[Senate Hearing 117-58]
[From the U.S. Government Publishing Office]
S. Hrg. 117-58
CHILD NUTRITION REAUTHORIZATION:
HEALTHY MEALS AND HEALTHY FUTURES
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HEARING
BEFORE THE
COMMITTEE ON AGRICULTURE,
NUTRITION, AND FORESTRY
UNITED STATES SENATE
ONE HUNDRED SEVENTEENTH CONGRESS
FIRST SESSION
__________
MARCH 25, 2021
__________
Printed for the use of the
Committee on Agriculture, Nutrition, and Forestry
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available on http://www.govinfo.gov/
__________
U.S. GOVERNMENT PUBLISHING OFFICE
45-390 PDF WASHINGTON : 2022
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COMMITTEE ON AGRICULTURE, NUTRITION, AND FORESTRY
DEBBIE STABENOW, Michigan, Chairwoman
PATRICK J. LEAHY, Vermont JOHN BOOZMAN, Arkansas
SHERROD BROWN, Ohio MITCH McCONNELL, Kentucky
AMY KLOBUCHAR, Minnesota JOHN HOEVEN, North Dakota
MICHAEL F. BENNET, Colorado JONI ERNST, Iowa
KIRSTEN E. GILLIBRAND, New York CINDY HYDE-SMITH, Mississippi
TINA SMITH, Minnesota ROGER MARSHALL, Kansas
RICHARD J. DURBIN, Illinois TOMMY TUBERVILLE, Alabama
CORY BOOKER, New Jersey CHARLES GRASSLEY, Iowa
BEN RAY LUJAN, New Mexico JOHN THUNE, South Dakota
RAPHAEL WARNOCK, Georgia DEB FISCHER, Nebraska
MIKE BRAUN, Indiana
Joseph A. Shultz, Majority Staff Director
Mary Beth Schultz, Majority Chief Counsel
Jessica L. Williams, Chief Clerk
Martha Scott Poindexter, Minority Staff Director
Fred J. Clark, Minority Chief Counsel
C O N T E N T S
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Thursday, March 25, 2021
Page
Hearing:
Child Nutrition Reauthorization: Healthy Meals and Healthy
Futures........................................................ 1
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STATEMENTS PRESENTED BY SENATORS
Stabenow, Hon. Debbie, U.S. Senator from the State of Michigan... 1
Boozman, Hon. John, U.S. Senator from the State of Arkansas...... 2
WITNESSES
Beers, Lee Savio, M.D., President, American Academy of
Pediatrics, Washington, DC..................................... 6
Green, Reynaldo, Vice-President, Nutrition and Family Well-Being,
Quality Care For Children, Atlanta, GA......................... 8
Gould, Jessica, Director, Nutrition Services, Littleton Public
Schools, Littleton, CO......................................... 10
Golzynski, Diane, Ph.D., Director, Office of Health and Nutrition
Services, Michigan Department of Education, Lansing, MI........ 12
Hoffman, Heidi M., Director, Colorado State WIC, Colorado
Department of Public Health and Environment, Denver, CO........ 13
Rodriguez, Carlos, President and CEO, Community Foodbank of New
Jersey, Hillside, NJ........................................... 15
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APPENDIX
Prepared Statements:
Beers, Lee Savio, M.D........................................ 40
Green, Reynaldo.............................................. 56
Gould, Jessica............................................... 62
Golzynski, Diane, Ph.D....................................... 64
Hoffman, Heidi M............................................. 68
Rodriguez, Carlos............................................ 78
Document(s) Submitted for the Record:
Boozman, Hon. John:
FMI 2021 WIC Reauthorization Priorities...................... 94
FMI, prepared statement for the Record....................... 96
Hyde-Smith, Hon. Cindy:
Senator Hyde-Smith, prepared statement for the Record........ 99
Question and Answer:
Beers, Lee Savio, M.D.:
Written response to questions from Hon. Debbie Stabenow...... 102
Written response to questions from Hon. John Boozman......... 103
Written response to questions from Hon. Kirsten Gillibrand... 104
Written response to questions from Hon. Richard Durbin....... 105
Written response to questions from Hon. Cindy Hyde-Smith..... 108
Green, Reynaldo:
Written response to questions from Hon. Debbie Stabenow...... 109
Written response to questions from Hon. John Boozman......... 110
Written response to questions from Hon. Cindy Hyde-Smith..... 110
Gould, Jessica:
Written response to questions from Hon. John Boozman......... 112
Written response to questions from Hon. Cindy Hyde-Smith..... 114
Written response to questions from Hon. Charles Grassley..... 115
Golzynski, Diane, Ph.D.:
Written response to questions from Hon. Debbie Stabenow...... 117
Written response to questions from Hon. John Boozman......... 117
Written response to questions from Hon. Patrick Leahy........ 118
Written response to questions from Hon. Cindy Hyde-Smith..... 119
Hoffman, Heidi M.:
Written response to questions from Hon. John Boozman......... 121
Written response to questions from Hon. Patrick Leahy........ 121
Written response to questions from Hon. Amy Klobuchar........ 122
Written response to questions from Hon. Kirsten Gillibrand... 123
Written response to questions from Hon. Richard Durbin....... 123
Written response to questions from Hon. Cindy Hyde-Smith..... 125
Rodriguez, Carlos:
Written response to questions from Hon. Debbie Stabenow...... 127
Written response to questions from Hon. John Boozman......... 128
Written response to questions from Hon. Patrick Leahy........ 131
Written response to questions from Hon. Amy Klobuchar........ 132
Written response to questions from Hon. Richard Durbin....... 133
Written response to questions from Hon. Cindy Hyde-Smith..... 134
CHILD NUTRITION REAUTHORIZATION: HEALTHY MEALS AND HEALTHY FUTURES
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THURSDAY, MARCH 25, 2021
U.S. Senate,
Committee on Agriculture, Nutrition, and Forestry,
Washington, DC.
The Committee met, pursuant to notice, at 9:35 a.m., via
Webex and in room 301, Russell Senate Office Building, Hon.
Debbie Stabenow, Chairwoman of the Committee, presiding.
Present or submitting a statement: Senators Stabenow,
Brown, Klobuchar, Bennet, Gillibrand, Smith, Durbin, Booker,
Lujan, Warnock, Boozman, Hoeven, Ernst, Hyde-Smith, Marshall,
Tuberville, Grassley, Thune, Fischer, and Braun.
STATEMENT OF HON. DEBBIE STABENOW, U.S. SENATOR FROM THE STATE
OF MICHIGAN, CHAIRWOMAN, U.S. COMMITTEE ON AGRICULTURE,
NUTRITION, AND FORESTRY
Chairwoman Stabenow. Good morning. I call the hearing of
the U.S. Senate Committee on Agriculture, Nutrition, and
Forestry to order, and welcome to all of my colleagues. I do
understand that we are going to have some challenges this
morning with votes. The first vote now has been moved up to
10:45. We will continue on through the hearing but please just
if you need to leave and vote and come back, we will keep it
going between the Ranking Member and myself chairing the
meeting, and making sure people have an opportunity to ask
their questions and so on.
I am so pleased to be here today to discuss how we create a
healthier future for our children. I know this is something we
all deeply care about. All parents want to see their children
grow up to lead healthy and successful lives. One of the best
ways to do that starts with the food on their plates. When
those plates are empty, it is a crisis for the children, it is
a crisis for the family, and it is a crisis, quite frankly, for
our country.
School meals were created because Congress recognized that
far too many children were growing up malnourished. On the
heels of World War II, that was a serious risk to our national
security. The Special Supplemental Nurtrition Program for
Women, Infants, and Children (WIC) was established in response
to the devastating impacts of poor nutrition on moms and
babies. Summer meals were created because children were going
hungry in between school years. At each of these turning
points, Congress saw a crisis and acted.
While a lot has changed since then, we need to take action
again today. The COVID-19 pandemic has only exacerbated the
dual challenge of obesity and hunger. Obesity rates for
children have been on the rise for years, again creating calls
for action from today's military leaderships, pediatricians,
public health experts. After the last year without recess or
after-school sports, early evidence is showing that the
pandemic has put more children at risk of obesity. According to
the American Academy of Pediatrics, who we will hear from
today, children in low-income households and communities of
color are more at risk of both obesity and COVID-19.
At the same time, too many children in this country do not
have enough to eat. Think about that--too many children in the
United States of America do not have enough to eat. One in four
children in the United States now face hunger because of the
pandemic.
It is clear we are facing a child health crisis and a child
hunger crisis. While the pandemic has created a new set of
challenges it has also created opportunities for us to improve
children's lives. Whether they are learning in person or
virtually, we know our children cannot focus with an empty
stomach. They need wholesome and nutritious breakfasts,
lunches, snacks in order to learn and grow.
During the pandemic, Congress gave schools new tools to
reach more families in need, minimizing paperwork and focusing
on creative ways to meet children where they are, whether it is
delivering meals along bus routes, giving out a week's worth of
meals at once, or providing a pandemic Electronic Benefit
Transfer (EBT) card to help families purchase food in the
grocery store. New tools helped schools reach more children in
need.
While we all are happy to be beginning to move past this
pandemic, we can apply these lessons and creative thinking to
how we reach children during the summer, on weekends, and after
school. As we transition back to in-person learning, we have to
use all of the tools in our toolbox to feed our kids and reduce
burdens on schools, daycare centers, and parents.
It is also important to make sure families have healthy
food for their children before they reach school age. The
successful WIC program helps pregnant moms and babies eat
healthy food in the critical first stages of life. Key
investments in technology and modernization, like telehealth,
data-sharing, even something as simple as text messaging can
help us feed more people in need.
It has been over 10 years since Congress last made
improvements to our critical child nutrition programs. With all
of the challenges we face, it is time to take action on a
bipartisan basis. Feeding kids is not and should not be a
partisan issue. I know my partner and my Ranking Member,
Senator Boozman, agrees. I look forward to passing a strong,
bipartisan child nutrition bill that helps our kids get
healthier, not hungrier.
Thank you so much, and I now turn to Senator Boozman.
STATEMENT OF HON. SENATOR JOHN BOOZMAN, U.S. SENATOR FROM THE
STATE OF ARKANSAS
Senator Boozman. Well, thank you, Chairwoman Stabenow, for
convening today's hearing, a very, very important hearing. I
want to thank all of our witnesses for their time and their
testimony today, and I also want to thank you for the
incredible that you have done over the past year during the
pandemic. Your organizations are made up of the heroes who are
on the front line every day, ensuring children receive the food
they need to grow and to thrive. Your innovation, your
tenacity, and the commitment to ensuring those in need have
access to food is truly amazing, and I think all of us on this
panel, and I think I can speak for all of us, truly commend
you.
I look forward to working with Chairwoman Stabenow and the
other members of the Committee to produce a bipartisan child
nutrition bill this year. I have been a co-chair of the Senate
Hunger Caucus for a number of years, so it is a priority of
mine to see a Child Nutrition Reauthorization bill cross the
finish line.
This hearing is the beginning of the process, and it is
critical that we listen to those of you who are operating the
programs, to understand the lessons you have learned during the
pandemic and to know what is working and where we may have
challenges. Many times things look good on paper, but when you
put them into practice reality demonstrates a different story.
We need your feedback so that government is helping you with
your mission, not getting in the way.
It has been over 10 years since the last child nutrition
reauthorization, and without a doubt some of the programs
certainly need to be modernized. There are many advances in
technology that the Chairwoman just talked about that we should
be considering for things like the WIC community. I hope to
hear more about telehealth, online purchasing of food items,
and other opportunities to move WIC into the 21st century.
We all know there are changes needed in the Summer Food
Service Program, an issue I have been working on for a few
years. The Summer Food Service Program needs to be modernized
to include flexibility in the congregate meals requirement to
better ensure that our Nation's children are getting the
nutrition they need to succeed.
Twenty-two million children receive free, reduced-price
healthy meals during the school year through the Federal
programs, but five out of six of these children are missing
meals during the summer. The Summer Food Service Program is
hamstrung by rules that dictate a one-size-fits-all solution,
requiring children to travel to a central location and eating
their meals together. However, more than 14 million low-income
children across the country live in communities that are
ineligible to operate an open summer meals site. In communities
where there are sites, access is far from easy. Lack of
transportation and extreme weather often keep children from
sites. In rural areas where roughly three million low-income
children live, the closest site may actually be several miles
away. The pandemic has heightened the need for increased
flexibility so that all options are on the table, from offsite,
grab-and-go models to home delivery to summer EBT.
I am also aware of the need for more streamlining across
the child nutrition programs and between WIC clinics and health
care professionals. When we streamline and reduce paperwork and
duplication it simplifies the process for everyone involved. I
hope to hear some thoughts on this also today.
Finally, I continue to hear concerns about the school meal
nutrition standards, and in particular the standards for milk,
sodium, and whole grains. The Arkansas School Nutrition
Association recently described to me the challenges they
continue to face with these standards. When schools are facing
the financial strain and doing their best to feed children
during the pandemic, I find it alarming that schools would also
be required to implement strict nutrition standards for which
product is not available. This is a concern that needs to be
addressed in the short term, but it is equally important to
find a long-term solution that gives schools certainty.
School nutrition professionals feed kids healthy,
nutritious meals each school day. I trust them to know their
students and what will work in their schools to ensure we are
feeding children and not trashcans. We know the healthiest
option for many students is to eat school meals. Our programs
should help empower schools to serve kids rather than create a
wedge that further decreases participation and increases
stigma.
Again, I want to thank all of you for your heroic efforts
this past year. As we move forward, I am committed to crafting
a bipartisan bill. I sincerely hope this will remain a
bipartisan process and the Committee can work its will in the
months ahead. We will have a better product certainly if we are
all at the table working together, and I have no doubt that we
will be.
Thank you for being here, and I look forward to today's
discussion.
Thank you, Madam Chair.
Chairwoman Stabenow. Well, thank you, Senator Boozman, and
I want to thank you for your leadership over the years on the
Hunger Caucus, and I could not agree more. I think we are going
to have a real opportunity to do something important for kids
and families, and do it in a bipartisan way.
We will now turn to introducing our witnesses, who are with
us virtually today. We thank each and every one of you for your
expertise and being willing to spend the time with us.
Our first witness is Dr. Lee Savio Beers. Dr. Beers is the
President of the American Academic of Pediatrics and a
Professor of Pediatrics and Medical Director for Community
Health and Advocacy at Children's National Hospital in
Washington, DC. She is the Founding Director of the DC Mental
Health Access in Pediatrics Program and Co-Director of the
Early Childhood Innovation Network.
She began her medical career as a naval officer in the
Medical Corps and has worked as a staff pediatrician at the
National Naval Medical Center in Bethesda, Maryland, and Walter
Reed Army Medical Center. Welcome.
I now recognize Senator Warnock, who will introduce our
next witness.
Senator Warnock [continuing]. and it is great to be here.
Thank you, Madam Chair. It is my distinct honor to welcome to
this Committee a fellow Georgian and also to welcome a fellow
alumnus of Morehouse College. We graduates of Morehouse College
call ourselves Morehouse Men, and they say you can always tell
a Morehouse Man but cannot tell him much.
[Laughter.]
Senator Warnock. We are grateful that Mr. Reynaldo Green is
her with us. He is the current President of CACFP Forum and is
the current Vice President of Nutrition and Family Well-Being
at Quality Care for Children in Atlanta, Georgia.
Since 2013, Mr. Green has been focused on his
organization's administration of a child and adult care food
program, serving four million meals and snacks to over 22,000
children across our State every year. We are so grateful for
their work. I applaud his work to ensure that the children of
Georgia have access to nutritious meals and snacks, and we look
forward to hearing his testimony. Once again, please welcome
Mr. Reynaldo Green.
Chairwoman Stabenow. Thank you so much, Senator Warnock. I
know turn to Senator Bennet, who will introduce our next
witness.
Senator Bennet. Thank you, Madam Chair Stabenow and Ranking
Member Boozman. Today I have an unbelievable privilege that I
never had in the Senator, which is to introduce not one but two
witnesses from Colorado.
Chairwoman Stabenow. That is correct.
Senator Bennet. Both are leaders in child nutrition who
work to ensure that kids across our State have access to
healthy and nutritious meals. First is Jessica Gould, who for
six years has served as the Director of Nutrition for Littleton
Public Schools. She is the Past President and Vice President of
the Colorado School Nutrition Association. Jessica has
extensive experience in school nutrition, when an emphasis in
advocacy, menu planning, purchasing, use of commodities, and
financial accountability. She is also a registered dietician
and school nutrition specialist.
Heidi Hoffman has also joined us. Heidi serves as
Colorado's State WIC Director. She has worked in the State's
Department of Public Health and Environment since 2017. She has
sought to modernize WIC services and connect families to local
farmers and food systems throughout the WIC Farmers Market
Nutrition Program. Previously she worked as a food access
program administrator for the City and County of Denver, and a
health promotion manager in Mesa County. She holds an MPA from
the University of Colorado and a nutrition and dietetics degree
from Colorado State University.
Thank you, Madam Chair.
Chairwoman Stabenow. Well, thank you, Senator Bennet, and
we really are bipartisan. You introduced a majority witness and
a minority witness, and just for the record we do not intend to
let this happen again.
[Laughter.]
Senator Bennet. I am proud of my whole State.
Chairwoman Stabenow. No, we are very proud of your
witnesses today. I am going to turn now to Senator Booker who
will introduce our next witness. Senator Booker.
Senator Booker. Thank you, Chairwoman. For I was hungry and
you gave me food. I was thirsty and you gave me drink. I was a
stranger and you welcomed me. I was naked and you clothed me. I
was sick and you visited me. Many Senators on both sides of the
aisle know that verse from Matthew 25, are animated, inspired,
and motivated by it.
I have the pleasure of introducing Carlos Rodriguez, who in
all of America is one of the best exemplars of that spirit. He
is recognized as a great and noble voice against hunger and in
doing the actual work of addressing the needs of the poor.
Over the course of the last 22 years, Carlos has focused on
improving policies and delivering services to the scale needed
to reach all the neighbors indeed. He was actually born in the
South Bronx, where he was raised, and Carlos has had a profound
appreciation for the impact that policy on people's lives. Much
of hunger and poverty is a policy choice and not an inevitable
reality.
Now Carlos saw the light and he rose on up to move to New
Jersey, got out of the shadow of our great State and became a
part of it. He is the CEO of the Community FoodBank of New
Jersey, where he focuses on bringing individuals, corporations,
community groups, and government organizations together for a
better future. He is responsible for serving over 1.2 million
people in New Jersey who are struggling with food insecurity.
His work to feed people and shorten the pantry lines involves
increasing distribution of nutritious food while helping to
address the root cause of hunger and connecting working
families with resources, helping them earn a sustainable
living. He is a noble man, a man of dignity and honor, and I am
grateful that he is in New Jersey, but I am grateful also that
he is here today with us.
Thank you, Chairwoman.
Chairwoman Stabenow. Well, thank you so much, Senator
Booker. We very much appreciate the introduction and the
witness.
Now last but certainly not least, from my book, is Diane
Golzynski, who is the Director of the Office of Health and
Nutrition Services and the State Child Nutrition Director at
the Michigan Department of Education. Diane, we are so glad to
have you with us. She is responsible for USDA child nutrition
programs, including school lunch and breakfast, summer food
service, and child and adult care food programs. She also
oversees USDA commodity household programs for families and
seniors in need, and the school and health and safety programs
to support mental, behavioral, and physical health for students
in our schools.
Diane is a registered dietitian and is passionate about
health and safety for all children and their families. We
welcome you as well.
To all of our witnesses, we will now hear from each of them
and then go to questions. First, Dr. Lee Beers. Welcome.
STATEMENT OF LEE SAVIO BEERS, M.D., PRESIDENT, AMERICAN ACADEMY
OF PEDIATRICS, WASHINGTON, DC
Dr. Beers. Thank you, Chairwoman Stabenow and Ranking
Member Boozman, thank you so much for the opportunity to
testify here today. My name is Dr. Lee Savio Beers, President
of the American Academy of Pediatrics, or AAP, a nonprofit
professional organization of 67,000 pediatricians.
As a pediatrician, I see first-hand the health effects of
food insecurity and malnutrition in my patients. I also see the
positive impact of Federal child nutrition programs. I began my
career as a Navy pediatrician. Many of the enlisted families I
cared for were food insecure and eligible for nutrition
programs, yet were not aware. I educated my patients about how
to access these critical programs which reduced stress on the
family and contributed to the servicemembers' readiness.
Since the pandemic began, food insecurity has increased
substantially, especially for households with children. Early
in the pandemic, many of my patients had difficulty obtaining
infant formula. While these challenges have improved, many
families still do not have enough food to make it through the
week. Significant racial disparities in food insecurity, which
existed before COVID-19, have persisted during the pandemic.
I see this in my practice, where we have been screening for
food insecurity for several years. Food insecurity affects the
health, growth, development, and educational outcomes of
children, from infancy through adolescence.
One of the most effective investments the Federal
Government can make to reduce food insecurity and obesity in
early childhood, improve birth outcomes, and support
breastfeeding mothers is to increase access to WIC. The waivers
USDA provided during the public health emergency to allow
remote enrollment, services, and benefits have been crucial to
helping families in need, and should be made permanent.
I am fortunate to practice in a place where our WIC clinic
is just across the hall. This proximity allows for better
collaboration and more consistent communication between health
care providers and WIC staff, and is significantly more
convenient for patients, many of whom rely on public
transportation.
We urge Congress to provide direct funding from USDA to
physician practices to support their ability to have a co-
located WIC clinic. Congress should encourage USDA to test the
feasibility of systems and data bases that break down the silos
that exist between WIC and physicians' offices, and allow them
to share limited health-related information in order to
streamline and improve patient care and enhance the participant
experience. This would reduce duplicative medical procedures,
such as the drawing of blood for testing, and the burden on
caregivers to communicate health-related information to their
child's pediatrician.
Before the pandemic, only 51 percent of eligible
individuals were participating in WIC. The AAP strongly
supports the WIC Act, which would address many of the barriers
to participating in WIC. We also encourage Congress to allocate
funding for USDA to conduct recruitment and retainment efforts
to reach more families.
Preliminary data shows an increase in pediatric obesity
during the pandemic. These findings mirror what I have seen in
my clinic and what pediatricians across the country are
reporting. One pediatrician I heard from saw a child who had
gained 90 pounds in the last year, one who had gained 60
pounds, and three who had gained 30 to 40 pounds, all in one
day in clinic. She was in tears describing it as the most
depressing day she has had in a long time.
As rates of food insecurity and child obesity rise, the
importance of healthy school meals has taken on new urgency. It
is critical we build on the progress made under the Healthy
Hunger-Free Kids Act to improve the nutritional quality of all
foods available in schools so that they are aligned with the
Dietary Guidelines for Americans and to provide schools with
the resources they need to serve healthy school meals.
AAP supports healthy school meals for all students,
regardless of income eligibility. The nationwide waivers put in
place during the pandemic have allowed every student to access
school meals, decreasing barriers to participation and stigma,
and should be extended beyond September 30, 2021.
We appreciate the Committee's focus on summer meals and
hope that Committee will increase resources for, and expand
access to, summer feeding programs. Given how effective the
pandemic EBT program has been, after the pandemic this model
should be used to ensure students have access to healthy meals
during the summer months, on weekends, and during school
holidays.
These elevated rates of food insecurity and obesity will
not vanish as soon as schools open for fully in-person learning
or the COVID vaccine is widely available. We are grateful for
the investments Congress has made in child nutrition in past
COVID-19 relief packages, and we support the effort to
reauthorize and strengthen these vital programs for children.
Thank you so much for the opportunity to be here today, and
I look forward to answering your questions.
[The prepared statement of Dr. Beers can be found on page
40 in the appendix.]
Chairwoman Stabenow. Thank you very, very much for that
important testimony.
Now we welcome Mr. Green. Welcome.
STATEMENT OF REYNALDO GREEN, VICE-PRESIDENT, NUTRITION AND
FAMILY WELL-BEING, QUALITY CARE FOR CHILDREN, ATLANTA, GEORGIA
Mr. Green. Thank you for this opportunity to speak with you
today. My name is Reynaldo Green, President of the National
CACFP Forum, a leading national organization that works to
strengthen and expand the program to underserved communities. I
am also the Vice President of Nutrition and Family Well-Being
at a statewide nonprofit called Quality Care for Children, a
CACFP sponsor located in Atlanta, Georgia.
I sincerely appreciate Chairwoman Stabenow and the Ag
Committee's leadership and commitment to CACFP, both during
COVID-19 and in normal times.
We are at a critical juncture to strengthen the Child and
Adult Care Food Program through Child Nutrition
Reauthorization. This will allow us to continue the original
intent of the program: to address hunger and improve the
nutritional well-being of millions of children across this
country.
In 2020, CACFP connected 4.2 million children with high-
quality meals and snacks, while providing $3 billion in
reimbursement to local communities. This program promotes early
healthy eating habits and helps prepare children for school by
being ready to learn.
The program plays a vital role in improving the quality and
affordability of child care for many families with a low
income. However, there are thousands of child care programs
that do not participate because the benefits are inadequate,
the program is wrought with burdensome paperwork, and the
losses and penalties are too detrimental to child care programs
that already operate on razor-thin margins.
The brunt of these barriers disproportionately impacts both
communities of color and providers with fewer resources,
contributing to gross inequities in child care quality and
nutrition.
The Forum believes equity in CACFP can be achieved through
CNR if we remove systemic barriers that often give advantages
to better resource programs. This is how we can do that. First,
we recommend Congress to expand CACFP to allow a much-needed
afternoon snack or supper for children in full day care. Right
now, providers can receive a maximum reimbursement of two meals
and a snack per children, per day, through the program.
Children need this additional snack or meal to meet their
nutritional needs if they are in care for eight hours or more.
This act will allow the program to support the nutrition
standards for children in full day care as specified by the
American Academy of Pediatrics and the American Public Health
Association.
Another need is for proprietary child care businesses to
undergo an annual eligibility verification process instead of a
monthly one. The vast majority of this type of child care is
small businesses or mom-and-pop-operated care. By switching
this process to one time per year we not only eliminate an
undue burden, but we also make this process consistent with
other Federal nutrition program eligibility requirements.
As stated earlier, burdensome paperwork has become a
deterrent to participation. Many issues can be solved by
streamlining CACFP processes to be consistent with the USDA
Paperwork Reduction Workgroup's Report to Congress. One step is
to modernize applications. We must eliminate normal days and
hours of time on enrollment forms. Based on Federal rules,
State agencies are penalizing program operators, resulting in
the loss of thousands of dollars each month, simply because the
original and signed enrollment form are not consisted with the
changing, on-demand work schedules of families today.
Second, allow the use of electronic data collection and
virtual visit systems that follow all the required Federal
CACFP standards. The pandemic has shown us that we can do this
with efficiency without losing program integrity. This is also
very beneficial to rural providers and their families.
COVID-19 has exacerbated inequities in food security and
education. Therefore, now more than ever, we need to strengthen
and enhance access to CACFP which supports quality child care,
good nutrition, and economic stability for families with low
incomes.
The positive effects of CACFP can be expanded and
strengthened by improving the adequacy of benefit by allowing
another meal or snack for children in full day care, making
proprietary care eligibility consistent with other Federal
nutrition programs by allowing yearly verification, and by
eliminating overly burdensome and outdated paperwork.
In the interest of time, I have focused on these key
points, but we have a full list of recommendations with
additional details in the written statement, and, of course, I
am more than happy to answer any of your questions.
[The prepared statement of Mr. Green can be found on page
56 in the appendix.]
Chairwoman Stabenow. Thank you so much. We very much
appreciate your comments, and the points you raised are very
important.
Next we will hear from Ms. Gould. Welcome.
STATEMENT OF JESSICA GOULD, DIRECTOR, NUTRITION SERVICES,
LITTLETON PUBLIC SCHOOLS, LITTLETON, COLORADO
Ms. Gould. Thank you. Thank you, Madam Chair and Committee
members, for the opportunity to share with you today. My name
is Jessica Gould and I am a registered dietitian and the
Director of Nutrition for Littleton Public Schools in
Littleton, Colorado. My district has approximately 15,000
students with 21 schools, all having full-service kitchens. We
are 18 percent free and reduced.
I want to start today by saying thank you for focusing on
Child Nutrition Reauthorization. When the Healthy, Hunger-Free
Kids Act became law, child nutrition operators were excited and
anxious because we agreed with many of the changes for our
program, and we had many challenges ahead of us. I am excited
to share with you today that our students finally understand
that fruit and vegetables are required to make a meal, and they
are enjoying and eating the options that we are providing.
We have seen this year that the waivers that eliminated
area eligibility and allowed students to take non-congregate
meals for multiple days have been incredibly advantageous for
our students and families. My district has operated k-5 in
person, secondary hybrid, fully remote, and now we are back
fully in person, and these flexibilities helped ensure we are
able to provide access to meals to all students.
I know that students in every one of my schools that are in
need, regardless of their free and reduced percentage, and I
have not seen this taken advantage of at this time. However,
the gratitude of my families that I am able to meet in their
neighborhood is overwhelming. I believe as you look at CNR
these flexibilities to ensure we are providing access to all
students is very important.
As a child nutrition operator, I also request that we
maintain the current flexibilities on sodium, whole grains, and
milk. Operators across the country are committed to serving our
students nutritious, well balanced meals, and I believe we are
doing just that.
Meeting Tier two and very soon Tier three sodium poses
serious concerns for our programs and ultimately students. How
many of you enjoy lettuce, tomato, and pickles on top of your
hamburger or cheeseburger? For my program to meet Tier one, we
have had to create a vegetable serving of these three items and
limit the pickles to only two to meet regulatory requirements.
Our students are now used to this. However, I also see many of
them walking across the street to a fast-food restaurant
because they think that our food does not have enough flavor.
Tier three sodium is incredibly concerning to me. Many meal
staples, like a turkey and cheese sandwich on whole grain
bread, or a salad with chicken breast and no dressing, and any
of our scratch-made items, including our students' favorite
marinara, would be cut. We all know that sodium is naturally
occurring in food. After removing the roughly 125 milligrams
just in our milk we would be left with only 515 milligrams for
a fruit, vegetable, and an entree at our elementary level. We
have also determined that this would eliminate protein options
from breakfast if we are required to meet Tier three.
This change would also have a significant impact on our
vegetarian options that we provide. Many of these items are
made with legumes or cheese and would have to be cut from our
menus. Even our sun butter and jelly sandwich would not be
allowed. Any variety and culturally diverse items would be a
thing of the past in our programs.
We are seeing more and more manufacturers leaving the
industry due to the constant changes within our Program, and
for the manufacturers that are sticking with us, yes, they can
work on reformulation of products. However, that cost will
eventually hit our school nutrition budgets, and we are
critically suffering right now. Who is to say, at the end of
the day, if that product will actually be palatable for our
students. Our meals are not nutritious until they are in the
bellies of our students.
In LPS, we are at 75 percent of our grains are whole grain,
and I request that we keep the grain requirements to 50
percent, because it allows for regional items to be offered and
accepted by students. From biscuits in the South to tortillas
here in Colorado, this option allows us to continue providing
meals our students will love and will eat. In LPS, we also use
the waiver for our pastas. We have a few scratch-made pasta
bakes, and whole grain pastas do not hold well. These recipes
were brought back after the whole grain requirement was changed
back to 50, because when I originally brought them out with
whole grain pasta I received calls from principals, parents,
and students, saying that our food was inedible.''
These are just a few examples of why it is critical for our
programs' participation and ultimately sustainability to keep
these regulations where they are. In my district where many
students can choose to eat with our program, I believe if
required to implement these changes we will not survive.
I could go on and on, and I also respect your time and my
limit. I am happy to answer any questions from an operator's
perspective. Thank you.
[The prepared statement of Ms. Gould can be found on page
62 in the appendix.]
Chairwoman Stabenow. Thank you so much. I very, very much
appreciate your input.
Let me now turn to Dr. Golzynski, and thank you so much for
your leadership in Michigan, and I appreciate your testimony.
STATEMENT OF DIANE GOLZYNSKI, Ph.D., DIRECTOR, OFFICE OF HEALTH
AND NUTRITION SERVICES, MICHIGAN DEPARTMENT OF EDUCATION,
LANSING, MICHIGAN
Dr. Golzynski. Thank you very much. Investing in the
education of our children is an investment in the future of
this great country. Reliable access to healthy foods is truly
one of the most important investments we can provide for our
children.
[Audio interruption]--in the great State of Michigan. I am
honored to be here with you today outlining priorities for that
investment in reliable access to and education around healthy
food.
The child nutrition programs, including SNAP, WIC, school
lunch and breakfast, child care meals, and summer meals provide
an incredible safety net for families and children, yet we are
seeing an alarming number of childhood poverty and hunger. No
child should experience hunger, and it is our responsibility as
the adults that care for them to design and build the strongest
safety net possible.
My dad grew up hungry, and I was a first-hand witness to
the life-long effects that childhood hunger had on him,
eventually contributing to his death. Chronic disease, high
health care costs, and a lower educational attainment were
preventable realities for my dad. No child chooses to be
hungry, and we have the opportunity to continue to strengthen
the child nutrition programs to help prevent futures for our
children that mimic what my dad experienced.
In 2010, the Healthy Hunger-Free Kids Act aligned our
school meals with the strong, science-based recommendations
from the Dietary Guidelines for Americans. We have learned a
lot from those early days of HHFKA, and we have an opportunity
to build on those lessons learned. We must continue to align
all child nutrition program meals with the most up-to-date
dietary guidelines.
We must put the education, attainment, and future health of
our children above all else and fund it like it is truly the
priority that it is. Strong nutrition standards should be
viewed as a goal that can be attained if we continue to equip
school nutrition programs, school staff, parents, and children
with the necessary tools and education to get there.
Just as we have put training wheels on a bike for a child
to learn, we must do the same with nutritious foods. From stir-
fry lines to cafeterias designed to mimic a food court, we
should never give up on the education of a child, whether it is
in reading, math, or nutrition.
In Michigan, we have additional State investment of 10
cents per meal when it includes a local fruit, vegetable, or
dried beans. This exposure to healthy local produce has
increased the children's acceptance and excitement to the point
where parents are telling us that the children now request the
produce grown by their local farmer at home.
The school meals of today do not look anything like what
you and I experienced when we were in school. We must do more
to engage parents and school staff in the incredible food being
served in today's cafeterias and the connection of those meals
to the well-rounded education of the whole child. Everyone
involved must understand that these meals provide invaluable
nutrition education for what a life-long, healthy diet looks
and tastes like, and we should never give up on that education.
As schools begin to reopen, we expect to see the school
meal revenue drop and unpaid meal debts soar, as families
cannot or will not easily return to sending money to school for
food. With the number of families struggling who have not
experienced poverty before, we believe the stigma of applying
for free or reduced-price meals will keep even more families
from seeking the assistance they need. Children simply should
not have to wonder if they are going to be able to eat while at
school.
We must also provide a healthy breakfast at school in a
manner to which reduces stigma and increases the opportunities
for children to participate. In talking with a local
superintendent, he told me that the number of children in his
district that qualify for free or reduced-price meals was not
high enough for him to do the work to even offer the program.
He has over 1,000 students in his district that qualify. That
is over 1,000 students that have no opportunity to eat
breakfast at school, and that does not take into account the
additional children whose families are too ashamed to apply or
whose incomes are just above the threshold to qualify.
Children should also not have to shoulder the burden of
wondering if they are going to eat when school is not in
session. Whether it be the weekend, school breaks, a natural
disaster, a pandemic, or the summer months, we need a child
nutrition program that can be immediately responsive and
provide healthy meals that strive to meet the dietary
guidelines. Lessons learned from non-congregate meals and
parent pickups during the pandemic should guide a future revamp
of that program.
As families try to regain some sense of normal, go back to
work, get caught up on rent and other payments, we must
continue to be that glue for our children. Mental health and
child hunger are realities of the pandemic that we should be
addressing now and continue that support for years after the
pandemic officially ends.
Thank you for your continued support of the child nutrition
programs. Thank you for maintaining high nutrition standards
that teach our future generations ways to meet the dietary
guidelines so that we can continue to tackle the diet-related
diseases that plague our country. After all, we must be
successful in nutrition because our future cannot be successful
without it. Thank you.
[The prepared statement of Dr. Golzynski can be found on
page 64 in the appendix.]
Chairwoman Stabenow. Thank you so much, Diane. I very much
appreciate your words and your work.
Ms. Hoffman, welcome.
STATEMENT OF HEIDI M. HOFFMAN, DIRECTOR, COLORADO STATE WIC,
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, DENVER,
COLORADO
Ms. Hoffman. Thank you. Madam Chair Stabenow, Ranking
Member Boozman, and members of the Committee, thank you for
inviting me to testify today about WIC. I am Heidi Hoffman. I
work at the Colorado Department of Public Health and
Environment as the State Director of our WIC program, which
serves 130,000 Coloradans each year. I am also here in my
capacity as chair of the Legislative Committee for the National
WIC Association, a nonprofit organization representing the
interests of 89 State agencies and nearly 1,800 local WIC
providers.
As you know, WIC provides personalized nutrition education,
healthy food, and support to pregnant and postpartum women, and
children up to age five. The evidence is clear that WIC leads
to healthy pregnancies and births and a healthier start for
young children, as well as significant taxpayer savings, with
every dollar spent returning at least $2.48 in future health
care savings.
WIC could have even more impact for Americans families by
enacting long-recognized, bipartisan eligibility expansions for
women and children who are not yet enrolled in school. The
challenges, however, are equally clear. Before the pandemic,
only 51 percent of those eligible were receiving WIC service,
even fewer in my State and others, due to a variety of
barriers, including things like reliable transportation and
getting time off from work. There is a lot of room to modernize
and streamline the program.
During COVID, waivers have allowed us to safely provide
services with phone and video appointments and to issue
benefits remotely onto EBT cards. This has helped growing
families and those caring for small children to put healthy
staple foods on their table, even during multiple upheavals to
their work, school, and home lives.
The clearest lesson we have learned is that we cannot
return to our prior business model, designed over 40 years ago,
and still meet the needs of busy parents and other caregivers.
Remote appointments allow more engagement during nutrition
counseling, without needing transportation or additional time
off work. As Dr. Beers discussed, sharing health screening
information with health care providers coordinates and improves
care. Extending certification periods ensures that benefits are
available at critical times in a child's development.
In order to reach all eligible families who want WIC, we
must be able to meet the expectations of a modern generation of
parents. Just two weeks ago, the American Rescue Plan included
$390 million for outreach, innovation, and program
modernization, a substantial investment that will help connect
eligible families with WIC support.
These resources can make a world of difference to cash-
strapped States. For example, Colorado and many others
participate in a national marketing campaign that provides
branding, social media content, and COVID information to create
a consistent national brand for the WIC program. We also work
with our State SNAP and Medicaid agencies to refer eligible
families between programs.
Creative outreach and data-sharing efforts are consistently
stymied by tight budgets and limited staff capacity, both the
result of an inflexible funding formula that routinely
underinvests in WIC's proven nutrition, breastfeeding, and
health benefits.
In Colorado, we developed an online referral form for
health care providers, food banks, and family members to refer
people to WIC. This pre-filled information is sent directly to
a local clinic to simplify and shorten the process for families
to get certified. All State WIC agencies need straightforward,
technological innovations such as this, that improve the user
experience and make services more accessible.
This is also clear in the shopping experience. As SNAP
agencies scaled up online purchasing options last year, that
conversation was just starting for WIC, which recently switched
over to EBT cards. We must thoughtfully work with our retail
and technology partners to develop nationwide solutions that
will make modern and accessible shopping options available for
WIC families, including online payment and home delivery.
One final thought I would like to share. Colorado greatly
values our partnership with the UTE Mountain UTE Tribe, which
operates as one of 33 Indian Tribal organizations directly
administering WIC services. This option empowers Tribal
sovereignty and builds stronger government-to-government
relationships. One way this partnership has benefited both
agencies is when Colorado obtained approval to join the WIC
Farmers Market Nutrition Program for the first time just this
year. FMNP provides an additional food benefit for families to
spend with local farmers. This is currently capped at just $30
per person, per year. An additional investment would help
strengthen the partnership between our local food suppliers and
WIC shoppers.
We are grateful that our UTE Mountain UTE Sister agency has
agreed to help distribute these benefits to their WIC families
living in Colorado, as we work together to serve the people and
the food producers living within our neighboring service areas.
Thank you again for the opportunity to testify. We
appreciate your support of WIC and CNR this year, and look
forward to your questions.
[The prepared statement of Ms. Hoffman can be found on page
68 in the appendix.]
Chairwoman Stabenow. Thank you so much. We agree, WIC is an
incredibly important program. Thank you so much.
Last but certainly not least, Mr. Rodriguez. Welcome.
STATEMENT OF CARLOS RODRIGUEZ, PRESIDENT AND CEO, COMMUNITY
FOODBANK OF NEW JERSEY, HILLSIDE, NEW JERSEY
Mr. Rodriguez. Thank you. Thank you, Senator Booker, for
the generous and kind introduction, and for your long-time
support of the FoodBank's mission and our neighbors in need.
Chairwoman Stabenow, Ranking Member Boozman, and
distinguished Committee members, thank you for the opportunity
to speak at today's hearing. I am privileged to serve as the
President and CEO of the Community FoodBank of New Jersey, our
State's largest anti-hunger organization that provides access
to food and other critical resources for 15 of New Jersey's 21
counties. For most of my career I have worked on the front
lines of the fight against hunger, including at three different
food banks across two States.
I am also someone with lived experience, relying on Federal
child nutrition programs as a child growing up in the South
Bronx. Meals provided by the Summer Food Service Program kept
me well fed when school was out, and nourished me to become who
I am today.
During the time that I have this morning, I will discuss
how we can bolster Federal after-school and summer meals
programs to achieve more meaningful effects on childhood hunger
year-round. First, because I can think of no better way to
illustrate the impact and importance of these programs, I want
to tell you the true story of a little girl who likely would
not have enough to eat without them.
In December 2019, just before COVID hit, our team met
Paige, a gregarious, eight-year-old at one of our partner sites
that offers both the Child and Adult Care Food Program and
Summer Food Service Program. She marched right up to us, eager
to talk about her experience there. While enjoying a well-
balanced meal of an apple, carrots, milk, and whole wheat
turkey sandwich, she explained that she and her two siblings
visited the site every day while their parents were at work.
She said one thing in particular that we will never forget.
``We like coming here because we don't get this kind of food at
home.'' I heard loud and clear that without the meals provided
by the after-school program, Paige and her siblings would have
had to contend with an empty refrigerator at home. Instead, she
skipped off from our conversation that day to go play
basketball with her friends, a happy and healthy child.
For so many kids like Paige, who live in households
struggling to make ends meet, the arrival of COVID-19 several
weeks later made putting food on the table an even more urgent
challenge.
Today more children than ever, at least one in six
nationwide, are going to bed with empty bellies. As we have
worked to nourish the record number of children in need during
the pandemic, we have learned valuable lessons that have been
informed the recommendations that I have for you today.
The goal of Federal nutrition program should be to
consistently nourish every child's success, not just to comfort
them in times of distress. Many of the flexibilities that the
USDA has enabled during the pandemic, particularly with regard
to CFSP and CACFP, should be made permanent, as they have
improved the program significantly, allowing them to reach more
children, more equitably.
This year, Congress has an important opportunity to improve
the health and well-being of millions of our Nation's children
by passing a strong reauthorization bill that provides a
seamless, year-round option for providers, lowers area
eligibility for site participation, relaxes the congregate
feeding requirement, and utilizes the efficiencies of a summer
grocery cart. These measures would strengthen the site-based
model for child nutrition programs by enabling the
participation of more sites, helping food banks and other
providers to reach more children, and reducing the
administrative burden. They would also enable us to provide for
more children in underserved and hard-to-reach area, meeting
them where they are with alternative distribution models.
The pandemic EBT program has also proven to be a powerful
mechanism to support children and families in a situation that
causes school closures. Our own experience in New Jersey has
shown that even under these challenging circumstances the
exceptions provided by the COVID-19 waivers have unlocked
enormous potential for Federal child nutrition programs to
yield gains in access, equity, and reach.
We urge this Committee to take these lessons to heart, if
the goal is to make real progress in ending child food
insecurity and ensuring opportunity for all of our Nation's
children.
On behalf of the Community FoodBank of New Jersey, the
nationwide network of Feeding America food banks, and our
community partners and the neighbors in need that we touch, I
thank you for your time and attention.
[The prepared statement of Mr. Rodriguez can be found on
page 78 in the appendix.]
Chairwoman Stabenow. Thank you very, very much. We will now
turn to questions, because of votes I want to remind colleagues
of a couple of things. We are going to really try to stay to
the five-minute rounds on questions. If you are virtual, please
put on a stopwatch or something so we are going to try to stay
to that. We will get through this and make sure that colleagues
who are virtual know at what point they will be in the line for
questioning.
First let me say, Dr. Golzynski, you noted that schools and
communities are likely to face some challenges as schools
transition back to in-person learning and more traditional
school meal service. That just makes common sense to me that
there are going to be some challenges.
What are some of the ways that we can make sure children
are not left behind as this happens?
Dr. Golzynski. Thank you, Chairman Stabenow. I believe that
we need to do outreach to parents and communities and school
leaders to assure that they know and understand the changes in
the program as we transition to whatever our new, better normal
is. We can look at expanding community eligibility, maybe
eliminating the reduced-price category. We need to make sure
that our food service directors and their staff know and
understand how to prepare the healthy foods, and we need to
make sure that our food supply chain has those products
available so that our programs can offer those to the students.
We need to also remind the students--we heard Jessica say
that her students know and understand that a fruit or vegetable
is required with all of the meals. We need to remind the
students, as we go back to school in person, that that is still
a requirement, even though they may not have seen that with
parent pick-up meals during the pandemic.
We need to look at our districts and not see them as a free
or reduced-price percentage but see them as students who are
there to learn and need to have the tools necessary in order to
learn.
I am looking forward to doing some additional outreach,
some additional training for our staff, and making sure that as
everyone starts to come back to this new, better normal that we
have really provided everyone with the tools necessary to be
successful.
Chairwoman Stabenow. Thank you so much. Now Ms. Hoffman and
Dr. Beers. First, Ms. Hoffman. In your testimony, you discussed
the need to modernize WIC, and some of the work that Colorado
is doing to reach more moms and babies. Can you elaborate on
the areas where innovation is most needed, and how some of the
coordination between programs and health care providers helps
WIC families? Then I would ask Dr. Beers, from your
perspective, as a physician, could you also speak to why this
coordination would strengthen outcomes. Ms. Hoffman?
Ms. Hoffman. Absolutely. Thank you, Senator, for the
question. We are excited about the potential for innovation in
the WIC program. One promising practice is creating closer
coordination between SNAP, Medicaid, and WIC. We need to build
in referral policies and assure buy-in from all three programs,
and we need sustained funding to help us with data security and
outreach.
As WIC works closer with health care providers, we need to
be able to share information, like iron tests, growth charts,
and developmental assessments, to ensure the best possible
outcomes and ease the burden on families.
Our technology and data systems were built years ago, to
deliver program benefits and ensure compliance, but not to
share, collaborate, or innovate. We need updated regulatory
flexibility and additional funding to modernize the program and
serve as a functional partner to our health care and other
programs.
Chairwoman Stabenow. Thank you. Dr. Beers?
Dr. Beers. Yes. Thank you for that question, and I would
very much agree with everything that was just said and would
even elaborate on some of those things. I think, you know, we
really are seeing, as I mentioned, in our offices that
children's nutrition is really suffering right now, and as
pediatricians we want to use every tool in our toolbox to help
address that, and good communication with WIC is one of those
things. If we can really be communicating well with our WIC
partners, and as I mentioned, co-locating WIC is honestly one
of the most important and best ways to do this, you know, for
me to be able to walk across the hall and poke my head in the
office of the WIC nutritionist is just--I cannot even tell you
how much that contributes to patient care. I think that is one
really important piece.
You know, the other thing that we have seen with our WIC
partners is that they can be great partners with us in terms of
education and in helping us to connect with families who have
been lost to care. That is another really important area for
coordination and collaboration together. I appreciate that
question, and I guess the last thing I would add is that the
electronic communication has been very, very helpful, and I
have been hearing from pediatricians that that has been a real
plus.
Chairwoman Stabenow. Thank you very much. Finally, my last
question. Mr. Rodriguez, during COVID pandemic, EBT and meal
delivery and pick-up were very, very helpful to make sure that
children got the meals they needed when they were not in
school. Could you speak about how these tools help to fill the
gaps that we see in summer and other out-of-school times after
the pandemic ends?
Mr. Rodriguez. Absolutely. Thank you for the question.
Flexibility was the key to being able to respond during this
pandemic, and just a few kinds of key examples. First, on the
whole concept of creating a seamless, year-round option for all
sponsors. I think it is important to realize how much
administrative burden and kind of bandwidth it takes away from
some of the same providers that are providing both programs, to
be able to stop and do a training that they just had a couple
of months earlier and kind of re-engineer very nuanced policy
changes to be able to administer the program. This streamlining
option, I think, can help us bank that effort to do more
outreach and focus on child enrichment programs.
I think specifically, in terms of what we can do with
flexibility, I share with you the story of an experience that
we had in Woodbine, a small South Jersey community, where
approximately one in five families were living in poverty
before COVID, and yet they would not have met the area
eligibility requirement to be able to provide a summer meal
prior to. In fact, we did not have any summer meal sites there
prior to COVID. Yet, because of the flexibilities afforded over
this last year, we did have that, along with 20 new sites
throughout the State during this much-needed time.
Because this is just one of many concrete examples of how
the program flexibilities introduced during the pandemic help
us create access needed for meals for children.
Chairwoman Stabenow. Thank you very much, Mr. Rodriguez,
and I will turn to Senator Boozman.
Senator Boozman. Thank you, Madam Chair, and again, thanks
so much to the panel and all you represent. Nobody has done a
better job during the pandemic than you all have, and before
the pandemic. We really do appreciate your service.
Ms. Gould, you are a registered dietitian responsible for
planning your menus to ensure your school meals meet the
nutrition standards. If all grains have to be whole grain-rich
and target three sodium restrictions take effect, how does that
affect your ability to plan your weekly menus, is there an
impact in terms of the variety of options available for
students, and cost impact to your program? Please tell us more
about what this means for you in the local school to implement
the final nutrition standards from the January 2012 rule?
This is something, you know, as I visit my schools, that
really is at the top of the list regarding concerns going
forward.
Ms. Gould. Thank you, Senator. I appreciate the question
and I am happy to answer. As I stated in my testimony, most all
of our scratch-made items would be eliminated. When a
manufacturer processes an item they have the ability to process
out the sodium. However, when we are making a scratch-made item
we cannot process out that sodium. Many of the items that we
are so proud of right now would be eliminated from our menu.
Protein at breakfast would be another big thing. Egg items
typically have more sodium in them than those regulations would
allow for. Even a half cup of baby carrots, which we all love
baby carrots, right? A half a cup of baby carrots has 50
milligrams of sodium.
Every little bit starts ticking down on where we can really
fall in line, and our variety would really be diminished. Any
of our salads, we would not be able to offer salad dressing.
The luncheon meat that is on top of those salads, that would be
gone. Cheese items would be eliminated. Marinara would be
eliminated, whether it is home-made or it is a processed item.
The impact would be devastating to our programs, and again,
even if something is formulated, will it be accepted by our
students? I think that is the biggest question as well. I am
already seeing, in a low free and reduced district, those kids
can walk away and go to a convenience store or a fast-food
chain, or their parents will bring in items. This opportunity
we have had through summer food service has actually allowed us
to really increase the amount of our quote/unquote ``paid
families'' to eat with us, maybe even more so our reduced
families are eating with us a lot more, and they are loving our
food. We want to keep that participation going, and I know that
if we have to get to Tier three, especially, we will
significantly have decreased participation.
Senator Boozman. Thank you.
Ms. Gould. I just want to give a little bit on the
manufacturing side. The cost there, it is about $15,000 for a
pre-existing item to be reformulated, and if it is a new item
it would be about $30,000. That is if they do not have to buy
new equipment.
Again, those are costs that they can deal with, but it
always ends up hitting the school nutrition budget, and that
is, I think, something we need to think about as well.
Senator Boozman. Right. Thank you very much. Ms. Golzynski,
I would ask you the same question. Have you looked at how to
plan a menu that incorporates Target 3 sodium with 100 percent
whole grain-rich items? If you can answer it fairly quickly, or
the Chairwoman will yell at me.
Dr. Golzynski. We do not want that to happen.
Senator Boozman. Since you are from her State she will
probably cut us a little bit of slack.
Chairwoman Stabenow. I have to apologize that I actually
broke my own rule by going over just a little bit.
Senator Boozman. Well, this is such an important thing. It
is good.
Chairwoman Stabenow. It is. It is really important.
Senator Boozman. Ms. Golzynski? I am sorry, Dr. Golzynski.
I apologize.
Dr. Golzynski. No worries. The Target 3 sodium is a very
strict level of sodium. It does meet the dietary guidelines. It
is a goal that we can attain. We have to work toward getting
there, and it is going to take us a bit. If you or I were
trying to immediately drop our sodium levels, we would need to
gradually get there in order to make it be a sustainable
change.
As Jessica was talking about bread, cheese, luncheon items,
yes, those are all processed items that are high in sodium. We
can work on cutting those back slowly. We can work on replacing
those with healthier items. Naturally occurring sodium
certainly makes sense, but that is going to be in some of our
products. As we work to increase our fruits and vegetables, as
we work to provide healthy whole foods for our children, with
less processed foods, we will start to get there.
We just cannot give up. Our children are not something that
we should ever give up on, and it is something that we should
just continue to work on, even if we have to lengthen the
amount of time it takes to get there, so our manufacturers can
catch up and our children can have access to those products at
home as well, so they are seeing them in both places.
Senator Boozman. Thank you very much. Thank you, Madam
Chair.
Chairwoman Stabenow. Thank you very much. Next up we have
Senator Brown and then Senator Fischer.
Senator Brown.
Senator Brown. Thank you so much, Madam Chair, for holding
this, and thank you to all the witnesses and the wisdom and
knowledge and insight and passion you----
Chairwoman Stabenow. Senator Brown, we are not hearing
volume. I am not sure if that is on your end, but we can barely
hear you.
Senator Brown. If I talk louder does that work?
Chairwoman Stabenow. It does work. We can hear you better.
Senator Brown. I like to talk really loudly, as you know,
Senator Stabenow. Senator Fischer is laughing at me, which is
understandable.
Chairwoman Stabenow. We can hear you.
Senator Brown. Thanks. Dr. Beers, Ohio is, unfortunately,
41st in the country in infant mortality rates. About 10 percent
of babies born in Ohio were born before the 37th week of
pregnancy. I have been working with a number of stakeholders on
this issue. There has been some improvement but not nearly
enough. Ohio, in fact, has seen a marked decline in
participation in WIC over the past five years, even during the
pandemic.
If you, Dr. Beers, would take to us about the role that WIC
could play in helping the Nation lower infant mortality rates
and reduce the rate of premature births, what steps should this
Committee take to improve participation rates?
Dr. Beers. Yes, Senator, thank you so much for that, and I
agree, this is an incredibly important issue. You know, as
pediatricians we often think about the fact that our care of
families really starts prenatally and ensuring that pregnant
women have adequate nutrition. The access that pregnant women
have to WIC services is incredibly important.
I think some of the general improvements that we have
recommended to the WIC program will help with enrollment. I
think it is also going to take some really targeted community
outreach and outreach through, just in the same way that we
work with pediatrician' offices, through obstetrician offices
as well.
I think it is also a moment to really think about the
postpartum time for pregnant women, particularly when you are
thinking about pregnancy intervals. Extending automatic
eligibility for WIC for children up to age two is an important
strategy to make sure that the family is still connected with
WIC, and needs that connection as they may be moving toward
inter-pregnancy, you know, thinking about the next pregnancy.
I think a final thing, which is not specific to this
Committee but the work that has been happening in extending
postpartum Medicaid eligibility to 12 months is incredibly
important, and I think that is something that we would like to
see continue as well.
Senator Brown. Thank you. Thank you very much, Dr. Beers.
Dr. Golzynski, I appreciate your State's and the Chair's--
Chairwoman Stabenow sings your praises far and wide--your
State's leadership in increasing the amount of locally grown
fruits and vegetables in school meal programs. How have you
been able to do this? What more can this Committee do to help
local growers sell more products to school districts?
Dr. Golzynski. I know farmers are the lifeblood of our
program. They really are so important to helping students to
recognize the healthy foods as well as recognize how it is
grown and where it is grown. Our 10-cents-a-meal program has
been critical for improving that. We are able to have that
State investment to encourage the purchasing from local
farmers. We do the education. The farmers come in and talk to
the students, or we do field trips, prior to the pandemic, of
course, field trips to the farms so that the children can see
where it is grown and how it is grown. It does not just come
from the shelves of the grocery store.
I think that one of the things that we can do is to--we
have the Buy American provision, which requires that food
products are grown and processed in America. What can we do
regionally to allow for increased purchasing from those local,
regional farmers, of the healthy products, so that they are not
traveling across the country prior to their ripeness, they have
the most nutrition available to them? Can we do something where
we can incentivize farmers to connect with schools, and can we
take away some of the paperwork around purchasing of those
products, and make it easier for our food service directors to
be able to incorporate that into their menus that they are
planning?
Our distributors could increase the number of local
products that they are slotting, and label it as such so that
our directors can prioritize that when they are purchasing.
They can prioritize a local, State-grown, or even a regional-
grown product.
We also need to be aware ourselves of what is grown and
processed in our own States and in our own regions. In a global
economy, it is easy to lose sight of what is actually grown
nearby, and the kids are so excited to have met the farmer that
grows the apple that they are going to eat, that they go home
and tell their parents whose apple they want to eat.
Senator Brown. Well said. Thank you. In the interest of
time, for Mr. Rodriguez I have a question I will for the record
about summer feeding programs, his thoughts about enrolling
Medicaid participants in WIC and what we should be doing there.
I will submit those questions.
Thank you, Madam Chair Stabenow.
Chairwoman Stabenow. Thank you very much, Senator Brown.
Senator Fischer?
Senator Fischer. Thank you, Madam Chair. Dr. Beers, I agree
that we should do everything we can to ensure children across
our country who are in need have access to free breakfasts and
lunch. You mentioned in your testimony the Community
Eligibility Program, CEP. Congress created CEP to provided
targeted assistance to low-income communities. Many schools in
Nebraska utilize CEP, but the number of eligible schools that
are not utilizing CEP, that is a much larger number.
We know that CEP increases participation and reduces
administrative burdens. In the past, I have heard it that CEP
was too complex or there were too many unknowns. I understand
different localities and States could face unique issues, but
in your opinion, what are some of the remaining barriers to the
adoption of CEP?
Dr. Beers. Yes, that is a great question and thank you for
that. Here in the District of Columbia, where I live and
practice, we also have CEP, and I know that it has been very
successful in schools. You know, a lot of this--and this is the
case for lots of the programs we are talking about today really
comes back to decreasing the barriers to participation and
enrollment and increasing the education around these programs.
I think for CEP, in particular, we have seen it be
incredibly successful in making sure that children have access
to healthy meals at school, and in the schools where it has
worked well I think it has been a really powerful tool. I think
we talked about this a lot. I mean, more of my patients who
need school meals and other nutrition supports do not access
them than do, oftentimes. Really working to increase the
education and decrease the regulatory barriers I think is a
critically important strategy.
Senator Fischer. Thank you. Dr. Golzynski, I wanted to give
you the opportunity to respond to this question, to hear it
from a State perspective. What barriers to adoption of CEP do
you see and what, if anything, should we be looking at as we
work on the Child Nutrition Reauthorization?
Dr. Golzynski. That is a great question and I greatly
appreciate you asking it. We have traditionally tied
eligibility to free and reduced-price meals to so many
different education side programs that we cannot even
disentangle it when we try to offer all meals for free to a
child in a district under the CEP program.
In a CEP district, now those families still have to fill
out some kind of household information survey to demonstrate
what their household income level is at, so that their child or
their district can qualify for at-risk funding, title funding,
other educational types of programs. Families do not understand
that. If I am getting free meals, why I am filling out
something about my income level? The connection is not there.
On the school administrator side, there is a stigma. There
is a great stigma because CEP means we are a needy district,
and not everyone wants to be seen in their community as this
needy district. Any way that we can disentangle the eligibility
for meal programs from the eligibility for education programs
will help our districts feel better in offering that for their
students. It does reduce the burden, the paperwork burden,
tremendously. It does help families tremendously. It has been a
wild success in our State, and I would love to see that
expanded so that other districts have the opportunity.
Senator Fischer. Very important. Thank you so much.
Mr. Rodriguez, the impacts of rural hunger is felt in a
State like mine, and some of the flexibilities, you know, that
have been discussed, like the non-congregate feeding, have
taken on a sharper focus in the last year during COVID. I
commend our food banks in Nebraska who, like yourself, have met
this challenge head-on.
What are some of the examples of granted flexibility and
how you have gotten food in the hands of children during this
season that may be replicated as we think about broader rural
needs during this reauthorization?
Mr. Rodriguez. I think the key word, and it has been stated
here by so many of the panelists, is flexibility. Flexibility
to understand that our communities are diverse, they are
different, and they have different access to resources and
programs, throughout our State and throughout our country. Many
examples, many of them listed in the written testimony, really
point to how these flexibilities were able to reach communities
that previously we could not touch.
I gave earlier an example of a small community in south
Jersey that pre-COVID we had a number of different families in
poverty, yet they did not meet current eligibility guidelines.
With the waivers, however, we immediately started feeding them
this summer, and we will continue to feed them.
This is true, I think, across urban, suburban, rural
communities. There is always one barrier or another. I think if
we take the approach to streamline, align where it makes sense
and put gradual process to changes, I think what we get left
with is a bank of time and energy that can be focused on
outreach, that can be focused on further innovation. I think
what was stated, I think, by so many of the speakers is we can
focus on having children really not only get access to the food
that they need but an appreciation for the healthy food that
is, in many times, unfortunately, foreign to them.
Remember Paige, her favorite food is a salad, and she did
not know what that was primarily before we were able to
introduce it to her.
Chairwoman Stabenow. Thank you so much. Thank you, Senator
Fischer. Thank you. We will turn to Senator Smith.
Senator Smith. Thank you so much, Madam Chair Stabenow and
Ranking Member Boozman for this Committee hearing, and thank
you to all of you for the work that you have been doing over
this last year.
In preparation for the hearing today I reached out to
Second Harvest Heartland, which is a food bank in Minnesota,
just to get their thoughts and input. One of the staff members
said to me, and this is a quote, she said, ``We learned that
lost opportunities to receive school meals causes overwhelming
food insecurity. When schools close, the community has to step
up immediately to provide support.''
I just wanted to take a moment with this in mind to think
about the work that food banks, like Second Harvest Heartland,
as well as school nutritionists and school cafeteria staff, all
of these folks across the country have done so much to lead the
way and to try to help families and students and people who are
experiencing food insecurity in this moment.
I am blessed to serve on the Agriculture Committee and I
also serve on the Health Committee and the Indian Affairs
Committee, and with that in mind I would like to just focus in,
for a bit first, on the issues around child nutrition and
Native communities, and what we can do better around outreach
and consultation there.
Just consider this. One in four Native Americans is food
insecure. Anemia in Native American infants and children is 1.5
times what it is for white children. Indigenous adolescents in
America are 30 percent more likely than non-Hispanic white
adolescents to experience obesity. Currently, 66 percent of
Native children--66 percent of Native children under the age of
six are enrolled in SNAP.
I would like to ask all of the witnesses here, we all see
that this is completely unacceptable inequity. Could you talk a
bit about what best practices you have seen, what we know about
what kind of outreach and education and consultation works with
Native communities, both Tribal nations as well as in the urban
indigenous community.
Any takers?
Dr. Beers. I can go ahead and start. I will say a few words
and I know others have much to add. Thank you for raising this
issue. It really is incredibly important. As a global statement
I would recommend to you, actually, the American Academic of
Pediatrics, just last week, released a new statement on caring
for children from Native American communities, and it is very
well done, so I would recommend that to you.
I think that from our perspective there really are two key
things. One is really fully funding the supports to our Tribal
communities. I think that is an incredibly important thing for
us to do. They have been under-supported for many, many years,
as I know you know. I think the second most important piece,
from our perspective, is really involving families and
communities in those efforts and in terms of outreach, as well
as accessing services and the cultural appropriateness of the
nutrition and other health services that we are offering. Thank
you.
Senator Smith. Thank you so much. Would anyone else like to
add anything?
Ms. Hoffman. I would add something from the WIC
perspective. We believe that Tribal health and the Tribal farm
economy can be enhanced with WIC support by creating and access
to health care and the market for rural vendors and farmers. We
need options for delivery and funding to support local young
stores and farms, and FDPIR eligibility should automatically
make families eligible for WIC. The health benefits of WIC,
such as reducing overall health care costs, decreasing pre-term
births, supporting chronic conditions, and improving readiness
for school can honor and benefit all Native communities.
Senator Smith. That is great. Thank you. Thank you so much.
I am going to actually use that as a little bit of a segue.
The second thing I wanted to talk about, in just the brief
second I have left, is as we focus on school nutrition and
serving nutritious meals, a lot of times we forget that schools
do not actually have the equipment--the refrigeration
equipment, the other equipment--to make healthy food. I have
come to appreciate how important this is for schools in
Minnesota. We do a good job in Minnesota. Ninety-three percent
of our school districts are serving healthy meals with a strong
nutrition standard. The need for equipment is a really big
need.
I am excited to be, having just reintroduced my legislation
with Senator Collins, the School Food Modernization Act, to
help schools modernize their equipment, and as you were saying,
it links directly then to the ability to participate in farm-
to-school programs to get farms and students and nutrition all
moving in the same direction.
Chairwoman Stabenow. Thank you very much, Senator Smith.
Such important issues. I hear both the same in Michigan.
A vote has been called. We are going to continue moving
forward. I know we have many members that want to ask
questions. This is such an important topic.
Senator Thune is next, and then Senator Gillibrand.
Senator Thune. Thank you, Madam Chair. Ms. Gould, in your
testimony you highlighted the importance of maintaining
flexibility for sodium, whole grains, and milk in school meals.
I have heard similar feedback from child nutrition directors in
South Dakota who are concerned that further regulation will
create additional meal procurement challenges. This is
particularly concerning for rural South Dakota schools that
already face procurement challenges.
Could you briefly describe the importance of sodium, whole
grain, and milk flexibility and what challenges would schools
face if this flexibility is not preserved?
Ms. Gould. Absolutely. Currently, there are not those
products to meet Tier two and Tier three readily available for
us. I think with COVID we have been faced--our manufacturing
community and just distribution, in general has faced major
hurdles, because of the multiple different service models that
we have been offering. It will be incredibly difficult for us
to transition at this time.
Now, in a few years would there be more products readily
available? Most likely. However, again, Tier three is
incredibly concerning just because of the limits and the very
vast reduction of sodium that we are looking at. Manufacturing
right now has not created those products. Your schools
currently will struggle to get that product in, and in the
future it will be a struggle as well.
Senator Thune. Ms. Hoffman, in South Dakota we have two
Indian tribal organizations, or ITOs, that support the needs of
our Native American population. How do geographic special
supplemental nutrition programs for women, infants, and
children, the WIC programs, and ITO State agencies, partner to
efficiently deliver WIC services and reach eligible families,
and do you have any suggestions for how we can improve those
WIC partnerships?
Ms. Hoffman. Thank you for that question. I think it is a
great opportunity for WIC programs, whether they are geographic
States or Indian Tribal organizations who are doing WIC
services for their communities to partner together. In Colorado
we have, as I mentioned, the great benefit of having a sister
agency in the UTE Mountain UTE WIC program, but we also have an
informal partnership with the Southern UTE Tribe that we
provide services. They do not have their own WIC program.
I think that depending on where WIC agencies are, and
depending on the other resources in their community, you can
work together, either formally or informally, to make sure that
families can access the services that they want, in the places
that they want. Some people would rather do that in the
community where they shop or where they work. Some people would
rather do that in their home community. I think that there are
opportunities to do that, both in soft ways, meaning just
building stronger partnerships that honor the needs of the
communities, but also in some more traditional ways, like
outreach and technology sharing and data sharing, and things
like that.
Then, of course, example of working together for the
Farmers Market Nutrition Program is unique and another
wonderful opportunity for WIC programs to work together.
Senator Thune. Dr. Golzynski, Ms. Gould, and Mr. Green,
given the experience you each have in operating child nutrition
programs, are there administrative challenges you have
encountered when working to comply with program regulations
that this Committee should seek to address through legislation
to reauthorize these programs, and have you experienced any
redundancies?
Dr. Golzynski. Yes. I would say that one of the biggest
challenges that we have seen is every program has its own meal
pattern, its own set of regulations, its own set of
requirements. When we went into the pandemic, we went to one
specific meal pattern that was not what the kids were used to
seeing during the school year, and then some of those
regulations continued, from the National School Lunch Program,
even though they were not regulations in the Summer Food
Service Program, which is what we were seeing for children.
Streamlining of those regulations and those requirements
across programs so that one sponsor, who might offer multiple
programs, does not have to try to train their staff as to which
program they are serving that meal in, that day, so that they
know what meal pattern or what paperwork requirement is tied to
that specific meal.
Senator Thune. I see, Madam Chair, my time has expired.
Thank you.
Chairwoman Stabenow. Thank you very much, Senator Thune. We
will now turn to Senator Gillibrand, and then Senator Marshall.
Senator Gillibrand. If not----
Senator Gillibrand. They just let me in. I am sorry. It
took them a while to get on my computer.
Chairwoman Stabenow. Not a problem.
Senator Gillibrand. I apologize.
Chairwoman Stabenow. Welcome.
Senator Gillibrand. Well, thank you to all the witnesses
today. I am extremely grateful to all of you for your work,
your advocacy. We have covered really important pieces of
legislation this morning, and I am grateful.
One piece is the Summer Meals Act, which I have long
championed with Senator Murkowski. That has created historic
investments in improvements to the summer nutrition programs
and addressed longstanding operational barriers based by summer
food sponsors and sites in serving more meals and connecting
services to more youth. Without the existing structure of the
summer nutrition program in place ahead of this pandemic,
community-based organizations would not have been able to
mobilize and organize in unique and new ways to continue to
serve meals, scale meal service operations quickly, and
maintain the critical community connection our Nation's school-
aged youth need now more than ever.
Mr. Rodriguez, what role have you seen the traditional
congregate meal sites and sponsors play in providing non-
congregate meal service options to help the most in need during
this pandemic, and what role do you envision them to continue
to play as frontline workers in both combating hunger and
supporting and strengthening social and emotional well-being of
our Nation's school-aged youth as we start to shift toward
recovery?
Mr. Rodriguez. Thank you for the question, Senator.
Congregate meals have played an important part to the response
of the pandemic, and I think what we have learned is with more
flexibility we can even do more. We would have had, even
despite the tremendous growth in programs we have seen, and so
many of our partners across the country have seen with the
pandemic, we know we could do more. Just by adopting something
that we know works.
Let's take what happens in school meals, for example, in
actual school settings, as an example of what could work.
Schools operation one national school lunch program, and it is
a seamless transition from the school year into the summer
years. We are asking for something very similar so that our
providers, many of which are nonprofits with very limited
resources, can make the same transition. If we do that, we can
have both congregate meals, we can innovate more in terms of
outreach, and really focus on leveraging with other
streamlining efforts, just making more sites available.
It has been said quite a few times today, most recently by
Dr. Golzynski, how much the transition, how much duplication
there is, and even just training. We have to train the same
staff in October, and then very quickly again right before the
summer meals, make nuanced changes to meal packs and menu
guidelines. If we streamlined the whole process and banked that
effort to reaching more children, or perhaps opening up more
sites, we would have overall greater reach and more impact for
the children that we are trying to reach.
Senator Gillibrand. Thank you. This question is for Dr. Lee
Savio Beers. The National School Lunch Program is one of the
most far-reaching and effective food security programs for
school-aged kids that we have. Thirty million students are
eating school meals nationally, every day. For some students,
those school meals may be the only meal that they get that day,
and over the past year, during the pandemic, we have seen just
how important these school meal programs are for absolute well-
being and nutrition.
National universal school meals for all students is a
fundamental education and health equity issue. Research out of
Syracuse University shows universal school meals subsequently
increase in school meal participation and lead to increase in
students' academic performance.
Dr. Beers, how do you anticipate universal free school
meals would further impact both children and their families,
and can you speak about how universal school meals will
positive impact the health of children?
Dr. Beers. Thank you for this question, Senator, and, you
know, as I noted during my testimony, food insecurity really is
at quite high rates in this Nation, one in six children, even
before the pandemic even began. We also know that good
nutrition is one of the most important things we can offer our
children in terms of helping them with a healthy lifetime.
I think, you know, in my experience, and the data shows
this, far more children are not able to access Federal programs
in school meals who need them than are, and so offering
universal school meals would really, first, increase and open
up those opportunities for children experiencing food
insecurity in their households to have access to meals. It
would also decrease stigma around school meals and increase
access further. You know, it is not an easy thing for a child
to come into school and admit that perhaps their family does
not have enough to eat, and so they may turn down the free
school meals because of that. I think that is another important
reason that universal school meals would be so effective.
Senator Gillibrand. Thank you, Madam, and thank you, Madam
Chairwoman.
Chairwoman Stabenow. Thank you so much. We are now going to
turn to Senator Marshall and then Senator Bennet.
Senator Marshall. All right. Thank you, Madam Chair. It is
great to be back here in an Ag Committee, talking about things
that are so important to me, nutrition. My first question is
going to be for Ms. Gould, if you do not mind.
Ms. Gould, we have a generation of children and young
adults who have not drank milk, and that is because we try to
serve them some imitation milk, fatless milk, that tastes like
water with powder in it. As an obstetrician-gynecologist I am
very concerned about osteopenia and osteoporosis, that in 20
years from now those young adults, children, never reach their
peak of their bone density, and no matter what medicines I give
them, when they reach menopause, the women, we will never be
able to keep their bones strong. I think that is a great
example of Washington, DC, trying to legislate, or trying to
tell nutritionists in schools what to serve children.
I am equally concerned about the Tier three specs, and I
know other folks have talked about this. I just want people to
realize that a Tier three pizza is basically a piece of
cardboard without cheese on it. What will happen is--and that
is, I guess, my question--which is going to be worse for a
young child, to eat all of a Tier two meal or eating a fourth
of a Tier three, because I just do not think kids are going to
eat Tier three diets. How hard is that going to be to implement
in the school system?
Ms. Gould. Thank you for your question. I think you nailed
it. It is going to be incredibly difficult, and ultimately we
want nutrition going in our students' bellies. We want them to
actually eat the meals and get the nutrition into them. We know
that if they do not like it, if it is too restrictive, they
will choose to not eat it. I think that is the balance we need
to be considering, because we are also in the limits of Tier
three. We are eliminating many culturally diverse items from
students' menus.
We have got to think about the whole child. I do not think
one nutrient is the premise for if they are going to be obese
or not. I think we have got to look at the overall meal and
ensure that there is nutritional quality in that meal, and it
is getting into their stomachs.
Senator Marshall. Thank you. I have just got to put an
exclamation mark on the whole milk part of this, that the whole
milk has fat in it, which allows people to absorb vitamins A,
D, E, and K, and that is especially important, of course, in my
pregnant patients, how important it is to absorb those
vitamins. There is such a thing as good fat.
I want to talk about meatless Mondays, and Ms. Gould, I am
sorry, but this question is going to come to you as well, since
you are from Colorado, another example of government trying to
tell people what is nutritious. I would put meat, especially
beef, in that same, right beside whole milk, as healthy and
nutritious. The meat industry has spent decades researching,
fine-toothing, making sure that this is a nutritious protein
source. It just drives me crazy, to be honest, for folks to
falsely attack the meat industry, when really the evidence says
it is a very healthy food when served properly, especially with
all the lean meats we have today.
I think about raising children. I did three sports myself
in high school, raised four kids doing sports, and nowadays,
today's varsity athletes in high school typically are lifting
weights for an hour and a half in the morning, then maybe they
have a P.E. class, and then they have two hours of practice at
night. My boys, specifically, would eat two meals, buy two of
the school lunches, and we still could not keep weight on them.
The thought of taking a proteins source like beef out of
the menu is crazy, okay? I think it is crazy. How can you get a
protein source? How much tofu would a high school football
player need to eat to be able to maintain his weight? You know,
it certainly would apply for the girls who are practicing
volleyball in the morning and lifting weights and then playing
basketball in the afternoon. How would that go over, not having
any protein, I mean, real protein like beef or pork or chicken,
on your meatless Mondays? How did that go, or how is it going
to go?
Ms. Gould. I think it is important to remember, and it is
important to educate our students that all food should fit into
a healthy diet. When we start specifying that they should not
be eating certain types of food we can really start getting
into the psyche of just how they interact with food. It is
important that in my district we are very adamant that all
foods fit, maybe some a little bit more than others.
I think that is something that would be important to be
educating, and we do not want to take any protein sources away.
I think that is a personal opinion for families.
Chairwoman Stabenow. Thank you so much, and thank you,
Senator Marshall.
I am going to turn to Senator Bennet.
Senator Bennet. Thank you. Thank you, Madam Chair, and
thank you again to both witnesses from Colorado. We are very,
very grateful that they are here.
Actually, my first question is for Dr. Savio Beers. I
cannot resist asking her this because of her role as the
president of the American Academy of Pediatrics. Dr. Beers, in
the American Rescue Plan that we just passed we made
substantial changes to the child tax credit that is going to
result this year in a glut of childhood poverty in this country
by almost 50 percent. There is a lot of effort now to try to
make that permanent.
I wonder if you would take a moment to share with the
Committee what the implications for pediatric medicine and for
young children's health care is if there are lifted out of
poverty.
Dr. Beers. Thank you so much for that question. Yes, you
know, as I mentioned earlier, nutrition is one of the most
important contributors to a child's long-term health and well-
being, and actually probably the most important contributor to
a child's long-term health and well-being is their economic
stability and whether or not they live in poverty, because
that, in so many ways, determines their ability to access and
receive any wide variety of supports, including nutrition, good
education, stable housing, all of these things that we know can
help children be successful and thriving members of our
society, and through a lifetime.
That is not something that we can just do in one year. It
really takes a child's entire childhood. By decreasing
childhood poverty, as the child tax credit does, I think this
is an incredibly important strategy and one that we would
really hope to see continue as one of the most important things
we can do for our children in this generation.
Senator Bennet. Thank you, and we would love to have this
be bipartisan as we make it permanent. It is an interesting
thing, because half of the kids are going to be lifted out of
poverty, but 90 percent of America's kids are going to benefit
from this. There is going to be, I think, broad support across
the country.
I then had a question for Heidi Hoffman, which is about
WIC. As you know, WIC reduces infant mortality and low birth
weight, and it also improves the rates of regular medical care
and timely immunizations and strengthens intellectual
development among children. In short, we know that WIC works,
and the American Rescue Plan works to build on the strengths of
WIC.
For instance, the plan increases the fruit and vegetable
allotment that is part of the tailored food package families
receive. It also increases WIC's capacity to do outreach to
expand the program's reach to more eligible families. With all
of these changes over the next several months, each person on
WIC will receive $35 to spend on fresh produce each month,
instead of the usual $9 to $11. These temporary investments
build on the nutritional strengths of WIC while boosting the
program's ability to draw more eligible families into the
program and address food security.
What would it mean, Ms. Hoffman, for Colorado WIC and the
families that it serves if these types of investments were made
permanent?
Ms. Hoffman. Thank you for this question, Senator Bennet.
We are very excited about the opportunity to offer more fruit
and vegetable benefit to WIC families. One of the nice things
about trying it for these four months, at $35 per person, per
month, is to really gauge the interest that we have been
hearing from people for a long time about wanting more access
to fruits and vegetables, and really overall increasing the
value of the food package for WIC.
I think that is going to benefit our families, definitely
and directly, but I also think that it will make the WIC
program, and participation in it, more attractive to families,
and hopefully retain them longer on the program, so that all of
those benefits that you mentioned can really be recognized by
anyone who chooses to be a part of the program.
We are looking forward to seeing what the USDA will do with
that additional funding to modernize the program and provide
more outreach, but we know that $35 will have an immediate and
beneficial impact for our families.
Senator Bennet. Thank you. Thank you, Madam Chair, or Mr.
Chair, Chair.
Senator Boozman. [Presiding.] Well, thank you.
Senator Bennet. Thanks.
Senator Boozman. Next we will hear from Senator Braun.
Senator Braun. Thank you, Chair. My question will be the
same question for three individuals, and it will be for Drs.
Beers, Golzynski, and Ms. Hoffman. Try to keep the answers
roughly a minute apiece, or maybe a little over that.
As much money as we spend on child nutrition, and as
important as it is, I think it is clear that we have devoted
resources to it. In running a business over the years, whenever
I would invest in something, to me the most important part
would be the metrics. Is the money that you are spending
actually getting the job done?
I would like each of you to address what you think of the
progress that we have made, and how specifically we have
measured it? Because I think we minimally need to see what we
might do differently, and I am just curious as to the metrics,
because in my opinion, whenever you do make an investment in
something, that is the other side of the equation.
Dr. Beers, would you start, please?
Dr. Beers. Yes, absolutely, and you are exactly right. If
we are investing resources in something, we want to make sure
that it is effective, and childhood nutrition and hunger is one
of the most important things that we really can be targeting.
I would say, as a broad statement, because I know I only
have about a minute, that these programs really have been very
effective at reducing childhood hunger. There is still more for
us to do, but we certainly have seen tremendous effects. We
know, you know, families who are enrolled in WIC, children have
higher birth weights. Their children have better nutrition.
We also know that we have seen great improvements in health
and nutrition through the changes in our school meal programs.
We have many more children who are accessing regular food and
meals. What we have seen, as pediatricians, is that these
programs have made a tremendous difference. There are still
things to work on, but we are heading in the right direction.
Senator Braun. Thank you. Dr. Golzynski.
Dr. Golzynski. Yes, thank you for the question. I would say
that these investments have been critical to introducing the
healthy foods to children and assuring that they have an
opportunity to try them and continue to practice eating those
foods. Our metrics can and should be not only participation in
the program and the financial health of our school and
nutrition programs, but long-term metrics we should be looking
at include things like graduation attainment, attendance at
school. We have a State Strategic Education Plan where we are
looking specifically at those metrics, in addition to the
shorter-term metrics, such as eating breakfast at school and
how many children have access to breakfast at school.
Senator Braun. Thank you. Ms. Hoffman?
Ms. Hoffman. Yes, thank you. Not to be duplicative to what
was already said, I would echo all of those things. I would
also guide you to a recent report by the Center of Budget
Policy and Priorities that collected all of the data that shows
how WIC works.
In addition to the things that have already been mentioned,
there is a higher rate of breastfeeding among WIC families.
Children whose mothers participated in WIC scored higher on
their assessments of mental development at age two, so they are
better prepared to start school. There are healthier food
environments within homes, within neighborhoods, within
communities, regardless of whether the people are themselves on
WIC or not. Kids that are in families that one child receives
WIC typically have a better and healthier diet.
The conversation we had earlier about health between
pregnancies, preparing for future healthier births, which then
not only have all the benefits for that child and that mother
but also reduce future health care costs are also very well
demonstrated for WIC.
Senator Braun. Thank you.
Chairwoman Stabenow. [Presiding.] Thank you very much,
Senator Braun. Senator Lujan, and then Senator Hoeven.
Do we have Senator Lujan? If I am not hearing from Senator.
Lujan, Senator Hoeven.
I am sorry. I guess we are back to Senator Lujan. This is
the world we are in, the virtual world we are in.
Senator Lujan, welcome.
Senator Lujan. I appreciate that last decision, Chair. It
is good to be with you all. Thank you so much to the panel for
being available today for this important conversation. I am Ben
Lujan. I am a Senator out of the State of New Mexico.
I wanted to start here by just reminding everyone that one
in four children in New Mexico were considered food insecure
prior to the pandemic. Tragically, due to the pandemic, now one
in three children in my State do not receive enough food to
support a productive, healthy, lifestyle.
Dr. Beers, yes or no. Should Congress use the upcoming
Child Nutrition Reauthorization as an opportunity to address
childhood food insecurity?
Dr. Beers. Senator, thank you for that question. That is an
easy one. Yes, absolutely. I think there are tremendous
opportunities to build on and strengthen our Federal nutrition
programs to address food insecurity.
Senator Lujan. Dr. Beers, yes or no. Should Congress use
Childhood Nutrition Reauthorization to improve childhood well-
being?
Dr. Beers. Yes, absolutely. Thank you, Senator, for that.
Senator Lujan. Yes or no. Should Congress maintain strong
nutrition standards and support nutrition education technical
assistance for operators and updating of food service equipment
to help kids consume healthier foods?
Dr. Beers. Yes, I believe that we should do that as well,
and really look to our experts to help us guide that.
Senator Lujan. Ms. Gould, as I noted before, a third of the
children in my State are considered food insecure. However, the
challenges faced by New Mexico children are not unique.
Nationally, food insecurity is also on the rise among Hispanic
and Latino communities and African American communities.
Last summer, 47 percent of Latino households with children
reported trouble accessing food. Since more than 40 percent of
WIC participants are Latino and nearly 25 percent of National
School Lunch Program children are Latino, I believe the
Congress can strengthen child nutrition programs to address
this challenge in New Mexico and across the country.
Can you quickly touch on how the pandemic worsened food
insecurity?
Ms. Gould. Absolutely. I believe the biggest challenge was
that our students were not coming to school, and that is where
we typically have access to them. The flexibilities that were
provided have given us a big opportunity to give more food to
those families, but we are still, if they are home-schooling,
many of those families might be learning from home still, even
if they were able to go to school. Some families just had the
ability to opt into a distance learning program, and that is
very difficult for us to still sometimes access those families.
Senator Lujan. Ms. Gould, let me followup there. What do
you think the Committee can do to expand access, remove
participation barriers, and improve quality of access for mixed
status or Spanish-speaking families from being negatively
impacted due to lack of accessible resources?
Ms. Gould. I believe continuing the flexibilities that have
been offered during this time period would be essential to
ensuring access, and then we are actually getting that
nutrition to those students. That would be the biggest
recommendation I could provide.
Senator Lujan. As far as healthy food for kids, I
understand the advocacy here, that they are saying, you know,
while you look at the standards of the quality of food and
processed food, we also know how that contributes to health
challenges as well. I want to make sure folks are getting food,
that they get tasty food, food they are going to eat, but I am
on the side that does not consider pizza sauce a vegetable. I
think it has got too much of the sugar and all the other stuff
that goes into it. If I make it at home I throw some blenders
and some garlic and whatever else I can find in a blender, and
I try to make it as good as I can. I know what is in it.
Now, I am not here to preach to anyone about being
healthier. I need to be healthier myself. What can be done by
working with food distributors, folks that are working with
schools, to make sure, No. 1, they are getting the best price
for the food that they are buying, No. 2, that they are getting
quality food. Are there standards with food processors, food
distributors across America that have contracts with schools,
and how can we make sure schools are not getting taken
advantage of when they are entering into contracts for these
agreements? I would ask anyone to jump in on that one.
Ms. Gould. I am happy just to jump in quickly. I believe
that with providing--we are providing nutritious foods for our
students. We have seen that. I think we will continue to
provide healthy foods for our students. Making scratch food
does have sodium in it, so I think that is where I am really
coming from there. Because we do not want all processed items.
We want to be able to still continue our scratch-made items.
We need to just have better and more open communication
with our manufacturers and distributors to really talk about
expectations.
Senator Lujan. I appreciate that.
Chairwoman Stabenow. Thank you so much.
Senator Lujan. Chair, just thank you for the time and I
look forward to following up.
Chairwoman Stabenow. Thank you so much for the questions.
We have Senator Hoeven and then Senator Warnock.
Senator Hoeven. Thank you, Madam Chair. I appreciate it.
Ms. Gould, for you. Given that school meal participation is
already low due to distance learning, if the current
flexibilities on sodium, whole grains, and milk were to end
this fall, what impact would loosening those flexibilities
have, or reducing them, on student meal participation, in your
opinion?
Ms. Gould. Absolutely, and thank you for the question. We
are trying to, at this time, really encourage all students to
eat with us. It reduces any stigma, and the last thing we want
to do is all of a sudden change the items that we are providing
them to something that they are not used to, they are not
prepared for, and they do not want to eat. We want to be able
to keep with what we are currently doing, the nutritious meals
that we are currently offering, and if we were to be able to
have those waivers extended, that would amazing, because then
we can continue to reduce stigma and ensure that every student
has access to healthy meals.
Senator Hoeven. I appreciate that. Also, in terms of that
flexibility, which is needed for the schools, and this is about
healthy meals, but it is also on making sure students eat the
meals, and, you know, obviously appreciate that they are good
and wholesome and healthy but also tasty. You know, I think
about meals we get around here or anywhere else. Everybody
wants those meals to be tasty as well in order to eat them.
In terms of the sodium, the whole grains, and milk, not
only from the consumer side, from the student side as far as
eating them, but then what about from the industry side, being
able to make those foods and supply them to you, so that they
are still, you know, something you can afford and available,
and again, so that they are tasty. I mean, we need that
flexibility for those reasons too, don't we?
Ms. Gould. Absolutely. Our manufacturing industry has been
up and down with the constant changes in our regulations. I
think the best thing we could do right now is to remain
consistent so they can really focus on ensuring that we will
have the quality products that we currently are providing.
Especially during COVID there have been challenges with
manufacturing. Let's just get them back on their feet so they
can ensure that we have the products that we need, when we need
them.
Senator Hoeven. Do you have any concern about whether or
not those meals will be healthy if you have that flexibility? I
have got to tell you, I am just not a fan, in a country of 320
million people, that one size fits all in every situation, all
across the country. I think people are smart and capable and
you have got to trust them and give them some flexibility.
Do you have any worry that if that flexibility is there
that these meals will not be healthy and good for our kids?
Ms. Gould. Absolutely not. As I have stated, I am a
dietitian. In my district, even though our whole grain
requirement is 50 percent, we are at 75. We are constantly
striving to meet higher and better nutritional needs for our
students, but we also have to make it work, and we have to
ensure that those students are eating it. Just like you said,
if it is going into the trashcan, that is not providing any
nutrition to our students. We think it is incredibly important
that we have the ability to make our meals, and make our menus,
based on what our students want, will eat, while we constantly
strive to increase our quality of nutrition and quality of
items served.
Senator Hoeven. Well, I think that is really well said.
Thank you for what you are doing out there for our kids. I
think any time we can empower somebody like you out there, we
ought to do it, rather than tell you exactly what you have to
do and when you have to do it and how you have to do it. I am a
big fan of flexibility, and I think you just epitomized what it
is so important that we have flexibility out there for the
professionals, like yourself, who are out there every day,
making sure those young people not only have meals but that
they are nutritious and healthy and tasty.
Thank you for that work. I appreciate it so much. You
represent many, many, many, many other nutritionists that care
about those young people and are doing a whale of a job taking
care of them.
One other quick question I have for Mr. Rodriguez. It is
just on in terms of any of the reforms as far as the food
service programs, streamlining the programs. What would be the
biggest thing that you think would really help in terms of
those community food banks?
Mr. Rodriguez. Well, thank you for the question. I think
flexibility is just a common theme here. I would add to that
that strengthening the site-based model by allowing community
providers to operate with one program year-round makes a lot of
sense. We have talked about that continuously.
One thing I have not mentioned as often is lowering the
area eligibility threshold to serve more children. Doing
something as simple as just looking at what other eligibility
thresholds already exist. For example, our 21st century Title I
program is 40 percent. Just doing simple things like this would
not only create alignment but it also creates simplification in
how we administer programs and how we do outreach and target
populations.
The other thing, I think, that we really need to look at is
how do we allow alternate program models in underserved and
hard-to-reach areas. You said it best, Senator. Three hundred
twenty million and that many more communities, very diverse in
what they have in terms of infrastructure and capabilities. We
learned during the pandemic that relaxing the congregate
feeding requirement worked, utilizing the efficiencies of a
summer grocery card, and we have seen that during pandemic EBT,
also worked, and created opportunities to reach underserved or
not-served-at-all areas.
Senator Hoeven. Right. Again, thank you, Mr. Rodriguez.
Thanks to all of you for what you are doing to help feed people
that need it, and it is a really important program and we
appreciate very much all that you do. Thank you, Madam Chair.
Senator Boozman. [Presiding.] Thank you, Senator Hoeven.
Senator Hoeven. No, Mr. Ranking Member. Excuse me.
Senator Boozman. Senator Warnock.
Senator Warnock. Thank you very much. I am not going to
make that same mistake. It is good to be here with you, and I
want to thank you and Chairwoman Stabenow for this opportunity.
It is great to be here to discuss a topic that will hopefully
generate increasing bipartisan consensus.
We all remember the painful images of long lines at food
banks as the COVID-19 pandemic sent food insecurity rates
soaring. Those lines are still with us. Some of the folks who
were passing out food a year ago found themselves in those
lines. The cars in those lines are getting nicer and nicer, an
indication of how food insecurity has impacted so many
families.
Dr. Beers, in your testimony you discussed some of the
barriers to accessing WIC, and specifically you noted that
Congress and the USDA should look for ways to align WIC
eligibility with other Federal programs like Medicaid and SNAP,
in order to combat declining enrollment in these programs.
The American Rescue Plan included similar incentives as the
Affordable Care Act, to encourage 12 remaining States,
including my home State of Georgia, to finally expand Medicaid.
We were able to get $2 billion in the American Rescue Plan just
for Georgia, more than enough for Georgia to finally expand
Medicaid.
Studies have shown that when States expand this critical
safety net program there is a decrease in prevalence of severe
food insecurity--so we get 500,000 people, in the case of
Georgia, nearly 500,000 people, out of the Medicaid gap so they
get health care--but the studies also show a decrease in
prevalence of food insecurity.
Georgia has yet to expand Medicaid. We are at yet another
turning point. We have got $2 billion on the table, over
400,000 Georgians in the Medicaid gap. The ball is in the court
of the legislature.
Dr. Beers, what impact does the lack of Medicaid expansion
in a State like Georgia have on hunger, and how would Medicaid
expansion help to reduce barriers to nutrition assistance
through other programs, such as WIC, and would expansion help
families free up household funds so that they can be less food
insecure?
Dr. Beers. Senator Warnock, thank you so much for that
question, and yes, you know, Medicaid expansion is an
incredibly important priority for us at the AAP because we know
that children and families who have access to good quality
health care, that they can access without worry, is an
incredibly important thing that improves outcomes. It will
address food insecurity in a number of ways.
It allows, for example, my own clinic, we screen families
for food insecurity, and we are a really important touch point
for families in being able to connect them to both Federal and
community resources. We do this at every well visit. We do it
at other visits as well.
You know, I will also add it is also a really important
strategy in addressing the increasing rates of poor nutrition
and obesity that we are seeing, which is also the other end of
the spectrum that we are seeing right now during the pandemic.
I mentioned my colleague's patient who had gained 90 pounds. I
will say that my colleagues daily are seeing kids who have
gained 30 to 40 pounds over the course of the pandemic, and we
know that just simply, you know, advising them to eat healthier
is not going to be enough. Being able to access the whole range
of services that families can access when they are insured and
can access good quality health care will be really important.
We are also seeing an increase in eating disorders, because
of the emotional impacts of the pandemic, and that is very
complex medical care, and even Medicaid is an important
strategy in ensuring that kids have the ability to access that
health care as well.
I appreciate your comment and your tying this issue to the
larger issue of access to health care. Thank you.
Senator Warnock. Food insecurity, lack of access to health
care, particularly in States that have yet to expand Medicaid,
larger issues around health, including obesity, all part of a
network of care that we address by expanding Medicaid.
Thank you so much.
Senator Boozman. Thank you, Senator Warnock, very much.
On behalf of myself and Senator Stabenow, who had to run
and cast a vote--that is the only thing we absolutely have to
do around here--we want to thank the panel. I think this was a
very, very good hearing, very helpful in the sense of helping
us to craft a way forward. These are difficult things, and
again, you all have been more than helpful.
The other thing, too, on behalf of myself and the entire
panel, thank you all for all you do, being on the forefront,
fighting the battle. As always, we appreciate the staff that
works so hard to put these things together.
With that I would say that in addition the record will
remain open for five business days for members to submit
additional questions or statements, and the hearing is
adjourned.
[Whereupon, at 11:40 a.m., the Committee was adjourned.]
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