Basic Food Nutrition Education Program Application Templates

2009 BASIC FOOD NUTRITION EDUCATION PROGRAM APPLICATION TEMPLATES DUE TO DOH BY MAY 1, 2008 Section A. Needs Assessment Methodology and Findings Needs Assessment Methodology (of your community) 1. Existing Information List groups in your community that might be income eligible for BFNEP. List the venues where these groups might live, meet, work, shop, and play. Indicate possible data and sources to document eligibility and groups’ nutrition and health status. Group Location in My Community *Possible Data/Source Students at school Sunshine Elementary School Elm Street Intermediate School Morris Schott Middle School Wally School High School Sentinel Tech Alternative School National School Lunch Program (NSLP) Head Start and ECEAP Merry Sunshine Head Start La La ECEAP Migrant Day Care Center Head Start and ECEAP data Grocery Shoppers Lep·re·kon Market Sunshine IGA Estudillos Many walk to grocery stores Census Tract 9814, Block grant 4 59.95% poverty rate Cascade Food Bank At the old high school trailer 2nd and 4th Saturday 12-3 pm Local statistics/records (< 1 year operation) Entre Mujeres Esperanza Woman support group-active in teaching classes in English, driving, variety of subjects Local stats Migrant stats Paradise Senior Center Rainbow alley-Paradise Senior Personal Information Form * See listing on next page. Potential data sources by category. 1 Potential Data Sources by Eligibility Category Use these categories to complete the prior page Category 1 Certified Eligibles A. Basic Food Program participants - BFP B. Food Distribution Program on Indian Reservations - FDPIR Category 2 Likely Eligibles as Established by Proxy Criteria C. Early Childhood Education and Assistance Program (ECEAP) D. Food Banks, Food Pantries and Soup Kitchens E. Head Start (HS) F. HUD subsidized housing (Section 8 Housing that is income-based) G. Medicaid Recipients (130% FPL category) H. Personal Information Form (PIF) I. Supplemental Security Income (SSI) J. Summer Food Service Program (SFSP) – closed enrolled sites K. Temporary Assistance to Needy Families (TANF) Category 3 Potentially Eligible by Site/Location L. Census 2000 – people living in census tracts where at least 50% of residents have incomes that are = < 185% poverty. M. Child & Adult Care Food Program (CACFP) N. Food shoppers in grocery stores located in census tracts where at least 50% of residents have incomes that are = < 185% poverty. O. National School Lunch Program (NSLP) P. Special Supplemental Food Program for Women, Infants and Children (WIC) Q. Summer Food Service Program (SFSP) – open sites If you checked Category 3 for any target audience you must complete the Waiver Request form for that audience. See page 18 in this document for a copy of the form. Other Audiences Contact your BFNEP contract manager 2 2. Other Nutrition-related Programs Serving Low-income Persons in your community are: (check all those that apply in your community) Child and Adult Care Food Program (CACFP) The Emergency Food Assistance Program (TEFAP) Expanded Food and Nutrition Education Program (EFNEP) Food Distribution Program on Indian Reservations (FDPIR) Maternity Support Services (MSS) National School Lunch Program (NSLP) Senior Services Special Supplemental Food Program for Women, Infants and Children (WIC) Summer Food Service Program (SFSP) Washington State University Food $ense Program Other: Please specify___________________________________________ 3. Describe areas of your community where Basic Food Program eligibles are underserved or have not had access to Basic Food Nutrition Education previously. According to Aging and Adult Care Agency in Rainbow County, there are no subsidized food programs for the elderly in this area; neither are there Meals on Wheels. A local BFNEP program addressed Basic Food Nutrition Education with this group last year. The majority of people living in Sunshine Alley are foreign-born and have moved here since 1990 so would have had little opportunity to have access to Basic Food Nutrition Education. Sunshine Alley is a rural community without the opportunities of a larger town that might have community education classes, Farmer’s Markets, supermarket shopping. Over 50% of Food Stamp recipients are children, thereby providing the greatest potential for impact on better health. Many live below the poverty level. Parents new to the area would be unfamiliar with local resources and available foods for feeding their children. The local WIC program provides nutrition information and healthy foods to preschool children. The Migrant Day Care and Head Start provide nutrition education and healthy meals as well. 3 4. Based on your needs assessment, who is your target audience(s)? Describe why you selected them. My target audience is Kindergarten and First Graders at the Sunshine Elementary School. Local WIC statistics indicated that over one-third of children receiving WIC in the Sunshine Alley area between the ages of 2 and 5 years old, inclusive, have a risk factor of BMI greater than the 85th%tile. Nutrition education is needed to reverse the trend of obesity. As shown in a graph focusing on the years 1986-2001,(and presented by Dr. Roland Sturm at the ECOR Conference on the Disparities Between Poverty and Obesity, March, 2008), there is a definite correlation between poverty and obesity. More than 80%of the children in the Sunshine Elementary School qualify for a free or reduced lunch, indicating a lower income level. A later comment by Dr. Sturm indicated that small stores typically have more processed foods which contain a high concentration of kcalories with the potential for excessive weight gain. Healthy food choices are limited. Children can learn to find the healthy choices. Typically we don’t think of 6 and 7 year olds as having many food choices. At home their parents control their food choices. When entering daycare/Head Start they are fed and monitored on their intake. WIC provides specific healthy foods for the preschooler. Once in school, however, there is much more freedom of choice on what they decide to eat from breakfast choices or from their lunch tray. Nutrition lessons can help them learn to make the better choice. The WIC data on ―low in vegetable‖ intakes show that classes which feature fruits and vegetables are appropriate. Most of the kindergartners just graduated from WIC @ 5 years old so the statistics reflect the average kindergartner entering school. Family composition information from the Census 2000 indicated 73.7 households have children. Children would be a prime target to learn the nutrition information and then impact the family. Teaching nutrition in Kindergarten and First-Grade will reach an underserved population group as well as having a positive impact on the whole family’s eating pattern. Nutrition education is provided for students and parents in WIC and in Head Start. Nutrition is studied in upper grade classes. There are many nutrition programs for youth. Kindergartners and First -graders are at a prime time for learning to make healthy food choices, but no program is aimed directly at them. How did you assess the 4 Needs Assessment Findings (of your target audience) You may duplicate this section for multiple target audiences. 5. Demographic Characteristics of your Target Audience Indicate the source of the data used to describe your Target Audience and their income eligibility. Category Sources of Data Specify    Census 2000 CSO Office Manager WIC Age Education Family Composition Gender Census 2000. In Rainbow County, 8.7% are under 5 years old; 26.5% of the population is 5-19 years old. In Sunshine, 12.5% are under the age of 5 years and 31.1% are 5-19 years old. 43.6% of the population in Sunshine are children. Census 2000. In Rainbow County, 72.2% have a high school education with 13.7% carrying a college diploma. In Sunshine, 19.1% have a high school education and 1.9% carry a college degree. In Sunshine, 73.7% of households have children under the age of 18. And 31.1% of people in Sunshine are ages 519 years, which is school age. Census 2000. Sunshine consists of 60.3% male and 39.7% female. Census 2000. In Sunshine, English is the only language spoken in 9.6% of homes. 90% of the homes speak Spanish with 69.9% speaking English less than very well, indicating a need for Spanish translation for take-home materials. No other languages. The selected area is a rural farming area with localized housing developments. Census 2000. In Rainbow, 79.2% of the residents are of the White race. 30.1% claim Hispanic (of any race). In Sunshine, 29.6 claim to be of the White race and 65% claim ―some other race." Language(s) Spoken Location (neighborhoods and areas where target populations reside) Race/Ethnicity If available from primary data sources like focus groups, interviews and surveys Barriers to accessing food or There are no authorized Farmer’s Markets within 45 miles. physical activity There are no Supermarkets within 45 miles, although 3 local grocery stores serve the area. A Food Bank was established last year and is open twice a month year round. Walking and field work comprise the majority of exercise. The schools have organized sports and Physical 5 Factors influencing foodrelated decisions Other Education classes. There is no nutrition program to help parents make wise choices in food shopping and preparation nor is there a group to teach utilization of available foods. There is a limited choice in grocery shopping for price comparison. It is more difficult to obtain all the nutrients needed within a budget constraint. The program will feature easy, inexpensive food samples. Local Sunshine WIC data (two clinics, serving a total of approximately 800 children). 85% of these children have a nutrition risk factor of ―Low vegetable servings.‖ The 5year old WIC children are graduating into the Elementary school kindergarten, probably with that same risk factor of low vegetables. The nutrition classes will address increasing F&V consumption. 6 6. Nutrition-related behavioral and lifestyle characteristics of your target audience using the information from your needs assessment: Include dietary and food purchasing attitudes, habits, as well as where your audiences eat, redeem Basic Food benefits, shop, live, learn and play. As gleaned from WIC dietary recalls, the majority of families prefer the traditional foods of their Mexican heritage. Variety is limited, particularly with vegetables. WIC statistics indicate that 85% of the 800 children served by the two WIC clinics in Sunshine Alley, have a nutrition risk factor of ―Low vegetable servings.‖ Sweetened beverages and desserts are commonly consumed by all age groups. All three grocery stores redeem Basic Food benefits and two accept WIC checks. Some families travel to a large town once or twice a month for groceries. Locally produced fruits and vegetables are eaten in season. Housing is typically a small home, mobile home or apartment with basic cooking facilities. Most meals are home-prepared. There are a couple of restaurants and taco wagons, but no fast food chains. The grocery stores and two gas stations also have ready-to-eat fried deli foods. The town park is a meeting spot for recreational soccer games. Walking around town is a common form of exercise. There is no community center. 7 2009 BFNEP Goals, Objectives, Strategies and Collaboration 1. Goal & Objectives – The WA State Department of Health has developed the following statewide goal and required objective for all local contractors to address: State Level Goal Increase the proportion of Washington State Basic Food Program participants whose diets reflect the Dietary Guidelines for Americans and who get at least 30 minutes of moderate activity on five or more days a week. Local Required Objective: By September 30, 2009 local program participants will increase fruit and vegetable consumption to amounts consistent with current Dietary Guidelines for Americans in an identified BFNEP population. Additional local objectives are optional. Local Optional Objective(s): Must be an objective focusing on Dietary Quality based on the 2005 Dietary Guidelines: Eat whole grains every day Eat fat-free or low-fat milk products every day Eat Lean meat and Beans Limit Fats and oils You may incorporate secondary messages into the required or optional objective. These messages can not stand alone and must be integrated into the main topics. Example, a ten minute physical activity demonstration in a 60 minute session. Other Secondary Messages: Food safety Food shopping and preparation MyPyramid-Healthy Eating Plan Promoting healthy weight Limit added sugars and caloric sweeteners Sodium and potassium 8 2. Project Description A. Project Planning Template For each target audience complete a template with the following information: Column 1: List the key data from your needs assessment Location of the Target Audience (street address, city) Data qualifying the audience as Basic Food Program eligible Source of the data Column 2: List the eligibility category of your data (see page 2 of this document) Column 3: Target Audience Indicate the number and age group of the people you plan to reach with your nutrition education activities Column 4: Local Objective Write a S.M.A.R.T. objective that addresses consumption of fruits and vegetables, is relevant to your target audience, and can be measured during the contract year. Column 5: Methods /Approach Identify and briefly describe the nutrition education approach you will use to influence your target audience behaviors. Indicate your overall methodology, why you chose your particular approach, and why you think it will be effective. Column 6: Nutrition Sessions, Reinforcing Activities, and Timeline List all group sessions specifying the intensity and duration. Be specific on the timeframe, number of group sessions, and series of sessions. List all reinforcing activities related activities/events that will help you achieve your objective(s) (i.e. staff training, focus groups, newsletters, bulletin boards, fieldtrips, demonstrations, recruitment etc.) *Note: you must incorporate a minimum of 3 group sessions of 30 minutes duration each in addition to reinforcing activities. (Current health promotion research recommends at least six sessions of 30-60minutes duration.) 9 NARRATIVE SECTION B. Summary of Research to support your educational approach/methods Describe the research that supports your educational approach with your target audience. Cite specific studies and date where appropriate. Discuss how the research studies demonstrate (and to what extent) the feasibility and effectiveness of your nutrition education methods. According to research, young children learn best by doing and require active thinking and experimenting to find out how things work and to learn firsthand about the world in which they live. Tasting activities have been a successful method of introducing children to a variety of fruits and vegetables that they had never tasted before. The greatest gains in health may be made through individual behavior change that is supported by families, households, and neighborhoods, institutions such as schools, local governments, businesses and voluntary groups. Whole community projects actively engage parents and local school districts in an effort to support the healthy habits to model for young children. Effective classes for children and adults present simple concepts with clear and consistent messages are fun and interactive, and food samples will have eye-appeal and taste good. Lessons must be presented in a language understood by the audience (lots of pictures for young children, and translation to Spanish for the parents.) Dr. Alonzo Plough stated at the ECOR Conference on Poverty and Obesity: Disparities in Diet and Health (March, 2008), ―Individuals make decisions within the context of the surrounding environment.‖ The classroom is an environment. The school is an environment. Students will learn as a group to make healthy food choices and influence each other, and then their families. There is an individual willingness to try new foods when the whole group is taking that action. Young children are at the age to educate in making wise choices. According to the Kaiser Family Foundation Report, March 2008, children ages two to seven see an average of 12 food ads every day, which adds up to more than 4,400 food ads (nearly 30 hours) of food advertising in a year. Can they discern the healthy foods? Young children can be taught to make healthy choices. For this project, a series of classroom activity sessions will include puppets, games, crafts, cooking projects, and various hands-on approaches to familiarize the students with F&V choices. Take-home activity calendars and newsletters will reinforce the classroom messages in addition to the school foodservice personnel who will promote featured F&V throughout the school with nutrition display boards. A grocery store field trip finale, with parents, will summarize the lessons learned. A subsequent health fair for the Kindergartners and first-graders will reinforce the preference to choose F&V. 10 As children enter kindergarten for the first time, parents report about 92 percent seem eager to learn and report that about two-thirds to three-quarters of beginning kindergartners ―often to very often‖ persist at tasks, seem eager to learn, and are able to pay attention. America's Kindergartners: Findings from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99: Fall 1998. Kindergarten and first-graders typically have an attention span of 20-30 minutes. The proposed lessons will be within that time frame. The Wally School District has written and implemented a Nutrition and Physical Activity plan following the CDC Obesity Prevention Project guidelines. Controlling access to unhealthy foods is a good foundation. Teaching about healthy nutrition choices to help control the obesity epidemic is a good next step. The proposed lessons will enhance and not supplant the Wally School District’s plan. 11 C. Use of Existing Educational Materials/Curricula Use Complete the table for materials you plan to use. You may duplicate the table if more space is required. You must use materials that are scientifically based and have been updated for the 2005 Dietary Guidelines. You may not use materials containing the old Food Guide Pyramid or materials from Produce for Better Health 5 a Day campaign. Title Author Source Language(s) Cost Target Audience Grades 1-  2 Description Provide a brief description of the content focusing on the key messages Lesson 1. Exploring My Pyramid for Kids introduces the food groups that make up My Pyramid for kids. An added emphasis will then focus on the Fruits and Vegetables Group. Extra activity will be a mystery food game. Lesson 2. Eat Smart with My Pyramid for Kids features making food choices for Healthy Eating. Children learn to categorize foods into the proper food groups. They will learn to recognize a variety of fruits and vegetables by name with corresponding samples. Added activity will be a Fruit and Veggies placemat. Lesson 3. Vary Your Veggies and Focus on Fruits includes completing a diary of foods. An added feature will be creating a booklet identifying fruits and vegetables as a rainbow of colors. Lessons 1-3 are from My Pyramid for Kids Team Nutrition Program available from the Food and Nutrition Service of the USDA. Downloadable from http://teamnutrition.usda.gov/Resourc es/mypyramidclassroom.html English and some Spanish Printing   Lessons 4-7 are adapted from Neat Solutions http://www.neatsolutions.com/lessons/ lessons.htm English and Spanish Cost of printing K-1 The lessons used will focus on particular fruits and vegetables.   Lesson 4 Enjoying Carrots focuses on carrots and beta-carotene. Adding activities about root vegetables. Lesson 5 from Seeds to Salad Bars includes information about heart health, cancer prevention, and fiber. Add an 12   activity of a Fruit and Vegetable Scavenger Hunt. Lesson 6 Amazing Pumpkins features measurement activities. Will make pumpkin pie in an orange. Lesson 7 Vegetable Party reinforces the recommended amounts of fruits and vegetables to eat each day and identifies the edible portions of plants. Lessons are 30 minutes and include an Overview, Key message, Objective and materials needed in the Trainer Summary Information. Actual lessons include an activity, nutritional lesson, cooking activity and lesson rein forcer. Children learn to incorporate fruits and vegetables into their daily meals. Lesson 8 Nutrition Basics for Super Star Menus will teach planning menus incorporating fruits and vegetables. Attention given to vitamins in fruits and vegetables. Activities including making fruit and vegetable collages from newspaper store advertisements. Lesson 9 Cooking Super Star Meals with Kids includes supervised preparation of recipes featuring fruits and vegetables which helps children appreciate healthy food choices as they learn about how fruits and vegetables look, smell, feel, sound, and taste. Lesson 10 Shopping for Super Star Menus helps children identify seasonal fruits and vegetables, and different forms of fruits and vegetables including canned and dried. A shopping trip is done with the parents. Lessons 8-10 are from Super Star Nutrition for Kids developed by the Oregon Department of Education. Lessons are downloadable from www.ode.state.or.us/nutrition/cacfp/tn/ lesson_plans.aspx English Cost of printing K-2     13 These programs will be supplemented with Arts & Crafts, Food Games, Science Experiments, and Songs from the Food Groupies as well as the University of Illinois Extension Wellnessways website at http://web.aces.edu/wellnessways, a Family Nutrition Program funded with Food Stamp Administrative funds. Fruits and Veggies, More Matters!: http://www.fruitsandveggiesmorematte rs.org Estimated cost for pamphlets, brochures and posters from this site is $150. Nasco Nutrition Teaching Aids. www.eNASCO.com $60 Fruit and veggie models, My Pyramid pocket chart, to support the program Neat Solutions. www.neatsolutions.com Puppets, Model Fruit and Vegetable sets $100.00 14 D. Modification of Project Methods Describe adaptations and modifications you will make to your education methods/approach and curriculum (listed above) to achieve your objective(s). Curriculum Title Team Nutrition Program and SuperStart Nutrition for Kids. Adaptation/Modification Justification The school aides and the assistant for Since Sunshine Alley is an this BFNEP project will translate materials area of a large number of going home to the parents. Spanish speaking individuals. Lessons 4-7 are adapted from Neat Solutions http://www.neatsolutions.com/lessons/lessons.htm Gardening is not BFNEP Only specific food lessons will be used from Neat Solutions—no gardening programs. Lessons 8-10 are from Super Star Nutrition for Kids developed by the Oregon Department of Education. Lessons are downloadable from www.ode.state.or.us/nutrition/cacfp/tn/lesson_plans.aspx The lessons on Food Safety and Fun with Physical Activities from the Super Star Nutrition for Kids program will not be used. The lesson is not BFNEP appropriate 15 E. Development of New Educational Materials: – See note beginning guidance page 16. Identify any new materials that you plan to produce or purchase and justify the need and cost. N/A 16 PROJECT PLANNING WORKSHEET 1 Needs Assessment Data (list qualifying data, source, and location of target audience) 2 Cate gory 3 Target Audience 4 Local Objective (outcome-based or factor-based) 5 Methods and Approaches 6 Nutrition Education Sessions, Reinforcing Activities and Timeline 3 Sunshine Alley Elementary School 400 N. Boundary, Sunshine Alley, WA 99349 At Sunshine Alley Elementary School, 82.03% of the students are eligible for free or reduced price lunch. OSPI Approximately 125 Kindergarten and First-grade students from 5 classrooms. By September 30, 2008, 50% of the Kindergarten and First-grade students who participate in the BFNEP nutrition program will show an increased preference for fruits and vegetables. Secondary Messages:  My PyramidHealthy Eating Plan  Food Shopping and Preparation A series of classroom activity sessions will include puppets, games, crafts, cooking projects, and various hands-on approaches to familiarize the students with F&V choices. Take-home activity calendars and newsletters will reinforce the classroom messages. Cooperation with the school foodservice personnel to promote featured F&V. Colorful nutrition display boards throughout the school will encourage more F&V choices. A grocery store field trip finale, with parents, will summarize the lessons learned. A subsequent health fair for the Kindergartners and first-graders will reinforce the preference to choose F&V. First Quarter: Program planning activities  Parent focus group  Staff orientation and training Second Quarter:  Series of 10 weekly nutrition education sessions of 30-minutes duration for each of the 5 classrooms that incorporate interactive games, cooking activity, and reinforcement take-home activity. Reinforcing Activities nd rd Will begin 2 -3 quarter  Health Fair for the Kindergarten and First-grade classes.  Grocery store field trip with parents and preparation of a recipe to sample  Parent oriented monthly newsletter  Room displays and cafeteria posters emphasizing current topic.  Take-home Food Activity Calendars 17 3. Evaluation Plans: For each target audience objective, complete an Evaluation Template (ET) Target Audience: Fill in information from column 3 of your planning template Objective: Fill in information from column 4 of your planning template Describe if the project has been previously evaluated and when Column 1. Activities: Fill in the activities that support your objective from column 6 of your planning template. Measures: Identify from your objective the change you want to measure and the amount of change you expect to happen. Methods/Tools: Describe what methods and tools you will use to measure change in factors or consumption. Data Collection: Indicate how and when you will collect data from your participants. Column 2. Column 3. A. Column 3. B. Column 3. C. Analysis: What is your plan for reviewing and analyzing your results? How will you use your evaluation data and information? 18 1 Activities that support objective From planning template Column 6 2 What are we measuring? Changes in factors like knowledge, skill, attitude or consumption 3 How will we measure? Methods and Tools used to measure change(s) A Methods and Tools First Quarter: Program planning activities  Parent focus group  Staff orientation and training Second Quarter:  Series of 10 weekly nutrition education sessions of 30minutes duration for each of the 5 classrooms that incorporate interactive games, cooking activity, and reinforcement take-home activity. Reinforcing Activities Will begin 2nd-3rd quarter  Health Fair for the Kindergarten and First-grade classes.  Grocery store field trip with parents and preparation of a recipe to sample  Parent oriented monthly newsletter  Room displays and cafeteria posters emphasizing current topic.  Take-home Food Activity Calendars. B Data Collection C Analyzing Your Results The BFNEP Coordinator will complete analysis of data after each session. Results will be shared with staff and teachers at regular meetings for discussion of successes and recommended changes for the next interventions. Changes in F&V Preferences by 50%. Formative Methods and tools  Staff input on methods and messages for students and parents during training and orientation.  Focus group to assess parents on their current understanding of F&V and willingness to change. Progress tools and methods  Attendance at class  # of posters/bulletin boards displayed  # of newsletters sent home  # students who try demonstrated food Outcome Tools and Methods Pre and Post Program Food Preference Survey for Children (Cullen) Formative will occur during the first quarter. BFNEP assistant will record notes from discussion. After each nutrition education session, data will be collected by BFNEP assistant and analyzed and summarized by the nutrition educator. 19 4. Coordination Efforts Put a check by the partner agency/program that you will collaborate with in order to deliver consistent behavior-focused messages. Submit a partnership agreement to document what each partner agency and/or program will do to contribute to your nutrition education project. If partnering with WIC, Head Start, or other USDA programs that have a nutrition education requirement you must describe how your BFNEP nutrition education activities will enhance, not supplant existing requirements. Agency on Aging After School Snack Program Basic Food Program (BFP) Boys and Girls Club Child and Adult Care Food Program Early Childhood Education & Assistance Program Farmers Market Head Start National School Lunch Program Parks and Recreation School Breakfast Program Summer Food Service Program The Emergency Food Assistance Program (TEFAP) WIC Other: (Specify) Sunshine Alley Elementary School X 20 ASSURANCES: To assure compliance with policies described in this guidance, the Basic Food Nutrition Education plan must include the following assurances. Mark your response to the right. To assure compliance with policies described in this guidance, the Basic Food Nutrition Education Plan must include the following checklist of assurances that: 1. The contractor is accountable for the content of the nutrition education plan and provides oversight to any sub-grantees. The contractor is fiscally responsible for nutrition education activities funded with Basic Food funds and is liable for repayment of unallowable costs. 2. Efforts have been made to target nutrition education to BFP participants and eligibles. 3. In cases where Food Stamp Nutrition Education projects may inadvertently benefit persons that are ineligible for the Basic Food Program because it is not practical or possible to meet the exclusivity requirement, the local agency has submitted waiver requests for each project. To be approved the waiver request(s) must clearly demonstrates how the proposed project provides a good means of reaching food stamp eligibles and documents that at least 50 percent of those reached will have gross incomes at or below 185 percent of the poverty thresholds or guidelines. 4. Only expanded or additional coverage of those activities funded under the Expanded Food and Nutrition Education Program (EFNEP) may be claimed under this application. Approved activities are those designed to expand the State's current EFNEP coverage in order to serve additional BFP eligibles or to provide additional education services to EFNEP clients who are eligible for the Basic Food Program. In no case may activities funded under the EFNEP grant be included in the budget for BFNEP. 5. Cash or in-kind donations from other non-Federal sources to Food Stamp Nutrition Education have not been claimed or used as a match or reimbursement under any other Federal Program. 6. Costs incurred by other state and/or local agencies for goods and services for BFNEP and which are then donated to DSHS make up the public in-kind contributions that are included in the State share of costs that are eligible for Federal Reimbursement. They cannot be used as a match under any other federally funded project. 7. Documentation of local agency costs, payments and donations for approved activities are maintained by the State and will be available for USDA and DOH review and audit. 8. Contracts are procured through competitive bid procedures governed by the State procurement regulations. 9. Program activities are conducted in compliance with all applicable Federal laws, rules, regulations including Civil Rights and OMB circulars governing cost issues. 10. Program activities do not supplant existing education program, and where operating in conjunction with existing programs, enhance and supplement them. 11. Program activities are reasonable and necessary to accomplish BFP nutrition education objectives. 12. All materials developed or printed with Food Stamp Nutrition Education funds include the appropriate USDA non-discrimination statement, credit to the Food Stamp Program as a funding source, and a brief message about how the Food Stamp Program can help provide a healthy diet and how to apply for benefits. 13. Messages of nutrition education are consistent with the Dietary Guidelines for Americans and stress the importance of variety, balance, and moderation, and do not disparage any specific food, beverage, or commodity. Yes No X X X X X X X X X X X X X 21 Waiver Request ONLY for Category 3 Target Audiences– Potentially Eligible by Site/Location a. Agency/Organization Name: Sunshine Alley Elementary School b. Local Project Objective: By September 30, 2009, 50% of the Kindergarten and First-grade students who participate in the BFNEP nutrition program will show an improved preference for fruits and vegetables. c. Narrative justification for need for waiver: Although the majority of students in Kindergarten and First Grade at Sunshine Alley Elementary School are in an area of eligible BFP participants and 82% are eligible for a free or reduced lunch, it is not practical to separate out the audience when an activity lesson is conducted. d. Description of low-income population intended to be reached that are not the project’s target population (Basic Food Program applicants and participants). 1. Location of project: Sunshine Alley Elementary School 400 North Boundary Sunshine, WA 99349 2. Demographic and census data documentation that demonstrates that at least half of this target population is at or below 185 percent of poverty: a. Data source Fee and reduced price meal applications in schools, OSPI b. Data School data: 82.03% of students are eligible for free and reduced lunch. 22 Signatures BASIC FOOD PROGRAM Fiscal Year 2009 Annual Plan for Nutrition Education For CONTRACTING ORGANIZATION:SUNSHINE ALLEY COMMUNITY MEDICAL CLINIC_ DATE: APRIL 30, 2008 Certified By: _______________________________________________________ AUTHORIZING SIGNATURE DATE PRINTED NAME POSITION OR TITLE 23