Food Access, Nutrition And Public Health In The Senate Farm Bill

Written by Kyla Kaplan for FBLE.

The Senate released its draft of the 2018 Farm Bill on Friday, June 8th. This post analyzes how the Senate Farm Bill addresses FBLE’s goals and recommendations from its report, Food Access, Nutrition, and Public Health. The Senate Agriculture Committee moved the Agriculture Improvement Act of 2018 (S. 3042) out of committee on June 13th. The Senate is voting on S. 3042 this week.  

Protecting and Strengthening SNAP

Maintain SNAP’s Ability to Adapt to Changes in the Economic Conditions

The Agriculture Improvement Act of 2018 preserves the Supplemental Nutrition Assistance Program (SNAP) in its current form. By leaving the nation’s key anti-hunger program largely unchanged, SNAP will continue to serve those low-income Americans who are currently eligible to receive benefits. Specifically, in contrast to the farm bill that passed the House last week, S. 3042 would not expandwork requirements for SNAP. Although FBLE recommends eliminating all work requirements that apply to “able-bodied adults without dependents” (ABAWDs) between the ages of 18-49, the Senate bill avoids putting SNAP even further out of reach for those who rely on it.  

FBLE is optimistic that additional provision in the Nutrition title will begin to address disparities between states in the quantity and quality of employment and training programs. The 2014 Farm Bill included SNAP Employment and Training (SNAP E&T) operation requirements for states surrounding job searches for unemployed individuals. The Senate bill will enhance these operations by allowing states to continue using effective SNAP E&T pilots that were authorized in the 2014 Farm Bill. Further, the Senate bill modifies the current SNAP E&T operations. These modifications to the work-related pilot projects are meant to meet the needs of individuals who are seeking work but face barriers to employment such as physical condition and personal situation when applying for a job. The Senate bill provides $185 million in addition funding to serve individuals who are struggling with barriers to employment for each fiscal year from 2019-2020. These programs are meant to assist in combating these barriers, but participation in work programs are not tied to receipt of benefits.

Enhance and Improve SNAP to Address Food Insecurity, Revitalize Local Economies, Improve Access and Efficiency Through Technology, and Remove Ineffective Barriers to Food Access

While S. 3042 makes no cuts to SNAP, neither does it strengthen the program’s ability to meet its core responsibility of providing access to an adequate diet. For example, the bill does not follow FBLE’s recommendation to raise benefit levels, which currently are insufficient to meet beneficiaries diet and health needs.

However, the bill does take some steps toward utilizing technology tools to help SNAP participants. One issue SNAP applicants have is that SNAP is an income-based eligibility program. This leads to many beneficiaries having a difficult time proving their income and receiving their benefits. These challenges often result in people losing benefits, extended cost the government, and other confusion.

However, the S. 3042 takes steps to ease the barriers to entry for SNAP, by promoting cost effective and more efficient tools to verify earned  household or individual income for those receiving SNAP benefits. Further, the Senate bill instructs the USDA to allow Electronic Benefit Transfer (EBT) at farmers’ markets so that  SNAP participants can redeem benefits at multiple locations and support local food options. In its’ current form the current EBT system is often unreliable and is not always available for participants to use, therefore preventing people from getting the food they need.

Improving Public Health and Access to Nutritious Foods

Strengthen Food Assistance Programs that Promote Healthy Choices among SNAP Participants

FBLE supports the Senior Farmers Market Nutrition Program (“SFMNP”), which awards states grants in order to provide vouchers to low-income seniors so that they can purchase foods (fruits, vegetables, honey, and fresh cut herbs) at farmers’ markets, roadside stands, and CSAs. S. 3042 would reauthorize SFMNP with $20.6 million per year in funding. Although the bill does not devote additional resources to the program, the bill would also ease the paperwork and office visit requirements on participants who are seniors or people with disabilities. This aligns with FBLE’s recommendation to strengthen SFMNP by helping to ensure that seniors receive assistance that can improve their access and health.  

FBLE also support the Food Insecurity Nutrition Incentive Program (“FINI”), which is currently a grant program that funds projects that aim to increase the amount of fruits and vegetables SNAP recipients purchase. FINI has been renamed “The Gus Schumacher Food Insecurity Nutrition Incentive Program.” FINI has been successful which led to its reauthorization and increased funding of $50 million per year, which is more than double the $100 million FINI received over the previous five years combined. FINI has also been authorized as a mandatory permanent program. This supports FBLE’s mission to devote additional resources to this program and ensure that low-income households are able to purchase nutritious food.

However, FINI is not everywhere and there needs to be improvements to the information and technology sharing across various FINI projects. FINI is often used as a pharmacy programs in states and is also used on other programs that are straight incentives for fruits and vegetables not tied to the healthcare system in any way directly.

Improve Health Outcomes of Low-Income Individuals Living with Serious Diseases by Establishing a Food is medicine Pilot

In a farm bill first, S. 3042 embraces the concept of “Food is Medicine.” Food is Medicine describes the provision of nutritious food tailored to the medical needs of an individual who lives with one or more health conditions likely to be affected by diet, such as diabetes, heart disease, certain cancers, and HIV.

FBLE’s proposes a Food is Medicine pilot program that supports and evaluates using medically-tailored meals to support the health of low-income individuals living with diseases. The Harvesting Health Pilot Program is a positive initial effort to connect low-income patients with fresh fruits and vegetables. However, this pilot does not provide meals or other types of food, and therefore is too narrow. A recent study found that a 16% net reduction in monthly healthcare spending for individuals receiving home delivery of medically tailored meals.

The Senate bill does not adopt FBLE’s approach, but takes a first step by creating the Harvesting Health Pilot Program, a $4 million program that receives funding each year and will be administered from 2019-2023. Under the program, the Produce Prescription Pilot will provide fresh fruits and vegetables to members through financial/non-financial incentives in order for members to purchase/procure fresh fruits and vegetables.

Eligibility for the program includes nonprofit organizations or state or units of local government. Further these groups are required to partner and involve a Health Care Program (hospitals, FQHC, healthcare provider groups, VA clinic) in the development of their “produce prescription” effort. In order to receive benefits, individuals must be receiving benefits from SNAP, Medicaid, or be a member of a low-income household that suffers from, or risks developing “a diet-related health condition.” There is also a broad requirement for members to provide educational resources on nutrition to members who receive benefits.

Evaluation and administration provides data to support the long term success of Food is Medicine initiatives. FBLE recommends “rigorously evaluation” of any Food is Medicine pilot program, which probably requires an amount greater than the 10% cap on program evaluation allowed by the Harvesting Health pilot.

Looking Ahead

Overall, S. 3042 is a bipartisan effort that rejects the partisan approach taken by the House bill and aligns much more closely to FBLE’s Food Access, Nutrition, and Public Health recommendations. In fact, the bill takes important steps forward by including pilot programs that continue to assist low-income and sick individuals. Moving forward, protecting the scope and scale of the food safety net will be a contentious issue as the Senate bill passes and the farm bill process moves into conference committee, where differences between the House and Senate versions will be negotiated. FBLE will be watching the process closely, so stay tuned.