Policy Memo 161

DOH-CACFP: Number 161 (07/11)

TO: All CACFP Sponsoring Organizations

FROM: Lynne Oudekerk, State Director, Child and Adult Care Food Program

SUBJECT: Nutrition Requirements of the Healthy, Hunger-Free Kids Act of 2010

I. Purpose and Scope

The Healthy, Hunger-Free Kids Act of 2010 (the Act), Public Law 111-296, was signed into law by President Obama on December 13, 2010. The Act modified requirements for fluid milk and fluid milk substitutions in the Child and Adult Care Food Program (CACFP) meal pattern. The Act also establishes a requirement to make drinking water available to children in CACFP. The purpose of this memorandum is to provide guidance on the implementation of these new provisions in all participating facilities, including child care centers, family day care homes, at-risk afterschool programs, adult day care programs, and homeless shelters. These provisions are effective immediately. However, to allow adequate time for training and technical assistance, full compliance must occur no later than October 1, 2011.

II. Background Information

  1. Fat-Free and Low-Fat Milk Requirement
    1. Milk served in CACFP must be consistent with 2010 Dietary Guidelines for Americans, which recommends that children two years of age and older and adults consume fat-free (skim) or low-fat (1%) milk.
    2. Effective October 1, 2011, children two years of age and older and adults must be served fat-free or low-fat fluid milk only.
    3. Fat-free and low-fat milk includes: unflavored skim or 1%, fat-free or low-fat lactose reduced milk, fat-free or low-fat lactose free milk, fat-free or low-fat buttermilk, fat-free or low-fat acidified milk (e.g., Kefir).
    4. Whole milk is still required for children who are one year of age.
    5. Milk must be pasteurized fluid milk that meets State and local standards.
    6. To be consistent with the NYS Healthy Meal Patterns, milk served to children 1-5 years of age must be unflavored. Unflavored milk is also recommended for school-age children and adults in CACFP. The menu must specify the type of milk served.
    7. Beginning with the October 2011 claim, facilities that do not comply with this requirement will have meals disallowed for reimbursement.
  2. Fluid Milk Substitutions
    1. Children and adults who cannot consume cow's milk due to medical or other special dietary needs, other than a disability, may be served non-dairy beverages in lieu of fluid milk.
    2. Parents or guardians may request, in writing, non-dairy substitutions without providing a medical statement. The written request must identify the medical or special dietary need that restricts the diet of the child or adult. For example, a parent of a child who follows a vegan diet may request soy milk be served instead of cow's milk.
    3. Non-dairy beverages must be nutritionally equivalent to milk and meet the nutrients found in cow's milk, as outlined below:

      Nutrient Per 8 ounce Cup
      Calcium 276 mg∗
      Protein 8 g∗
      Vitamin A 500 IU∗
      Vitamin D 100 IU∗
      Magnesium 24 mg∗
      Phosphorus 222 mg∗
      Potassium 349 mg∗
      Riboflavin 0.44 mg∗
      Vitamin B-12 1.1 mcg∗

      ∗mg = milligrams; g = grams; IU = international units; mcg = micrograms

    4. Sponsors are responsible for ensuring non-dairy substitutions meet the requirements stated above. Non-dairy milk substitutions are at the option and expense of the facility.
    5. The requirements related to milk or food substitutions for a participant with a medical disability remain unchanged. Please refer to Policy Memo DOH-CACFP Number 46 (02/09) CACFP Requirements for Meal Substitutions and Meal Pattern Modifications.
  3. C. Water Availability
    1. Suitable drinking water must be made available to children one year of age and older throughout the day, including mealtimes and upon request. Water does not have to be available for children to serve themselves.
    2. While drinking water must be made available to children during mealtimes, it is not part of the reimbursable meals and may not be served instead of fluid milk.
    3. To be consistent with the NYS Healthy Child Meal Pattern, facilities must serve water with snacks when no other beverage is being served. The menu must specify when water is served at a snack.
    4. This requirement does not apply to adult day care centers.
    5. The purchase of water may be considered a reasonable and allowable expense, if safe water is not readily available in a facility. However, purchasing water for adult or employee consumption is not an allowable cost.

III. Summary of Changes

The purpose of this memo is to notify CACFP Sponsoring Organizations of nutrition requirements of the Healthy, Hunger-Free Kids Act of 2010. The Act requires fat-free or low-fat fluid milk be served to children two years of age and older and adults participating in CACFP and allows non-dairy beverage substitutions for cow's milk. The Act also requires the availability of drinking water for children throughout the day. Sponsors must begin to implement these provisions immediately and be in full compliance by October 1, 2011. Meals that do not meet the requirements specified above will be disallowed beginning October 1, 2011.