BOISE, Idaho -- A pilot program that prescribes a trip to the produce aisle has been a success in Idaho.

The Nebraska-based Gretchen Swanson Center for Nutrition evaluated the Idaho Hunger Relief Task Force's (IHRTF) Prescription for Fresh Fruits and Vegetables program, which offers vouchers to food-insecure patients with diabetes and prediabetes.

It found significant improvements in participants' health.

Julie Walker, manager of diabetes education at Saint Luke's Humphreys Diabetes Center in Boise, said there was a lot of positive feedback, including from a young woman with Type 1 diabetes.

"She had called and wanted to know if there was any way she could get re-enrolled in the program because she really attributed that to her success in reducing her A1C, and if she could be re-enrolled again it would really be helpful," Walker recalled. "And fortunately, she was."

A1C levels measure a person's blood sugar.

Walker said levels above 7 significantly increase the risk of nerve damage, and the woman's A1C was cut from 9 to 6.3 during the program. The evaluation found participants' A1C levels dropped by an average of 13% over the course of the program.

Cliff Metcalf, owner of Cliff's Country Market in Caldwell, accepted vouchers for the program.

"We ring it up like a regular transaction," Metcalf explained. "They give us the vouchers instead of cash, and then they go home with some really good produce."

Metcalf added people get the vegetables and then find out they like them more than the sugary foods they're used to buying.

Christina Tierney, manager of the Prescription for Fresh Fruits and Vegetables program for IHRTF, said the budget for fresh foods is often the first thing to go when people are experiencing food insecurity. She reiterated a lack of these healthy foods in people's diets is tied to diseases like diabetes.

"What we've proven through the Prescription for Fresh Fruits and Vegetables is that access to fresh fruits and vegetables actually can reverse those diagnoses and bring down the A1C levels," Tierney confirmed.

Tierney added they hope to scale the program up beyond the Treasure Valley.

Alabama is one of 14 states opting out of the 2024 summer electronic benefit program.

As summer rolls around, there will be no programs in place to help low-income families with grocery costs.

LaTrell Clifford Wood, hunger policy advocate for the group Alabama Arise, said as a result, more than 500,000 children who usually receive free or reduced lunch could go without meals. She noted while summer feeding programs will be available, they will not reach everyone in need.

"Ninety-four percent of Alabama children who rely on free and reduced-price meals won't have access to them over the summer," Clifford Wood reported. "That means that only 6% of the children who rely on those meals during the school year are going to be fed through summer feeding programs."

Clifford Wood warned limited hours, transportation and strict program rules will hinder many families from benefiting from such vital programs. The Alabama Legislature did not allocate the necessary $15 million for the program by the end of the last session. However, Clifford Wood noted there is a chance the program will be funded in the summer of 2025.

As legislators focus on next year's budgets, Clifford Wood stressed the need for funding next summer's EBT program. She pointed out Alabama Arise is calling for lawmakers to allocate funds from the Education Trust Fund to combat child hunger, affecting one in four children in the state.

"This is a program that's been tested for 13 years," Clifford Wood emphasized. "It's had three rigorous evaluation periods, and it was shown to improve the diet of children and decrease children's food hardship by a third."

Clifford Wood believes prioritizing children's needs and addressing food insecurity is a form of preventive care and serves as an early investment in the state's overall wellness.

The Food Research and Action Center said funding the e-benefits program would also benefit the economy - adding anywhere from $98 million to $117 million. The Alabama Senate Finance and Taxation Education Committee is expected to vote on the budget next week.

California's program helping low-income families buy fresh fruit and vegetables is on the chopping block and health care advocates are asking legislators to save the Market Match program.

Gov. Gavin Newsom has proposed cutting most of the program's $35 million budget to help close the state's budget shortfall.

Sophia Vaccaro, a participant in Market Match from Echo Park, said she depends on Market Match in more ways than one.

"It helps people being able to stretch their budget further," Vaccaro explained. "Then, I think it helps the community, in that it creates a sense of camaraderie at the farmers' market and makes people more invested in the community itself."

The program matches every dollar CalFresh customers spend on fresh fruits and vegetables at a farmer's market up to between $10 and $20 per day. It is active at 294 sites across the state and is partially paid for through federal matching funds.

Dr. John Maa, surgeon at Marin Health Medical Center and board member of the San Francisco Bay Area chapter of the American Heart Association, said Market Match promotes healthy eating and boosts the local farm economy.

"An improved diet really will have long-term meaningful impacts on health, and also reduce health care costs," Maa explained. "It really helps to sustain the growers and the merchants. I guess it's a win-win-win."

Siu Han Cheung, outreach coordinator for the Tenderloin Neighborhood Development Corporation and board member of the Heart of the City Farmers' Market, argued the program is vital to residents across the state.

"If the Market Match will be cut, that is terrible," Cheung stressed. "That means they have less money to buy their food. So, Market Match is very important for the low-income families and the seniors."

Legislators and the governor are working toward the May budget revisions, and must pass a balanced budget by June 15.

South Dakotans face high prices at the grocery store and some are working to ease the burden.

A new report from the Federal Trade Commission finds some grocery retailers used the supply-chain disruptions of the pandemic to raise prices and collect bigger profits, even after supply chains regulated.

One South Dakota group is trying to reduce sticker shock by targeting the state sales tax on groceries. Dakotans for Health is sponsoring a citizens ballot initiative to repeal the 4.2 % tax.

Rick Weiland, co-founder of the group, said lower food bills would make a meaningful difference for some.

"People of modest means, or low income hardworking families, disproportionately spend upwards of 30% on food," Weiland pointed out. "This is going to be helpful."

South Dakota is one of only two states in the country to apply its full state sales tax rate to groceries with no exemptions, Mississippi being the other. More than 9% of South Dakotans are considered food insecure, meaning they do not always have access to enough healthy food.

The grocery tax has been a popular topic among state legislators in recent years. Republican Gov. Kristi Noem even campaigned on the promise to repeal it. Critics have said proposing a tax cut without a way to finance it is irresponsible.

Weiland pointed out Gov. Noem had a formula spelled out when she brought forward her bill in 2023, which was voted down.

"She had no problem defending her position in front of the Legislature, in terms of how much revenue the state was going to lose and where they could make it up," Weiland recounted.

The initiative needs about 17,500 signatures by next month to appear on the November ballot.