In a recent study by Dr. Susana Matias, BFI Faculty Director, and her colleagues found that pandemic-era changes to a federal program, the Child and Adult Care Food Program (CACFP), helped family child care homes serve nutritious meals to young children by reimbursing providers for nutritious food. This federal program has been shown to improve children’s nutrition—participating providers serve more fruits, vegetables, and whole grains compared to those who don’t participate.

However, before the Covid-19 pandemic, CACFP participation among family child care homes had been declining for years. One major reason is the program’s two-tiered reimbursement system. Providers in low-income areas receive higher “tier 1” payments (about $5.67 per child daily for two meals and a snack), while others receive much lower “tier 2” rates (around $2.29 before the pandemic). The tier 2 rate barely covers food costs, and providers must also complete burdensome paperwork to document family incomes.

During COVID-19, temporary policy changes gave all family child care providers the higher tier 1 reimbursement rate from July 2021 through June 2023. The study examined whether these changes affected participation in California, home to the largest number of family child care homes in the country.
Researchers analyzed five years of state data (2018-2023) covering over 46,000 licensed family child care providers. The results were striking:

• Before the pandemic, CACFP participation was slowly increasing for both tier groups.
• During the early pandemic (with tiers still in place), participation declined for both groups as providers struggled with lockdowns and food shortages.
• When tiers were eliminated, tier 1 participation stabilized after its decline, while tier 2 participation actually reversed course and began increasing. The higher reimbursements allowed tier 2 providers to serve better quality and variety of foods while likely reducing costs passed to families.
• After tiers were reinstated in July 2023, participation dropped sharply again—especially for tier 2 providers, who saw the steepest decline.

During the two-year waiver period, approximately 4,820 more children received nutritious meals through tier 2 providers—equivalent to over 7,000 additional meals annually for young children.

You can read the full study by Dr. Matias and her colleagues here.