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Policymakers all over the country have used legislation about farmers markets and sugar-sweetened beverages to help curb many of the negative impacts of food environments.

Vaccines are one of the greatest public health achievements of the last century, as well as some of the most powerful and cost-effective tools to prevent disease, disparities, disability, and death among children and adults. The COVID-19 pandemic and the unprecedented development and distribution of the vaccines against the novel coronavirus have generated much focus on state laws related to vaccinations. As state and territorial legislatures prepare to convene in the coming weeks, we can already identify several topics within vaccine law that policymakers across the country will consider.

Policy Trends Shaping Healthy Food and Chronic Disease in 2026 Policy Trends Shaping Healthy Food & Chronic Disease in 2026 Learn about policy trends shaping healthy food and chronic disease in 2026, such as regulating ingredients and modifying SNAP. A growing focus on links between nutrition and public health outcomes is driving legislative efforts across the country, with states actively responding to rising rates and the cost of chronic disease. As state legislatures consider ways to combat chronic diseases, they are also implementing policies aimed at addressing the food environment by introducing and enacting bills that regulate ultra-processed foods (UPFs), adjust SNAP benefits, and improve access to healthy food. Regulating Food Ingredients and Ultra-Processed Foods While efforts to define and regulate UPFs are still in development at the federal level, several states have decided to move forward with legislation targeting the use of specific artificial dyes and chemical preservatives in food products. West Virginia enacted HB 2354, prohibiting the sale or manufacturing of any food containing a list of specified dyes and certain preservatives. Similarly, Vermont is considering H 260, and New York is considering companion bills S 1239/A 1556. These bills aim to ban the manufacture, sale, or distribution of food containing a core group of chemicals (e.g., potassium bromate, propylparaben, and Red 3). Meanwhile, North Carolina introduced HB 440, which would prohibit additional color additives and ban the sale of food products containing nine specific dyes and chemicals. Pennsylvania introduced HB 1134, which focused on warning labels and would require foods with dyes Blue 1, Blue 2, Green 3, Red 40, Yellow 5, or Yellow 6 to include a label that states, “This product contains synthetic colors, which may have an adverse effect on activity and attention in children.” Leg Prospectus-2026 - CD - CA Restricting Ingredients in School Meals While previous years have focused on access to school meals, a growing wave of recent state legislation aims to eliminate UPFs, synthetic dyes, and chemical preservatives from children's diets. Several states have enacted or advanced bans on specific chemical additives in school meals: Utah’s HB 402 and Virginia’s HB 1910 prohibit schools from offering food containing common food dyes (Blue 1, Blue 2, Green 3, Red 3, Red 40, Yellow 5, and Yellow 6) or certain preservatives like potassium bromate and propylparaben. Similarly, Texas enacted SB 314 prohibiting specific additives in free or reduced-price school meals and SB 25, which mandates warning labels and expands state nutrition curriculum. In addition, other jurisdictions have introduced but not passed numerous bills proposing similar restrictions including South Carolina's HB 4339, which would prohibit certain additives in school meals. Modifying SNAP SNAP is the nation's largest federal food assistance program, providing benefits to low-income households. While the program is federally funded and administered by USDA through its Food and Nutrition Service, individual state agencies operate and manage eligibility and distribution. Since SNAP is governed by federal law, states must obtain a USDA waiver to implement changes that deviate from the federal rules. Several states are exploring waivers to limit the use of SNAP funds for purchasing candy and sweetened beverages or soft drinks, with Arkansas (SB 217), Idaho (HB 109), and Texas (SB 379) having passed legislation. Arkansas's new law requires the Department of Human Services to request a waiver to exclude candy and soft drinks, and reapply annually if denied. This dual ban was also the subject of bills introduced in Wyoming (HB 323) and South Carolina (HB 4061). Indiana (HB 1486) considered broader restrictions on “accessory foods,” aiming to prohibit the use of SNAP benefits for items like chips, energy drinks, sweetened beverages, soft drinks, and prepared desserts while New Jersey (A 5697/S 4348) introduced a narrower set of proposed restrictions, focused on soft drinks (including soda and sugary/sweetened beverages). Expanding Detection and Coverage for Chronic Diseases In response to high chronic disease rates — including diabetes, cardiovascular disease, cancer, and respiratory illnesses — states are enacting and proposing legislation focused on treatment coverage, awareness, and prevention. Several states are directly addressing obesity and pre-diabetes by mandating insurance coverage. Colorado (SB 25-048) enacted legislation requiring large group health plans to cover treatment for obesity and pre-diabetes, including medical nutrition therapy and metabolic/bariatric surgery. In Nevada, AB 555 caps patient cost-sharing for a 30-day supply of insulin for people with state-regulated commercial health plans. To aid early detection of diabetes, New Hampshire (SB 102), Louisiana (SB 26), and Florida (SB 958) enacted new laws requiring the creation of informational materials on Type 1 diabetes risk factors, warning signs, and screening available to students and parents. To reduce financial barriers to necessary cancer screenings, several states have enacted bills to mandate insurance coverage and/or lower the cost of diagnostic breast exams and supplemental testing. Virginia (HB 1828), Florida (SB 158), and Oklahoma (HB 1389) have enacted bills to limit or lower the cost of such breast imaging. Meanwhile, Colorado enacted HB 25-296, clarifying that health insurers cover medically necessary diagnostic and supplemental breast imaging that goes beyond routine screening. Looking Ahead ASTHO expects state and territories to continue advancing legislative proposals that focus on the prevention of chronic diseases and access to healthy foods in 2026. Future legislative action may include: Establishing policies to address food insecurity and promote access to nutritional foods by targeting food deserts. Exploring policy and leadership options to discourage the consumption of high-sugar drinks. Developing and adopting standards for healthy food procurement policies for state agencies and public institutions to increase the demand for nutritious products. Continuing to enact insurance coverage mandates for comprehensive chronic disease screenings and treatment. OE22-2203 PHIG article yes

Building a Resilience Framework in Colorado Creating Resilient Communities in Colorado Heather Tomlinson, Kerry Wyss Learn how Colorado public health is building community and cross-sector partnerships to build community resilience. Following the 2012 wildfire season and the 2013 Colorado Floods, Colorado recognized the opportunity to better prepare for natural disasters and coordinate efforts across state agencies to build resilience into their regular operations. In 2015, Colorado became the first state to develop a resilience framework and created the Colorado Resiliency Office (CRO) with the goal of building more resilient systems in the face of shocks and stressors. The Colorado Resiliency Working Group (CRWG) is an interagency group that meets on a quarterly basis to collaboratively implement and advance resilience actions and goals. The Colorado Resilience Framework serves as interagency guidance on strengthening resilience and emphasizes finding co-benefits across community sectors, reducing community risk and vulnerability to disruptions, and supporting the state in anticipating and preparing for current and future conditions. The framework is updated every five years to adapt priorities and to keep up with current conditions. Changes from 2015 to 2020 included a shift from focusing heavily on long-term recovery to taking a more holistic approach to resilience. The CRWG is currently working on the 2025 update with a focus on statewide vulnerability where they can have the most impact and prepare for future conditions with available resources. They are also focusing on clear metrics and being able to communicate progress effectively. The state also created a statutory definition of resilience, which has helped with coordination across long- term projects and agencies. Coordination with Partners Resiliency work in Colorado is greatly enhanced by working with a wide range of partners that bring their subject matter expertise to the table. As a state with strong local control, Colorado has prioritized working collaboratively with local partners, providing technical assistance and subject matter expertise to support their work on the ground, from planning support to targeted grant programs. This collaboration helps ensure continuity from the state to the local communities. Colorado’s approach to resilience ensures resilience is integrated within its many agencies. For example, the Colorado Department of Public Health and Environment (CDPHE) has continued to evolve and advance their agency’s resiliency work. Beginning March 2025, CDPHE developed a monthly internal working group to funnel knowledge into resilience leadership across CDPHE — including environmental health, chronic disease, environmental justice, disease and public health, and air pollution. Their goal is to build partnerships across internal programs and state agencies. The CRO was first established in the Governor's Office and moved to the Department of Local Affairs (DOLA) in 2018. This move strengthened continuity of its long-term work and, given Colorado’s strong local control governance structure, enabled the CRO to further the goals of building a more resilient Colorado by partnering with and supporting local governments with planning and technical assistance to build greater resilience. The CRO offers flexible Future-Ready Technical Assistance Opportunities for state agencies, which helps them apply adaptability and future-visioning lenses to their resiliency principles in programs and operations. To involve the wider network of resilience practitioners within communities across the state, the CRO launched a community of practice on LinkedIn to foster peer-to-peer learning and dialogue and ensure all voices are heard in a collaborative environment. The Governor’s Office of Climate Preparedness and Disaster Recovery (CPO), facilitates cross agency coordination and collaboration while driving proactive state-wide climate preparedness priorities and supports development of the state’s disaster recovery capacity and capabilities. The CPO also coordinates efforts to ensure that the state budget and legislative processes reflect statewide climate preparedness, disaster recovery, and resilience priorities and leads the development of Colorado’s Climate Preparedness Roadmap — a strategic guiding document updated every three years that uses the best available science and data to prioritize near-term climate adaptation actions across Colorado state government. In collaboration with the implementing state agencies, the first Roadmap, released in 2023, set achievable near-term action items ensuring clear steps to strengthen climate resilience and adaptation. Among the actions, the Roadmap outlined the need to tackle extreme heat through a collaborative interagency approach, while better understanding the unique ways that heat affects Colorado. Social and community capacity were also outlined in the framework as a priority. CDPHE has worked with the Governor's Office to evaluate best practices and strategies tailored for each unique region and implemented their first heat plan in 2024. Extreme heat can be deadly and is projected to continue to intensify. CPO takes the lead in coordinating extreme heat work across agencies. They are partnering with the Colorado State Forest Service to pilot solutions such as climate-smart tree planting to help keep people safe during high-heat events by reducing ambient neighborhood temperatures and shading individual homes to lower indoor temperatures and reduce cooling costs for residents. Building Disaster Recovery Capacity Colorado is investing in disaster preparedness and recovery capacity to reduce the impacts of disasters, help communities recover more effectively, and build resilience into recovery efforts. Ensuring strong recoveries allows for the integration of strategic investments in resilience and hazard mitigation, which the state did in partnership with Xcel Energy — in the wake of the Marshall Fire, the state provided financial assistance to rebuild home to high performance standards and integrated wildfire mitigation actions during the rebuild process. In recent years, Colorado has expanded their recovery investments, including the addition of key positions in targeted recovery areas including within CPO, at DOLA within the Division of Housing and within the Division of Local Government, at the Colorado Department of Agriculture, and at the Department of Public Health and Environment. Technical expertise and capacity at the agency level is leveraged to strengthen preparedness and to support recovery from state declared disasters through the Colorado Department of Public Safety's State Recovery Task Force, providing recovery expertise when activated according to their assigned Recovery Support Function (RSF). Colorado partnered with FEMA’s State Technical Assistance for Recovery Strategies Program to develop processes and strategies that can be integrated into the RSF plan updates within the State Emergency Operations Plan, and to refine RSF functions, capabilities, and partnerships. Over the last year, the state has additionally conducted numerous discussion-based exercises to strengthen RSF relationships and operational capability. The state continues to identify and enhance new opportunities in supporting local communities with pre- disaster recovery technical assistance. Examples include: Hosting Department of Public Safety-led regional recovery symposiums. Piloting additional focused recovery workshops that prioritize rural and less resourced communities. Developing and refining disaster recovery planning tools. Offering recovery and resilience toolkits and expertise to local governments led by DOLA. Strengthening integration of disaster considerations into local planning processes. Colorado implemented this work in summer 2025 when the state experienced numerous wildfires in short succession that received state disaster declarations, activation of the State Recovery Task Force, and required close state-local disaster recovery coordination. Ensuring strong recovery capacity and capabilities is critical to long-term resilience, enabling communities to recover more quickly, more completely, and in ways that integrate proactive resilience strategies. A Path Towards Long-Term Sustainability A key element in Colorado’s long-term approach to building resiliency is closely involving the local community. Building robust community planning and response capabilities at the local level allows for agencies to tailor plans to community needs and ensures everyone is engaged in the process. The CRO, in collaboration with state agency partners in the CRWG, developed the Guidance for Local Government Climate Adaptation, which provides comprehensive guidance, funding resources, case studies, and connections to state and federal programs that can provide support in over 25 implementable actions. The CRO has also focused their resiliency work on anticipating what is to come down the road by assessing current and future community needs. An example is the Rural Resiliency and Recovery Roadmap Program, which brought together 16 different regional community teams with over 150 rural jurisdictions and non-governmental partners to support diversifying and strengthening their economies while building regional resiliency following the COVID-19 pandemic. Each regional team developed a roadmap that evaluates local stressors and how conditions may change in the future. This program also looks at what may impact the community from perspectives of housing availability, workforce, and potential resiliency stressors. Another example is the Camp Resilience: A Rural Prosperity Leadership Academy program, which offers a summer camp themed workshop to build rural community capacity to long-term stressors such as droughts, population loss, climate change, and lack of affordable housing. While funding cycle ebbs and flows

While COVID-19 is still present and ever-changing, public health professionals must also grapple with new challenges such as monkeypox, increasing firearm homicide, and widespread heat waves. In the wake of such emergencies, public health preparedness is more critical than ever.

The ASTHO State Health Policy team provides brief updates on 5 of the ten state health policy issues to watch in 2022: mental and behavioral health, rural health, e-cigarettes and flavored tobacco products, HIV and PFAS.

ASTHO’s 2024 Legislative Session Update: Part One legislative session, state policy, data collection, domestic violence, health information exchange, data privacy, substance misuse, overdose prevention, sexually transmitted infections, reproductive health, contraceptive care, climate change, public health, protect data, user data, personal data, centers for disease control, disease control and prevention, social media, data management, primary care, health organizations, higher risk, family planning, data sources, astho, association of state and territorial health officials Lillian Colasurdo, Maggie Davis, Lana McKinney, JoAnne McClure This past December, ASTHO announced the top 10 public health state policy issues to watch for during the 2024 state and territorial legislative sessions. With at least 30 states concluding their regularly scheduled 2024 sessions, here is a brief update on five of the topics to watch. Data Collection and Exchange As expected, there was an increase in proposed legislation that specifically advances electronic health data access, encourages interoperability, and safeguards identifiable patient health records; this was particularly true for vital records. Hundreds of bills have been introduced this session addressing state vital records systems. The state of Illinois alone has already passed several bills, including HB 2856, which requires veteran status to be designated on death certificates, and HB 2841, which prohibits the assessment of fees to victims of domestic violence who are seeking a certified vital record (birth or death certificate) from the state. Other states such as Arizona (SB 1252) considered legislation that would require the Department of Health to provide vital records information on deceased individuals to the qualifying health information exchange (HIE). Arizona is one of eight jurisdictions (AZ, FL, IA, IL, NH, NJ, OK, and WV) that have proposed legislation addressing HIEs this session. Most of these bills increase requirements to connect to HIEs, but New Hampshire HB 1663 and Oklahoma HB 3556 would allow patients and health care providers to opt out of HIEs. As many states look to address health data privacy concerns, New Hampshire recently passed a constitutional amendment granting the explicit right to privacy and has introduced HB 1663, which would update many of the state’s privacy laws regarding medical records to conform with the constitutional requirements. Just next door, Maine considered legislation (LD 1902) that would strengthen privacy requirements for reproductive and gender-affirming patient health information. Finally, the launch of the new federal Trusted Exchange Framework and Common Agreement (TEFCA) led to the Florida legislature proposing SB 668, which, had it passed, would have required hospitals to make patient records available through a nationally recognized trusted exchange framework. It would also have required the Agency for Health Care Administration to adopt relevant rules. Substance Misuse and Overdose Prevention Measures to prevent substance misuse and reduce overdoses, namely increasing access to opioid antagonists, such as naloxone and regulating substances with the potential for misuse, are priorities this legislative season. ASTHO anticipated that states would consider legislation to reduce fatal overdoses including decriminalizing drug checking equipment, expanding naloxone access and distribution, establishing overdose prevention centers, and establishing state regulatory frameworks for commercial substances with the potential for misuse, including kratom and Delta-8. Current legislative priorities to expand access to naloxone include public spaces, such as libraries, schools, workplaces. Island jurisdictions along with at least four states—Colorado (HB 24-1003), Tennessee (SB 2141), Virginia (HB 732), and Wisconsin (AB 223)—passed legislation to provide greater access to and/or proper storage of naloxone in school settings. Additionally, Virginia passed HB 342 that requires naloxone access in state agency buildings. These legislative actions, along with the approval last year by the FDA of two non-prescription naloxone spray products for over-the-counter use, are collectively powerful policy shifts to expand access to naloxone. In an attempt to regulate substances with the potential for abuse or misuse, specifically kratom, eight states have considered legislation that would restrict the sale to people under the age of 18. Similarly, twelve states have considered legislation that would restrict the sale of kratom to those under the age of 21. At least 22 states have considered legislation that would compel specific labeling requirements for kratom. Of those, California (AB 2365) and New Jersey (A 1188) would require kratom products to be registered with the state health department annually and require lab testing of the product to meet certain qualifications. Preventing Sexually Transmitted Infections ASTHO has spotlighted the growing concerns of rising rates of sexually transmitted infections and state actions reducing congenital syphilis rates and expanding access to HIV prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Rates of both syphilis and congenital syphilis continue to rise at an alarming rate, with more than 10 times as many babies being born with syphilis in 2022 than in 2012. Routine screening and timely and adequate treatment of pregnant people for syphilis, ideally more than 30 days before delivery, can effectively prevent this condition in newborns. Due to increasing cases, the American College of Obstetricians and Gynecologists recently updated their guidance for obstetrician–gynecologists and other obstetric care professionals advising serological screening for all pregnant individuals at the first prenatal visit and universal screening at the third trimester and at birth. During the 2024 legislative session at least two states—Missouri (SB 1260) and Maryland (HB 119)—are considering legislation that would require testing during pregnancy care at the third trimester for syphilis. Maryland’s legislature passed HB 119, which would require screening at the third trimester and at birth, as well as requiring the hospital to determine the syphilis status of the birthing parent before discharging the newborn. In 2023, New York enacted legislation (A 3007) that requires syphilis screening in the third trimester, and in the current legislative session they are considering S 2472, which would allow the state health department to provide education about congenital syphilis and screenings. At least six states have considered and passed legislation during the 2024 legislative session regarding expanded access for HIV prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Of those considered, Georgia enacted HB 1028 to allow PEP to be issued by a standing order; Florida’s legislature passed HB 159 that would allow pharmacists to screen for HIV exposure, order, and dispense prevention drugs PEP and PrEP and sent it to the governor. Similarly, in Delaware the Senate chamber passed SB 194 that would permit pharmacists to provide PrEP and PEP pursuant to an approved protocol. Family and Reproductive Health Policymakers across all levels of government continued taking steps to make it easier for people to access contraceptives. In 2023, at least 14 states enacted laws in 2023 to facilitate expanding access to contraceptive care by either expanding the ability for pharmacists to dispense birth control without an individualized prescription and/or allowing pharmacists to dispense up to 12 months of contraceptives at once. So far in 2024, at least 13 jurisdictions considered legislation allowing pharmacists to dispense contraceptives without a prescription and at least 18 states considered legislation supporting access to 12 month supply of contraceptives. Following FDA’s July 2023 approval of Opill—the first over-the-counter (OTC) birth control pill—the drug is currently available in stores with several major pharmacies and health plans announcing that they will provide the medication at zero cost for many health plan sponsors. To further support access to Opill, at least two states (New Mexico and Wisconsin) issued standing orders for Opill to facilitate Medicaid coverage of the medication. Additionally, Maryland’s legislature passed SB 527 in March 2024, which requires community colleges to develop and implement a plan to provide students access to OTC contraception. In February 2024, New York enacted S 8096 allowing the commissioner of health to issue a standing order allowing a pharmacist to dispense self-administered hormonal contraceptives, effective retroactively to January 1, 2024. Under the new law, New York’s Commissioner of Health issued a standing order to allow pharmacists to dispense up to 12 months of self-administered hormonal contraceptives like birth control pills, vaginal rings, and contraceptive patches. Optimal Health for All ASTHO anticipates policymakers will take steps to improve collection of health disparities data, address inequities rural communities face in accessing care, and to support climate change adaptation planning efforts. So far in the 2024 legislative session, several states are considering bills to improve health care access and outcomes in rural areas. California is considering legislation (SB 945) that would build an integrated data dashboard to provide the public with information on the health impacts caused by wildfires and the effectiveness of forest health and wildfire mitigation on health outcomes. Additionally, California (AB 2342) is looking to ensure critical access hospitals on remote islands receive adequate funding through a dedicated annual supplement. New York is considering at least two bills that would promote rural health care access. First, New York S 8582 would create a pilot program to identify rural health zones and convene a rural health zone board

Food System Resilience: A Planning Guide for State Governments Food System Resilience: A Planning Guide for State Governments Heather Tomlinson, Shihui Yang This adapted guide provides actionable strategies to support food systems in times of natural disasters and other disruptions. Environmental and human-made disasters and even seasonal changes affect people and the functioning of food systems. These shocks and stressors to food systems can be acute events such as extreme weather phenomena (hurricanes, earthquakes, etc.) or long-term political, economic, and/or environmental disruptions, during which food is not accessible, available, or acceptable. While these factors can impact everyone, those with the most vulnerabilities and who are the most marginalized are at the greatest risk. State governments around the United States are taking action to prepare for and prevent the consequences of these disruptions on their food systems, but there is limited guidance available to support states in this work. This planning guide provides actionable tools for developing strategies to create and support resilient food systems. This guide is an abridged adaption of the Food System Resilience: A Planning Guide for Local Governments, developed by the Johns Hopkins Center for a Livable Future and Bloomberg Center for Government Excellence with a local government community of practice. ASTHO has tailored this version to state governments. For more information on a specific topic, please refer to the local guide for additional context. Get the Report (PDF) article yes

This report contains lessons learned and examples of messaging strategies that were successful during cyanobacterial bloom responses, they were collected from 17 state health agency staff members across 12 states.

State Policies Aim to Eliminate Food Deserts Beth Giambrone Learn how states are working to improve access to healthy foods and eliminate food deserts in this Health Policy Update. The environment where we live, work, and play can shape eating habits and make healthy eating difficult. This is especially true when nutritious foods are costly and unavailable and unhealthy foods are abundant and accessible. More than 47 million people nationwide live in food insecure households, including more than 7 million children. In addition, more than 27 million people live in "food deserts," generally defined as areas where residents do not have a convenient option for affordable, healthy food, like a supermarket or large grocery store. People who live in food deserts may be at higher risk of obesity and chronic disease. Furthermore, children and young adults who live in food insecure households are more likely to have poor academic outcomes. Increasing Access to Healthy Foods In recent years, jurisdictions have taken a multi-layered approach to increasing access to healthy foods. In 2023, the Texas legislature enacted HB 3323, which established a food system security and resiliency planning council, and requires a food system security plan for reasonably-priced food to ensure public health and welfare, economic development, the protection of the state’s agricultural resources, and includes legislative recommendations to facilitate the availability of food in the state. In 2024, Delaware enacted SB 254, establishing the Delaware Grocery Initiative to expand access to healthy foods in the state’s food deserts and areas at risk of becoming food deserts. The bill authorizes the state’s Division of Small Business to award grants and financial assistance to entities that provide or support affordable, accessible, or healthy food, including food banks and pantries, supermarkets, and corner stores. It also directs the Delaware Council on Farm & Food Policy to develop a strategy to address food insecurity in communities throughout the state and issue a report by June 1, 2025. Also in 2024, Colorado enacted HB 24-1416, codifying an incentive program designed to increase access to fresh fruits and vegetables in low-income communities. In 2024, jurisdictions also enacted legislation that makes supplemental nutritional assistance more accessible. California (AB 2786) requires the Department of Food and Agriculture to allow newly created certified mobile farmers’ markets to participate in the Women, Infants, and Children Program (WIC) Farmers’ Market Nutrition Program, if approved by USDA. Connecticut (HB 5003) requires the Department of Agriculture to purchase and make needed equipment available so certain nutrition program participants can make purchases at farmers’ markets. And Pennsylvania (SB 721) established a permanent Women, Infants, and Children State Advisory Board to advise the Department of Health on solutions to increase participation in the WIC program, including increasing access to WIC-authorized stores for participants. Jurisdictions also enacted legislation ensuring students receive healthy school meals through farm-to-school programs. New Hampshire HB 1678 created a pilot program that incentivizes school districts to buy food for school meals that come from local farms and producers. Virginia HB 830/SB 314 established a Farm to School Program Task Force within the Department of Education to increase farm-to-school school programs within the state, including programs where public schools purchase and feature locally produced food prominently in school meals and learning opportunities related to local food and agriculture. Ensuring Students are Fed At the beginning of the 2023-2024 school year, eight states, including California, Colorado, Maine Massachusetts, Michigan, Minnesota, New Mexico, and Vermont, provided free school meals to all public-school students regardless of income. In 2023, Illinois (HB 2471) and Washington (HB 1238) also enacted legislation to provide universal free school meals or expand access to free school meals for public school students. The programs in both states are subject to funding. In 2024, at least two jurisdictions enacted legislation to study and report on the cost and impact of providing free breakfast and lunch to all public-school students. Maryland (SB 579) required the Department of Education to submit a report on the cost of providing free meals to all public school students by December 1, 2024, while Virginia (SB 283) directed the Superintendent of Public Instruction to explore the impact of offering free school meals to all students and identify options to eliminate student and school meal debt and leverage federal and state programs to provide school meals. Virginia’s report was published in November 2024 and, while noting the significant costs and sustainability concerns associated with free school meals for all students, it included several strategies for maximizing existing meal programs in the state. A number of jurisdictions have also expanded eligibility requirements or updated student meal program policies in recent legislative sessions. Two states enacted legislation requiring all public schools to provide a free breakfast and lunch to students who qualify for a reduced-price meal under the Federal School Breakfast Program and Federal School Lunch Program: Louisiana in 2023 (HB 282) and Delaware in 2024 (HB 125). New Jersey (A5684) took a similar approach and also expanded state-based income eligibility criteria to allow more students to receive free meals at school. In 2023, North Dakota (HB 1494) enacted a law requiring schools participating in the federal school lunch program to adopt and publish a school meals policy that prohibits schools from taking action against students who lack funds or have unpaid meal balances, such as taking away a student’s food if they have already been served, requiring the student to work to pay off the debt, or limiting participation in school activities due to an unpaid balance. Several states also enacted legislation to benefit students during the non-school months through summer food programs. In 2023, Maine enacted LD 947, which requires summer food service program rules to allow for maximum flexibility under federal law for mealtimes and packaging of meals to send home with students. That same year, as part of a broader piece of human services legislation, California (AB 120) required the State Department of Social Services to maximize participation in the Summer EBT program, which provides funding to families with school-aged children to buy groceries during the summer. And in 2024, Hawaii (HB 2430) and New Hampshire (SB 499) enacted legislation authorizing participation in the Summer EBT program. ASTHO will continue to monitor and report on this important issue. article yes

Learn how federal and state policies are lessening the presence and negative health effects of PFAS in water and consumer products.