The federal Child and Adult Care Food Program, or CACFP, is designed to bolster childhood food security and improve diet quality in early care and education settings. However, a new collaborative study from the Nutrition Policy Institute reveals a concerning trend: the program's administrative burdens and inadequate reimbursements for providing healthy meals and snacks are pushing providers to leave the program.
The study examined the return of tiered reimbursements for participating family child care home providers in 2024, where tier 1 providers received $5.70 and tier 2 received $2.27 per day to serve two meals and a snack that meet CACFP nutrition standards. This was a change from 2022-2023 rates, which were $5.67 per day for all providers when tiers were eliminated during the COVID-19 pandemic. To measure the impact, researchers surveyed 277 California family child care home providers in 2023 and 2024, before and after tiered rates returned, and conducted interviews with 10 providers, 5 sponsoring organizations, and 5 family recipients.
Survey and interview data illuminated a widening gap between the cost of providing nutritious meals and the federal reimbursements available:
- Financial burden and economic pressure - 97% of providers reported increased financial burden due to inflation and rising operational costs, and 29% of providers passed these costs on to families.
- Insufficient reimbursements - 96% of both tier 1 and 2 providers reported tiered reimbursements were insufficient, covering less than half of their food costs, which contributed to reduced variety (29%) and quality (20%) of foods offered to children, and created a ripple effect diminishing the overall quality of child care they offered.
- Leaving CACFP - providers shared that the administrative effort required to maintain the program was increasingly outweighing the financial benefit. While some providers reported staying to offset inflation, 42% of providers planned to leave the program, despite the program’s benefits, with one provider simply stating, “It’s just not worth it anymore.”
- CACFP meals are critical to support child food security - one-in-three providers reported that the meals they served were the only meals children ate.
- Meeting providers’ needs - providers requested four meals and snacks be reimbursed instead of three, as they served on average four meals/snacks daily. They also requested elimination of tiers and for reimbursements larger than $6.00 per day to continue offering three meals/snacks, as they spent an average of $7.31-$7.86 per day on three CACFP-adherent meals/snacks that appealed to children.
Study authors recommended policy change for an additional eligible meal reimbursement, increased reimbursement rates, and the elimination of tiered reimbursements in order to sustain family child care home provider CACFP participation and protect child nutrition and food security.
The study was published in the Journal of Nutrition Education and Behavior by Nutrition Policy Institute researchers KC Fiedler, Kassandra Bacon, Danielle Lee, Reka Vasicsek, Celeste Felix and Lorrene Ritchie in collaboration with Samantha Kay-Daleiden Marshall and Elyse Homel Vitale from CACFP Roundtable and Susana Matias from the University of California, Berkeley. This research was funded by the Healthy Eating Research Program grant no. 283-5102 and the California Collaborative for Pandemic Recovery and Readiness Research Program (funded by the California Department of Public Health).