Access to fresh fruits and vegetables is a significant challenge for households experiencing food insecurity. From February 2020 to February 2021, the number of food insecure households rose from 8.2% to 16.7% in Utah — an increase of 8.5% (Northwestern University U.S. Census Bureau’s Household Pulse Survey Visualization Tool, 2021). Additionally, communities of color and minoritized communities experienced significantly larger increases. As of February 2021, 21.4% of Latino households, 20.6% of Asian households, and a staggering 45% of Black households are experiencing food insecurity in Utah (Northwestern University, 2021). These numbers are often higher with households that have children (Northwestern University, 2021). Federal nutrition programs are a key tool in combating food insecurity and lifting families out of poverty. In 2020, federal programs like the Supplemental Nutrition Assistance Program (SNAP) were increased to account for the sharp rise in food insecurity across the country. In Utah, 26,211 SNAP households received more than $17.5 million in SNAP benefits through the Pandemic EBT Program, with an additional 3,517 households applying for new benefits (UT Dept of Workforce Services, 2021). In addition, the maximum SNAP allotment has been temporarily increased in Utah by 15%, providing more benefit to families that need it the most (UT Dept, 2021). Despite these important changes, many households still lack sufficient access to fresh, healthy, local foods.
The Double Up Food Bucks Program (Double Up) is a national program operated in 28 states that provides a dollar-for-dollar match to SNAP recipients to double the value of purchases made on fresh fruits and vegetables. This program can significantly increase the financial accessibility of fruits and vegetables for SNAP households.
Work on developing this intervention began in 2017 when Department of Health staff from the Utah Comprehensive Cancer Control (CCC) program and Utah Physical Activity, Nutrition, and Obesity (PANO) program collaborated to explore increasing available programming to help food insecure populations access healthy food options. A small non-profit organization, Utahns Against Hunger, had previously operated the Double Up Food Bucks program with a small amount of federal funding in 2015. The program at that time served a small number of clients in only a few areas of the state. Utahns Against Hunger was no longer able to continue operating the program, so Utah CCC staff engaged with them to discuss a strategy for building out a statewide program that could more broadly impact food insecurity. A significant amount of work was undertaken to build partnerships around produce incentive programs in Utah, including outreach to other local advocacy and non-profit organizations; state, county, and local government leaders; state agencies; and private organizations. Through this effort, the Utah Produce Incentive Collaborative (UPIC) was formed to help develop an advocacy strategy and build partnerships with funding organizations to support the SNAP fruit/vegetable incentives. Department of Health staff engaged with local non-profit organizations, as well as banks with community giving arms, to secure over $100,000 in local funding for the first year of offering the Double Up Food Bucks program. During this first year, staff engaged with the legislatively-mandated Utah Local Food Advisory Council (LFAC) to discuss the importance of the State Legislature in supporting local food resources and in establishing the economic value of connecting local farmers to food insecure Utah households. (This one-pager contains the Utah Produce Incentives talking points). Engaging with the LFAC led to securing state funding for the program in year 2 and allowed for us to qualify for federal funding shortly after (Step 1: Engage, Step 2: Scan).
A limiting factor for developing this intervention was the lack of quality consistent food security data in Utah. Staff worked closely with the state SNAP agency to get data on SNAP households and SNAP utilization. Additionally, Utah CCC and PANO staff collaborated to add food security questions1 to the annual BRFSS survey and partnered with universities and the Utah SNAP-Ed Program to gather better data on food insecurity and food access in Utah (Step 3: Assess).
Utah CCC worked closely with UPIC to develop strategies to successfully build out a state-run Double Up Food Bucks program. A policy subgroup was formed to look at political feasibility of ongoing state support for these programs, which is critical to ensure the long-term sustainability of the program. This subgroup included representatives from the American Heart Association, state and local government, farmers markets, and non-profit advocacy groups. The policy subgroup looked at other state approaches for funding Double Up, engaged with other states – such as Arizona – that had previous success, and developed an advocacy strategy to gain legislative support for this program. Additionally, the Double Up Food Bucks program is coordinated nationally by the Fair Food Network (FFN), who became a close ally and partner on this work in Utah. FFN provided information on how other states had implemented these programs, overcome common barriers, and engaged with policy makers in similar political climates (Step 4: Review).
A robust partnership was developed with the state SNAP agency to market and promote this program to SNAP households. This included developing mailers that were sent to all SNAP households in zip codes where Double Up redemption sites exist, informing them of the program and how to utilize it. Additionally, ads were placed in the online SNAP portals informing all SNAP clients of the availability of this program to double purchases on fresh produce. Utah CCC and PANO staff also coordinate closely with local health departments statewide to promote this program to local communities, and to engage with non-participating farmers markets on the value of participating and to help them come on board (Step 5: Promote).
How often in the past 12 months would you say you were worried or stressed about having enough money to buy nutritious meals?
In the past 12 months, how many months did anyone in your household receive benefits from a federal food assistance program such as SNAP (food stamps), WIC, and free and reduced lunch program? Do not include “Meals on Wheels”, or food pantries, food banks, soup kitchens, church welfare, backpack programs, or any other charitable food source.
In the past 12 months, how many months did anyone in your household receive food assistance from any non-federal food source such as “Meals on Wheels,” food pantries, food banks, soup kitchens, church welfare, backpack programs, or any other source.
Steps taken to further this initiative included:
Form the Utah Produce Incentive Collaborative (UPIC) – a group of community, government, and policy stakeholders interested in seeing this program implemented statewide.
Engage with partners to develop an advocacy strategy for legislators and policy makers on the value of connecting local food to Utah families in need. A one-pager was developed for the legislature outlining the three benefits of the program: A win for Utah farmers, a win for Utah families, a win for the Utah economy.
Engage directly with Utah farmers markets to understand their needs and support them in offering SNAP at their markets and onboarding them to Double Up Food Bucks. This includes building relationships with all participating markets each year.
During the 2019 Utah Legislative session, the Utah State Legislature appropriated funding of $400,000 per year to support the Utah Double Up Food Bucks program. This appropriation was the first of its kind in Utah, and allowed Utah CCC staff to apply for and receive a federal Gus Schumacher Nutrition Incentive Program grant through the U.S. Department of Agriculture.
Currently, DUFB is available in nearly half of all counties across the state, with new local farmers markets, farm stands, community supported agriculture programs, and grocery retailers coming on board each year.
The number of customers reached through the program increased 94% between 2019-2020 with the amount of SNAP redeemed increasing between 200%-700% across participating markets.
Success Factors and Key Questions Addressed
Was enough awareness about the PSE change established to ensure successful and seamless implementation? If so, how did you generate awareness?
This program has been successful largely due to the efforts to generate awareness and support from diverse stakeholders. Staff partnered with the Utah SNAP-Ed program through Utah State University, as well as the Farmers Market Promotion Program (FMPP) and Farmers Market Network. These organizations allowed us to interface directly with farmers markets and market managers around the state to inform them of this program, how it can benefit their customers, and how it can bring more money into their markets each year. In addition, we directly reach out to SNAP households through mailers and social media to inform clients of the availability of the program. Finally, we continue to coordinate with Utah Produce Incentive Collaborative and Local Food Advisory Council partners on the ongoing implementation of this program, opportunities for future growth, and any barriers during implementation.
Were stakeholders committed and engaged?
Nearly all stakeholders have been highly engaged and committed to these efforts. Most were previous advocates of Double Up and/or SNAP who recognized the value of these programs in improving client health, access to food, and/or expanding the use of SNAP in Utah.
Additional facilitators of successful stakeholder engagement included:
American Heart Association had recently identified nutrition and healthy food access as an advocacy priority, which facilitated a connection to that organization’s government relations specialist, who helped advocate for funding.
Utah CCC and PANO staff engaged organizations that run farmers markets and would directly benefit from the program and funding. They were a great asset in engaging policy makers, as they were so passionate and able to talk about the economic benefits of these programs. Staff similarly engaged farmers and producers.
Department of Health staff worked with academics whose research focus was food security and local food. The researchers also assisted with project evaluation.
Prior to Double Up, much of the food security work in Utah traditionally happened at the local government or non-profit level and was implemented by smaller entities with more limited resources. These organizations understand the importance of Double Up and also were enthusiastic about a state agency working to develop these programs on a larger scale.
Describe how sufficient resources were secured to ensure successful implementation and sustainability of the PSE change.
Early in the development of this program, funding was a significant challenge. This program matches SNAP purchases for fruits and vegetables, which requires a significant amount of money that can be distributed through participating markets. In addition, significant resources are needed to conduct marketing and awareness campaigns and maintain staff time. In 2017, a small number of staff and partners dedicated to getting this program off the ground reached out to local organizations to raise enough funds to begin operating the program on a small scale with hopes of expanding in the future. We were able to successfully raise money from local non-profit organizations; however, we were most successful reaching out to banks. Many banks are required to contribute funding to the communities they serve through the Community Reinvestment Act. Staff reached out to these banks and were asked to deliver information at board meetings about the program and why banks should contribute. Through this effort, we secured over $100,000 to operate the program during the 2017 and 2018 market years. This funding was critical because it allowed us to show the benefit and value of operating this program in Utah. In 2018, we began to engage with the Utah legislature through the legislatively created Local Food Advisory Council (LFAC), a body tasked with evaluating local food resources and maximizing local food production and consumption. Through the LFAC, our partner coalition was able to secure an ongoing state appropriation for this program in 2019. This funding was significant, not only for operating the program, but also because it was able to serve as matching funds for a federal grant through the USDA. From 2017-2019, the program went from a $0 budget to a budget of over $800,000 per year. As a result, additional staff were hired, and a new program was established at the Utah Department of Health – the Utah Community Food Security Program (CFSP).
How will you continuously engage stakeholders to keep momentum going?
Partners are engaged using a hub and spoke information sharing model. This model includes the Utah Department of Health Community Food Security Program working with local health departments throughout the state to understand this program and distribute information directly to communities. In turn, local health departments work to inform UDOH of stakeholder barriers or concerns to be addressed. Staff also continue to work with local universities and the Farmers Market Promotion Program and Farmers Market Network to engage markets and onboard new markets each year. Each year, SNAP households receive mailers informing them of the availability of the program and how to utilize it in their area. This is the result of a close relationship with the Department of Workforce Services, Utah’s SNAP agency.
What is the next step(s) in your PSE change effort or program to ensure sustainability?
Despite the incredible amount of work over the last four years, this program is still in its infancy. The program is working to develop a more rigorous evaluation plan that includes understanding drivers of program participation, key informant interviews to understand client perceptions, and identifying technological and other innovations to streamline the distribution and redemption of these benefits. In addition, these evaluation results will be compiled into program impact reports that outline what impact this program is having on Utah food insecurity, local food purchasing and consumption, and healthy food access. These results will be communicated to the legislature and UPIC partners.
Currently, staff are working to move the Double Up program into grocery retail settings to enable significantly more Utahns to access this benefit at their local grocery store in addition to famers markets, farm stands, and community supported agriculture programs. This is a significant undertaking that requires close partnership with grocery organizations, as it is necessary for participants to incorporate this program into their point of sale systems, staff training, and corporate workflow. Currently, several grocery chains in Utah are in process of accepting this program. As these programs grow in grocery retail, our goal is to develop a process for grocery stores to match a small percentage of each DUFB transaction to increase reach of the program and serve more of their customers.