Real Experiences

Background: Family childcare homes (FCCH) are one kind of childcare environment that can receive support from Child and Adult Care Food Program (CACFP). In order to participate, FCCHs must work with a sponsoring organization. Sponsors oversee logistics of participation, including administrative and financial management and ensuring FCCH training and compliance with CACFP requirements. The number of sponsors in the United States is declining, as the number of participating FCCHs declines. The decrease in sponsors raises concerns for equitable access to CACFP. The brief performed semi-structured interviews with 15 California CACFP family home sponsors to understand their challenges.
Sponsor Concerns: A primary concern of sponsors is inadequate administrative reimbursement. The interviewed sponsors emphasized two main impacted areas. First, sponsors lack tools to support non-English-speaking childcare providers. Second, sponsors lack resources to hire staff needed to complete sponsor tasks. As a consequence, sponsors lack resources to work with new FCCHs. A second primary concern of sponsors is the challenges that accompany FCCH visits. Sponsors are required to visit FCCHs three times at least three times a year. Twice must be unannounced, and one must be during a meal or snack. Sponsors report that visits are time-consuming and expensive, can be difficult to coordinate at a time providers will be present, and present staff safety concerns. Recommendations: Sponsors must be adequately supported through funding and training resources, and virtual alternatives to in-person visits could be explored.

This study's purpose was to explore the perceptions of Oklahoma FCCH providers of these enhancements and to determine current meal practices as an opportunity to foster collaborations between educators, service providers, and health and nutrition professionals.

Providers want to do what is best for children while saving money and time. Collaborative practice between allied health, nutrition, and CACFP service providers and child educators would likely assist FCCH providers in meeting nutrition best practices.

The serious deficiency process is considered a barrier to CACFP participation. The serious deficiency process is intended to ensure integrity and make sure operators follow CACFP laws, rules, and regulations. Operator actions that are considered non-compliant can place them on serious deficiency. If operators cannot correct the errors, they are terminated from CACFP and cannot participate again for seven years.
Semi-structured interviews were conducted with 10 California CACFP sponsors to understand the challenges faced by family childcare center (FCCH) providers in CACFP. The sponsors reported three primary concerns. First, the regulations providers are expected to follow are too harsh. The ease of disqualification from simple mistakes paired with the severity of the consequences hinders participation. Second, limited technical and language resources create equity issues for providers who are less familiar with technology and whose first language is not English. Inadvertent discrepancies can put providers at risk of termination from the program. Third, sponsors report that the serious deficiency process is subjective, unclear, and time-consuming. The process cannot be upheld consistently without clarity and structure.

Context: The child and adult care food program (CACFP) transitioned from the oversight of the California Department of Education (CDE) to the California Department of Social Services (CDSS) July 1, 2021. This project was intended to inform the CDSS of administrative challenges and potential improvements of the CACFP. CACFPR and the National Policy Institute (NPI) interviewed independent childcare centers across the administrative regions of the CDSS. Specifically, CACFP and NPI interviewed independent childcare centers that directly contract with the state, those that operate under sponsors, and sponsors themselves.
Findings: Benefits and Challenges: Key benefits included food reimbursement, ability to support low-income families and communities, and access to nutrition guidelines. Independent childcare centers that operate under sponsors reported benefits of administrative oversight and provision of software. Benefits also included having a reliable source to ask questions and help ensure compliance with nutrition guidelines. Key challenges spanned across administrative challenges, technological challenges, and the difficulty of offering adequate culturally responsive food options. Independent childcare centers directly contracting with the state identified more challenges than those operating under sponsors.
Findings: Recommendations: Primary recommendations involved online chat-rooms and telephone access to improve communication with CACFP staff, and online and streamlined paperwork to reduce paperwork load. Additional recommendations included further support for meeting nutrition standards, and in preparation for administrative reviews. Childcare centers also recommended additional CACFP materials to share with families, and further guidance for offering culturally responsive options. Sponsors recommended more consistent, program-specific report communication from the state. Sponsors also requested more supportive relationships from CDSS and analysts, and quarterly meetings with other sponsors.

This Connecticut-based study of licensed child care centers aimed to identify facilitators and barriers to CACFP participation to expand the CACFP reach and improve the nutrition of young children. Using data from an online survey of licensed child care centers in Connecticut, the study analyzed predictors of CACFP participation, assessed program experiences, knowledge and challenges, reasons for not participating, and opinions about increasing the program appeal. The study's secondary goal was to estimate the amount of foregone federal funding because of CACFP underuse.

Sponsor-perceived barriers to provider CACFP: eligibility (costs, background checks, fear/stigma, and delays in becoming state-approved providers); enrollment (lack of translated/low-literacy materials and cumulative systems requirements); and participation (challenges maintaining qualifying menus and documentation and accessing qualifying food, inadequate reimbursements, and unannounced visits). Sponsors suggested systems changes to improve provider support (eg, more assistance with becoming state-approved and for start-up costs and accessible, progressive nutrition training opportunities).

Background: U.S. Child and Adult Care Food Program (CACFP) provides tiered reimbursements for meals served in eligible family childcare homes (FCCH). Higher tier 1 reimbursements apply to providers who operate in low-income communities or are personally living on a low income. Tier 2 reimbursements apply to all other FCCHs. The tiered structure is intended to direct resources toward low-income families. However, the same program requirements apply to all FCCHs, which presents administrative burdens that can limit access to CACFP.
The Context of The Study: The USDA temporarily waived tiered reimbursements in response to increased food insecurity during the COVID-19 pandemic. The waving of tiers allowed all FCCHs to access higher reimbursement rates, and tier 2 providers’ reimbursements more than doubled. California FCCH providers were surveyed about their experiences with the higher reimbursement rates. 518 surveys were analyzed to understand providers’ perceptions of current impacts and future challenges of the reinstated tier system.
Survey Findings: Impacts of Higher Reimbursement Rates: Over half of the providers across tier 1 and 2 reported the following impacts: ability to pay less out of pocket for food costs, serve a greater variety of foods, and serve better quality foods. Additional reports included the following impacts: ability to serve more meals and snacks, choose more options children like, and not charge families more for childcare or food costs. The vast majority of providers across tier 1 and tier 2 also reported that it was easier to implement CACFP’s nutrition guidelines. Significantly more tier 2 providers reported benefits from the higher reimbursement rate, overall.
Survey Findings: Anticipated Changes After Tier Reinstatement: Providers across tier 1 and 2 reported that they would have to charge families more for childcare and decrease the variety of foods provided. Under half of providers reported that they anticipated withdrawing from CACFP or ending their childcare business after tiers returned.
Recommendations: Increased reimbursement rates for all FCCHs may support increased FCCH participation in CACFP, and ensure that more children benefit from nutritious meals and snacks.

Objectives: Child day care centers that serve low-income families may qualify to participate in the US Department of Agriculture Child and Adult Care Food Program (CACFP) and receive reimbursement for meals and snacks served. In 2017, day care sites were mandated to follow the new CACFP meal guidelines. The objective of this study was to assess knowledge and perspectives about the new CACFP meal guidelines among parents of children attending day care sites.