[House Hearing, 116 Congress]
[From the U.S. Government Publishing Office]
GROWING A HEALTHY NEXT GENERATION:
EXAMINING FEDERAL CHILD NUTRITION PROGRAMS
=======================================================================
HEARING
BEFORE THE
SUBCOMMITTEE ON CIVIL RIGHTS AND HUMAN SERVICES
COMMITTEE ON EDUCATION
AND LABOR
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTEENTH CONGRESS
FIRST SESSION
__________
HEARING HELD IN WASHINGTON, DC, MARCH 12, 2019
__________
Serial No. 116-8
__________
Printed for the use of the Committee on Education and Labor
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Available via the World Wide Web: www.govinfo.gov
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__________
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COMMITTEE ON EDUCATION AND LABOR
ROBERT C. ``BOBBY'' SCOTT, Virginia, Chairman
Susan A. Davis, California Virginia Foxx, North Carolina,
Raul M. Grijalva, Arizona Ranking Member
Joe Courtney, Connecticut David P. Roe, Tennessee
Marcia L. Fudge, Ohio Glenn Thompson, Pennsylvania
Gregorio Kilili Camacho Sablan, Tim Walberg, Michigan
Northern Mariana Islands Brett Guthrie, Kentucky
Frederica S. Wilson, Florida Bradley Byrne, Alabama
Suzanne Bonamici, Oregon Glenn Grothman, Wisconsin
Mark Takano, California Elise M. Stefanik, New York
Alma S. Adams, North Carolina Rick W. Allen, Georgia
Mark DeSaulnier, California Francis Rooney, Florida
Donald Norcross, New Jersey Lloyd Smucker, Pennsylvania
Pramila Jayapal, Washington Jim Banks, Indiana
Joseph D. Morelle, New York Mark Walker, North Carolina
Susan Wild, Pennsylvania James Comer, Kentucky
Josh Harder, California Ben Cline, Virginia
Lucy McBath, Georgia Russ Fulcher, Idaho
Kim Schrier, Washington Van Taylor, Texas
Lauren Underwood, Illinois Steve Watkins, Kansas
Jahana Hayes, Connecticut Ron Wright, Texas
Donna E. Shalala, Florida Daniel Meuser, Pennsylvania
Andy Levin, Michigan* William R. Timmons, IV, South
Ilhan Omar, Minnesota Carolina
David J. Trone, Maryland Dusty Johnson, South Dakota
Haley M. Stevens, Michigan
Susie Lee, Nevada
Lori Trahan, Massachusetts
Joaquin Castro, Texas
* Vice-Chair
Veronique Pluviose, Staff Director
Brandon Renz, Minority Staff Director
------
SUBCOMMITTEE ON CIVIL RIGHTS AND HUMAN SERVICES
SUZANNE BONAMICI, OREGON, Chairwoman
Raul M. Grijalva, Arizona James Comer, Kentucky,
Marcia L. Fudge, Ohio Ranking Member
Kim Schrier, Washington Glenn ``GT'' Thompson,
Jahana Hayes, Connecticut Pennsylvania
David Trone, Maryland Elise M. Stefanik, New York
Susie Lee, Nevada Dusty Johnson, South Dakota
C O N T E N T S
----------
Page
Hearing held on March 12, 2019................................... 1
Statement of Members:
Bonamici, Hon. Suzanne, Chairwoman, Subcommittee on Civil
Rights and Human Services.................................. 1
Prepared statement of.................................... 3
Comer, Hon. James, Ranking Member, Subcommittee on Civil
Rights and Human Services.................................. 3
Prepared statement of.................................... 5
Statement of Witnesses:
Berlew-O'Meara, Ms. Nikki, Wilkes-Barre, PA.................. 29
Prepared statement of.................................... 31
Johnson, Ms. Cheryl, MS, RD, LD, Director of Child Nutrition
and Wellness, Kansas State Department of Education......... 17
Prepared statement of.................................... 19
Martin, Ms. Donna, EdS, RDN, LD, SNS, FAND, Director of
School Nutrition Programs, Burke County, Georgia Public
Schools.................................................... 23
Prepared statement of.................................... 25
Ochoa, Dr. Eddie Jr., M.D., Associate Professor of
Pediatrics, University of Arkansas for Medical Sciences
Community Pediatrics Medical Director, Arkansas Children's
Hospital................................................... 8
Prepared statement of.................................... 11
Additional Submissions:
Mr. Comer:
Letter dated March 11, 2019, from the Council of the
Great City Schools..................................... 53
Letter dated March 12, 2019, from the Council of the
National School Boards Association (nsba).............. 54
Dr. Ochoa:
Appendix 2: Estimating the Health-Related Costs of Food
Insecurity and Hunger.................................. 56
Preventing Chronic Disease............................... 74
Scott, Hon. Robert C. ``Bobby'', a Representative in Congress
from the State of Virginia:
Article: Effect of the Healthy Hunger-Free Kids Act on
the Nutritional Quality of Meals Selected by Selected
by Students and School Lunch Participation Rates....... 87
Letter dated January 29, 2018............................ 93
Questions submitted for the record
Thompson, Hon. Glenn, a Representative in Congress from the
State of Pennsylvania:
Article: The Guardian.................................... 97
Article: Full-fat Dairy May Reduce Obesity Risk.......... 100
Article: Full-fat Dairy May Actually Benefit Heart Health 101
Questions submitted for the record by:
Chairwoman Bonamici...................................... 107
Schrier, Hon. Kim, a Representative in Congress from the
State of Washington.................................... 110
Shalala, Hon. Donna E., a Representative in Congress from
the State of Florida
Omar, Hon. Ilhan, a Representative in Congress from the
State of Minnesota..................................... 108
Responses to questions submitted for the record by:
Ms. Martin............................................... 112
Dr. Ochoa................................................ 117
GROWING A HEALTHY NEXT GENERATION:
EXAMINING FEDERAL CHILD NUTRITION PROGRAMS
----------
Tuesday, March 12, 2019
House of Representatives
Committee on Education and Labor,
Subcommittee on Civil Rights and Human Services
Washington, DC
----------
The Subcommittee met, pursuant to notice, at 10:15 a.m., in
room 2175, Rayburn House Office Building. Hon. Suzanne Bonamici
[chairwoman of the subcommittee] presiding.
Present: Representatives Bonamici, Schrier, Hayes, Trone,
Lee, Comer, Thompson, Stefanik, and Johnson.
Also present: Representatives Shalala, Grothman, Allen,
Watkins, Omar, Scott, and Foxx.
Staff present: Tylease Alli, Chief Clerk; Nekea Brown,
Deputy Clerk; Ilana Brunner, General Counsel Health and Labor;
Emma Eatman, Press Aide; Alison Hard, Professional Staff
Member; Carrie Hughes, Director of Health and Human Services;
Stephanie Lalle, Deputy Communications Director; Andre Lindsay,
Staff Assistant; Richard Miller, Director of Labor Policy; Max
Moore, Office Aid; Veronique Pluviose, Staff Director; Banyon
Vassar, Deputy Director of Information Technology; Katelyn
Walker, Counsel; Cyrus Artz, Minority Parliamentarian, Marty
Boughton, Minority Press Secretary; Courtney Butcher, Minority
Coalitions and Members Services Coordinator; Bridget Handy,
Minority Legislative Assistant; Blake Johnson, Minority Staff
Assistant; Amy Raaf Jones, Minority Director of Education and
Human Resources Policy; Hannah Matesic, Minority Legislative
Operations Manager; Kelley McNabb, Minority Communications
Director; Jake Middlebrooks, Minority Professional Staff
Member; Brandon Renz, Minority Staff Director; Mandy
Schaumburg, Minority Chief Counsel and Deputy Director of
Education Policy; and Meredith Schellin, Minority Deputy Press
Secretary and Digital Advisor.
Chairwoman BONAMICI. The committee on Education and Labor
will come to order. Welcome, everyone. I note that a quorum is
present. I ask unanimous consent that Representative Shalala of
Florida, Representative Omar of Minnesota, and Representative
Grothman of Wisconsin be permitted to participate in today's
subcommittee hearing with the understand that their questions
will come only after all members of the Subcommittee on Civil
Rights and Human Services on both sides of the aisle who are
present have had an opportunity to question the witnesses.
Without objection, so ordered.
The committee is meeting today in a hearing to hear
testimony on Growing a Healthy Next Generation, Examining
Federal Child Nutrition Programs. Pursuant to committee rule 7C
opening statements are limited to the chair and ranking member.
This allows us to hear from our witnesses sooner and provides
all members with adequate time to ask questions. I recognize
myself now for the purpose of making an opening statement.
We are here today to discuss our responsibility to make
sure that all children have access to healthy food, all year
round in and out of the classroom, and to discuss why doing so
is a good investment.
More than 70 years ago, Congress passed the National School
Lunch Act as, and I quote, ``a measure of national security, to
safeguard the health and well-being of the Nation's children.''
Through the enactment of this first Federal child nutrition
program, Congress recognized that feeding hungry children was a
moral imperative and a vital tool to protect the health and
security of our Nation.
Kids, families, and communities all do better when kids
have nutritious food that helps them learn, grown, and thrive.
Studies have found that healthier students are likely to have
fewer absences and disciplinary issues.
When children have consistent access to nutritious food it
improves their health and wellbeing from early childhood
through adulthood. This, in turn, results in substantial long-
term savings in healthcare and education.
Roughly 15 million households face food insecurity today.
In my home State of Oregon, one in five kids live in a
household where financial hardship makes it difficult to put
food on the table. Child nutrition programs remain critical to
preventing child hunger and setting a strong foundation for the
next generation.
Today, child nutrition standards and programs like the
National School Lunch Program, School Breakfast Program, and
Child and Adult Care Feeding Program, and the Summer Food
Service Program provide healthy meals for more than 30 million
children in all 50 States all throughout the year. In Oregon,
nearly 300,000 students participated in the National School
Lunch Program, and nearly 150,000 students participated in the
School Breakfast program in the school year 2017 to `18.
These programs have historically enjoyed bipartisan support
in Congress and in communities across the country. We know that
many communities do face challenges in feeding their children,
and as a Congress, we should do more, not less, to address
these issues. Unfortunately, yesterday the President made clear
that he does not share these goals.
Under the President's budget proposal, roughly 1.3 million
additional children would go without free school meals. That is
a lot of hungry children. This hearing will be an opportunity
for all Members to hear about why these programs are vital to
the health and success of communities across the country from
Oregon to Kentucky and everywhere in between.
I hope this hearing is a first step toward renewing the
historically bipartisan commitment to childhood nutrition, and
I look forward to hearing more about these important programs.
Congress and this Committee have a responsibility to make sure
that every child has access to a quality education. Child
nutrition programs are an important part of making sure that
education results in every child having the foundation for a
healthy and productive future.
I want to thank all of our witnesses for being with us here
today and I look forward to your testimony. I now recognize the
distinguished Ranking Member Mr. Comer for the purpose of
making an opening statement.
[The statement of Chairwoman Bonamici follows:]
Prepared Statement of Hon. Suzanne Bonamici, Chairwoman, Subcommittee
on Civil Rights and Human Services
We are here today to discuss our responsibility to make sure that
all children have access to healthy food, all year long, in and out of
the classroom, and to discuss why doing so is a good investment.
More than 70 years ago, Congress passed the National School Lunch
Act as and I quote ``a measure of national security, to safeguard the
health and well-being of the Nation's children.''
Through the enactment of this first Federal child nutrition
program, Congress recognized that feeding hungry children was a moral
imperative and a vital tool to protect the health and security of our
Nation.
Kids, families, and communities all do better when kids have
nutritious food that helps them learn, grown, and thrive. Studies have
found that healthier students are likely to have fewer absences and
disciplinary issues.
When children have consistent access to nutritious food, it
improves their health and wellbeing from early childhood through
adulthood. This, in turn, results in substantial long-term savings in
health care and education.
Roughly 15 million households face food insecurity today. In my
home State of Oregon, 1 in 5 kids live in a household where financial
hardship makes it difficult to put food on the table. Child nutrition
programs remain critical to preventing child hunger and setting a
strong foundation for the next generation.
Today, child nutrition standards and programs like the National
School Lunch Program, School Breakfast Program, the Child and Adult
Care Feeding Program, and the Summer Food Service Program provide
healthy meals for more than 30 million children, in all 50 States, all
throughout the year. In Oregon, nearly 300,000 students participated in
the National School Lunch Program, and nearly 150,000 students
participated in the School Breakfast program in school year 2017 to
2018.
These programs have historically enjoyed bipartisan support in
Congress and in communities across the country. We know that many
communities do face challenges in feeding their children, and as a
Congress, we should do more not less to address these issues.
Unfortunately, yesterday the President made clear he does not share
these goals.
Under the president's budget proposal, roughly 1.3 million children
would go without free school meals. That is a lot of hungry children.
This hearing will be an opportunity for all Members to hear about why
these programs are vital to the health and success of communities
across the country from Oregon to Kentucky and everywhere in between.
I hope this hearing is a first step toward renewing the
historically bipartisan commitment to childhood nutrition, and I look
forward to hearing more about these important programs. Congress and
this Committee have a responsibility to make sure that every child has
access to a quality education. Child nutrition programs are an
important part of making sure that education results in every child
having the foundation for a healthy and productive future.
I want to thank all of our witnesses for being with us today; I
look forward to your testimony. I now yield to the Ranking Member, Mr.
Comer.
______
Mr. COMER. Thank you, Madam Chairman. I would like to thank
my colleagues across the aisle for holding today's hearing.
Before coming to Congress I served as Kentucky's Commissioner
of Agriculture where I worked with school food service
personnel from school districts across the Commonwealth to
promote initiatives, including the Farm to School Program,
encouraging fresh Kentucky proud foods to be served in local
cafeterias.
As I met with these local administrators they consistently
emphasized the crucial role that child nutrition programs play
in supporting kids' health development, especially the free and
reduced price meals offered through the Federal School Meal
Programs.
Free and reduced prices meals ensure that children from low
income households have reliable access to nutritious breakfasts
and lunches while at school. Each school year nearly 30 million
lunches are served to students each day with most participants
receiving a free or reduced price meal. Program participation
has been steadily rising for decades, but in 2012 the Obama
Administration finalized an onslaught of Federal mandates on
school nutrition, delivering a blow to many cafeteria
operations. Schools had to overhaul their menu programming,
including meeting new requirements that limit the kind of milk
they can offer, mandate the color of vegetables they must serve
and limit the type of grains they must use.
Since the Obama Administration enacted the regulations
housed in the Healthy and Hunger-Free Kids Act school lunch
program operating costs have risen while National program
participation has dropped. While we would hope that means there
are fewer hungry children in this country we have reason to
believe that is not the case. School districts already tasked
with operating on a tight budget now face higher cafeteria
operation costs, onerous compliance rules, and mounting food
waste problem as students pass up the food that cafeterias are
now required to serve.
When kids are at school they do not have a parent there
encouraging them to eat the green peas on their plate. And
while I know cafeteria professionals are doing all they can to
get kids to eat their vegetables the truth is some kids just
are not going to try them. However well-intentioned these
requirements may be they are limiting program effectiveness and
causing students to forgo the meals they need. Kids deserve
health and nutritious meals at school, but if the Federal
Government mandates meals that students will not eat than
Washington is categorically failing to combat hunger. For these
reasons Agriculture Secretary Sonny Perdue recently finalized
new rules easing requirements on sodium, milk, and whole
grains.
School districts will benefit from these eased requirements
and Congress should take note. While many folks found ways to
help limit waste and increase participation I hope this new
limited flexibility from USDA will boost meaningful
participation in these programs and result in less tax payer
dollars being thrown straight into the cafeteria trashcan.
Congress should work with these States to provide school
districts with greater latitude over their offerings. By
delivering this flexibility and limiting burdensome paperwork
school districts will be able to customize their cafeteria
menus to give the students they know and serve health options
they will enjoy.
As a farmer myself, I understand the importance of
supporting local farmers by providing school access to local
farm fresh ingredients, and with three young children in public
schools I certainly understand the duty we have to educate our
growing children about eating balanced meals. I look forward to
today's conversation and am hopeful we can find a solution that
helps lower program costs, eliminates food waste, and ensures
that students have access to nutritious, enjoyable meals.
[The statement of Mr. Comer follows:]
Prepared Statement of Hon. James Comer, Ranking Member, Subcommittee on
Civil Rights and Human Services
Thank you for yielding.
I'd like to thank my colleagues across the aisle for holding
today's hearing. Before coming to Congress, I served as Kentucky's
Agriculture Commissioner where I worked with school food service
personnel from school districts across the commonwealth to promote
initiatives including the Farm to
School Program, encouraging fresh, ``Kentucky Proud'' foods to be
served in local cafeterias. As I met with these local administrators,
they consistently emphasized the crucial role that child nutrition
programs play in supporting kids' healthy development, especially the
free and reduced-priced meals offered through the Federal school meal
programs.
Free and reduced-price meals ensure that children from low-income
households have reliable access to nutritious breakfasts and lunches
while at school. Each school year, nearly 30 million lunches are served
to students each day, with most participants receiving a free or
reduced-price meal.
Program participation has been steadily rising for decades, but in
2012, the Obama Administration finalized an onslaught of Federal
mandates on school nutrition, delivering a blow to many cafeteria
operations.
Schools had to overhaul their menu programming, including meeting
new requirements that limit the kind of milk they can offer, mandate
the color of vegetables they must serve, and limit the types of grains
they must use.
Since the Obama Administration enacted the regulations housed in
the Healthy and Hunger-Free Kids Act, School Lunch Program operating
costs have risen while national program participation has dropped.
While we would hope that means there are fewer hungry children in this
country, we have reason to believe that's not the case.
School districts, already tasked with operating on a tight budget,
now face higher cafeteria operation costs, onerous compliance rules,
and a mounting food waste problem as students pass up the food that
cafeterias are now required to serve.
When kids are at school, they don't have a parent there encouraging
them to eat the green peas on their plate. And while I know cafeteria
professionals are doing all they can to get kids to eat their
vegetables, the truth is some kids just aren't going to try them.
However well-intentioned these requirements may be, they are limiting
program effectiveness and causing students to forgo the meals they
need. Kids deserve healthy and nutritious meals at school, but if the
Federal Government mandates meals that students won't eat, then
Washington is categorically failing to combat hunger.
For these reasons, Agriculture Secretary Sonny Perdue recently
finalized new rules easing requirements on sodium, milk, and whole
grains. School districts and students will benefit from these eased
requirements, and Congress should take note.
While many folks found ways to help limit waste and increase
participation, I hope this new, limited flexibility from USDA will
boost meaningful participation in these programs and result in less
taxpayer dollars being thrown straight into the cafeteria trashcan.
Congress should work with the States to provide school districts
with greater latitude over their offerings. By delivering this
flexibility and limiting burdensome paperwork, school districts will be
able to customize their cafeteria menus to give the students they know
and serve healthy options they will enjoy.
As a farmer myself I understand the importance of supporting local
farmers by providing schools access to local, farm-fresh ingredients,
and with three young children in public schools, I certainly understand
the duty we have to educate our growing children about eating balanced
meals.
I look forward to today's conversation and am hopeful we can find a
solution that helps lower program costs, eliminates food waste, and
ensures that students have access to nutritious, enjoyable meals.
______
Mr. COMER. Madam Chairman, I ask unanimous consent to
insert two letters into the record. One from the council of the
Great City Schools and the National School Board Association
supporting the new school meal regulatory flexibility.
Chairwoman BONAMICI. Without objection.
Mr. COMER. And with that I yield back.
Chairwoman BONAMICI. Thank you, Mr. Ranking Member. Without
objection all other members who wish to insert written
statements into the record may do so by submitting them to the
Committee clerk electronically in Microsoft Word format by 5
p.m. on March 25, 2019.
I will now introduce our witnesses. Dr. Eduardo Ochoa is
the principle investigator for the Children's Health Watch
Little Rock site at Arkansas Children's Hospital. His research
interests include Latino health, health disparities, children
with special health needs, and community engagement. He is a
fellow of the American Academy of Pediatrics and a tenured
associate professor of pediatrics at the University of Arkansas
for Medical Sciences.
Nikki Berlew O'Meara is a 33-year old mother of two who
lives in Wilkes Barre, Pennsylvania. Her son James is in the
third grade and her daughter Natalie is in kindergarten. They
both love to do Cub Scouts, read books, and go swimming. An
active volunteer, Berlew-O'Meara is secretary of her children's
parent/teacher association, assistant den leader for a lion
scout den, and a board member for Queer Northeastern
Pennsylvania Acts. Berlew-O'Meara holds a bachelor of science
in psychology from, this is going to be hard, Misericordia. Was
I close?
Ms. BERLEW-O'MEARA. Very close, ma'am. Misericordia.
Chairwoman BONAMICI. Misericordia University.
Ms. BERLEW-O'MEARA. It is tiny.
Chairwoman BONAMICI. Now, I am pleased to recognize my
colleague Representative Allen to introduce his constituent who
is appearing before us as a witness today.
Mr. ALLEN. Thank you, Chairwoman Bonamici and Ranking
Member Comer for allowing me to cross committees. I am on two
other subcommittees here on the Educational Labor Committee,
but I had to be here this morning, and when I say I had to be
here I was not going to miss this because one of my favorite
people are here.
I am pleased to introduce my friend Donna Martin who is a
registered dietician and nutritionist and is currently the
director of Burke County School Nutrition Program in
Waynesboro, Georgia. And the past president of the Academy of
Nutrition and Dietetics. She has worked in the area of school
nutrition for over 25 years in both large systems with over
38,000 students, and currently in a small system with 4,500
students.
Donna's school system operates the National School
Breakfast Program, the National School Lunch Program, the After
School at Risk Snack Program, the Fresh and Fruit, Vegetable
Grant Program, the Supper Program, and the Summer Feeding
Program. Donna has long been dedicated to improving the health
of her students at school by offering nutritionally balances
meals that also teach the students about good nutrition.
Donna has a master's degree in clinical nutrition from the
University of Alabama in Birmingham, and a specialist degree in
administration and supervision from Augusta University in
Augusta, Georgia. In 2006 Donna received a Summer Sunshine
Award for the southeast region of the United States from USDA
for innovation in implementing the Summer Food Service Program.
Burke County is a very large rural county. In fact, it's the
largest county in our district. They decided to serve the
children over the summer out of school buses that made stops
throughout the county so that kids would have access to summer
meals.
Donna was also awarded the 2016 Golden Radish Award for the
State of Georgia because of her efforts in the farm to school
movement. I have visited Donna's district on numerous occasions
to eat lunch and to participate in her farm to school events.
In fact, as a Member of Congress I have never missed that
event, and good lord willing I will never miss that event. It
is my favorite time. Obviously, you can tell that I do love
good food, and it is the best.
And these students are just, I mean, in fact, they grow
their own food there. I mean, it is just incredible. But I have
seen first-hand how the students love her program. Thank you,
Donna, for sharing your testimony today, and it is always great
to see you.
Chairwoman BONAMICI. Thank you, Representative Allen. I am
pleased to recognize my colleague Representative Watkins to
briefly introduce his constituent who is appearing before us as
a witness today.
Mr. WATKINS. Thank you, Chair, and thank you ranking
members for allowing me to introduce my constituent. It is a
better panel because of you, Ms. Johnson, and we are a
healthier state because of you. Thank you for being here and
god bless you.
Ms. Johnson is the director of child nutrition and wellness
for the Kansas State Department of Education. As director, she
serves as the liaison between the State Department of Education
and the Food and Nutrition Service at the USDA. Cheryl and her
team administer the nutrition programs in Kansas and then
provide leadership and training and monitoring for over 800
local sponsors who provide over 102 million meals and snacks to
Kansas children in 2018 alone. They strive to make nutrition
and wellness an integral part of a student's success.
Cheryl has worked as Director of Nutrition Services at the
Kansas Neurological Institute, and as a consultant dietician,
and as an adjunct professor at Topeka's own Washburn
University, Go Ichabods. She holds a B.S. in food and nutrition
and a master's in dietetics and institutional management from
Kansas State University. Go Cats. She is a registered and
licensed dietician and a Kansas Health Foundation leadership
fellow. She has served on the School Nutrition Association's
Governance Board, the Governor's Council on Fitness, the USDA
Professional Standards Work Group, and KSU Human Ecology Alumni
Board, and Dietetics Advisory Board.
My mother is Barbara Watkins and taught Cheryl's son Craig
at Logan Junior High and taught her other son Kyle at Seaman
High School in Topeka. However, my mother did not teach your
youngest son Mark who he, himself, is now a teacher, as I
understand. Needless to say, thank you for being here, Ms.
Johnson. It is a pleasure to have you and it is a pleasure to
introduce you.
Chairwoman BONAMICI. Thank you, Mr. Watkins. We appreciate
all of the witnesses for being here today and we look forward
to your testimony. Let me remind the witnesses that we have
read your written statements and they will appear in full in
the hearing record. Pursuant to Committee Rule 70 and committee
practice, each of you is asked to limit your oral presentation
to a 5-minute summary of your written statement.
I will also remind the witnesses that pursuant to Title 18
of the U.S. Code Section 1001 it is illegal to knowingly and
willfully falsify any statement, representation, writing
document or material fact presented to Congress or otherwise
conceal or cover up a material fact.
Before you begin your testimony please remember to press
the button on the microphone in front of you so it will turn on
and the Members can hear you. As you begin to speak the light
in front of you will turn green. After 4 minutes the light will
turn yellow to signal that you have 1 minute remaining. When
the light turns red your 5 minutes have expired and we ask that
you please wrap up your testimony.
We will let the entire panel make their presentations
before we move to Member questions. When answering a question
please remember to, once again, turn on your microphone.
I first recognize Dr. Ochoa.
STATEMENT OF DR. EDDIE OCHOA, ASSOCIATE PROFESSOR OF
PEDIATRICS, UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
COMMUNITY PEDIATRICS MEDICAL DIRECTOR, ARKANSAS CHILDREN'S
HOSPITAL
Dr. OCHOA. Thank you very much, Madam Chair Bonamici and
other members of the House Committee on Education and Labor for
the opportunity to submit this testimony. My name is Dr.
Eduardo Ochoa and I am a general pediatrician practicing at
Arkansas Children's Hospital in Little Rock. I am also a
faculty member at the University of Arkansas for Medical
Sciences, and a principle investigator with Children's Health
Watch, a non-partisan network of pediatricians and public
health researchers committed to improving the health of young
children and their families by informing policies that address
and alleviate economic hardships.
I am also a member of the American Academy of Pediatrics, a
non-profit professional membership organization of 67,000
primary care pediatricians and medical and surgical pediatric
sub-specialists dedicated to the health and well-being of all
infants, children, adolescents and young adults. The testimony
I give today is on behalf of Children's Health Watch and the
American Academy of Pediatrics.
As a practicing pediatrician I know the importance of
consistent access to nutritious foods for healthy growth and
development among my young patients. This is one of the main
reasons why we have been screening for food insecurity and
other social needs for several years in the primary care
clinics at Arkansas Children's Hospital. Through this effort we
have found that about a quarter of our patients are food
insecure.
Decades of research has documented the adverse health
effects of food insecurity on the health, growth, development,
and educational outcomes of children from infancy through
adolescence. Naomi is one such patient who we identified as
having food insecurity. I talked with her mother who did not
know that I also work at the clinic where Naomi was seen
recently. Naomi's mom recounted that she was in clinic for
Naomi's checkup and was surprised that she was asked to
complete a questionnaire that asked about social needs. She
responded with two affirmative answers to the hunger vital
sign, a measure validated by Children's Health Watch and
endorsed as a best practice by the American Academy of
Pediatrics.
Naomi's mother's earnings at work are stretched thin, and
even though Naomi is fed at her head start program there's
still worry about whether the food at home will run out before
she has money to buy more. They left our clinic with a full
grocery bag and a list of local resources to get more when she
needed it.
It is great that we could help Naomi and her family, but
this help is very short term and childhood hunger and its
sequelae of adverse health consequences should not have to
persist in this country. Federal nutrition programs that feed
millions of children every day are an effective solution for
both reducing hunger and food insecurity, and improving the
health and well-being of growing minds and bodies.
For these reasons I am pleased to discuss the importance of
child nutrition programs in the United States, including the
National School Lunch Program and School Breakfast Program, the
Child and Adult Care Food Program, and the Summer Food Service
Program. This committee has a unique opportunity to invest in
our Nation's children by investing in programs that feed
children from their earliest days through the end of high
school, setting them up for a health start in life.
The National School Lunch and School Breakfast Programs
feed 30 million children healthy meals each school day across
the country. Research shows NSLP and SBP are associated with
numerous benefits for children, including reduced food
insecurity, improved test scores, lower rates of absences and
tardiness, improved dietary intake, and lower risk of obesity.
I know the value of proper nutrition in schools for my
patients. Many children, especially those from low income
families, consume up to half of their daily calories at school.
And for some children, including those whom I see in my clinic,
the meals they eat at school may be the only meals they eat in
a day.
This is why evidence-based meal standards that are age
appropriate for growing bodies and brains are necessary. In a
country where obesity affects nearly one in five children which
places children at greater risk of cardiovascular disease and
diabetes, healthy school meal are necessary for reversing this
concerning health trend. In fact, just recently in my home
State of Arkansas, results were released from a Centers for
Disease Control funded study on sodium reduction in school
meals.
The study was conducted in partnership with 30 schools in
northwest Arkansas with the goal of reducing dietary sodium
intake in food service procurement and preparation. The study
found an 11 percent decrease in sodium content in the meals
served over the course of a year, and underscored that a
comprehensive approach to healthier diets through reduced
sodium is feasible. Given the wealth of evidence on the need to
increase intake of nutritious foods for health weights and
prevention of chronic illness I hope this Committee will
continue to ensure the retention of nutrition standards set
according to prevailing science.
Since 2013 Arkansas Children's Hospital has provided
lunches year round to children as a sponsor site of the Summer
Food Service Program and the Child and Adult Care Food Program.
From August 2017 to `18 we provided approximately 27,000 meals
to children and their siblings seen in our clinics. Because I
know that many of the children in our service area receive care
in the primary care clinics at Children's I take comfort in
knowing that we are asking about food insecurity and have
several tools, including CACFP and Summer Feeding to help
alleviate this experience over the summer.
For young children, WIC and CACFP play an important role in
ensuring that children have nutritious, age appropriate food,
and have the best opportunity for brain and body growth. In
Arkansas my department at the University of Arkansas for
Medical Sciences runs the Head Start Program in our county and
gives nearly 2,500 meals per day to children across 13 sites. I
can tell you that our nutrition director has said that children
are asking for more vegetables like spinach that they've eaten
at Head Start for the first time to be purchased at home.
In summary, Federal child nutrition programs feed children
every day, preventing them from going hungry and ensuring they
have a healthy start in life, no matter where they live.
Investing in these programs is an investment in the future
health and well-being of our country. I look forward to
discussing potential policy solutions for strengthening and
improving these programs so they reach more children. Thank you
for your time.
[The statement of Dr. Ochoa follows:]
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Chairwoman BONAMICI. Thank you, Dr. Ochoa, for your
testimony. I know recognize Ms. Johnson for 5 minutes for your
testimony.
STATEMENT OF CHERYL JOHNSON, DIRECTOR OF CHILD NUTRITION AND
WELLNESS, KANSAS STATE DEPARTMENT OF EDUCATION
Ms. JOHNSON. Good morning, Madam Chair, Ranking Member
Comer, and members of the Committee. I appreciate Congressman
Watkins for his kind introduction. Thank you for inviting me
today and for your interest in making sure students have access
to healthy meals that impact student success. Child nutrition
programs provide a strong safety net for children by ensuring
their nutrition needs are met while providing nutrition
education, and they contribute to growing a health next
generation which lead the lifelong benefits.
Decisions about the specific foods to serve and the methods
of preparation are made by the local school food authorities.
The USDA final rule child nutrition programs, flexibilities for
milk, whole grains, and sodium requirements increased many
planning flexibilities for school year 1920. They include
providing the option to offer flavored low fat milk, requiring
that half of the weekly grains be whole grain rich, and provide
more time to reduce sodium levels. Kansas schools are doing an
excellent job implementing the nutrition standards and serving
tasty meals, and have expressed appreciation for these small
tweaks. Many have indicated they will continue to offer more
than the minimum required 50 percent whole grain rich products,
but welcome the opportunity to reintroduce some favorite items
of students such as homemade macaroni and cheese, and homemade
chicken and noodles. Industry has been working hard to reduce
sodium levels in food products. This final rule provides more
time for research and development of tasty options that
students will eat. Allowing flavored low fat milk to be offered
as a milk choice may result in increased consumption.
As direct of the State agency it is appreciated when
flexibilities are put into permanent regulation, as opposed to
being allowed via a waiver. Waivers take a great deal of State
agency and local educational agency resources to write,
process, review for approval, and then collect and report data.
The Health Hunger-Free Kids Act gave USDA the authority to
regulate other foods in the school environment. Monitoring
foods outside the school nutrition program has increased time
required to complete the administrative review, and increase
the record keeping burden for schools to track that nutritional
content of foods sold outside the school meal programs.
Currently, not all food items served as a part of the
reimbursable meal can be served a la carte. One example as
school food service director uses frequently is they can serve
broccoli with limited cheese, a little cheese to make kids
consume it, but it cannot be sold separately on the a la carte
serving line. Two sets of standards are confusing.
USDFNS has adopted customer service as a strategic priority
and listened to concerns from State agency directors. The
recent policy memo flexibility for administrative review cycle
requirements will allow State agencies to request waivers of
the 3-year requirement and extend the review cycle if it
hinders State effective allocation of State agency resources.
This is another instance where a waiver is required, and it
would reduce State agency burden if it could be put into
regulation.
In Kansas, an increasing number of local educational
agencies are now also implementing the Summer Food Service
Program and the Child and Adult Care Food Program. To decrease
burden we are working to develop one application for multiple
programs instead of three separate applications. Schools
administering multiple programs have indicated they could
operate more efficiently if their site review and reporting
requirements could be streamlined. Burden could also be reduced
in administering the Summer Food Service Program in rural
communities and access increased if there were flexibilities
available regarding congruent meal requirements.
While many of the child nutrition program regulations are
the same for all of the three major programs it is challenging
to streamline when there are miniscule program differences. For
example, in the Child and Adult Care Food Program meal pattern
for per-K it requires 1.5 ounce meat alternate. Yet, the meal
pattern for K-5 in school nutrition programs only requires 1
point meal equivalent, 1 ounce meal equivalent. Milk, fat, and
flavor requirements are also not consistent between the
programs. It is possible to serve a granola bar for school
breakfast and in the after school meal program, but you cannot
serve those as a part of the Child and Adult Care Program at
Risk after School Meal Program.
It is essential to have a sufficient lead time to work with
local educational agencies once regulatory guidance is
received. For example, many schools write menus and begin the
procurement process for the next school year in the winter of
the current school year. When policy memos and guidance are
provided in the spring or summer for the upcoming school year
it is challenging to implement these and able to have
competitive procurement and pricing.
If USDA is continuing their willingness to listen to other
folks, including State agencies and local education agencies,
including food service directors, administrators, school
boards, and parents, and obtain input I do think that this
makes the reality of policy implementation more effective.
Schools are leading culture change in instill health habits for
a lifetime, and child nutrition professionals are leading this
change to instill the health habits. And we do appreciate your
willingness to help them efficiently and effectively serve the
children.
[The statement of Ms. Johnson follows:]
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Chairwoman BONAMICI. Thank you, Ms. Johnson, for your
testimony. I now recognize Ms. Martin for 5 minutes for your
testimony.
STATEMENT OF DONNA MARTIN, DIRECTOR OF SCHOOL NUTRITION
PROGRAMS, BURKE COUNTY, GEORGIA PUBLIC SCHOOLS
Ms. MARTIN. Thank you, Chairperson Bonamici, Ranking Member
Comer, Committee members, and my fellow distinguished
panelists. I am honored to have the opportunity to speak before
you today. My name is Donna Martin and I am the director of the
School Nutrition Program for Burke County Public Schools, a
small rural district in Georgia. I am also the immediate past
president of the Academy of Nutrition and Dietetics, and we are
committed to strong nutrition standards for school meal
programs.
School nutrition programs are essentially like running a
restaurant, a PR agency, and a nutrition education campaign all
while operating under a tight budget with minimal time and
resources. Being as school food service director is a complex,
demanding profession, and I think it is the best job on earth.
I will stress three important points today.
First, school meal programs can have high nutrition
standards and be financially solvent. Second, school nutrition
professionals need access to equipment and training resources.
And, third, good nutrition for students is critical for our
Nation's children to succeed. Our program serves five schools,
offering breakfast in the classroom, lunch, and after school
snack, and supper, the Fresh Fruit and Vegetable Program, and a
Summer Feeding Program. We serve nearly 4,000 meals a day, and
our lunch participation rate is 89 percent, and our breakfast
participation rate is 78 percent.
We operate under the community eligibility provision which
has made running my program more efficient by eliminating
unnecessary administrative time, paperwork, and cost. We
started moving to healthier foods in our district even before
the new standards were required, and you can bet that I was
nervous. You know we take our fried chicken and grits very
seriously in Georgia, so we went to work and developed a
health, nutritious herb-baked chicken, scratch whole grain
rolls, and locally grown whole grain grits that are absolutely
awesome. I brought each of you a bag, and I know you'll agree
that these grits are delicious.
I am incredibly proud of our farm to school program that
provides farm fresh produce to our students. We found that when
we started offering local fresh produce like collards, berries,
and peaches, our fruit and vegetable consumption rates doubled.
From scheduling recess before lunch, to providing choices so
students can select the food they like, we manage to keep our
food waste low, but we would love to see children have more
time to eat their meals. My own grandson tells me he doesn't
have enough time to finish his food in school.
Since the last time I spoke before the committee the Smart
Snacks rule has been implemented. In Burke County I have been
able to find almost any product that you can image to meet the
criteria. We even offer items like ice cream and cookies that
meet the standards and the children love them.
We need to protect our nutrition standards from loopholes
that would undermine the intent of the Smart Snack Program. I
am proud of how we have meet the needs of our community. When
our high school football coach came to me with concerns about
his players not getting the fuel they need to be successful, we
worked together to provide dinner after school while our
tutoring enrichment programs were running to make sure the
athletes and other students were well-nourished. Not to say it
was not challenging. The supper program can be administratively
burdensome since the lunch and supper programs are overseen by
two different State agencies.
Like many communities around the country our rural
community faced challenges in delivering summer meals to kids.
Traditional feeding sites simply did not meet all of our needs.
The community and district worked together to find solutions
and we now run 15 summer bus routes feeding over 2,500 children
daily. We also provide the food for programs in the community
that are operating summer enrichment programs like vacation
bible schools and the public library.
So what is the cost of running a successfull program you
ask? I am not here to tell you that it is easy. Feeling the
strain of labor and insurance costs myself, but I am here to
tell you that it is possible to meet nutrition standards and be
financially solvent. We are fiscally sound because we offer
seasonal fresh produce. We work with the Burke County farmers
to provide local fruits and vegetables at very competitive
prices.
In fact, I have had local farmers beating down my door to
set up contracts with me. In the school nutrition world we call
this a win, win, win. A win for the farmer, a win for the kids,
and a win for our local economy. In Burke County I am lucky to
have up to date equipment and staff with nutrition expertise.
While president of the Academy I have visited many school
districts that did not have the same level of resources as me.
The Academy created a video and held a briefing for Members of
Congress to communicate the real need for modern equipment. I
have provided the video link in my written comments so you can
see the equipment needs for yourself.
We could do more for our students nationally if
reimbursement was increased to accommodate rising food costs,
and if there were supplemental funding for equipment and
training needs. But we will do worse for students if we lower
the bar to accommodate costs by not serving kids what they need
to thrive. Thank you for listening to my story and for your
commitment to our Nation's students. I respectfully ask each of
you to keep children's best interests in mind if you plan to
move forward with the reauthorization of child nutrition
programs. Thank you once again, Chairman Bonamici, Ranking
Member Comer, and all the committee members. I will be happy to
respond to any questions that you may have.
[The statement of Ms. Martin follows:]
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Chairwoman BONAMICI. Thank you, Ms. Martin for your
testimony and for the grits. And I now recognize Ms. O'Meara
for 5 minutes for your testimony.
STATEMENT OF NIKKI BERLEW-O'MEARA; WILKES-BARRE, PA
Ms. BERLEW-O'MEARA. Good morning, Madam Chair Bonamici,
Ranking Member Comer, and members of the Subcommittee, and my
fellow panelists. My name is Nikki Berlew-O'Meara and I'm a
proud member of MomsRising from Wilks Barre, Pennsylvania.
Thank you for inviting me to testify today about the vital role
school lunches play in my family's life and my children's
nutrition.
I am the mother of a 9-year-old named James and a 6-year-
old named Natalie. As a single mom, money is tight for my
family. Thankfully, both of my children receive free lunch at
school which is a huge help for us. The National School Lunch
Program has been a crucial lifeline as I strive to give my
children the strong, healthy start they deserve. One of my top
priorities is giving my kids balanced diets to help grow their
minds and bodies. The National School Lunch Program's nutrition
standards are a huge help.
When I drop my kids off at school each morning I know they
will get a healthy lunch with the vegetables, fruit, whole
grains, and lean proteins that are essential for their health.
The lunch they get at school every day is healthier and more
substantial than the lunch I would be able to pack for them.
And because enough students in my children's district qualify
for free lunch, everyone at their school gets them, meaning no
children have to feel singled out.
The National School Lunch Program benefits my children's
nutrition outside of school too. Because I am not paying for
lunch every day I have a little more money to spend on their
dinners. Every penny counts in our household. It means I can
afford healthier options like fresh produce, as well as
introduce them to new foods. I am always trying to get my kids
to try new things, which any parent will tell you can be
difficult, doubly so for kids on the autism spectrum like my
son. The National School Lunch Program gives me the buffer I
need to do so.
As a result, my children eat better and more diverse food,
both at school and at home. They love turkey tacos and chuck
roast with potatoes at home, and at school they like to eat
chicken sandwiches, meatloaf, and mandarin oranges. I have been
trying for years to get my daughter to try salad and she
finally tried it at school with her friends. It is good, mom,
she tells me. We all know sometimes kids listen to their
friends first before they listen to their parents.
If we did not have the National School Lunch Program my
kids' meals would be simpler and less nutritious. We also would
not be able to afford the occasional discounted movie night, or
even going out to eat for their birthdays which create precious
memories for my family. I know what it is like to have to cut
costs like that. We have endured more difficult periods where
we had to cut these expenses are more.
After my divorce things were really tough. The three of
used SNAP benefits for a while, and I was wearing just two
hoodies at home when the kids were with their father, setting
the heat at 55 degrees to save on utilities. During these
periods the National School Lunch Program was even more crucial
for us. Simply put, without it my kids would have eaten much
less at that time in our lives, and they would have eaten more
meals like pasta and white rice which keep their bellies full,
but do not provide the adequate nutrition they need to grow.
The National School Lunch Program provides essential
support for my children's education as well. It is so important
to me that they get the best education possible so that they
can reach their potential and pursue their dreams, and these
programs are a huge part of that. If my kids did not get the
food and nutrition they need they would be much more distracted
at school. They would not be thinking about upcoming vocabulary
tests or science projects, but instead they would be thinking
about and wishing for their next meal. Simply put, kids cannot
learn if they are not getting proper nutrition.
Because my children get well-balanced meals at school they
can focus on what matters most, feeding their minds and
broadening their horizons by working hard in their classes. My
son has always dreamed of being a teacher, and my daughter
wants to be both a pediatrician and a veterinarian. They need
the proper nutritious to realize all of their dreams.
As the committee discusses the reauthorization of child
nutrition programs I hope you remember James, Natalie, and
other families like mine. The decisions this committee makes
will have a significant impact on working families and whether
we will be able to set our children up for future success.
Child nutrition programs need to continue to be well-funded,
supported, and improved, not only for my kids but for the other
children at their school who have fallen on much tougher times.
My kids deserve healthy food and all kids deserve healthy food
regardless of how much money their parents make. These programs
are a crucial part of ensuring their very basic needs are met.
Thank you for remembering the importance of healthy food for
our Nation's next generation of children.
[The statement of Ms. Berlew-O'Meara follows:]
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Chairwoman BONAMICI. Thank you so much for your testimony.
Under Committee Rule 8A we will now question witnesses under
the 5-minute rule. As chair, I will recognize myself first,
followed by the ranking member of the full committee, and then
we will alternate between the parties. I now recognize myself
for 5 minutes.
Ms. Berlew-O'Meara, thank you for sharing your story. I
know from working at Legal Aid that families do not struggle by
choice, and children should not suffer because families are
struggling. In your testimony you state that because enough
students in the district qualify for free lunch everyone at
school gets them, meaning your children do not feel singled
out. This describes a provision added in the Health Hunger-Free
Kids Act of 2010 known as community eligibility. Why is that
important to you and your children?
Ms. BERLEW-O'MEARA. It is important to me and definitely to
my children as well because I do not want them to feel singled
out. I do not want any child to feel singled out because kids
talk, and they may find out, oh, this child gets a free lunch.
This kid's parents cannot afford to pay for it. They have
enough to worry about. We don't--I just do not feel we need to
have them be worried about what their parents make and do they
qualify for these things.
I know just from my own experiences at school and from my
mother's experience at school that can be really difficult for
children to deal with, and they have already got enough on
their plate. We do not need to be adding more.
Chairwoman BONAMICI. Thank you. And I am going to followup
with Dr. Ochoa about this issue too. We heard, Dr. Ochoa, we
heard a little bit about school meal participation rates, and I
want to highlight a study conducted by the University of
Washington's School of Public Health, itound that new standards
put in place after Healthy Hungry Free Kids Act increased
access to whole grains, vegetables and fruits, they found that
while the nutritional qualify of school meals improved after
new requirements went into effect, the standards did not affect
school lunch participation. So we know that there are many
complicated factors that impact participation rates, and it is
important to examine the entire picture.
And I have to say I am pretty alarmed by the President's
budget proposal to cut 1.7 billion dollars from child nutrition
programs. A cut of that magnitude will certainly affect
participation rates and result in fewer children accessing
meals. Can you comment on how changes to community eligibility
might impact participation?
Dr. OCHOA. Yes. I would think that community eligibility is
important not just to keep more kids fed and keep them out of
food insecurity, but also to prevent healthcare costs in the
long run. Children's Health Watch has done research showing
that the longer that food insecurity persists there are chronic
health issues that are worse and developmental issues that are
higher in kids that are food insecure than those that are not.
My colleagues at Children's Health Watch, Drs. John Cook
and Anna Poblacion created an economic simulation model where
they showed that CEP alone moved about three quarters of a
million people from food insecurity to food security. And so we
know that if food insecurity costs our Nation nearly $178
billion a year it would make sense to invest in that as a
preventive measure to prevent health care costs in the future.
Chairwoman BONAMICI. Thank you. I am going to move to
another question, but thank you so much for that. Ms. Martin,
in Oregon there are more than 800 summer food service sites.
Thank you for talking about the Summer Meals Program. I visited
one that serves 30,000 summer meals, but even with that number
the district knew they were not reaching all the families in
need, and that kids were going hungry over the summer.
There has been a pilot program in Oregon that has been very
effective helping to bridge the gap. Can you describe some of
the challenges your community faces in rural areas and serving
summer meals, and what more can we do to make sure that
students do not go hungry during the summer months?
Ms. MARTIN. Well, thank you for that question. I think food
security in my district is a huge issue and we find out that
when kids come back from just the weekends or a holiday they
are racing into the cafeteria to eat breakfast or eat lunch.
They are so hungry. We had teachers who were putting kids into
summer school not because they needed to go to summer school,
but to make sure they had healthy meals over the summer. So
because we have a large rural community we had a need, and we
did not have any way of reaching the kids. They did not have
transportation to come to our schools or come to our site so we
came up with the idea of doing these school busses.
So the school busses go out all over the community. They
stop at about 105 different stops. The kids get on the bus.
They eat the healthy meal. They finish their meal and they love
the fact that their bus is air conditioned because a lot of our
kids do not even have air conditioning in the summer. So they
get on the busses. We provide some books for them on the bus so
that they have an opportunity to read on the bus. They get off
the bus and they go home.
Chairwoman BONAMICI. That is a great model. I want to try
to get one more question in. Dr. Ochoa, how do strategies like
the Summer EBT Program work in concert with the Summer Food
Service Program to improve access to nutritious meals?
Dr. OCHOA. It does work very well to improve access, and I
think the point that Donna was making is a good one. We know
that only one in seven kids that participate in school lunch
during the year participate during the summer. So we know that
anything that can increase access over the summer is good
because there are nearly 17 million kids who are eating free
and reduced lunch at school during the school year that do not
get it during the summer.
Chairwoman BONAMICI. Thank you. And thank you for also
recognizing that this is a health care issue, and that it is a
good investment and we are actually preventing more expenses in
addressing health care later, so appreciate that long term
approach. And I now recognize the Ranking Member of the full
committee, Dr. Foxx for her questions.
Mrs. FOXX. Thank you, Ms. Bonamici, and I want to thank the
witnesses for being here today and presenting their testimony.
Ms. Johnson, every time I am in a school, and I am in the
schools a lot, I am always careful to go by the cafeteria and
say thank you to the food nutrition people because I know they
struggle to keep up with the rules and regulations, and provide
those good meals to the students every day. So please convey to
them my thanks. I do that myself personally when I can.
I want to thank you for helping us get a better idea of
what all the requirements and rules mean for people doing the
real work. While some of the paperwork is necessary for
compliance and accountability I think you implied there is too
much paperwork, but if you would talk a little bit more about
that? And could you share some examples of paperwork that makes
the program overly burdensome?
Ms. JOHNSON. Yes, I would be happy to do that because our
focus is on feeding kids, and there are somethings that I think
could be reduced paperwork wise and still maintain integrity.
Things like waiver. Having waivers takes a lot of time for us
to write waiver applications, approve waivers, and then we have
to collect data on waivers, and then we write reports on
waivers.
CEP reporting, community eligibility is a great program,
but there is a reporting requirement for schools even below the
40 percent ISP threshold that could never apply. They still
have to do notification reporting. That could ease some burden.
The site monitoring. When multiple child nutrition programs are
being administered, like at our Wichita school district. They
have hundreds of monitoring reviews that they have to complete
because they run every single program that we have in many,
many sites.
Summer reporting data is extensive. I know it is helpful,
but it quite a chore for the State agency. Illuminating those
nuances between the child nutrition programs. There is this
little thing, about 80 percent of regulations are the same for
all programs. There is this 20 percent difference that makes it
so difficult for a director of multiple programs. They want to
be in compliance. They want to do the right thing, but just to
streamline that would be so helpful.
And then we do have a paid lunch equity tool that also can
cause some burden. The flexibility that was recently enacted
for school districts in a positive financial status is
extremely helpful in Kansas, and I do appreciate that. So there
are a few examples.
Mrs. FOXX. Thank you. You also mentioned that USDA seems to
be more customer friendly and really listen to you and your
colleagues. Can you tell us a little bit more about what you
mean and discuss why that mindset's important for the success
of the programs?
Ms. Johnson. Absolutely. USDA has been taking a very
customer service stance in the last few years, especially. They
are listening. They have put together a committee of State
agency directors who are giving input on how paperwork can be
reduced. Extremely helpful.
They are more accessible at conferences. I was just at the
Legislative Action Committee. They met with State directors for
2 hours, and they allowed us to ask questions and listened.
They have had work groups prior to final rules being enacted
for the Child and Adult Care Food Program, also professional
standards done and I work both on that group. When they listen
I do think it helps with implementation. When they hear from
the stakeholders, not just school food service directors and
State agency, but also parents and administrators, school
boards, all those folks that have an interest. So there have
been a lot of examples recently and I applaud them for that.
Mrs. FOXX. Well, thank you very much and I hope it is not
just listening, but taking action, particularly on those minor
little differences that occur. It seems to me that you all
would be able to convince them to make those modifications so
that you can devote more of your time to serving the children.
Ms. JOHNSON. I do think they are listening and I think
there are, just like with the Summer Food Service Program,
waivers. They know how important it was to get those approved
prior to summer starting. In Kansas we had ours in first and we
got those back quickly. We did not have to change our computer
systems and then change them back. I do feel like they are
being very responsive and listening and helping.
Mrs. FOXX. Thank you, Madam Chairman. I yield back.
Chairwoman BONAMICI. Thank you, Dr. Foxx. I now call on Dr.
Schrier from Washington for 5 minutes for your questions.
Ms. SCHRIER. Thank you, Madam Chairwoman, and thank you to
all of our witnesses. I am thrilled to have you all here. First
of all, Ms. O'Meara, I want to tell you that veterinary
medicine and pediatrics, in many ways, are very similar that in
that first year our patients cannot talk to us. I am sure Dr.
Ochoa will appreciate that.
Also, nutrition is one of the big topics that comes up at
every well child check, and so I am super grateful for this
whole discussion and grateful for the food insecurity questions
that I also ask. And one thing I just wanted to mention because
I look at these school nutrition programs as having three big
goals, and forgive me if I am leaving one out. But one is
simply addressing food insecurity and hunger. The other is
helping kids do better in school and have better behavior which
I do not even think we talked about, but that has been proven
too.
But the third is really setting them up for a lifetime of
success and health. And a lot of the conversations that I have
with patients or with the parents involve how to make kids like
food. And my typical answer to that is just make food that
tastes good and there should not be kid meals and adult meals,
like, feed them curry, feed them Thai food. Give them whatever
tastes good, and that usually works.
So I wanted to applaud you, Ms. Martin, for your work in
making sure food tastes good and wanted to talk to you about
really having a focus on that because if we can make spinach
taste good for kids then that means when they are adults and
they go do their shopping they will buy spinach and know how to
make it. So could you talk a little bit about that, maybe even
if any school districts are experimenting with having chefs?
And even, I was just at a school the other day, I am using up
all my time.
I was in a school the other day where they have a school
garden, but they are not allowed to eat the food from the
garden.
Ms. MARTIN. Yes.
Ms. SCHRIER. And so could you talk about that a little bit?
Ms. MARTIN. No, absolutely. So we have three things that we
say in school nutrition. We say if the kids taste it they will
eat it, so you have got to do a lot of taste testing. So when
our kids come through the line, and we have hummus on the line.
They are like what the heck is that, but if you do a taste test
with it they like it and they eat it, so taste testing is
really key.
If they grow it they will eat it. So we have tower gardens
and we have outside gardens, and our kids plant the seeds, they
grow the food, and they do get to eat it in the classroom. We
just cannot serve it school-wide, so if they grow it they will
eat it. And if they cook it they will eat it. So we have this
Charlie Cart where we do all these cooking classes. So we take
what they have grown and turn it into a cooking class, and we
get kids to eat brussel sprouts and asparagus and all these
things that nobody thinks they will eat, but they have cooked
it.
And I had a middle school student the other day in the
cooking class said, this was the best day of my life. I could
have died. A middle school student, really? So it is all about
getting them involved. So you have got to, you know, talk to
them about what they want, and you also have to do nutrition
education. That is what we are not doing enough of. And so my
very favorite program for that is the Fresh Fruit and Vegetable
Grant Program where right now we offer 65 different fruits and
vegetables fresh every day, not at breakfast, not at lunch, but
in the afternoon. And our kids run in off the bus, come into
the lunchroom to see the Lucite placard to find out whether
it's blood oranges or jicama or mushrooms or red bell peppers
or whatever, what they are getting for the snack that
afternoon.
And they go home and their parents call me and they say,
what is that star shaped fruit you served today? And I said
starfruit, and then the grocery stars call me and say, would
you please let me know what you are serving because the kids
are running in here asking for it and we do not have it. So
that program needs to be expanded, and it also teaches the
parents about nutrition. So nutrition education and remember
those, taste it, cook it, and I cannot remember the third one,
but anyway.
Ms. SCHRIER. Prepare it.
Ms. MARTIN. You got it. Thank you.
Ms. SCHRIER. Yes, preparing it together. And by the way,
preparing it together is a great way to connect--
Ms. MARTIN. Preparing it, right.
Ms. SCHRIER [continuing]. with teenagers who will not talk
to you otherwise. So thank you for that perspective, and, also,
cutting up fruits and vegetables increase consumption for
people.
Ms. MARTIN. Oh my gosh. And the other thing is time to eat,
and people do not really focus on that enough, and they look at
the trash cans and they say, oh, they threw all this food away.
It is because they do not have enough time to eat, and so if we
do not give them enough time to eat. Salads take a lot longer
to eat than a piece of pizza, and, also, the kids need to go to
recess before lunch because if you put recess between a meal
and a kid, recess is going to win every single time. So they go
to recess. They are hungry. They are thirsty and they eat
better.
Ms. SCHRIER. Thank you very much, appreciate it. I only
have 10 seconds left, maybe next time or at some point we could
talk about milk, 20 calorie difference between 2 percent and
whole. Why is whole milk getting such a bad rap? But you do not
have time to answer so we will talk later.
Chairwoman BONAMICI. Thank you, Dr. Schrier. I now
recognize Ranking Member Comer from Kentucky for 5 minutes.
Mr. COMER. Thank you, Madam Chairman. Ms. Johnson, I know
most of the food service directors in the First congressional
District. I worked with a lot of them, as I said in my opening
statement, when I was Commissioner of Agriculture, and they
want to serve healthy, tasty food to their students. They are
very passionate about it and do a very good job, but many
complain about the excessive regulatory environment, especially
the changes that were made during the Obama Administration. Do
you believe the new regulations on grains, sodium, and milk
help more programs find this balance in their offerings?
Ms. JOHNSON. I believe that the final rule with the
flexibilities really are just small tweaks and I do not think
they undermine the intent of the nutrition standards. I do feel
that more time is needed by industry to develop products lower
in sodium so they are tasty and so students will eat them, so I
really appreciate that flexibility.
The milk flavoring I think it is nice to have that
additional choice, although I will be honest, in Kansas, the
students do consume the skim chocolate and flavored skim fine.
That does not seem to be a problem. I did not have any waiver
requests for that when it was a possibility, thankfully. It was
one thing. But we did get a lot of whole grain rich waivers
because we have communities in western Kansas in those small
rural communities who actually make homemade noodles still, and
you cannot do that with whole grain flour. And we have a lot of
folks of different cultures. Whole grain tortillas are not
accepted well by some of the students, so some of them had
waivers in for just a plain tortilla.
We had some waivers for pasta because whole grain pasta is
still not holding well on the serving line. It gets mushy and
students do not eat mushy, brown macaroni and cheese. I mean, I
think that as there is more product development happening and
pasta, whole grain pasta maybe gets to the point that it will
stand up better. Maybe that will be a good choice. And some
schools, if they do not have to transport foods long distance,
I mean, I think it could work for them, but having this
flexibility is helpful to our rural, small school districts,
especially.
Mr. COMER. Ms. Johnson, as we begin the work on the
reauthorization of the child nutrition programs can you
recommend a few principles for us to keep in mind to guide our
work as we move forward?
Ms. JOHNSON. Yes. Stay the course. I do not think that our
food service directors and our school food authorities and our
Child and Adult Care Food Program sponsors and summer sponsors,
any of them, need the additional chaos of change. They are just
now starting to feel comfortable and having good understanding
of those multitude of regulations with the Health Hunger-Free
Kids Act. They are now being able to start innovative breakfast
methods. They are now working on farm to plate. They are able
to expand and try to reach more children in rural communities
in the summer because they are feeling like, oh, we are
understanding this and we can do it. So please think about
that.
Also, reducing the differences between the child nutrition
programs so that operators of multiple programs can operate
them with integrity, and helping them increase access, but yet,
decreasing their paperwork burden. I truly believe you can do
that and still operate programs of integrity. And stability, by
reauthorizing our programs our child nutrition program
operators they know what the future holds.
It is really difficult to operate on waivers. Say, for
instance, for me as a State agency the new 5 year waiver. I do
not want to reinvent my staff and do all of that when I am
actually doing fine with resources when I do not even know if
it would last more than a year. It affects people and that is
really difficult. So stability is extremely important.
Mr. COMER. Well, thank you very much and I yield back.
Chairwoman BONAMICI. Thank you, Mr. Comer. I now recognize
Representative Hayes from Connecticut for 5 minutes for your
questions.
Ms. HAYES. Thank you, Madam Chair, and thank you to all of
the witnesses who are here today. I am so happy that we are
holding this hearing because this is a challenge that I have
dealt with at the local level, at the State level, and now, I
guess, at the Federal level. I come from a district. I was a
educator in Waterbury Public Schools for almost 15 years and
this is something that is very personal for me. My district had
more than 70 percent of the students who were eligible for free
or reduced lunch so we participated in the community
eligibility provision. One of only 13 districts in my State who
did that, so I know what it means. I know what that looks like
in the school setting. I know what it means for children and
families.
I guess my question would be to Ms. Martin. What would
you--I mean, we constantly see this provision under attack. It
was in the last budget there were proposed cuts. We saw in the
draft of this budget $1.7 billion in proposed cuts to food
security nutrition programs, and I can imagine that the
community eligibly provision would fall under this. What would
you propose to districts who are not taking advantage? We have
over 160 districts and only 13 of them use the community
eligibility provision.
Ms. MARTIN. Well, it is very confusing to me that we offer
free busing, free books, free computers, free teaching, but
school lunch is not free to all our students. Why is that any
different than the rest of the school day? One of my biggest
jobs as school nutrition director is to provide students to the
teachers ready to learn. So I have got to make sure they have
breakfast, and I have got to make sure they have lunch.
And I have watched what the kids bring in their lunch box,
and I almost think those are the kids that need to be shamed.
We have this fabulous school nutrition program and we have got,
you know, a lot of people think it is just for the free kids
and it is just for the reduced kids, so what she said is so
true. When it is community eligibility it is for all the kids,
and we have got to reduce our burdens on our future healthcare
costs with obesity and diabetes, and heart disease and all
these things.
And I think if we do not get these kids and these future
generations to start eating better we are never going to get
there. So the administrative burden for the teachers, the
teachers have the hardest job in the school. I would last 10
minutes as a teacher. But they love community eligibility
because they do not have to collect applications. They do not
have to decide whether the kid is paid, free, reduced, or has
lunch money. They do not have to worry about the kid that did
not bring their lunch money and take money out of their pocket
to pay for the kids. They do not have to worry about lunch
boxes being stolen or lunches being stolen.
So we have the opportunity to make a huge difference in
these children's lives, and they take it home and make a
difference in their families' lives. So I say we just need to
make sure that all programs have the opportunity to do CEP do
not go back. It is such a profound impact in my district and
every other district that does it.
Ms. HAYES. I mean, so once again, I know what I bring to
this conversation. I was the teacher who had a closet who kids
came to my room in the morning or I emptied out my own lunch
or--
Ms. MARTIN. Right.
Ms. HAYES [continuing]. my own wallet--
Ms. MARTIN. Right.
Ms. HAYES [continuing]. to give them money to go buy a
snack in the morning.
Ms. MARTIN. Right.
Ms. HAYES. This is before we moved to this community
eligibility provision. Is there anything, because I only know
what I bring, on the flip side, is there any benefit to cutting
this provision in the communities where we have, like mine, 70
percent of our students already receive free or reduced lunch?
I know what it meant to try to collect these forms where a kid
was not eligible for $5.
Ms. MARTIN. Right.
Ms. HAYES. Not even a huge span.
Ms. MARTIN. Right.
Ms. HAYES. You were $1 over the eligibility and it made all
of the difference. Is there any benefit that I am just not
seeing to cutting this provision?
Ms. MARTIN. Zip. Zero. Zilch benefit of cutting this
program. It would do more harm. And my teachers in the school
would be devastated, and to get the teachers in support of a
program is huge. So, no, there is absolutely no advantage and
our kids deserve healthy meals. And we are a nutrition program,
not just a feeding program.
Ms. HAYES. I guess, Ms. Johnson, you talked about in your
statement about planning for next year and some of the
challenges with planning that budgetary insecurity means for
you and the communities that you serve. How would that impact
the way you plan for the future of your district or the
communities that you serve, not knowing what is in the budget?
Ms. JOHNSON. OK. So you mean if community eligibility was--
Ms. HAYES. Yes.
Ms. JOHNSON [continuing]. rolled back? Well, we are dealing
with that right now in the Kansas City, Kansas school district
they are coming up to the last year that they can go ahead and
have the program. Their identified student percentages have
decreased in that school district, and so they are not going to
be able to offer community eligibility or they are trying to
figure out a way, but they just really are not going to be able
to do it financially. And so there is a lot of work that is
going to have to be done in educating--
Ms. HAYES. So without the community eligibility the food
program goes away?
Ms. JOHNSON. The food program will not go away, but it
will, again, be based upon their free, reduced eligibility
status. And so now we are educating parents about what that
means. So, again, that stability is important and the changes,
it really is an issue that we have to deal with at the State
and local level.
Ms. HAYES. Thank you. I yield back.
Chairwoman BONAMICI. Thank you. I now recognize
Representative Thompson from Pennsylvania for 5 minutes for
your questions.
Mr. THOMPSON. Chairwoman, thank you so much. Thank you for
hosting this very important hearing too. Thanks for all the
witnesses here providing your testimony. I have found it all
very helpful. Nutrition is important to me. Last term I was the
chairman of the nutrition subcommittee on our agriculture
committee, and I am a former, or as I like to say it, a
recovering school board member. And I know that, you know, from
all different perspectives. You know, my family, my wife and I
when we were first pregnant with our first child we were in the
WIC program and we were eligible for that and we needed it. It
was important.
And I just want to speak to the whole issue of kids
standing out. There is no excuse for that today with EBT cards.
School districts are failing and In fact, the legislation we
put forward to reform the current law, and it did not,
unfortunately, did not go anywhere a few years ago we addressed
that because there are technologies today that whether you are
paying yourself or free or reduced that there are ways to do
that and school districts should be doing that in a way that,
you know, we do not allow kids to stand out and to be
discriminated against. There is no excuse for that when schools
do that today.
Also, I understand the challenges of administering a school
nutrition program. I mean, I think it is the only part of our
school budgets where we expect you to cover all your own costs,
and yet, we hold you to these high standards dictated from
Washington, not all bad, but it is just it does not work,
frequently does not work. And quite frankly, I believe that
hunger is preventable.
And so we need a significant review and changes to the
Health Hunger-Free Kids Act that was passed in 2010. I was here
for that. That review is long overdue. Some of the lessons we
have learned from it, quite frankly, I don't care how you set
the nutritional standards. If the food is not eaten it is not
nutritional, period. Caloric intake, portion size varies by
kids. Sixty pound girls and 200 pound linebackers and there is
a difference there, so the cookie cutter approach with
Washington standards have failed a lot of kids.
We have, you know, standards that deny science can have
devastating consequences. We have seen that on milk. Empowering
our school-level nutrition professionals with flexibility will,
I believe, best meet the children's nutritional needs. You
know, one of those unintended consequences from the 2010
standards was the impact on milk consumption, and I am glad to
hear observations that some of you some of you--have not seen a
decrease in consumption, but let me share you what has happened
Nation-wide.
You know, milk, as we know, is the No. 1 source of nine
essential nutrients in young Americans' lives, and provides
more health benefits, including better bone health, lower blood
pressure, reduced risk of cardiovascular disease, reduced type
2 diabetes, and now we know that milk fat in whole milk, in
particular, can help to reduce obesity. I actually believe
since 2010 with what did out of this Committee, we decreased
milk consumption to the point--and it is always going to get
replaced with something, but today, most of it is replaced with
empty calories, really contributing toward greater childhood
obesity. So that is why it is really important that we have
this conversation and we look at these standards, and that we
let science guide us and make sure that it is good science.
Milk is a source of three out of the four under consumed
nutrients: calcium, potassium, and vitamin D. And no other
berries naturally comes closer to this level of nutritional
value. But since from 2014 to 2016 schools served 213 million
fewer half pints of milk, you know, despite the fact that the
public enrollment was growing. Now, I actually think they
counted some of the half pints that were taken that we force
our kids on free and reduced to take, but after their first
milk experience with non-fat milk, and that is great that some
kids might like that, but quite frankly, it is chalk water, as
a milk drinker, and non-fat chocolate is just disgusting. Some
of those things that got counted as consumed did wind up in the
garbage can, based on a bad milk experience.
We know that children over 4 years or older not meeting the
recommended daily servings of dairy in the dietary guidelines.
And I have three articles just I want to submit, ask unanimous
consent to submit for the record. These are studies from TUFT,
from Harvard, and one from McMaster University dealing with
that.
Chairwoman BONAMICI. Without objection.
Mr. THOMPSON. Actually, I apologize. I acted like I was in
the Senate. I filibustered on this. I did not even get around
to asking my question on it, but my point is that I am glad we
are looking at this. Madam Chair, I really appreciate your
leadership on this, and we need to let science guide us because
hunger is preventable, nutrition matters, and I think we can do
a better job opening up these standards and updating them.
Chairwoman BONAMICI. Thank you for your questions. I now
recognize Representative Lee from Nevada for 5 minutes for your
questions.
Ms. LEE. Thank you, Madam Chairwoman, and thank you all for
coming here. You know, with a significant amount of our
Nation's kids participating in the school lunch and school
breakfast program, I represent Clark County, Nevada, the fifth
largest school district. Over 68 percent of the students
qualify for free and reduced lunch, so I certainly appreciate,
first of all, how important it is that the calories that our
children consume pack as much nutritional punch as possible,
but also understand I met with many food service employees this
week how incredibly complicated the process is, especially on a
limited budget. And not only that, especially with respect to
the breakfast program where it is done, at least in Clark
County, in the classroom, making it as convenient as possible.
But currently our standards right now do not address sugar
content in school breakfast and do not require a protein. And
when you look at the various breakfast meals that are served to
children it is not uncommon to find breakfast that can deliver
between 40 and 50 grams of sugar in one sitting which
translates to ten to 12 teaspoons of sugar, far greater than
the two to three teaspoons that is recommended for children by
the American Heart Association.
So, Dr. Ochoa, I wanted to ask you, can you speak to the
importance of limiting added sugar within the diets of our
Nation's young children, and how increased sugar intake is
linked to serious health issues during subsequent development?
Dr. OCHOA. Yes, absolutely. Our Academy of Pediatrics
recommends, going back to the milk issue and talking about
sugar, that low fat or non-fat unflavored milk is really the
way to go because it removes two things, sugar and saturated
fat, that we know are leading risk factors for a whole host of
adult problems like obesity, cardiovascular disease, stroke,
high cholesterol and things like that. So, the sugar content in
food that is served at school is certainly a contributor to
excess calories that kids do not need.
We talk about the first 1,000 days of life and the
scaffolding effect that the nervous system goes through to
develop to get a child from zero to three ready to go to
school. I like to think of the different meals that we provide
at different ages through these programs that we are talking
about as a scaffolding as well that we have to adjust both the
nutrient and caloric makeup of those meals to have kids get the
right things at the right time so they can thrive through
school, not just for grade-level reading, decreased behavior
problems like Ms. Schrier mentioned earlier, but just overall
better performance in school. And I think taking the sugar, the
excess sugar out where we can is very important.
Ms. LEE. Yes. Thank you. I was going to ask about,
obviously, the rollback, the regulatory actions on the rollback
which now allow for flavored milk, low-fat milk instead of milk
which, in some cases, can add another 18 grams of unnecessary
sugar to a child's diet. Dr. Ochoa, in line with what you
mentioned in your testimony about ensuring the benefits of
consistent access to nutritious meals for children, do you have
any recommendations for this legislative body on how we can do
a better job of regulating sugar intake within these nutrition
programs, again, also recognizing the complexity that Ms.
Johnson and Ms. Martin have in actually implementing this as
well?
Dr. OCHOA. Yes. Well, I will agree with Mr. Thompson that
science is very important, and so the prevailing science that
is out there to undergird what we serve our children in these
various programs that we are talking about is very important.
The science that is developed is from the National Academies,
and as somebody who has served on a National Academy review
before I can tell you that the makeup of those committees is
done very carefully, and the input that those committees get is
very wide and deep.
Our committee went to places like Arkansas, Louisiana,
Chicago to get input from the community on adolescent care, and
so I know that the science that is coming out of the National
Academies, just like the guidance that came out last week on
sodium and potassium is really rooted in the prevailing science
of the times. So, I think, if anything, the committee should
look at the science that comes out of bodies like the National
Academies in addressing the composition of what we feed kids.
Ms. LEE. Thank you. I agree. I think that definitely it is
crucial that our nutrition standards are aligned with science
and research, so thank you very much.
Dr. OCHOA. You are welcome.
Ms. LEE. Thank you all for your testimony. I yield.
Chairwoman BONAMICI. Thank you, Representative Lee. I now
recognize Representative Johnson from South Dakota for 5
minutes for your questions.
Mr. JOHNSON of South Dakota. Thank you, Madam Chairman, and
I would just note to the panelists that, I mean, I grew up in a
family that was of modest means, and certainly there were times
when we availed ourselves of the free and reduced school lunch
program, so thank you to the efforts that a number of you have
made in making sure that we have got programs that do a good
job of delivering those nutritional benefits to families like
mine.
Both the gentleman from Pennsylvania, as well as the
honorable doctor from Washington started to ask about whole
milk, but ran a little short on time, so I'll lend my voice to
theirs. Mrs. Johnson, can whole milk be part of a nutritional
toolbox at the school level?
Ms. JOHNSON. Whole milk is allowed in the Child and Adult
Care Food Program up to 2 years where the science supports
that. Again, our program regulations are based on the current
science, and so that we follow what the science standards
regulate. So I do not know that I can tell you personally what
I feel as a State agency representative, but I can tell you we
do allow whole milk up to 2 years of age.
Mr. JOHNSON of South Dakota. So I know there has been some
studies and the gentleman from Pennsylvania referred to them
that whole milk, when used properly, can be a part of driving
down childhood obesity. Is that literature maybe just not
mature enough yet? And if you prefer I ask Dr. Ochoa I
certainly can.
Ms. JOHNSON. I think that would be a good question for the
Dr.--
Mr. JOHNSON of South Dakota. Yes. All right, Doc, I mean,
is this just not a mature level of literature yet?
Dr. OCHOA. I think that is one way to talk about it. I am
not aware of the literature that shows a direct connection
between whole milk and obesity prevention.
Mr. JOHNSON of South Dakota. OK. Very good. Thank you. And
then maybe back to you, Ms. Johnson. We have talked a little
bit about flexibility and how that can help with these
nutritional programs, but what about in rural areas are there
any unique challenges that rural areas, rural school districts
face where flexibility is helpful?
Ms. JOHNSON. Yes, and I was not able in my time limit to
talk about the professional standards of rural. The flexibility
we just received a couple weeks ago now. But I was on the same
committee as Donna when the professional standards went into
place and I kept saying, I was one of the few folks from a
rural area and I kept saying, yes, but how about western Kansas
or South Dakota or North Dakota.
We need strong, talented people to run our programs, well-
educated, but reality is in some of the small districts that
you cannot find people who are able to provide the leadership
as a school nutrition director that have 3 years of school food
service experience. So the recent flexibility really does help
those rural areas.
We go in and we train and we encourage them to take a lot
of professional development classes. We encourage them to go
ahead and further their education when possible, but just to
have someone able to be out there feeding kids is really
important in rural areas. So I appreciate that flexibility very
much.
Mr. JOHNSON of South Dakota. Excellent. And then maybe for
Ms. Johnson and Ms. Martin, we have talked about how, you know,
2 million fewer, I think it is 2 million fewer school children
are taking school lunches in recent years. I think there has
been some supposition that is directly linked to these more
stringent nutritional standards. Is that a fair assumption?
Maybe Ms. Martin first.
Ms. MARTIN. I disagree with that assumption. I think that,
you know, in our district we really worked hard to get the kids
ready for the standards, and I think a lot of school districts
did not think that they were going to come about, and so they
just kind of threw it on the kids. Changes should be gradual,
like with milk, what we did with milk was we went from whole to
low fat to 1 percent to skim, and we made sure with our milk
that we have cold milk. We use plastic bottles and did things
to encourage the kids to drink the milk.
So I think with the standards doing it gradually was the
big difference, but I think what hurt participation was the
lunch paid equity situation where the meal cost went up and up
and up and you have a family of four and they were having to
pay $3 for a meal and that is $12 a day. They could not afford
it. So I think that is where we saw the decrease in
participation much more, and I think our kids are getting used
to the food, our schools and our industry are doing a much
better job of coming up with innovative ways of preparing an
innovative food for us to purchase, and so I think that is
turning around, but I think it was the paid lunch equity more
than the food.
Mr. JOHNSON of South Dakota. Ms. Johnson, did she miss
anything?
Ms. JOHNSON. I agree completely that it is the paid lunch
equity regulation. It has outpriced some of our folks who do
not qualify for free and reduced that are not able then to
purchase meals at the paid price. That is what we saw in
Kansas.
Mr. JOHNSON of South Dakota. Well, Madam Chair, I would
just note as my time expires that these are great panelists who
answered in such nice, short, direct bursts that let me get
through my questions. So thank you very much and I yield back
the time I no longer have.
Chairwoman BONAMICI. I appreciate that and I now recognize
Representative Trone from Maryland for 5 minutes for your
questions.
Mr. TRONE. Good morning, everybody. I would just thank you
guys, again. As Dusty said, these are wonderful, wonderful
panelists and we have really enjoyed this presentation. It is
great to see folks thinking long term. I mean, the most
important thing in long term thinking is about our kids and
thinking about the next generation, and so often we in this
body are kind of thinking about today and only today and that
is not where we need to be, so thank you.
Parts of my district like Washington County over 60 percent
of the kids are on free and reduced lunches, and it is not just
the economic hardship, but it is often single parents. And
there is no coincidence that area is the real heart of this
opioid epidemic. So many tragedies have befallen these families
one after another.
As you said earlier, so eloquently, it is free books, it is
free computers, it is free teachers. How would we not have free
lunch? I mean, my goodness, I mean the engine of a young child
is running on food, and I have four at home and they eat a lot
of food. So we really need this, but yesterday we saw the
administration, you know, cut CEP. It could lead to 1.3 million
kids not having those free lunches or breakfast.
What do you see, Dr. Ochoa, as far as the long term issues
of this food insecurity, but not enough nutrition for their
development? And what are some of those health consequences
that later on will manifest themselves?
Dr. OCHOA. Thank you. Our research from Children's Health
Watch shows that food insecurity not only exacerbates problems
that maybe have started in birth, but then will lead to bigger
consequences in the long term, more hospitalizations more
emergency department visits, more chronic health conditions.
And what we are talking about in this hearing to improve the
reach of these programs not only reduces food insecurity, but
also promotes healthy growth and development, as you mentioned.
The door for our hospital to begin to offer food to kids
who are coming to our clinics was CEP. Our hospital, like many
academic health centers across the country is in a low income
part of Little Rock in the shadow of Central High School. So,
because of the community eligibility provision we are able to
start with summer feeding and have expanded that to CACFP as
well, and offer up to 25,000 meals to kids that are at our
clinics. Our kids sometimes wait three and 4 hours during an
appointment for a complex health issue. They bring siblings
with them. So if we can alleviate the food insecurity that they
have the day they come all the better, but we do know that
starting early with WIC and all through school, the better that
you can feed the engine, as you said, kids will not only do
better in school and be ready to enter the work force later,
but other chronic health conditions that we can all agree are
bad like high blood pressure and obesity could hopefully be
prevented.
Mr. TRONE. Anything you would like to add, Ms. Johnson or
Ms. Martin?
Ms. JOHNSON. I would just like to add that for a period in
my life when my children were small and I did not work in
school nutrition but was a consultant dietitian I consulted in
nursing homes and for hospices, and we kept having to get
larger wheelchairs, beds of bigger size, dining room table
chairs bigger, and I was seeing more and more patients under 50
with obesity, sometimes on dialysis, heart problems, diabetes.
I have a real passion for child nutrition and public health
because of that. I do want to prevent that for my
grandchildren.
Ms. MARTIN. And I would just like to say we have the
opportunity to change future generations, and if we wait shame
on us. Shame on us. I mean, those of us that are in school
nutrition who see these kids come to school so excited to have
school lunch, and some of them only come to school because of
school lunch, and we have got to educate these kids to become
productive citizens. And with our supper program the only
reason they stay after school to be tutored is because of our
supper program. And the reason our athletes are performing
well, we had malnourished athletes and because we were able to
offer them supper they won their first ever State football
championship, and that coach credited the school nutrition
program. Imagine that, with that fact that they were able to
perform on the field, and for some of our kids that is the only
way they are going to get a scholarship to go to school.
Mr. TRONE. Excellent.
Ms. MARTIN. So nutrition just impacts much, much more.
Mr. TRONE. So that is the whole key. That is why so many of
us love being on this education committee because it is all
about the investment upfront, the investment in our kids, and
then the long term payback on better health, better productive
jobs, tax revenues. All that money comes back multiple times.
Thank you for your time.
Chairwoman BONAMICI. Thank you very much Representative. We
are going to finish the questions from members on this
subcommittee, including Chair of the full Committee
Representative Scott before we move to questions from the
members who are not on the subcommittee. But I did want to note
that Representative Stefanik was here and is not able to join
us now. I did want to note that Representative Stefanik and I
have been working on and continue to work on a Child and Adult
Care Food Program bill that does extend meals to children who
are in care, but it also addresses paperwork reductions and
simplifies participation eligibility requirements. So I want to
just note that because I am sure that Representative Stefanik
would have discussed that had she been here. So I now recognize
the Chairman of the full Committee, Representative Scott from
Virginia for 5 minutes for your questions.
Mr. SCOTT. Thank you, Madam Chair. Ms. Martin, as a
Registered Dietitian you understand the importance of
prioritizing diets. Can you share some innovative strategies
that schools are using to serve meals that are nutritious and
come up to the standards and also delicious?
Ms. MARTIN. Well, I tell you what, we have been very, very
creative in doing our meals, and we have worked with the
students to get input from them, and so we are now doing things
like walking tacos and Asian bowls and hummus. And we actually
are trying to fight with these kinds that bring these
Lunchables that can be less than appealing, and so we have
started making our own healthy lunchables to compete with them.
So we offer lots and lots of choices, and when you offer
lots and lots of choices they pick what they want to eat so
nothing goes into the trashcan. We also make sure that we cut
up the fruit so that they have time to eat it, and we make sure
that we have enough time. So sometimes we have had to add
vending machines because we do not have enough serving lines,
and not enough time to get the kids through so we have added
vending machines to speed up the process.
We prepackage our salads. People are doing salad bars.
Salad bars have been huge in the schools. The kids, to see them
go through the salad bars. They just pile up their plate with
all these fruits and vegetables and they eat ever bite of it
because they have chosen it. So it can be done, but we need
strong nutritional standards. You have to be passionate about
what you do as a school nutrition director and you have to be
creative, and so we have got to do a lot of training and we
have got to get those people in there that want to do it. And
not because they were a principal that got reassigned to be the
school nutrition director. Sorry if any of--
Mr. SCOTT. Thank you. No, we have heard a lot of comment
about if you have nutritious food it is going to get thrown
away and I think if you have food that is nutritious but not
tasty people will be throwing it away, but you have shown how
you can do both. And can you say another word about why strong
professional standards are important? The administration has
given flexibility on professional standards. Why is it
important to be a fully qualified professional?
Ms. MARTIN. Well, when you were talking about sugars and
some of these other things and we talked about whole milk and
things like this, as a Registered Dietitian Nutritionist I
understand nutrition, and so it is easy for me to plan meals
that are low in sugar and are low in fat and saturated fat, and
I understand the importance of the dietary guidelines. And so I
know how to do menu planning, but if you bring somebody in that
does not have those skill sets, honestly, when I am out talking
about our program and I have parents tell me, well, all I get
is pizza and french fries and juice is what my kids drink and
eat every day. It is because they did not have a professional
that knew how to plan healthy meals, and that is cheap and easy
and they know the kids are going to eat it so that get away
with that.
So I think it is just so important to have, and I think it
is a huge burden on the State staff to have to train those
people that do not know anything about nutrition and do not
meet the standards and do not meet the regulations. And that is
why I do like a little bit of flexibility with administrative
reviews. I have been doing this for 25 years. I know what I am
doing. Do not come see me every 3 years. Go see that new
director who was the principal and does not know what they are
doing and give them the help. So I think we need to stay
strong. In Georgia we are hearing a lot of districts get
together and have one qualified person be over numerous
districts, small districts, and that way everybody gets the
benefit of having somebody qualified.
Mr. SCOTT. Thank you. Dr. Ochoa, you said you were in an
area with a summer meal program. We have seen evidence that low
income students if they do not have activities during the
summer will actually regress several months, so when they come
back in September they are worse off than they started. Can you
say a word about the importance of nutrition programs during
the summer months to prevent the summer slide?
Dr. OCHOA. Yes, Chairman Scott, definitely. We know that
lots of programs that offer educational opportunities for kids
in the summer are also summer feeding sites. And so the fact
that they can offer both of those things simultaneously will
prevent those kids from, A, going hungry for a longer time
during the summer, and, B, preventing that educational slide
that you mentioned as well. We have a shelter in Little Rock
that also has a early childhood program that has a very robust
education component and also offers meals to those kids.
Mr. SCOTT. And has the summer EBT program helped in food
insecurity?
Dr. OCHOA. Yes, absolutely. Anything that makes it easier
for the kids to access those programs is helpful.
Mr. SCOTT. Thank you. The Chairwoman discussed in her
opening remarks that the National School Lunch Program actually
began as a national security program. We are still having the
same problems, 71 percent of young Americans are ineligible to
serve in the military, some for inadequate education, some for
criminal records, but a lot for nutritional programs. And I
will not ask a question, I will just make the statement that
these kinds of programs can address a national security need as
well as education and nutrition. So thank you, Madam Chair. I
yield back.
Chairwoman BONAMICI. Thank you, Chairman Scott. I now
recognize Representative Grothman from Wisconsin for 5 minutes
for your questions.
Mr. GROTHMAN. Thanks. We will start by asking Ms. Martin,
but you can pitch in if you want. We have other hearings on
this Committee and you are asking for higher reimbursement
rates. The Federal Government, as you all know, is very broke.
You know, I think we are borrowing 19 percent of our budget,
and while we certainly have to make sure all children all
adequately fed I am going to ask you why or to what degree, you
are from Georgia, right?
Ms. MARTIN. Yes, yes.
Mr. GROTHMAN. To what degree have you communicated with the
Georgia Legislature or your local school districts as far as
putting money into this program instead of the Federal
Government, and if you are primarily asking the Federal
Government why don't you ask the State or local government?
Ms. MARTIN. Well, you know, I think all school systems will
tell you they are struggling to pay teachers, and buy books,
and have busses that are safe, and have public security
officers, and the requirements upon them are increasing every
single day. And so I communicate all the time to our school
board and they see the value of school meals. And I understand
about the deficit. I am a taxpayer, but I go back to the
statement I made earlier. We are either going to pay now to
change our children's eating habits or we are going to pay
later in health care costs.
And I honestly do not feel like we are going to have enough
physicians to meet the needs of the diabetics, heart disease,
renal failure, high blood pressure and all these issues,
cancer. All that are related to eating habits, and if we do not
do it now we cannot afford to do it later. We already have--
Mr. GROTHMAN. Let me cut you off.
Ms. MARTIN [continuing]. a great number--
Mr. GROTHMAN. I mean, I know in Wisconsin we ended last
year anticipating ending with hundreds of millions of dollars
of surplus, and when I Google it that is not unique to
Wisconsin. Because the booming economy, high State sales tax
receipts, high income tax receipts it is not unusual for States
to be running big surpluses, and I just wondered why you are
here asking us for our money rather than the, first of all,
units of government that are going to have less regulation for
you. You need less regulation. And, second, that are running
surpluses. I mean, does the Georgia Legislature not appreciate
this crisis or do the local school districts not appreciate it
or why are you not leading with them?
Ms. MARTIN. Well, I think Cheryl Johnson will tell you
there are a lot of school districts in the country that are
running in the red because of economic costs and their school
boards are having to pick up for the program, and so I think
that is a struggle. But I think that the State does provide
some money for health insurance benefits and does provide us
with guidance and stuff, but I feel like it is a Federal
responsibility.
Mr. GROTHMAN. OK. Next question. Doesn't, in general, more
Federal money mean more regulations? I mean, you kind of
breathed a sigh of relief when you heard that we were doing
kind of a little working group on less regulations, and my
school districts, and I talk about them, all are kind of
irritated with the Federal regulations. They feel the Federal
regulations are causing children to throw away their food.
Would you, Obviously--
Ms. MARTIN. Yes.
Mr. GROTHMAN [continuing]. that is part of the Federal
problem, but would you prefer it if we just took this program,
found out how much Georgia or any other State received last
year, give them a check and go away and assume that the local
people know how to buy nutritious food or do you think we
cannot trust the local people and we should continue to do
something other than just write a check? And I will ask Ms.
Johnson the question.
Ms. MARTIN. Well, let me absolutely just tell you that, no,
absolutely, I am totally against that because you cannot have
50 different States deciding what kind of food they are going
to serve. The manufacturers could not deal with that. You have
got to have national standards with all the programs, and you
do not have qualified people always running these programs, so
I would be very, very much against that.
Mr. GROTHMAN. So you do not trust the locals?
Ms. MARTIN. I don't trust--It is not that I do not trust
them. It is just that nationally our food manufacturers are
struggling now because--
Mr. GROTHMAN. OK.
Ms. MARTIN [continuing]. the stability that she talked
about--
Mr. GROTHMAN. Well, we will switch to Ms. Johnson.
Ms. MARTIN. Go ahead.
Ms. JOHNSON. I would have the most concern about the effect
on our students because if a school district was given just a
certain amount of money there would be no reason to try to do
innovative school breakfast. There would be no reason to try to
feed more kids. They would just want to preserve the funds they
had. Or say we had a disaster.
Mr. GROTHMAN. OK.
Ms. JOHNSON. That would be my major concern too.
Mr. GROTHMAN. OK. Now I want to get my final thing in here.
I was so relieved because I was here when President Obama was
President. I was so relieved when President Trump got in there
and his folks began to allow flavored milk so people would not
throw away the milk as much. Are you supportive of President
Trump, his Administration's initiative to include flavored milk
as an option for the kids?
Ms. JOHNSON. I am in favor of children drinking more milk
in whatever way that happens because I do believe that calcium
is a nutrient that is not consumed in enough quantity in the
American diet, especially in teenagers. So that is my stance,
personally, as a Registered Dietitian.
Ms. MARTIN. And they never took away the possibility of
serving flavored milk. We have always been able to serve
flavored milk. That has never gone away, just for a point of
reference.
Chairwoman BONAMICI. Thank you, Mr. Grothman. I now remind
my colleagues that pursuant to committee practice materials for
submission for the hearing record must be submitted to the
committee clerk within 14 days following the last day of the
hearing, preferably in Microsoft Word format. The material
submitted must address the subject matter of the hearing. Only
a member of the committee or invited witness may submit
materials for inclusion in the hearing record, and documents
are limited to 50 pages each. Documents longer than 50 pages
will be incorporated into the record via an internet link that
you must provide to the committee clerk within the required
timeframe, but please recognize that years from now that link
may no longer work.
Again, I want to thank the witnesses for their
participation today. This has been an excellent discussion and
what we have heard has been very valuable. Members of the
committee may have some additional questions for you, 5 minutes
goes by quickly, and we ask the witnesses to please respond to
those questions in writing.
The hearing record will be held open for 14 days to receive
those responses. And I remind my colleagues that pursuant to
committee practice, witness questions for the hearing record
must be submitted to the majority committee staff or committee
clerk within 7 days. The questions submitted must address the
subject matter of the hearing.
I now recognize the distinguished ranking member for his
closing statement.
Mr. COMER. Well, thank you very much for being here today.
It is very clear from this testimony and all of our past
experiences that these programs are critical to students and
families. We know students cannot learn if they are hungry. We
also know how important these programs are to parents who want
to give their kids the best opportunities. Thank you, Ms.
O'Meara for sharing your story and support for these programs.
We also heard how the paperwork burden and complicated
compliance issues can cause significant time and money from
programs that do not have much of either. As we begin
reauthorization it is critical we make sure the program works
on the ground, in our school, and for the students. That means
commonsense rules that are not overly complicated and limited
paperwork that ensures that the taxpayer dollars are protected
without wasting them.
Thank you, again, for being here. Thank you for being on
the frontlines and I yield back.
Chairwoman BONAMICI. Thank you, Mr. Comer. I now recognize
myself for the purpose of making my closing statement. Thank
you, again, to all of our witnesses for being here and sharing
your statement stories and your expertise. Today we heard about
the importance of childhood nutrition programs in combating
hunger and malnutrition across the country.
We heard how for too many families the struggle to put
healthy food in the table undermines their financial stability
and their children's ability to reach their full potential. We
also heard about how research and experience demonstrate that
child nutrition standards and programs are among our most
effective tools for preventing child hunger and making sure
that students are able to focus on learning.
With these child nutrition programs, including the National
School Lunch Program, the School Breakfast Program, the Summer
Food Service Program, the Child and Adult Care Food Program,
and more, Congress has consistently recognized through
bipartisan support that a quality education includes making
sure that every child has access to healthy and nutritious
food. And my list was not exclusive. The Farm to School
Program, all of those are wonderful programs.
But our choices are clear. We can either invest in these
important programs now and support healthy eating in schools
and do what is best for our Nation's children, or we can cut
corners and put the well-being of our children and our Nation's
future at risk. I hope that for everyone here the answer is
simple. We must continue to strengthen child nutrition programs
and protect the progress we have made toward providing all
children with the nutritious food that fuels their health and
their futures. And this is something that I am convinced we can
do on a bipartisan basis.
The United States is a wealthy country. We have the
resources to reduce hunger and food insecurity. This is a way
to break the cycle of poverty. This is a matter of basic
humanity and equity, and it is also a good investment. So I
look forward to working with all of my colleagues on this
important issue, and if there is no further business, without
objection, the committee stands adjourned.
[Additional submission by Mr. Comer follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
[Whereupon, at 11:56 a.m., the subcommittees was
adjourned.]
[all]