Child & Adult Care Food Program (CACFP)

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CACFP is a federal nutrition assistance entitlement program that, among other things, provides more than $2 billion in reimbursement for meals and snacks served to more than 3.4 million children (see “CACFP Reimbursement” below for more). Most ECE facilities are eligible to participate, and some receive higher reimbursements if they serve children from low-income families. All Head Start programs not participating in the National School Lunch and Breakfast Program must participate in CACFP. Both ECE centers and family day care providers are eligible to participate in CACFP, but homes must work with a sponsoring agency that is responsible for ensuring that homes meet both federal and state regulations. More than 30 states require ECE facilities to meet CACFP standards regardless of participation in the CACFP program.

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CACFP regulates meal patterns and portion sizes, provides nutrition education, and offers sample menus and training in meal planning and preparation to help ECE providers comply with nutrition standards. CACFP standards are based on food categories including meat/meat alternates, fruits, vegetables, milk/dairy, and grains, rather than nutrients. Although specific nutrients are considered, such as vitamin A and vitamin C, they are not the basis for CACFP standards. While USDA encourages providers to serve healthy meals, includes a fruit/vegetable meal component requirement, and requires low-fat or nonfat milk, CACFP’s current food-based standards give participating ECE programs substantial leeway in the nutritional quality of foods served and the methods of food preparation. For example, a program can serve fried chicken and enriched white bread instead of baked chicken and whole-grain bread as part of a meal.  Nonetheless, CACFP has demonstrated a positive impact: Children eating through the CACFP program have been shown to eat more nutritious food than those not participating in the program.1

The Healthy, Hunger-Free Kids (HHFK) Act of 2010 requires USDA to update the CACFP meal and snack patterns to align with the Dietary Guidelines for Americans; new regulations are expected to be proposed in 2014.  An Institute of Medicine (IOM) report recommended several ways to improve CACFP, including increasing fruits and vegetables and decreasing the fat, sodium, and sugar content of meals and snacks served in CACFP facilities.

In addition to reimbursement for meals and snacks meeting program standards, providers and sponsors also receive ongoing training, technical assistance, and support through CACFP. A new nutrition and wellness guide for ECE providers who participate in CACFP, which addresses physical activity and screen time in addition to nutrition, was released in 2013. Additionally, the Act requires USDA to conduct a national study on nutritional and wellness quality in ECE settings.

States can use CACFP to help promote healthy eating and decrease obesity in young children in ECE by:

  • Providing CACFP training and technical assistance focused on nutrition, breastfeeding, physical activity, and screen time education for children, teachers, and parents;
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  • Enhancing state CACFP standards to align with other national nutrition guidelines such as the U.S. Dietary Guidelines for Americans; and
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  • Working to increase CACFP participation among eligible facilities.
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Click here for a more detailed discussion of working within state CACFP program to promote obesity prevention (with state examples).  Click here to read 15 brief case studies profiling how ECE programs across the U.S. have improved the nutrition quality of meals and snacks served through CACFP.

 

State Example: West Virginia

In June 2011, the West Virginia Department of Education (WVDE), Office of Child Nutrition adapted the Delaware CACFP nutrition standards. These standards are referred to as the Child Care Nutrition Standards and are being instituted in more than 500 licensed ECE centers across the state. Within 1–2 years, family day care homes will be required to follow the standards. These standards are age appropriate and require low-fat dairy for children 2 years and older, fruits and vegetables every day, whole grains, and lean meats. They do not allow sugary beverages, high-sugar grains, or processed meats. This CACFP initiative has led to other collaborations. For example, the WV CACFP staff are working with the state ECE licensing office to implement I am Moving, I am Learning.

How It Came About

WV has one of the most progressive standards for competitive foods in schools. The state passed and implemented a strong nutrition policy in the school lunch program, and the Child Nutrition team felt it was critical to have consistent messages across all federally funded programs. The WVDE learned of the Delaware initiative and adapted their standards and materials, which they re-branded with Delaware’s permission.

Implementation

In June 2010, WVDE introduced the ECE nutrition standards with a one-year implementation phase using State Administrative Expense Funds. Through a collaboration with the Department of Public Health, WVDE received additional funds through a CDC Communities Putting Prevention to Work (CPPW) grant, which provided the initiative with more resources than originally planned. A resource website for ECE providers was developed which includes the Leap of Taste, WV Child Care Nutrition Standards resource book and a window sticker indicating participation in the program, as well as parent resources. WVDE also worked with the CPPW team to add a physical activity component.

WVDE has trained their licensing specialists to monitor implementation of the ECE nutrition standards to help support the initiative. While WVDE is holding the centers accountable for the standards, they cannot withhold funds.

In 2009, WV adopted the standards and then trained ECE providers across the state from June 2010 to June 2011 using the Leap of Taste booklet. In addition to the trainings, WVDE funded four culinary institutes to teach cooking classes on scratch cooking, menu planning, and kitchen efficiencies such as deboning a chicken. Videotapes of these trainings are available on their website (http://wvde.state.wv.us/child-nutrition/leap-of-taste/tv/). The culinary institutes used CACFP approved menus.

The state provides a statewide training every 2 years with regional trainings in between. In 2011, the regional trainings focused on the website, family materials, and outreach on the guidelines. Over the course of 2 years, the WVDE, Office of Child Nutrition spent approximately $243,000 to develop and implement materials as well as develop the licensing language.

Lessons Learned

  • Use clear language in all materials developed for use as guidance.
  • Provide tools to implement standards. Appealing materials are important, and paying for a quality marketer is worth the expense.
  • Work with procurement to ensure products exist and are available to meet the standards.
  • Ensure that training is available both in person and by video to address staff turnover or staff who cannot attend the in-person trainings. Staff turnover and the training of new staff were barriers in WV.
  • Be flexible with partnerships. Not all partnerships work out as planned.

 

References

  1. Food Research and Action Center. Child Nutrition Fact Sheet: Child and Adult Care Feeding Program. (n.d.). Available from http://frac.org/newsite/wp-content/uploads/2009/09/cncacfp.pdf.

 

For each child enrolled in an eligible facility, CACFP provides funding reimbursement to the facility for up to two meals and one snack or one meal and two snacks daily. Reimbursement rates for meals and snacks served in ECE centers are based on meal type (e.g., breakfast, lunch, or dinner) and the child’s eligibility for free, reduced-price, or paid meals and snacks. For family child care homes, meal and snack reimbursement rates are based on two tiers of provider eligibility: Tier I rates support family child care homes located in low-income areas and low-income ECE providers, while Tier II rates apply to all other participating family child care homes. CACFP also reimburses facilities for exclusively breastfed infants. Thus, ECE programs can receive funding through this program and still support breastfeeding mothers.