Food insecurity among children and their families is a persistent national public health problem—one associated with a host of problems that affect children’s short- and long-term development. The Child and Adult Care Food Program (CACFP), which helps pay for nutritious meals for children in child care programs, is one of the key federal child nutrition programs designed to support children’s healthy nutrition and development.
Our research focused on a major gap in the CACFP coverage and ability to reach children. Specifically, although it is allowed under CACFP law, relatively few states extend CACFP eligibility to children cared for by small home-based child care providers and friends and relatives who are legally exempt from their state’s child care licensing requirements—providers who care for 11.5 million children nationwide. Further, these providers disproportionately care for many vulnerable children including infants and toddlers, children with disabilities, children from immigrant families, families who face challenges affording child care, and families working nontraditional hours.
We spoke with a variety of stakeholders in three states that allow these providers to participate in CACFP to explore what could be learned from their efforts to inform other states that might be interested in expanding eligibility and participation in CACFP for this population. Our review suggests we are missing a remarkable opportunity to reduce food insecurity and support the healthy development of many children.
Specifically, we found the following:
- States are not using the flexibility in CACFP to make these providers eligible. Specifically, the relatively few states that allow these providers to access CACFP most commonly limit eligibility to providers who are approved by the child care subsidy system, which though significantly better than not allowing providers to be eligible at all, significantly restricts the eligible pool of providers. However, although it has received little attention, CACFP allows states to set up alternative approaches that would make the program much more broadly available to providers and potentially stabilize enrollment. Both Louisiana and California have developed alternative approaches that significant expand the pool of providers who could become eligible.
- The CACFP administrative and funding approach does not adequately support sponsors to enroll and support LEHBCC providers in general and is particularly inadequate to support participation of providers in underserved communities. Our review highlighted that making LEHBCC providers eligible is the first step but will not likely be sufficient to significantly improve participation unless additional resources and supports are made available to CACFP sponsors. This is because these providers include people who are less accustomed or equipped to meet government requirements and thus need more support, and because CACFP sponsor agencies that support providers may not have sufficient administrative funding, training, or tailored materialsto engage in these extra activities. These challenges are even greater for providers who face extra barriers such as language, literacy, and technology, or who have had negative experiences with government agencies.
- CACFP’s policies and payment levels create significant barriers to participation overall and particularly for LEHBCC providers. Our study highlighted a number of CACFP policies and practices that can make it challenging for smaller home-based providers to participate. These include low payment rates for meals, extensive paperwork and reporting requirements, and unannounced monitoring visits.
Our review suggests that the following steps could significantly improve LEHBCC providers’ participation in CACFP:
- States should use the flexibility in CACFP to prioritize making more LEHBCC providers eligible for participation in the program, using strategies other than limiting eligibility to providers approved for the child care subsidy program.
- Federal and state governments, and philanthropy, could provide sponsors financial supports and other resources to reduce the costs associated with recruiting, enrolling, and retaining LEHBCC providers, and help sponsors develop intentional efforts to support outreach to and enrollment of providers in underserved communities.
- Federal and state governments, and sponsor agencies, could assess CACFP policies and practices in light of LEHBCC providers’ realities and capabilities, and work to either change these policies (at the federal level) or identify ways to help agencies reduce the barriers (at the state and local levels).
Taking these steps could result in nutritional supports becoming available to many more children.