Originally posted at California Health Report.
By Fran Kritz.

Since Jan. 1, thousands more kids in California have had improved access to breakfast and lunch at school for little or no cost.

That’s when a new law took effect requiring schools that serve subsidized federally funded meals and post the application forms online to have those applications available in multiple languages. The new law will make it easier for non-English speaking parents to apply for meals for eligible kids.

“It is simply unconscionable that there are children who go throughout the school day hungry due to something as simple as a language barrier…” said State Senator Tony Mendoza, the bill’s sponsor.

The new law also requires schools to instruct their software vendors not to include questions on school meal applications that violate a parent’s privacy, such as a request for parents’ birth countries. Undocumented immigrant parents, or parents with an undocumented immigrant family member living in the household, often forego benefits signup, say experts, fearful that information they provide could trigger an immigration investigation.

The  law is one of several innovative ideas aimed at reducing hunger in the state, where, according to the California Association of Food Banks, 5.2 million people, 13.5 percent of the state’s population, are “food insecure,” unable to consistently afford food.

The 2015 edition of “Map the Meal Gap,” produced by Feeding America, a network of 200 food pantries across the U.S., finds that three California counties, Alameda, San Diego, and Los Angeles, were among the top ten most food insecure counties in the U.S. And in Los Angeles, the situation is even more dire. A recent report from the Los Angeles County Department of Public Health found that L.A. has about 1.4 million food insecure adults and children, making it the most food insecure county in the U.S.

Low incomes contribute to the problem, of course, but so does the high cost of living in the state.  “The economic recovery has not reached all Californians “and that is very clear [from] the long lines at our food banks and pantries and requests for free and subsidized meals at school,” says Sarah Palmer DeFrank, advocacy manager at the California Association of Food Banks.

One initiative that could make a big difference, say experts, is the governor’s proposal to add more than $800,000 to the 2016-2017 budget to add staff to the CalFresh program. CalFresh is California’s Supplemental Nutrition Assistance Program, or SNAP, formerly known as food stamps, and about half of those eligible don’t apply, according to research by California Food Policy Advocates (CFPA), a state policy and advocacy organization.

Reasons include fear of stigma, not knowing they’re eligible, paperwork that can be cumbersome, and, as with subsidized school meals, concern that signing up could trigger deportation of undocumented immigrant family members. “The hope of reaching more people is why the name of the program was changed from food stamps to CalFresh,” says Tia Shimada, director of programs at CFPA, “but we still have too many people not taking advantage of the help.” Recent efforts to get more people signed up include: registration tables at community events and posters letting eligible participants know that signup does not have to be in person, but can be done online and over the phone.


Groups across the state have championed a few innovative ideas to combat food insecurity in the last year. “California has never been a one-size-fits-all kind of state,” says Palmer DeFrank. “Our state is so big, and regional areas are very diverse including rural areas that are especially hit hard by food insecurity in part because of lower average wages and more barriers to food access.”

Last April the city of San Francisco launched EatSF, a voucher program aimed at giving low income residents and residents with chronic illnesses such as diabetes and high blood pressure $5 to $10 a week to buy fruits and vegetables. “Produce often falls to the bottom of the list when people have little to spend on food,” says Hilary Seligman, PHD, an associate professor at UC San Francisco and the senior scientist at Feeding America. The program is unfolding by neighborhood and so far more than 1,000 households have enrolled.

Seligman says the owner of one corner store participating in EATSF told her that since the voucher program began, he needs to restock produce several times a week, up from once or twice before. Jackie Walker, 38, a stay at home mom with six kids ages 2 to 14, says the program “helps free up other money for groceries.” Walker learned about the program through a case manager at the public housing development where she and kids live and they use the funds at a nearby farmer’s market. She takes the kids with her “because they like the free samples,” and recently added a canary melon, the first time the family had tasted one, to the produce she bought with the voucher. “It was sweet, and they liked it,” Walker said. .

In Santa Rosa, the Redwood Empire food bank was part of a two year pilot study, along with food pantries in Ohio and Texas. that looked at whether combining diabetes -friendly food packages, physician referrals and diabetes management support could improve diabetes control. The pilot was run by UC San Francisco and Feeding America and results were published in the November 2015 issue of Health Affairs.

More than half of the almost 700 participants were Latino or Hispanic, generally middle aged and stayed in the pilot for six months. The food packages included whole grains, lean meats, fresh produce, and low or non-fat dairy products, and got high marks: : 87 percent reported eating all or most of the food, and most saw their glucose levels improve at the end of the program. .

That’s an important finding because diabetes control can lower patients’ risk of complications like kidney, eye and nerve disease, says Hilary Seligman, senior scientist at Feeding America. “[And] although this study specifically examined…diabetes, it presents a model in which food banks can respond to any of a number of diseases with education, self-management and—most importantly—the provision of nutritious food.”

The three pantries are continuing the program and Feeding America hopes to roll it out to more counties across the state and country.

Paul Simon, MD, MPH, Director of the Division of Chronic Disease and Injury Prevention at the Los Angeles County Department of Public Health, says that especially in Los Angeles where the cost of living is so high, food insecurity can only be solved for many people by also addressing affordable housing, education, health and wages. In October, Feeding America announced another trial project, Collaborating for Clients, which brings partners together to address not just food insecurity but many of the other factors that Dr. Simon points out.

In California, the FIND Food Bank, which serves the rural communities of Riverside County, received a $500,000 grant for the project which will create a needs assessment among low income people in the food bank’s neighborhood, developed in partnership with the Price School of Public Policy at USC. The goal of the assessment is to find the interventions most needed in each location. FIND will then work with partners to develop solutions including affordable housing and job training. Partners include United Way of the Desert, the Desert Healthcare District and the Riverside County Economic Development Agency. The pilot will run for three years and then calls for local funds to be added. Directors at FIND say they don’t expect drastic changes for ten years or more, but “the time to start looking at hunger from this perspective is way behind us.”

Two other ideas to combat hunger have not made it past the proposed bill phase but advocates hope legislators will try again this year. One is Summer EBT, a U.S. Department of Agriculture program that gives families who receive SNAP benefits extra money during the summer to replace the meals their kids eat for free or at reduced cost during the school year. Despite massive efforts to find and feed kids during the summer, ranging from paper flyers to texting programs that that direct parents to summer food programs by zip code, Feeding America says only about twenty percent of kids enrolled in school year food programs sign up for summer meals. For several years the USDA held Summer EBT demonstration projects in several states, though not California and legislation has been proposed by Representative Susan Davis (D-California) and Senator Patty Murray (D-WA) to make it a permanent national program..

Food policy advocates are also disappointed that in California an initiative adopted in some other states, Breakfast After the Bell, was held in committee last year and hope to try again in 2016. The concept calls for making breakfast free for all students, not just those eligible for free and subsidized meals, which could help end the stigma many children feel about eating breakfast at school. Serving breakfast before class starts is often too early for many families, says CFPA’s Shimada. “Providing the meal after the school day starts removes the stigma and gives everyone the same healthy start to the day.”