Providing Meal and Nutrition Services During COVID-19

Providing Meal and Nutrition Services During COVID-19

Marco Beltran: Good afternoon and welcome. I want to start with some housekeeping prior to starting the webinar. We really want to hear from you, so please use the “Ask a Question” feature to submit your questions. We will try to answer as many questions as we can. In addition, we want to let you know that your questions become the foundation for future webinars. Slides and resources are available for you to download. Under the “Ask a Question” section, you will notice an “Event Resources” section. If you click on the tab, it will expand, and you will be able to see the list of the available resources that are available for you to download today. A recording of this webinar will be posted on the ECLKC. Until that time, you can use the webinar link that you used to join the broadcast to watch the recording again and to let us post it on the ECLKC. In addition, certificates of attendance will not be provided at the end of this webinar.

I'm so happy to be with you today. My name is Marco Beltran. I am the health lead for the Office of Head Start, and I am your host, and I'll be facilitating some of the questions at the end of the webinar. The Office of Head Start is concerned about what the worsening of the food insecurity during the pandemic means for Head Start children and families. It is a priority for us to do all we can during these difficult times to address food insecurity for our children and families, and we are hardened that Head Start programs can make a big impact in this area. To get us started, I want to introduce you to Dr. Deborah Bergeron, who I want to thank for being supportive of our efforts and for being a champion for our children, families, and staff. Dr. Bergeron?

Dr. Deborah Bergeron: Thank you, Marco. And for everyone listening, you're in good hands. Marco has done an incredible job – he always does a great job. But since this pandemic hit, he has kept the Office of Head Start well ahead of the curve in terms of health issues, nutrition being right at the center of that. And so, I want to just recognize his dedication to this. So, this is going to be an incredible webinar. I'm very excited to be able to offer it. 2021 is underway, everyone was looking forward to New Year’s Eve and a new year, but of course, practically, the year is all part of what's been going on. It doesn't just start over on January 1st. So, we have a lot of work ahead of us. It's great to see things getting better, but we know that there are issues at hand. The pandemic continues to cause hardship and suffering, and one of those big pieces is student security. I published a letter back in December talking about this important topic, and I did a blog as well, just because it is so important. I'm super excited to be here today to welcome you to this webinar, and we're hoping to take both of those pieces of communication and elevate them to be a little bit more specific. This will be on providing meals and nutrition services during COVID-19. The number of children living in households struggling with food insecurity right now is three times – let me repeat that – three times what it was before the pandemic. So, we know the need is out there, and we know programs are doing so much. I get all kinds of emails and tweets about these creative things folks are doing, but we are a little concerned from some of the preliminary data that programs may not be doing as much as they were earlier in the pandemic and that they may be hitting roadblocks that they're not sure how to get around, and that's what we want to deal with today. We know that Black and Hispanic families are suffering at a greater rate, and we know it is our Head Start kiddos and their families who are the hardest hit. We also know that Head Start is the kind of organization that is creative and innovative. As I said, I've seen so many incredible examples of how food has been delivered. At the height of where folks were fearful, you all stepped up and made it happen. And we know that with enough support, which is what you're getting here today, you can find ways of creating hubs in your communities and to make an impact on your families and children. I'm super excited about the content. This is a great topic, but in addition to that, is nothing better than where you see offices coming together to really make the most out of what they're both doing.

USDA is here with us today to give us rich information and resources about CACFP WIC and other programs. There are flexibilities in place that maybe you don't know about, or maybe you're not sure how to put them into place. We also have our National Center of Behavioral Health and Safety, and can I just give them a big shout out; incredible group of people to talk to us about meal preparation, food safety, and how to tackle some of the barriers of providing meals and nutrition. Colleen Rathgeb, who is our director of policy at the Office of Head Start and is incredible in terms of knowing the detail and how to really maximize what we're capable of doing. And she's going to talk to us about programs and how you can use your Cares Act funds as well as funds Congress recently appropriated. So, maybe there's some potential there for you. Before I close out, I just want to thank you for the work you're doing. You may or may not be aware, this is actually my last meeting. This is my last day as the director of the Office for Head Start. It's been about three years, and this is my last official meeting. I can't think of a better way of closing out this work than to do so – promoting something as important as nutrition. It all starts with those basics, and that's what Head Start and Early Head Start does best. So, as I hand it back to Marco, for all of my Head Start folks in the audience listening here, I just want, from the bottom of my heart, thank you for the incredible work that you have done over the last almost year, if you can believe it, since the pandemic hit. Not only have you been champions for our children and families, you have kept Head Start and Early Head Start ahead of the curve. We have been recognized nationally for the work that you have done. I couldn't be more proud to have called this my professional home for the last three years, and it is because of you. So, I just want to thank you for that and to thank all of the folks with the Office of Head Start who are working tirelessly to make sure that you're supported. Together, we do some pretty awesome things, and I think we're a great example of what happens when people come together around a common vision. So, I will turn it back over to the wonderful Marco Beltran, and he will take you through the webinar. Enjoy the series, and good luck as you take your next steps into 2021.

Marco: Thank you, Dr. Bergeron. I messed up a little bit. When Dr. Bergeron was talking, I forgot to advance the agenda slide. So, I'm going to put that back so you can take a look at the agenda. As Dr. Bergeron indicated, this agenda was developed in collaboration with our USDA colleagues in hopes of addressing many of the questions and concerns that have been expressed by many of you. So, we took the opportunity to look at all the stuff that we've been getting over the past several weeks – months and came up with this particular agenda. We're going to be addressing the food insecurity, as Dr. Bergeron indicated, as well as USDA program benefits during COVID-19. We're going to have some opportunities to look at some technical assistance resources, strategies, and best practices, and finally, addressing some of the key questions that we've been receiving related to CARES Act Funds and what programs can do to support food and nutrition services. So, now I'm going to turn it over to Nicole so she can get us started in addressing food insecurity.

Nicole Patterson: Thank you, Marco, and hello everyone. My name is Nicole Patterson. I am a nutrition and dietetic technician registered with the Academy of Nutrition and Dietetics. I'm also the content manager for the National Resource Center for Health and Safety in Early Care and Education, and we're responsible for managing the ongoing revisions of the “Caring for our Children” National Health and Safety Performance Standards, or CFOC. I also serve as a content leader for nutrition services within the National Center for Health, Behavioral Health, and Safety. And I really want to open up our discussions today talking about how these are uniquely challenging times, and the information that will be presented today comes at a time in which these children and families that we serve really need it the most. Through research and numerous surveys, we're seeing the number of children living in households that are struggling with food insecurity increasing due to COVID-19. So, first I want to go over what is food insecurity. Food insecurity is defined as “having limited or uncertain access to sufficient, safe, and nutritious food to meet dietary needs and food preferences for an active and healthy lifestyle.” If Head Start families were not food insecure before, they're more likely to be food insecure due to the pandemic. We also want to remember that food insecure households are not necessarily food insecure all the time, and food insecurity may reflect a household need to make trade-offs between important basic needs, like housing, utilities, or medical bills, and purchasing nutritious food. Some questions you may be considering are, “How do I, maybe as a Head Start teacher or a family child care provider, identify family struggling with food insecurity?” Later in the webinar, we'll discuss that really important question as well as strategies for supporting children and families to becoming food secure.

Food insecurity is a major concern because Head Start programs will, and may have already begun, seeing an increase in the number of children that are hungry and likely not getting adequate calories and vitamins and minerals that are critical for their growth and development. When it comes to education and learning, we know through research that hunger can impact a child's ability to learn, and therefore, we may see children struggling in school. Let's take a moment to look at some important figures surrounding food insecurity. So, pre-COVID data in 2018 from USDA food insecurity surveys showed that 37 million individuals were experiencing food insecurity, of which, 11 million were children. As of COVID or due to COVID, these numbers have increased to 54 million individual experiencing food insecurity with an estimated 18 million being children. The evidence suggests that many Head Start children come from households that struggle with food insecurity, which is why Head Start has always included a nutrition component that consists of healthy meals and educating children and families about healthy food habits. Program staff may want to consider having conversations with families to determine whether they need additional food resources, or perhaps, need nutrition support for the first time. So, again, really, we're here today to provide as much information as possible so that you as program staff feel properly equipped to support food security among the children and families that you serve. So, right now, I want to turn it over to Melissa Daigle Katz and Angela Spencer with the USDA to discuss USDA policy updates.

Melissa Daigle Katz: Thank you, Nicole. Hello, everyone. I'm Melissa Daigle Katz. I'm a program analyst with the US Department of Agriculture Food and Nutrition Service, and I work on Child and Adult Care Food Program and Summer Food Service Program Policy.

Angela Spencer: And I'm Angela Spencer, a program analyst with the WIC policy branch.

Melissa: To say that a lot has changed since this time last year would be a huge understatement. Although there's never been a year quite like 2020, we're so proud of the way that the Head Start community has worked through the challenges. You have thought really creative ways to ensure that our nation's children and their nutritional needs are not forgotten. On behalf of all of us at USDA, I want to thank you for the tremendous work that you're doing. Over the next few minutes, Angela and I will provide an update on where things currently stand with child nutrition and WIC policies and policy flexibility at the national level. Let's get started. As part of the federal response to the novel coronavirus, USDA Food and Nutrition Service plays a vital role by responding to nutrition assistance needs, and through our state and local partners, USDA is working to maintain food access for children and for low-income Americans. Throughout the pandemic, USDA has ensured continued access to our child nutrition program and to WIC benefits in two important ways. First, we've allowed flexibility in how our existing child nutrition and WIC programs are delivered. And second, we're implementing new temporary nutrition programs created by Congress in response to the pandemic. Let's talk about some of the policy flexibility for existing child nutrition programs, first focusing on CACFP the Child and Adult Care Food Program. So, USDA has issued nationwide waivers. Those are policy waivers that allows state agencies to administer our programs in ways that reduce potential exposure to COVID-19. Issuing waiver is not commonly done in a child nutrition programs, especially nationwide waivers. So, let's spend a moment talking about how waivers actually work. So, what's the nationwide waiver? It's an approval for all state agencies that administer child nutrition programs to have flexibility around federal regulations – those are our rules. Each state must notify FNS – that's a Food Nutrition Service – if they want to use the waiver, and each state determines where and how to use the waiver. Each program’s operators must follow the direction of their own state agency when implementing the waiver. So, that means if you hear information about a flexibility today that you would like to use, please make sure to get in touch with your Head Start regional office or program specialist before making any changes to your program. To see which waivers your state is using, you can visit the web address that's on this page, click on your state, and you'll see the complete list.

The nationwide meal service waivers can directly impact how you are serving CACFP meals. These waivers were introduced last spring, early in the pandemic, and as the pandemic situation has continued, these waivers have been extended, and they're now in effect all the way through June 30th of this year. The waivers allow no required time of meal service. That means there's not a particular time to serve breakfast as an example, or no particular time that must elapse between meal services. Children do not have to eat onsite; we call this a non-congregate meal service, and meal components can be waived with state permission under certain circumstances. Meals also can be given to the parents for serving to the child. When used together, the waivers allow you to implement meal pickup and delivery services, multi-day meal packages, and including folks with meal kits, and we understand that you actually have a lot of questions about these options still. So, let's look more closely at them. Let's start with meal pickup and delivery. Pickup simply means that children, parents, or guardians can pick up the meals from you, and delivery means that you either can hand deliver or mail meals to a child's home. When designing your non-congregate meal service, you have the ability to work around your days and hours of operation. You might have, for instance, limited onsite care, such as when children are attending Head Start onsite, but perhaps not during mealtime, maybe you're offering virtual or offsite care. You might be offering both onsite and virtual care, or you might even be on hold from offering care altogether, but with children still enrolled in Head Start. Let's look at some examples of how meal service would look under adoption.

Here’s scenario one: Let's say a Head Start center is approved to serve breakfast and lunch every day, and right now, they're offering limited onsite care for scheduled after breakfast and before lunch. One meal service solution would be to, at dismissal each day, send home children with a lunch for today and a breakfast for tomorrow. How about if the Head Start center is offering parents the choice of either onsite or virtual care for their children? Well, in this case, the center could choose to run two different modes of food service on the same day. They can serve congregate, that means onsite meals to the children attending onsite, and then, for the children who are receiving virtual care, they could offer non-congregate meals, such as delivering the meals, using their center’s plan. Here's another possible scenario for when centers offer a combination of onsite and virtual care for each child. Let's say that children at a Head Start center attend half a school day onsite, then half a day virtually on the same day. Some children attend onsite in the morning, some attend onsite in the afternoon. A solution could be for the children who are onsite in the morning to eat the breakfast on site, and then, take home their lunch and snack, and for the children who are onsite in the afternoon, to take home their breakfast the day before to eat at home and eat lunch and snack onsite. For our last scenario, how about when a Head Start center is temporarily not offering either onsite or virtual care? If they're still able to offer a safe food service and the children who attend Head Start are still enrolled during the closure, the center could obtain the parent's permission to offer temporary meal delivery services during the closure.

Now, best practices for designing great meal pickup and delivery operations are already emerging. So, you'll want to check out our new technical assistance piece called “Child Nutrition Program Meal Service During Coronavirus” for all the details, but here are a few highlights. When planning a delivery or pickup think about, which mode is the best for families and your center? What's the plan for ensuring meals only go to enrolled children? What's your strategy for preventing the distribution of duplicate meals? That is, more than one of the same kind of meal for the same child, such as a child receiving two lunches on the same day. And also, how will you ensure a COVID-safe meal distribution? Here are a few best practices that we've seen. You can use regular bus or van routes to do meal delivery if you have a bus or a van. You can do a drive-through pickup, so parents don't have to get out of their car to pick up the meal. You could try using rearview mirror hangers, or placards to indicate that a child is eligible for the meal. We do recommend having signage at the site about eligibility so that ineligible people do not try to attend to get meals, which can really slow down your meal service. And you can use staggers pickup times so that you don't have long lines, and also could best serve parents with different schedules. You can also provide reminders to parents and staff to not come if they're sick, keep your site safe.

When a center usually serves more than one meal a day and is doing a meal distribution, those meals can be bundled together for one meal pickup or delivery, and this is a great service to parents and guardians who work. You might bundle up meals for one day, for more than one day, even up to one week. Let's look at an example of this. A center serves breakfast, lunch, and snack to enrolled children, and they want to reduce the number of times that parent have to come by from meal pickup. Many of their families don't live close to the site. So, they decide to do two pick-ups per week: one in the morning, and one in the evening. Parents can choose either the pickup time and pick up one meal bundle for the week, and each meal bundle would contain five days’ worth of meals. But when you're planning on how to bundle meals, make sure to think about how long foods can be stored before the food quality and the safety declines, the participants access to refrigeration and freezer space for the amount of food and milk you'll be providing, the food store space at the child care sites and on meal delivery vehicles like possible food trucks, and then also, whether fewer pickup days and times might actually cause a decrease in access to meals for some children. But thinking back to our example, on the previous slide with a center who bundles meals, this center should consider including some shelf-stable items in the meal bundle to reduce the refrigeration space needed by parents, and the center could put the shelf stable items and refrigerated items in two separate bags to make it easy for parents to put them away when they get home. Program operators may also provide bulk food items to families. So, what do we mean by bulk food? It's food in a package that contains more than what's required at a single meal under CACFP meal patterns. For example, instead of including four eight-ounce single serve milk boxes in a meal kit, you can include a quarter of milk instead. And as you're likely aware, single serving food packages, like milk boxes or on-the-go infant formula packets, can be very expensive and sometimes hard to find. So, serving one or more foods in bulk packaging can really help you keep your food budget under control.

USDA has some requirements and recommendations around multiple meals and bulk foods. USD requires that food components are provided and a proper minimum amount for each reimbursable meal being claimed and that food items are clearly identifiable as making up a reimbursable meal. We also recommend that you provide menus with directions indicating which items are to be used for each meal and the portion sizes, that you consider whether households have access to refrigeration, stoves, and microwave when providing food that requires some refrigeration or preparation like repeating, and that you ensure that only minimal preparation is required, and that the food provided is not ingredients for recipes that require a lot of chopping and mixing and baking. Our worksheet titled, “Providing Multiple Meals at a Time for Children During the Coronavirus Pandemic” has 16 pages of content to help you get started planning meals that contain bulk items. It also includes tables with commonly served items and how much you need to pack based on the child's age and the number of meals in each kit. It includes tips for communicating with parents about how to build meals from the food provided, and it has guidance on how providers can bag items so that they're easy for parents to receive and store.  I'd like to take a moment here to address disability accommodations, which includes, under USDA's definition of a disability, accommodating food allergies and sensitivity. We had been asked if child care providers still have to accommodate disabilities due to any constraints around COVID. The answer is yes, you must still accommodate disabilities, including providing meal pattern accommodation and auxiliary aids and services. So, if you're struggling right now with continuing to provide accommodations, please make sure to discuss this with your Head Start point of contact so you can get assistance right away.

In addition to the flexibilities for delivering our existing benefits, we're also offering new temporary benefits for children and child care providers during COVID. We understand that Head Start centers perform a really vital role in serving families by making them aware of resources in their community, and while we can't reimburse for CACFP or summer food service program meals that are served to parents, through the summer food service program, we can offer meals to other children and the child's family during COVID. This is how USDA is now allowing schools and community organizations to serve meals through the summer food service program and the national school lunch program seeing with summer options. They can serve them throughout the community. The meals are free. They can serve them to any child, zero to 18 years of age, and children receiving CACFP meals through Head Start may also receive meals through the summer food service program as long as they're not receiving duplicate meals, meaning receiving more than one of the same meals on the same day. State agencies are allowed to approve the distribution of summer meals in any community, and they may even approve the service of meals on weekends. This option is available through the entire 2021 school year. To advise your families on where to find the summer meals, please visit the USP meals for kids site finder at the address on this slide. Just enter your location or address, and the summer site locations and hours will pop up for you.

During COVID, USDA is also offering the “Farmers to Families” Food Box Program. USDA is purchasing fresh produce, dairy products, meat, and seafood from American producers. Distributors are packaging those items into family size food boxes and providing them to food banks and other nonprofit organizations who are then giving them to families in need. To find out whether food boxes will be available in your community, which nonprofits will be providing them, and even whether you can help, just contact a distributor in your state. Just follow the link on this page to a list of the latest distributors, each state, and their contact information. Last year, we also introduced pandemic EBT or P-EBT which helps supplement family food budgets by replacing the value of lost school meals. The benefits are available on an EBT card to spend at a grocery store, and the last school year, 2019-2020, it was available in all 50 States, the Virgin Islands, Puerto Rico, and DC, and it provided over $8 billion in benefits. This school year, P-EBT is continuing. It'll be expanding to cover children under six years of age in child care, which is very exciting news, and the benefits will also be available in Puerto Rico, American Samoa, and the Commonwealth of Northern Mariana Islands. We're currently working on a plan for how to implement P-EBT for children under six years of age, and we don't have details to share today, but we will make sure to share the information with you as soon as it becomes available. In the meantime, if you'd like to advise your families on how to access to P-EBT for their school-aged children, just let them know to contact their child's school.

And we have more exciting news to share. The COVID-19 relief package passed by Congress in December authorized emergency CACFP funds for child care centers that serve fewer meals to children last spring due to COVID. This is brand new. We're still developing guidance for states on how to administer the benefits, and states will need to develop plans on how to distribute the benefits. Again, we'll make sure to share detailed information on this funding as soon as it becomes available. Now, lately we've received a lot of questions from Head Start grantees, and we'd like to share our answers on two frequently asked questions before I wrap up my section. Very popular question is, “If a child care center provides CACFP meals during the pandemic, can it also be approved to operate a summer food service program site?” The answer is yes. CACFP institutions that have a separate food service program for children who aren't enrolled in Head Start may also be approved to operate as summer food service program site under a sponsor that has been approved by a state agency. The institution must ensure that the same children aren't served the same meals in both programs each day and that they keep separate records for each program. We think this is really great news for you providers who want to go above and beyond to serve your family. We've also been asked, “Can Head Start programs deliver meals to children enrolled in home-based program option?” The answer is that these children may not be served meals with USDA funds. Head Start programs may only distribute meals to children who were already receiving meals through CACFP or the national school lunch program, and Head Start children don't normally receive meals under CACFP or NSLP if they're in the Early Head Start home-based program. These kids can instead get their meals from summer food service programs in their community. However, children enrolled on an Early Head Start or Head Start home-based option can still get meals from other funds that Head Start sets aside which OHS will discuss more later in this presentation. Also, remember still that you can use the USDA “Meals for Kids” Site Finder at the link on this page to locate meal sites for these kids. We want to let you know that we're still actively listening to the questions and concerns of all of our stakeholders, and we're continuing to work through the issues to find solutions that promote flexibility and strengthen food security while maintaining program integrity. So, please keep your feedback coming, and we'll make sure to respond accordingly. So, that's our child nutrition part of the presentation. Let's turn to Angela Spencer now for updates on WIC.

Angela: Thank you, Melissa. As mentioned before, my name is Angela, and it's my pleasure to talk to you all today about WIC. As many of you know, the WIC program operates in 89 state agencies and provides its participants with many benefits, including supplemental, nutritious food, nutrition education, breastfeeding promotion, and support and screening and referral to other health welfare and social services. In addition, 49 WIC state agencies also operate the farmer's market nutrition program. This program serves WIC participants and provides them with a $10 to $30 seasonal benefit that they can redeem at authorized farmer's markets during the summer. WIC participants are deemed eligible to receive the program benefits if they meet these criteria. “Categorical eligibility” means that the participants must be either a pregnant woman, a breastfeeding or non-breastfeeding postpartum woman, an infant or a child under five years old, but also check the participants residential eligibility to ensure that they live in the same state in which they are applying. State agencies determine what is acceptable documentation, but generally, something like a utility bill is sufficient to demonstrate residency. Participants must also provide documentation that their income is at or below 185% of the federal poverty income guidelines. Currently, a four-person family living in the continuous United States who makes less than $48,470 a year could qualify for WIC. Applicants can also be automatically eligible if they participate in other federal and state programs, such as SNAP and Medicaid. Lastly, a WIC participant must also be at nutritional risk. A WIC staff member will do a nutrition assessment of the participant to see if they have a qualified medical or dietary based condition. Such conditions include, but are not limited to, diabetes, hypertension, anemia, being overweight or underweight, or inappropriate nutrition practices. I would just like to remind everyone that if families that stopped participating WIC but are still eligible according to these work criteria, they're absolutely allowed to restart the participation with WIC. Please encourage them to reach out to their local WIC clinic or refer them to the WIC application pre-screening tool on the USDA WIC website. During the public health emergency, most of the clinics have remained open and are still open today. With additional flexibilities provided by the COVID-19 related waivers of program regulations, many clinics across the country shifted to partial or fully remote operations that enable them to continue to serve the participants and provide benefits. From mid-March until September 30th, FNS responded to over 850 state agency requests per week waivers feeding 16 different types of waivers. The most common waivers were for requirements related to physical presence, remote benefit issuance, and food package substitutions. Many of you know that WIC has a federal requirement that the participant needs to be seen in person. With the physical presence waivers, state agencies were able to perform all aspects of the enrollment appointment remotely. State agencies who were granted remote benefit issuance waivers were able to give their participants their benefits remotely, whether that was by electronically uploading more benefits to their EBT cards or sending EBT card for coupons in the mail. Lastly, the food shortages that mini grocery store faced this last year impacted which WIC eligible foods were available to participants. States are granted waivers to substitute certain food package items when availability was limited. In addition to waivers, FNS provided technical assistance to help state agencies use existing flexibilities within program regulations including provision of remote nutrition education and breastfeeding support.

And now, let's walk through some USD resources that might be of interest to you. In early 2020, the WIC national office and the Office of Head Start jointly released a resource that is commonly called the 10 weeks document. This resource shares 10 real-life examples of how WIC and Head Start providers have collaborated on the state and local level. Some of these collaborations included co-location of WIC and Head Start services, cross training nutritionists to provide both WIC and Head Start families with consistent nutrition education messaging, and data sharing between the two programs. Since both WIC and Head Start serve the same population, there are many opportunities to collaborate in both our services. Many of you are already collaborating with your local WIC clinics, and I would like to thank you for your work with WIC. For those of you who are interested in collaborating with your local WIC clinic, please contact your WIC state agency. Their contact information can be found in the “Event Resource” tab on the left-hand side of your screen.

Melissa: Please also make sure to download the team nutrition resources we've reviewed today. And as a reminder, they are “Feeding Kids with Schools are Closed Due to Coronavirus, “Child Nutrition Programs Meal Service During Coronavirus,” and “Childhood and Adult Care Food Program: Providing Multiple Meals at a Time During the Coronavirus Pandemic.” For those of you who work closely with schools or community organizations serving summer or school meals, follow the web address on the bottom of this slide to find technical assistance resources specific to summer and school meal programs. And as we all began this new way of doing business, during coronavirus, there were naturally a lot of questions from state agencies and program operators. And to make sure that everyone had access to the same information, we've been issuing a series of question-and-answer documents, which are available on the USDA documents and resources page at the web address on this slide. You can find all of the nationwide waivers we've discussed along with all of our COVID-19 policy guidance on USDA Food and Nutrition Service COVID-19 response webpage at the address on this slide. The most important resource is, of course, each other. So, in addition to sharing resources within the historic community, we highly recommend being a regular visitor to the Institute of Child Nutrition’s Child Nutrition Sharing Site. The Institute of Child Nutrition is our partner in providing excellent technical assistance products for state agencies and program operators. The sharing site is a treasure trove of resources from state agencies and program operators that have built really great COVID-19 operations, and it's updated with new resources often. Don't delay, check it out on the web address on this page. So, this ends the USDA portion of the webinar although Angela and I will be back to respond to your questions during the question-and-answer session. I'm now going to turn it over to Nicole with the National Center on Health, Behavioral Health, and Safety to discuss food service, safety, and nutrition.

Nicole: Thank you, Melissa. Thank you, Angela. And there's quite a bit of information to unpack when it comes to food service, safety, and nutrition. So, first, I'd really like to touch upon food safety and echo how important it is to continue safe food practicing – or safe food practices –  and food safety and sanitation practices during this time. So, through guidance from the Centers for Disease control and Prevention, we know that it is possible that a person can get COVID-19 by touching a surface or object, including food or food packaging that the virus has on it, and then touching their own mouth nose or eyes. However, it is not thought to be the main way that the virus spreads, especially when we're practicing appropriate hand-washing procedures. Therefore, the CDC states that the risk of getting sick with COVID-19 from eating or handling food and food packages is considered very low. I also want to mention that the virus that causes COVID-19 has not been found in drinking water and the Environmental Protection Agency continues to regulate water treatment plants to ensure that treated water is safe to consume. Next, hand-washing. Head Start staff should continue to practice and educate children on the importance of hand-washing. Hand-washing continues to be so very important when it comes to decreasing your exposure to the virus. After shopping, handling pre-packaged food, or before preparing or eating food, it's important to always wash your hands with soap and water for at least 20 seconds. If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry. Please continue to check CDC hand-washing guidelines and “Caring for Our Children” Standard 3.2.2.2 for further information on hand-washing procedures. These resources, as well as others, have been provided to you in the “Food Insecurity Webinar Resource List” that's available for you to download.

Now, next, we want to remember to clean and sanitize all kitchen and meal preparation surfaces regularly using disinfectant products. You can use the EPA's “List N Tool: Disinfectants for Coronavirus,” and always remember to follow manufacturer's directions. Another excellent resource for selecting a disinfectant comes from the “Caring for our Children,” a collection of health and safety standards. Again, this one is “Appendix J: Selecting an Appropriate Sanitizer or Disinfectant.” Then again, these resources are available on that resource list previously mentioned. When thinking about disinfecting products, do not use disinfecting products on food or food packaging, and do not use disinfectants designed for hard surfaces, such as bleach or ammonia on food packages, including those that are in cardboard or plastic wrap. And when unpacking groceries or receiving food from a vendor or a supplier, refrigerate and freeze meats, poultry, eggs, cheeses, and other perishable items immediately upon receiving. Programs should remember to clean and disinfect high touch surfaces daily, such as handles, kitchen countertops, tables, faucets, light switches, doorknobs, and so on. While practicing physical distancing and enhanced hygiene practices, we know these things can be challenging, especially in early care and education settings, so, every attempt should be made before, during, and after meal service. We also want to follow safe food practices while maintaining safe distancing guidelines and keep in mind other employee health considerations during the COVID-19 pandemic. Use proper food safety practices when handling food and before, during, and after preparing or eating food. Safely handle and continue to cook foods at the recommended cooking temperatures to prevent potential foodborne illness. And again, I can't stress it enough, wash your hands often when you prepare and cook food to prevent the spread of germs. Also, continue to wear face masks to spread the slow of the virus that causes COVID-19. Wearing face masks may help people who unknowingly have the virus – may prevent them from  spreading it to others. If your programs provide meals in-house, maintain social distancing in all food production areas where staff may typically work within close distances. Staff who are involved in meal prep should continue to follow CDC protocols about staying home when sick if they test positive for coronavirus or if they've been exposed to somebody with coronavirus. We've provided the URL for a great resource from the Environmental Protection Agency, or EPA, and the Occupational Safety and Health Administration, or OSHA, that contains an employee health checklist with links to CDC and OSHA guidance, as well as several useful graphics, similar to the one pictured, that programs may find helpful for how to set up workspaces and stations to maintain physical distance. And lastly, programs, we want to [Inaudible] really using more convenience type of foods that don't require the same amount of food preparation. This can help with staffing challenges and possibly reduce the amount of time that staff are within close distances of each other during meal preparation.

Next, I want to provide a few ideas and things to consider when providing food to families. So, whether it be the grab and go type of foods, like individual pre-packaged sandwiches, to individual servings of fruit and vegetables, or maybe complete frozen meals with all the milk components, or maybe you're considering providing those book type of foods like Melissa spoke about earlier. Consider potential challenges that your families may face when given several days to a week's worth of food. Think about storage and food quality. How long can these foods be safely stored before eating and before food quality starts to suffer? That also helps with avoiding potential food waste. Think about your participants access to refrigeration and freezer space, especially for the amounts of food and milk provided. We've seen some programs being able to provide one gallon of milk per eligible child. Do your families have space to hold two or three gallons of milk if they have several children. Next, check whether your current food distribution schedule – maybe for food pickup or food delivery – is meeting the needs of your family. Are fewer pickup days and times potentially decreasing access to meals for children? If you see a need, consider shifting what weekdays or times these services are provided. And then, next, transportation – do families have regular transportation to pick up food, or do they rely on public transportation? And consider potential challenges with physically bringing home large quantities of food with maybe one or two children present with them on a bus or other mode of transportation, and really listen to concerns around feeling uneasy about traveling in the current COVID environment.

Next, consider how the foods you provide may or may not be culturally familiar to families. This can lead to some families of diverse backgrounds struggling to prepare and serve the foods provided to them. And this is why I'm going to get into next recipes. This is why recipes and directions are so important and can be a great addition to the foods provided. Also, consider foods that do not require much preparation or the addition of other ingredients before eating. And next, as mentioned, consider including recipe cards and meal preparation instructions or ideas for families. This would also be a good time to include tip sheets or one-page educational materials on following safe food handling practices at home and remember to include resources in multiple languages to reach all the families. Next, for those Head Start programs that have remained onsite with in-person learning, these resources and tips have led to much success in planning, meals, and snacks. First, standardized recipes programs should consider using a variety of standardized recipes that meet meal pattern requirements for all meal pattern components, and really, having a variety of recipes ready on hand can help with meal planning during food shortages or when typical items are temporarily unavailable. Programs should also consider temporarily using more convenient soup and recipes that require less prep work as compared to foods made from scratch. The term “convenient cuisine” refers to these quick convenient methods of providing quality meals and snacks that are nutritious while still saying budget friendly. And just keep in mind, these should only be used for short periods of time during the pandemic or for programs experiencing staff shortages. And remember variability in your menu. So, rotational menus that consist of these types of recipes can help centers from feeling like they're constantly serving the same type of foods over and over. Variability also depends on the seasonal availability of certain fresh fruits and vegetables. So, having these variety of recipes on hand can definitely help with those potential challenges.

Next, if programs are not sure how to credit foods, we definitely recommend using the “Food Buying Guide” for child nutrition programs. This resource is still available for staff to use to get crediting information for CACFP. This resource is available to you on the webinar resource handout provided for you to download. Consider how any extra foods as well – foods that are served in addition to the meal pattern requirements – contribute to the child's overall nutrition needs. And really, remember that your CACFP State Agency contacts are on your side, and they want to see you succeed. They can also be a great resource for CACFP-approved meals and recipes. We're also seeing a lot of mealtime adaptations in the classroom. The COVID-19 pandemic has resulted in a unique environment in which adaptations have to be made so that we can continue to provide services while maintaining the health and safety of children, families, and staff. The following are adaptations to mealtime services that Head Start programs should be practicing. First, we want to make sure that we're practicing safe setup and seating. So, make sure that all mealtime surfaces and areas are clean and have been disinfected, ask staff, not children, to handle setup of table and place setting and the distribution of meals and beverages, and remember to keep food covered to avoid contamination. Ensure meals are provided by staff wearing face masks, and the use of paper gauze and disposable plastic utensils can be used during this time for quick cleanup and also to reduce potential exposure. Maintain distances of six feet between tables and between children and try to stagger seating so that children are not directly in front of or facing each other. When children must share a table, use name cards to ensure adequate seating, and then once seated, remind children to catch their coughs and their sneezes using their elbow. Adaptations to family style meals. Family style meals have become an important foundation, a critical foundation for meals in Head Start. It has been proven to help children make healthy food choices by seeing positive attitudes from teachers and peers, and the Child and Adult Care Food Program, or CACFP, recognizes family style dining as a meal service option. And other benefits of family style meals include improving motor skills, self-confidence, expanding social skills, and practicing the use of proper table manners. However, due to COVID-19, the full practices of family style meals are not feasible at this time. Head Start programs should not pass around serving utensils, bowls, and pitchers during mealtime. While programs should not participate in the physical movement of food items around the table, programs should still participate in the social aspects of family style meal. Staff are not permitted to serve components and lesser portions unless specified in the meal pattern to accommodate a child's request. However, initiate those conversations at the table so children understand that they can and still are able to decide, what and how much of each item they want to eat. And obviously, do not allow children and staff to share and touch each other's food to reduce exposure. Another great resource for further information on this topic as well others, is the webinars series, “Collaborating Actively in Meaningful Planning,” or CAMP. This webinar series sets out to address questions and concerns about offering Head Start and Early Head Start services during the COVID-19 pandemic. We've provided a link to access each series, including series five on health programs services on the webinar resource list available to you.

Next, let's take a look at that important question that I brought up earlier in the webinar. So, how do I support food security among the children and families that I serve? And really, it starts with using assessment strategies to identifying families struggling with food insecurity. According to the American Academy of Pediatrics, a screening assessment tool, as simple as a two-question survey, can accurately help to identify families struggling with food insecurity. Examples of these “yes or no” type questions include, “In the past one to two months, we worried whether our food would run out before we got money to buy more” or “In the past one to two months, the food we bought just did not last, and we did not have money to get more.” A third option, “In the past one to two months, we've had to lower the quality of food because money was tight.” So, many of these types of questions are routine questions asked in enrollment, and programs may want to consider revisiting these questions and checking in with families that may now need food assistance as a result of COVID-19. And remember, answering yes to these style of questions may indicate that a family is struggling with food insecurity, even though they're not necessarily aware that they're expressing it. These assessment questions allow us to recognize and provide resources for families who may be hesitant to admit or ask for assistance.

The next step in supporting food security for families, once they're identified, will need to largely focus on having supportive conversations with families, or “ask and acknowledge.” Listening and understanding the fact that it's hard to eat healthy on a budget can be helpful in initiating more open conversations with parents and caregivers. If transportation access and transportation costs are something that families are struggling with in your program, perhaps look at your communication system. Setting up reliable communication systems ensures that families can plan accordingly, so they know where food services will be for pickup, or so they can plan for someone to be available to receive food items being delivered to their home. Research also points towards low rates of seeking food assistance among newly food insecure households. We're also seeing populations living outside major metropolitan areas may be more likely to use friends and family for support and see community assistance programs as the last resort. However, COVID has created environments of social distancing and widespread financial challenges, that these safety nets may be no longer available, and these households may be of particular concern because they may be needing help but yet still feel uneasy about reaching out for assistance. Other barriers may include families simply not knowing where to find help accessing food. So again, we really encourage families to take advantage of all of those food programs offered to them and in their community. And I really want to echo the importance of listening and sharing resources. Communicate with families in a way that promotes positive, ongoing, and goal-oriented relationships with families in their journey to becoming food secure.

So, the next and final step in the discussion with me today is going to be a call to action. So, get involved in supporting Head Start families in becoming food secure by providing nutrition education in your program. We also want to remember that children are part of the food insecure household, therefore, the fight against food insecurity involves us helping the family unit. Focus on education around meal planning. For some households, having the ability to plan and prepare meals with low-cost wholesome ingredients can be an important buffer against being otherwise vulnerable to food insecurity. Planning meals in advance makes better use of foods that families already have and also can help promote better shopping choices. Encourage families before meal planning and shopping to check and make a list of all the items in their refrigerators, their freezers, their pantries as well. This can be a first step in helping families use what they have and limiting the amount of money spent as well as their time and number of trips to the grocery store. Encourage families to check local grocery store ads for sales on fresh fruits and vegetables, as well as lean meats. Many grocery store ads are now available electronically or as mobile apps. And make a shopping list and stick to it. Encourage families to only purchase items that they need for no more than two weeks. Once they've brought home items on their grocery list, express the importance of eating fresh fruits first to avoid spoilage and food waste, and then, gently remind families to continue to encourage the use of face masks and social distancing while grocery shopping or picking up food items. Provide regular recipes and creative new ideas for families as well. And then, lastly, use MyPlate. So, use MyPlate in your teaching. Research shows that children living in food insecure households may consume less fresh fruit and vegetables than their peers. We're also seeing that many food insecure kitchens rely on foods that maybe less nutrient dense or have less vitamins and minerals in them, such as processed microwaveable or quick cook, instant, frozen type of foods. Calorie-dense foods, or foods that are high in calories but low in vitamins and minerals, are often inexpensive staples for feeding family. One way to promote food security for families is to focus on educating parents on the importance of nourishing themselves and their families with healthy foods. A great resource is the USDA MyPlate. MyPlate provides many resources on food planning and activities for children and families. Improvements to overall eating patterns, things as simple as just increasing fruit and vegetable intake, can be made simply and in small steps by reminding families the importance of eating the recommended amounts of each of the food groups and following MyPlate. Parents can also rest easier knowing their families are getting the calories and the vitamins and the minerals they need by following MyPlate. We've included a link to MyPlate on your webinar resource list. And with that, I want to go ahead and turn it over to Colleen with the Office of Head Start.

Colleen Rathgeb: Thank you, Nicole. Hi everybody. This is Colleen Rathgeb. I'm the policy director at the Office of Head Start, and I'm really excited to be with you guys today to talk about this just incredibly important topic. And just from the questions we're getting in and all of this discussion, I think that there's a lot that, hopefully, we can even do more going forward. I wanted to just start just reminding everyone, and I know this is not an audience that I need to necessarily remind, about how child nutrition is just such a fundamental and foundational element of what Head Start is, what Head Start was founded for, and what we do. And really, just helping us think even in this time that we're in, absolutely unprecedented, the types of services and the flexibility that you guys are showing in the way you're providing services to families is incredible. And just thinking of the heart of our nutrition services, and what we have in the performance standards around programs really thinking about designing and implementing nutrition services that are developmentally and culturally appropriate to meet the nutritional needs of each child. And we really just want to make sure you keep that idea of the ways we can meet the nutritional needs of each child central to what you think about what you can do for nutrition services during the pandemic. And so, we really want you to think about how you can use your resources, how you can design the program differently than you may think about it what you normally would do obviously and even differently than what might be you started doing at the beginning of the pandemic. As obviously USDA has talked about, we've got flexibilities there, we've got a lot of flexibilities in the Head Start standards, and how you can use funds, and so, that's what I want to talk about a little bit.

One of the reasons we also wanted to have this webinar is we've seen a little bit of some data from a couple of different research studies that have shown that programs and families aren't necessarily getting what they need on the nutrition side. So, we heard from preliminary research that about half of programs have reported that they've stopped or reduced the food and nutrition services that they had provided before the pandemic. And in some ways, we're not surprised that it's been reduced or stopped particularly earlier in the pandemic, but we really think we want to make sure programs are thinking about it, and knowing what they can do, because as Debbie talked about at the beginning, the need is greater than it's ever been before, and we really want to think about how we can continue and you all can continue with Head Start programs to be creative and thinking really how we can help meet this need. We've also seen some research that showed that Head Start parents are reporting that more than any other early childhood or elementary program that Head Start programs are receiving support from their early childhood program from Head Start in getting meals remotely. But there's still only about 60% of Head Start families that were asked in this research said that they were receiving that remote assistance. That was better than most programs, but still, it means we've got 40% of families that aren't receiving the support that we really think is critical and that they can. So, we want to think about and make sure you know ways that you can provide those services and use your resources to do that.

I want to start talking about the CARES Act funding, the funding you've already received, and ways you can broadly think about using that funding, and then get a little bit more specific about how to use it in nutrition services area. Generally, when you think about your CARES Act funding, you just need to remember the main purpose. So, it's for things you can do under the Head Start Act that's connected to preventing, preparing for, and responding to COVID-19. The grantees have a lot of flexibility within those parameters of the uses about preventing, preparing for, or responding to COVID-19. So generally, like you do with any of your funds, you want to think about the overall cost principles. You need to ensure that what you're doing with these funds are reasonable and necessary. What you want to think what's reasonable, and what's reasonable right now in the light of the unprecedented circumstances that families are dealing with may be little bit different than it would be under normal circumstances. So, you need to think about what's reasonable in light of what the circumstances are in your communities right now, and if there is an expense that's necessary to deliver services to enrolled children and families, if perhaps – we're going to talk about it a minute – providing nutrition services for more folks in that family, and that's the only way to really be able to get the nutrition services to be enrolled children and families, it can be reasonable. So, what we need programs to do is to be able to document why they're making the decisions they are so that they can show why the costs that they're doing are reasonable and necessary. For example, nutrition services – we've had people ask can we provide food boxes that includes more food than just for their own child, or can they provide other things that support the nutrition of family members beyond the enrolled child? And we want people to think about how hunger can really interfere with the ability of the family to support and participate in the delivery of the services to those children.

So, with Head Start funds, like your CARES Act funding, could be used to provide food to the household members so that the learning can effectively occur. That may be necessary, particularly, if there are cases where community food resources are exhausted in your community. The partnerships you might normally be able to have in place with food banks aren't working because they're overwhelmed with the need, or you have families that can't get out of the home to be able to get to those food banks. We really want programs to be able to, again, document the circumstances on the ground in their community and make that link, if that is necessary and reasonable, to be able to provide in order to get those nutrition services to the children that are enrolled in Head Start. I wanted to just show folks a slide here about what programs have been telling us that they are doing with their CARES Act funding that they have so far been provided. We want programs to think about what types of things they need to do to support nutrition services that might be beyond what they would normally do. So, we have a small percentage of programs, just 2% of programs have … Programs are reporting that just 2% of the money they're planning to use for meals and snacks that aren't reimbursed by USDA. So, one, we just want to remind people it's very clear in the Head Start standards that you can use Head Start dollars, including new CARES Act dollars, to pay for meals and snacks if it can't be reimbursed by USDA. You can also use the CARES Act funds or other Head Start funds for things like vans to deliver meals to children that are served remotely or virtually, for supplies that you would use to store or seal meals for refrigerators or things that you need in your program in order to be able to provide these services.

So, we have a lot of programs looking differently at what they're doing, thinking about how the CARES funding that can be used, what they already have, and we want programs to think more about whether they need to use this funding in these ways. Also, there'll be more official news coming out through a PI about this shortly, but as some folks are aware, that in late December, there was an additional COVID relief funding passed, and included in that funding is an additional $250 million for Head Start programs. That funding will be going out this year to all Head Start programs by formula. It is going to go out very similarly as the first amount of CARES Act funding went out. The CARES Act initial funding was $750 million, and this second round of COVID relief has $250 million, so it's about a third of the amount. So, it was a way just to think and to plan for programs. Most grantees will receive about a third of what they received through the CARES Act in this second amount of CARES funding. So, we just want programs to be able to keep in mind, what they are doing now, what they could be doing, and how potential these funds may be able to support those programs. If we just want to make sure ... We'll have time for Q&A's in a few minutes, but one thing I saw clearly in some of the Q&A's were questions about whether programs could be providing meals, either reimbursed through CACFP or with Head Start funds, for children enrolled in a home-based option. That is an area that we absolutely think programs can be thinking differently right now when we're in this emergency situation than they normally would for home-based operations.

So, as friends from USDA said at the beginning of the call, if you're providing remote services and you have enrolled children and families in remote services, you can absolutely be providing meals through delivery, through “Grab and Go,” through different mechanisms to the children that are getting remote delivery. Our home-based children very much would be in that same category right now, that they're receiving remote services. You have a lot of flexibility right now, under the fact that we're under this public health emergency, exactly how you think about what children are in what program options … As you guys know, the services are looking really different right now, and definitely, like you would normally provide socialization meals to those families, we can definitely do that, but you also really could be thinking about how you're getting meal delivery to all your enrolled children and families even if in normal operations you might not be able to do that. That is something either through the remote options that you have, that the folks from USDA we're talking about early, or if there's other reasons that you need to think about using different funds for that, but we definitely want to think about all of your enrolled children, how can you be really meeting their nutritional needs.

So, one of the things we want to make sure that we're sharing great things that programs are doing out there, that we find ways to get these practices out to the field. We really encourage people to be part of MyPeers. We're going to be putting more information out about some specific success stories and ideas of what programs are doing. But just some of the things we've been hearing about, lots of partnerships with local education agencies and schools. Our friends from USDA talked about how much their opportunities for being able to connect with those services. And also, really figuring out how you're individualizing, and making sure your families are actually getting those services, or thinking about families that can't get there, or aren't getting there, and what you can do to support that in a real direct way, and how your resources and staffing can support that. I've talked a lot about Grab and Go meals and backpack programs, delivering food to families on a weekly basis. We have programs that have been doing like farm-to-table work, and learning about rearing and harvesting, and growing their own fruits and vegetables, are now doing this in a delivery way. They're doing virtual nutrition sessions and healthy diet training for families and parents. Folks are partnering with local schools and non-profit organizations to really connect how to deliver food and how to get meals and clothes and other things to them as well, as well as figuring out how you can box fresh fruits and vegetables, like how we've talked about food-to-home to farm-to-home programs that have been being built out of initiatives that are going on broadly. So mostly, we really just want programs to take this time as we're entering a new year where things are still in really different service delivery options, really to think about all of your enrolled children and your families, what are things you could do – that you're already doing or with flexibilities that USDA might have or that we have at Head Start – what more can you be doing to really address the food security of our kids and families? Again, one of the foundational and most fundamental parts of Head Start programs. So, I am going to turn it back to Marco to talk us through some Q&A's to wrap up, but I really appreciate being able to be with all of you today. And like Dr. B said, getting just to really commend everyone on the incredible work and flexibility and creativity they have in this time. We really – really are proud to be a part of the work you do every day.

Marco: Great. Thank you, Colleen, and also, thank you to all the presenters. It's always interesting to listen to a presentation. For me, it's the second time, and still picking up new information that I wasn't aware of. Especially from our USDA colleagues, I was really intrigued by some of the promising practices and some of the new programs that we weren’t – or program benefits – that we weren't aware of. But before we go a little bit deeper into the Q&A's. We've gotten so many questions. I wanted to just point people to the resources. So, slides on the resources are available for you to download. So, under the “Ask a Question” section, you'll notice an “Event Resources” section. If you click on that tab, you'll be able to expand it, and from there, you'll be able to download the available resources and the slides. They're available as PDF. So, that addresses a lot of the questions that were coming in. So just wanted to take care of that. For some of the questions where people were trying to scribble down what folks were saying or what were on the slides, as I indicated, the slides are available via PDF in that event resources. So, you can revisit those as you need. So hopefully, you didn't stress out about scribbling everything down. But right now, I want to turn it over to our USDA colleagues. I want to turn it over to Kenya. There's a lot of questions that came in related to USDA. And so, she's going to help to facilitate those questions for them. So, Kenya, can you take it over?

Kenya Pennington: Thank you, Marco. Hi everyone, I'm Kenya Pennington. I work for USDA Child Nutrition Programs, and I will be helping answer questions with Melissa. First question for Melissa is, “Must parents and guardians accept the pickup or delivery of meals?”

Melissa: Thanks, Kenya. The answer is no, they don't have to, and we recommend because parents don't have to accept the meals that are offered to them, that you make sure to talk with them before you're planning a meal pickup to make sure that you're preparing the right number. Some parents may have other sources of meals that they prefer to use. Definitely, if you are doing meal delivery, it's absolutely essential and required to get the parents or guardians consent before delivering the meal.

Kenya: Thank you, Melissa.

Kenya: Another question we have for you is, “May a Head Start center claim reimbursement for CACFP meals that children take home to consume on weekdays when they're not in care?”

Melissa: I think, was that question about weekends, Kenya?

Kenya: Yeah. Weekend days. Sorry.

Melissa: Weekend. OK. Yeah. So, yes, the Head Start centers can be approved for weekend meals as long as the child is enrolled for weekend care. So, that means that if the child was just receiving weekday care, and you want to be able to serve meals on the weekends too. No, you wouldn't be able to do that, but if the child normally gets weekend care, then they can receive weekend meals. And we know that a lot of centers are actually asking that question. We've heard this before because they want to be able to extend the number of meals that they serve. So, if you really want to extend the number, and you've got a child enrolled for weekday care, that's when you're going to want to look at the Summer Food Service Program that we talked about earlier and see if the summer program in the child's community is perhaps offering weekend meals to supplement their CACFP meals.

Kenya:  Excellent response, Melissa. And so, now I'm going to look at a couple great questions from you guys. Well, what [Inaudible] … First question: What are parents … So, say a parent's working and they are not able to pick up the child's meal. Can a child’s babysitter or grandparent pick up the meal?

Melissa: Yes, absolutely. We're calling those "guardians," and the parents or guardians can pick up the meals. And what a guardian means depends on how the state agency is defining it for the purpose of the waiver that we're offering allowing someone other than the child to pick up the meal. So, if the Head Start center has any questions about who they can determine is a guardian in their state, just make sure to contact your state agency's program specialist.

Kenya: OK. Just a quick little follow-up to that question. So, when folks are getting their meals delivered, does a parent need to be present for a parent signature, or when we say, "social distancing," does that mean we should just drop and go. Drop the meal and go?

Melissa: OK, that's a great question. No, you do not have to get the parent's signature when the meal is delivered, you can do a completely contact-less delivery. In fact, the child or the family doesn't need to be present at the time of the delivery. You just have to make sure that you're arranging the delivery so that there's good food safety. So, if it's shelf stable, that's not a problem if no one's present. If it's not shelf stable, then you're really going to want to talk with the parent about arranging a pickup time where they can immediately get the food off the front stoop.

Kenya: So, would you say it's a matter of communication and coordination with parents and guardians during this time?

Melissa: Absolutely, absolutely Kenya. Anytime that you're going to do food delivery, you got to make sure that the parent wants it, that they've authorized it, and they understand when they're going to get it, and they're ready to get it off the front porch in time to get it to the refrigerator.

Kenya: Great, great response. So, maybe we have time for our little section of when to [Inaudible] … your family is still experiencing students’ securities and programs be reimbursed if they provide additional food to the family?

Melissa: No, the limits on meals served through CACFP had not changed. So, that's still up to two meals and a snack or per day or two snacks and one meal per day. So, if the family needs more food for that child, other members of the family, that's when you are going to want to look outside the CACFP, and we've heard Colleen talk earlier about other sources of funds that are available. We still get that summer food service program and other child nutrition benefits. So, make sure to look at all the resources when you're advising the family.

Kenya: And so, one last question. So, a sponsoring organization of Head Start sites is asking how to provide more meals to households. Can they add the at-risk after-school meals program if they provide a virtual activity and use the non-congregate waiver?

Melissa: OK. So, this is an example of a sponsoring organization really trying to go above and beyond and add some benefits. A Head Start site could also operate an at-risk after school meal program if they had the virtual activity and they have the non-congregate waiver. However, “at-risk” is a CACFP program, and so, the total number of meals that could be claimed per child per day is still that two meals and a snack or that one snack, two meals total. So, actually, adding the at-risk afterschool program wouldn't allow the organization to actually serve more meals. So, once again, you'd want to look outside of CACFP for other resources.

Kenya: Thanks, Melissa. So, before I wrap up our little section, I noticed a lot of questions were about the link, and so, we will be fixing the links and everything, but for right now, I wanted to give folks just the general idea of where all the FNS and Coronavirus materials live. And that's at FNS.USDA.gov. So, FNS.USDA.gov/coronavirus. So, C-o-r-o-n-a-v-i-r-u-s. And that is where all of the information on how FNS is responding to COVID-19 right now, that's where all the information lives. And with that, I'm going to hand it back to Marco. Thank you.

Marco: Thank you, Kenya. So, with the limited time left, I'm going to try to address some really quick policy. Well, I'm going to ask Colleen to help me address some quick policy questions that are popping up. And then, there's a couple of really key health and safety questions that we're going to ask the National Center, but to start off, I'm going to try to group the questions, Colleen, because a lot of them came in and they were kind of talking about the same thing. They were a little nuanced. The first question that I'm going to ask you is, “Can programs purchase food cards for families with their Head Start funds?”

Colleen: So, we get a lot of questions about, whether it's purchasing cars or purchasing food for families, and I want to be clear that there isn't a blanket answer. In general, the services, particularly, the nutrition services for children, is for the enrolled child. So, but there are cases … And we want programs, you know, we understand that this is kind of unprecedented times right now. So, I popped back the slide that we had on this issue, that if hunger among a household’s members is problematic and there aren't the community resources that can help that family in the certain situation, either the regular Head Start funds or CARES Act funds, it could be reasonable and necessary to provide those services for – provide that food for the family or … I saw a question about  – for policy council meetings or something different, but the program really have to be able to document again why that is reasonable and necessary. And so, we want programs to think about that flexibility, to think about kind of the unprecedented times we are, if really … Community food resources are exhausted, the family can't leave the home. There may really be reasons where that's the case. It doesn't mean that on [Inaudible] programs should go out and provide grocery cards to all family members without really them having to go through the process to determine if that's reasonable and a necessary expense. So, it's not a straight-out prohibition, but it's also not kind of a one size fits all. Programs really need to think about the cross principles and the purpose of their funding and the CARES Act funding as well.

Marco: And in addition to that, would you add the piece related to making sure that you adequately documented what you were doing and why you were doing it?

Colleen: Of course, I think that's a very good point  – is programs, again, just to be able to document so that when they have folks, looking at that and asking questions about that, they can say that is why this is a necessary expense.

Marco: Great. Thank you. So, there's been some interesting questions related to trying to differentiate between CARES Act funding and their main grant and the program's main grant. So, programs are asking if they've used up their CARES Act funding, can they use main grant dollars to provide for such things as food boxes for families during this time period.

Colleen: Again, if that is something that they can document – it's a necessary and reasonable expense of their Head Start dollars – nutrition services is absolutely something that can be done with their regular services. Again, it's a clearer always OK. If you're talking about nutrition services for an enrolled child, that is an absolute easy, of course answer would get a little bit trickier for a program to have to kind of, to document why that's really necessary if it is not being enrolled child. It's not that it can't be, but again, there's really the next link that the program has to really be able to say why that hunger in the family is so great that they really can't be providing the services to the child and be able to have them benefit from those services without doing it. But yes, the CARES Act funding and the regular funding are very similar. The big difference is that the CARES Act, you have to be able to make the link to the prevention for preparation or response to COVID.

Marco: OK, couple more. [Inaudible]

Colleen: Similarly …

Marco: Go ahead.

Colleen: Providing the remote families that you have – that you need to provide different services. You need a van to be able  – you need supplies to be able to do those grab and go meals for some families. You can absolutely be using your regular Head Start funds for those types of things as well.

Marco: OK. So, this is a little bit more related to the CARES Act funding. Well, actually the funding that was received in December, people are asking if it's to benefit all programs. And I know that you indicated that in the slide, but if you can just clarify that a little bit.

Colleen: Yes, it is. For all programs, it will go out to all programs based on the number of their funded enrollment. So, it will be per the number of children a grantee has; that is the amount of funding each grantee will receive for the grantees funded enrollment.

Marco: Great. Thank you, Colleen. Now I'm going to turn it over, cause I have some interesting questions that I want to ask Nicole, and I think they're really important to kind of address them as it relates to health and safety. Nicole, during your presentation, you spoke of when you were talking about cleaning, one of the things you said was to be careful with how you clean the food, and you indicated cleaning cardboard and or what not to clean as it relates to like hardware. Can you go a little bit deeper and tell us a little bit more and just kind of highlight why it's important or not? Why we shouldn't do it?

Nicole: Absolutely. So, the main takeaway is we don't want to accidentally consume any disinfecting products. So, guidance would be not to use disinfecting products on food or food packaging due to accidental exposure or accidental consumption of those products that may be harmful to health. We don't want to use disinfecting products on food, produce, anything that's going to be consumed right away, but if programs are maybe asking about canned products, like “Can I wash a can of vegetables before serving it?” Those types of products can be wiped down, so you can wipe those types of things down the outside of those things with soap and water and make sure that they're rinsed thoroughly with water and less to air dry prior to opening. So again, disinfecting products should be used for surfaces high touch areas to minimize the exposure to the virus, but also germs in general. And we don't want to use those types of things on food products.

Marco: Thank you. During your presentation, when we were talking about food insecurity and supporting food security, you spoke about a couple of questions that individuals can or programs can ask when they're enrolling families. I love the way you frame the questions to get at food insecurity. Can you give us a little bit more information about a screening assessment and the tool related to that?

Nicole: Of course. So, the questions are – pretty much questions written in a way that when asked to families who are maybe struggling with food insecurity but don't necessarily want to share that. We want to write questions in a way that we can identify potential struggles without them feeling pressured to share very personal information. So, questions such as one that I provided. So again, I'll reiterate those: “In the past one to two months, we worried whether our food would run out before we got money to buy more.” Another example of a question: “In the past one to two months, the food we bought just did not last, and we did not have money to get more. “And then, “In the past one to two months, we've had to lower the quality of food because money was tight.” Example of those questions, especially that last one, can really help identify families that may be struggling with a quality of food – the nutrients component of food, while still trying to purchase the amount of food needed to feed their family. And again, these questions, we will put together an FAQ after the webinar to provide more information on these types of questions, how to write these types of questions, and really using these types of assessment tools for identifying families with food insecurity or struggling with food insecurity.

Marco: Great. Thank you, Nicole. And just keeping to our time and just be respectful of time,  I just wanted … First of all, thank you. Thank you to all the presenters, thank you to the folks that are listening to us and for participating. I wanted to just give you a quick resource I wanted to – for those of you that are not familiar and for those of you that are – that are wanting to, hopefully, you'll join the MyPeers community. MyPeers is a collaborative platform for EC programs to ask questions and share resources where National Center regularly post information in the health, safety, and wellness community, and many other communities on MyPeers. So, if you're not a member of MyPeers, you can access it via the ECLKC and set up an account. You'll be able to do that by going to the main landing page of the ECLKC and scrolling all the way to the bottom. You'll see a quick links, and there you'll find the MyPeers link. So, this is an opportunity for us to continue the conversation for programs to come up with some really promising practices and see what other programs are doing. So, in closing, we know that many of you are worried about providing safe services to children and families, as well as helping to support families and ensure that their children are healthy and safe. We want to thank you for doing what you do. Without what you're doing, our families would be struggling a lot more. So, thank you for all your efforts and for keeping our children and families safe and for all the work that goes into making sure that our staff are also safe. So, with that, I want to thank our presenters for helping us to address the questions that were coming through. This concludes our presentation, and we want to thank you for joining us today, and please continue to reach out to us with your questions and concerns. Stay healthy and safe.

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