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Cooperating to Improve Nutrition and Food Access

by George Reistad, Director of Food Policy, City of Madison

Willy Street Co-op has written about the Double Dollars and Fruit & Vegetable Prescription Pilot programs before, and they asked me to share my perspective on them as Director of Food Policy for the City of Madison. Both programs continue to build impactful collaborations and have created new ways to serve community residents. I’ll start with a little background on each program in case one or both are new to you.


Originally launched in 2013, the City of Madison and Dane County Double Dollars Program continues to thrive and expand its community impact in its sixth year of operation. The program allows Supplemental Nutrition Assistance Program (SNAP) EBT users to leverage up to $25 of SNAP benefits at participating farmers’ market locations and $20 of SNAP benefits at Willy Street Co-op locations and “double their dollars” for food purchases at those venues (fresh fruit and vegetables only at Willy Street Co-op locations). Annually, the program receives $25,000 from both the City and the County to pay administrative and staffing costs related to program management at Community Action Coalition of South Central Wisconsin. Based largely on collaborations established by a $93,000 USDA Food Insecurity Nutrition Incentives (FINI) Grant awarded to the City in 2016, an innovative partnership formed between Willy Street Co-op and Community Action Coalition for South Central Wisconsin. As a function of this partnership, an agreement formed to split proceeds from cash donations at the registers and the Co-op’s reusable bag incentive program between Co-op retail locations and participating farmers’ markets.


In late 2016, the City of Madison received a $25,000 Wholesome Wave Nutrition Incentive Program Support and Innovation Grant (NIPSIG) to create a Fruit and Vegetable Prescription Pilot Program (FVRx) for food-insecure residents on the northside of Madison. Because of the proximity of the Northeast Family Medical Center to Willy North (less than a quarter-mile away), this program was formed with a healthcare focus, providing convenient access to high-quality fresh produce for identified food-insecure patients at the clinic. Working in close partnership with Willy Street Co-op, UW Health’s Northeast Family Medical Center, Second Harvest Foodbank’s HungerCare Coalition, Center for Patient Partnerships, and Public Health Madison & Dane County, the program provided vouchers for fruit and vegetables to clinical patients who answered ‘yes’ to one of two USDA-approved HungerCare Coalition Food Insecurity Screening Tool questions. Vouchers were distributed under two different models to clinical patients. In Phase I, patients received $20/month in $2 vouchers for six months as well as a separate $4 voucher to pay the first year of Co-op ownership fees and automatically enroll in the Access Discount Program, which offered a 10% discount on products storewide. Each batch of $20 vouchers expired monthly and were redeemable for fresh produce at any Willy Street Co-op location. In Phase II, patients received $40 in $2 vouchers with a two-month expiration period.


Through a robust partnership, the Double Dollars Program has expanded its reach substantially since the program launch in 2013. Financial data show that the program has grown from $9,300 in redemptions at three farmer’s market locations in 2013 to almost $97,500 in redemptions at six farmers’ market and three Willy Street Co-op locations in 2017. This illustrates growth of over 1000% in redemption amounts for the program in five years of operation! The program benefits the community members using the Double Dollars as well as the Co-op, and the farmers vending at these markets, providing more local food and improving our local economy. Also, since April 2017, the Co-op and its customers have contributed almost $87,000 to Double Dollars through cash donations and by reusing bags almost 647,000 times.


In 17 months of operation, the FVRx Pilot Program distributed 570 voucher packets (420 in Phase I and 150 in Phase II) to identified food-insecure patients at the UW Health Northeast Family Medical Center, located on Dryden Drive just off Northport Drive. Over that time, data showed that there was a redemption rate of about 36% for enrollees. Telephonic survey follow-ups showed that there were a number of program participants who found the vouchers to be extremely helpful in increasing their access to healthier foods, which they considered prohibitively expensive prior to program enrollment. However, as evidenced by the relatively low redemption rate, there was also a sizable number of program participants that, while they liked the spirit of the program, found it difficult to use the vouchers for a variety of reasons. Survey data showed that ease/convenience of retailer access, lack of one-on-one assistance and/or coaching on nutrition and culinary skills, and retailer preference were some of the top barriers to higher redemption rates. Additionally, a novel component of the FVRx Program is its intentional disconnection from SNAP enrollment. Clinical patients, who identified as being food-insecure through the USDA-approved HungerCare Coalition screening questions were not required to be SNAP beneficiaries to use the FVRx vouchers at Willy Street Co-op locations. By adopting this level of flexibility, I believe the FVRx Pilot Program was able to serve a broader audience who had an expressed need for food, but may have fallen outside of qualifying federal government imposed poverty line thresholds.


As many of us know, this is a tumultuous political climate, with ramifications on a number of issues, and there exists potential for a sea change in administration, funding, and eligibility standards for nutrition assistance programs. The current Farm Bill debate, and the wide ideological schism illustrated by the differences between the House Bill and the Senate Bill, highlights what’s at risk for low-income families in America. If significant and adverse changes to SNAP and other programs were adopted, the effects would ripple through lower-income communities in the US, with disparate effects felt by qualifying families with children and immigrant families.

I want to say that the City of Madison and our partners in Madison and Dane County are absolutely committed to continuing to create policies and fund programs that break down barriers, remove obstacles, and ensure access to fresh, healthy foods for low-income families and individuals within our community. The political landscape at the state and federal level may change, but our commitment remains unwavering and we, at the City, will always explore the options and resources at our disposal to alleviate the effects of poverty and make sure that eating food which contributes and betters the health of our residents is always a convenient possibility.


I would like to close by thanking our generous funders and supporters, because without them, Double Dollars and FVRx would not exist.


Over the years, the following organizations have offered steadfast support for the Double Dollars Program, allowing it to grow and prosper within our community:

•Healthy Dane: (link is external)

•UW Health: (link is external)

•UnityPoint Health Meriter: (link is external)

•SSM Health: (link is external)

•Group Health Cooperative: (link is external)

•Stoughton Hospital: (link is external)

•Madison Area Chefs Network: (link is external)

•Dane County Department of Human Services: (link is external)

•Public Health Madison & Dane County: (link is external)

•Community Action Coalition of South Central Wisconsin: (link is external)

•Willy Street Co-op:

I am also thankful to the United States Department of Agriculture for granting the City a Food Insecurity Nutrition Incentives (FINI) Program Grant, which allowed the relationship between Willy Street Co-op and CAC of South Central Wisconsin to flourish and created the programmatic partnership we have today.


I would like to thank Wholesome Wave for entrusting The City of Madison with grant funding to implement an FVRx Pilot Program in Madison. Working with their staff was an absolute pleasure, they were very flexible in allowing FVRx Pilot Program staff, and partners to make tweaks and changes to that would benefit community members.

I would also like to thank FVRx partners:

•Center for Patient Partnerships: / (link is external)

•Public Health Madison & Dane County: (link is external)

•Second Harvest Foodbank of Southern WI HungerCare Coalition: (link is external)

•UW Health Northeast Family Medical Center: (link is external)

•Willy Street Co-op:

I would also like to offer up another, extra special thank you to Willy Street Co-op’s front office, store, communications and cooperative services staff. I have worked with Willy Street Co-op very closely in my almost two years in this position and I can say, without a doubt, that Co-op staff go so far above and beyond what is required of them to provide assistance with new program or project implementation. I am looking forward to continuing to work with them on these nutrition incentive programs and any other programs that lower barriers to accessing good food for community residents.

Thanks for reading everyone!

George Reistad serves as the Food Policy Director in Mayor Paul Soglin’s Office. In his role at the City of Madison, he focuses on creating and continuing programs and advancing policies that increase food access for residents of the City, with particular focus being paid to initiatives that create healthy affordable food access and build more robust community food systems.

For more information on the City of Madison’s Food Policy and Programming, please see the Mayor’s Priorities: Food web page:

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