Senate Select Committee on Select Committee on Social Determinants of Health

The select committee on social determinants of health will begin in thirty seconds. Good morning, everyone. Thank you for being here today at this very important hearing of the Senate Select Committee on the social determinants of health. As Chair, it is my honor to welcome you, community members, food security advocates, educators, health care professionals, county and state administrators, and policymakers. I am Senator doctor Akila Weber Pearson, Senator for California Senate District 39.

And I wanna thank my staff, the Senate staff, and the county team for your work in organizing today's event. A few housekeeping notes, please silence your cell phones and other electronic devices. We will be allowing public comment in person only. There will be no remote public comment for this hearing. In order to facilitate the goal of hearing from the public while maintaining order, we will not permit conduct that disrupts, disturbs, or otherwise impedes the orderly conduct of this legislative process.

Disruptive behavior or behavior that incites or threatens violence, including veiled threats, will not be accepted. Perfect timing. I also wanna take the moment to acknowledge Senator Padilla from the 18th Senate District for being here today as a member of the select committee on social determinants of health. Senator Padilla, would you like to take a minute to welcome everyone?

There we go. Really simple. Thank you, madam Chair. And I think many of us know in the region that Senator Weber Pearson is an absolute leader in this space, obviously, both professionally, but also in the legislature, and I serve with her on her committee on health in the capital. And I'm happy to be here with you today in your company, and I think it's important to always remember context.

Right? That how we define health and well-being is not just in clinical terms, but it's in terms of our lives and the meaningful and fullness of that and all the things that are impacted by our health. And many of those determinants and factors are beyond beyond interventions and treatments and preventative measures, but they're they're the climate we live in in so many ways. And so that's why I'm happy to serve as a member of the select committee. Appreciate the center's leadership.

Really appreciate the opportunity to be here this morning.

Thank you, Senator Padilla. I also want to, mention that there is someone from, county supervisor Monica Montgomery Stepp's office here as well representing her office. Thank you so much for being here. Today's hearing will examine the nutrition gaps in three parts, from a physician's perspective on how food access connects health to health outcomes, food security in California and San Diego, including CalFresh landscape, policy access and the challenges facing families and administrators and finally, California's school nutrition programs and how they reach kids where they are.

Our goal is to understand what is working, what barriers remain, and potentially next steps the legislature can take.

California grows and produces more food than almost anywhere else in the world. Yet too many of our own families, including right here in San Diego, do not have reliable access to enough nutritious food. Health is not created in clinics or hospitals. It begins at the kitchen table, in the school cafeteria, or at the local grocery store. And food insecurity is not just about hunger.

It is a powerful predictor of chronic disease, poor school performance, and long term health outcomes for children. A child who doesn't know where their next meal is coming from cannot focus in the classroom. A family skipping meals to make rent is more likely to face diet related illnesses down the road. Programs like CalFresh and Universal School Meals are among our most effective tools for closing this gap. But enrollment gaps, administrative barriers, and shifting federal policy threaten to widen it.

Here in San Diego, the picture is clear. Some neighborhoods have easy access to full service grocery stores and fresh produce, where others are food deserts miles from their nearest grocery store. This hearing is designed to shine a light on the scope of the problem, the policy shaping it, and solutions already underway. Now access to food is one of our most important things that we can protect for the health of our families. And right now, that access is being tested.

CalFresh, which is California's version of SNAP, provides federally funded food assistance for about 5,300,000 low income Californians according to the legislative analyst office. About 90% of Cal enrollees are also enrolled in Medi Cal. Food and health are not separate issues. They are the same families and often in the same household. HR 1 signed on July 2025, which some of you may know as the big beautiful bill, makes multiple significant changes to CalFresh.

Some are already in effect and others are still to come. Beginning in June 2026, California's statewide waiver ended and the expanded work requirement tool went into effect. Adults aged 18 to 64 who are not exempt must work, take part in a work pro... Program, or do community service for at least twenty hours a week to keep their benefits.

There are some exemptions, including people who care for children under the age of 14, those who care for a dependent with a disability, pregnant individuals, and people who are medically unfit to work.

But the LAO estimates that over 713,000 Californians are affected by the requirement after exemptions and that about 562,000 could be disenrolled. Food banks and community organizations are doing critical work, but their capacity is limited. They cannot replace the benefits of... That CalFresh provides. And the Medi Cal work requirement begins in January 2027, so just in a few months.

Because most CalFresh employees are also on Medi Cal, many families will soon lose both. That is why today's conversation matters. Keeping eligible families connected to food assistance is a health issue, an education issue, and more importantly, an equity issue. Our panelists will help us understand what it means statewide in our region and our schools and what we can do about it. Food insecurity does not affect every community equally.

Communities of color, immigrant families, and low income neighborhoods carry the greatest burden. For example, a senior on a fixed income must choose between medications and groceries. A working parent who earns just enough to be ineligible for CalFresh, but not enough to consistently put food on the table. These stories are repeated across our state and are rooted in long term policy decisions. Addressing inequalities mean listening to our communities, considering their experiences, and ensuring policies reflect the need of those most affected.

Our work must be shaped by the reality of families and not by assumptions made in Sacramento. So I'm looking forward to hearing and would like to thank in advance all of those who are participating in our panel today. I would like to thank all of you who are attending in person, but also those who are watching on livestream. Today, we have the benefit of hearing from an outstanding group of experts and administrators working at the intersection of food access, policy, and health.

And it is now my honor to introduce our first speaker.

Doctor Alexandra Kazare is a board certified cardiothoracic surgeon, cardiovascular health advocate, and dedicated community leader committed to improving heart health and advancing equitable access to life saving care. In her clinical work, doctor Kuzari specializes in the surgical treatment of complex conditions affecting the heart and chest, her experience in caring for patients with advanced cardiovascular disease reinforces her commitment to prevention, early intervention, and empowering individuals with the knowledge and resources necessary to protect their long term health.

A passionate advocate for women's health and the next generation of health care professionals, doctor Kuzari is actively involved in community initiatives that inspire young women to pursue careers in science, technology, engineering, and medicine. She recognizes that access to nutritious foods is foundational to cardiovascular health and that addressing nutrition security is an essential component of prevention chronic disease, reducing health disparities, and building healthier communities.

She will help us connect the dots between access to nutritious foods and health outcomes, setting the stage for the later conversations that we will have this morning.

Doctor Kuzari, the floor is yours.

Good morning. Thank you. As you just heard, I'm doctor Alexandra Khurazi. I am a cardiothoracic surgeon here in San Diego. And I wanna start by saying that cardiovascular disease is the number 1 killer of men and women in The United States annually.

So this is a big issue at... Not only in health care, but in our community that affects, all of our community members. Now as a cardiothoracic surgeon, I see people at the very end stage of this disease. So the most common surgery that I do is a bypass surgery, and that is when the disease has gotten to the point where, there's blockages in the heart that can't be fixed, not even by stents, or medication, and we have to go in and do open heart surgery.

And this is just one example.

And why I'm bringing this up is because the risk factors that lead to this disease are high blood pressure, high cholesterol, smoking, and family history. The biggest one, the biggest modifiable risk factors that we work on, the diabetes, high high blood pressure, and high cholesterol.

Now where this really becomes important and what really brought me into to speak about the food access portion of this is that as a surgeon, this has very real implications on not only pre op care, but post op care of people at the end stages of the disease. We know that it's not just... We're seeing it at when you're 60, maybe 70, but it starts when you're 20.

We have more and more data that this plaque is found in arteries of 20 year olds and that we're seeing these changes early, and then they progress as we as we age. That becomes important again when we consider the fact that particularly in the South Bay where I do a lot of my work, people oftentimes have, there's there's a more of a disparity with the food that where people are able to have access to. And so we do see that disease getting...

Affecting them more so and then being able to have a harder time maintaining their health in the postoperative setting and keeping those risk factors under control.

The big part, I think, that I wanna say is that when I see a post op patient, like, after a bypass surgery, what I tell everyone is the clock starts again once we've done the surgery and the same risk factors that brought you to this point in the first place where you've had surgery are the same ones that can give you recurrent issues.

Right? And so when Aye... When they tell me, doctor, what can I do? Because a lot of them haven't even had the education to know that, you know, lifestyle is such a big comp1nt. So what's the number 1 thing we can do to modify those risk factors?

Well, diet. Right? That diet's the number 1 thing. And that's what I tell people is we start with diet and exercise. And then if that doesn't work, then we move on to medication and then disease of...

And then really... Then it depends what people are able to have access to. If you're somebody that has access to medical care, if you're someone that has access to a primary doctor, if you're someone that has insurance, then you're gonna... Probably your disease will be a bay for a long time, and those people tend to be very well preserved. And as a surgeon, we see them at much lower risk profiles.

So what that means is if I I have a patient that has... That's been taking care of their health, even if they do need surgery down the line, their surgery is much lower risk. But that's not who I see, particularly in some of these lower resource communities like the South Bay, and I see the same demographic of people with less resources. And because of that, their disease has progressed much more significantly, and that's really where we see that disparity in care.

So when my patients ask me post op, what can I do?

And I say, well, what I tell them all the time is more pro... Less processed foods, more lean protein, more fruits, more vegetables, and a lot of them have trouble, like, getting that. You know? And that's really the... Is that...

The fact that that affects the outcomes of their health in a very real tangible way that I see as a surgeon and leads them to get surgery sooner oftentimes and leads them to have repeat surgery and repeat intervention all because they are unable to really make that work, whether that be financially or or otherwise. And so it's a very... It's the lifestyle aspect with modifiable risk factors in preventing these high risk complications is key.

And in addition to that, even when I do have to operate on them, the risk point is much lower, if they have access to these basic needs. Right?

And so once again, those those diet factors are so important. So just basic access to fresh food, anything that's not processed. We now have research that even microplastics in processed foods is a risk factor for cardiovascular disease. And so in the care of my post op patients, this is an issue that's not just discussed here. Like, I'm discussing it here.

Sure. But at the end of the day, I discuss it every day in clinic. I'm seeing patients in clinic today, and this is the discussion I'm gonna have with them. So I'm hoping that maybe having a discussion here will help have those downstream effects to where, we're helping as doctors. We're helping people before it ever gets to that point before I ever have to open anyone up.

Thank you.

Thank you so much, doctor Khurazi. With you, we're gonna do it a little different because you, like myself, oftentimes, I have to run off to the OR. I know you have a surgical case as well. So we will take any questions at this moment before you have to leave for the other panelists. We'll do all the questions at the end.

Senator Padilla.

Thank you, Chair. And just maybe a comment. Nice to see you, doctor. Appreciate your work very much. And I just might...

What I'm thinking when you talk... We're talking about the correlations between early access, long term sort of clinical outcomes, the patients you're seeing, the reboot conversation you're having. We've all seen this movie before, some of us up close with family members and others. But I'm reminded from a policy standpoint about taking the sort of immediate obvious institutional opportunities in government. Right?

Our educational institution setting. There's an example in my district in South County where the district there has combined an operational requirement, which is providing nutrition and meals and lunch service with an educational interface where they're doing production of community garden on campus. They're utilizing those healthy ingredients for instructional opportunities on the preparation of meals. Then they're actually consuming it in a market place on-site.

And so they're getting opportunities for an educational experience, they're consuming appropriate product, they're getting early nutritional self care education early in life, and they're benefiting from those because we all remember, I'm old enough to remember back in the olden days when they actually had hot meals in schools, and then we all bemoan the fact that by the time we...

I got to high school, boy, the quality of what I got served in high school really dropped quite a bit, and my options weren't great. It was, you know, some really bad options and maybe a couple off to the side that were good. All of this to say that from a policy standpoint, if we can think about institutional settings, broad touches to big populations early, incentivizing the right kind of interactions, educational exposure opportunity, those kinds of things where you start making some some broader impacts.

And I think there are things to continue to think about. There's a lot of great stuff happening up and down the state in that regard, but I also think that maybe that's a place for some of us to think a little bit about broadening those kinds of interactions.

Very much appreciate your testimony and you being here, doctor. Thank you.

Thank you.

Wanna echo what Senator Padilla said, and really thank you so much for taking your time to be here. You know, Aye... As I stated in the beginning, some of the things that we see with inequities have been a result of policies that were decided either at a local, state, or federal level, and sometimes all three.

And so when when you notice certain things within patients that you may have that live in South Bay that you wouldn't see, in a patient that may live in, you know, North County, those were sometimes decisions that were made as to what kind of resources would be available in certain communities. You know, I love the fact that you touched on the, the fact that we can give recommendations, but if they don't have access to it in their communities, that it's really hard to make the change.

Years ago, we used to talk about the noncompliant patient. You'd send them... You'd say, do all of this thing to lose weight and... And they come back and they've actually probably gained weight without recognizing that we're asking you to to eat fresh fruits and vegetables, but you don't have that in your community. You have the ultra processed foods.

You have the... You know, here in San Diego, we have... You know, we boast that we have the best Mexican kind of hole in the wall shops, but sometimes those are not the best for our health. But you'll see them, very prevalent in certain communities. And so I really appreciate you highlighting that.

And also the fact that this is... That these things start early, which is why it's extremely important to start talking about and providing access to good nutrition for our youth, because what they do as kids will show up as young adults and then which will ultimately lead to health outcomes when they're older adults. But also the other thing that I really hadn't even thought about myself is just postoperatively.

What kind of care will you have postoperatively to prevent needing another procedure is extremely important, and it has to do with your... The environment that you're in.

So my one question for you is saying that we focus... Here, we're focusing on policies and what it is that we can do. Do you have any suggestions, that we can do at a state level? Because, yes, as a physician, you talk one on one to your patients, you talk, one on one with their families. We're dealing with policies that can have a a broader impact on communities.

What is it that we can do from the state that could help you and your patients and the communities that you serve?

That's a great question. I think, I have a few thoughts on this. The first thing I do see is the education and I touch on that because the risk factors that lead to the complications of cardiovascular disease are often deemed particularly high blood pressure the silent killer. So and that's because you can feel totally fine and come in and for example, have an aortic dissection, which is a surgical emergency that someone like me has to fix.

And, you know, they're the all comers mortality, the risk of dying within the perioperative period from a surgery like that is twenty percent in the data.

So it's not an insignificant thing. And there's an education gap that I do see as a surgeon in private practice that goes to multiple hospitals. I definitely see a discrepancy in the education and just the knowledge level. A lot of people coming into that specific ED to, like, have no idea that this... That they even should have been getting checked or having access.

And then there's so many different priorities that they have that aren't getting care. They're just trying to meet the bottom line and, you you know, get their kids food and and things like that. They're not worried about their own health.

think in addition to providing access pathways, and as a doctor, I don't know how to tell you to do that, but access pathways to make this a priority, but also the education and the narrative surrounding that and getting that out there, I do know that there's societies like the American Heart Association and and things like other other educational societies that help with that in the community. However, I do still see that gap, and it's a very real gap.

So I

And I will add to that that this is also a women's health issue. So women are more likely to be asymptomatic and present with atypical symptoms. And by the time we see them as doctors and surgeons, we are more likely to have, you know, a higher risk surgery because it's gone for so long.

So, and that's a lot of the studies haven't been done on women and, a lot of the education still isn't targeted that way and women tend to, in my practice as a surgeon, not prioritize themselves, but prioritize our families. So an educational component focusing specifically on women's health because even even the food is a women's health issue, like I've... It disproportionately affects women as well because we tend to go longer without even having symptoms or having a... And be dismissed from the ED when we do.

So a lot of the time we have to take because we know that the system is inherently biased.

Right? So I see women... I'll give you an example. Aye... I'll see a woman who needs bypass surgery, and I'll look back in her chart and she's been sent out of the ER multiple times for menopause or perimenopause symptoms when in reality, it was heart disease.

And you don't see that as often with men. So I often tell my patients, I say, you know, I'm taking... Putting it in your hands. You gotta tell your doctor and insist on that heart workup because we know that these systems are inherently biased. And as such, to answer your original question, to in...

To really empower people through education and have those access pathways through knowing that this is such an important... Their nutrition is an important component, that speaking up is an important component, that would be huge. And how to incorporate that is a bigger issue I'll leave to you.

Thank you so much for that question. I wanna thank you so much for for being here this morning. Good luck on your case. Thank you. So we will now, move into our first panel, which will help us understand the scale of the nutrition gap statewide in our region and in the CalFresh program that so many families rely on.

Our first panelist is Jared Kahl, director of policy and advocacy with the California Association of Food Banks. He is a long time anti hunger policy advocate with a breadth of experience in the nonprofit space. Before taking his current role as director of public policy and advocacy at California food banks, Jared spent nearly a decade at Nourish California where he launched several CalFresh initiatives, including establishing special rules that expanded access to the program for older Californians.

Today, Mister Call will explore the nutrition gap across the state and discuss CalFresh program statistics. We are also joined by Alondra Alvarado, president and CEO of the San Diego Hunger Coalition.

Miss, Alvarado brings more than twenty years of experience in government and nonprofit leadership across Mexico and California, including roles with a Tijuana city council member, a Baja California state legislator, and San Diego city council member Moreno of District 8. She joined the hunger coalition in June 2023 and has served as president and CEO since December 2023. Today, she will present the regional snapshot and the regional food gap, and we'll also hear from doctor Alberto Banuelo. So... I'm sorry.

Interim director for self sufficiency service for the County Of San Diego. He has spent nearly his entire career at county government, including sixteen years with the Tulare County HHSA HHSA before joining San Diego County in 2016. His accomplishments include centralizing eligibility services during COVID nineteen pandemic and integrating the county's office of military and veteran affairs and office of immigration and refugee affairs. He was appointed interim director in November 2025.

He will share what is working, what isn't working with CalFresh in San Diego County, the impacts of HR 1, and our current CalFresh participation rates.

We will begin with Mister Jared Call. The floor is yours. Thank you.

Good morning, Chair Webber Pearson and Senator Padilla. Jared Call with California Food Banks. I wanna start by thanking you for holding this hearing and inviting me to share the perspective of our association's 44 member food banks across the state serving all 58 counties, and two of which are located here in San Diego and do fantastic work. I'm gonna start with an overview of the picture of food insecurity in California, which frankly is a serious and growing problem.

I'm gonna share a lot of data with you, but I I wanna note first that our job in in gathering and compiling and publishing data was made more difficult last year when the USDA canceled the...

Their annual food security study, excuse me, which is really the benchmark that we've relied on for decades to have a baseline of food and security for our state and be able to compare it to other states. So our research and and data team partnered this year with, Urban Institute, to obtain California specific data on food and security rates through their well-being and basic needs survey.

So this allows us to have 2025 data as a baseline as those cuts from HR 1, which you referenced in your opening Chair, Weber Pearson, have are just now going into effect will have something to compare them to in 2025. So the data we published show that in California in 2025, twenty four percent of all adults in California experienced food insecurity. And among adults living with children, that number is thirty three percent, so just about one in three.

The study also found, crucially, that food insecurity doesn't just exist among low income households. A large share of families whose incomes exceed the eligibility limit for CalFresh benefits experience food insecurity. So the gross income limit for CalFresh is 200% of the federal poverty level. That's about $60,000 for a family of four. In California, seventeen percent of adults who were above that threshold reported food insecurity in the past year.

And even for adults earning twice that, above 400% of the federal poverty level, that number was 9% in California. So there are people who are falling into that gap where they don't qualify for federal food assistance, but still aren't able to make ends meet. It's also important to note that those rates are higher among black and Hispanic households. That rate is thirty five percent. And among households with disabilities, it's forty percent.

So that's the baseline for 2025. With inflation increasing the prices of food, fuel and other basic needs, groceries are the most common affordability concern among US adults. And for lower income households, which typically spend a larger share of their household income on those basic necessities, those price increases can be especially difficult to absorb.

Food insecure families, according to our our data from Urban Institute, had a higher likelihood of using cash from a payday loan to pay for groceries, using savings to pay for groceries, and missing payments on credit cards. So these data points are definitely worrisome.

And, unfortunately, we expect things to get worse in the next year as those cuts to HR 1 mean more people will be losing federal food assistance. So what's driving those elevated rates of food insecurity? It's by and large the high cost of living in California because food insecurity rates don't really paint the full picture. They don't capture the full extent of those who need food assistance because food insecurity is a symptom of broader economic strains.

Over the past year, our research and data team at California Food Banks developed a new measure, which we call the basic needs gap, and that calculates how many people lack sufficient income to cover the cost of living where they live in the

state locally. Dollars So according to that basic needs gap study, 16,000,000 Californians, 40%. For 40%, the cost of basic needs in their community exceeds their income. The basic needs we use to calculate this measure include housing, health care, transportation, childcare, and food. And of course, those costs vary according to where people live in the state.

And those are the households that may need support from a local food bank. This is a diverse group. They face a wide range of circumstances. Some rely on CalFresh and food banks regularly. Others may visit a food pantry occasionally just to free up funds to help pay bills at the end of the month.

And some don't use food assistance yet. But many of them are really just one event away from potentially needing to turn to a food bank. So one unexpected medical bill, job loss, a car repair, or a natural disaster would put them over the edge financially. So that's why our food banks need sustained support from the state. One in five Californians received help from the charitable food system last year.

And our our food bank network is serving 6,000,000 people per month, and that's been the steady over the past three years. And because of HR 1 cuts, we expect this picture to potentially get worse over the next year. The full extent of those cuts have not been felt yet. As you said in your opening, Chair Webber Pearson, the bulk of those changes were enacted in June of this year.

We're grateful to state leaders and to the California Department of Social Services for delaying the implementation of those cuts and those restrictions as long as possible.

But as we look at other states that implemented them sooner, I point at Arizona in particular, their SNAP caseload fell 47% over the year that they implemented, particularly those work reporting requirements. So SNAP is the nutrition safety net. Food banks are not. Food banks are the hands beneath the safety net. But as that safety net gets holes in it, more and more people are falling into our hands.

I'll also note that the LAO report that you cited, Chair Weber Pearson, citing a case load of 5,300,000 participants in CalFresh, that number now as we sit here today is just over 5,000,000. We've lost about 300,000 people over the past eight months. A 130,000 of those about are children. And that's not because of HR 1 cuts. That's largely driven by confusion about federal changes and fear among immigrant families of accessing public benefits.

So we're already sort of behind the eight ball. We're already having issues connecting people to CalFresh before these more cumbersome work reporting requirements go into effect. HR 1 is the largest cut to SNAP in the program's history. We saw in April, 34,000 humanitarian immigrants lose access.

And just this month, we'll probably lose another 40,000 people due to those work reporting requirements, that extra paperwork where people can't qualify for an exemption or prove that they qualify for an exemption from those work reporting requirements or just can't meet enough hours.

People don't have control over their work schedules. Their hours get cut, their food assistance can get cut. And so over the next year, yeah, we're anticipating over half a million people to lose access to CalFresh. And then HR 1 goes further, compounding that challenge. It shifts more costs from the Federal Government to the state.

Just October... This October 1, the administrative shift... Cost shift went into effect. We're very grateful to the legislature and governor in this year's budget for covering that cost so that we can continue to fully operate CalFresh and particularly the CalFresh outreach program. There was an additional allocation of $14,000,000 to sustain the CalFresh outreach program.

I especially wanna thank you, Senator Padilla, for for leading that effort in the legislature. Those are community based organizations that meet people where they're at and are able to literally speak their language and and, help them navigate the already complex, process of applying for and staying connected to CalFresh, excuse me, which is, again, only getting more difficult with these work reporting requirements. And it doesn't end there. Next October, California could face a $2,000,000,000 cost to cover a share of the benefit costs.

That is the first time that's ever happened in the history of the program.

It fundamentally breaks the federal state relationship when it comes to food assistance. We're working hard with our members in Congress to seek at least a two year delay in that cost shift. So to give states, California, and other states time to at least prepare and budget for that. But you know better than I do that a $2,000,000,000 hole in social human services budget will come from somewhere, and it will come from programs, unfortunately, that serve the same people. So I know I've painted a concerning picture.

I don't, I I don't wanna end on all bad news. I I will say that advocates felt very, encouraged by the legislature's leadership last year on these issues. The Cal Food Program, which supports food banks and allows them to purchase California produced foods, largely fresh produce, healthy proteins, the healthiest food that food banks are able to provide people because they can purchase what they don't get donated. As one food bank executive director tells me, donations are great, but sometimes I've got marshmallows and jalapenos.

And that's not what people need to put on their table.

And so they use those Cal Food Dollars to supplement that, and it goes directly to California farmers and California food producers. So for next year, we we are again advancing a three pronged approach to help abate a hunger hunger crisis. One, continue to bolster the emergency food system by funding Cal Food. And, crucially, the Cal Food baseline level of funding is only $8,000,000.

In this last year's budget, we were very grateful to have $118,000,000 But the new normal for the past five or six years has been a minimum of $60,000,000 That's to serve the 6,000,000 people per year that they've been...

That our network has been serving. So we really... To reduce volatility, allow food banks to plan ahead and get more food for the state dollar, we'll be requesting that that baseline increase to $60,000,000 per year. On top of that, we will need additional funding to help meet the need due to those HR 1 cuts and those 500,000 people that'll be cut off. Second, ensure as many people as possible can stay connected to CalFresh.

That means continuing to fund the CalFresh outreach network. That $14,000,000 investment pays off many, many, many times over in federal benefits that end up in people... On people's EBT cards and food on people's tables and help support local economies. And third, we really are urging the legislature to think big. We have a state funded version of CalFresh called the California Food Assistance Program.

It was set up in 1996 after a similar situation when the Federal Government cut a a group of people off of federal food assistance. It's been working since then to serve a certain group of immigrants. We need again to expand access to that program so that California can take care of its own and provide food assistance when federal decisions don't reflect California values. So with that, I'll just say no one should go hungry in California.

I'll stop my comments there, and I'm happy to take questions at the appropriate time.

Thank you.

Buenos Dias, Senator, Weber Pearson and Senator Padilla. I'd like to thank you all for your time, especially Senator Akila Weber Pearson and her team for the invitation to participate in today's Senate committee. Here's a quick, overview of where we are headed headed today. I'll start with a quick introduction to the San Diego Hunger Coalition, our mission and vision, and how we define nutrition security.

Then I'll give a regional snapshot of who exactly is affected across San Diego County and finish with call fresh participation rate and the impact this has on our local economy.

Our mission to... Is to create equitable access to food assistance to research, education, and advocacy. We're a backbone organization fighting to end hunger across San Diego County. We're a network of 500 plus community partners from San Diego and beyond that, and we lab... Leverage and work collaboratively to fulfill our mission.

And today's presentation highlights how we use data to measure hunger in the region, keep others informed, and help leaders understand which areas need additional resources. This information is also available in our research center at sdhunger.org/research. For... Sorry. At at San Diego Hunger Coalition, we define nutrition security as being unable to afford three nutritious meals per day using earned income.

Our measure is based on economic indicators, particularly household income, which allows us to update the estimate as a... Sorry, which allow us to update the estimate as economic conditions change. For June 2026, we estimate the population at risk by using the number of San Diegas living below 2025% of the federal poverty level, which is roughly roughly 74,000 a year for a family of four. One in four San Diegans are nutrition insecure, but this burden isn't really is isn't share, equally.

The rate is 36% for black African Americans residents and 35% for Hispanic Latino residents compared with 25% countywide.

That's ten and eleven percentage points above the county average. These gaps aren't about individual or cultural choices. It's a reflection of equity issues across our region who has had access to stable income, affordable housing, and well resourced neighborhoods, and who hasn't. When rates differ this much by community, a one size fits all response leaves people behind. This is why we tailor our mission and approach to addressing hunger to include research, advocacy, and education.

Over time, nutrition security in San Diego County has stayed consistently high. Since 2019, the rate has ranged from about twenty three percent to twenty six percent. This twenty five percent mark is the rate we saw at the height of COVID COVID nineteen pandemic. The need in a region surge in our hunger relief sector mobilized to provide, to provide relief. However, what this trend shows is that we need, we never came back down.

There's been a slight movement year to year, but brother picture is clear. Roughly one in four San Diegans has experienced nutrition security throughout this entire period from 2019 to now. That persistence matters. This isn't a temporary reaction to one economic shot... Chuck.

It reflects an ongoing gap between household resources, the cost of living, and the food assistance available to families across the county. In June 2026, all food assistance programs provided about 25,700,000 meals across San Diego County. CalFresh accounts for 14.9 millions or 58% of those meals, more than all the other programs combined. Food distributions like our local food banks and pantries at about 4,700,000 meals or 18%.

School and youth meals about 3.3 millions, about 13%, and the rest comes from summer, EBT, week, meals for older adults, or the food distribution program on Indian reservations.

This is how we calculate the meal gap in San Diego County. We take the total number of nutrition secured San Diegans and multiply by three meals a day per month. We estimate how many of those meals households can buy themselves with their own income, and then we subtract all the food assistance meals provided about 25.7 millions from call fresh school meals, food distributions, wink... Week, and the rest of the programs. What's left in the missing meals, about 5,500,000 meals in juice...

Is in June 2026 alone. In other words, only approximate 59% of the total need is met through self purchase, 34% through food assistance, and 7% is still missing. That 7% sounds small, but it's it is 5,500,000 meals every single month. Nearly two full days without a single meal per person in need. This map shows the monthly meal gap by ZIP code for June 2026.

The meal gap is the number of additional meals households will need each month after accounting for the meals they buy, themselves and the food assistance already being provided. The gap varies widely across the region. Some ZIP codes have relatively small remaining gaps while others are still short by hundreds of thousands of meals in a single month. Some of the largest and consistent gaps are Escondido, University City, and Oceanside, Though unmet need, shows up through the region.

I know University City is a surprising name to see among the largest gaps since it's generally a higher income area.

We speculate this is due to the high concentration of college students living in this same area. So even beyond the county wide nutrition security rate, geography matters. Different communities face very different levels of need, which tells us where outreach and enrollment and food assistance resources are most needed. Over the past two years, Call Fresh participation has declined. After reaching about 70% in late twenty twenty four and early twenty twenty five, it has fallen back into the mid 60% range as the chart on the right shows.

That matters because crawfish is a largest source of food assistance in the county. When fewer eligible residents participate, fewer fewer meals reach households that could still be in need. All of this is happening while nutrition security remains at pandemic levels. That's why protecting access to crawfish matters right now. In June 2026, about 60%...

5% of San Diegans estimated to be eligible for crawfish were enrolled. That list roughly a 194,600 people who are likely eligible but not participating. If eligible eligible individuals were enrolling CalFresh, about 8,100,000 additional meals per month and 67,700,000 in federal funding will have a ripple effect in our... On our local economy. Because enrolling all the CalFresh eligible individuals will provide more meals than our countywide meal gap to end hunger in a region, we must encourage CalFresh participation among all eligible individuals.

As of August 2026, there were approximately 30,000, 32,000 fewer coffers recipients compared to the previous year, representing an 8% decline in a loss of 1,000,000 of millions to our local economy. We can speculate as was previously, said that self unenrollment started as the conversations around HR 1 and changes to public charge started. Eligible people are stepping away from CalFresh on their own because new requirements, paperwork, and or sensitivity make staying enrolled feel harder or riskier.

Every person who disenrolls, even when they still qualify, is a household that loses support. Of the 34,000 individuals who went through recertification between June and August, approximately thirty four percent had their benefits discontinued.

Overall, nearly 30,500 San Diegans have already lost benefits under these changes with many more recertification still to come. These findings demonstrate how HR 1 is already reducing access to food assistance and why continued targeted outreach and support to households that are still eligible are essential. A few, takeaways. First, nutrition security in San Diego is widespread and persistent. About one in four residents every year since 2019 and higher for children, seniors, and people with disabilities.

Second, even when 25,700,000 food assistance meals and months, there's still a gap of about 5,550,000 meals, and it's concentrated in particular communities across our region. Third, CalFresh is the biggest lever we have to find nutrition security in San Diego County. It already provides the majority of food assistance. By connecting the roughly 195 eligible... Thousand eligible residents who aren't enrolled in CalFresh, we could bring in one, my apologies, 8,100,000 needed meals and 67,600,000 in local economic activity.

The work we've done at San Diego Coalition, the education, research, and direct outreach is helping increase enrollment and end hunger in San Diego County. Thank you, again, for your time. Before I finish, I want to share a few ways you or people in the community to get involved. There's a truly role for everyone. Check their data in a in a in a...

In a... For your own neighborhood on a resource center. Stay informed. Share our resources and whatever honors your capacity and passion. And remember, ending hunger takes a community.

Excuse me. Good morning, everyone. Thank you, Senator doctor Wilbur Pearson and Senator Padilla for inviting me for inviting me here today. The County Of San Diego is dedicated to the health and safety of all of its residents. As the interim director for county self sufficiency services, my priority is ensuring that our residents can access the benefits they are eligible for.

HR 1, house Resolution 1, is probably the biggest challenge that I have contended with my twenty eight year career. Already, we are hearing from people struggling to feed their families without CalFresh, including legal noncitizens and other noncitizens with permanent residency applications that are pending. Looking at CalFresh, a total of 93,500 people in San Diego are at risk of losing benefits due to the work requirements. Of those, forty eight thousand six hundred are likely are likely to lose benefits outright due to the federal changes.

For Medicall, that impact is is larger with 309,000 people subject to the work requirements and another sixty eight thousand are likely to lose benefits outright.

In these in these first few months, we are we are already seeing disparities in the data of CalFresh discontinuances. We have seen in the September data, Hispanic, Latinx have have fall off at twenty eight percent, and average age of this continuance is eighteen to twenty seven years old at thirty two percent followed by twenty eight to thirty seven year olds at twenty four percent.

When we look at when we look at overall CalFresh enrollment demographics, we see a large majority in the Latinx at about 40%, white at 16%, black or African American at 6%, Asian also at 6%, and American Indian at just a third of a percent. Half of our CalFresh customers are at either end of the age spectrum, with a third in the age group of zero to seventeen and twenty one percent aged 65. Our customers live across the region, but we see higher concentrations in the...

In our South, Central, and East County, regions that are... That historically are underserved. Adding to the federal changes for our customers is the new public the new public charge rules that went into effect in September, making people more hesitant to access services they need. So how did we get here? The need for safety net services has surged in the last two decades, but, really, our history goes back to the great recession.

In 2006, San Diego County has... Was helping more than 83,000 neighbors get nutrition food get nutrition food they need through CalFresh. During the pandemic, we surged to a record high around 391,000. At the same time, the county was proactive... Proactively reaching out through partners, leveraging grassroots efforts to ensure people were connected to all the services they needed.

In the month of October, we dropped from our pandemic high to around three hundred and sixty two thousand of CalFresh recipients. Medi Cal experienced similar surges over the past twenty years. Medi Cal, which is... Which much of the nation refers as Medicaid, is California's low cost health care. In 2006, the county of San Diego had 260,000 recipients.

Passage of the Affordable Care Act drove expansion to a high of 744,000, and sub... And this subcompandemic surge then created a new record high of more than a million San Diegans receiving Medi Cal. By October of this year, that number has declined to nearly 781,000 recipients even though most of the HR 1 Medicaid reforms provisions don't start having material effects until 2027. HR 1 has pulled and continues to tug the rug out from thousands of our clients to get ahead for...

To get ahead of what we foresaw the county acted.

Importantly, that included assist... Assigning staff to explore options to create a safety net bridge program and reaffirm the county's indigent care program. The county working with two zero one San Diego, one of our partners in the CalFresh space, along with my colleagues here sitting next to me, we built a virtual hub of of partner volunteer work and training opportunities. Our our task was to gather the... Our task was to gather the various opportunities in one place to get people connected and and paying benefits.

The virtual WorkReady Hub launched June 1, the same day work requirement started. Since then, the hub has had more than 10,000 visits. In addition, the the county regularly promotes volunteer and job opportunity through our partner

network, social media, and the mail campaigns by eligibility staff to ensure we are walking shoulder to shoulder with our customers, teaching them about the changes and resources available. We have gathered valuable feedback on any on any places customers are getting stuck, reconnecting eligible customers who have fallen off, and providing resources. For the public, we posted inform... Informative social media graphics explaining the tens of thousands of views, and more than 2,000,000 views from our entire campaign since March.

For for traditional news, we have had more than a billion views from media outlets all over the world also since March.

To grow the safety net, the county in August launched the food distribution program. The year long food distribution program started with six locations across the region, most likely to be hit hardest by federal changes. The six locations were determined by by data identifying 16 ZIP codes that hold nearly half of the impacted individuals countywide. County owned buildings were identified in those areas, allowing quicker activation of the program.

We partner with the San Diego Food Bank and Feeding San Diego to bring food and other resources into these neighborhoods.

So far, we have hosting 18 events with one happening right now in San Ysidro. Since our start, we have served more than 2,900 households, meeting a need of food meeting a need the food banks have been voicing for months. Together, our food bank partners serve more than 600,000 people each month, but we didn't stop there. We kept building we kept building and are looking to expand the program to potentially 12 sites with wraparound services.

In addition to food distributions and research navigation, select sites now include vaccines, behavioral health, housing, child and family well-being, and agent and independent services resources.

Adding these services enables residents to receive critical connections while accessing much needed nutrition. These expanded offerings reflect the county's commitment to reducing barriers and making multiple forms of support available in one place. There's more to come as we continue to explore opportunities to expand our reach for those who may not feel comfortable coming to an in person site for food resources.

In a week, the board of supervisors will review our updated plan to help people who lose their medical benefits stay connected and receive care from their medical home while we assist assist them in reenrolling in Medi Cal. The county will support expanded health fairs to provide a primary care on the spot and connect people with a medical home for future care.

We also support clinics who will continue to serve the uninsured and redirect the uninsured, in some cases, to a new medical home. Widely available application assistance, which is being offered to keep as many people covered as possible, gives us a chance to share opportunities for telehealth, in person, and mobile unit care at events. While the county has made strides to support vulnerable populations amid uncertainty and complicated changes, fear remains and and so do the challenges.

California counties have a statutory responsibility under Section 17,000 of the welfare and institution code to provide care for qualifying low income residents who lack other sources of support. San Diego also...

San Diego is also an Article 13 County. We do not operate a public hospital primary care clinic system. Looking ahead, the county has no built in infrastructure to absorb a large surge of indigent health care without additional state or regional support. Our projections show that our projections show that health care uninsured rates is expected to double if we are unable to reach them due to fear or other complications, preventing visits could shrink... Excuse me.

If we aren't able to reach them due to fear or other or other complications, preventative visits could shrink through our local health system. This means Jane isn't going isn't going to her annual checkup or seeking routine care for small things like a bothersome backache. The need for emergency services may also grow. Also, people like Jane ignore also people like Jane ignore or put off care. They get to...

Until they get into a critical point where it's an emergency and they are now in the emergency department. Regional hospital infrastructure may face a deluge of patients and then see that then see that spread to a health system wide strain on resources. Hospitals and clinics could struggle financially and functionality to absorb those newly uninsured uninsured patients. The fiscal impacts already are being felt at the county level.

We we expect to spend an extra 29,000,000 this fiscal year and likely more in the next with an anticipated increase of 150,000,000 for the CalFresh administrative cost alone.

Expenses already included 122 additional staff to fulfill new federal eligibility checks, including the twice a year Medi Cal renewals, verification of work requirements for both Medi Cal and CalFresh, and supporting functions, including our call center, which has been inundated with questions on how to navigate these new complicated changes. The remaining county funded safety net programs will feel stressed, and opportunities to bill for behavioral health services will be lost. Expenses will grow in time when revenue is already tight.

The bright spots are the commitment of our board of... Our board and county staff, community partners, stakeholders to find ways to provide these basics to provide these basic necessities.

The climb ahead is steep, and and in all support is welcome. Thank you.

Thank you to all of the panelists, and we're actually gonna have you stay for for questions. Senator Padilla?

Thank you. Madam Chair, as much commentary as other... But first, thank you all for the work that you do. I think fundamentally, you're looking at sort of a situational and programmatic assessment for us, showing us sort of up to the minute.

Appreciate sort of highlighting at least from a state government standpoint sort of the fluctuations in baseline at Cal Food, kind of where the delivery gaps exist in terms of actual benefit and an assessment of sort of the efficacy of sort of county deployed programs and the impacts on the county system lack of infrastructure as you testified.

So to all three of you, thank you very much for those, valuable insights. I think just a couple of observations, that I take away from your testimony, and that is on the one on the one hand, we find ourselves situationally, programmatically, in a period of scarcity because of unstable politics, a change in policies at the federal level, and the state government from a program and budget standpoint always having to be trying to be very nimble to step up and fill in gaps.

And that creates great instability and inconsistency in the delivery of services and then all the pertinent impacts that flow from that. Right? And so that I think our challenge as policymakers when we think about budget, especially when we're trying to continue to resolve structural deficit in the out years, is how do we be better at being better strategically in making the right investments at the right programmatic point so that we get the maximum benefit.

Obviously, in the near term, we have to talk about expanded access, understanding education, and programmatic delivery. Right? But from a broad policy goal, social policy goal, our goal in California should be to kinda reduce your your market and your participants and depopulate... Reduce that demand. And I just would note, I think one of the things that's always striking to me, and it's sad, is that we are one of the wealthiest states in the union.

We often talk about, you know, 60% of venture capital comes to California, fourth largest economy in the world, but we also have the greatest wealth disparity wage. We've high levels of poverty, working poverty, children in poverty, highest wealth disparity, highest disparity in wages. And in a state with this vast amount of advantage in wealth, the fact that we have... Just looking at San Diego County, the kind of persistent numbers we've had, people with food insecurity, particularly with children, and this is... It's almost immoral.

Right? I mean, it is. It is a failing on a lot of levels, and so we certainly have that work to do. And I think where my continuing focus will be is, what does that architecture look like now? What does the data tell us about what's really has some efficacy, what does not?

Where are the real needs? And how are we from, at least on the budget side, being much more strategic with the dollars that we do have, and where do we need to rethink those priorities so that we're creating the right outcomes? But, ultimately, those outcomes need to lead to less dependency and more economic empowerment and people's ability to...

You know, that we invest in their training and education and that their skill sets command a better, you know, value in the marketplace so they can meet their basic needs. I mean, the social contract is really broken, particularly in California, and we can do better.

We've done a lot of great work. I'm not gonna take that away from anyone. We've made some good progress. We've had to deal with some crazy circumstances, but we have a lot of work to do. And your testimony, the data you've provided here is a reminder and also very enlightening about how we can we can...

And where we can focus that. So I'm gonna... I will have to depart this meeting for another one in a few minutes, but I wanna, again, thank my friend and colleague, doctor Weber, again, for your leadership and partnership here. And I know that we're both prepared to roll up our sleeves and continue continue the work. So thank you.

Thank you so much, Senator Padilla. And I wanna thank this panel as well. Do have a couple of of questions. We'll start with, Mister Call. So when you discuss food insecurity, just wanna make sure your definition of food insecurity aligns with the definition that miss Alvarado had stated, Or is it or is it different?

Yeah. No. We, define food insecurity as limited or uncertain access to enough food to lead a healthy active life.

Okay. So it's not as specific as the one that, miss Alvarado was using because that could differ from person to person.

Yeah.

Okay. Now you had mentioned, one of the reasons for the high percentage of food insecurity in California, is due to our high cost of living. Not sure you know the answer to this. But do you happen to know how our rates of food insecurity compare to other states?

Well, that's one thing we lost with the cancellation of the USDA food security supplement survey. Can follow-up with your office on that, though.

Okay. Thank you. And then one other question, and Senator Padilla was talking about, you know, our our morals and our values as a state as a whole. And oftentimes, we say in our budget hearings, like, our budget is an example of what we prioritize. Understanding a lot of the changes that are happening, the Federal Government is pulling back on a lot of the commitments that they've made.

Those responsibilities, financial responsibilities are now shifting over potentially to the state and also at the local level. So much has been said about potential structural budget deficit that we're gonna have at the state next year that, I think, dollars 30,000,000,000 or so has been kind of put out there as what our structural budget deficit will be for next year.

Having conversations with my colleagues who may not necessarily be here, what would you say, to them to ask them to really focus on providing more resources in this area given the fact that we're already in a deficit and that will require us to take from other areas?

Thanks for the question. I would say that not only is it immoral, it's bad policy. Food is an investment in our kids, in our future. We already spoke to, food and nutrition being a building block for higher educational outcomes. There's a wealth of research that shows that good nutrition reduces health care costs.

In some cases, particularly for older adults, more than pays for itself. And in terms of, yeah, educational outcomes, lifelong earnings, these are all linked to good nutrition. So it's good policy in addition to being the right thing to do.

Thank you for that. May need to call on you to come up to some of these hearings, because

Happy to.

Sometimes when you're looking at a lot of different things, that kind of gets lost in the, in all of the all of the other things that that are being dealt with. Miss Alvarado, there was a slide there... That you had that talked about the declining CalFresh participation in San Diego County, and you mentioned that the participation has decreased since December 2024. Do we have any understanding of why it has dropped since 2024, which was before...

Or December 2024, which was before HR 1 was voted on and,

had? Yes. We haven't conducted the research. You'll have specific information on that. But for what we are hearing from our community partners across San Diego County, plus some of the things that we can speculate, given, like, every time that we look at specific sick ZIP codes is that, the changes in policies and the potential fear of, public charge and how this is gonna affect some of the immigrant of mixed status families.

At the same time, with all the ice raids that have been happening around San Diego County, some families are starting to be afraid of, Federal Government. And so, unfortunately, some of these families and individuals still qualify for Calfrac, but they are afraid of what that will represent for them if they are still enrolled in a federal food assistance program.

Thank you. And, Doctor. Banuelos, I just really want to thank you for all of the work that you have been doing. The implementation of wrap around services at these pop up sites is so critical and so important and goes to show the level of understanding that health is more than just one thing. Food is more than just one thing.

And we really need to go to where the people are instead of expecting them to navigate all of these very complicated systems and come to this building for one thing and this location for another thing.

And so I really applaud you all for doing that and hope to see more of that in the future because that will not only help people from, disenrolling or falling off enrollments for for various things, but it also helps out the entire community because they are then your best, messengers to other people that live and say, hey.

If you come here, not only can you get your food, but you can get your health care, you can see your doctor, you can do this, you can do that. And that's really how we, combat some of these things that are coming down from the Federal Government, but also use this as a tool to really start creating healthier communities. So I just really want to applaud you all and thank you so much for for that foresight, in doing that.

And with that, we'll move to the next panel. So our next panel turns to how we feed kids at school, where California's Universal School Meals program meets the realities of local implementation. Our first speaker is Kim Frenzel, director of nutrition services division at the California Department of Education, where she leads a team of more than two, 270 professionals overseeing seven federal child nutrition programs. Miss Frenzel joined the CDE in 2013 after eleven years with the California Department of Public Health WIC program.

Today, she will describe the Universal School Mills program and its history, its evaluation, state budget allocation, and policy initiatives, including AB 2535, supporting the farm to fork model and reducing ultra processed foods.

We are also joined by Alicia Patron Hauser, executive director of food and nutrition services for San Diego Unified School District. Miss Hauser has spent her career in school nutrition beginning with a, internship in Boston Public Schools and serving as a school nutrition director for more than a decade before joining San Diego Unified in 2023. Today, she will ex... Share her experience and perspective on the universal school meals, local procurement of California grown foods, CalFresh cross enrollment, and the Sunbucks rollout.

These efforts are important to ensuring children have consistent access to nutritious foods and the support they need to be healthy and successful.

Thank you both for being here, and we will begin with miss Franzel. Thank you.

Thank you so much, Senator Weber, Pearson. I just really appreciate the opportunity to be able to come down here today and to share with everyone around California Universal Meals Program and the value that it really does bring to our state, to our youth, to our communities, and to our local economies. And I'll also address, just some food for thought for policies as we move forward in thinking about how best to support our Californians.

We are celebrating the fifth year, it's the fifth anniversary of our state passing legislation that was truly historic to adopt the first in the nation, a state universal meals program to really uplift and acknowledge that school meals are essential, just like free textbooks are, that all of our children need to have access to a breakfast and a lunch each and every school day.

And actually, my slides today, while there's not a lot of words on them, you're going to see a lot of photographs because I wanted to highlight in our state the investments that California is making.

We've heard a lot about, you know, the the budget and whatnot. And I really want to uplift what our schools are doing throughout the state of being good stewards of the funding that the State of California is providing for universal meals, and that it's not just the state meal reimbursement, but also the grant programs with the infrastructure. You'll see the what's coming out of our schools and I think you'll hear from Alicia in a few minutes as well. Our state has 5,700,000 public school students.

Of that, 62 over 62% are eligible for free and reduced price meals, which means they are very student population, are living below the federal poverty line, and I'll define what that threshold is in just a few minutes.

In, school year 'twenty five-'twenty six, our state collectively, our schools have served over eight sixty eight million school breakfast and lunch. And, even though we've seen declining enrollment in our schools, we are seeing that our meal programs are very stable. And I think that's another testimony to the need of food and nutrition and security in our state. And, as we think about public policy, California Universal Meals is so much more than just making available a breakfast and a lunch. I'm gonna...

You'll see these photos in a few minutes. These are not the school lunch programs that all of us have gone... Have had in the past. They're truly,

culturally diverse. There's student voice in the

the from the State of California. And I say this because when we think about 62% of our children being eligible for free and reduced priced meals, that and we've heard from the other panelists about nutrition insecurity and food deserts and not having access to fresh locally sourced meals the school meal program has quickly become a safety net. And I feel like COVID-nineteen really kind of peeled out that onion where we really saw how dire communities were and how fragile nutrition was in our state of California.

So, the value of California funding and making sure that every child, every instructional day has access to a breakfast and a lunch, to put this in perspective, if 62% of our children are eligible for free and reduced price meals, at the federal level, the Federal Government sets the threshold for a family of three will be the example that I use.

A family of three, if they want their child to be eligible for free meals at no cost to them, they would have to be at 130 percent of the federal poverty level.

For a family of three, a household of three, their annual income cannot be a penny more than $33,566 annually, which is appalling than that they would have to then start to pay for their child's meal. That same family, if they were in the 185% of the federal poverty level, the reduced price for that meal, they could not make a penny over $47,767 annually. And you heard from the, second panel and talking about the choices that families are having to make.

And the cost of living in California is so high and there is no regional indexing at the federal level for the National School Lunch, School Breakfast Program, which just is another reason why California Universal Meals are so imperative. And when families are having to make very hard decisions about medical costs, gas, transportation, housing, clothing, the last thing they need to think about is if they're sending their child off to school hungry.

And we know that, the University of Berkeley, the Nutrition Policy Institute, actually did a study and they found that of the states that had implemented some sort of state universal meal program that 12%, they saw a 12% decrease in reported food insecurity in those states that had implemented a universal meals program. And that was particularly in families that are socially disadvantaged. And so, I think that's important to remember that the value that California Universal Mills brings to the state.

And we also know that research confirms that and this is through a Tufts University study, that the healthiest meals are the school meals. It's not what's coming in the lunch bag from the family.

It's what the school food service professionals are putting on that, those plates each and every day. And so we know that and you mentioned this in your opening remarks but the research is so solid and really confirms the connections to good nutrition and educational outcomes.

And when we think about wanting to give our children the best

possible outcome, we're going to potential for life, it's just kind of a no brainer, right? It's just common sense and the research confirms that they when they are well nourished, there's improved concentration and cognitive function. There's reported increase in standardized testing, especially when breakfast is offered. There's improved academic performance, reduced absenteeism, and overall, we are setting them up in the state for healthier weights, nutrient. We're teaching them early about good nutrition.

And we are also, helping to reduce some of the health, disparities and the health diseases that, the doctor presented on earlier today. And our school meals are science based, right? They include whole grain rich items, meat items, plant based protein options, a variety of fruits and vegetables and possible health outcomes as possible. So, again, these are foods that are coming out of our California schools thanks to the funding the state funding, the state meal reimbursement for California Universal Meals.

It is also we can't talk about California Universal Meals without talking about the state funding that is coming.

We've had four rounds of the kitchen infrastructure and training funding and our schools are able to do the much needed upgrades to very outdated kitchens. Many times you might tour a school and you see a beautiful remodel and then you walk into the kitchen from the 1950s. Yeah. Maybe and you're just and you see how small it is and what that amazing team is trying to do to put meals out.

And as we think about wanting less processed foods, more freshly prepared as we take this journey to eliminate ultra processed foods of concern, we truly do need the funding so that they are able to purchase those local foods, prepare them, and then serve them to their students.

And it's not nutritious unless it's eaten, right? We don't want that food going into the garbage can. And so it's just truly important that we think about what we can do to preserve our policy considerations and funding. And as I mentioned, as we're moving forward in the coming years, we're California is once again leading the nation. And with the passage of Assembly Bill 1264 where we're starting to eliminate ultra processed foods of concern in our schools.

And I would venture to say this is not just a school problem. It's a community problem and a food system problem that we need to address as well. So, what can we do as we think about some of the policies certainly making sure that Universal Meals in California remains fully funded and is not prorated by any means.

I think we have great opportunity around policy to think about nutrition education and the connections in our classrooms to what's being served in not only in the cafeteria, but what's at the family table, what's at the farmers' market, what's in the community, the impacts on our climate. We just passed I think we're the third state to have passed a state seal of climate literacy.

I think we have a golden opportunity here to think about solid policy there. And I think enjoy the foods that they're being served and they need time to do that. And then local school wellness policies is yet another opportunity to really help bring school policy outside of the school cafeteria and the many responsibilities of the food service director, that is a school responsibility. That is at the local educational agencies.

School boards need to be very actively involved in setting meaningful, connections to local school wellness policies to the bell.

So, in closing, Universal Meals is sound public health policy. We are the fourth largest economy in the world, yet we have kids that are hungry. They should not have to worry about where their next meal is coming from. And they should not have to worry that they're over the weekend that hungry and that they are so dependent on the school breakfast program.

Healthy school meals is an investment in our children's future, providing science based nutrition and standards to support their growth, development, and educational successes for lifelong well-being.

And as we face these national trends, federally around our threats to, our Child Nutrition Program, now is the time to take bold policy statements to, to lead the nation in what is right and moral for our children. So thank you.

Thank you, Senator Weber Pearson. It is an honor and a privilege to present to you today. My name is Alicia Patron Hauser. I'm a dietitian by education and the executive director of food and nutrition services for the San Diego Unified School District. We are the largest, fast food establishment in the county with over 200 locations.

We are known, as the Sandy Coast Cafe, and our pillars are nutritious and delicious, California fresh and served with love. And these photos represent our why. I am an operator. I am on the front line. And as Kim mentioned, these these photos demonstrate our why.

What you see here are children participating in nutrition education experiences where they enjoy harvest of the month items like persimmon and avocado. We have a nation... Nationally known nutrition education farm to school program, and those pictures are demonstrating what the doctor mentioned earlier, the need for education. And then, in the bottom right, you see, a mom enjoying breakfast with her two girls. And so, this slide demonstrates our why.

Last year, the Universal School Meals Program, we we served a total of eighteen point one million years to the tune of $76,000,000 in investment in our students, Through the Community Eligibility Provision and the Universal Meals Program, we offered every child breakfast and lunch at no cost, regardless of household income. I have been in school nutrition for over twenty years. My my whole career pretty much spent in, San Diego. And, you know, the universal skill... School meal program is, one for which I have tremendous gratitude.

It has leveled the playing field. No child, despite the charge to, operate in a way that free and reduced price children were not distinguishable in our programs, that there has always been a stigma associated with free meals, and this program has, turned turned it around. Any child regardless of income can participate, and it's just been amazing for me to see.

And I am before you with much gratitude, and I'll echo Kim's punch line, which is, please continue to sustain the funding for us to be able to offer this amazing program. We have here Maslow's Hierarchy of Needs.

And as you can see, and as other panelists have pointed out, it just makes perfect sense. It's good public policy to meet the foundational needs of, our most vulnerable populations, our children, and as, as, as was mentioned, our, elderly and disabled. And so this... These are statistics on what is happening right now in the Universal Meals Program, and we're we're hitting around 100,000 meals a day. We also are a very, good supporter of the local economy, and what this slide demonstrates are our statistics on produce.

Nearly 50% are California grown. Not on this slide, but also a way in which we support the California economy, our our local dairy, which is right in San Marcos. We purchased bread from a bakery in Los Angeles. We buy beef from Harris Ranch beef in the Central Valley. And so, our program is supporting California agriculture while delivering fresh, nutritious meals to students.

And so, while the the policy is outstanding, I'm a member, I'm a board member, on the Urban School Food Alliance. I network with my colleagues in other states where they don't have the good fortune of a universal meal program. And and so, I think California is groundbreaking, forerunning in this work, and the policy foundation has been set. My ask is that it it stays. And so access is the first step.

The second step, and Kim alluded to this pillar, adequate time to eat, seated time. And so I'll get into that a little bit in another slide, but that is critically important. Quality infrastructure, people, and community support. And so, great grat... Gratitude for the policy adoption to create lasting impact.

We must consider these other supports for meaningful access. Time to eat is access. And so what I've demonstrated here are a typical breakfast and lunch tray at San Diego Unified. You can see that they're very full trays. And I've got a simple video to show you the challenge.

And so what you're gonna see is a time lapse at Patrick Henry Middle School. The space that you're looking at in the middle of the slide is what we call a speed room. We've used kitchen infrastructure and training funds to outfit eateries in a way that we can serve students in the quickest time possible. And so Patrick Henry High School's enrollment, is at least 1,500 students. We have one lunch period to feed the students.

And so if... As you can imagine, high school students don't wanna spend their time waiting for food. And so this this video will share with you what we've done, what we've strategized, knowing the constraints, so that we can maximize that access to the program. Okay. And so, an ask would be, statewide standards guaranteeing seated meal time.

And so, a bell schedule might plan a half a half hour for lunch, that doesn't account for, the the time it takes a student to access a meal. And so this would be critically important if we guaranteed seated time for our students to enjoy just ten minutes for breakfast and twenty minutes for lunch. The kitchens and the people behind every meal, we've been able to address the challenges that I've noted here with the generous funding via the kitchen infrastructure and training support. We're addressing aging infrastructure.

Kim mentioned the kitchen infrastructure is the highest cost square footage on a school campus.

And so it is... It has oftentimes been left out of a whole site modernization plans. And so the kitchen infrastructure and training monies has allowed us to address some of these challenges. It's allowed us to, train and educate our staff, so that they do have the skill to, prepare fresh meals, and it's also afforded us the opportunity to upgrade old equipment.

More pictures that demonstrate the, way in which we put the money to good use, which you can see a warehouse full of milk coolers and heated cabinets and, speed line equipment, a culinary instructor.

And then in the bottom right, you see Pega, who is in front of two combi ovens, which are the the Cadillac of of ovens combining convection and steam, to, make fresh, meal preparation as easy as the push of a button. And so the bottom line is achieving higher quality food requires modern kitchen equipment and the capacity to train and develop our staff. We've we've taken technology to another level.

If you have frequented, anytime lately a fast food establishment, you'll notice that, you know, they're all carrying iPads or they're asking you to check yourself out. And so this slide is just a demonstration of how the funding has allowed us to update our technology infrastructure.

On the bottom right, you can see digital menu boards. And so, again, achieving high quality food requires the capacity to make all of these updates. And so what can the state do to help? Appreciate so much the policy. Universal Meals has just been a game changer in the profession.

We're asking if it may be sustained with adequate funding, continue to invest in our kitchens and people, protect time for the students to eat, and, continue to help strengthen the food systems around our students, like CalFresh and Sunbucks. And so, thank you so much for, the leadership and partnership, and, I look forward to more good work and partnership with the state. Thank you.

Thank you so much, to both of you for, your presentations. There was a slide, I believe it was during the first presentation, of a student chopping broccoli. Is that a part... Are the... Is this now a part of the nutrition curriculum where they actually learn how to prepare food?

It can be. And that's a great example of the kitchen infrastructure and training funding as well as some of the, other, the farm to school funding. We also have some special, federal funding, but we can... Schools are offering, right, that hands on experience to really engage, especially the younger children, right, and learning about where the food is grown, so whether it's just working in a school garden or helping to prepare. And so many times they'll...

And you can probably speak very eloquently to this. They'll have, competitions. Right? And where the child... The children will prepare a menu, then it gets taste tested and then can actually then be adopted onto...

Into the school menu. So, yes, many schools are doing that sort of engaged... Student engagement.

And is that something that individual districts decide that they want to do? Is it funding that they apply for? How how is that trickle down to

the individual districts? Individual, and I'll let Alicia speak to that. And so when I brought up my slide about, potential state policy, around nutrition education. I think we have some considerations around, is it optional or what is required and how could we tie that to, core curriculum?

It is optional. And, at San Diego Unified, I'm fortunate to be able to afford those players on my team. We have a specialist, a Farm to School specialist who does... Has an extensive nutrition education program. You saw the students tasting the avocado and the persimmon.

We also partner with our secondary school culinary arts classes and, work with them. Last year, we held a competition and, garlic hot honey chicken is on the menu this fall. And so, there is, as Kim mentioned, it is optional, but the work is... It could be endless and it's great fun and great education for our kids in so many ways.

Can I add one thing? And while I mentioned the 2026 kitchen infrastructure, training funding, that state funding, dollars 500,000,000 that will go out and was outlined. Every year, it's been a little bit different, but one of the the options this year for schools is around nutrition education, and food pantries is on there for the first time. So for funding. So pretty exciting.

And in San Diego, you said that it is optional. So is every school deciding it's something that they wanna do? Is there extra funding that you're providing to the schools that do that? Or is it a... Another pot of money that they're just using...

That they're just deciding to use it?

The resources are coming from the Child Nutrition Program budget as well as CDFAs. And, Kim, you might be able to speak to CDFAs programming. We use a lot of their funding to, subcontract with garden educators. It is a school choice, to have a school garden, and, we have many at San Diego Unified. And so we kind of grabbed the resources in a variety of different ways to bring, those kinds of programs to our schools.

Thank you. When I I saw that slide, it just kinda perked my interest. My kids went to a Montessori, and they do this part of their everyday routine for for the younger kids to be able to actually prepare their own fresh, you know, meals.

There's a great opportunity if you think about the local... The local control... The plan that schools... The LCFF plan. And, you know, many school...

Some schools, we really encourage our food service departments to have a seat at the table when that plan is being developed. And this would be, you know, a really great example of starting to make those strong connections.

Great. Great program. Great ideas. So I wanted to ask about the adequate time to eat, and I kinda chuckled because, you know, a couple weeks ago, I was talking to my youngest, and he was like, mom, I only have twenty minutes to eat for lunch, because I was asking him, like, well, did you eat everything? So...

And and so, one, understanding that Senate bill 348 required CDE to develop the recommendations, but it's not a mandate for individual school districts to actually adopt it. Do we have any information or any data as to how many school districts in the state have actually adopted the recommendations for the ceded time?

That is a great question. And we are currently releasing a voluntary survey to start collecting to see what are... What are the barriers, you know, what are their practices, and what what is the landscape in California. So we're just embarking on that now.

Okay. And for the time to get the actual food, and appreciate the speed lines. My oldest is now in high school, and they had us come to the school. So I got a chance to actually, like, see the speed line in action, and it and it works. But do we know, like, the average time for students to get their food?

It can be as as quick as ten to twelve minutes. Eight to 900 students. It really works.

Yeah. So if you are saying an average of, like, twelve minutes and they then need to sit down and eat, a thirty minute lunch period is not adequate. Correct. Okay. Correct.

Okay. Alright. Definitely an eye opener. Thank you so much for, for your presentations. I'm sure that we will be discussing this further in the future.

At this point, we will open it up to any comments from the public. I wanna thank all of our panelists for all of their very, very thoughtful, presentations. So if you are interested in providing a public comment, you may come to the center lectern, in order to accommodate, any and everyone who may want to speak on what we were discussing today. We're gonna limit public comment to one minute, and you may come up and speak.

Madam Chair, Senator Pritsen, may we request me to read her inputs because of her medical condition?

Yes.

Thank you, ma'am. This might exceed one minute, but I'll try to compress it, and I'll give the copy to your staff.

I will let you know when you reach one minute.

Yes, ma'am. Thank God. We love you. This is a divine guidance to us. We didn't know that you have a a meeting today.

I am Purita Javier, senior with existing medical condition and victim of ceramic skin toxicity since 1997, My husband in 2012. We live in fear, and we are hurt. We referred our case from the police up to the latter city San Diego officials, county air pollution control district, and even Sandag and the FBI. And up to this date, five years since, there was no action. Ignored, neglected, particularly mayor Gloria, councilor Rivera, who are the accountable leadership as far as our community is concerned.

And we are here to declare that we have to uproot the cause, not just eating good food, inhaling the clean air, drinking the clean water, staying in a safe... And it's one minute. My turn, ma'am, if I may extend. This is our value analysis from the presentation. Thank God.

We love you. We represent 77 neighbors under District 9. Yes. We need food. We need clean air, clean water.

We have all pipings, ma'am, in our community, particularly San Diego City. We need clean food. Yes. And so we recommend that every family as a policy must have at least two parts or three parts to plant, for example, Moringa, a miracle tree vegetable. Thank you, ma'am, for the opportunity.

Let's work together, and we are ready to help, ma'am.

Thank you. I'm going to ask for one of my district staff because I've got a lot in the audience to speak with you at this time, and we'll bring the next speaker up. Hello. You may begin.

Thank you for having this committee for nutritional access. I started a nonprofit called Your Garden Connection, and I am building and maintaining gardens at schools. And to help bridge the gap for nutrition for families, I think it would be helpful to grow more food at all school campuses, have more community gardens that are walkable too. There's one community garden in El Cajon. And if we were to simplify food distribution by having everyone grow their own food, it can help bridge that gap even further.

Creating incentives for property owners to grow food and by having gardens instead of lawns. Having raised garden beds uses less water than maintaining green landscape lawns. And being able to grow vertically can help grow more food with less space. So I hope that you can consider funding for more community gardens. Thank you.

Thank you, Senator Weber Pearson, for the opportunity to speak and for all the work that you do for Californians and specifically as San Diegans. My name is doctor Gail Bachman. I'm a physical therapist, here in San Diego, and I've spent most of my career working with, patients who have suffered neurological conditions, a large portion of those being individuals with stroke. As we heard from doctor Carazzi earlier, cardiovascular disease is a leading cause of death, and disability and stroke is a major contribution to that burden.

According to CDC, more than half of stroke survivors experience reduced mobility, and that includes their ability to take care of themselves, feed themselves, bathe, dress, walk to any nearby market.

These are life changing individuals that don't only affect the individuals, but also their families as well who often have to take off time for work to to take on that burden of care. Prevention through access to healthy foods and nutrition is critical in reducing stroke risk factors, particularly high blood pressure. And then as we've talked about a lot today, processed food that's usually high in sodium. And it's not just for the initial reduction in

Thank you for this time. Thank you for this time. I really look forward to the continued work that you're gonna do and any opportunity to collaborate with local partners or your office.

stroke risk factors, but often for those not getting a secondary stroke.

Thank you, Senator, Weber Pearson and also Senator Padilla. CalFresh provides my cell phone service. Domino's fall when CalFresh is lost, and it can be just a little trip up and cause us a lot of problems. Transit costs have risen. That gives me a lot of problems too because now I have to come with the extra dollars.

So losing a a CalFresh benefits hurt local economy, and we need to know that. Many times, I have to spend extra money with my CalFresh so that I can use retail club dollars to get toothpaste, toilet paper, detergent that's not covered under it. When I was young and living in government housing due to my dad needing surgery and heart transplant, we had a community garden space. I loved, getting my hands in the soil and having the chance to produce something, grow something by my work.

It really changed my life till today.

That year via this Minneapolis Star Tribune, I earned my first trip to San Diego selling subscriptions. I was 11 years old then. Yet we still can do better. We can do better. Let's do better.

Can the state ask churches and community colleges to provide gardens? Maybe include even public utility lands also. Thank you very much.

Good morning. My name is Mary Young. I'm from Encanto, which is in Southeastern, San Diego. I wasn't planning to speak, but as I heard them, talk about programs, I thought about Morris High School. Morris High School has a school garden.

They work with project new village. And so I wanted to give them a shout out, because they work very hard in, producing, fresh, vegetables for the community and also for the schools. It does work. We would like to see more. We have land out there.

And I'm I'm I'm thinking that that's something that we should do, have the community fruit produce more fresh vegetables and things like that, and use that land more appropriately, and have the schools more involved in projects like that. So we thank you for being here today. Thank you.

Good morning, Senator Weber Pearson. Thank you for having this, event today. I'm doctor Gerald Tolbert, an emergency medicine physician at UC San Diego and faculty Chair of the Food is Medicine unit at the Center for Community Health. In the emergency department, I care for in house patients who come in regularly for clinical evaluation. We check their vital signs.

We check their labs. We treat what we can. But oftentimes, we can't provide them the thing that they need because they're just simply hungry. And their access to food is reduced as well as I appreciated doctor Carraza's point about how does one heal after a surgery if one is hungry. I think California has some tools to deal with this, even with these federal cuts.

So I would encourage, one, we can protect CalFresh so no eligible family loses food because of paperwork. We can backfill the gaps for immigrants, communities losing benefits for... And for the food banks facing rising demand, as well as we can build on what we work... Works for our kids, universal school meals and summer food benefits. So I appreciate your time.

Thank you.

Well, that is the end of public comment as I don't see anyone else, looking to come forward. Really wanna thank everyone for coming out today. I think we had some very informative, very good presentations that sparked a lot of ideas, at least for myself and hopefully also for any of my colleagues that may have been watching and also for Senator Padilla.

It is very clear the link between access to fresh fruits and vegetables and adequate nutrition and the overall health of an individual and the health of a community. I love all of the people who who came up and talked about community gardens because I do think that is something that we should be looking more into and investing in.

Studies have also come out showing the just putting your hands in in the dirt, how that has a positive impact on a certain portion of some of the hormones that that your body produces. But also as we are looking around and we're and we're seeing some of the significant outbreaks from the fruits and vegetables that we're buying, I know for myself it has made me start growing things at home.

So it is not only healthier in terms of what we'd be bringing into our bodies, but the the actual process of gardening has an impact, a positive impact on one's health and just the entire community bringing people together. And so I really, really appreciate all of those who've lifted up the the idea of us focusing more on community gardens.

Food as medicine is something that I strongly believe in, and one of my colleagues has really been trying to get that through the legislature, more focus, more funding.

Definitely committed to doing that. Again, we've hit roadblocks every time we've tried it, but it's it's important. And it is something that we need to be investing in and understanding that if we wanna reduce a lot of the cost within our health care system in terms of, managing chronic diseases with drugs and and hospitalizations and ER visits and and other things that we really need to focus on the fact that food is medicine.

Food can help prevent a lot of these things, and it can also help treat some of these things once individuals have it. And so I look forward to the continuing conversations, the partnerships, the working on our our school meals, ensuring that that we're able to sustain them in this very, very difficult budget year.

I know as a parent of two children in schools that it is it is something that we utilize and it is something that is extremely important that we, as California, embrace as the only one and as the only state. And it is important not only for the students, but the families and all of the communities that we serve. So I wanna thank you all so much for coming out and participating and look forward to the continued partnership.

If anyone has any further questions, concerns, comments, you can always direct those to my district office here. I have lots of staff here who will wave their hands if you wanna get a card or any questions.

And, Jesse, you can raise your hand in the front. Malaya is back in the green. Moana is in the white, and and Sam is back there waving his hand as well. So thank you all so much for coming, and I hope you have an amazing day.