    [Senate Hearing 114-149]
    [From the U.S. Government Publishing Office]

                                                            S. Hrg. 114-149

                      A REVIEW OF CHILD NUTRITION PROGRAMS

    =======================================================================

                                    HEARING

                                   before the

                           COMMITTEE ON AGRICULTURE,
                            NUTRITION, AND FORESTRY

                              UNITED STATES SENATE

                        ONE HUNDRED FOURTEENTH CONGRESS

                                 FIRST SESSION

                                   __________

                                  MAY 7, 2015

                                   __________

                           Printed for the use of the
               Committee on Agriculture, Nutrition, and Forestry

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               COMMITTEE ON AGRICULTURE, NUTRITION, AND FORESTRY

                         PAT ROBERTS, Kansas, Chairman

    THAD COCHRAN, Mississippi            DEBBIE STABENOW, Michigan
    MITCH McCONNELL, Kentucky            PATRICK J. LEAHY, Vermont
    JOHN BOOZMAN, Arkansas               SHERROD BROWN, Ohio
    JOHN HOEVEN, North Dakota            AMY KLOBUCHAR, Minnesota
    DAVID PERDUE, Georgia                MICHAEL BENNET, Colorado
    JONI ERNST, Iowa                     KIRSTEN GILLIBRAND, New York
    THOM TILLIS, North Carolina          JOE DONNELLY, Indiana
    BEN SASSE, Nebraska                  HEIDI HEITKAMP, North Dakota
    CHARLES GRASSLEY, Iowa               ROBERT P. CASEY, Jr., Pennsylvania
    JOHN THUNE, South Dakota

                   Joel T. Leftwich, Majority Staff Director
                    Anne C. Hazlett, Majority Chief Counsel
                        Jessica L. Williams, Chief Clerk
                 Christopher J. Adamo, Minority Staff Director
                  Jonathan J. Cordone, Minority Chief Counsel

                                      (ii)

                                C O N T E N T S

                                  ----------
                                                                       Page

    Hearing(s):

    A Review of Child Nutrition Programs.............................     1

                                  ----------

                             Thursday, May 7, 2015
                        STATEMENTS PRESENTED BY SENATORS

    Roberts, Hon. Pat, U.S. Senator from the State of Kansas,
      Chairman, Committee on Agriculture, Nutrition, and Forestry....     1
    Stabenow, Hon. Debbie, U.S. Senator from the State of Michigan...     4

                                    Panel I

    Lord, Stephen M., Managing Director, Forensic Audits and
      Investigative Service, U.S. Government Accountability Office,
      Washington, DC.................................................     6
    Neuberger, Zoe, Senior Policy Analyst, Center on Budget and
      Policy Priorities, Washington, DC..............................     8

                                    Panel II

    Riendeau, Brian, Executive Director, Dare to Care Food Bank,
      Louisville, KY.................................................    27
    Goff, Richard, Executive Director, Office of Child Nutrition,
      West Virginia Department of Education, Charleston, WV..........    29
    Jones, Cindy, Business Management Coordinator, Food Production
      Facility, Olathe Unified School District 233, Olathe, KS.......    31
    Hassink, Dr. Sandra G., President, American Academy of
      Pediatrics, Wilmington, DE.....................................    33
                                  ----------

                                    APPENDIX

    Prepared Statements:
        Casey, Hon. Robert, Jr.......................................    48
        Leahy, Hon. Patrick J........................................    50
        Goff, Richard................................................    52
        Hassink, Sandra G............................................    58
        Jones, Cindy.................................................    66
        Lord, Stephen M..............................................    69
        Neuberger, Zoe...............................................    84
        Riendeau, Brian..............................................   101
    Question and Answer:
    Goff, Richard:
        Written response to questions from Hon. Debbie Stabenow......   112
        Written response to questions from Hon. Michael Bennet.......   114
        Written response to questions from Hon. Sherrod Brown........   117
        Written response to questions from Hon. Robert Casey, Jr.....   119
        Written response to questions from Hon. Heidi Heitkamp.......   124
        Written response to questions from Hon. Patrick J. Leahy.....   124
        Written response to questions from Hon. Thom Tillis..........   128
    Hassink, Sandra G.:
        Written response to questions from Hon. Debbie Stabenow......   132
        Written response to questions from Hon. Michael Bennet.......   135
        Written response to questions from Hon. Sherrod Brown........   139
        Written response to questions from Hon. Robert Casey, Jr.....   140
        Written response to questions from Hon. Heidi Heitkamp.......   142
        Written response to questions from Hon. Patrick J. Leahy.....   142
    Jones, Cindy:
        Written response to questions from Hon. Debbie Stabenow......   145
        Written response to questions from Hon. Michael Bennet.......   145
        Written response to questions from Hon. Robert Casey, Jr.....   147
        Written response to questions from Hon. Heidi Heitkamp.......   148
    Lord, Stephen M.:
        Written response to questions from Hon. Debbie Stabenow......   150
        Written response to questions from Hon. Robert Casey, Jr.....   151
    Neuberger, Zoe:
        Written response to questions from Hon. Debbie Stabenow......   153
    Riendeau, Brian:
        Written response to questions from Hon. Debbie Stabenow......   155
        Written response to questions from Hon. Michael Bennet.......   158
        Written response to questions from Hon. Sherrod Brown........   162
        Written response to questions from Hon. Robert Casey, Jr.....   163

                      A REVIEW OF CHILD NUTRITION PROGRAMS

                                  ----------

                             Thursday, May 7, 2015

                                  United States Senate,
             Committee on Agriculture, Nutrition, and Forestry,
                                                         Washington, DC
        The committee met, pursuant to notice, at 10:05 a.m., in
    room 216, Hart Senate Office Building, Hon. Pat Roberts,
    Chairman of the Committee, presiding.
        Present or submitting a statement: Senators Roberts,
    Boozman, Hoeven, Perdue, Ernst, Tillis, Grassley, Thune,
    Stabenow, Brown, Klobuchar, Bennet, Gillibrand, Donnelly,
    Heitkamp, and Casey.

     STATEMENT OF HON. PAT ROBERTS, U.S. SENATOR FROM THE STATE OF
    KANSAS, CHAIRMAN, U.S. COMMITTEE ON AGRICULTURE, NUTRITION, AND
                                FORESTRY

        Chairman Roberts. Good morning. I call this meeting of the
    Senate Committee on Agriculture to order.
        Welcome to our first hearing on child nutrition
    reauthorization in this Congress. I commend my colleague,
    Senator Stabenow, for her leadership on this issue, and more
    especially, the hearings she held last year.
        The Richard B. Russell National School Lunch Act and the
    Child Nutrition Act of 1966 authorize critical programs of
    great importance for Kansas, our nation, our farmers, our
    ranchers, our growers, and our vulnerable populations,
    including, of course, hungry children.
        The School Lunch Program was originally created as a
    measure of national security, ``to safeguard the health and
    well-being of the nation's children and to encourage the
    domestic consumption of nutritious agricultural commodities.''
        Coming out of World War II, Congress saw the need to
    establish the School Lunch Program, in no small part to ensure
    our military had a sufficient supply of eligible individuals to
    defend our nation from global threats.
        Additionally, the current research regarding the need for
    adequate nutrition during a person's developmental stages
    provides further support for what Congress knew even back then.
    Hungry children do not learn.
        With threats to our national security and increasing
    economic competition, it is imperative that our nation's youth
    are physically fit for military service and are not
    malnourished at key times in brain development.
        Furthermore, the original two-fold intent of the program
    still holds true today. First, the programs provide a safety
    net for our most vulnerable populations, mainly children, that
    are at times without sufficient food.
        Second, the law requires a portion of the assistance for
    the school meal programs to be in the form of agriculture
    commodities produced here in America by our nation's farmers,
    ranchers, and growers.
        As we begin the reauthorization process, it is important to
    remember the purpose of these programs. These programs are not
    about anyone's legacy. They are about ensuring our nation's
    security, ensuring that our children are well educated and
    productive contributors to a competitive economy, and about
    helping the vulnerable among us who cannot help themselves.
        I plan to conduct this reauthorization, with full
    cooperation with our distinguished Ranking Member, in the same
    way in which I am seeking to conduct all of our business here
    at the Agriculture Committee. First, with the perspective of
    our constituents in mind. We are here for farmers, ranchers
    small businesses, rural communities, and program participants
    and stakeholders. We are here to write their interests and
    their will into law, not to impose the government's will and
    interest on them.
        Second, this reauthorization will include rigorous and
    thorough oversight of these programs. Periodic expiration and
    reauthorization of legislation provides Congress with the
    opportunity to review and evaluate programs, and this
    opportunity should not be taken for granted. It is our
    responsibility to closely examine each program. Not every
    program needs a major overhaul, but every Federal program can
    benefit from increased efficiency, improved integrity, and
    reduction of waste.
        Our committee will conduct this reauthorization in an open
    and transparent manner that gives members an opportunity to
    pass good legislation for their constituents. I would like for
    this to be a bipartisan bill, and I am pleased that Senator
    Stabenow feels the same way. With the entire committee working
    together, we can develop a well-rounded bill that will improve
    the operation of these important programs.
        It is also my intention to complete this reauthorization on
    time, before the programs expire at the end of September. I
    understand there are some that may prefer that we not succeed
    in this endeavor. I caution those individuals that these
    programs are too important not to reauthorize. Gambling,
    fortune telling, or using a crystal ball to predict a better
    reauthorization in the future is foolish and short-sighted. It
    is time for folks to come together and be part of crafting
    legislation, not to stand outside the process hoping it fails.
        We have been in a listening mode in preparation for this
    reauthorization and that culminates in today's hearing. I have
    traveled throughout Kansas, visiting school food directors,
    talking with parents, students, school administrators, and
    others involved in these programs. We have had hearings last
    year and we have our experts here today. As we seek to put what
    we have learned into legislative form, several priorities have
    become clear.
        First, reauthorization provides an opportunity to review
    programs and improve their efficiency and effectiveness. In the
    school meal programs, there are significant error rates and
    improper payment levels. These have recently been highlighted
    in reports from the Department of Agriculture's Office of
    Inspector General and the Government Accountability Office. We
    will need to improve the administration of these programs to
    reduce errors, but do so in a way that does not layer
    additional Federal bureaucracy and overreach on those who are
    seeking to feed hungry schoolchildren.
        Second, it is evident that evolving programs encounter
    different challenges as they try to adapt to changing times.
    Each new challenge is met with additional modifications,
    guidance, or regulation, and these can unintentionally evolve
    into very complicated systems that are often outdated or
    needlessly cumbersome. We need to identify areas in which we
    can simplify, make things easier for those implementing and
    participating in the programs.
        Third, my travels in Kansas, and I am sure that this
    opinion is shared by many on this committee, have also
    indicated that we need some flexibility. Many folks are worried
    about what flexibility means. But to me, flexibility means we
    will still protect the tremendous gains already achieved by
    many and provide assistance to others so they, too, may achieve
    success. These programs cannot help anyone if they are not
    workable.
        The Department of Agriculture and others have worked very
    hard to help those who are not meeting the current standards
    and have promoted statistics citing high rates of compliance.
    Yet, we have schools that are currently struggling. I
    understand that at least 46 States applied for the recent whole
    grain waiver, and we have additional sodium restrictions that
    are still on the way. Lines in the sand and uncompromising
    positions will benefit nobody, and especially not the hungry
    children that these programs serve. Working together, I am
    confident we can find a way to preserve the nutritional quality
    of school meals without a one-size-fits-all approach that
    prevents some local flexibility.
        These programs have historically had strong bipartisan
    support. In 2004 and 2010, child nutrition reauthorizations
    passed the Senate by unanimous consent. But, debate leading up
    to those bills also included significant controversy similar to
    the issues we face today. Yet, Republicans and Democrats worked
    through the process together and came up with legislation that
    everybody could support.
        Finally, it is vital that this legislation does not contain
    additional spending without an offset. That is just where we
    are. We have received many bipartisan suggestions for ways to
    improve these programs, but many of those have considerable
    price tags. Our budgetary constraints are real. Our
    responsibility to our constituents includes not spending money
    that we do not have.
        I look forward to working with Senator Stabenow and each
    member of the committee throughout this reauthorization
    process.
        I am also appreciative of the witnesses here today. A
    special thanks to Ms. Cindy Jones, who has been our shotgun
    rider, if that is the proper term, and who has traveled from
    Olathe, Kansas, to be on our second panel. I look forward to
    hearing from our witnesses regarding their experiences with
    these programs and I thank them so much for their testimony
    before the committee and taking their valuable time to come
    here.
        I now turn to my colleague, the Chairperson Emeritus of the
    committee, Senator Stabenow, for any opening remarks she may
    have.

    STATEMENT OF HON. DEBBIE STABENOW, U.S. SENATOR FROM THE STATE
                              OF MICHIGAN

        Senator Stabenow. Well, thank you very much, Mr. Chairman,
    and I look forward to working with you on this important issue.
        We have been talking and looking for ways that we can move
    forward together and I look forward to working with you on
    this, as well as the entire committee, as we continue the work
    we began last year to strengthen child nutrition programs.
        I want to thank the witnesses, as well, for testifying
    today. You bring very important perspectives from all sides of
    the issue. There are a lot of important pieces to this
    legislation and it is important we hear from you and work
    together to move forward.
        As we all know, our children's health and well-being really
    are at a crossroads. Obesity rates in children have tripled in
    the last 30 years. Today, one in three American children and
    teens are overweight or obese. We are now seeing health
    problems typically unseen until adulthood--high blood pressure
    to type 2 diabetes--that are in young people who should be
    focused on Little League or going to the prom. This obesity
    epidemic requires a serious commitment on our part to continue
    moving forward with the nutrition policies we put in place five
    years ago in order to give our children a fair shot to be
    healthy and successful.
        Last year, this committee heard from retired military
    leaders desperate to help improve the health conditions of our
    soldiers and young recruits, and as the Chairman said, the
    School Lunch Program actually started as a result of our
    military leaders and the Department of Defense. In his
    testimony, retired four-star Air Force General Richard Hawley
    said that obesity is one of three main reasons why an estimated
    70 percent of all young people who walk through the recruiters'
    door at the age of 17 through 24, one of three reasons why they
    do not qualify for military service, and they indicated that
    was the largest reason.
        Their concerns are echoed by more than 450 retired generals
    and admirals who are trying to raise awareness about the impact
    that poor childhood nutrition has on our national security and
    its cost to taxpayers. This recruitment crisis also requires us
    to continue moving forward with the nutrition policies we have
    put in place five years ago.
        In addition to childhood obesity issues, we also have the
    second challenge of childhood hunger. As we approach the end of
    the school year, more than 20 million young people--20 million
    students who eat at school because they qualify for free and
    reduced price meals--will struggle to eat any meal, let alone a
    healthy meal, in the summer. This hunger crisis for our
    children requires us, as well, to continue moving forward to
    strengthen our Summer Meals Programs and other supports for
    children.
        We also have millions of pregnant moms and children in our
    communities who are nutritionally at risk, which can lead to
    low birth weights, increased childhood disease, and impaired
    brain damage. That is why continuing to protect and strengthen
    the WIC program is so important.
        It is for all of these reasons and many, many more that we
    meet today, and it is the reason we must take this process of
    reauthorizing our child nutrition programs seriously, and I
    appreciate that the Chairman does.
        The good news is, for the first time in years, it looks as
    though we are beginning to make some progress on these issues.
    Obesity rates have begun to stabilize in some areas. More
    children are eating healthy breakfasts and lunches than ever
    before. Children are eating 16 percent more vegetables, 23
    percent more fruits, according to the Harvard School of Public
    Health.
        I have said many, many times, it seems to me that our
    children are worth continuing the requirement of school meals
    for a half-a-cup--that is not very big, there is not a whole
    lot that goes in this, actually--a half-a-cup of fruit or
    vegetable as part of our commitment--it is not the whole
    commitment, but a very important part of our commitment--to our
    children's health and success.
        But, we know there is much more to do. Nutrition at its
    core is preventative medicine, and child nutrition is about
    leveling the playing field so that any baby, any child, any
    teen, whether they are in Detroit or rural Kansas or a suburb
    of Atlanta or a farm in Iowa, has every opportunity to be
    healthy and successful.
        That is why it is crucial that this committee work together
    in a bipartisan way to ensure these nutrition programs continue
    to operate efficiently and effectively and that we continue to
    move forward for our children. Our children and our families
    are counting on us to do just that.
        Thank you, Mr. Chairman.
        Chairman Roberts. Thank you, Senator Stabenow, for an
    excellent statement.
        All members should be advised we have a vote at 10:30.
    Well, let us just change that. The vote has been postponed
    until 2:00 this afternoon.
        Senator Stabenow. Oh, there you go.
        Chairman Roberts. So we can finish.
        Senator Stabenow. Magic. You have such power, Mr. Chairman.
        [Laughter.]
        Chairman Roberts. It is just amazing what you can do with a
    new Congress, Senator.
        [Laughter.]
        Chairman Roberts. Sorry about that.
        Senator Stabenow. I object.
        [Laughter.]
        Chairman Roberts. Let the record show an objection was
    heard.
        [Laughter.]
        Chairman Roberts. Let me introduce our first panel. Stephen
    M. Lord, Managing Director, Government Accountability Office,
    Forensic Audits and Investigative Service. Mr. Lord currently
    serves as the Managing Director of the Forensic Audits and
    Investigative Service at the GAO. He oversees a highly trained
    staff charged with conducting special audits and investigations
    on major Federal programs prone to fraud, waste, and abuse. Mr.
    Lord has received many awards over his 30-year career,
    including awards for Meritorious and Distinguished GAO Service.
        Mr. Lord, welcome, and I look forward to your testimony.
    Please go ahead, and then I will introduce Ms. Neuberger for
    her statement.

       STATEMENT OF STEPHEN M. LORD, MANAGING DIRECTOR, FORENSIC
           AUDITS AND INVESTIGATIVE SERVICE, U.S. GOVERNMENT
                 ACCOUNTABILITY OFFICE, WASHINGTON, DC

        Mr. Lord. Thank you, Chairman Roberts, Ranking Member
    Stabenow, members of the committee. Thanks for inviting me here
    today to discuss the findings and recommendations of our 2014
    report on the School Meals Program.
        As you know and as you mentioned in your opening remarks,
    the School Lunch and Breakfast Programs play a very important
    role in providing for the nutritional needs of schoolchildren
    across the nation. At the same time, the National School Lunch
    Program is on OMB's list of high error prone programs due to
    its large estimated improper payments rate, and this
    underscores the need to me to ensure sound controls are in
    place to ensure that $15 billion in Federal funds are spent
    wisely.
        Today, I would like to discuss two things, first, some
    positive actions USDA has taken to strengthen oversight of the
    program, as well as additional opportunities that GAO has
    identified to enhance controls.
        First, in terms of USDA actions, the Department has worked
    closely with Congress to develop legislation that requires
    school districts to directly certify students in the SNAP
    Program, and according to USDA officials, direct certification
    of these students reduces the administrative burden on school
    districts. It also reduces certification errors and helps
    without adversely impacting access to the program.
        Another positive development is State agencies now conduct
    administrative reviews of school districts every three years as
    opposed to every five years, as it was done formerly. We think
    that is a really important part of the oversight process and
    the effort to help ensure correct eligibility determinations.
        Despite these positive actions, we did identify some
    additional areas where they could enhance verification without
    compromising legitimate access to the program.
        First, we believe the school district reviews of
    questionable applications could be strengthened. Of the 25
    school districts we examined, 11 did conduct these so-called
    ``for cause'' verifications, but unfortunately, nine school
    districts did not conduct any ``for cause'' verifications of
    questionable applications, and the remaining five districts
    said they would do it on an occasional basis when prompted to
    do so by outside stakeholders. That is why we recommended that
    USDA study this ``for cause'' verification process, figure out
    why the school districts were reluctant to do it, and consider
    issuing additional guidance, if needed.
        We also recommended that USDA consider using computer
    matching to help identify households whose income exceeded
    eligibility thresholds. Under the current standard verification
    process, it is difficult to detect all households that
    misreport income because the so-called standard verification
    process is focused on a small slice of beneficiaries, those
    with annual income within $1,200 of the eligibility threshold.
        For example, in our work, we found that nine of 19
    household applications were not eligible for free or reduced
    benefits, yet only two of these households would have been
    subject to the standard verification process because of the way
    they defined error prone applications. Thus, we think verifying
    a broader window of applications as well as using computer
    matching techniques, could potentially significantly strengthen
    the verification process, and again, without adversely
    impacting access to the program by those truly in need.
        Finally, our report also recommended that USDA explore
    expanding the verification process to include those who are
    deemed categorically eligible for the program by virtue of
    their participation in other public assistance programs, such
    as SNAP, TANF, et cetera. We found that those applications are
    generally not subject to verification as highlighted by a few
    examples in our report.
        We found one household that was certified through this
    process because they stipulated they had a foster child. Yet,
    when we interviewed the household occupants, we found they did
    not have any foster children. Another applicant reported they
    were enrolled in SNAP, therefore, they were automatically
    eligible. Yet, when we contacted the State officials, they said
    this individual was not enrolled in the SNAP program. So, we
    found some examples--again, these examples are not
    generalizable to the entire population, but we found enough
    examples to suggest that USDA needed to take another look at
    that.
        So, the good news is, USDA agreed with all our report
    recommendations and we think the collective impact of all the
    recommendations, when implemented, will help strengthen the
    verification and oversight process to, again, to ensure only
    those truly deserving of the benefits receive them.
        Chairman Roberts, other members of the committee, this
    concludes my prepared remarks and I look forward to any
    questions you may have.
        [The prepared statement of Mr. Lord can be found on page 69
    in the appendix.]
        Chairman Roberts. Mr. Lord, thank you very kindly.
        Our second witness is Ms. Zoe Neuberger. Ms. Neuberger
    joins us today from the Center on Budget and Policy Priorities,
    where she is a Senior Policy Analyst. She works on the school
    meal programs and WIC and has been with the Center since 2001.
    Obviously, she is a veteran and knows what she is talking
    about. I did not mean to insinuate you did not, prior to 2001.
        [Laughter.]
        Chairman Roberts. Previously, she was a Budget Analyst for
    these programs at the Office of Management and Budget.
        Welcome, madam, and I look forward to your testimony and
    your insight.

     STATEMENT OF ZOE NEUBERGER, SENIOR POLICY ANALYST, CENTER ON
              BUDGET AND POLICY PRIORITIES, WASHINGTON, DC

        Ms. Neuberger. Thank you very much for the invitation to
    testify today on improving accuracy in the school meal
    programs. As you said, I am a Senior Policy Analyst at the
    Center on Budget and Policy Priorities, a nonprofit policy
    institute that conducts research and analysis on budget and tax
    policy as well as poverty and social programs.
        Out of our roughly 50 million schoolchildren, about 30
    million eat a school lunch on a typical school day. That is
    extraordinary reach, and that figure includes more than 21
    million low-income children for whom school meals may be the
    healthiest and most reliable meals they get.
        There are also nearly 100,000 schools that operate the meal
    programs and they do a remarkable job. They process
    applications, provide healthy meals, and keep track of the
    eligibility of each student so they can claim the appropriate
    Federal reimbursement. Their work means that we have fewer
    hungry children and that our students are better prepared to
    learn.
        As you can see, the school meal programs play a vital role
    in children's health and well being. They must continue to play
    this role while also administering the programs accurately. The
    Department of Agriculture just estimated that the net annual
    cost of lunches that did not meet the nutrition standards was
    $444 million. That is not acceptable. The programs must make
    sure that Federal funds are used for meals that meet Federal
    criteria.
        Fortunately, we have some powerful tools to address the
    issues. There is a verification process already in place. There
    is a new rigorous review process. USDA has instituted new
    oversight measures. USDA just completed a detailed nationally
    representative study that not only measures errors and their
    costs, but also identifies a great deal of information about
    the causes of errors, which allows for specific and effective
    policy solutions.
        But, there are also challenges to improving accuracy in a
    vast and complex system whose main focus is to educate
    children, not administer the meal programs. As I mentioned, the
    school meal programs operate in nearly 100,000 schools
    nationwide and there is wide variation among them. Their
    staffing, resources, and technological capacity vary widely.
    There is also a lot of variation in the way children get meals
    in the lunchroom or the classroom and how the school checks who
    is in which category and counts the meals.
        Small rural schools have very different operational and
    administrative capacity than large districts that serve
    hundreds of thousands of students. Meal tracking and accounting
    systems can range from paper systems to state-of-the-art
    software.
        Schools are not currently set up to do the kind of
    eligibility determinations that other public benefit programs
    do. The SNAP Program or Medicaid, for example, have teams of
    professional eligibility workers who spend all day, every day,
    sorting out the details of applicants' income and household
    circumstances. In schools, there might be a cafeteria worker or
    secretary who handles meal applications for a few weeks at the
    start of the year.
        So, the question is, given the tools at the program's
    disposal and the system we are dealing with, how can Congress
    improve accuracy in the meal programs?
        An example can help show the way. Beginning with the 2004
    reauthorization and building on that in 2010, Congress set a
    clear expectation for school districts and States to improve
    their use of the rigorous eligibility determinations made by
    other programs, primarily SNAP, to approve children for free
    meals automatically. That is the direct certification process.
    Because the school meal programs are relying on a more rigorous
    income assessment, this approach saves time and reduces errors.
        In the past decade, there have been striking improvements.
    Nearly half of all children approved for free or reduced-price
    meals are now approved without having to complete an
    application. That is an enormous simplification and Congress
    played an important role by setting an expectation and then
    providing tools and support to meet it.
        My written testimony describes many other tailored steps
    Congress and USDA have taken to strengthen the meal programs,
    but there is certainly room to do more. It is important to
    strengthen management and oversight across the board, provide
    more extensive help to districts that persistently struggle
    with errors, and pursue innovations that could open up new ways
    to improve accuracy.
        For example, GAO recommended exploring the use of data
    matching to identify applications that might have incorrect
    information. That is worth trying. USDA plans to develop a
    model electronic application for the first time. That is
    another promising innovation.
        As you consider ways to improve accuracy in the school meal
    programs, I urge you to consider these four questions. First,
    does the proposal have a proven record of reducing errors? Some
    ideas that sound promising, like requiring households to submit
    pay stubs with their application, have not actually been
    effective when tested.
        Second, will it maintain program access for the most
    vulnerable children? Nearly 16 million children live in a
    household experiencing food insecurity. We certainly do not
    want to worsen that problem.
        Third, is it administratively feasible? Adopting a more
    time consuming documentation or verification system might
    prevent some errors, but it could cause others by adding a step
    to the process and would force school staff to spend much more
    time determining school meal eligibility at the expense of
    other educational priorities.
        Fourth, is it cost effective? High-quality information
    management systems can be very effective, but might cost too
    much for a small school district.
        As I noted, it is critical that error reduction strategies
    not reduce access to school meals for children who need them.
    The best way to improve integrity in the school meal programs
    is not through punitive policies, but instead to continue
    sending a clear message to school nutrition officials that
    program accuracy is important, that it will be measured, and
    that Federal officials will support them in implementing needed
    improvements.
        Thank you very much.
        [The prepared statement of Ms. Neuberger can be found on
    page 84 in the appendix.]
        Chairman Roberts. Thank you very much.
        Mr. Lord, do you think that a shift from the current
    verification process that emphasizes ``for cause'' verification
    would enhance the program integrity, and secondly, would it
    have a negative effect on access for eligible participants?
        Mr. Lord. No. I think, again, Senator, there is a way to do
    it without adversely impacting people who truly deserve it, and
    what we found in our work is the ``for cause''--again, that is
    the review of questionable applications--some school districts
    were not doing any ``for cause'' verifications of questionable
    applications. So, there is definitely potential there to do
    that more consistently across school districts.
        I should add, that is a USDA requirement. School districts
    are required to conduct these type of reviews, so any time we
    see that type of inconsistency, that gives us some concern.
        Chairman Roberts. Ms. Neuberger, I would like to know more
    about the point of service, when the child and the cafeteria
    worker interact and determine how the meal will be paid. You
    have cited this in your statement as a step at which many
    errors occur. Can you walk us through what happens exactly at
    the point of service? I am not an expert, but Cindy Jones is,
    and there seem to be a number of points of error. If you could
    clarify that point of contact for me, please, it would be
    helpful.
        Ms. Neuberger. Absolutely, and it sounds like you have had
    a chance to visit school meal programs, which is great. I hope
    that if the rest of you have not had an opportunity, that you
    will find one soon, because there is nothing like seeing it
    firsthand.
        Chairman Roberts. Well, you can lose a little weight there,
    too.
        [Laughter.]
        Ms. Neuberger. But, let me describe a typical scenario.
    There is a lot of variation, but you might have a cafeteria
    with a 30-minute lunch period, dozens if not hundreds of
    students coming through a line. Sometimes there is choice about
    what they take, not always. When they have their meal on their
    tray, they go to a cashier at the end of the line. That cashier
    needs to check the meal to make sure it is meeting nutrition
    standards and figure out who the child is to make sure that
    meal is marked down in the right meal category, free, reduced-
    price, or paid.
        Now, that is a process that has to happen very, very
    quickly when you have lots of students waiting in line and it
    is only when they get through that process that they finally
    get to eat. So, this is not a sophisticated interaction. We are
    talking about, maybe a seven-or eight-year-old and a cashier
    and it has to happen really fast, and that does create
    opportunities for errors.
        There are also more innovative models that are being tried
    now that can make it easier for kids to get meals. So, for
    example, for older students, there might be a cart in the
    hallway where you can pick up a breakfast and take it with you
    to class. That makes it much easier for students to eat. It
    also reduces errors related to what is in the meal because they
    are taking a prepackaged meal. But, that is a very fast
    transaction where you have to have a process for knowing who is
    taking the meal and keeping track of that.
        Meals are sometimes served in the classroom. Again, the
    process is decentralized and that means there are sometimes
    opportunities for error and you need to react accordingly.
        Chairman Roberts. Well, thank you for that explanation.
        A question for you both. Is electronic data matching the
    method of additional verification that would be least
    burdensome to school food service providers. Which of the other
    methods of improving program integrity that you recommend will
    cause the least additional burden?
        Mr. Lord. Do you want to go first?
        Ms. Neuberger. Sure. I will go ahead. So, data matching is
    used now at two different steps in the process, first, at the
    certification, which is the approval point, where you can use
    data from SNAP anywhere in the country and certain States are
    allowed to use Medicaid data to automatically enroll kids. The
    application process has been a source of error, and so the
    fewer families have to go through that process, the more that
    can be automatically enrolled, the more you reduce
    opportunities for error.
        The program has been moving in that direction. Over the
    last five years or so, many more students are directly
    certified. As a result, even though there are more children in
    the free or reduced price category now than there were because
    of the recession, schools have to process applications for two-
    and-a-half million fewer children. So, that is much less
    paperwork for schools. That is a great step forward.
        The other place where data can be used is at the
    verification stage. That is checking applications. That is
    where I think there is room to look at more data sources, as
    GAO recommended.
        I would caution against just expanding the number of kids
    that get verified because many families do not respond to that
    request, and if they do not, they lose benefits whether or not
    they are eligible. But, data could be a very good way of
    pinpointing applications----
        Chairman Roberts. I am a little worried about the privacy
    issue.
        Ms. Neuberger. Yes.
        Chairman Roberts. Well, I am more than a little worried,
    but at any rate, let me just say that I have a concern about
    holding States accountable to a different standard. We received
    a report from the Inspector General of the Food and Nutrition
    Service indicating, and I think my figures are accurate here
    errors of $1.9 billion in school lunch, errors of $770 million
    in school breakfast. We are not the Pentagon, or, for that
    matter, any other agency, but that is a considerable amount of
    money. I do not know if either one of you have had access to
    that information or if you would like to make a comment on
    that, but it is a concern of the committee.
        Mr. Lord. I agree with you, Mr. Chairman. The improper
    payments rate overall for the programs is about 15.25 percent.
    The good news is it has declined slightly from last year,
    assuming, the data is reliable. At the same time, close to a
    billion dollars of the improper payments were in the
    certification area----
        Chairman Roberts. Let me just----
        Mr. Lord. --errors, so----
        Chairman Roberts. I apologize for interrupting----
        Mr. Lord. Sure.
        Chairman Roberts. --but I am already over time and we have
    gone on a considerable amount of time. We have a lot of people
    waiting. But, basically, we have very large errors--$1.9
    billion in school lunch, $770 million in school breakfast. It
    is my understanding that States are asked to audit every three
    years, but this last report, or the last report that we could
    come up with, was based on data from clear back in 2005. That
    has been ten years. So, I think we are holding the FNS and the
    Federal component of this, which, of course, is now playing a
    much stronger role, to a different standard than that of the
    States, and that is of concern to me. Why ten years?
        Ms. Neuberger. So, the reviews of districts do happen now
    every three years. The kind of report that you are talking
    about----
        Chairman Roberts. Right.
        Ms. Neuberger. --is the nationally representative study
    that USDA does. It is a very in-depth report where they go out
    and interview households, they stand in cafeterias and watch
    what is on the tray to make sure there is accuracy. That kind
    of report is very important. It also is relatively costly and
    takes a long time to do. But, it provides the kind of
    information that can be very helpful to developing proposals
    for how to improve errors because you really get to the bottom
    of what is causing errors and what kind of errors are most
    prevalent and that allows you to design tailored solutions.
        Chairman Roberts. Senator Stabenow.
        Senator Stabenow. Well, thank you very much, Mr. Chairman.
        In this area, we juggle, of course, the desire and the need
    to make sure that we are accurate, that children who need and
    qualify for lunches and breakfasts are getting it as opposed to
    those who should not be. On the other hand, we have situations
    where we do not want to add additional costs to the local
    schools who are juggling between administrative costs and
    actually providing quality meals, and so we have a number of
    issues to juggle.
        I know in the last bill that we did, having community
    eligibility put into place has made a huge difference in
    Michigan in schools being able to be more efficient and have
    more dollars going actually to feeding hungry children.
        But, Mr. Lord, first, it sounds like you were saying that
    the USDA has accepted your recommendations and are moving
    forward to make changes, is that my understanding?
        Mr. Lord. Yes, absolutely. They agreed with all of our
    report recommendations and recently provided an update of steps
    they are taking to implement them, which is, frankly, good news
    for the program.
        Senator Stabenow. That is great. That is wonderful.
        When we talk about program integrity measures, which are
    very important, they can have unintended consequences of
    removing children who actually should be getting food. Could
    you give us some examples when this happens and what approaches
    we can take to actually improve improper payments at the same
    time protecting access for children? What is the best way to do
    that?
        Mr. Lord. Well, as we highlighted in our report, we think
    you can attack this from various angles. Obviously, the
    verification process, we think, could be strengthened. Again,
    you can do it in a way it is not going to adversely impact
    children truly in need. I get the sense the school districts
    are reluctant to do this, though, because of the lack of
    training, expertise, fear----
        Senator Stabenow. Is it extra cost for them and the kinds
    of things that you are talking about?
        Mr. Lord. I believe it would impose some additional cost,
    but in the end, the net result would be, though, you are
    potentially freeing up some additional funds you could devote
    to the program, to those who are truly deserving. So, from a
    cost-benefit standpoint, I think it would be effective, but
    that is USDA's call. They would have to do more additional
    studies on that.
        Senator Stabenow. I think that is always the juggling.
        Ms. Neuberger, talking about the verification steps and the
    additional administrative costs and how we balance that,
    obviously, we want integrity in these programs and we want
    every penny to go to children who need it, but even automated
    tools can be cost prohibitive for some schools that are on
    tight budgets. Do you believe additional investments in error
    reduction could come at the expense of improving meals, and
    when you look at the per meal reimbursement, what funding do
    they get to cover administrative costs associated with meal
    programs versus investments in technology, because I think we
    really need to understand this so that we can do this right.
        Ms. Neuberger. That is a really important question. At the
    school district level, schools get a per meal reimbursement.
    That is for free meals, just about $3 right now, and that has
    to cover all the costs associated with running the program. So,
    it is buying the food, it is the staff to serve it and prepare
    the food, and it is all of the administrative processes. There
    is not a separate funding stream to cover buying a software
    system or putting more staff in place to do these kinds of
    checks. So, it is really important to balance the goals here,
    because if too much of those funds have to go toward
    administrative processes, they are not available for food.
        At the Federal level, there have been grants to States to
    improve their technology systems and those seem to have been
    contributing to a reduction in that kind of error. So, that has
    been a great investment that is paying off.
        Senator Stabenow. The Chairman and I have been talking
    about the fact that particularly for very small schools--I went
    to school in one of those in Northern Michigan--it can become
    particularly difficult, and so we are interested in working
    with you on recommendations as it relates to very small
    schools, as well.
        Chairman Roberts. Yes. Would the Senator yield on that
    point?
        Senator Stabenow. Yes, I would be happy to.
        Chairman Roberts. I have not visited enough schools yet,
    but we are getting there, and there is a tremendous difference
    in the school that Cindy represents and other schools that are
    doing this. They are doing a pretty darn good job. Then you go
    to rural and small town America, and, I mean, real rural and
    small town America. They simply cannot keep pace with the
    regulations, the paperwork, et cetera, et cetera. Training, as
    Mr. Lord says, obviously would certainly help out. They are
    doing the best they can. So, this is not a one-size-fits-all. I
    know that is obvious to everybody here, but I wanted to
    underscore what Senator Stabenow has said. I mean, we have got
    some real challenges out there. Thank you.
        Senator Stabenow. I am going to reclaim my time and take
    one more question--ask one more question, and, Ms. Neuberger,
    for you, as well. We know that simple errors on applications--
    and this goes to how we--the bureaucracy and how we do all of
    this for families. It is not only the school, but we need to
    care from the families' end of things in terms of what we are
    adding in bureaucracy. Simple errors on applications are often
    the cause of improper payments. So, it is not just intentional
    lack of reporting. If somebody makes a mistake----
        Ms. Neuberger. That is right.
        Senator Stabenow. --they do not fill in a box, they do
    something that is simple but it creates that error that Mr.
    Lord is talking about. In some cases, errors result in children
    ending up having to pay for meals or they may not be paying for
    meals because of some simple error.
        So, to help make the system more efficient and ensure all
    children receive meals, what are, again, some of the ways
    applications can be improved, the actual application? I know
    that direct certification has been very successful. How can we
    better utilize the data matching to reduce errors so that we,
    again, from the families' end, are not penalizing a child
    because somebody did not check a box?
        Ms. Neuberger. That is a great question. So, the first step
    is to make sure you are relying on data from other programs as
    often as possible, so as few children as possible go through
    the application process. That improves accuracy right there.
        But, then, there will always be children who are going
    through the application process and so you need to have it be a
    simple, understandable form. The process cannot be like other
    programs where you are sitting in an office with a professional
    eligibility worker who can provide a lot of information and ask
    a lot of follow-up questions. Typically, the application goes
    home, families fill it out on their own without assistance, and
    they may not know that you need to multiply weekly income by
    4.3 to get your monthly income. They may not know who they are
    supposed to list in the household.
        It is very clear that people have trouble understanding the
    application, and one indicator of that is that in USDA's study,
    they found that out of the children who did not get meals that
    they actually legitimately were eligible for, three-quarters of
    the time, that was because the family had understated their
    income on the application. So, these are families that bothered
    to apply, they qualified for the meals, but they did not get
    them because they misunderstood what was expected.
        USDA has just issued a brand new revamped application that
    is much simpler than the old version and should be helpful in
    terms of eliciting correct information, and they are just
    embarking on developing an electronic application, which is,
    again, very promising for making it easier for families and
    schools to get the right information.
        Senator Stabenow. Thank you.
        Thank you, Mr. Chairman.
        Chairman Roberts. Senator Boozman.
        Senator Boozman. Thank you, Mr. Chairman.
        I guess the question I would have would be, do we have
    districts that--Mr. Lord, do we have districts that you have
    knowledge of that are doing a much better job than the average
    in regard to the problem? Are there districts that we can learn
    from that we can then take their knowledge and push to other
    districts?
        Mr. Lord. Sure. I am sure there are, Senator, but
    unfortunately, our scope was confined to the 25 school
    districts we examined in detail. There are thousands of school
    districts across the nation. We did not have the time or
    resources to visit all of those, but we did get some important
    insights just from visiting the few we did examine in great
    detail.
        Senator Boozman. Very good.
        Ms. Neuberger. If I can add to that, with regard to direct
    certification, the use of data from other programs, USDA does
    rank State performance. There are States that are doing a
    fabulous job. West Virginia and Kansas are example of those,
    and you will have people on the next panel who can speak to
    that. Michigan is another great example where they have taken
    advantage of resources and made continuous improvements and got
    a performance bonus and are now directly certifying one hundred
    percent of the kids who they should be. So, there are great
    examples at the State and district level and USDA is working on
    sharing those best practices so that others can learn.
        Senator Boozman. Good. I would like to just also
    acknowledge the importance of simplifying the application
    processes. I was on the school board for seven years, and the
    paperwork on these type of things, our poor special ed teachers
    that work so hard, the paperwork that they endure, and the list
    goes on and on. Again, I would just like to throw my two cents
    in that is something that, that does not cost any money. That
    ultimately saves a lot of money. There is just something about
    government--and I am part of government--that we just add to
    that burden, whether it is the IRS or this or anything else.
    So, again, I think that is very, very important, and hopefully,
    we can work to remedy that.
        Thank you, Mr. Chairman.
        Chairman Roberts. Thank you, Senator.
        Senator Gillibrand.
        Senator Gillibrand. Thank you, Mr. Chairman, thank you,
    Ranking Member Stabenow, for holding this hearing. This is an
    issue that I care deeply about. I brought apples today, so this
    is the half-cup of apples that I am really hoping we can get in
    every school lunch program across New York. Lots of States have
    lots of great produce, but this is a half-cup, so for parents
    in the room, we know this is not a lot of--you brought your
    half-cup. I am going to put these in the anteroom. Staff can
    have them. I had a pack. They are really good.
        So, since we are talking about this issue of school meals,
    the one issue that I want this committee to remember, because I
    think it is so important, that we should not cut the standards.
    The Chairman said that 40--what did he say, 46 States applied
    for whole grain waivers. Those are just individual schools
    within 46 States, but 90 percent of schools are complying. So,
    we are actually doing quite well in meeting the nutrition
    standards that we set aside in the last bipartisan bill on this
    topic.
        So, I really want to make sure we do not cut the
    requirements, specifically for the half-cup of fruits and
    vegetables, because as Senator Stabenow mentioned about
    obesity, if one in three kids are obese in this country, what
    are we doing? I mean, we need to make sure these kids
    understand they should be eating fruits and vegetables daily,
    that they are a really important part of how they grow, how
    they learn, how they are healthy. The rate of obese adults in
    this country is, again--and your statement about our military
    and having access to the men and women they need to be fit is a
    real concern.
        So, I think it is important for us to look at the dynamics
    of the fruits and vegetables requirement. If we are cutting the
    standards for school meals, I think the kids get the biggest
    hit. Who suffers most financially? Who loses the most business?
    It is actually farmers, and I want to talk about the farmers in
    my State and the farmers in other States on this committee.
        So, in Kansas, they produce honeydew melons, which I know
    my kids love, and that is a great school snack, to have access
    to real melons. In Mississippi, blueberries--kids love
    blueberries. Kentucky, blackberries. Arkansas, edamame, one of
    the most easy, fun vegetables for kids to eat. They love
    edamame. Sweet potatoes--we prefer them fried, but, yes, they
    are very good, too. Cherry farmers in Nebraska, fields greens
    in North Dakota, watermelon in South Dakota, peach growers in
    Georgia, and apple growers in New York. All of those farmers
    across the States represented by this committee would really be
    harmed if we reduced the standards for that half-cup.
        If we cut fruits and vegetables from our school meals, not
    only do the farmers suffer, but I really believe the kids
    suffer. My children benefit so much from having access to fresh
    fruits and vegetables every day, in every meal, and they love
    them as a consequence. They know how good it is to eat fresh
    fruits and vegetables during their meals.
        So, I am hoping that as we debate these issues going
    forward, we can focus specifically on how we keep these
    standards.
        Now, I know both of you are testifying specifically about
    how we can affect and change errors, so I want to talk
    specifically about that for a question. Ms. Neuberger, in your
    testimony, you mentioned that counting and claiming errors
    often result from busy lunchrooms where students have little
    time to select, pay for, and eat their meals. Many of these
    operational errors occur at point of sale. Should we consider
    making more resources available for point of sale systems to
    reduce errors and improve program integrity?
        Ms. Neuberger. Thank you. Certainly, automated systems can
    make the process much easier. They do take an up-front
    investment and so you need to balance the costs involved with
    the simplifications and the error reduction. But, places that
    are using them generally report that they do simplify the
    process tremendously for students and for the school nutrition
    staff, who clearly have a lot of things that they are juggling
    in the lunchroom. And making that process simpler and more
    accurate is a great way to go.
        Senator Gillibrand. You mentioned a bit about the community
    eligibility and that we need to eliminate the need for meal
    applications completely and eliminate much of the potential
    error. What can we do to lower the barriers to CEP
    participation by eligible districts and schools? What are your
    top recommendations to do that?
        Ms. Neuberger. So, it is actually a new option that is
    working very, very well right now. This is the first year that
    it is available nationwide. It builds on options that have been
    available for a long time, which are available to high poverty
    schools so that they do not have to go through the standard
    application process, where, essentially, they would be finding
    the few children who do not qualify for free or reduced price
    meals. In essence, the whole school qualifies to serve meals at
    no charge.
        With community eligibility, they do not take applications.
    They rely exclusively on data from other programs, so that
    reduces errors and opportunities for error. In USDA's report,
    they found, as expected, that there were fewer errors in those
    schools. So, the school districts are realizing what an
    advantage that can be, and what they see is, because they do
    not have to spend time on paperwork, the savings that they get
    on the administrative side can be reinvested in meal quality
    and in serving all students at no charge.
        Senator Gillibrand. Thank you, Mr. Chairman. Thank you.
        Chairman Roberts. Senator Casey.
        Senator Casey. Mr. Chairman, thank you very much, and I
    want to thank Ranking Member Stabenow for having this hearing,
    as well. You are both good to have us gather on these issues.
    We are grateful.
        I wanted to say, first, that we have two major concerns
    when we talk about these programs and about food insecurity.
    One, of course, we should start with the children. In
    Pennsylvania, we have not only a lot of children participating
    in both school lunch and school breakfast--in fiscal year 2014,
    over a million children in the School Lunch Program and a
    little more than 346,000 in the School Breakfast Program--but
    at the same time, we have almost a half-a-million children in
    poverty in our State. So, this is of great urgency and concern
    that we get this right.
        I have always been a believer that these programs, just
    like a number of other programs or strategies, can help us not
    only ensure that more children have a measure of food security
    and get the nutrition they need, but it can also help them
    learn, of course, and I have always believed that kids, if they
    learn more now, they are going to earn more later, and it is
    not just a rhyme, it is backed up by all the evidence.
        The second major concern we have, of course, is not only
    making sure these programs work for kids, but making sure they
    are administered in a way that is consistent with the
    expectations of taxpayers and use taxpayer dollars efficiently.
    So, I appreciate the fact that you are bringing to us not only
    kind of a diagnosis of where the problems are, but also
    remedies for improving both programs.
        Ms. Neuberger, I will get to you in a moment on kind of a
    broader question, but I want to ask you a specific question
    about the WIC Program, the Women, Infants, and Children
    Program. Your firm, the Center on Budget and Policy Priorities,
    just released a report with regard to new research linking
    prenatal and early childhood participation in WIC with improved
    cognitive development as well as academic achievement. So, kids
    whose moms are participating in the WIC Program while pregnant
    scored higher on assessment of medical development at age two
    than similar children whose mothers did not participate.
        So, in light of this link between a program like that, the
    WIC Program, and the cognitive development of the child, and my
    learn means earn connection, can you walk through some of the
    benefits of WIC and why we should focus on that, as well?
        Ms. Neuberger. Absolutely. WIC provides nutrition
    assistance for pregnant women and very young children and those
    are critical times for brain development, as we heard earlier.
    There is a large body of research that shows that WIC is
    successful in bringing participants very important
    improvements--improvements in health, improvements in their
    nutrition, eating healthier foods, improvements in
    breastfeeding rates, better connections to preventive care,
    higher immunization rates, and new findings on the link to
    cognitive development. So, that is a panoply of ways in which
    participating in the program can help low-income families and
    at this critical time, so that they get off to a better start.
        Senator Casey. I appreciate that, and I think it bears
    repeating.
        Speaking of things we should repeat, could you walk through
    the four questions again that you had in your testimony, in
    other words, questions we should consider when we are analyzing
    these programs. I think it is very important to have that
    guidance. I just want to have you repeat it, because around
    here, it helps to repeat things.
        [Laughter.]
        Ms. Neuberger. Okay. Absolutely. So, does the proposal have
    a proven track record of reducing errors, and that is where all
    the research on this subject can be very helpful.
        Will it maintain program access for the most vulnerable
    children? So, of course, when you are reducing error rates, you
    do not want to have the unintended consequence of making it
    harder for kids who qualify for the meals and need them to get
    them.
        Then, is it administratively feasible? So, that goes to,
    there is not a one-size-fits-all solution. You need to think
    about what works.
        Fourth, is it cost effective? So, will the error reduction
    be worth the cost involved in setting up the system and not
    make it such a cumbersome process that it is more difficult for
    schools to administer.
        Senator Casey. We may put those on a chart so we can have
    them in front of us.
        [Laughter.]
        Senator Casey. In the very limited time I have, Mr. Lord, I
    just want to ask you one question, and I may submit more to
    both of you for--written questions.
        On this question of direct certification, do you think that
    increasing participation in community eligibility and direct
    certification would help reduce improper payments?
        Mr. Lord. I believe it could, if applied properly. We
    looked at the direct certification for 23 households. We found
    errors in a couple, but in our discussions with USDA officials
    and as Ms. Neuberger pointed out, that would greatly relieve
    the administrative burden at the school district level and has
    potential for streamlining the entire process.
        You just want to make sure the initial certifications at
    the SNAP level and other program levels are being done
    correctly. But, it is--I should point out, the improper payment
    rate in the SNAP Program is much smaller than the improper
    payment rate in the School Lunch Program, so that suggests that
    is a good way to go, based on just that comparison alone.
        Senator Casey. Thank you.
        Mr. Chairman, thank you for the 45 extra seconds.
        Chairman Roberts. Any time the gentleman requests
    additional--well, not maybe any time.
        [Laughter.]
        Senator Casey. I am ready.
        Chairman Roberts. Thank you, Senator Casey.
        I want to thank the first panel. Thank you so much. The
    first panel is now concluded. I am sorry.
        Senator Stabenow. Is that because he is so far away?
        Chairman Roberts. Senator Thune, I apologize to you, sir.
        Senator Thune. Well, thank you, Mr. Chairman. I know that I
    am down here a long ways----
        [Laughter.]
        Senator Thune. --at the children's end of the table, so----
        Chairman Roberts. Well, a man has got to do what he has got
    to do.
        [Laughter.]
        Senator Thune. That is right.
        I appreciate you and Ranking Member Stabenow holding this
    hearing today, and as we do prepare to reauthorize the child
    nutrition legislation this coming year, we need to, I think,
    take an objective and bipartisan critical assessment of the
    programs and make sure that they are working in an efficient,
    effective, and accountable manner for the people that they are
    intended to help.
        I have serious concerns about the error rates in the
    National School Lunch and Breakfast Programs, which for the
    2013 and 2014 school year were 15.8 percent and 23.1 percent,
    respectively. Improper payments for these programs total almost
    $2.7 billion for the 2013-2014 school year, which is a
    staggering amount. Obviously, no one in this room wants any
    child to go hungry. We all know there are legitimate needs for
    food assistance. But, when we have programs with error rates
    that are $2.7 billion just for one school year, we simply have
    got to figure out how to put this money to better use.
        There is another area that I think needs attention of this
    committee and that is eligibility standards for these programs.
    Do the current standards result in child nutrition assistance
    being distributed wisely to the people who really need it the
    most?
        Just a couple of questions, if I might, for this panel. I
    would love to hear from the second panel, too, about the
    rigidity in the programs and the people who are actually out
    there on the front lines. I would love to get a sense for the
    standards and just the lack of flexibility that exists today
    and doing a better job of balancing nutritional offerings. So,
    anyway, I would love to hear from the second panel about that
    subject.
        But, I guess the question I have for you is what would you
    change about the eligibility requirements of the current child
    nutrition assistance cadre of programs as they exist today?
        Ms. Neuberger. I think the important thing when you are
    talking about reducing errors and improper payments, which I
    think we all agree is a very important endeavor, is to create a
    culture of compliance with the rules. We want the rules to be
    followed. I do not think the rules themselves are the problem.
    I think it is helping people understand them, and there are
    lots of different people involved in the system. It is families
    when they are filling out applications. It is schools when they
    are running programs. It is States when they are administering
    them. So, I think that kind of day in and day out work is what
    is most important to reduce errors and reduce improper payments
    in the program.
        Senator Thune. Okay.
        Mr. Lord. I would second that and also add it is important
    to, as a former President once famously stated, it is important
    to not only trust, but verify. I would add to that and say it
    is important to trust and verify in a meaningful manner. We
    found through our work that the verification process could be
    strengthened in several important ways, and I think that will
    serve the reduced improper payments rate and help drive that
    number down.
        Although, I should add, in response to what Ms. Neuberger
    noted on the counting side of the equation, over $700 million
    of the improper payments estimate is due to simple counting
    errors at the school district level. So, I think that is an
    area that could be addressed, as well, through technology,
    better training. So, there are some important ways they could
    drive that number down and enhance the operations of the
    program.
        Senator Thune. So, do you believe that more State and/or
    local input on establishing eligibility requirements could be
    helpful in cutting down on some of the incorrect reimbursement
    rates?
        Mr. Lord. Well, personally, I think there are two ways to
    go at it. You have to, first, explore the potential of data
    analytics and computer matching to help simplify the process,
    make it more efficient, and you can do that at the State agency
    level without getting down to the school district level.
        But, at the school district level, again, I think there
    needs to be greater awareness about how to fill out
    applications completely, the need to periodically do spot
    checks of what people are reporting.
        So, I think you have to approach it in a multi-faceted
    manner, centrally at the State agency level as well as the
    school districts. As Ms. Neuberger pointed out, though, they
    are not as well equipped to do real vigorous verification.
        Senator Thune. Right.
        Ms. Neuberger. One of the things that makes the school meal
    programs easier to understand and administer now is that they
    do have one set of rules that applies across the country, and
    that is an important simplification and source of fairness. I
    think it is important to consult with districts and States
    about what will work to help the programs run more smoothly and
    more accurately in their areas. But, that is not the same as
    considering changing the eligibility rules or other program
    rules.
        Senator Thune. Right. Do you think that categorical
    eligibility for school meals ought to be eliminated?
        Ms. Neuberger. No. That is basically the source of
    tremendous simplification. I mean, that is what allows families
    who are already getting SNAP benefits, where there is a very
    rigorous eligibility determination, to get free school meals.
    Their income levels are going to be at or below the levels that
    are already set within the school meal programs. So, basically,
    that is a tremendous simplification right now and I think it--
    --
        Senator Thune. So, if that is true, then which ones should
    be utilized the most?
        Ms. Neuberger. Right now, anyplace in the country is
    allowed to use data from the SNAP Program or TANF cash
    assistance. There are certain other categories, like children
    who are homeless or in foster care, that can also be
    automatically eligible. Medicaid is only available for use in
    seven States right now, and so that is a potential--there is
    untapped potential there where additional States could benefit
    from utilizing that data.
        Senator Thune. Good. All right. My time has expired, Mr.
    Chairman. I thank this panel and will look forward to the
    testimony from the next one. Thanks.
        Chairman Roberts. Senator Stabenow.
        Senator Stabenow. Thank you, Mr. Chairman.
        I just wanted to do a quick follow-up, Mr. Lord. You were
    talking about how, as we look to simplification but also making
    sure we are rigorous in our oversight standards and so on, you
    indicated the SNAP Program has a smaller error rate, which it
    does, one of the smallest in the Federal Government in terms of
    overall errors, and that there is a larger error rate in the
    food program. So, if we were going more in the direction of
    tying it to SNAP, community eligibility, which has saved a lot
    of money in Michigan and been very effective, is that what you
    were suggesting, looking at SNAP, which actually has more
    rigorous oversight, lower error rate, and tying it to that
    might actually accomplish both goals of simplification and also
    tightening things up?
        Mr. Lord. That was--yes, that is what I was suggesting, and
    I was citing the OMB figures on their estimated improper
    payments rate.
        Senator Stabenow. Right.
        Mr. Lord. You know, there is some degree of imprecision
    with it, but that alone suggests SNAP, even though there are
    some errors in the program----
        Senator Stabenow. Right.
        Mr. Lord. --when you rely on that method to enroll people
    in the school meals, it is----
        Senator Stabenow. It is actually less----
        Mr. Lord. Yes----
        Senator Stabenow. --because I think it is below three
    percent, if I remember right----
        Mr. Lord. Yes, it is----
        Senator Stabenow. --right now, which is a very--it is
    actually the lowest error rate of anything that we have in----
        Mr. Lord. Yes.
        Senator Stabenow. --agriculture programs, so----
        Mr. Lord. It is around three percent, and again, the
    National School Lunch Program is 15.25 percent.
        Senator Stabenow. Right.
        Mr. Lord. So, it is much higher.
        Senator Stabenow. So, that is an interesting--I just think
    that is an interesting thing for us to highlight.
        Mr. Lord. Although----
        Senator Stabenow. Thank you very much.
        Mr. Lord. Okay. One last point. In our report, even though
    we did note that if you are deemed categorically eligible for a
    program through programs such as SNAP, though, under the
    current verification process, you are excluded completely from
    verification. So, our point was you may want to subject some of
    those categorically eligible applications to scrutiny.
        Senator Stabenow. Thanks very much.
        Chairman Roberts. Senator Klobuchar.
        Senator Klobuchar. Well, thank you.
        [Laughter.]
        Senator Klobuchar. I am sorry. We had a hearing on patent
    reform, which was quite exciting, or I would have been here
    earlier.
        Thank you, Chairman Roberts and Ranking Member Stabenow for
    holding this important hearing to review the child nutrition
    programs in advance of our work to reauthorize the program.
        I worked hard in the last reauthorization to strengthen
    local wellness policies, to update the nutrition standards for
    child care centers and after-school programs, and also to
    ensure that vending machines and a la carte choices would not
    undercut good nutrition in the sale of junk foods. I think we
    all know how important schools are to our kids' nutrition. I am
    proud of the work that we have done in the bill and I think we
    know that we have seen some improvements, but I think we also
    know that there are problems ahead if we do not continue this
    work to make sure the kids get the most nutritious meals
    possible when they are at school.
        The 2010 reauthorization of child nutrition programs
    specified that USDA conduct a review of food items provided
    under the WIC Program at least every ten years based on the
    Institute of Medicine recommendations. Some have argued that
    the review process should be expedited in certain
    circumstances.
        Ms. Neuberger, does the current review timeline keep pace
    with scientific advances on the nutritional quality of fruits
    and vegetables, and what can be done to improve the process?
        Ms. Neuberger. There is a review underway right now, so I
    just want to make sure everybody is aware of that, so that is
    working as planned. The rule is actually that the review has to
    happen at least every ten years, but it can happen more often
    than that if there is reason. So, if there were important
    changes in dietary recommendations, that might warrant a more
    frequent review. But, I think the rule that is in place makes
    sense.
        Senator Klobuchar. Okay. Very good.
        It has been estimated by the Journal of Health Economics
    that nearly 20 percent of annual medical spending in the U.S.
    is obesity related. How does this factor into the decision
    about how we reauthorize this bill? Either of you can answer
    that.
        Ms. Neuberger. I think we have talked early on----
        Mr. Lord. Yes.
        Ms. Neuberger. Both programs, school meals and WIC have
    tremendous benefits in terms of helping children achieve the
    health and development outcomes you would like to see as well
    as better preparing them for learning. So, they are critical
    investments, particularly for low-income children who may not
    have access to adequate nutrition elsewhere, to help them
    develop properly, stay healthy, and be ready to learn at
    school.
        Senator Klobuchar. Okay. Thank you.
        Could you comment, also, on the potential cuts to the child
    nutrition programs under the fiscal year 2016 budget resolution
    that we have just been talking about on the floor, Ms.
    Neuberger?
        Ms. Neuberger. I mean, broadly speaking, we would be very
    concerned about the consequences for low-income families in
    that agreement. That is not specific to these programs, but
    across the programs that families rely on when they are
    struggling to feed kids or make ends meet.
        Senator Klobuchar. Yes. Just one last thing, back to the
    WIC Program that we just talked about. As it plays a critically
    important role in promoting the health of pregnant and
    postpartum mothers as well as young children. The continued
    success of the program is contingent on sound cost control, and
    I understand that States that are given flexibility to develop
    their own food list based on USDA's minimum standards, and yet
    some of the States leave lower-cost products off the list of
    approved foods. Without dictating to States their WIC food
    list, how can we incentivize States to consider cost controls
    when determining approved food items?
        Ms. Neuberger. Just to be clear, WIC is a Federal program.
    Most of the rules are Federal. There are certain areas where
    there is State flexibility. States have a built-in incentive to
    contain costs in WIC----
        Senator Klobuchar. Because they have limited----
        Ms. Neuberger. --because they get a limited amount of
    federal funds. So, the more efficiently they can use that
    money, the more people they can serve, and that has been very
    motivating. WIC is a very cost effective program. WIC costs
    have increased at about half the rate of inflation over time.
    It is a very sound investment and States have played an
    important part in that. So, the way the program is structured
    really contributes to that incentive structure.
        Senator Klobuchar. Thank you very much.
        Mr. Lord, did you want to add anything for any of these
    questions?
        Mr. Lord. Not on the WIC, no, Senator. Thank you.
        Senator Klobuchar. Okay. Very good. Thank you very much,
    and I am glad you are here. It is a very important topic, and
    as I said, the last bill that Senator Stabenow was involved in,
    and I know Senator Roberts on the committee and now leading the
    committee, I think was very important and we have made some
    great strides and we need to continue improvement in the
    nutrition standards. Thank you to both of you.
        Chairman Roberts. Senator Tillis.
        Senator Tillis. Thank you, Mr. Chair.
        Ms. Neuberger or Mr. Lord, I want to look back at the
    program. I am from North Carolina. I was Speaker of the House
    and I worked a lot with the various school systems. We have 115
    school systems in North Carolina. They seem to be both
    supportive and against certain components of the food nutrition
    programs in terms that they like the potential benefits, but
    they do not like the overhead, or they do not necessarily like
    how the regulations required them to implement the nutrition
    programs.
        Has there been any work done to try and figure out how we
    can measure outcomes, and that is a question I had for you, Mr.
    Lord. I know that you and the GAO are evaluating the
    verification process, making sure the people who are entitled
    to it get it and those who do not do not, but what about the
    more fundamental question of the baseline when this program
    started, the year over year improvement in outcomes, which at
    the end of the day is the children's health and making sure
    that they are fed. Are we measuring those outcomes in a
    scientific way and identifying best practices and intervening
    when they are compliant with the program but not producing
    positive outcomes?
        Mr. Lord. Well, I know Ms. Neuberger is probably more well
    versed on that. But, in terms of the outcome measures for the
    verification process, that was one of our suggestions to USDA.
    They are collecting--they have recently started collecting a
    lot of good information on the so-called ``for cause''
    verification process, but they mix it together with other
    reporting, so it is unclear to us what the outcomes of all
    their efforts to conduct ``for cause'' verifications, and those
    are reviews of questionable applications. So, at least in that
    one area I am very familiar with, there is broad agreement they
    need to do a better job in looking at outcome measures in that
    area. That is verification related, and perhaps Ms. Neuberger
    can comment on the broader nutritional outcomes.
        Senator Tillis. Ms. Neuberger.
        Ms. Neuberger. Sure. There is generally quite a lot of
    research on the positive benefits of these programs. In
    particular, for example, children who eat breakfast at school
    have been shown to have fewer behavior issues, less absence and
    tardiness, and better performance at school. So, that is a
    clear area where there is a strong tie between participating in
    the meal programs and the kind of educational outcomes we would
    like to see in schools.
        Senator Tillis. One question I have, I do not know if it is
    anecdotal or something that we need to look at more, but you
    hear the stories of putting--I am not going to pick a
    vegetable, because I always make a segment of agriculture mad
    when I do--but let us just say a vegetable that, for whatever
    reason, kids do not like yet, and administrators are concerned
    that they are satisfying the letter of the regulations, but a
    lot of that goes into the trash. Do we have any data to get
    beyond anecdotal to where there may be something else you could
    put on that plate to make sure the young person's belly is full
    and more efficient with what we are putting on their plate?
        Ms. Neuberger. I hope that you will ask that question in
    the second panel, because we have some program operators who--
    --
        Senator Tillis. I am going to. I just do not know if I am
    going to be here, so I thought I would at least get it out.
        Ms. Neuberger. Right. There is research on the extent to
    which children are eating the meals. This is not an area that I
    focus on, so it is not my expertise, but it has shown that
    there is less waste under the new rules than there was
    previously, and there is certainly always room for improvement.
    But, it is important to know that things seem to be moving in
    the right direction in terms of figuring out how to get kids to
    eat healthy foods.
        Senator Tillis. I think that is one of the concerns
    expressed by a lot of the people. I met with some members of
    the School Boards Association and Superintendents Association.
    That seems to be a concern that they have expressed and I think
    it is an area we need to investigate. In the next panel, I hope
    I am here so that I can brag a little bit on our farm-to-school
    initiatives in North Carolina, because we have been very
    aggressive in that area and I think it is very beneficial. We
    need to do more of it, convince those kids that Brussels
    sprouts are actually really good, particularly when they know
    where they came from.
        But, I am going to hold and allow us to move to the next
    panel and reserve my questions for that panel. Thank you.
        Chairman Roberts. Well, Senator Tillis, I have been known
    to eat a Brussels sprout or two, but always with cheese on it.
        [Laughter.]
        Senator Tillis. Mine is with bacon.
        Chairman Roberts. Well, with bacon and cheese, it might
    work out, but I have problems with the cheese, too, but then
    that is another whole nut. We do not want to go there at this
    particular time.
        [Laughter.]
        Chairman Roberts. Senator Heitkamp.
        Senator Heitkamp. Thank you, Mr. Chairman, and thank you
    for this important hearing. Making sure our children have every
    opportunity to succeed is something I think the entire
    committee believes in, and this is a good place to start, when
    we are talking about child nutrition and basically giving them
    the opportunity to grow up healthy and learn throughout the
    day.
        Nutrition standards set in the Healthy, Hunger-Free Kids
    Act, I think, are an important first step to help create a
    healthier and more prepared next generation. But, we should
    also make sure that the schools have the tools they need to
    provide healthy meals.
        In North Dakota, 100 percent of our schools, I am proud to
    say, are meeting the standards, and a couple months ago, only
    one school had asked for a waiver on the whole grain pasta
    requirement. So, that is pretty incredible in a State that has
    a fairly high rate of problems as it relates to obesity.
        However, the Pew study found that 74 percent of North
    Dakota's schools still need at least one piece of school
    equipment, kitchen equipment, in order to meet the standards,
    and Senator Collins and I have introduced a bill to help
    schools purchase new equipment and provide them with technical
    assistance on food preparation and meeting the standards. I
    just want to put a plug in for the School Food Modernization
    Act, which I think will give the tools to many of our people
    who serve our children every day, and by that I mean literally
    and figuratively, the equipment and the tools that they need.
    This is especially important in rural schools, where the school
    districts are already strapped, where you have a small
    population but a huge need for upgrading.
        I have said it many times. My mom was a lunch lady, so I am
    especially partial to the School Lunch Program. I know what
    that had meant. I know what she did every day to try and put
    nutritious and good food on the table. I also knew that there
    were kids that I went to school with where that may have been
    the only meal that they got all day. She took that
    responsibility seriously.
        We have been talking a lot, Mr. Lord, about program
    integrity and making sure people who should not be
    participating in the program are not. Obviously, the surfer
    dude hit the news last year in a big way. But, Ms. Neuberger
    noted that one in four applications were denied despite actual
    household circumstance. We are wondering, as we close the
    loophole and make sure that we do not have fraud in this
    program, how can we make sure more kids get into this program
    who actually need these nutritious meals, who actually need
    that backpack going home on the weekend?
        Mr. Lord. Well, I think you need to raise awareness and
    perhaps do additional outreach at the school district level. I
    think there is good awareness of the program, but in some
    pockets, perhaps there is not. So, that is part of your
    outreach campaign for the program. You always want to be sure
    those who are deserving are in the program, but----
        Senator Heitkamp. So, we have done outreach. I am looking
    for a new solution.
        Mr. Lord. Well, that is probably, in my humble opinion,
    Senator, that is something that the next panel could probably
    better address. They are obviously working at the local level
    and they probably have really good perspective on that. I have
    the global view.
        Senator Heitkamp. But, I think you take my point seriously,
    which is we have fraud, but we also have a lot of kids who go
    home hungry and that has got to be part of this discussion.
        Ms. Neuberger, can you suggest any ideas on how we can
    expand awareness or how we can expand participation for
    children who go hungry?
        Ms. Neuberger. Sure. Awareness is certainly an important
    part of it, making the programs accessible and making sure they
    stay that way. So, we have focused quite a lot on the ways that
    you can improve accuracy and make sure the programs are working
    as they should. It is important at every step of the way to
    make sure that you are not putting barriers in the way for
    families who qualify for the programs and need the benefits.
    That balance is an important way of making sure that the
    programs remain available to students.
        Some of the approaches we talked about earlier, of relying
    on data from other programs, the community eligibility
    provision, where very high-poverty schools can serve meals at
    no charge to all students, are ways to make it easier for low-
    income families to get those benefits.
        Senator Heitkamp. Thank you. I yield the rest of my time.
        Chairman Roberts. Thank you, Senator.
        Senator Brown and Senator Bennet have questions for the
    next panel, so I think, unless I am mistaken, this concludes
    the contributions from the first panel. Thank you so much for
    coming and thank you for your very valuable testimony.
        If we could now have the second panel please come forward.
        [Pause.]
        Chairman Roberts. I think, in the interest of time, we are
    going to introduce all of the witnesses. Each one, of course,
    deserves their timely moment of fleeting fame before the
    committee.
        We would like to welcome Mr. Brian Riendeau. He joins us
    today from Louisville, Kentucky, where he is the Executive
    Director at Dare to Care Food Bank. Earlier in his career, Mr.
    Riendeau also led Government and Community Affairs for the KFC
    Corporation--I think everybody understands who that is--and
    served as a Legislative Assistant for Senate Majority Leader--
    let me see, that would be Mitch McConnell, would it not?
        Senator Stabenow. Oh, I cannot remember.
        Chairman Roberts. You cannot remember? All right.
        [Laughter.]
        Chairman Roberts. Thank you for being here today. We look
    forward to your testimony.
        Mr. Richard Goff of the Office of Child Nutrition from West
    Virginia and their Department of Education is next. Mr. Goff
    joins us today on behalf of the West Virginia Department of
    Education, where he has served as Executive Director of the
    Office of Child Nutrition since 2005. He has 26 years of
    experience with the West Virginia Department of Education,
    including work with the Child and Adult Care Food Program. In
    his current role, he oversees development of policies and
    program administration related to all child nutrition programs.
    Welcome. I look forward to your testimony, sir, and your
    insight.
        Ms. Cindy Jones of the Olathe Unified School District 233.
    I am especially happy to introduce to the committee Ms. Jones,
    who serves as the Business Management Coordinator for Food
    Service at the Olathe Public Schools in Kansas. She has worked
    for the Olathe Public Schools Food Service for over 20 years.
    She started at 17, as I recall.
        [Laughter.]
        Chairman Roberts. She currently serves as the Public Policy
    and Legislation Committee Chair in the School Nutrition
    Association of Kansas and has also served as Vice President and
    President. I certainly look forward to Cindy's testimony and
    her insight.
        Dr. Sandra Hassink, who is President of the American
    Academy of Pediatrics. She currently serves as President, and
    hails from Wilmington, Delaware. The doctor has focused her
    career on preventing and treating obesity in children. She is a
    pediatrician at Nemours Alfred I. DuPont Hospital for Children,
    where she founded the weight management program in 1988, serves
    as the Director of the Nemours Pediatric Obesity Initiative.
    The doctor began her medical career at the Vanderbilt School of
    Medicine as one of only 12 women in her graduating class. Thank
    you for being here today.
        I look forward to all of your testimony. We will start with
    you, sir, Mr. Riendeau.

     STATEMENT OF BRIAN RIENDEAU, EXECUTIVE DIRECTOR, DARE TO CARE
                    FOOD BANK, LOUISVILLE, KENTUCKY

        Mr. Riendeau. Thank you, Chairman Roberts, Ranking Member
    Stabenow, and the members of the committee. Thank you for
    inviting me here today. I am honored to represent Feeding
    America's network of 200 food banks that serve more than 46
    million people in need, including 12 million children.
        Dare to Care Food Bank works with more than 300 agencies
    across 13 counties in Kentucky and Indiana. Our service area
    spans nearly 4,000 square miles and includes urban, suburban,
    and rural areas.
        I am here today to tell you that child hunger is real, real
    in the communities we serve and it is real across this great
    country, and it is a particularly stark reality when children
    are not in school. But, I am also here to tell you today that
    we can solve child hunger. Through innovative public-private
    partnerships and strong Federal nutrition programs, we can
    ensure all children have access to enough food for an active
    and healthy life. I am here to ask you to help us make good
    programs even better.
        Food banks like mine cannot do our work without the Federal
    Summer Food Service Program and the Child and Adult Care Food
    Program. If certain changes were made to these programs, we
    could reach even more kids in need.
        My food bank provides more than 1,000 hot meals a day to
    kids throughout the year. Children who visit our partner sites
    will not only receive a nutritious meal, but they will have a
    safe alternative to being on the streets. They get tutoring,
    mentoring, and sports. But, far too many children cannot reach
    summer and after-school meal programs, particularly in the
    summer. In fact, the Summer Food Service Program in my State
    reaches less than ten percent of the low-income kids and only
    18 percent nationally.
        Why is that? Well, at Dare to Care, our programs are
    concentrated in Jefferson County, an urban county where summer
    programming and services are available and where many of our
    children can get to sites. The current summer feeding model,
    which requires children to consume meals at a designated site,
    works great in these instances where children have already
    congregated for tutoring and mentoring.
        However, we face two challenges in reaching kids in our
    more rural communities, lack of sites and transportation. Those
    communities simply lack facilities where kids can congregate
    and consume a meal, which makes the on-site feeding requirement
    difficult or impossible to comply with. Even schools in those
    counties that try to provide summer feeding report low
    participation rates because kids are not able to travel to the
    site each day.
        There are several policy changes that you can make that
    would help Dare to Care Food Bank reach more kids during the
    summer and after school, and we believe it will require a two-
    part strategy. First, we need to strengthen the site-based
    model by streamlining Federal programs and making it easier for
    community providers to expand the number of sites available to
    children. Currently, we have to operate two different Federal
    programs, one during the school year and another in the summer,
    even if we are serving the same kids the same meals at the same
    sites year round. Moving to one program will allow us to focus
    on feeding kids and not pushing paperwork. Additionally,
    lowering the area eligibility threshold from 50 percent to 40
    percent will expand the number of sites available and align
    SFSP eligibility with other federally funded youth programs.
        Second, no two communities are the same. We need to
    continue to maintain strong national standards and
    accountability while providing new program models that local
    communities can tailor to best meet their circumstances to
    really make progress in closing the summer gap. Dare to Care
    currently runs privately funded programs to fill this gap. Our
    backpack program in rural communities provides children with
    nutritious foods on the weekends and in the summer, but limited
    resources mean that we cannot provide a backpack to every kid
    who needs one.
        We have also looked into mobile summer feeding programs,
    but our rural communities are so small and far apart that the
    time requirement of having kids eat a full meal before we can
    go to the next location, as required, would limit the number of
    children we serve and, therefore, be cost prohibitive. Waiving
    the congregate requirement to allow innovative program models
    in hard-to-reach areas will address these barriers and
    significantly expand the number of children we reach.
        Finally, the summer EBT demonstration projects provide
    another model that has been effective at both reducing food
    insecurity and increasing nutrition. In this model, families of
    children receiving free or reduced price school meals are given
    an EBT card to purchase food at retail stores during the
    summer. We would like to see this program significantly
    expanded in communities that have high need and are
    particularly difficult to reach.
        I would like to close by saying that I am convinced that
    child hunger is a solvable problem. It is going to require
    collaboration between government, business, and nonprofit
    stakeholders, and we are counting on you to make closing the
    summer hunger gap a top priority in the child nutrition
    reauthorization and to give food banks like mine the tools we
    need to serve every hungry child.
        I thank you for this opportunity to testify and I am happy
    to take questions.
        [The prepared statement of Mr. Riendeau can be found on
    page 101 in the appendix.]
        Senator Boozman. [Presiding.] Thank you.
        Mr. Goff.

    STATEMENT OF RICHARD GOFF, EXECUTIVE DIRECTOR, OFFICE OF CHILD
     NUTRITION, WEST VIRGINIA DEPARTMENT OF EDUCATION, CHARLESTON,
                             WEST VIRGINIA

        Mr. Goff. Thank you for the opportunity to be here today. I
    am the State Director in West Virginia and I would like to give
    you my perspective of the last two reauthorizations and how we
    implemented them at the State agency level.
        In April of 2007, the IOM released the report, ``Nutrition
    Standards for Foods in Schools.'' Nine months later, West
    Virginia adopted those standards in our Standards for School
    Nutrition Policy. The progressive standards were implemented in
    the cafeteria and outside the cafeteria. We required schools to
    have more fresh fruits and vegetables. We also implemented the
    skim and one-percent milk provision. Our sodium standard was
    1,100 milligrams of sodium, which is a little bit more
    stringent than the tier one requirement. We also adopted the
    whole grain rich standard, and this was all back in 2008.
        We do not permit a la carte sales in West Virginia. When
    children enter the cafeteria, they get a unitized meal that
    meets the meal pattern for USDA. We just felt that it was the
    right thing nutritionally for the student and financially for
    the school district.
        Also, outside the cafeteria, we implemented the competitive
    sales rules that the IOM recommended for all foods sold,
    served, and distributed to students during the school day. We
    removed soft drink machines and sugary sweetened beverages.
    Junk food machines, vending machines, and school stores had to
    meet the nutrition standards set forth by the IOM.
        We also addressed healthy fundraising and required that if
    in-school fundraising was to occur during the school day on
    school property, that it had to meet the nutrition standards,
    as well.
        We also instituted the professional standards at the time
    and had a staffing requirement whereby we required continuing
    education hours and a certain level of a degree for the food
    service director at the district level.
        Additionally, we did something different, as well. We
    addressed the food coming in from outside sources. We had done
    everything that we could to ensure that the school environment
    was a safe and healthy learning environment in the cafeteria
    and throughout the school environment, yet we were turning a
    blind eye to what was coming in the back door in the form of
    parties and things of that nature. So, we instituted a
    provision to address that, as well.
        In 2010, in anticipation of the Healthy, Hunger-Free Kids
    Act, we redirected our focus on the technology and we developed
    a State-wide automated electronic system whereby every public
    school in West Virginia uses the same point of sale software.
    Students that come through the public school system in West
    Virginia a lot of times will just put their finger, their index
    finger, on a biometric scanning pad and it logs and categorizes
    the meal. That has increased efficiency and accountability in
    the program and has dispensed with a lot of the over-claiming
    problems that other school districts were seeing.
        The direct certification match when you have a Statewide
    system like this, it is done at the State agency level. We do
    the direct certification match as well as the determination for
    community eligibility at the State agency and we push the data
    down to the schools. Once schools figure their claim for
    reimbursement, that data is loaded up to the district level and
    then pushed to the State agency level. So, the interface goes
    both ways, from the State agency to the school, from the school
    to the State agency.
        By doing that, we were able to have Statewide eligibility.
    So, as needy families typically move around throughout the
    State, what we were able to do is focus on ensuring that their
    meal eligibility benefits were not interrupted. No longer were
    they required to submit an application at the new school
    district. Eligibility followed them, just like their name or
    their student ID did.
        This also made it easy for us to monitor the system and
    improve efficiency and the integrity of the system. The three-
    year monitoring cycle, when we went from a five-year to a
    three-year, was not a burden for us. Fifty percent of our
    monitoring is completed in our office, at the central office at
    the State agency level in Charleston before we even enter the
    field. We have a great relationship with the SNAP and TANF and
    foster child folks to get that data electronically. Direct
    certification is then uploaded on a weekly basis.
        We also piloted the second year community eligibility. The
    first year, West Virginia was not selected, but we did it
    anyway. We piloted it at a State agency level on something
    called the West Virginia Universal Free Meals Pilot Project.
    CEP is very alive and thriving in West Virginia. Fifty-four
    percent of all of our public schools are community eligible in
    West Virginia, and I am very proud of that.
        The key to that working was an Act that we brought about
    called the Feed to Achieve Act that was enacted, our State
    legislature passed, that realigned school breakfasts with the
    instructional day. I am about to run out of time. The Act
    passed without a fiscal note and actually built upon the
    programs that we already had in place and ensured that all
    children would receive at least two reimbursable meals per day.
        Thank you, and I will take questions.
        [The prepared statement of Mr. Goff can be found on page 52
    in the appendix.]
        Senator Boozman. Thank you.
        Ms. Jones.

    STATEMENT OF CINDY JONES, BUSINESS MANAGEMENT COORDINATOR, FOOD
       PRODUCTION FACILITY, OLATHE UNIFIED SCHOOL DISTRICT 233,
                             OLATHE, KANSAS

        Ms. Jones. First, I want to thank you for inviting me here
    today to testify. School nutrition professionals across Kansas
    are working hard to ensure children receive the nutrition
    required for their health and academic success. Hungry children
    simply cannot learn and thrive.
        Olathe Public Schools is the second largest school district
    in Kansas. I am responsible for all financial aspects of our
    nutrition programs. Our department has 275 employees serving
    24,000 meals per day on a $12.5 million budget. Twenty-seven
    percent of our students receive free or reduced price meals.
        At Olathe, we are committed to delivering nutritious meals.
    Thanks to our universal free breakfast in the classroom program
    in five elementary schools, we are serving 850 more healthy
    breakfasts each day, resulting in fewer tardies and absentees
    and better behavior as students are no longer complaining about
    being hungry. We also participate in summer feeding, serving
    1,900 meals per day. Expanding access to these critical
    services has helped our program remain financially sound while
    providing the nutrition that is vital to our students.
        Even before the Healthy, Hunger-Free Kids Act, school
    nutrition professionals had been working hard to improve school
    menus. In our district, we have offered unlimited fruits and
    vegetables, served whole grains, and meet limits on calories
    and unhealthy fats by reducing sodium.
        However, we faced many challenges. Under the new rules,
    many students are now bringing meals from home. Our elementary
    school participation has dropped more than nine percent, and at
    the secondary schools, revenue has dropped as many students
    have stopped purchasing a la carte choices.
        Almost all the students leaving the lunch program are paid
    students. If this trend continues, the school cafeteria will no
    longer be a place where all students go to eat, but rather a
    place where poor students go to get their free meals. We have
    worked for years to fight this stigma, so it is heartbreaking
    to see our progress decline.
        Kansas students are leaving the program for a variety of
    reasons. Paid lunch equity mandates forced many schools to
    raise lunch prices. Many families do not qualify for meal
    assistance, but are struggling financially. As we continue to
    raise prices, some will no longer be able to afford to eat with
    us and the financial losses may force our program to cut staff,
    so they are impacting the community
        Smart Snacks rules have led to huge declines in a la carte
    sales, too, with an estimated loss of $700,000 in revenue.
    Items such as our fresh to go salads had to be taken off the
    menu because the small amounts of meat, cheese, and salad
    dressings do not meet the sodium and fat requirements. Our sub
    sandwich was a very popular a la carte item, but to meet the
    rules, we had to shrink their size, remove the cheese, and
    switch to whole grain bread. Now, we sell very few.
        We also have opportunities to serve diet soda, sugar-free
    gum, and coffee. We have chosen not to serve these items, but
    it just shows you how these regulations do not always make
    sense.
        Despite our best efforts to make meals more appealing, we
    are struggling with student acceptance. We are particularly
    challenged to find whole grain-rich tortillas, pizza crust, and
    other specialty items that appeal to our students.
        Every student must now take a fruit or vegetable with their
    meals, whether they intend to eat it or not. As a result, we
    have seen an increase in good food going to waste in our
    schools. We promote fruit and vegetable choices with free
    samples and ``I Tried It'' stickers to encourage consumption,
    but forcing students to take fruits and vegetables turns a
    healthy choice into a negative experience. Encourage and
    educate instead of require is always the best option.
        Olathe Schools' meal program is self-supporting and
    operates on a tight budget. After labor and supply costs,
    insurance, utilities, and equipment and other expenses, we are
    left with just over a dollar to spend on food for each lunch
    tray. Imagine going to the grocery store with just five dollars
    to spend for a family of four, including milk, fruit,
    vegetable, and a healthy entree. Could you do that every day of
    the week?
        My involvement in the School Nutrition Association of
    Kansas has allowed me to witness the accomplishments and the
    challenges of colleagues all across Kansas and Missouri. Some
    districts have overcome challenges under the new rules,
    particularly those with high free and reduced price
    eligibility, which provides higher reimbursements and
    participation and access to Federal grants and programs.
    However, many districts like Olathe are struggling with reduced
    revenue, declining participation, and the higher cost of
    preparing meals. We do not have access to many Federal grants.
        That is why it is vital to allow flexibility, so all
    programs can be successful for the students and families we
    serve. There is a lot of negative press about school nutrition
    programs asking for flexibility. To me, this is very hurtful.
    We are only asking for flexibility to ensure all school
    nutrition programs are successful. Have faith in the knowledge
    that all school nutrition professionals want the very best for
    America's children. After all, they are our children and
    grandchildren, too.
        Thank you for the opportunity. I will take any questions.
        [The prepared statement of Ms. Jones can be found on page
    66 in the appendix.]
        Senator Stabenow. [Presiding.] Yes.
        Dr. Hassink.

       STATEMENT OF SANDRA G. HASSINK, M.D., PRESIDENT, AMERICAN
              ACADEMY OF PEDIATRICS, WILMINGTON, DELAWARE

        Dr. Hassink. Thank you and good morning, and I would like
    to thank Chairman Roberts and Ranking Member Stabenow and the
    members of the committee for inviting me here today.
        As I was introduced, I am Dr. Sandra Hassink and I am
    President of the American Academy of Pediatrics, a nonprofit
    professional organization of 62,000 primary care pediatricians
    and pediatric medical and surgical sub-specialists whose
    mission it is to attain the optimal physical, mental, and
    social health and well-being for all infants, children,
    adolescents, and young adults. It is an honor to be here today
    speaking about a subject to which I have dedicated my life's
    work, childhood obesity and the connection between nutrition
    and health.
        The foundations of child health are built upon ensuring the
    three basic needs of every child: Sound and appropriate
    nutrition; stable, responsive, and nurturing relationships; and
    safe and healthy environments and communities. Meeting these
    needs for each child is fundamental to achieving and sustaining
    optimal health and well-being into adulthood for every child.
        Early investments in child health and nutrition are
    crucial. The time period from pregnancy through early childhood
    is one of rapid physical, cognitive, emotional, and social
    development, and because of this, this time period in a child's
    life can set the stage for a lifetime of good health and
    success in learning and relationships, or it can be a time of
    toxic stress when physical, mental, and social health and
    learning are compromised.
        Micro-nutrients, such as iron and folate, have demonstrated
    effects on brain development, but are commonly deficient in
    pregnant women and young children in the United States. These
    deficiencies can lead to delays in attention, motor
    development, poor short-term memory, and lower IQ scores.
        One of the most effective investments Congress can make
    during the prenatal to school-age period is to support the
    Special Supplemental Nutrition Program for Women, Infants, and
    Children, or WIC, and I thank the committee for its strong
    bipartisan support for WIC over the past four decades. WIC
    helps give children a healthy start at life by providing
    nutritious foods, nutrition education, and breastfeeding
    support. Children who receive WIC have improved birth outcomes,
    increased rates of immunization, better access to health care
    through a medical home, and participation may help reduce
    childhood obesity.
        WIC has also played an important role in promoting
    breastfeeding and improving breastfeeding initiation. We
    recommend that the committee seek to find ways to promote
    breastfeeding initiation and continuation even further in the
    WIC program, including by an increase in the authorization for
    the Breastfeeding Peer Counseling Program for $180 million.
        WIC is a targeted intervention for mothers and young
    children with impacts that can be long-term in nature,
    including improved health outcomes, educational prospects, and
    the prosperity of our communities. As a pediatrician, I have
    seen firsthand the importance of nutrition in child health.
        When I started my practice in childhood weight management
    27 years ago, I was seeing adolescents. When I retired last
    October, I had a special clinic for children under five with
    obesity, and we were seeing infants. These children were
    already showing the effects of their increased body mass index
    on blood pressure and measures of blood sugar control. We saw
    obesity-related liver disease in four-year-olds and in children
    with pre-diabetes at age six.
        Today, our children are experiencing an unprecedented
    nutritional crisis resulting in the double burden of food
    insecurity and obesity. The connecting factor for both is
    poverty. The highest rates of obesity are found in people with
    the lowest incomes, and increasingly, the picture of food
    insecurity in children is that of a child with overweight or
    obesity consuming a poor quality diet. Good nutrition is not
    only an essential component of chronic disease prevention and
    treatment, it also helps treat the effects of chronic hunger.
        WIC is just one intervention to address the double burden.
    Families, our schools, child care communities, and certainly
    pediatricians play an important role in shaping healthy habits.
    When you are in the middle of an epidemic, you cannot keep
    doing what you have always been doing. As pediatricians,
    parents, community leaders, and policy makers, we have an
    obligation to ensure that the food we provide our children is
    healthy and nutritious and that we model healthy eating as
    adults.
        Good nutrition in childhood sets the stage for lifelong
    health, and just like we vaccinate to protect against illness,
    we can also vaccinate against chronic disease by providing
    pregnant women and children with nutritional assistance and
    breastfeeding support.
        As we celebrate our mothers this weekend, I urge the
    committee to put mothers' and children's nutritional needs
    first. Our children's health simply cannot wait.
        Thank you, and I will be happy to take any questions.
        [The prepared statement of Dr. Hassink can be found on page
    58 in the appendix.]
        Senator Stabenow. Thank you very much. We will proceed with
    questions. I know the Chairman will be returning in just a
    moment.
        So, thank you to each of you for your comments. We very
    much appreciate them, and Dr. Hassink, thank you very much for
    reminding us all what this is really about in terms of children
    and health and the stake we have in children being healthy and
    having a chance to succeed.
        Mr. Goff, I wanted to start with you, because when I think
    of West Virginia, you have all kinds of schools, you have
    rural, you have urban, and yet your State is 100 percent
    compliant with the new meal standards, including Smart Snacks.
    It looks like you were ahead of the game, anticipating things.
    I want to congratulate you and the State for that, and I am
    wondering how you were able to help your schools in the State
    to be able to achieve the goals. Secondly, when many schools
    rely on the a la carte sales to supplement their budgets, and
    we understand tight budgets for schools, but the change to
    healthier items does not seem to have impacted your schools.
    So, how did you help schools be able to achieve and how is it
    you were able to do that, including a la carte sales, in a way
    that did not hurt your schools?
        Mr. Goff. Okay. Thank you for the kind comments. When we
    adopted the IOM standards in 2008, right after they were
    released, and we put together a very comprehensive
    implementation plan, as far as bringing the schools on board,
    we went through the black eyes like everyone else is going
    through with the Healthy, Hunger-Free Kids Act, but we used
    quarterly workshops. We created a Listserv where we could
    communicate with each food service director through the
    Internet with the push of a ``send'' button. We issued guidance
    memos. We met with principals' groups. We met with
    superintendent groups. We did presentations before boards to
    get the word out and let them know just why the standards were
    changing, why we were doing what we were doing, and the science
    behind it. We created a website called Smartfoods for parents,
    to educate parents of all the changes.
        So, we have had a very comprehensive implementation plan,
    and we staffed at the State agency level in preparation for all
    the changes, as well, as far as grant writers and registered
    dieticians and things of that nature. Our automated system,
    where we have an electronic technology system, point of sale
    system, that is integrated throughout the entire State. They
    just need to know one system. Our reviewers go into the
    schools. They just have to monitor one system.
        Many of the concerns that Mr. Lord spoke of, we do not
    experience in West Virginia because of the direct certification
    and community eligibility determination is done at the State
    agency level and we notify the schools of that information. Our
    free and reduced application is online, so we have had a lot of
    the problems that we experienced with the paper application,
    which has basically become obsolete in West Virginia.
        As far as a la carte, we in West Virginia--when children
    come into our cafeterias, they either get a unitized meal that
    meets the meal pattern that is fully reimbursed by the Federal
    Government regardless of whether it is free, reduced price, or
    paid, and we just felt that that is in the child's best
    interest. We also worked to have salad bars put in place.
        Now, by not offering a la carte sales, that makes the point
    of sale a lot cleaner. There is not a lot of activity at the
    point of sale. So, that lends itself to increased
    accountability as far as logging and claiming the meals.
        But, we have never had an issue with--as far as the revenue
    goes on a la carte sales. You get a unitized meal, which you
    get the full price of the paid meal, and then you get the full
    Federal reimbursement, so you get both revenue streams in West
    Virginia. With a la carte, that was never an issue for us.
        Senator Stabenow. Well, it is very impressive, what you
    have done, and when you look at the automated point of sale and
    the Statewide eligibility so that the schools do not have to be
    focused on that and it moves with the child, I just think that
    is really something that we need to look at and how we can save
    the costs and the paperwork for schools and families and still
    achieve things. So, congratulations.
        Mr. Riendeau, we have had a lot of bipartisan support over
    the years for our summer meals programs and we want to continue
    that. We know we need to strengthen both the congregate and
    non-congregate models. I am concerned that we create more
    flexibility. In Michigan, we have submitted a request for a
    waiver for the congregate requirements, and, in fact,
    unfortunately, it was denied because of the current
    restrictions when a waiver can be issued.
        So, I wonder if you might speak a little bit more about the
    need for flexibility in terms of the summer and what is
    happening in terms of communities, whether it is on where
    children meet or what has been called grab and go or other
    kinds of models, why this is important.
        Mr. Riendeau. Sure. Thank you for that question. In our
    case, at Dare to Care, we serve both urban and rural counties,
    and I think that is where the difference between the two models
    is most stark. The vast majority of the meals that we serve
    through SFSP are served in Jefferson County, the home of
    Louisville. It is an urban county. It is a place where kids--
    there are plenty of sites for kids to gather in the summer,
    sites with programming and activities that the kids want to be
    a part of. The kids are there, and it is easy for us to get
    those meals to those kids, have the kids consume them on site,
    and allow us to comply with the requirement of that program.
        In fact, we have--our model is based on a 6,000-square foot
    kitchen that we invested in to build two years ago that
    provides over 1,000 hot meals a day now and takes those meals
    to those sites, and the program works very well there.
        Where the need for flexibility comes in is in our rural
    counties. Our other 11 counties are rather rural. Many of them
    are very rural. Frankly, they just do not have the community
    centers, the facilities for kids to gather. Even if they did
    have those, there is a transportation issue. These kids are
    spread out. Many of them are living in small communities. They
    are dispersed across those counties. In the summer, they do not
    congregate.
        What we would like to see is the ability to work on the
    ground in those communities with government and business
    leaders in those communities to come up with unique
    partnerships and innovative programs that are tailored to meet
    the specific needs of those individual counties, and I think if
    we could have the flexibility that we are talking about here, I
    am very confident that we could reach many, many more of the
    kids in need.
        As I mentioned in my testimony, 90 percent of the kids in
    the State of Kentucky who are eligible for SFSP do not get it
    because there is either no site for them to go to or they
    cannot get there.
        Senator Stabenow. Thank you very much. Thanks.
        Chairman Roberts. [Presiding.] Ms. Jones, Cindy, thank you
    for your help in our traversing Kansas and enjoying school
    breakfasts and school lunches. If you were provided with some--
    that word again--flexibility, what changes would you make?
        Ms. Jones. I would go back to serving 50% whole grain rich
    products. This would give us the flexibility to add back some
    of the student's favorite items. Two items that we are
    struggling with are whole grain biscuits because they have no
    flavor and crackers that taste like sawdust. Just some simple
    changes would make a big difference. Also all children love
    chicken nuggets, however the children do not like the new
    chicken nuggets because of the taste of the breading.
        I would go back to encouraging kids to take fruits and
    vegetables, which is what we have always done in our district.
    We keep hearing about, it is just half-a-cup, but we have
    29,000 students in our district. That is a lot of half-a-cups,
    and if two-thirds of those kids eat the fruits and vegetables,
    that is still 10,000 half-a-cups that we throw away, and over a
    year, that is 1.7 million half-a-cups.
        In our district, we want the kids to eat their fruits and
    vegetables. We love our unlimited fruits and vegetables. We
    encourage our students by giving them ``I tried it'' stickers,
    because we want them to eat their fruits and vegetables. But,
    because of all the tight budgets we are having right now, we
    may have to discontinue the unlimited fruits and vegetables. I
    would hate for the students that want to eat their fruits and
    vegetables to lose that opportunity because other students are
    forced to take them and just throw them in the trash.
        Also, I would like to be able to make the decision on
    whether to raise the prices for our meals. I think a lot of our
    students are leaving the program because they can no longer
    afford to pay the meals prices. I was visiting with a little
    girl the other day and she shared with me that her mother now
    makes her choose two days a week to eat with us because they
    can no longer afford to pay the costs. So, I would like for
    district to be able to determine their own meal pricing.
        Chairman Roberts. We have just been joined by the whole
    grains champion of the Senate, who has a bill to exempt that
    standard, and I will give you every opportunity to discuss
    that, Senator Hoeven.
        But, at any rate, let me also ask you, in my travels
    throughout Kansas, there were some schools doing well in
    implementing the standards and they seemed to be the schools,
    obviously, with a lot of resources. In your testimony, you
    mentioned that some high free and reduced-price districts in
    Kansas have also overcome challenges. Is there a way to
    characterize the districts that are having a hard time, or does
    it vary based on the individual community?
        The reason I am bringing this up is that I think the
    distinguished Senator from Michigan and I tend to pay special
    attention to rural and small town schools.
        Ms. Jones. Right.
        Chairman Roberts. Goodness knows, they have problems with a
    lot of things. But, I am not sure I am getting this exactly
    right. Is there a way to characterize the districts that are
    having a hard time, or does it vary based on the individual
    community and what they are doing, how they accept a program,
    et cetera, et cetera?
        I know there has been a lot of talk about training. I am
    trying to get at something here. I do not want to call it the
    attitude of the community or the attitude of the district or
    whatever--not much choice in this regard. But, help me out
    here.
        Ms. Jones. What I am seeing, districts like my own are
    struggling the most. We have a lower amount of free and
    reduced, so a lot of our students are choosing to bring their
    own lunch if you are at a district where there is a high amount
    of free and reduced, those children will continue to eat what
    they are being offered.
        I was actually speaking to a director from a larger
    district and he shared with me that because of the revenue that
    he is losing, he will end up in the red for the first time.
    This is his tenth year working in his district. I believe that
    a lot of the problem is the schools that do not have the high
    free and reduced student, are unable to qualify for grants that
    are available to the schools with a high amount of free and
    reduced students.
        In my district, we have a centralized building and two
    registered dieticians on staff. We have to pay for all of our
    costs. We even pay indirect costs to our districts to help pay
    for the utilities and the custodial staff at the schools. Small
    school districts nutrition programs are housed within one of
    the schools, so they do not have all the extra costs that large
    districts have. Plus, many of them have high free and reduced
    percentages. So, they not only have less expenses, they also
    have more funding available to them.
        Chairman Roberts. Well, you have given me the exact reverse
    of what perhaps some of us may have as a bias and I truly
    appreciate it. That is exactly what I was asking about.
        I have so many different questions here, but I do want to
    get to Senator Donnelly, who I think is next, and then we have
    Senator Hoeven.
        Senator Donnelly. Thank you, Mr. Chairman. I want to thank
    all of you for being here.
        Mr. Riendeau, I know you are based in Louisville, but I
    want to let everybody know that you also--Dare to Care serves
    Washington, Crawford, Harrison, Floyd, and Clark Counties in my
    home State of Indiana. We are grateful to you for that. I
    wanted to talk to you for a second about something that I know
    you have heard about, as well, and that is the area that you
    serve, just outside of it is Scott County, which is just to the
    north of where you serve, and we have had a devastating HIV
    outbreak there and drug epidemic there. The county also has one
    of the highest food insecurity rates for children in our State.
    I was wondering, in your mind, what is the best way to reach
    those kids, to make sure they have had enough to eat, to make
    sure they stay in school and, hopefully, stay away from drugs,
    as well.
        Mr. Riendeau. Thank you, Senator. Yes, I live just down the
    road from Scott County, and I just want you to know,
    personally, I share your pain with what is happening there. It
    is horrific.
        You know, I guess I think in my mind, what is happening
    there sort of points to the larger issue that is before the
    committee with this whole reauthorization, that is, investing
    in our kids today can prevent so many issues down the road. We
    heard that kids who grow up in a food insecure environment are
    going to have all kinds of issues, and as they age up, they are
    going to find themselves with less options for becoming
    productive, self-sufficient members of our community. I am
    certainly not an expert on drug addiction or HIV, but I would
    have to guess that there is a very close correlation between
    the levels of food insecurity that you see in that county and
    some of the problems that folks are facing with no alternatives
    to turn to.
        I think the best way that--one of the great ways that we
    could better serve counties like Scott would be going back to
    the Ranking Member's question about flexibility, giving us the
    ability to tailor programs to be able to provide summer food to
    kids in those rural counties where the current model and the
    current regulations may not fit so well.
        Senator Donnelly. Which ties in a little bit to my next
    question, which is that in some of our rural areas that you
    serve, and obviously throughout the rest of the State and in
    the country, there are Pack a Backpack programs for kids on the
    weekend and such. I know you help to work with that, also. Do
    you think that as you look at that, we would be able to reach
    more food insecure children if those meals in that program were
    eligible for reimbursement, as I know the funds come from the
    private sector for that?
        Mr. Riendeau. Absolutely. That program is--in our case with
    Dare to Care and serving our rural counties, that is one of the
    programs that we do use to reach kids in the rural counties,
    because when kids are congregated at school, it is the one
    place we can get nutritious food to them to take home for the
    weekends.
        Currently, we fund that program entirely with private
    donations, so it is an entirely privately funded program. But,
    in my mind, it is a great public-private partnership because we
    are leveraging those private dollars to help address an issue
    that we currently cannot address with Federal dollars.
        So, the answer is yes. I think if we could find a way to
    involve--find a new revenue source that would allow us to
    provide more backpacks, that would certainly have a positive
    impact on our ability to reach those kids.
        Senator Donnelly. Thank you.
        Dr. Hassink, one of the areas of concern for me with food
    insecurity is also the general obesity that has occurred in
    children and the increase in diabetes type 2. As you look at
    that and as we look at that going forward, what more can be
    done to teach about healthy eating, lifestyles, and how to
    prevent things like diabetes type 2, because they can be so
    debilitating.
        Dr. Hassink. Well, thank you, and certainly we, as
    pediatricians, are seeing the rise in type 2 diabetes in
    younger and younger children, something we never thought we
    would have to deal with as pediatricians.
        I think starting very early with early healthy infant
    nutrition and transition to solid foods and good feeding
    practices are important. Healthy habits for families at home to
    start out right is essential. Many of the children who have
    severe problems in adolescence with their health, with type 2
    diabetes, have already by age five have had obesity. So, early
    intervention. That means family education, stronger links with
    the health care system and food and providing information about
    food programs, providing education, understanding what is
    available for those families in the community, I think, would
    help get them off to a good start.
        In 2007, when we wrote the expert guidelines for obesity,
    we considered all children at risk for obesity in this country
    and we have trained physicians to do preventive counseling for
    everyone because of this problem.
        Senator Donnelly. Thank you very much to the panel. Thank
    you for all your work to try to help our children and our
    families.
        Thank you, Mr. Chairman.
        Chairman Roberts. Thank you, Senator Donnelly.
        Senator Hoeven.
        Senator Hoeven. Thank you, Mr. Chairman. I appreciate you
    holding this hearing today and thanks to all of the witnesses.
        Ms. Jones, you mentioned in your testimony some of the
    difficulties in complying with the lower sodium standards and
    also the 100 percent whole grains requirement. What can we do
    to help in that regard? What do you think the solution is?
        Ms. Jones. We just want to make sure that we do not go
    forward with target two for the sodium, right now we are able
    to get by. We are struggling, but we are able to meet those
    requirements. But, if we go on to target two, that would mean
    we are serving a therapeutic low sodium diet. There will be no
    flavor to the kids' food. I just received an e-mail from my
    director letting me know that our parent surveys are back and
    many of them say that their children are no longer eating with
    us because there is no taste to their food. That is a big
    concern, and if we continue on, I think that will be even a
    larger concern.
        Senator Hoeven. So, last year, I included a provision that
    actually kept the whole grains at 50 percent rather than having
    100 percent of the grain products having to be whole grain
    enriched, and now I have introduced legislation with Senator
    King--this was bipartisan legislation, Senator King from
    Maine--that would both keep us at the lower sodium level, but
    not go to the next target level, and would continue the
    provision that 50 percent of the grain products have to be
    whole grain enriched. Is that something that you think is
    workable and that your State would find workable and that you
    feel other States would find workable?
        Ms. Jones. Absolutely.
        Senator Hoeven. Okay. Then, touch on for just a minute
    issues as far as the competitive requirements for the a la
    carte menu. So, we want to make sure that the school lunches
    are healthy and the kids are eating them----
        Ms. Jones. Right.
        Senator Hoeven. --and then we also want you to be able to
    continue with the a la carte, and I understand there are some
    issues in terms of what you can provide a la carte.
        Ms. Jones. Correct. We would like to be able to serve items
    on a la carte that are also on the reimbursable meal, because
    right now, you have to look at each a la carte item. If it is a
    part of a meal, you can compare that throughout the week and
    fit it into the requirements. So, it is much more difficult to
    be able to get an item to serve on a la carte menu. If we can
    serve it on a reimbursable meal, it should be healthy enough to
    serve a la carte.
        Senator Hoeven. Okay. So, again, just some flexibility
    there----
        Ms. Jones. Some flexibility, absolutely.
        Senator Hoeven. Thank you.
        Mr. Goff, I am glad to hear of your successes in terms of
    implementing the program in West Virginia, and certainly
    flexibility does not mean a rollback of good nutrition
    standards, but, again, making sure that we have healthy meals
    and meals that the kids will eat and that our schools are able
    to make their budgets. Could you tell me how many of your
    schools have applied for an exemption from the 100 percent
    whole grain requirement?
        Mr. Goff. Well, we did the 100 percent, the whole grain
    rich requirement back in 2008. The only thing that has affected
    our schools--and that was implemented across the board in all
    schools and schools are not having a problem with it. The only
    thing that has really touched in West Virginia is the--as it
    relates to pasta, and that is only because we have some schools
    that are having trouble getting the product.
        Senator Hoeven. Right. That is the point. In some cases,
    whether it is pizza or tortillas or pasta, I mean, when we talk
    about whole grain enriched, it is not just the bread and so
    forth. It is all these other products. Hence, some flexibility
    is helpful, and that is why I have advanced the 50 percent
    whole grain enriched.
        You have had a number--I actually have the number. You have
    got quite a few schools that actually have applied for
    exceptions. Would not some flexibility be helpful to them here?
        Mr. Goff. Well, I cannot speak for the schools. I think
    that when you are looking at granting waivers, my fear of that
    would be that it would give industry a pause to come on board
    and make the products more available at a sooner time. We had
    lots of waiver requests when we were implementing some of our
    standards as it relates to professional standards or even
    competitive sales, and I think if you have a good standard that
    is in the child's best interest, then you hold that standard.
        I certainly cannot speak for a State like Kentucky, but our
    participation in West Virginia in our school meals is the
    highest it has ever been. Our breakfast participation is
    starting to exceed that of lunch. So, I think in West
    Virginia--and we have cooperative purchasing groups that pool
    their efforts to get the product. I think we are on the right
    track there.
        Senator Hoeven. But, you--so, you do not feel there needs
    to be any flexibility, even though you have schools that have
    applied for exemptions?
        Mr. Goff. Well, I do not have--know the number of those
    schools----
        Senator Hoeven. Twenty-two.
        Mr. Goff. Twenty-two schools out of--and we have about 700.
    So, certainly, that is cause for an exemption, or a waiver
    until the product can become available. But, it was my
    understanding that it was more related to pasta.
        Senator Hoeven. I understand in some cases it relates to
    pasta or tortillas or some of these other products, and that
    makes sense, if they are healthy and the kids will eat them.
        I will wrap up here, Mr. Chairman, but the current dietary
    guideline recommendations allow for some refined grains, as
    well. So, if we allow it in the dietary guidelines, which is
    for all Americans, why would not some flexibility in that
    regard make sense for school kids, too?
        Mr. Goff. I understand.
        Senator Hoeven. Thank you. Thank you, Mr. Chairman.
        Chairman Roberts. Senator Stabenow, you had an additional
    question?
        Senator Stabenow. I do. Thank you. I do have some, and
    thank you again to all of you.
        I guess I am trying to put in perspective--I realize we are
    making changes in the last five years, and the behaviors are
    always hard to change where it is sort of in the process of
    moving in the direction, all of us, of wanting to be more
    focused on health and wellness, and we all know the benefits of
    that, and we know sometimes change is hard.
        I do have to say, I have seen--I have visited a lot of
    school districts, some very creative, where you take the
    vegetable and you put green peppers and onion in the tacos and
    the kids do not even know they are getting it, which is great,
    and others where someone says, no, the government says you have
    to eat broccoli. So, there is a very different reaction
    depending on how things are presented, and we want to be in the
    creative process of that where we are sneaking it in and kids
    do not even know beans are a vegetable, right?
        But, Mr. Goff, I wanted to ask you about specifically the
    exemptions for whole grains. My dear friend, and I really mean
    that, from North Dakota has been very passionate about this.
    But, yet, out of thousands of schools across the country, we
    have had only 350 requests for waivers on whole grains. To put
    that in perspective, 350 requests across the country, there are
    900 school districts in Michigan alone. One request in North
    Dakota, four requests in Kansas. I am wondering, have you
    received very many requests at this point, and again, why would
    you believe your schools would not be asking for the
    flexibility of the waiver that we put in place at this point?
        Mr. Goff. Well, I could not give you the number. We have
    received some requests. But, it is my understanding in talking
    with the cooperative purchasing groups that comprise our State
    that the request is for pastas and it is because the product is
    not readily available for them to purchase, and it has
    something to do with that particular product has trouble
    maintaining its consistency. So, until more of that type
    product hits the market, some of our schools were struggling
    with it.
        But, as far as the whole grain rich requirement, we have
    had that in place since 2008. Students are very accepting now
    of what they call the brown bread. So, I think it is a good
    standard and I think we just need to wait for industry to come
    up to speed.
        Senator Stabenow. I am wondering, also, there are
    differences between larger and smaller districts and some that
    have the community eligibility, and as Ms. Jones was saying,
    just in larger districts with their smaller number of students
    that are qualified for free and reduced lunches and so on.
        Again, in West Virginia, how do you handle that with a
    larger district where there is a smaller number of children and
    sort of the economics of that for schools, because I am sure
    that is different. So, have you--how have you handled that in
    terms of districts where virtually all of the children are
    qualifying for free and reduced lunch versus a district where
    it may be less than 50 percent?
        Mr. Goff. As far as----
        Senator Stabenow. As far as sort of the economics of
    funding and so on, because that seems to be one of the
    concerns, is that----
        Mr. Goff. With community eligibility----
        Senator Stabenow. --large districts are losing money
    because there are fewer children being reimbursed on free and
    reduced lunch and other children are not buying lunch.
        Mr. Goff. That is a great question, and we anticipated
    those types of things before we implemented community
    eligibility. Like I said, the first year that they piloted
    that, we were not selected, so we did our own version called
    West Virginia Universal Free Meals. We knew that if we just
    selected nine districts, or however many we did select, and
    said that you now can have breakfast and lunch at no charge, if
    we did not fundamentally change something, it was going to
    create a problem with their budget.
        So, we worked in conjunction with our State legislature and
    we passed Senate Bill 663, called the West Virginia Feed to
    Achieve Act, and what that did, one of the provisions of that
    act, is it realigned breakfast with the instructional day. See,
    we were offering breakfast at the worst possible time, as most
    schools do, at the start-up of school, when the bell is
    ringing, the buses are arriving late, kids want to talk to
    their friends. So, we have a State law that mandates that
    school breakfast can no longer compete with the start-up of
    school. It has to be offered either breakfast in the classroom,
    breakfast after first period, or breakfast after the bell, or
    some combination of that, in every school, at every grade
    level.
        What it has done, that in conjunction with community
    eligibility, our breakfast participation is starting to exceed
    that of lunch. Now, financially speaking, that is very good for
    the programs because the margin of profit, if you look at the
    Federal reimbursement versus the cost to produce a breakfast,
    the margin of profit is higher on a breakfast than that of a
    lunch. Plus, it is the most important meal of the day.
        Now we have the naysayers in the beginning, for example,
    the teachers that did not want the food in the classrooms, will
    now go to bat for the program and are actually promoting the
    program because they can see such a huge difference in test
    scores, student attentiveness, reduced tardies, fewer trips to
    the school nurse, fewer behavioral problems. It has really
    changed the way we are educating kids in West Virginia.
        We have one school district that, district wide, Mason
    County, their breakfast participation last year averaged almost
    90 percent. Ninety percent of the children in that school had a
    breakfast on a daily basis. That is how we have done it.
    Through the economies of scale, the cost to produce one more
    breakfast or one additional breakfast, the cost is not that
    significant, but the Federal revenue coming in on that one more
    breakfast is substantial.
        Senator Stabenow. Thank you very much.
        I know my time is up, Mr. Chairman, so thank you.
        Chairman Roberts. Senator Boozman.
        Senator Boozman. Thank you, Mr. Chairman, and I apologize
    to you and the Ranking Member for running back and forth today.
    This is such an important hearing and such an important topic
    for Arkansas and the rest of the country. I am on another
    subcommittee, though, that also is very important and it has to
    do with violent crime, gangs and things like that, which,
    again, all of these things go together. So, like I say, I
    apologize for running back and forth.
        Mr. Riendeau, and again, I know that these things have been
    discussed already and things, but it is such an important thing
    for Arkansas. Our summer meal participation has increased in
    recent years and is very, very important. However, we struggle
    to reach children in rural areas. Can you talk a little bit
    about the challenge that you have experienced with the meals
    program, and then, also, based on your experience, can you give
    us some concrete recommendations as to what we can do to
    overcome some of those challenges.
        Mr. Riendeau. Sure. You know, as I said before, we have--
    Dare to Care serves both urban and rural counties, and probably
    much like your rural counties, particularly in Indiana, the
    distance between the communities is so great and the
    communities are so small that it is just very, very difficult
    to find locations where kids can go and congregate. Unlike our
    urban counties, there are not robust Boys and Girls Clubs with
    all-day programming and lots of things that these kids want to
    get to.
        So, the challenge is how do we find a way to get these kids
    access to summer food based on the realities of the county in
    which they live. So, we have looked at several different
    options. One of the thoughts we have is we have looked at--we
    actually have a bus. We have a school bus now, and we are
    actually looking at the possibility of preparing meals in our
    community kitchen, loading those in Cambros, and putting them
    on the bus and taking them out to the rural counties and simply
    driving to the hollas [phonetic], where you will have a
    community of 20 families, and dropping the meals off and
    letting the kids consume them as the bus goes away and goes to
    the next community.
        The challenge with that model under the current rules is
    unless the kids--unless we stop and the kids eat the meal on
    the bus and we count the number of children, we cannot be
    reimbursed. So, the sustainability of that model is doubtful
    and that is kind of the challenge that we are facing, which is
    why, one of the things we would like the committee to consider
    is allowing us to look at more flexible models in those
    counties, like I am sure in Arkansas would probably benefit
    deeply from that. Let us look at those and make those eligible
    for reimbursement, as well.
        Senator Boozman. Right. Mr. Goff, you mentioned that you
    started your program in 2009, and I think that is correct,
    okay, and I think that our States need to do as they feel like
    is best. Can you tell us, based on 2009 to now, what are your
    obesity levels? Have they gone down, or have they flattened
    out, or do they continue to go up, or do you have any knowledge
    about that?
        Mr. Goff. In West Virginia?
        Senator Boozman. Yes, sir.
        Mr. Goff. We adopted those standards in 2008, and our, I
    think----
        Senator Boozman. What has happened as a result?
        Mr. Goff. I think our obesity rate has leveled off. I do
    not have the data, but I do know that our school environments
    are healthier. In West Virginia, hunger and obesity live side
    by side. In trying to put the finger on the culprit, we have
    done everything in our power to provide safe and healthy
    learning environments for our kids.
        Senator Boozman. No, and I agree with that, totally. The
    only reason I mentioned that is that this really does go
    together with a whole host of other things----
        Mr. Goff. Mm-hmm.
        Senator Boozman. --and, so, we need to address this. Like I
    say, I do not disagree that you all are doing a great job in
    the sense of doing what you feel like is best for your kids,
    but it is--I think one of the problems we run into is that we
    feel like if we just do this or that in this particular area,
    we are going to solve our problem, and the reality is, with
    P.E. and lots of other things, after-school activities, all of
    that goes together, and if we do not do it all, then we are
    going to be in trouble.
        Ms. Jones, you mentioned in your testimony the importance
    of flexibility. Can you talk to us a little bit about
    specifically the kind of flexibility that you would like, or
    maybe in some areas or two.
        Ms. Jones. Sure. In a la carte menu the fact that we had to
    take a healthy choice off like a sub sandwich with turkey and
    cheese, does not make sense to me. That is a healthy item. We
    would like to have that flexibility to put those type of items
    back on our a la carte items.
        Having the decision to be able to raise the price of a meal
    or not, that should be determined by each district by what they
    feel their enrollment would be able to pay for. We want to be
    able to keep children coming into the cafeteria, because we
    cannot serve them nutritious meals if we do not have them
    eating with us.
        These are examples of the type of struggles that we are
    asking for flexibility. With the fruit and vegetable
    requirements, we really want to encourage our kids. That is
    something we have always thought was very important. But, we do
    not want to lose our unlimited fruits and vegetables because we
    cannot afford to offer them.
        Senator Boozman. Thank you. Thank you, Mr. Chairman.
        Chairman Roberts. Dr. Hassink, I apologize that we have not
    paid more attention to you, especially with all of the work
    that you have done.
        Senator Boozman. I would have if I had more time.
        [Laughter.]
        Dr. Hassink. Thank you.
        Chairman Roberts. But, and this is the typical situation
    where the Chairman of a committee is answering the question
    that I would have asked you. You made some excellent points
    with regard to a lack of specific nutrients at a specific time
    and the detrimental effect that that has had on attention and
    development, short-term memory, IQ scores----
        Dr. Hassink. Yes.
        Chairman Roberts. --everything that everybody strives for.
    But, if they miss the boat, they miss the boat. I am not asking
    you to expound upon that research. I think it is self-evident.
    But, I want to let you know how much we appreciate your coming
    and your statement.
        I am now moving to the conclusion of our hearing this
    afternoon. Yes, it is this afternoon.
        Thank you to each of our witnesses and to the first panel,
    as well, for taking your time, your very valuable time, to
    share your views related to the child nutrition programs. These
    testimonies that have been provided today are very valuable for
    the committee to hear firsthand and to keep on record. Your
    thoughts and insights will be especially helpful as we undergo
    the reauthorization process.
        To my fellow members, I would ask that any additional
    questions that they may have for the record be submitted to the
    committee clerk five business days from today or by 5:00 p.m.
    next Thursday, May 14.
        The committee now stands adjourned.
        [Whereupon, at 12:32 p.m., the committee was adjourned.]

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