What is the CACP? Where’s it Going? And How Can You Help?

1. What is the CACP? Where’s it Going? And How Can You Help? Presentation for CAPPA Conference July 26, 2007 Ed Mattson

2. What is the CCFP/CACFP? • Introduction: • “Section 17 of the National School Lunch Act, as amended, authorizes assistance to States through grants-in-aid and other means to initiate, maintain, and expand nonprofit food service programs for children or adult participants in nonresidential institutions which provide care. The Program is intended to enable such institutions to integrate a nutritious food service with organized care services for enrolled participants.”

3. Meals and the Meal Pattern • 2 meals & 1 snack per day. • Family style encouraged. • Meal pattern based on school lunches. • Designed to meet 1/3 of RDA. • Coming into alignment with Dietary Guidelines in year or two. • Meal patterns for infants, children & adults.

4. Meal Pattern for Children: • Component Sizes Broken Down By Age – • 1-2 • 3 thru 5 • 6 thru 12 • Lunch for a 3 – 5 Year Old Includes – • ¾ cup fluid milk • ½ cup 2 or more fruits and/or vegetables • 1 ½ oz. meat or meat alternates • ½ slice bread or bread alternates

5. Reimbursement Based on Family Size & Income (FS&I) • CACFP, like school lunch (NSLP), uses FS&I level to determine reimbursement rates. • “Income Eligibility Guidelines” based on federal income poverty guidelines. • In school lunch a student is eligible for a free meal if FS&I is up to 130% of federal poverty guideline. • Same student is eligible for a reduced-price meal if FS&I is between 130% and 185%. • If FS&I is above 185% then must pay for meal. • For a family of 4 free = $26,845, reduced-price = $38,203. • FS&I scales adjusted in AK & HI. Why not in CA? • In child care all meals served free but reimbursement still based on FS&I like in NSLP.

6. Center Basics – • Like NSLP obtain FS&I info from families. • Use “income eligibility application” (IEA). • Categorical Eligibility: • Food Stamps • FDPIR • CalWORKs • Centers report monthly meals served by type and income category. • Allowed to use annual enrollment percentages to report meals by income category.

7. Center Reimbursement Rates – • Plus cash-in-lieu (CIL) for every lunch & Supper of $0.1675 (last year’s rate).

8. Family Child Care Homes Basics – • Must have a “sponsor” to participate. • Separate reimbursement for provider meals and sponsor administrative costs. • Reimbursement systems have changed with legislation over the years. • One provider rate from 1978-1996 • Republican victory in Congress in 1995 & move towards “welfare reform” lead to Tiering legislation aimed at targeting benefits to low-income providers and children. • Under Tiering previous rate rolled over to Tier I and much reduced rate established for Tier II. • To qualify for Tier I a provider must be income eligible or reside in a “low-income area.” • Defined as attendance area of elementary school where at least 50% qualified for free and reduced meal, or eligible census block group.

9. Family Child Care Reimbursement Rates – • Administrative rate based on homes claiming in a month. • Rate adjusted for economies of scale. • Rate has not kept up very well with costs. • Many sponsors turn to grant funds to survive.

10. Sponsor Administrative Responsibilities – • Enrolling new providers. • Completing the sponsor-provider agreement. • Determining & documenting provider eligibility. • Collecting IEA’s from parents of Tier II homes. • Monitoring homes: • Pre-approval visit • 3 visits per year – 2 unannounced. • Annual program training. • Reviewing menus, processing monthly claims and paying providers. • New integrity rules.

11. History Highlights • So How Did We Get Here? • May 1968 – Congress establishes Special Food Service Program for Children • November 1975 – Congress establishes and authorizes for 3 years the Child Care Food Program (CCFP), adding family child care homes and Head Start, and requiring licensing. • December 1980 – Certain for-profit centers allowed. • August 1981 – Dramatic cuts made to program including reducing age to 12, limiting meals to 2 +1 snack, reducing reimbursement rates by 10%, requiring SSN’s, and revised FS&I to 130/185%. • October 1986 – breakfast rates increased by 3 cents! • November 1987 – Certain licensed adult day care centers added.

12. History Highlights Continued • September 1988 – An extra reimbursable meal or snack added when child in care for 8 or more hours. • November 1989 – Name changed to CACFP, expansion funds created, SSN from primary wage earner only. • October 1994 – Automatic eligibility for Head/Even Start, 3 year applications, allowed FDCH admin $ for outreach, homeless kids pilot. • August 1996 – Tiering, meals reduced back to 3 total, term “outreach” removed from regulations. • October 1998 – Certain at-risk programs added for 13-18 year olds in low-income areas, homeless program made permanent, reduced audit funds. • June 2000 – Integrity changes to regulations added. • June 2002 – First Interim Rule • September 2004 – Second Interim Rule

13. Integrity Rules Background & Summary – • Growing pains by 1990’s leads to fraud by mid-1990’s in TX and other states. • USDA Office of Inspector General begins series of audits culminating in “Operation Kiddie Kare” report in 1999. • USDA begins work on proposed rule to improve program management. • But Congress passes Agricultural Risk Protection Act in 2000 before they are released. • USDA modifies rule to reflect ARPA discretionary changes and issues proposed rule in September 2000. • Non-discretionary changes included in First Interim Rule (June 2002). • Second Interim Rule clarifies differences between first two (September 2004).

14. First Interim Rule – • Serious deficiency process strengthened. • Performance standards for sponsors • Financial viability • Administrative capability • Program accountability • Suspension & termination rules clarified. • National disqualified list established. • Corrective action timeframes strengthened. • Hearing process clarified and strengthened. • Unannounced reviews mandated (2 of 3). • Monitoring staff ratios • Review frequency by state agency shortened. • 15% admin cap on center sponsors. • Transfers limited to one per year.

15. Second Interim Rule – • Block Claiming – defined as any 15 consecutive day period where same numbers of meals are claimed. Sponsor must conduct follow-up within 60 days to verify reason. • Household Contacts – state agency discretionary policy usually used to confirm block claiming or other perceived violations. • 5-Day Reconciliation – part of a review of a facility where for 5 day period sponsor must reconcile meals claimed to enrollment and attendance records. • Advance Payments - at state agency discretion.

16. Problems & Issues – • Succession of additional administrative duties since tiering without increase in administrative reimbursement. • Most sponsors have lost homes. • Only saving grace is younger providers who don’t remember when. • CDE NSD understaffed and inexperienced, but at least trying. • Tiering and integrity changes have had devastating impact on homes & sponsors: • Sponsors down 45% • Total FCCH’s down 21% • Tier II homes down 47% • Tier I homes down from peak 11%

17. What’s This About an Obesity Epidemic? • Facts & Stats About Obesity & Child Care – • Between 1971 & 2004 rate of obesity for kids 6-11 increased from 4 to 19%; and for preschoolers 2 to 5 it increased from 5 to 14%. • Only ¼ of kids ages 2 to 11 consume 3 daily servings of vegetables and less than ½ of those kids consume 2 daily servings of fruit. • The proportion of working mothers with young children increased from 39% in 1975 to 63% in 2003. • 60% of infants and children up to age 5 spend an average of 29 hours a week in some form of child care setting. • More than half of young children ages 5-14 years also spend time in a regular child care setting. • For children from birth to age 5: • 35% receive relative care • 22% receive home-based, non-relative care • 60% receive center-based care (www.healthyeatingresearch.org/uploads/PromotingGoodNutritionResearchBrief.pdf)

18. CACFP to the Rescue – • Same authors in Spring 2006 Future of Children article on ‘Childhood Obesity,” maintain that “child care represents an untapped rich source of strategies to help children acquire positive healthy habits to prevent obesity. The infrastructure already exists within Head Start and CACFP…to incorporate healthful eating and exercise programs, thus reaching many low-income children who are at the greatest risk for obesity.” • Challenges: • Nutrition knowledge lacking among child care providers. • Need for more current research to evaluate the meals and snacks served and consumed in low-income facilities in low-income areas or operated by low-income providers.

19. Opportunities: • CACFP linked to quality child care in a number of studies (for example): • The National Center for Children in Poverty’s report, In the Neighborhood: Programs that Strengthen Family Day Care for Low-Income Families, cited CACFP as one of the important supports for long-term success in building strong family child care for low-income families. • The Families and Work Institute’s Study of Children in Family Child Care and Relative Care reported that 87% of family child care homes considered to be providing good quality child care participated in the CACFP. • The U.S. General Accounting Office’s report, Promoting Quality in Family Child Care, stated: “Because of its unique combination of resources, training, and oversight, experts believe the food program is one of the most effective vehicles for reaching family child care providers and enhancing the care they provide.” • So CACFP could be the answer, but it needs further research and some regulatory upgrades, and that’s where we come in! (www.frac.org/html/federal_food_programs/programs/cacfp_bblock.html)

20. Who & What is the CCFP Roundtable? • Mission & Organization – • Our mission is to promote the health and wellbeing of children in child care by providing leadership and advocating for enhanced and expanded CACFP. • We started in 1977 to foster a role for CA sponsors in the development and implementation of statewide program policy. • Now influential voice nationally for child care component of CACFP. • Work collaboratively with CDE NSD, USDA, CFPA, National CACFP Forum, FRAC, and other regional and national program and children’s advocates. • We seek to improve nutrition quality, program integrity and provide a voice for sponsors, providers and kids! • Advisory Committee made up of key member organizations and representatives from CFPA, CDE NSD & DHS; meets 6 times per year to identify issues and trends, do strategic planning, establish meeting agendas; discuss and respond to issues impacting nutritional status of young children in CA.

21. Conference, Summit & the Future • Nationally recognized conference since 1992. • Our 1999 Summit brought together state and national stakeholders to discuss policy implications for improving child care and children’s health through the CACFP. Now considered a national model. • In 2003 we joined with the California Adolescent Nutrition & Fitness Program, the California Center for Public Health Advocacy, CFPA, the California WIC Association and others to become the Strategic Alliance Steering Committee.

22. Our Current State Issues • Increase State Meal Reimbursement – • We have joined efforts on school nutrition side to increase state meal reimbursement. • State Meal $? • Yes, and the “Moscone Nickel” is now 15.63 cents. • Low-Income Breakfasts & Lunches • 75% FCCH with up to 30% allowed for administration. • What Efforts? • Governor’s May Revise last year included 6.75 cents; died in negotiations with legislature over meal standards. • Governor wants to eliminate deep fat fried foods. • This year CFPA & Roundtable began lobbying hard in January to include child care in the negotiations. • Governor’s plan in AB 1503 • Torlakson Plan SB 20 – contained more rigorous standards • We lobbied hard for alternative for child care • May Revise this year contained enough for 4.7 cent increase in schools only. • Things have now stalled over budget negotiations.

23. Current State Issues Continued • What Can You Do Now? • It may not be too late to contact your legislator: • If your Senator is listed below, call: • Denise Ducheny (San Diego & Imperial Co) 916-651-4040 • Michael Machado (San Joaquin, Sacto & Yolo Co) 916-651-4005 • Dennis Hollingsworth (Riverside & San Diego Co) 916-651-4036 • If your Assemblyperson is listed below, call: • Mark Leno (San Francisco) 916-319-2013 • John Laird (Santa Cruz) 916-319-2027 • If legislator not listed above, call: • Senate Budget Chair – Denise Ducheny at 916-651-4040 • Assembly Budget Chair – John Laird at 916-319-2027 • Market the Program • 1999 Summit • Interagency Meetings • CACFP Week activities

24. Current Federal Issues • Market the Program – • Branding • Forum adopted new logo • Child Nutrition Reauthorization 2009 • Congress tweaks CN programs every 4-5 years. • Minor changes in 2004 • Paperwork reduction effort • Permanent eligibility for for-profit centers • Extension from 3 to 5 years for tiering determinations. • We have high hopes for 2009 • Pay-go could be a problem

25. Federal Issues Continued • Join us in Taking Action This August – • We are asking everyone to contact their Congressperson this August and talk about the CACFP! • It is even more important if your service area is within the district of House Ed & Labor Committee members in CA: • George Miller – D 7th – Contra Costa Co. • Lynn Woolsey – D 6th – Sonoma & Marin Cos. • Susan Davis – D 53rd – San Diego Co. • Linda Sanchez – D 39th – Whittier, Lakewood, Lynwood, South Gate • Howard “Buck” McKeon – R 25th – Santa Clarita, San Bernardino, Inyo & Mono Cos. • If not certain go to www.house.gov and enter zip code. • Find helpful information on our web site www.ccfproundtable.org under Legislation & Advocacy tab.

26. Can We Be Partners? • Contact the Roundtable – • Web Site : www.ccfproundtable.org • Ed Mattson, Roundtable Coordinator • Tel/Fax: 530-677-9410 • Email: mred94523@earthlink.net • Our Fall Conference • October 15-17 at Sheraton Grand Hotel in Sacramento