child and adult care food program (cacfp) administrative training child nutrition and food...

Child and Adult Care Food Program (CACFP) Administrative Training Child Nutrition and Food Distribution Programs North Dakota Department of Public Instruction Wayne G. Sanstead, State Superintendent

GOAL OF CACFP Helping to improve and maintain the health and nutritional status of children and adults in care while promoting the development of good eating habits

UPDATES New & Updated Creditable food guide New Reimbursement Rates Income Eligibility Guidelines

Creditable Food Guide http://www.dpi.state.nd.us/child/CACFPcredit able.pdf http://www.dpi.state.nd.us/child/CACFPcredit able.pdf

New Reimbursement Rates CHILD AND ADULT CARE CENTER REIMBURSEMENT RATES July 1, 2012 June 30, 2013 FullReduced Price Free Breakfast$.27 $1.25 $1.55 Lunch/Supper$.27 $2.46 $2.86 Snack$.07 $0.39 $0.78 Cash in Lieu $.2275 The new rates are posted on the DPI/Child Nutrition website.

Updated Income Guidelines http://www.dpi.state.nd.us/child/new/income _eligibility_guidelines12-13.pdf http://www.dpi.state.nd.us/child/new/income _eligibility_guidelines12-13.pdf

Extended Eligibility Policy Children receiving SNAP, FDPIR, or TANF benefits are always categorically eligible for free meals and their eligibility extends to all household members participating in CACFP.

MILK F luid milk served to children 2 years and older must be: Fat-free (skim) or low-fat (1%) Fat-free or low-fat lactose reduced milk Fat-free or low-fat lactose free milk Fat-free or low-fat acidified milk Fat-free or low-fat flavored milk (i.e. chocolate) All milk must be pasteurized fluid milk that meets State and local standards 8

MILK It is recommended that whole milk be served to children from age 1 to 2. However, meals are still reimbursable if reduced, low or non-fat milk is served to these children. Whole milk or reduced-fat (2%) milk may not be served to children age 2 and older without a medical statement. Meals served with whole or 2% milk are non- reimbursable. If whole or 2% are listed on menus or observed during a review, meals will be disallowed. 9

MILK Non-dairy Milk Substitutes: Non-dairy milk substitutes may be served in lieu of fluid milk to children who cannot consume fluid milk due to a medical or other special dietary needs, other than a disability, Non-dairy milk substitutes must be nutritionally equivalent to milk (8 grams of protein per serving). 10

MILK Parents may request in writing non-dairy milk substitutions without providing a medical statement. Example: if a parent has a child that follows a vegan diet, the parent may submit a written request asking that soy milk be served in lieu of cows milk. The written request must identify the medical or other special dietary need that restricts the diet of the child. 11

MILK SUBSTITUTES Milk substitutions are at the option and the expense of the facility. Parents may supply a creditable non-dairy milk substitute and the center may claim the meal. If the non-dairy milk substitute does not meet the USDA standards, the meals may not be claimed for reimbursement.

Creditable Non-Dairy Milk Substitutes Currently, the following brands are known to fulfill the non-dairy milk substitute nutrient requirements. Rice, almond, coconut, flax and other milks do not meet the nutrient standards. Acceptable Non-Dairy Milk Substitute Where to Purchase (based on information on brands websites) 8 th Continent Soy Milk Original & Vanilla Target, Walmart, SunMart, Hornbachers, Albertsons (Williston), Dans Supermarkets, check other local stores Pacific Ultra Soy Milk*Walmart, Amazon.com, check local stores Pearl (Kikkomen) Soy Milk * Unsweetened Walmart, Hornbachers, Amazon.com, check local stores *Available in aseptic cartons which are shelf-stable; often located near cereal sections in grocery stores. These cartons keep the soy milk fresh without refrigeration until they are opened.

WATER Drinking water must be made available to children throughout the day as nutritionally appropriate. Options for compliance are: Simply provide water to a child when it is requested. Having water pitchers and cups set out and offering water. Water can be served at a meal but it cannot be served in lieu of milk when milk is required in the meal pattern. 14

SOCIAL SECURITY NUMBER Only the last four digits of the SSN is required on the free and reduced price meal application. 15

FOSTER CHILDREN The foster child is categorically eligible for free meals and is no longer considered a household of one. Households with foster and non-foster children may choose to include the foster child as a household member. 16

Cheese- Whats Creditable Whats Not Natural Cheese: Packages that state 100% natural cheese credits ounce for ounce as a meat alternate. For example: Cheese sticks, Cheddar, Mozzarella, Monterey Jack. Processed Cheese: To make processed cheese, natural cheeses are melted together with small amounts of liquids and emulsifiers added. An ounce of processed cheese credits as an ounce of meat alternate.For example Deli Slices. 17

Cheese- Whats Creditable Whats Not Processed Cheese Product: Contains less than 51 % cheese. A cheese product is NOT Creditable. This includes Kraft Singles (and store brands) and Velveeta. Processed Cheese Food or Spread: Contains at least 51% cheese. One ounce of cheese food or spread only credits as ounce meat alternate. 18

Civil Rights The U.S. Department of Agriculture prohibits discrimination in the CACFP on the basis of race, color, national origin, sex, or disability. 19

Civil Rights Collection and use of data Program applicants/participants may not be required to furnish information on their race or ethnicity on the child enrollment form 20

Civil Rights Public notification systems Place the nondiscrimination Justice for All poster in a prominent area where participants and potential participants have ready access The public notification system contains the following basic elements: Program Availability Complaint information Nondiscrimination Statement 21

Civil Rights Complaint procedures The person alleging the complaint must be provided with the nondiscrimination statement and procedure The nondiscrimination statement has the complaint process (the statement is on the Justice For All poster) A complaint alleging discrimination must be made within 180 days of the event Complaints should be forwarded to the State Agency or directly to USDA using the address in the nondiscrimination statement 22

Civil Rights Compliance review techniques The State Agency reviews civil rights as part of the compliance monitoring Sponsor of Centers must check for civil rights when doing the on-site reviews 23

Civil Rights Resolution of noncompliance Resolve all civil rights issues (examples- special dietary needs, language asst.) Be responsive to corrective action regarding civil rights 24

Civil Rights Requirements for reasonable accommodation of persons with disabilities such as- Special dietary needs Special eating utensils Equal access and service 25

Civil Rights Requirement for language assistance Forms are available in different languages, please contact the State Agency for access to these forms If you need an interpreter to explain the program to parents and one isnt available locally, please contact the State Agency 26

Civil Rights Conflict Resolution Assess the nature of the problem Take appropriate steps to notify all pertinent parties that there is a problem and work together to make a solution Follow-up 27

Civil Rights Customer Service All participants must be treated in the same manner Be proactive and accommodating When a parent approaches you regarding a special dietary accommodation or any civil rights issue, treat them with respect and be helpful 28

Civil Rights Examples of Discrimination: Refuse a childs enrollment based on disability Serving meals at a time, place, or manner that is discriminatory Selectively distributing applications Not offering the program to infants Segregating kids by gender or ethnicity/race 29

Serious Deficiency Process The State Agency Will: Identify Serious Deficiency Prepare Serious Deficiency Notice Assess Corrective Action Prepare Notice of Termination (if not corrected) Hold the Appeal Place on National Disqualified List 30

Claims will now be done on the ND Food System For-profit sponsors will also submit claims online 31

For-Profit Center Claims

Claims Due Dates Submit claims by the 10 th of the month for the preceding month to receive payment in a timely manner Direct Deposit available (payment received within 2-3 days) Checks can be mailed (payment received with 4-5 days) You have 60 consecutive days (not working days) to submit a valid claim (after 60 days, claims cannot be accepted) 40

Where Are the Forms? www.dpi.state.nd.us/child Programs Child and Adult Care Food Program Forms 41

For-Profit Centers Roster (submitted with claims in the NDFOODs system each month) must have current dates for both: CACFP enrollment dates CACFP Application for Free and Reduced Price Meals Termination dates (when children leave your center) 42

Sponsor of Centers Must monitor and complete self- monitoring form for each site (including the main site) three times per year Follow up on errors/problems NEW-5 day reconciliation as part of the self-monitoring 43

Infants USDA defines an infant as ages birth through the 11 th month. 47

Birth through 3 months Required at all meals and snacks: Iron-fortified formula and/or Breast milk

4 through 7 months Required at all meals and snacks: Iron-fortified formula and/or Breast milk Solid foods when developmentally ready

8 Through 11 months Required at Breakfast: Iron-fortified formula and/or breast milk Iron-fortified infant cereal (IFIC) Fruit and/or vegetable ( not juice)

8 through 11 months Required at lunch and supper: Iron-fortified formula and/or breast milk Fruit and/or vegetable(not juice) Iron-fortified infant cereal (IFIC) and/or Meat/meat alternate Lean meat, fish, poultry, egg yolk, cheese, and beans

8 through 11 months Required at snacks: Iron-fortified formula and/or Breast milk or Fruit juice (full strength) Optional at Snacks: Crusty Bread or Crackers

Introducing Solids Introduce new foods one at a time: Allow 3 to 5 days between each new food Observe infants closely for any reaction to new food items. Serve appropriate textures in small amounts DO NOT ADD SUGAR, SALT, FAT, OR SPICES TO FOOD

Transition Period After the 1 st Birthday Between the 12 th and 13 th month Transition from IFIF to cows milk Offer as a mixture Follow parents lead on transition

Transition Period Q : A 12+ month old infant is still consuming breast milk. According to the CACFP Meal Pattern, breast milk is not an option for fluid milk. Is a doctors statement needed for this situation since it deviates from the Meal Pattern? A: No. There are no ramifications for an otherwise healthy child who is over 12 months of age consuming breast milk rather than fluid milk, as long as the infant is also consuming solid foods. The American Academy of Pediatrics has recommended that mothers breastfeed infants until the age of two years old, as long as it is still mutually desired.

Happy 1 st Birthday After the 1 st Birthday Serve off of the 1-2 year old meal pattern Medical statements required: Infants not ready to transition to cows milk after their 13 th month Infants not ready to be served the 1-2 year old meal pattern

Creditable Foods for Infants Foods Prepared at the center, with appropriate modifications. Commercially prepared foods must be plain fruits, vegetables, and meats. Infant cereals must be iron fortified and made specifically for infants.

Iron-Fortified Infant Cereals Creditable Infant Cereals Iron-fortified Can be mixed with breast milk or formula Non-Creditable Adult Cereals Non iron-fortified infant cereals Infant cereals containing fruit Jarred infant cereals

Commercially Prepared Infant Food Fruits and Vegetables Creditable The fruits or vegetable is the first ingredient. Contain multiple fruits or vegetables ingredient Water is not the first ingredient. Non-Creditable Baby dinners. Jarred cereal with fruit. Desserts. Water is the first ingredient. Containing DHA

Commercially Prepared Infant Food Meat & Meat Alternates Creditable Plain strained baby food meats Including those with beef, chicken, turkey, lamb, veal and ham Non-Creditable Combination dinners Meat sticks Breaded/battered seafood and canned fish with bones. Nuts, Seeds, and nut/seed butters.

8 though 11 months Optional at Snacks: Crusty bread or Crackers

Non-Creditable Breads and Crackers for Infants Allergies(whole eggs) Pancakes Waffles Muffins Calories: Brownies Cakes doughnuts Choking: Hard pretzels Breadsticks Tortilla chips Granola bars Some ready to eat cereals

Creditable Breads for Infants Breads (without seeds, nuts, or hard pieces of grain kernels): White Wheat Whole Wheat French Italian Other similar Breads

Creditable Breads and Crackers for Infants Other Foods: Biscuits Bagels English Muffins Pita Bread Rolls Soft tortillas Crackers: Saltines Snack Crackers Animal Crackers Graham Crackers(Without Honey)* *clostridium botulinum spores = serious food borne illness

Creditable Foods for Infants Fruit Juice Creditable Full strength juice Only at snack for 8-11 months old Non-Creditable Unpasteurized fruit juice Vegetable juice Fruit juices with yogurt

Infant Formula Center must supply at least one creditable infant formula. Must be Iron-Fortified To view the list of approved iron-fortified formulas, go online to: www.fns.usda.gov/cnd/Care/RegsPolicy/infantmeals/formulalist.htm This List is not comprehensiveContact your State agency if you have questions.

Parent Provided Food &Formula A parent my choose to provide food and/or formula for their own child. Must be an approved iron-fortified infant formula. Maintain documentation that the parent declined offered food and/or formula

Food Provided by Parents Parents may provide breast milk, formula, and/or foods, However, the center must: Supply at least ONE required component when two or more components are offered, in order to claim the meal for reimbursement.

Medical Statement A signed statement by a recognized medical authority is required to support the use of: Low-iron infant formulas Follow-up formulas when served to infants less than the specified age. Exempt infant formulas

Exempt Infant Formulas i.e. Nutramigen, Pregestimil, Alimentum Specialty formulas required for: Inborn errors of metabolism Low birth weight Unusual medical or dietary problems www.fda.govwww.fda.gov and search exempt infant formula

Medical Statements Also required for serving: Cows milk to children under 1 year Formula to children over 13 months. An alternate meal pattern.

Food Provided by Parents When mom comes to the site and nurses. The meal is not reimbursable. UNLESS The center supplies an additional component if it is required for a reimbursable meal. Only applies to ages 8 months and older.

Meal times for Infants No specified meal time May offer meal at more than one sitting Complete one meal before serving the next

Meal Times for Infants On-Demand infant feeding Feed when hungry Only Approved meal types can be claimed

Infant menus must contain the following information: Food components offered Names of infants Infants age Meal type Date of meal service

Common Menu Documentation Errors Non-creditable foods Missing required components Breast fed infants are included in the meal counts (and no other components are supplied by the site).

Common Menu Documentation Errors Not moving to next set of meal pattern requirements at start of their 8 th month. Infants are moved to the Toddler Room and their meals are no longer recorded on infant menu records or fed the child meal pattern. Children over age 1 are still in the infant room and fed infant meal pattern.

Want more on infant feeding? www.fns.usda.gov/tn/resources/feeding_infants.ht ml

CONTACTS Stacie Morowski CACFP Manager 888-788-8901 [email protected] http://dpi.state.nd.us/child/ 82

THANK YOU 83

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