Detailed Information on the
Senior and Woman, Infants, and Children Farmers' Market Programs Assessment

Establishing and implementing monitoring and reporting requirements for the Senior Farmers' Market Nutrition Program.

Measure: Number of outlets (farmers' markets and farm stands) authorized to accept FMNP benefits

Explanation:Trends indicate changes in program access (ability of clients to redeem benefits)

Measure: Average FMNP benefit redemption rate

Explanation:Represents program's rate of effectiveness in converting benefits into food received by clients through direct agriculture marketing outlets. Various factors impact redemption rates, including weather, crop production, market accessibility and the coupon reimbursement process.

Measure: Number of outlets (farmers' markets, farm stands, and community-supported agriculture programs) authorized to accept SFMNP benefits

Explanation:Trends indicate changes in program access (ability of clients to redeem benefits)

Measure: Average SFMNP coupon redemption rate

Explanation:Represents program's rate of effectiveness in converting benefits into food received by clients through direct agriculture marketing outlets. Various factors impact redemption rates, including weather, crop production, market accessibility and the coupon reimbursement process.

Is the program purpose clear?

Explanation: The purpose of the WIC Farmers' Market Nutrition Program (FMNP) is to provide fresh, nutritious, unprepared, locally grown fruits and vegetables to participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and to expand the awareness, use of and sales at farmers' markets. The purposes of the Senior Farmers' Market Nutrition Program, as set forth in Public Law 107-171 (the 2002 Farm Bill), are to: (1) provide resources in the form of fresh, nutritious, unprepared, locally grown fruits, vegetables, and herbs from farmers' markets, roadside stands and community supported agriculture programs to low-income seniors, (2) increase the domestic consumption of agricultural commodities by expanding or aiding in the expansion of domestic farmers' markets, roadside stands, and community support agriculture programs, and (3) develop or aid in the development of new and additional farmers' markets, roadside stands, and community supported agriculture programs.

Evidence: FMNP Regulations at 7 CFR Part 248; Farm Security and Rural Investment Act of 2002.

Does the program address a specific and existing problem, interest, or need?

Explanation: Approximately 30% of the adult population are obese. Similarly, since 1980 the percentage of children who are overweight and obese has doubled from 7% to 15%, increasing the number of years they are exposed to the health risks of obesity. The consumption of fruits and vegetables can help lmaintain a healthy diet and reduce the risk of obesity and overweight. Fewer than one in five WIC children consume the recommended quantity of vegetables each day; fewer than half consume the recommended quantity of fruits. Fruits and vegetables consumption is an important component in preventing, managing and treating the leading causes of mortality and morbidity in older adults, which include heart disease, cancer, stroke, and diabetes. Fewer than one-third of elderly males and fewer than half of elderly females consume the recommended quantitities of vegetables each day. Fewer than one quarter of elderly males and fewer than 40% of elderly females consume the recommended quantities of fruits each day. Low-income is associated with lower than average intakes for both kinds of foods in each group. Farmers' markets can help promote the appeal of fruits and vegetables, provide additional access to fresh produce, and provide a market for small farm operators (with less than $250,000 in annual receipts).

Evidence: U.S. Department of Health and Human Services; Centers for Disease Control and Prevention; National Cancer Institute, Five a Day Program; Institute of Medicine: The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population (2000). American Dietetic Association Nutrition Screening Initiative (NSI) on Fitness and Nutrition: The Prescription for Healthy Aging - Testimony to the Senate Special Committee on Aging, March 11, 2003; U.S. DHHS-NIH National Institute on Aging; U.S. Administration on Aging.

Is the program designed so that it is not redundant or duplicative of any other Federal, state, local or private effort?

Explanation: While the farmers' market programs are designed to create incentives for participants to seek out fresh produce in venues that highlight its appeal, they overlap with the major nutrition programs in certain ways: ?? They overlap with the Food Stamp Program which provides electronic benefits to purchase food, including fresh produce, for use at home. Most food stamp benefits are redeemed throgh retail stores. However, in FY2005, about 2,100 FSP-authorized retailers who characterized themselves as farmers' markets, collectively redeemed about $42 million in FSP benefits. ?? While the WIC FMNP is specifically designed to complement the WIC program, the overlap between the two programs will increase substantially when the new food package is implemented in FY2007. Similarly, USDA's Agricultural Marketing Service (AMS) conducts a range of activities to promote farmers/ markets and other direct-to-consumer marketing activities. AMS is implementing a Farmer Direct Marketing Action Plan, including a range of activities designed to help small resource farmers, especially women-owned and/or minority-owned farms, improve access to markets. AMS also provides Farmers' Market Promotion Grants to assist in the development of new farmers' markets.

Evidence: Section 17 of the Child Nutrition Act of 1966; FMNP Regulations at 7 CFR Part 248. SFMNPP Federal Register Notice (November 2000) 65 FR 65825, 11/2/2000 Public Law 107-171 (the Farm Bill) AMS's Farmer Direct Marketing Action Plan is on the AMS web site at http://www.ams.usda.gov/directmarketing/frmplan.htm. A press release on the most recent Provision of Farmers Market Promotion Grant announcement can be found at: http://www.usda.gov/wps/portal/!ut/p/_s.7_0_A/7_0_1RD?printable=true&contentidonly=true&contentid=2006/03/0087.xml

Is the program design free of major flaws that would limit the program's effectiveness or efficiency?

Explanation: The extremely low value of the benefits provided in the farmers' market programs severely limits their ability to improve the diets of program participants. WIC FMNP provides farmers' market vouchers worth $19 on average per person per year. SFMNP provides vouchers worth $35 on average per person per year. By contrast, the FSP and WIC programs provide larger benefits which can be used at retail outlets for greater flexibility and accessibility. In addition, because of the small size of the farmers' market programs, their fixed administrative costs represent a relatively large proportion of total program funding, limiting the programs' efficiency.

Evidence: Section 17 of the Child Nutrition Act of 1966; FMNP Regulations at 7 CFR Part 248. For the FMNP and SFMNP, all State agencies must agree to comply with the following USDA regulations and Office of Management and Budget (OMB) circulars: * 7 CFR Part 3015: Uniform Federal Assistance Regulations; * 7 CFR Part 3016: Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments (Reference OMB Circular A-102 Common Rule); * 7 CFR Part 3017: Subparts A-E Government-wide Debarment and Suspension (Non-procurement); * 7 CFR Part 3017: Subpart F Government-wide Requirements for Drug-free Workplace (Grants); and, * 7 CFR Part 3018: New Restrictions on Lobbying.

Is the program design effectively targeted so that resources will address the program's purpose directly and will reach intended beneficiaries?

Explanation: WIC FMNP is available only to WIC participants, all of whom must meet residency, income, and nutritional risk requirements, as well as categorical requirements (i.e. being pregnant, postpartum, or breastfeeding woman, or a child under the age of five). Two major types of nutritional risk are recognized for WIC eligibility: 1) medically-based risks such as anemia, underweight, maternal age, history of pregnancy complications, or poor pregnancy outcomes and 2) diet-based risks such as inadequate dietary pattern. Nutritional risk is determined by a health professional such as a physician, nutritionist, or nurse, and is based on Federal guidelines. Participants must have annual income less than or equal to 185% of poverty or must participate in or have a family member who participates in certain other benefit programs, such as Food Stamps, Medicaid, or Temporary Assistance for Needy Families. SFMNP: Low-income seniors, generally defined as individuals who are at least 60 years old and who have household incomes of not more than 185% of the federal poverty income guidelines are the targeted recipients of SFMNP benefits. Some State agencies accept proof of participation or enrollment in another means-tested program, such as the Commodity Supplemental Food Program or the Food Stamp Program, for SFMNP eligibility.

Evidence: Section 17 of the Child Nutrition Act of 1966; FMNP Regulations at 7 CFR Part 248 SFMNP: FNS-529, Grant/Cooperative Agreement and SF-424, Application for Federal Assistance

Does the program have a limited number of specific long-term performance measures that focus on outcomes and meaningfully reflect the purpose of the program?

Explanation: The WIC FMNP and the SFMNP do not have long-term performance measures that focus on outcomes and meaningfully reflect the purpose of the program. Across all its nutrition programs, USDA uses measures of the prevalence of very low food security, and dietary quality as reflected by USDA's Healthy Eating Index, for children and low-income people, to track the overall outcomes to which nutrition assistance programs are intended to contribute. Because of the small scope and low level of benefits provided by the farmers' market programs, their impact on the cross-cutting measures is negligible. The agency has proposed to implement new performance measures in each farmers' market program to increase the number of outlets authorized to accept program coupons and to increase the average coupon redemption rate. While these measures can track accessibility and efficiency of the program, they are not sufficient to meet the PART guidance.

Evidence: USDA Strategic Plan 2005-2010; USDA internal planning documents.

Does the program have ambitious targets and timeframes for its long-term measures?

Explanation: The WIC FMNP and the SFMNP do not have long-term performance measures that focus on outcomes and meaningfully reflect the purpose of the program. USDA has set quantitative targets reflecting meaningful improvements in program results for Federal nutrition assistance in the aggregate. However, because of the small scope and low level of benefits provided by the farmers' market programs, the impact of the programs on USDA's cross-cutting nutrition assistance outcome measures is negligible.

Evidence: USDA internal planning documents.

Does the program have a limited number of specific annual performance measures that can demonstrate progress toward achieving the program's long-term goals?

Explanation: The WIC FMNP and the SFMNP do not have annual performance measures that can demonstrate progress towards achieving the program's long-term goals. USDA has established new measures of program access and efficiency. * USDA will increase the number of farmers authorized to accept benefits from each program to increase program access. * USDA will increase the average benefit coupon redemption rate to improve the efficiency of WIC FMNP operations, including market accessibility and the coupon reimbursement process. USDA will begin setting targets and collecting data on this measure in the SFMNP as well.

Evidence: USDA internal planning documents.

Does the program have baselines and ambitious targets for its annual measures?

Explanation: The WIC FMNP and the SFMNP do not have annual performance measures that can demonstrate progress towards achieving the program's long-term goals.

Evidence: USDA internal planning documents.

Do all partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) commit to and work toward the annual and/or long-term goals of the program?

Explanation: The WIC FMNP and the SFMNP do not have annual or long-term performance measures that focus on outcomes and meaningfully reflect the purpose of the program.

Evidence:

Are independent evaluations of sufficient scope and quality conducted on a regular basis or as needed to support program improvements and evaluate effectiveness and relevance to the problem, interest, or need?

Explanation: Independent evaluations are not conducted on a regular enough basis nor are they of sufficient scope to improve program planning. Two studies examined nutrition-related impacts of FMNP in the early 1990's, but both had methodological problems. One study found that participants ate more fresh fruits and vegetables and one found no effect.

Evidence: Fox, M. (ed.) Effects of Food Assistance and Nutrition Programs on Nutrition and Health: Volume 4, Executive Summary of the Literature Review (2004)USDA, ERS; Anliker et al., 1992. "Evaluation of the Connecticut Farmers; Market Coupon Program," Journal of Nutrition Education 24(4):185-91;' Galfond et al. 1991. Evaluation of the Farmers Market Coupon Demonstration Project. USDA/FNS; The Seniors Farmers' Market Nutrition Pilot Program - A Preliminary Assessment. USDA/ERS, 529 Grant Agreement SFMNP.

Are Budget requests explicitly tied to accomplishment of the annual and long-term performance goals, and are the resource needs presented in a complete and transparent manner in the program's budget?

Explanation: FNS' budget request displays resources for the farmers' market programs and other programs in alignment with long-term USDA strategic goals, and fully accounts for all resources by providing full cost by strategic goal which includes all administrative expenses allocated to program accounts. However, the budget does not explicitly tie the farmers' market programs budget requests to the accomplishment of or improvement in annual or long-term performance goals.

Evidence: FNS FY 2007 budget submission. USDA Strategic Goal 5: Improve the Nation's Nutrition and Health and its related objectives: 5.1-The Reduction and Prevention of Hunger by Improved Access to Federal Nutrition Assistance Programs and Strategic Goal and 5.2-Eating Habits More Consistent with the Dietary Guidelines for Americans.

Has the program taken meaningful steps to correct its strategic planning deficiencies?

Explanation: USDA has not established outcome- and output-oriented performance measures for the farmers' market programs.

Evidence:

Does the agency regularly collect timely and credible performance information, including information from key program partners, and use it to manage the program and improve performance?

Explanation: FNS collects participation and expenditure data from grantees in both farmers' market programs. However, it is unclear how these data are used to manage the program and improve performance. FMNP State agencies are required to report participation and expenditure data on an annual basis. For SFMNP, financial and program progress reports are submitted biannually by each grantee. These reports are used by FNS to track expenditures and to identify problems in program operations that may need to be addressed. The SFMNP Proposed Rule (70 FR 30558, 5/26/2005) would require State agencies to implement reporting and monitoring activities related to SFMNP operations. Such provisions will become effective after publication of the final SFMNP rule for FY 2007. FNS regional offices perform management evaluations of FNS programs, in which aspects of program management and performance are examined and corrective actions are recommended for improvement. However, because of the small size of the farmers market programs, management evaluations of these programs are done relatively infrequently (less than once every four years.)

Evidence: FMNP regulations at 7 CFR Part 248; FNS-529, Grant Agreement (for SFMNP).

Are Federal managers and program partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) held accountable for cost, schedule and performance results?

Explanation: FMNP State agencies submit annual plans, outlining how they will administer the program during the coming year. These plans represent their commitment to administer the program according to basic regulatory requirements and goals. They are held accountable through regular monitoring of financial reports, along with management evaluations on an infrequent basis. When SFMNP regulations are implemented, that program will use similar processes. Senior FNS managers' performance contracts include explicit reference to FMNP/SFMNP when significant policy or program changes are planned.

Evidence: FMNP regulations at 7 CFR Part 248; FNS-529, Grant Agreement (for SFMNP).

Are funds (Federal and partners') obligated in a timely manner, spent for the intended purpose and accurately reported?

Explanation: The farmers' market programs receive appropriated funds that remain available for two years. In FY 2004 and 2005, states obligated 77 and 86 percent of the funds respectively in the first year. In every year but one, 100 percent of the funds have been fully obligated over two years. In both farmers' market programs, State agencies submit annual financial reports showing total expenditures for the program and, in the case of WIC FMNP, expenditures for food and administrative costs. While this data is self-reported by the State agencies, USDA reviews the report for overall consistency with annual program reports indicating numbers of people served, the value of benefits provided, and the number of participating farmers and farmers markets.

Evidence: In WIC FMNP, states annually report on the FNS-683 the allocation of grant funds for food and administrative funds. The FNS-683 also provides information on the gross outlays, the recipients' share of net outlays and the amount of Federal funds to be recovered and returned to FNS. States annually report program data on the FNS-203, including data on the different categories of recipients that receive benefits, the number of participating farmers, farmers' markets and roadside stands, the total value of coupons issued (Federal and non-Federal), and the total value of coupons redeemed (Federal and non-Federal funding). States also submit annual plans indicating the number of participants they intend to serve, the number of farmers, farmers' markets and roadside stands that will participate, and the amount of Federal funding requested to administer the program. Each SFMNP grantee is required to submit annually financial and progress reports. The financial reports are submitted on the SF-269A and indicate the Federal SFMNP grant, funds that have been obligated, and funds that have been expended. The progress reports include the number of SFMNP participants, the per-participant SFMNP benefit amount, the number of farmers authorized to accept SFMNP coupons or other benefits (in the case of community supported agriculture (CSA) program models), the number of authorized SFMNP outlets, and any problems or challenges encountered as well as steps that were taken to address/resolve them.

Does the program have procedures (e.g. competitive sourcing/cost comparisons, IT improvements, appropriate incentives) to measure and achieve efficiencies and cost effectiveness in program execution?

Explanation: FNS has proposed to implement new efficiency measures in each of the farmers' market programs. In both programs, the goal is to increase the average coupon redemption rate. The coupon redemption rate is affected by various factors including participant demand, weather, crop production, market accessibility and the coupon reimbursement process. A higher redemption rate means that more people actually use the farmers' market coupons for the same level of administrative resources. Currently, baseline and targets are available for the WIC FMNP, but under development for SFMNP.

Evidence: Section 17 of the Child Nutrition Act of 1966; FMNP regulations at 7 CFR Part 248; Reports from SFMNP State agencies.

Does the program collaborate and coordinate effectively with related programs?

Explanation: FMNP regulations specify that the Chief Executive Officer of a State shall ensure coordination between the designated administering State agency and the WIC State agency, if different, by ensuring that the two agencies enter into a written agreement. In addition, Cooperative Extension Programs, local chefs, farmers or farmers' markets associations, and various other non-profit or for-profit organizations may provide nutrition education to FMNP recipients. In the SFMNP, partnerships have been established among State Departments of Health, Agriculture, Aging, Extension and/or Social Services in order to operate the program. Functions that directly involve participants and farmers are performed by a variety of local-level entities, such as Area Agencies on Aging or local nonprofit organizations. Program functions and activities in the SFMNP that are accomplished through effective collaboration and coordination include outreach, certification, benefit issuance, farmer/outlet authorization and training, transportation of participants to authorized outlets, delivery of eligible fruits and vegetables to home-bound participants, and nutrition education.

Evidence: FMNP regulations at 7 CFR Part 248; Reports from SFMNP State agencies.

Does the program use strong financial management practices?

Explanation: Financial Management practices of the agency comply with Federal financial managment system requirements, Federal accounting standards and the Standard General Ledger at the transaction level. Because of their small size, there have been no external audits or separate financial management reviews of these programs conducted in recent years. SFMNP Grant Solicitations require: 1) detailed descriptions of systems for ensuring that benefits are issued to and used only by eligible recipients, 2) that coupons be submitted for payment by authorized farmers through appropriate farmers' markets, roadside stands, and/or community supported agriculture programs and 3) that all coupons be matched to an authorized farmer and recipient before payment is made. The SFMNP Propose Rule, published in May 2005, would require States agencies to implement reporting and monitoring activities related to SFMNP operations.

Evidence: Financial statements receive a clean audit opinion and are free of material internal control weaknesses. USDA OIG audit of Consolidated Balance Sheet as of September 30, 2005. Food and Nutrition Service (2005). Federal Managers' Financial Management Integrity Act (FMFIA) Report: Fiscal Year 2005.

Has the program taken meaningful steps to address its management deficiencies?

Explanation: FNS's management control process includes a series of annual reviews and documented assurances by regional and national program managers, designed to identify program management deficiencies and identify strategies to correct them. The process is led by a Management Control Steering Committee, comprised of a team of senior leaders from across the agency. No major control weaknesses in, or resulting changes to, the management of the FMNP or SFMNP have been identified in recent years.

Evidence:

Does the program have oversight practices that provide sufficient knowledge of grantee activities?

Explanation: Oversight is accomplished through annual reports from State agencies to FNS on participation and expenditure data. These reports are used by FNS to track expenditures and to identify any potential problems in program operations that may need to be addressed for each grantee. The SFMNP Proposed Rule, published in May 2005 (70 FR 30558, 5/26/2005), included provisions that would require State agencies to implement specific reporting and monitoring activities related to SFMNP operations.

Evidence: FMNP regulations at 7 CFR Part 248; FNS-529, Grant Agreement (for SFMNP).

Does the program collect grantee performance data on an annual basis and make it available to the public in a transparent and meaningful manner?

Explanation: WIC FMNP State agencies and SFMNP grantees are required to report participation and expenditure data on an annual basis. The SFMNP Proposed Rule, published on May 2005, included provisions that would require State agencies to implement new data reporting requirements.

Evidence: Expenditure and participation reports are available on the web at http://www.fns.usda.gov/wic/FMNP/FMNP2004.htm (FMNP) and http://www.fns.usda.gov/wic/SeniorFMNP/SFMNPFY2004Profile.htm (SFMNP); SFMNP Proposed Rule (70 FR 30558, 5/26/2005)

Has the program demonstrated adequate progress in achieving its long-term performance goals?

Explanation: The WIC FMNP and the SFMNP do not have long-term performance measures that focus on outcomes and meaningfully reflect the purpose of the program.

Evidence:

Does the program (including program partners) achieve its annual performance goals?

Explanation: The WIC FMNP and the SFMNP do not have annual performance measures that can demonstrate progress towards achieving the program's long-term goals.

Evidence:

Does the program demonstrate improved efficiencies or cost effectiveness in achieving program goals each year?

Explanation: The average WIC FMNP coupon redemption rate did not improve between 2003 and 2004, the two most recent years for which data is provided. The SFMNP coupon redemption rate measure is under development.

Evidence: State WIC FMNP administrative reports (FNS-203).

Does the performance of this program compare favorably to other programs, including government, private, etc., with similar purpose and goals?

Explanation: Given the low value of the WIC FMNP and SFMNP benefit, the programs are unlikely to improve the nutrition and health status of participants. Participants have less flexibility to use farmers' market coupons to buy fresh produce than food stamp benefits which can be used at more accessible retail outlets. Evidence is not available to demonstrate that the programs are more effective than nutrition education at promoting fruit and vegetable consumption, nor that the programs are more effective than AMS activities that support farmers' markets.

Evidence: Fox, M. (ed.) Effects of Food Assistance and Nutrition Programs on Nutrition and Health: Volume 4, Executive Summary of the Literature Review (2004)USDA, ERS; Anliker et al., 1992.

Do independent evaluations of sufficient scope and quality indicate that the program is effective and achieving results?

Explanation: The available body of research is limited and provides no firm conclusions about the impact of the programs on participants' consumption of fresh produce or on any associated nutrition-related effect. Two studies examined nutrition-related impacts of WIC FMNP in the early 1990's but both utilized research designs that were vulnerable to selection bias, and based results on self-reported consumption. One study found that participants ate more fresh fruits and vegetables (Galfond et al., 1991) and one found no effect (Anliker et al., 1992). Customer satisfaction surveys suggest that almost all (94%) of the FMNP recipients participants are very satisfied with quality of the produce, and while many had not been to a farmers' market previously, most (71%) indicated that they would continue to shop at the farmers' markets, even without coupons. There was no follow-up to determine whether participants actually did continue to shop at farmers' markets.

Evidence: Fox, M. (ed.) Effects of Food Assistance and Nutrition Programs on Nutrition and Health: Volume 4, Executive Summary of the Literature Review (2004)USDA, ERS; Anliker et al., 1992. "Evaluation of the Connecticut Farmers; Market Coupon Program," Journal of Nutrition Education 24(4):185-91;' Galfond et al. 1991. Evaluation of the Farmers Market Coupon Demonstration Project. USDA/FNS; NAFMNP, 2003. Program Impact Report for the 2002 WIC Farmers' Market Nutrition Program; FANRP, 2001. The Seniors Farmers' Market Nutrition Pilot Program - A Preliminary Assessment. USDA/ERS.