Presented at the 142nd Annual APHA Meeting, November 17, 2014 Organizations that Fund or Participate in SNAP-Based Incentive Programs at Farmers Markets: Findings from the USDA Food & Nutrition Service Farmers Market Incentive Program Study Melissa R. King, MSPH, Sujata Dixit-Joshi, PhD, MPH, Keith MacAllum, PhD, and Eric Sean Williams, PhD

Presenter Disclosures Melissa R. King (1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: No relationships to disclose.

Background FNS has facilitated Supplemental Nutrition Assistance Program (SNAP) recipients’ access to farmers markets (FMs) by mitigating barriers introduced by the adoption of SNAP electronic benefits transfer (EBT). Since 2008, there has been a 76% increase in the # of FMs authorized to accept SNAP benefits.1 Non-federal organizations have also contributed to increasing SNAP recipients’ access to healthy foods at FMs. 1USDA AMS, Marketing Services Division National Count of Farmers Market Directory Listing Graph: 1994-2014 (http://www.ams.usda.gov/AMSv1.0)

Background FNS has facilitated Supplemental Nutrition Assistance Program (SNAP) recipients’ access to farmers markets (FMs) by mitigating barriers introduced by the adoption of SNAP electronic benefits transfer (EBT). Since 2008, there has been a 76% increase in the # of FMs authorized to accept SNAP benefits.1 Non-federal organizations have also contributed to increasing SNAP recipients’ access to healthy foods at FMs. 1USDA AMS, Marketing Services Division National Count of Farmers Market Directory Listing Graph: 1994-2014 (http://www.ams.usda.gov/AMSv1.0)

Background Financial and non-financial support has been provided by private, public, and non-profit organizations in support of SNAP-based incentive programs (SBIPs) at FMs. SBIPs at FMs are designed to: Encourage SNAP recipient patronage. Improve the purchasing power of SNAP benefits. Provide dollar per dollar or partial match of SNAP benefits spent at FM for the purpose of buying additional SNAP-eligible products. (usually weekly or daily match ceiling).

Questions addressed today: Who are the organizations supporting SBIPs and why are they involved? Where does the money for SBIPs come from? What is needed for implementing an SBIP? How do organizations perceive SBIP success? What data is available for evaluating the impact of these programs on SNAP recipient shopping behavior at FMs?

Methods: February - June 2013, conducted 141 semi-structured key informant interviews with 103 organizations supporting SBIPs. Typically spoke to the Program Director/Coordinator and/or the Executive Director. Used a referral-based sampling approach that began with 17 initial large and known organizations involved with SBIPs at FMs. Qualitative analysis conducted to aggregate, categorize, and summarize information provided across all interviews.

Who are organizations supporting SBIPs? Findings… Who are organizations supporting SBIPs?

A cluster of relatively small, collaborative organizations who provide specific types of support to a relatively local SBIP. Funders Coordinators Farm Associations Local businesses Non-profits Supporters Foundations Operators Banks Universities Health Departments Extension Services Health Insurance Carriers City Governments Hospitals Municipal Agencies

Can be categorized by their SBIP role: Type of Organization Role in SBIP Cluster N=103 Funders Provide main sources of SBIP financial support. 13 Coordinators Design, implement, and serve as key administrators of the SBIP. 34 Supporters Provide a variety of support services for the SBIP. 29 Operators Implement the SBIP at the local or market level. 27

General Characteristics of SBIP Organizations About half have <10 employees Funder and Coordinator organizations generally had more staff than Supporter and Operator organizations. Most allocate <25% of their overall budget to SBIPs Only 3 allocated >75% of their budget Overwhelming majority provide support at the local or State level. Only 2 reported working at the national level. Their motivation for providing support aligned with their mission  access to nutritious foods,  positive health outcomes, social inequity,  local economy

SBIPs require financial support for a host of activities: $ for the incentive. $ for incentive distribution at the market. Dedicated market-level staff to manage incentives and reconcile accounts at the end of the day Program training and technical assistance with equipment $ for SBIP administration. Efforts to promote the program (marketing, community outreach) Staff to identify partners, select markets, track redemptions, evaluate performance, and contribute to a variety of fundraising efforts.

Characteristics of SBIP Financial Support: Largest portion of financial support is provided by non-profit organizations and foundations. Multiple sources of financial support were critical. Funding often earmarked for a specific aspect of the SBIP (e.g. incentive or purchase and use of equipment). Funder fatigue a common occurrence. Funders often interested in providing $ for program implementation (seed money) but unwilling or unable to provide funds to maintain an ongoing program.

Perceived Factors for Success Funding and Financial Support 1/3 ~2/3 Marketing, Outreach, and Promotion

Defining and Measuring Success Organizations tended to define SBIP success in terms of their mission. General consensus between Funders and Coordinators that a strong measure of SBIP success is  vendors and farmer sales. Supporter organizations reported “repeat customers” as a measure. 56/103 organizations reported having some type of evaluation data available for assessing market-level SBIP performance. Customer surveys commonly cited Many organizations (Coordinators and Supporters) using evaluation data for reports and obtaining more funding.

A Glimpse of Organizational Self-Evaluation Data: 14 organizations shared market-level quantitative data available for evaluating SBIP success (10 Coordinator and 4 Operator). Measures most frequently tracked were total value of incentives and total value of SNAP redemptions. Fewer provided the total # of SNAP transactions (examine trends in average SNAP recipients shopping habits) Only a few had information to determine the average # of visits/SNAP customer (potential measure of impact on creating repeat customers.

Conclusions: Organizations participating in SBIPs are generally fulfilling part of their organizational mission. SBIPs composed of a variety of different types of organizations that each play a critical role. Sustainability of established SBIPs is challenged by the lack of reliable, ongoing funding sources. The quality and extent of data available to assess the impact FM SBIPs are having on SNAP recipient purchases appears to be highly variable among participating organizations.