Background: 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.

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 which 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 located in a county with a high level of food insecurity.
Fruit and vegetable vouchers are 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 which 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.

Responsibilities of Department of Health. DOH must:

collaborate with the other state agencies to develop 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: We currently have an obesity problem—we have our first 100 pound kindergartner. Food access and access to quality healthy food is real challenge for low-income households and seniors. This bill is subject to appropriations and there are private foundations that will make the state dollars go farther. It is all about prevention, either we pay for access to healthy food now or we pay for increased health care costs later. Farmers markets have seen a tremendous increase of SNAP participants which is a win-win; a win for the small businesses and a win for families having access to healthy foods, the ability to shop with dignity and connect with their community. At farmers markets, a SNAP recipient's dollars are matched 1:1 which is a great incentive.