Peer-reviewed article
"It's just not worth it anymore": A Mixed Methods Study Examining the Impact of Reinstating Reimbursement Tiers in the Child and Adult Care Food Program.
Fiedler KC, Bacon KA, Lee DL, Vasicsek R, Felix C et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how changes to reimbursement rates in the US Child and Adult Care Food Program affected family child care home providers, sponsors, and families. Nearly all surveyed providers said the reinstated tiered reimbursement rates were not enough money, leading to reduced food variety and quality for children in their care. The study recommends increasing reimbursement amounts and expanding the number of meals and snacks covered to support better nutrition for young children.
Key points
- 92.4% of surveyed providers reported reinstated tiered reimbursements were insufficient
- 39.1% of providers reported reduced food variety and 14.8% reported reduced quality as a result
- 96.9% of providers and 24.0% of parents experienced increased financial burden
- Providers identified $7.58 per child daily as the ideal reimbursement amount for 2 meals and 1 snack (compared to current rates of $5.70 tier 1 and $2.72 tier 2)
- Qualitative analysis identified challenges including economic pressure on providers, participation barriers, and concerns about food quality and care standards
Limitations
The study was limited to California and did not include a comparison group to assess causality. The family participant sample was small and conveniently selected, which may not represent broader parental experiences.
Abstract
Objective Assess impacts of the Child and Adult Care Food Program (CACFP) reinstatement of tiered reimbursements among family child care home (FCCH) providers, sponsors, and families. Design Mixed methods (survey and interviews). Setting California. Participants Randomly selected FCCH providers surveyed (n = 277); purposively selected FCCH providers (n = 10) and sponsors (n = 5), and conveniently selected families (n=5) interviewed. Phenomenon of interest and variables Perceptions of adequacy and impacts of tier reinstatement, and optimal amount and number of meals/snacks covered by CACFP. Analysis Linear and logistic regression for survey responses by tier; qualitative analysis using the framework method. Results Irrespective of tier, surveyed providers reported that the reinstated, tiered reimbursements were insufficient (92.4%), resulting in reduced food variety (39.1%) and quality (14.8%), and increased financial burden on providers (96.9%) and parents (24.0%). The ideal number of meals/snacks reimbursed was 4, and the ideal reimbursement amount for 2 meals/1 snack daily per child was $7.58 (currently $5.70 tier 1, $2.72 tier 2). Qualitative analysis identified 4 themes providing context on the challenges resulting from tier reinstatement: economic landscape, CACFP participation, food and care provided, and policy solutions. Conclusions and implications Increases to CACFP reimbursements and meals/snacks covered is recommended to support healthy eating by FCCH children.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Reinstatement of tiered reimbursement rates in the Child and Adult Care Food Program
- Population
- Family child care home providers (n=277 surveyed, n=10 interviewed), program sponsors (n=5), and families (n=5) in California
Key finding
92.4% of providers reported reinstated reimbursements were insufficient