The Child and Adult Care Program, or CACFP, is a federally funded program that subsidizes nutritious meals in child care settings. It has been shown to improve diet quality and reduce food insecurity among children in participating child care. However, CACFP participation among family child care home providers has steadily decreased following the implementation of a tiered reimbursement system in 1996, resulting in reduced reimbursement rates for providers that do not live in low-income communities, despite having the same administrative burdens.
Researchers conducted a trend analysis using California administrative data from October 2018 through December 2023. Their goal was to examine whether the temporary increase in the amount and elimination of CACFP’s tiered reimbursements during COVID-19 was associated with changes in participation rates among licensed family child care home providers. They found that CACFP participation rates plateaued among tier 1 providers after a previous decrease, while participation increased among tier 2 providers, who received greater reimbursements when tiers were temporarily eliminated. Once the tiered reimbursements were reinstated at the end of the pandemic, participation declined for both groups, with a sharper decline among tier 2 providers.
These findings suggest that a permanent increase in CACFP reimbursements and the elimination of tiered reimbursements for family child care home providers could improve retention, expand CACFP participation, provide nutritious meals to more children, and support the financial stability of providers. Study researchers suggest that future studies examine CACFP participation trends across varying provider characteristics, and replicate analyses in other states to better understand policy impacts.
This study was published in the Journal of Nutrition Education and Behavior. It was conducted by Susana Matias with the Department of Metabolic Biology & Nutrition at the University of California, Berkeley, Kassandra Bacon, Danielle Lee, Celeste Felix, and Lorrene Ritchie with the Nutrition Policy Institute, and Samantha Marshall and Elyse Vitale with the Child and Adult Care Food Program Roundtable. This study was funded by Healthy Eating Research.