                 substitutions or modifications in school meals for  
                 children whose disabilities restrict their diets; and


               d)     Declares that gluten-free foods are available at  
                 prices that are comparable to foods made with wheat, rye,  
                 and barley.


             2)   Permits, but does not require, a school district or  
               county superintendent of schools to do all of the following  
               in either the free or reduced price meal application packet  
               or notification of eligibility for the free and reduced  
               price meal program:
               a)     Notify parents/guardians that if his/her child  
                 qualifies for free or reduced price meals and the child  
                 has an individualized education program (IEP) authorizing  
                 gluten-free meals, then the child may request a  








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                 gluten-free meal; and


               b)     Provide a request for the applicant's consent for  
                 the child to receive a gluten-free meal if eligible for  
                 free or reduced price meals and the child has an IEP  
                 authorizing gluten-free meals.


             1)   Specifies that if a school district or county  
               superintendent of schools provides the notifications  
               pursuant to this section, the notice shall use simple and  
               culturally appropriate language.


             2)   Specifies that if a school district or county  
               superintendent of schools provides the notifications  
               pursuant to this section, the notice shall, effective  
               January 1, 2015, comply with the federal Americans with  
               Disabilities Act of 1990 and any other applicable federal  
               or state disabled access law.


             3)   Permits, but does not require, a school district to  
               include these notifications in the notifications provided  
               at the beginning of the first semester or quarter of the  
               regular school term, as required under existing law.



           EXISTING LAW  
          1)Finds that the proper nutrition of children is a matter of  
            highest state priority and that there is a demonstrated  
            relationship between the intake of food and good nutrition and  
            the capacity of children to develop and learn. 


          2)Requires the governing board of each school district and each  
            county superintendent of schools to formulate a plan, which  
            shall be mailed to the California Department of Education  
            (CDE) for its approval, that will ensure that children  
            eligible to receive free or reduced priced meals and milk  
            shall not be treated differently from other children. 










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          3)Requires School Food Authorities and local educational  
            agencies (LEAs) of schools participating in the National  
            School Lunch Program (NSLP), School Breakfast Program (SBP),  
            or Special Milk Program to take all actions that are necessary  
            to insure compliance with nondiscrimination practices for  
            children eligible to receive free and reduced price meals or  
            free milk:


          4)Specifies that, because a hungry child cannot learn, the  
            Legislature intends, as a state nutrition and health policy  
            that the SBP be made available in all schools where it is  
            needed to provide adequate nutrition for children in  
            attendance.  Requires CDE, in cooperation with school  
            districts and county superintendents of schools, to provide  
            information and limited financial assistance to encourage  
            program startup and expansion into all qualified schools.


          5)Requires each school district or county superintendent of  
            schools maintaining any kindergarten or any of grades 1  
            through 12 to provide for each needy pupil one nutritionally  
            adequate free or reduced priced meal during each school-day,  
            except for family day care homes that shall be reimbursed for  
            75% of the meals served.


          6)Defines needy children as those children who meet federal  
            eligibility criteria for free and reduced price meals, except  
            for family day care homes which shall be reimbursed for 75% of  
            the meals.


          7)Requires the governing board of a school district and the  
            county superintendent of schools to make applications for the  
            NSLP available to students at all times during each regular  
            school-day and requires the application to contain specified  
            information. 


          8)Requires, under federal law, any school district or county  
            office of education receiving federal funds under the NSLP to  
            serve special meals, at no extra charge, to a student whose  
            disability restricts his/her diet and permits the school  
            district or county office of education to require the student  








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            to provide medical certification that special meals are needed  
            because of his/her disability.


           FISCAL EFFECT  : This measure is keyed non-fiscal by the  
          Legislative Counsel.

           COMMENTS  :   
           Free and Reduced Price Meal Program
           The free and reduced price meal program operated through the  
          United States Department of Agriculture includes the NSLP, the  
          SBP, the Snack Program, Special Milk Program, and the Summer  
          Food Service Program.

          The NSLP is a federally assisted meal program operating in over  
          100,000 public and nonprofit private schools and residential  
          child care institutions. It provided nutritionally balanced,  
          lowcost or free lunches to more than 31 million children each  
          school day in 2012.  In 1998, Congress expanded the NSLP to  
          include reimbursement for snacks served to children in  
          afterschool educational and enrichment programs for children  
          through 18 years of age.  The Food and Nutrition Service  
          administers the program at the federal level. At the State  
          level, the National School Lunch Program is usually administered  
          by state education agencies, which operate the program through  
          agreements with school food authorities.  In California, the CDE  
          administers the program.  

          Under existing law and at the option of the school district or  
          county superintendent, the following information may be  
          incorporated into the National School Lunch Program application  
          packet or notification of eligibility: 
           
          1)   A notification that if a child qualifies for free lunches,  
               then the child may qualify for free or reduced-cost health  
               coverage.

          2)   A request for the applicant's consent for the child to  
               participate in the Medi-Cal program, if eligible for free  
               school lunches, and to have the information on the school  
               lunch application shared with the entity designated by the  
               State Department of Health Care Services to make an  
               accelerated determination and the local agency that  
               determines eligibility under the Medi-Cal program and a  
               notification that the school district will not forward the  








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               application to this entity without the consent of the  
               child's parent or guardian.

          3)   A notification that the school lunch application is  
               confidential and, with the exception of forwarding the  
               information for use in health program enrollment upon the  
               consent of the child's parent or guardian, the school  
               district will not share the information with any other  
               governmental agency, including the federal Department of  
               Homeland Security and the Social Security Administration.  

          4)   A notification that the school lunch application  
               information will only be used by the entity designated by  
               the State Department of Health Care Services to make an  
               accelerated determination and the state and local agencies  
               that administer the Medi-Cal program for purposes directly  
               related to the administration of the program and will not  
               be shared with other government agencies, including the  
               Department of Homeland Security and the Social Security  
               Administration for any purpose other than the  
               administration of the Medi-Cal program.

          5)   Information regarding the Medi-Cal program, including  
               available services, program requirements, rights and  
               responsibilities, and privacy and confidentiality  
               requirements.      

           Celiac Disease, Glucose Intolerance, and Wheat Allergies  
          Gluten is a protein found in wheat, rye, and barley. Celiac  
          disease is an auto-immune disorder caused by the consumption of  
          gluten. For those with Celiac disease, exposure to gluten causes  
          an auto-immune condition where the body attacks normal  
          intestinal tissue. In response to eating gluten, the body  
          destroys the intestinal villi, which are the small finger-like  
          projections in the small intestine that absorb nutrients from  
          food. Repeated exposure to gluten, and resulting intestinal  
          inflammation and destruction of the villi, leads to  
          malabsorption of food, iron deficiency, anemia, osteopenia,  
          increased risk of developing other auto-immune disorders, and  
          gastrointestinal cancers. The disease is recognized as a "slow  
          killer," because symptoms associated with the body's inability  
          to absorb nutrients become more serious over time. (American  
          Celiac Disease Alliance, 2014.)

          Gluten intolerance and wheat allergies, which are not classified  








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          as auto-immune disorders, are even more common than celiac  
          disease. For individuals with food intolerances and allergies,  
          the body is responding to external stimuli that cause illness,  
          rather than attacking itself, as is the case with celiac  
          disease. For those with gluten intolerance and wheat allergies,  
          exposure to gluten and wheat may cause reactions in the skin,  
          mouth, gastrointestinal tract, and lungs, and cause rashes,  
          wheezing, and lip swelling. Immediate intestinal symptoms of  
          celiac disease, gluten intolerance, and wheat allergy include  
          diarrhea, abdominal cramping, pain, and distention. (American  
          Celiac Disease Alliance, 2014.)

          According to the author, estimates from the National Institute  
          of Health establish that celiac disease is widely  
          under-recognized, affecting as many as 1 in 22 people with  
          genetic risk factors, and 1 in 133 people with no genetic risk  
          factors. Gluten intolerance and wheat allergy are even more  
          common, with wheat allergy being one of the top eight food  
          allergies in the United States.  These numbers indicate that a  
          large number of children in California's K - 12 public schools  
          are likely to struggle with the chronic illness caused by Celiac  
          disease, gluten intolerance, and wheat allergy, whether or not  
          they have been formally diagnosed with these disorders. 

           Arguments in Support  
          According to the author, this simple addition to the changes  
          already enacted under previous legislation will ensure that all  
          children have access to gluten-free foods and establish an easy,  
          low-cost mechanism to ensure that California schools are in  
          compliance with federal regulations as they relate to students  
          with celiac disease and wheat allergy. 

          The federal Healthy, Hunger-Free Kids Act of 2010 requires new  
          nutritional standards for elementary, middle, and high-school  
          meals.  AB 626 (Skinner), which was signed into law in 2013,  
          amended California's existing school nutrition standards and  
          programs to meet the new goals set forth in federal law. These  
          new federal goals include increased access for students to  
          nutrition programs (or meals), improved oversight of nutritional  
          programs, and improved nutritional standards. Although AB 626  
          implemented important changes in state nutritional programs to  
          address the federal goal of improved nutritional standards, AB  
          626 does not address the nutritional needs of students with  
          Celiac disease, gluten intolerance, or wheat allergy. 









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          State law currently allows schools to elect to provide  
          alternative foods for students with immediately life-threatening  
          food allergies, but does not address the needs of students with  
          health-threatening allergies or diseases that are  
          life-threatening in the long-term. In most instances, neither  
          celiac disease nor gluten intolerance is immediately  
          life-threatening, despite their potentially life-threatening  
          long-term impacts and immediate impacts on the health and  
          wellbeing of those afflicted. To ensure the greatest number of  
          students receive the nutritious meals they need, committee staff  
          recommends language that would encourage schools to provide  
          gluten free meals to students without IEPs as well.

           Arguments in Opposition  
          Celiac disease, gluten intolerance, and wheat allergy are  
          serious conditions that should not be ignored.  However,  
          existing law and practice already permit and encourage the  
          actions specified in this bill.  Because this bill applies only  
          to those pupils who have an IEP that recognizes the dietary  
          condition and that pupil is eligible for the free and reduced  
          price meal program, this could potentially apply to a small  
          number of pupils.  As such, it may be more effective to inform  
          these eligible pupils of the availability of this resource  
          during his or her annual IEP meeting.  Such wide-spread  
          notification may cause confusion among parents and guardians if  
          their child does not have an IEP in place or does not qualify  
          for the free and reduced price meal program.  Such confusion may  
          result in a significant increase in the work load for schools  
          and districts.

          There are countless other allergies, intolerances, and dietary  
          needs that from which students may suffer.   This bill  may open  
          the flood gates to legislation requiring or encouraging schools  
          to provide meals to meet the needs of all of its students,  
          thereby potentially crippling a food service program.

           Previous Legislation  
          AB 422 (Nazarian) of 2013, adds information regarding health  
          care coverage available through the California Health Benefit  
          Exchange, known as Covered California, to notifications that may  
          be included at the option of the school district or county  
          superintendent on applications for the School Lunch Program.

          AB 626 (Skinner) of 2013, makes numerous changes to school  
          nutrition standards to conform to the federal Healthy and Hunger  








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          Free Kids Act.

          SCR 7 (Huff) of 2011, proclaims the month of May 2011 as Celiac  
          Disease Awareness Month to promote statewide awareness of celiac  
          disease.  

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          None on file

           Opposition 
           
          None on file
           
          Analysis Prepared by  :    Jill Rice / ED. / (916) 319-2087