Child and Adult Care Food Program Meal Reimbursement Rates and Program Participation by Family Child Care Homes in California

Abstract

Background

The Child and Adult Care Food Program (CACFP) provides tiered reimbursements (I/II) to family childcare homes (FCCH) to serve healthy foods to a large proportion of children from households with low-income. Due to COVID-19, federal waivers allowed all FCCH on CACFP to temporarily receive the higher Tier-I reimbursement rate from Jul. 1 2021-Jun. 30, 2023.

Objective

The study objective was to evaluate the impact of the increase in reimbursement on CACFP participation rates among FCCH in California.

Study Design, Settings, Participants

We conducted a secondary analysis of program data collected by the relevant state agency between Oct. 2018-Dec. 2023. The sample included all licensed FCCH in California (∼28,000).

Measurable Outcome/Analysis

We analyzed trends using Joinpoint regression (segmented regression) to detect monthly percent changes (MPC) and identify significant shifts in CACFP participation (p 90% of CACFP FCCH).

Results

Monthly percent changes (MPC) were detected and significant shifts in CACFP participation (p 90% of CACFP FCCH) identified. A different pattern was observed among Tier-II FCCH, which received a substantial increase in meal reimbursement during the waiver period. CACFP participation in this group increased from Oct. 2018-Sep. 2020 (MCP=0.12), followed by monthly decreases (MCP=-0.51), but only through May 2021, the month following the announcement of the waiver. No significant trend was detected from May 2021–Jun. 2022 (MCP=0.08). Newly analyzed results on trends from Jun. 2022-Dec. 2023 will also be presented.

Conclusions

Among Tier-II FCCH, the temporary increase in meal reimbursement appears to have stopped the decreasing CACFP participation rates that were likely due to the pandemic. This suggests that higher reimbursements could increase CACFP participation among this FCCH group, which currently serves more than 200,000 meals/month to young children in California.

Funding

Robert Wood Johnson Foundation UC San Francisco California Collaborative for Pandemic Recovery and Readiness Research (CPR³), funded by the California Department of Public Health (CDPH)