New York City Department of Health and Mental Hygiene 2015 Health Bucks Application Information
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1 New Yrk City Department f Health and Mental Hygiene 2015 Health Bucks Applicatin Infrmatin Thank yu fr yur interest in the New Yrk City Health Department s Health Bucks prgram. Health Bucks are cupns redeemable fr $2 wrth f fresh prduce at all NYC farmers markets. Yur participatin in the prgram will encurage mre New Yrkers t purchase fresh prduce frm their neighbrhd farmers market. Please review the infrmatin belw t cmplete a successful applicatin. Hw can cmmunity grups participate? Apply t receive free Health Bucks: Cmmunity rganizatins can apply t receive a limited number f Health Bucks t distribute as an incentive t their clients fr participating in farmers market walking turs, cking demnstratins, nutritin classes r ther health-related prgrams. The gal is t intrduce mre cmmunity members t the benefits f shpping at neighbrhd farmers markets and t increase fruit and vegetable cnsumptin by increasing purchasing pwer fr farm-fresh prduce. Purchase additinal Health Bucks: If yur rganizatin requires mre Health Bucks cupns than the Health Department alltment, yu can purchase additinal Health Bucks frm the Fund fr Public Health in NY. Fr mre infrmatin please visit What benefits and activities at farmers markets can my cmmunity-based rganizatin prmte? SNAP/Fd Stamp Incentive Prgram: At all farmers markets in NYC that accept Supplemental Nutritin Assistance Prgram benefits (SNAP, frmerly knwn as fd stamps), fr every $5 a custmer spends with their EBT card, they receive a $2 Health Buck representing a 40% increase in purchasing pwer. Nutritin Classes and Cking Demnstratins: At participating markets, the NYC Health Department s Stellar Farmers Market (SFM) and Farmers' Markets fr Kids (FMK) prgrams prvide free nutritin wrkshps and cking demnstratins fr adults and children. Each SFM and FMK wrkshp includes practical nutritin infrmatin, cking demnstratins using lcal prduce purchased at the market, and recipe tastings. SFM and FMK participants receive easyt-prepare recipes, nutritin handuts, and ne $2 Health Buck cupn. T crdinate a trip t a Stellar Farmers Market r Stellar Farmers Market fr Kids wrkshps, farmersmarkets@health.nyc.gv. NYC Health Department Farmers Market Walking Turs: The Health Department ffers walking turs f lcal farmers markets. Turs familiarize participants with their neighbrhd market by engaging them in interactive games, prviding market shpping tips and much mre. A farmers market tur is a great activity t increase cupn redemptin rates. Please farmersmarkets@health.nyc.gv t schedule a tur. 1
2 Health Bucks Applicatin Guidelines Please review and sign the participatin agreement frm n page three. Please be thrugh and incrprate the best practices belw when cmpleting yur applicatin. Fllwing the best practices will help ensure that yur clients redeem their Health Bucks at the farmers market. Best Practices Remind yur clients t spend their Health Bucks befre using EBT tkens r cash because they expire n Nvember 30, Distribute 2-3 Health Bucks per persn r family member. Hand ut the 2015 farmers market map with the lcatins and hurs f peratins f all farmers markets in NYC. Highlight markets mst cnvenient t yur clients. Review the attached farmers market list t lcate the market clsest t yur site and prmte it t yur clients. Display prvided prmtinal materials, including psters and fld-up maps, in visible lcatins within yur rganizatin and arund yur neighbrhd. Schedule a farmers market walking tur. Organizatins, especially new participants, are strngly encuraged t incrprate market tur int their prgram plan. Fr mre infrmatin, cntact farmersmarkets@health.nyc.gv. Crdinate a trip t a Stellar Farmers Market r Farmers' Market fr Kids nutritin wrkshp and cking demnstratin, where available. Fllw up with yur recipients t see whether they ve used their Health Bucks and if nt, encurage them t use the cupns. Hst a cking demnstratin at yur rganizatin and hand ut healthy recipes using items that can be purchased at the farmers market. Make sure yur clients knw hw t maximize their SNAP dllars at farmers markets that accept EBT. Fr every $5 they spend in EBT, they will receive a $2 Health Buck, while supplies last. Applicatins will be reviewed and accepted n a first-cme, first-served basis as Health Bucks are limited. Once yur applicatin is apprved, yu will be cntacted by yur Health Department representative fr infrmatin n receiving yur Health Bucks. Visit fr a list f NYC farmers markets, infrmatin n leading a farmers market walking tur, free prmtinal materials, recipes, and additinal infrmatin n Health Bucks and nutritin classes. 2
3 Health Bucks New Yrk City Department f Health and Mental Hygiene 2015 Participatin Agreement: Cmmunity-Based Organizatins Belw is infrmatin abut what yur rganizatin will receive and requirements fr participatin. The requirements were develped t ensure the integrity f the Health Bucks prgram and t prmte equity in implementatin acrss rganizatins. Please read carefully, as failure t cmply with the requirements may jepardize yur eligibility t participate in the Health Bucks prgram. Please nte the number f cupns rganizatins receive will be based n need and available supplies. What Yur Organizatin Will Receive: Health Bucks cupns Tlkit f best practices and resurces t supprt yur Health Bucks prgramming Tracking lgs and technical assistance fr maintaining accurate cupn distributin recrds Prmtinal materials including psters listing market lcatins and fld-up farmers market maps Redemptin infrmatin detailing the number f Health Bucks cupns that were used at the farmers market Requirements fr Participating Organizatins: Submit a prgram plan detailing hw yur rganizatin will use the Health Bucks cupns; include hw yu will integrate recmmendatins utlined in the Best Practices dcument. Pririty deadline is June 30 th. Link Health Bucks distributin t yur rganizatin s nutritin r health-related prgramming. Meet with a NYC Health Department representative t receive Health Bucks, review prgram requirements, discuss best practices, and receive prmtinal materials and a tlkit. Hang psters t advertise the prgram and distribute Health Bucks maps with cupns. Designate ne persn frm yur rganizatin t be in charge f Health Bucks fr the entire seasn. Ensure they are trained t mnitr and track Health Bucks distributin. Distribute Health Bucks between July 1 t Nvember 30, Return cupns that were nt distributed t the NYC Health Department by December 15, Cmply with all tracking and mnitring requirements. Stre cupns in a lcked secure area and submit mnthly distributin lgs t ensure accurate redemptin infrmatin at the end f the seasn. Additinal Health Bucks cupns can be purchased frm the Fund fr Public Health f New Yrk. Only rganizatins r markets that purchase their cupns may brand them with their name r lg. Branding r C-branding must be agreed upn by the NYC Health Department and the purchasing rganizatin r market. Branding r c-branding can be dne with a sticker r stamp and must be n the reverse side f the cupn and nt cver the UPC cde. Health Bucks are nly redeemable at NYC farmers markets, unless pre-apprved by the NYC Health Department fr use at ther direct-t-cnsumer marketing venues such as CSAs. Signature: Title: Date: Organizatin Name: 3
4 Health Bucks Applicatin 2015 Organizatin Infrmatin Organizatin Name: Prgram Name (if different frm rganizatin name): Address: Zip Cde: Brugh: Brnx Brklyn Manhattan Queens Staten Island Cmmunity District (if knwn) Did yur prgram/rganizatin distribute Health Bucks last year? Yes N I dn t knw Cntact Infrmatin Cntact Persn Name: Title: Phne Number: Address: Abut Yur Organizatin 1. Please check ne bx that best describes yur rganizatin. Faith-based rganizatin K-12 schl: What grade(s)? Clinical (hspital, healthcare center, etc.) Cllege r university Husing Senir center Anti-hunger (fd pantry, advcacy grup, etc.) Library WIC center Farmers market Yuth prgram r services Benefits enrllment (e.g. SNAP, cash assistance, etc.) Child care center Circle ne: Head Start Grup Day Care Family Day Care Other: Please describe 2. Hw many peple wrk at yur rganizatin? I dn t knw 3. Apprximately hw many peple des yur rganizatin reach/serve annually? 4. Please indicate yur rganizatin type: Nn-Prfit City Agency Other: Please describe 5. What is yur prgram s missin and what rle will Health Bucks play in cntributing t this missin? (100 wrds r less) 4
5 Health Bucks Distributin Plan 6. Describe yur Health Bucks distributin plan. Fr example, t whm will yu distribute, in crdinatin with what activity, fr what purpse and hw many at a time. It is recmmended that yu distribute 2-3 Health Bucks per client r family member t help ensure cupn redemptin. (150 wrds r less) 7. Please indicate all activities that will be part f yur rganizatin s Health Bucks distributin plan. Please check all that apply. Nutritin educatin and/r cunseling Circle: Grup cunseling Individual cunseling Cking class r demnstratin Farmers market walking tur r farmers market based activity Grup physical activity (e.g. walking grup r fitness classes) Health care visit (e.g. health screening) Other Please explain 8. Will yur rganizatin distribute Health Bucks at mre than ne lcatin? N Yes Please list the zip cdes f lcatins where the Health Bucks will be distributed: 9. Hw will yu incrprate nutritin educatin int Health Buck distributin? (100 wrds r less) The NYC Department f Health and Mental Hygiene wuld lve t take yu and yur clients n a farmers' market walking tur! T schedule a walking tur r grup trip t a Stellar Farmers Market r Farmers' Markets fr Kids wrkshp, please farmersmarkets@health.nyc.gv. cmpleted applicatin and market t farmersmarkets@health.nyc.gv. Yu may als fax it t , Attn: Nicle Andersen r mail t NYC Department f Health and Mental Hygiene, Gtham Center, th Street, 11th Flr, CN 46, Queens, NY Nte: All dcuments assciated with Health Bucks are subject t audit at any time. 5
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