Background: Food Insecurity Incentives Program. The Department of Health (DOH) manages the Food Insecurity Incentives Program (FINI). FINI was funded in 2015 by a $5.86 million five-year grant from the United States Department of Agriculture (USDA). The FINI grant period ends March 31, 2020.

FINI incentivizes purchases of fruits and vegetables by participants in the Supplemental Nutrition Assistance Program (SNAP). FINI consists of three components: farmers' market incentives, grocery store incentives, and fruit and vegetable prescriptions. Farmers' market incentives and grocery store incentives provide SNAP participants with matching funds to purchase fruits and vegetables. Fruit and vegetable prescriptions are vouchers provided by health care providers to food-insecure patients for purchasing fruits and vegetables.

SNAP, also referred to in Washington as Basic Food, provides nutrition assistance to low-income individuals. In Washington, the Department of Social and Health Services (DSHS) administers SNAP benefits. Generally, a household must have a monthly income at or below 200 percent of the federal poverty guideline in order to qualify for SNAP. Participating households receive a monthly benefit in the form of electronic debit cards also known as electronic benefit transfer. SNAP benefits are limited to purchasing food items for use at home as well as seeds and plants to produce food.

Women, Infant, and Children Farmers' Market Nutrition Program. The federal Women, Infants, and Children (WIC) Farmers' Market Nutrition Program (FMNP) provides fresh, locally grown fruits and vegetables to participants. Women who are pregnant, breastfeeding, or post-partum and children ages 1 to 5 years are eligible to participate in the WIC FMNP. In Washington, the WIC FMNP is administered by the Department of Health (DOH). Each eligible client receives a $20 benefit for the summer season for purchasing fruits and vegetables at an authorized farmers market.

Summary of Bill: Fruit and Vegetable Incentives Program. The Fruit and Vegetable Incentives Program is administered by DOH. The Fruit and Vegetable Incentives Program includes:

Farmer's market basic food incentives, to provide eligible participants with extra benefits to purchase fruits and vegetables at authorized farmers markets when the participant uses basic food benefits. The incentives are additional funds that may be used to purchase eligible fruits and vegetables as defined by DOH. When authorizing a farmers market, DOH may give preference to a farmers market that accepts or has previously accepted SNAP benefits, has the capacity to accept SNAP, or is located in a county with a high level of food insecurity.
Grocery store basic food incentives, to provide eligible participants with extra benefits to purchase fruits and vegetables at authorized grocery stores that are authorized SNAP retailers, when the participant uses basic food benefits. The incentives are additional funds that may be used to purchase eligible fruits and vegetables as defined by DOH. When approving a grocery store, DOH may give preference to a store that is located in a county with a high level of food insecurity.
Fruit and vegetable vouchers provided by a health care provider, health educator, community health workers, or other health professional to an eligible participant for use at an authorized farmers market or grocery store. The vouchers are cash-value vouchers that may be distributed to a patient who is eligible for basic food and has a qualifying health condition, as defined by DOH, or is food insecure. The voucher may be redeemed at a participating retailer, including an authorized farmers market or grocery store. DOH is to approve participating health care systems and may give preference to systems that have operated fruit and vegetable prescriptions programs, routinely screen patients for food insecurity, have a high percentage of patients who are Medicaid clients, or are located in a county with a high level of food insecurity.

Women, Infant, and Children Farmers' Market Nutrition Program. DOH is to distribute a fruit and vegetable benefit of at least $30 per summer farmers market season to each eligible person in the WIC FMNP, subject to amounts appropriated for this purpose. To the extent federal funds are available, federal funds must be used to pay for this benefit.

Responsibilities of Department of Health. DOH shall:

collaborate with the other state agencies in developing the program, including DSHS and USDA;
provide resources, coordination, and technical assistance to program partners including farmers markets, grocery stores, government agencies, health care systems, and nonprofit organizations for targeted outreach to food insecure populations and for administration of the program;
evaluate the program's effectiveness by collecting information related to fruit and vegetable consumption by participants, levels of food insecurity, and likely impacts on public health outcomes as a result of the program;
submit a progress report to the Governor and the Legislature by July 1, 2021, describing the results of the program and recommending any legislative or programmatic changes to improve effectiveness of program delivery; and
submit by December 1, 2023, a complete program evaluation describing the program's effectiveness and including any additional recommendations for program improvements.

Definitions. For the farmers market and grocery store basic food incentives, an eligible participant means a recipient of basic food benefits, including SNAP and the food assistance program. Food insecure means a state in which consistent access to adequate food is limited by the lack of money and other resources at times during the year.

Staff Summary of Public Testimony: PRO: Fruits and vegetables are an important part of our diet, they help our children succeed. Over 900,000 people in Washington face food insecurity. The average SNAP budget is $4 per day. Given that fruits and vegetables are more expensive than processed food, families are not as likely to purchase them. FINI has been a very successful 3-year federally funded pilot program we want to continue with state dollars when the grant ends. Families like the program due to the increased benefit. Health care likes it as it addresses healthy. Farmers markets and grocery stores like it due to increase in purchasing power. At the farmers markets, fresh bucks allows families to buy food without losing dignity. It is a dollar for dollar match. This bill not only has a positive impact on families, but also to small family farmers. Safeway has implemented this program. For every $7 a SNAP recipient spent on fruits and vegetables, Safeway provided a $5 match. This program was so successful they ran out of their grant money in a year. This program has implemented differently in different parts of the state. There are 15 health care systems and 68 clinic sites using the incentive differently. Harborview is participating and providing this incentive to their mental health patients. The VA is also doing this. DOH will run out of funds before the grant ends in March 2020. Continuing this program with state dollars will allow Washington to be a competitive applicant for any future federal grants down the road. Washington has been a model with its success of the federal FINI program. Charitable relief is great and many organizations help to address food insecurity, like Food Lifeline, but the collective work of such organizations is no match for what the government can accomplish. Charitable organizations provide one meal to SNAP's twelve. This program has great health outcomes; people will eat healthier after the incentive ends as they have created lifetime habits. Participating in SNAP results in lower health costs, so it is a very common sense approach. As for the WIC Farmers Market incentive, there have also been great outcomes as there is a huge connection between mental health, parenting, and health outcomes.