Thursday, July 01, 2010

Today: House Ed & Labor Committee Hearing: “Improving Nutrition for America’s Children Act” - UPDATED

Update 3: The transcript & video of Agriculture Secretary Tom Vilsack's testimony, after the jump...

As he began his testimony, Sec. Vilsack said he was going to "speak from the heart," and put aside the prepared testimony he had for the Education & Labor committee (his remarks are in the video, below).

"It's important that every single youngster be at the top of their game,"Sec. Vilsack noted, and added that a robust reauthorization of the Child Nutrition Act is a health care issue, an educational achievement issue, a national security issue, and a moral issue.

"This is an opportunity for us to make a clear, unconditional statment about the importance of our children..and NOT to delay," Sec. Vilsack said. "This is a top priority of USDA. There are tens of millions of children whose future depends on this." (Sec. Vilsack, above, during the hearing)

"I encourage you and your colleagues to take the difficult steps to get this done this year," Sec. Vilsack added, as he thanked Rep. George Miller for introducing the legislation. Read the full transcript, below. Chef Tom Colicchio led the second panel of witnesses; his remarks are here. The video:



Update 2: As the hearing ends, Chairman Miller announces that the legislation will be marked up the week after Congress returns from July 4 recess. Testimony will be posted shortly. Check @ObamaFoodorama to read Tweets from hearing, also @USDAgov and @Hbottemiller.

Update 1 during the hearing:
Sec. Vilsack testifying, above. He put aside his prepared comments, to "speak from the heart." During his testimony, Sec. Vilsack is repeatedly referencing The Institute of Medicine report School Meals: Building Blocks For Healthy Children.

The original post:
The House Education & Labor Committee, chaired by Rep. George Miller (D-Ca), will begin a full committee hearing on H.R. 5504, the “Improving Nutrition for America’s Children Act” at 9:15 AM EDT (livestream here).

Agriculture Secretary Tom Vilsack
will be the first witness, and he'll be followed by Chef Tom Colicchio; Major General Paul D. Monroe, U.S. Army (Ret.), from Mission: Readiness; James D. Weill, president of Food Research & Action Center; Dr. Eduardo J. Sanchez, Vice President and Chief Medical Officer, Blue Cross and Blue Shield of Texas; and Robert Rector, Research Fellow, The Heritage Foundation.

Download the full bill text [PDF]; a fact sheet is here. Some of the reports that will be referenced during the hearing: The Robert Wood Johnson Foundation's F As In Fat 2009 Full Report (PDF), released earlier this week; "How Obesity Policies Are Failing In America," Executive Summary (PDF). Trust For America's Health: New Report Finds Obesity Epidemic Increases; TFAH Release (PDF). From Mission: Readiness, download Too Fat to Fight [PDF]. The legislation has bipartisan support, and was introduced by Rep. Miller on June 10. The full list of committee members is here.

Update 3:
Transcript: Sec. Vilsack's prepared testimony:


Mr. Chairman and members of the Committee, thank you for the opportunity to discuss the pending legislation to reform and reauthorize the Department of Agriculture’s (USDA) Child Nutrition Programs and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) program. The first task that the President asked me to take on when I was first selected for this job was to provide our children with healthier, more nutritious meals. I pledged then and reaffirm now -- the USDA will do everything it can to support the health of our children and the health of the school environment in thousands of schools across the country.

I appreciate the Committee’s leadership on this legislation and the efforts to date to pass a robust Child Nutrition bill. The Administration is strongly committed to passing legislation this year that reduces child hunger and improves the quality of school meals and the health of the school environment.

The priorities that the Administration has unveiled for this legislation would transform our school meals programs by making it easier for eligible students to participate in the programs, expanding program coverage to gap periods like breakfast, after school, and summers when some children struggle to access healthy meals, and significantly improving the nutritional quality and health of school meals and the school environment through upgraded meal standards and targeted increases in meal reimbursement rates, new standards for competitive foods, and support for school food service professionals through training, certification, and investments in school food equipment.

I am proud to be joined in my support for this effort by the First Lady of the United States, Michelle Obama, as well as Education Secretary Arne Duncan and the Secretary of Health and Human Services, Kathleen Sebelius. This showing of support underlines the fact that reforming these programs can have a significant positive impact on child obesity and nutrition, as well as health and education outcomes. The recently released White House Report on Childhood Obesity called for the passage of a robust Child Nutrition Reauthorization bill as a key strategy to combat child obesity.

I thank Chairman Miller for his leadership on this issue. The legislation he recently introduced would achieve a number of the policy priorities of the Obama Administration. The legislation proposes to invest significant resources in these programs and would reduce barriers to participation, improve program access, and enhance the quality of school meals and the health of the school environment. There are a number of provisions in this proposal that mirror the legislation that was passed unanimously by the Senate Agriculture Committee and reported out in early May. The strong letter of support from 221 Members of the House of Representatives for a robust Child Nutrition Reauthorization, along with the bipartisan Senate action and the Chairman’s bill show that there is broad support for this important legislation.

As the number of remaining legislative days continues to get smaller, I urge this Committee to continue your work and to act quickly and forcefully on this legislation in order to provide all of
our children with the healthy meals that are so important to their health and education. If we are going to support our children, we must pass a strong bill this year.

Background
A discussion of the importance of reauthorizing the Child Nutrition and WIC programs must begin with the recognition that these programs are some of the largest and most important enterprises in our nation to invest in and support a healthy future for our children. Operating in over 100,000 schools in nearly every community in America, the school meals programs touch the lives of millions of children every school day and represent a partnership between the Federal and State governments and local schools.

The meals served through the National School Lunch Program (NSLP) and the School Breakfast Program are the main nutrition intervention in elementary and secondary schools. The lunch program is available to 90 percent of the 55 million American children enrolled in elementary and secondary schools -- that is 75% of all Americans under age 18. And these meals are a substantial and important part of the diets of many school children. For schools to contribute effectively to reshaping eating behaviors, the meals offered at schools must model healthful choices and contribute effectively to healthful dietary intakes.

The National School Lunch Act, now the Richard B. Russell National School Lunch Act, (NSLA) was enacted in 1946 as a necessary response to the widespread malnutrition-related health problems revealed among young draftees during World War II. Leaders in Congress also
recognized that nutritious lunches would contribute to success in schools.

Yet, now – over 60 years later, a recent report showed that 75 percent of Americans ages 17 to 24 are not fit for military service. Unlike the malnurishment problems of the 1940s, today, being overweight is the leading medical reason that young Americans are rejected from military service. Our understanding of the links between nutrition, health, and education have grown over time, and the program has responded with changes that make the program more accessible to low-income children, and improve the content of meals to reflect the day’s nutrition science. Through these changes, the core nutrition and education mission behind school meals remains just as important, if not more important, today; but, there is more that we can and must do to continue making important and necessary changes to the programs.

Over the years, USDA has made a number of changes to bring school meals into alignment with the most current Dietary Guidelines for Americans. Given the scope and complexity of the 2005 Dietary Guidelines recommendations, USDA contracted with the National Academies’ Institute of Medicine (IOM) to provide evidence and science-based recommendations for the foods offered in these programs. Last Fall, the IOM issued recommendations, including –
increase the amount and variety of fruits, vegetables, and whole grains; set a minimum and maximum level of calories; and increase the focus on reducing the amounts of saturated fat and sodium provided.

I am pleased to report that we will be ready to publish proposed changes to the school meal nutritional requirements based on IOM’s recommendations as soon as later this year. Stakeholders and the public will have ample opportunity to comment on USDA’s proposed rule.
After all public comments are considered, USDA will issue a final rule to implement changes to school meals.

In the meantime, USDA will continue to provide technical assistance to schools to increase the availability of the food groups recommended by the Dietary Guidelines (fruits, vegetables, whole grains, and low-fat/fat-free dairy products) in the lunch and breakfast menus. USDA’s HealthierUS School Challenge is also helping schools move in the direction of the recommendations of the 2005 Dietary Guidelines. The awards criteria have been updated to reflect the 2005 Dietary Guidelines. To date, over 700 schools have received Challenge awards and we are working towards increasing the number of award winners to 3,000 by fiscal year 2012.

As we improve school meals to ensure they are promoting good health, we must improve other foods, sold in competition with school meals, as these foods can displace these more balanced meals and undermine healthy choices. Nutrition education, food service settings, and operational constraints, along with other aspects of the school environment, should also be strengthened.

To sustain a food and nutrition environment that fosters children’s healthful behaviors, we need your help to support improvements in the nutritional content of school meals to meet updated standards; changes in other foods available to ensure that all food sold at school support healthful diets and revisions to policies and practices in the Child and Adult Care Food Program (CACFP) and the WIC Program to ensure that key childhood programs also support healthy eating.

We know that healthy eating habits are established early in the lives of young children, and quality food and nutrition in child care and after school can be a sound, effective foundation. The CACFP provides healthful meals through preschool child care and also includes after school care programs, along with other community settings. Currently serving about 3.2 million children on an average day in child care homes and centers, CACFP supports the health and education of the children that participate in these programs, and enhances the ability of child care providers to ensure quality care. We have asked the IOM to recommend improvements to nutrition standards for CACFP just as they did for the school meal programs. We expect the expert panel to issue their findings this Fall.

Finally, WIC continues to serve as both a supplemental nutrition program and as a gateway to the health care system. WIC provides supplemental foods to pregnant, postpartum and breastfeeding women, infants and children. WIC reaches nearly 9.1 million people each month. About half of the infants in the United States participate and benefit from the WIC program.
I am pleased to report that the new food packages now include fruits, vegetables and whole grains, and less fat, along with other changes to reflect the latest nutrition recommendations. Contracting with IOM to review and recommend changes to the WIC food packages proved invaluable in improving the supplemental foods offered under WIC.

WIC offers a critical opportunity to intervene early to reduce the likelihood of childhood obesity. We know children who are breastfed during the first nine months of life are at reduced risk of childhood or adolescent obesity. Studies have found that the likelihood of obesity is 22 percent
lower among children who were breastfed. The strongest effects were observed among adolescents, meaning that the obesity-reducing benefits of breastfeeding extend many years into a child’s life.

Despite these health benefits, although most (74%) babies start out breastfeeding, within three months, two-thirds (67%) have already received formula or other supplements. By six months of age, only 43 percent are still breastfeeding at all, and less than one quarter (23 percent) are breastfed at least 12 months.

While breastfeeding is not a viable alternative for all mothers and babies, it can be more widespread than it is today. WIC provides an opportunity to increase breastfeeding initiation and duration rates. Providing recognition and financial incentives to State agencies and clinics that support breastfeeding will complement Congress’ support of breastfeeding peer counseling in the FY 2010 appropriations.

Given the reach of the Child Nutrition and WIC Programs and the substantial investment Congress has made to the national nutrition safety net, the tools to become an active part of the solution are within our grasp. Yet, absent a robust reauthorization bill, we cannot move forward.
Schools need resources to improve the quality of school meals and to increase the number of needy children participating in the programs. USDA needs the authority to set nutrition standards for all food sold in schools. And we need funding to improve wellness activities in schools and in child care centers and to encourage breastfeeding in the WIC program.

Challenges
There are compelling reasons to act now. This reauthorization comes at a time of significant challenges. Addressing them boldly and decisively is critical to the future of our country.
Our most fundamental challenge is a health crisis of the first order – the epidemic of obesity among our children. One in every three children and adolescents in the United States is overweight or obese, with particularly high rates among certain populations, such as Hispanic boys, African-American girls, and American Indian/Native Alaskan children. This has a negative impact on children’s health and well-being today, and even more serious consequences for their future.

Research shows that children and adolescents with this condition are more likely to be overweight or obese as adults. And that obesity increases health risks for coronary heart disease, Type 2 diabetes, cancer, stroke, and a range of other serious conditions – and causes an estimated 112,000 deaths per year in the United States. Experts forecast that one third of all children born in the year 2000 could develop diabetes during their lifetime.

These devastating health impacts result in substantial economic costs. Excess weight is costly during childhood, estimated at $3 billion per year in direct medical costs, and far more costly in future years. Obese adults incur an estimated $1,429 more in annual medical expenses than their normal-weight peers. Overall, medical spending on adults attributed to obesity topped approximately $40 billion in 1998, and by 2008, increased to an estimated $147 billion. We cannot let these costs continue to grow at a time when we must reduce health care costs to
remain competitive. Absenteeism and lost productivity at work are additional costs of obesity that our nation cannot afford.

The second major challenge we face is the need to ensure that our children have access to the healthful, nutritious food they need to support educational achievement. As the members of this Committee know as well as anyone, a successful educational experience for every child is critical to our nation’s future. President Obama has said that what matters is what we do to lift up the next generation – and that few issues speak more directly to our long term success as a nation than the education we provide to our children.

Yet we know that for too many families in our country, hunger remains a real problem. In over 500,000 families with children in 2008, one or more children simply did not get enough to eat-- they had to cut the size of their meals, skip meals, or even go whole days without food at some time during the year. This costs us more, not to mention the suffering and deprivation of those families. Ask any teacher how students who fail to eat a healthy breakfast or lunch perform in class. Hungry kids don't learn as well. In fact, the damage extends beyond the hungry children. We want and need our children to be fully prepared for a competitive world and global economy. We will not succeed if our children are not learning as they should because they are hungry, and cannot achieve their potential because they are unhealthy.

Finally, the problem of poor nutrition among our children represents a challenge to our nation’s military readiness. As I noted previously, during World War II, the health effects of malnutrition were a common disqualifier for military service. Our leaders understood the importance of
investing in good nutrition to ensure that the country would never want for healthy, strong young people to serve in uniform. And so, in 1946, President Harry Truman signed the National School Lunch Act, declaring that “in the long view, no nation is healthier than its children.”

Today, the nutrition problems are different, but the impact on preparedness for the military remains. A recent report showed that 75 percent of adults age 17-24 are not physically fit for military service. One of the top disqualifiers for service is obesity. Because of these troubling statistics, a coalition of retired generals and admirals has formed to advocate for a strong Child Nutrition reauthorization bill that ensures that the programs can address today’s nutrition issues as effectively as possible. I thank them for their leadership and welcome their efforts to promote this important legislative initiative.

The Child Nutrition Programs can do more to address these challenges:

• We are working to update school meals nutrition standards based on recommendations from the Institute of Medicine. We must use the opportunity of reauthorization to strengthen our work with schools to improve the content of the meals they serve in ways that make them appealing as well as nutritious.
• We need to ensure that all food sold in school supports good nutrition and health by creating the statutory authority to set national standards for these foods.
• We must ensure, simplify, and expand access to programs when and where children need them
• And we must make physical activity a natural and compelling choice for our children, so that they can strengthen their bodies and develop good habits that can last a lifetime.
So today, President Truman's belief that a healthy nation depends on healthy children remains as true as ever. We must respond as past generations have before us to improve child nutrition. Our children deserve more and our country's better and brighter future depends upon it. And with the reauthorization of the Child Nutrition Programs scheduled this year, now is the time to act boldly.

Priorities
For all of these reasons, we must take steps to streamline access, improve the quality of school meals, increase participation, and work to eliminate childhood hunger in this country. For many children in our programs, school lunch and breakfast represents the only healthy food that they eat all day. We must work to ensure access to nutrition assistance for children, when and where they need it, particularly during the “gap periods,” when we know children struggle to receive the nutrition they need - summer months, during breakfast, and in after-school environments.

Bold action with reauthorization must include the following elements:

1) Improving access to the school nutrition programs must be a priority. States and local communities need to be fully engaged as partners in our efforts to identify innovative strategies to ending child hunger. We cannot rest while so many of our young children struggle with access to food, which is why I’m calling on Congress to provide tools to increase participation, streamline applications, and eliminate gap periods. Quite simply, we must do everything we can to ensure that eligible children have access to these critically important programs. I call on you to fund a new program of State Hunger Challenge Grants for States willing to take strides to reduce and eliminate hunger in their communities. With authorization and funding, we will provide competitive grants to Governors for them to implement creative and innovative approaches to eliminating hunger. We want States to be the laboratories for successful strategies and that means freeing them up to be creative and providing resources for innovative models that match program delivery with evaluation, so that we can learn what works and what does not.

These steps will include policy modifications to existing nutrition programs, enhanced outreach efforts, improved coordination between nutrition assistance programs and family supportive services, such as emergency housing, child care, and family preservation services, counseling and support services, and work with community and non-profit organizations to coordinate services and resources. Competitive grants would be provided to States with comprehensive and innovative plans for reducing hunger, applications that target communities with higher prevalances of hunger, especially among children, and projects that reflect collaboration with a wide range of partners.

In addition, we should offer grants to states and non-profit organizations to develop web-based or other systems to streamline the application process and expand efforts to enroll eligible
students through direct certification. If a child already qualifies for other assistance programs, there is no reason why their parent should have to fill out one more application to qualify for school breakfast or lunch. Bonus payments should be offered to states and school districts that effectively use direct certification to enroll children who currently qualify but who are not participating. The object should be to ensure – particularly in communities where children are at high risk for hunger – that every child eats the food they need.

I am also calling on Congress to provide USDA with the tools necessary to establish paperless application programs in school districts with very high rates of children with free and reduced price-eligible students. In these districts, the cost of paperwork and the risk of lost of forms far outweigh any benefits. We must ensure that communities across the country have access to these types of solutions in order to get more kids into the program and reduce the bureaucracy of filling out forms. Through these reforms, I believe that we will be able to increase participation in these programs by one million children in the next five years.

2) Increasing financial support and expanding participation in School Breakfast is a vital part of reauthorization. I view breakfast as one of the critical gap periods when children struggle to access nutritious meals. On school days, almost two-thirds of children who participate in the lunch program do not participate in the school breakfast program. While School Lunch is served in around 100,000 schools, the breakfast program is only available in 88,000. A healthy breakfast is critically important to educational achievement. No child should go without fueling up at the beginning of the day. Innovative approaches like breakfast in the classroom have been shown to reduce stigma and improve participation rates.

This reauthorization is an opportunity to reduce stigma and promote participation in the breakfast program. The Institute of Medicine’s recommendations show that the biggest gap between current Federal support and what will be needed to support healthy meals is for the breakfast program. I call on Congress to increase the reimbursement rate for school breakfasts and combine that support with USDA-purchased foods to give more children the option of a healthy breakfast. And, I call on K-12 organizations and States to work with USDA to aggressively promote the breakfast option and to ensure that policies and practices are in place to reduce stigma.

3) Our efforts to combat hunger cannot end when the school bell rings on the last day of the school week or year. More children report going hungry during the summer – which is when we see a significant drop in participation in our programs. Working with local governments, nonprofit organizations and community groups, USDA must continue to help bridge the nutrition gap when school is out. We need to encourage more schools, community centers and organizations to provide meals during the summer, and to increase the number of days they make meals available. And we should expand the existing authority of the Child and Adult Care Food Program to all 50 states to provide after-school meals to at-risk kids.

This important program currently provides additional nutrition assistance to eligible children in 14 States – it is a successful and popular program and there is no reason it should be limited to only a handful of States. This reform will increase access to another 140,000 school children. I commend Congress for providing $85 million in the in the fiscal year 2010 agriculture appropriations bill to test innovative methods to improve access to healthy foods during the summer. We have already awarded projects to two States – Arkansas and Mississippi – to test ways of increasing the number of sponsors, sites, and children served through the Summer Food Service Program(SFSP) with incentives to extend the duration of operations and funding to support improved enrichment activities. Next summer, we expect to award additional state projects.

4) But no matter how many children we reach, we do them a disservice if we are not offering them meals that help them be their best. Reauthorization must substantially improve the nutritional quality of the meals being served to our children, which plays a central role in the First Lady’s effort to solve childhood obesity in a generation. The recent Institute of Medicine study commissioned by USDA sounded an alarm about the nutritional value of school meals. The study concluded that our children are eating too much sugar, salt, and fats and too few fruits, vegetables, whole grains, and low fat dairy products. This mix may help explain why one half of the calories consumed by children ages 6-11 in this country are "empty" calories.

USDA is working as aggressively as possible to implement the Institute of Medicine recommendations to better align our meals with the Dietary Guidelines, but we also know that the improved foods will increase costs for local schools. The very same Institute of Medicine report showed that increases in reimbursement rates, training, school equipment, and technical assistance will be necessary to implement this package. This assistance is critically important if we expect schools and school food service professionals to successfully implement the new standards and our enhanced expectations for the program.

That is why I am calling on Congress to improve meal quality by increasing reimbursements for schools that meet the new nutritional standards and providing funding for equipment upgrades and additional training. We must empower our schools to take important steps toward enhanced nutrition. Higher reimbursement rates, tied to performance, will help schools purchase the whole grains, fruits, vegetables, and low fat and fat-free dairy products that our children need to grow strong and healthy.

At the same time, Congress should provide USDA with the tools we need to ensure that the reimbursements we are providing for schools are being used appropriately for the program, so that all kids have access to healthy meals. And, it is our responsibility to work together with schools to ensure they are serving the most nutritious meals possible.

Recognizing that many schools do not have the equipment in place to improve food selections, our hope is that Congress will build upon the investments in equipment made by the American Recovery and Reinvestment Act and the FY10 appropriations act, and provide funding to improve school kitchens so schools can provide meals that meet the Dietary Guidelines and offer fresh fruits and vegetables. At the same time, we should create a credentialing program for school food service directors, and support school food service providers with resources for the critical training they need to do their jobs.

5) The reauthorization effort should ensure that all foods served in schools are healthy and nutritious. A 2006 study showed that outside the cafeteria, children are three times more likely to be able to purchase cookies, cakes, pastries, and high fat salty snacks than fruits or vegetables. Foods served in vending machines, the a la carte line, and other school settings should not undermine our efforts to enhance the health of the school environment. That is why USDA must have the capacity to set standards for all foods sold in schools.

It does not mean the end of vending machines in schools – it just means filling them with nutritious offerings to make a healthy choice the easy choice for our nation’s children. Though many in the media have portrayed this as an area of conflict, I will tell you that I have heard nothing but broad support for efforts to establish standards for food sold in schools. From food service professionals to the National PTA to the food industry, there is support for this authority, and it is an essential component of the reauthorization bill.

6) We also believe that every lunchroom ought to double as a classroom – and that schools should be challenged to make meals a learning experience. That is why it is important for us to build on the step taken in the 2004 Reauthorization bill to establish school wellness policies in every school by strengthening the requirement and raising the standard. Schools should work in consultation with parents to develop and implement a strong wellness policy centered on healthy eating, nutrition education and physical activity.

7) Making sure that parents and students have correct and complete nutritional information about foods being served in schools must be part of the reauthorization effort as well. With better information and simple assessments, parents will know what is available in their child’s cafeteria and can better assist their children in making the right nutritional choices. And, in addition to transparency, we also need to work on being smarter about how we serve food: Steps as simple as putting the fresh fruit in a more prominent place in the cafeteria can help kids eat healthier. And we should promote new approaches based on the most recent research.

8) Strengthening the link between local farmers and school cafeterias must also remain a priority in this legislation. Supporting farm-to-school programs will increase the amount of produce available to cafeterias and help to support local farmers by establishing regular, institutional buyers. Many schools have found farm-to-school programs an important component of nutrition
education and I call on education leaders and our State and local partners to embrace farm to cafeteria programs and school gardens.

9) Guaranteeing the integrity of the nutrition programs remains central to a credible reauthorization. We should fund periodic studies to eliminate erroneous payments in the meals programs. Support for new technology will help schools avoid inaccuracies in eligibility determinations, and maintain the confidence that our help is provided to those who truly need it.
In his first year in office, President Obama pulled us back from the brink of the greatest economic crisis since the Great Depression and worked to lay a new foundation for economic growth. He identified three key strategies to building that lasting prosperity: innovation, investment, and education. All three strategies require the next generation to be the healthiest and best educated in our history. The health of our nation – of our economy, our communities, and our national security – depends on the health of our children. We will not succeed if our children are not learning as they should because they are hungry, and cannot achieve their dreams because they are unhealthy.

When our future was on the line after World War II, our nation’s leaders understood the importance of well-fed and healthy youngsters. We would do well to remember that lesson today, and to act on it once again.

Again, I would like to thank the Committee for the opportunity to appear before you this morning to discuss the reauthorization of the USDA’s Child Nutrition Programs and I look forward to answering any questions that you may have.

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*Photo by Obama Foodorama; video from Hosue Education & Labor Committee