What’s for lunch? The Child Nutrition Act Reauthorization

1. What’s for lunch?The Child Nutrition Act Reauthorization Zoe Shamash, MD Corinna Rea, MD Dina Ferdman, MD

2. National School Lunch Program--history •  The Richard B. Russell National School Lunch Act is a United States federal law signed by President Harry S. Truman in 1946.  • The act created the National School Lunch Program, a program to provide low cost or free school lunch meals to qualified students through subsidies to schools.  • The program was established as a way to prop up food prices by absorbing farm surpluses, while at the same time providing food to school age children. • In response, Congress enacted the 1946 National School Lunch Act as a "measure of national security, to safeguard the health and well-being of the Nation's children." • The majority of the support provided to schools participating in the program comes in the form of a cash reimbursement for each meal served. 

3. Who is eligible? • Any child at a participating school may purchase a meal through the National School Lunch Program. • Determined by household income • Free lunch: income </=130% of the federal poverty level • Reduced price lunch, 130-185% federal poverty level  • For 2006-07 for a family of 3:  • 130 % of the poverty level is $21,580 • 185 % is $30,710. Friday, June 11 2010: pizza, fruit cup, carrots

4. National School Lunch Program: Participation • Open to all children enrolled in a participating school.  • Approximately 95% of public schools participate. • During the 2004-05 school year 29.1 million children in more than 98,900 schools and residential child care institutions participated  • On a typical school day, 17.1 million of these 29.1 million total children, or 59 percent, were receiving free or reduced price lunches.

5. Educational Benefits...lots of potential • Studies show that proper nutrition improves a child’s behavior, school performance, and overall cognitive development. • Properly nourished children more actively participate in the education experience, which benefits them, their fellow students, and the entire school community. • A healthy eating environment teaches children good nutrition and the elements of a proper diet, which can have positive effects on children’s eating habits and physical well-being throughout life.

6. National School Lunch Program: Guidelines • In the 2004-05 school year, 93-94% of meals failed to meet all nutritional standards, primarily due to not meeting standards for fat, saturated fat, or calories. • Most schools offered students the opportunity to select a balanced meal, but few students made the healthful choice.  • In about 90% of all schools nationwide, a student had opportunities to select low-fat lunch options, but in only about 20% of all schools did the average lunch actually selected by students meet the standards for fat • Schools offer few whole grain foods, and french fries and other similar potato products accounted for a disproportionate amount of the vegetable options on school lunch menus. • The Institute of Medicine recently provided recommendations for updated nutrition standards consistent with the 2005 Dietary Guidelines • increasing the amounts of fruits, vegetables and whole grains;  • reducing the amount of sodium and saturated fat provided; and  • setting a minimum and maximum number of calories for school meals.  • USDA is currently developing a regulatory proposal to guide schools in implementing updated standards.

8. Let’s Move • In February, First Lady Michelle Obama launched the Let's Move! campaign to solve the childhood obesity epidemic within a generation. • As part of this effort, President Barack Obama established the Task Force on Childhood Obesityto develop and implement an interagency plan that details a coordinated strategy, identifies key benchmarks, and outlines an action plan to end the problem of childhood obesity. • The action plan defines the goal of ending childhood obesity in a generation as returning to a childhood obesity rate of just 5 percent by 2030, which was the rate before childhood obesity first began to rise in the late 1970s.

9. Let’s Move • Four Major Goals: • Helping Parents Make Healthy Family Choices • Serving Healthier Food in Schools • Accessing Healthy, Affordable Food • Increasing Physical Activity

10. Star Power • Many celebrities have joined the cause… • Rachael Ray is drumming up support for the new bill: "The difference an apple or a good school lunch makes to these kids is more than just keeping them focused in class, you know, it literally is everything."

11. Star Power • Rachael Ray is campaigning for the new child nutrition act, joined the Chefs Move to Schools initiative, and is helping NY city schools to provide healthier options for lunch. • She has gone to congress in person to use her “big Sicilian mouth” to campaign for more money to be spent on each child’s meals and for trans fats to be abolished from school cafeterias.

12. Star Power Jamie Oliver traveled to Huntington, WV, the “unhealthiest city in America,” and spent three months improving the food in the schools in his reality TV show, Jamie Oliver’s Food Revolution.

13. Star Power • http://www.youtube.com/watch?v=bGYs4KS_djg

14. Star Power • John Salley, Tobey Maguire, Ellen DeGeneres, Scarlett Johansson and many more have all contacted Congress about improving the quality of food in America’s schools.

15. In the Media • There have been many articles, op-eds, blogs and videos deicated to the debate over school nutrition. Many non-profit organizations are lobbying hard for their views:

16. In the Media • Alice Waters (of Chez Panisse fame) wrote a famous NY Times Op-Ed recommending a budget of $5 per child per meal. • An angry mom has become known all over the internet for eating lunch at a school cafeteria every day for a year and posting pictures online on her blog. • A self-proclaimed “Renegade Lunch Lady” named Ann Cooper has devoted her life to improving school lunches.

17. Healthy, Hunger-Free Kids Act of 2010S.3307 • Amends the Richard B. Russell National School Lunch Act and the Child Nutrition Act of 1966 to revise the school lunch and breakfast programs, the summer food service program, the child and adult care food program (CACFP), and the special supplemental nutrition program for women, infants, and children (WIC program).

18. EXPANDING FREE MEALS • Expanding Afterschool Meals for At-Risk Children Nationwide • Child and Adult Care Food Program receives reimbursement for snack only, will expand to include an additional 21 million meals annually by 2015. • Connecting More Eligible Low-Income Children with School Meals • Expanding certification process to include all Medicaid patients • Creates a new option that will allow schools in high-poverty areas to offer free meals to all students without collecting paper applications, which will expand access to more children and reduce administrative burdens on schools • Eliminates the “letter method,” which requires families to return a letter to the school to establish eligibility • Estimate this will include 115,000 new students annually by 2015 • Automatically Enrolling Foster Children for Free School Meals • Promoting the Availability and Locations of Summer Meal and Breakfast Sites • New requirement of school food authorities to coordinate with the Summer Food Service Program in their neighborhoods to todevelop and distribute materials to families to inform them of the availability and location of summer meal sites and school breakfast sites. • Piloting Innovative Methods to Provide Nutrition to Hungry, Low-Income Children • New funding to test pilot projects to improve methods of providing nutritious foods to hungry children, including during out-of-school times.

19. PROMOTING HEALTH AND REDUCING CHILDHOOD OBESITY • Helping Schools Improve the Nutritional Quality of School Meals • Performance-based increase inthe federal reimbursement rate for school lunches — 6 cents per meal • Establishing National Nutrition Standards for All Foods Sold in Schools • Secretary of Agriculture will have the authority to establish national nutrition standards for all foods sold on school campuses throughout the school day. • Promoting Nutrition and Wellness in Child Care Settings • Revises the nutrition standards for meals, snacks and beverages served through the Child and Adult Care Food Program (CACFP) • Provides education and encouragement to participating child care centers and homes to provide children with healthy meals and snacks and daily opportunities for physical activity, and to limit screen time. • Farm-to-School Programs • $40 million in mandatory funding to help schools establish school gardens and source local foods into their cafeterias. • Supporting Breastfeeding in the WIC Program • Expanding the collection of WIC breastfeeding data, creating performance bonuses for state agencies with high rates of breastfeeding, and allowing contingency reserve funds to be used to purchase breast pumps. • Mandatory funding for a program to recognize exemplary breastfeeding practices at the WIC clinic and state agency levels. The Healthy, Hunger-Free Kids Act permanently authorizes this program within child nutrition law and expands the collection of WIC program data on breastfeeding rates.

20. IMPROVING PROGRAM MANAGEMENT & INTEGRITY • Establishing Professional Standards for School Food Service • New training and qualification standards for the people who operate the National School Lunch and School Breakfast Programs at the local and state levels. • Simplifying Program Rules and Reducing Paperwork for Day Care Sponsors and Providers • Gives Child and Adult Care Food Program (CACFP) sponsors greater flexibility with their administrative funds, and eliminate the need for sponsors and day care centers to resubmit duplicative paperwork each year. • Estimates that roughly an additional 2,500 day care homes will receive the higher tier 1 reimbursement rate. • Allowing WIC to Share Educational Materials with Other Programs • Allows state WIC agencies to permit local WIC agencies to share WIC nutrition education materials with CACFP institutions at no cost if a written materials sharing agreement exists between the relevant agencies • Improving Food Safety Requirements for School Meals Programs • extending existing HACCP requirements to cover activities like breakfast in the classroom.

21. Bill Status • 3/17/2010 Introduced by Senator Blanche Lincoln (D-Ar), Chairman of the Senate Agriculture Committee • 3/24/2010 Unanimously passed by the Senate Agriculture Committee • 5/5/2010 Introduced to the Senate Floor • Placed on Senate Legislative Calendar under General Orders. Calendar No. 363. • 6/10/2010 George Miller (D-CA) chairman of the House Education and Labor Committee introduced the Improving Nutrition for America's Children Act, a bill to reauthorize and amend the Child Nutrition Act

22. Controversy • The main source of controversy regarding the two bills introduced in Congress is funding. • Both bills increase the reimbursement for each meal by 6 cents, which is the first increase above inflation in over 30 years. But many argue that the increase is not enough to substantially improve the quality of food. The School Nutrition Association recommends a 35 cent increase, and Rachael Ray and Senator Kirsten Gillibrand are lobbying Congress to increase the reimbursement to 70 cents per child. A coalition of school reformers, including the “Renegade Lunch Lady” Ann Cooper, is asking for a $1 increase. • Obama had requested $10 billion over 10 years in new money for child nutrition, and the Senate and House bills only provide $4.5 billion and $8 billion, respectively.

23. Controversy • Even at the recommended level of reimbursement, the bills are pricey and it is questionable whether Congress will be able to pay for them. • The Senate Agriculture committee, which introduced the senate version of the bill, has found enough areas to cut their budget to fund the bill. The bill proposes the appropriation of funds that would otherwise go to USDA’s Environmental Quality Incentives Program, or EQIP. This program allocates subsidies to farmers to use environmentally friendly farming practices.  If passed by Congress, the Healthy, Hunger-Free Kids Act would reallocate $2.8 billion over the next 10 years from EQIP’s budget to the new efforts to the new child nutrition programs.

24. Controversy • Many environmentalists oppose the cut: “This current proposal would not only rob farmers, ranchers, and forest landowners of conservation and environmental stewardship assistance in the next decade, but would take away well over $2 billion from the farm bill conservation baseline, or nearly half of the widely lauded conservation increase in the 2008 Farm Bill.” • The bill would also cut $1.2 billion from the nutrition education component of the federal food stamp program (now known as the Supplemental Nutrition Assistance Program, SNAP) over the next decade, which some say negates the whole pupose of the new bill. • In contrast, although the House bill is more ambitious than that of the Senate, they have not found the funds to pay for it.

25. Controversy • Others argue that while the bills do address food safety, the provisions are too small, especially in the Senate version of the bill. Food safety experts are calling for a rapid alert system to notify schools about recalled food, higher purchasing standards for high-risk foods, and arguing that school purchasers should have access to safety information regarding the organizations they are purchasing from.

26. Will this even happen? • It is unclear whether Congress will have time to debate and pass a unified piece of legislation. The current legislation expires on September 30, so if they do not produce a bill before the August recess, they will have to extend the current funding and no changes will be made for another year (like last year…).

27. How to Advocate • https://secure3.convio.net/voices/site/Advocacy?cmd=display&page=UserAction&id=2037 • http://www.change.org/petitions/view/tell_senate_leaders_dont_delay_healthy_food_for_americas_children

28. The best part about researching this talk? • You Tube videos… • http://www.youtube.com/watch?v=lint8PiGuRY • http://www.youtube.com/watch?v=Kj_2xx-UKWo • http://healthtopic.nationaljournal.com/2010/03/lincoln-v-obama-school-lunches.php