Streamlining Administrative Processes for Nutrition Incentive Programs

By Michelle Shippy and James Groh

The Supplemental Nutrition Assistance Program (SNAP) is a federal nutrition assistance program that provides low-income individuals and families benefits to purchase eligible food at SNAP-authorized retailers, including farmers’ markets. While the goal for SNAP is to help participants purchase healthier food, the higher cost of fruits and vegetables can make it difficult for participants to afford these foods. Access to fruits and vegetables is important because eating the recommended amount of fruits and vegetables can prevent and manage chronic disease. Nutrition Incentive programs improve access to fruits and vegetables for SNAP participants at various types of food outlets to make fruits and vegetables more affordable. This in turn increases consumption.

In Marion County, IN the nutrition incentive program called Fresh Bucks, began in 2013 at farmers markets. To receive Fresh Bucks, participants present their SNAP/EBT card at farmer market information tables and indicate the amount of benefits they want to use. Participants then receive a dollar-for-dollar match for that amount, up to $20 per day. Both SNAP benefits and incentives were provided to participants in the form of wooden tokens. SNAP tokens can be used on any SNAP eligible food items and the incentives could be used for fresh fruits, vegetables, and herbs.

In 2018, the Marion County Public Health Department inherited the Fresh Bucks program to make improvements and help create sustainable solutions to expand and continue the program. One improvement was the transition of Fresh Bucks incentives from wooden tokens to valid checks that could be deposited/cashed directly by produce vendors. This innovative approach streamlined the incentive process since wooden tokens pose challenges such as inefficient processes to track participant usage, distribution, and liability. Additionally, participants and vendors can easily misplace or lose tokens and tokens circulate without being used. Further, vendor reimbursement can be delayed. This transition only applied to Fresh Bucks incentives and wooden tokens were still used for SNAP.

Transitioning Fresh Bucks incentives from wooden tokens to checks eliminated the administrative burden on market managers to tally incentives and process vendor reimbursements for Fresh Bucks. Additionally, since growers were provided checks directly from participants, they could deposit/cash them as often as they wanted. Distribution data were tracked by market managers who recorded the range of check numbers that participants received while redemption data were collected by Fresh Bucks program administrators who pulled monthly bank reports. Monthly bank statements included the check images and the check numbers of cashed checks with vendor stamp numbers. With the new process, each approved produce vendor was assigned a number and stamp. It was required that each check was stamped which allowed us to identify the vendors that redeemed the checks.

We did experience some limitations such as some checks not being stamped, farmers not depositing checks for a long period of time, and vendors accepting expired checks. However, overall, this process created better quality control and reduced liability since we knew which checks were distributed, redeemed or still needed to be redeemed. We utilized this process for three farmers market seasons. Each new season started at our winter farmers markets in November with expiration dates on the checks ending on December 31st the following year. Additionally, we indicated on the checks that produce vendors had 60 days after the expiration date to deposit the checks. We created tally sheets for the markets to tally the check ranges that were issued for each SNAP transaction and provided training materials and on-site training to all market managers, volunteers, and vendors.

Overall, the transition from tokens to checks was well received by participants and vendors. In the summer of 2022, the program evolved again by introducing an e-incentive platform where incentives are loaded on a Fresh Bucks card. We also joined statewide efforts in building Double Up Indiana as a network of SNAP matching programs across the state. The goal is to provide our expertise and shared experiences to expand e-incentives and uniformed programming across Indiana.

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Article Details
Fresh Bucks: A Process Approach for Improving Supplemental Nutrition Assistance Program (SNAP) Matching Programs at Farmers’ Markets
James M. Groh, MPH, Michelle Shippy, MS, RDN, Jill Bumpus Edwards, MA, and Sandra Cummings, MSW
First published online November 14, 2022
DOI: 10.1177/15248399221112036
Health Promotion Practice

About the Authors

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Michelle Shippy, MS, RDN: Michelle is a Registered Dietitian Nutritionist (RDN) and has worked with the Marion County Public Health Department (MCPHD) for 15 years. Her current position at MCPHD is the Nutrition Incentive Project Director, funded through the Centers for Disease Control and Prevention, Racial and Ethnic Approaches to Community Health (REACH) project. Michelle’s experiences and passion in public health includes food and nutrition program management, improving food environments, and building better systems for equitable access and affordability to nutritious foods. She has made improvements over the years and continues to support the Marion County SNAP matching program, Fresh Bucks, and has also built and expanded the Marion County Produce Prescription (Rx) program by collaborating with healthcare systems, food retailers and stakeholders. She is a part of and has lead food and nutrition committees, coalitions, community of practices and work groups. Building strong partnerships and relationships is core to her personally and professionally.

Education: Michelle received her Bachelor of Science in Dietetics at Western Michigan University, completed her Dietetic Internship at Indiana University, and received her Master of Science with a Public Health concentrate from Indiana State University.

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James Groh is an epidemiologist at the Marion County Public Health Department (MCPHD) in Indianapolis, IN. Initially conducting syndromic surveillance, James now leads the evaluation for a CDC grant called Racial and Ethnic Approaches to Community Health (REACH) which addresses racial inequities in chronic disease through PSE changes. James has also been involved in MCPHD’s COVID-19 response by monitoring schools and LTC facilities as well as serving as the Deputy Planning Section Chief in the ICS. Prior to his current position, James conducted environmental health assessments of Lake Michigan beaches for the City of Racine Health Department and provided data analysis support for a local CBO. Throughout James’ career, he has sought to leverage data to inform public health activities and advance health equity.

Education: James received his Bachelor of Science in Biology at the University of Wisconsin – La Crosse and completed his Master of Public Health from the Joseph J. Zilber School of Public Health at the University of Wisconsin – Milwaukee where he is also currently pursuing his PhD in Epidemiology.