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1 Revised 8/13/

2 The Program Agreement and the Free Food Sack Allotment forms must be completed and turned in before you are officially enrolled in the Backpack Buddy program. Information may not be removed or added to any Backpack Buddy form. What is the Backpack Buddy Program? The Backpack Buddy Program is intended to feed chronically hungry children over the weekend. Schools within 18 counties are eligible to participate. In FY 15, over $500,000 in donated revenue was utilized to operate the Backpack Buddy Program. I. Identify food insecure children Staff Awareness: Please explain the Backpack Buddy program to all your school staff and ask for their help in identifying children that would benefit from the program. Food Bank Guidelines Please stress that teachers should only refer students who are chronically hungry. Participating students must be receiving free or reduced lunch. In order to be in compliance with the Texas Emergency Food Assistance Program (TEFAP), If student is not a recipient of free or reduced lunch, the student must have a letter on file from the parent or guardian stating extenuating circumstances or economic hardship(s). The same students should receive the food sacks each week. Upon submission of the Program Agreement, you will be informed of your allotment. The allotment will define the amount of children that you may select to participate in the Backpack Buddy Program. This number is based on the number of students who receive free lunch, reduced lunch and the school s total enrollment. Helpful Tips Discuss your plans for how food will be distributed. Get input from staff so that everyone will be accommodating to your plan of food/backpack distribution. II. Logistics Food Storage: You will need an approved location in the school where food can be safely stored. Food Bank Guidelines All food (whether in a box or just in the sack) must be stored at least 4 inches off the ground (on a pallet, shelf, and/or desk), away from the wall and 6 inches below the ceiling. Storage area should be dry, clean and free of pest. Storage area should be climate and temperature controlled. Revised 8/13/15 2

3 The storage area should be locked when not in use. Food should be stored away from cleaning materials and toxic chemicals. It is pertinent to utilize the first in, first out (FIFO) method when distributing the food. Make sure that the date in which the food is received is clearly stated in/on the storage area. Organize the food stock so that the first received is the first given out during distributions. This is to ensure that the older food is distributed prior to the newer shipment of food. Distribution Method: Develop a plan for how food will be distributed each Friday. STEP 1: Determine how the food sacks will be distributed. a) What will be the best time for children to receive their backpack? b) What will be the most efficient way to hand them out? c) Who will be your back-up person if you are absent? Child Confidentiality: Please distribute the food in a way that the children will not be embarrassed. Even if children are not embarrassed to receive the food, please maintain a level of confidentiality to prevent potential problems (e.g., other children seeing the food sack and asking for it). Avoid making obvious public announcements that refer to children receiving the food. For example: instead of announcing, Backpack Buddy program, come to the office, try saying, Backpack Buddy members please come to the office. Do not hand food to children in the midst of their peers who are not receiving food, e.g., coming in a classroom with food sacks and calling referred students to receive food in front of the class. Hall passes can be used to gather the students at the time of distribution. On Friday mornings, the hall passes can be placed in the boxes of the teachers that have students that are participating in the Backpack Buddy Program. The hall passes can be found on the last page of this packet. In order to be in accordance with The Emergency Food Assistance Program (TEFAP), it is necessary to inform the Houston Food Bank of the names of the children who are receiving the food sacks. If confidentiality is a concern, the first initial and last name (or vice versa) of the student will be accepted. STEP 2: Keep accurate records of children receiving food. Food Bank Guidelines Backpack Buddy Monthly Report: due on the fourth (4 th ) Friday of the month. The report will be send to you every month via . The report will be sent out a week after the previous month s due date. There is no grace period for reports to be turned in to the Houston Food Bank. If you fail to turn in a monthly report, we will not be able to order or distribute food sacks for your school until the report(s) are submitted. Revised 8/13/15 3

4 If there are extra food sacks at your campus (at the end of the month; at completion of the monthly report), please denote the quantity on your monthly report. Please complete the monthly report in its entirety. The testimonial section of the report is vital and assists with funding the Backpack Buddy Program. III. Contact Due Dates of Backpack Buddy Report Monthly Reports September 25, 2015 January 29, 2016 October 30, 2015 February 26, 2016 November 20, 2015 March 25, 2016 December 18, 2015 April 29, 2016 May 27, Denotes the 5 th Friday of the Month You must contact the parents/guardians about their child s invitation to participate in the Backpack Buddy Program. Food Bank Guidelines: Only parents whose children have been referred by a teacher or staff member should be contacted. Each child must have a permission slip on file at your campus, prior to the receipt of food on behalf of the Backpack Buddy Program. Child: Explain that they will receive a sack of food each week First priority for enrollment should go to your homeless students. Students that are living in homeless shelters may not be the best candidates for this program. Tell the child that the food is for them to eat when and if they get hungry throughout the weekend. Although it is okay for them to share, try and stress that the food is for them. If you hear a child say that another family member is taking all their food and they are left with nothing to eat, please contact the parent to resolve the situation. This may also be a good opportunity to talk to them about going to a food pantry. Please visit the Houston Food Bank s website to locate a food pantry near you or call the hotline for Social Services. Caution the child not to share the food with their friends or open the food sack until they get home. If you have any issues of children selling the food, giving it all away to friends or taking advantage of the program, you do have the authority to discontinue services to that child. Each participating child should receive a food sack; even if there are siblings at one campus. Revised 8/13/15 4

5 TEFAP Declaration: Standards for participation in the Program are the same for everyone regardless of race, color, national origin, age, sex or disability. You may appeal any decision made by the local agency regarding your denial or termination from the Program. If your application is approved, the local agency will make nutrition education available to you and you are encouraged to participate. o TEFAP products comprise a large percentage of the food sacks that are distributed to the Backpack Buddy Participants IV. Ordering Ordering is not necessary; the shipments are consistent unless otherwise specified. Shipment quantity can be adjusted should there be extra food sacks at your campus. Please be sure to denote the remaining amount of food sacks at your campus on the monthly report. All will have a standing order throughout the school year. The order will be based off of the percentage of students who qualify for free and/or reduced lunch at each campus. If the shipment quantity is greater than the needs at your school, please contact the Backpack Buddy Coordinator at or by to make the proper adjustments. Please be advised: During times near holidays or extensive breaks from school (i.e. Christmas, Thanksgiving and Spring Break holidays) deliveries of extra food sacks may be made.) V. Delivery/Pickup Each school will work with the Houston food Bank to arrange a pick up regime or delivery regime. The Houston Food Bank cannot guarantee delivery and some schools might have to retrieve the backpack buddy food sacks from Houston Food Bank. Delivery Pickup Under certain circumstances, deliveries to local agencies or individual ISD distribution centers can be provided by the Houston Food Bank. If your school is eligible you will be notified when you submit the agreement, and details will be discussed. Backpack Buddy food sacks can be picked up by all actively participating schools at the Portwall location only. Located at 535 Portwall St., Houston, Texas Pick-Ups are done by APPOINTMENT ONLY. Failure to make an appointment may result in the declination of the food sack(s) retrieval. Revised 8/13/15 5

6 o Appointment times are as listed: Tuesday Thursday from 11:00am 3:00pm o Standing appointments are welcomed and suggested. o Appointments must be mad by the end of business on Mondays for the week of the pick-up via . o If pick-up cannot be made at the scheduled time, please call and reschedule. Failure to reschedule will result in the declination of food sack(s) retrieval. VI. Site Visits To ensure that the food is being stored properly, site visits will take place. These visits may be random (unannounced) or announced. At this time, any questions or concerns about the storage and/ or distribution of food can be assessed and answered. It is pertinent that the food sack distribution be very discrete and conducted as such. Random (unannounced) or announced visits may be conducted at your campus to assess the distribution of the food sacks. Free and Reduced lunch status of the Backpack Buddy participants will be checked to confirm compliance with TEFAP Guidelines. Permission forms will be audited, please keep forms in an organized fashion by academic school year. Each school/campus and agency is subject to a site visit; announced or unannounced. VII. Teachers Aid Incentive to Backpack Buddy Participating Campuses Teachers Aid is a program offered to Teachers and Counselors at schools in which 70% of students are receiving free and/or reduced-price lunch and who participate in the Backpack Buddy Program. Teachers are allowed to visit Teachers Aid on a scheduled basis to gather school supplies for their students. Appointments are mandatory for admittance to the Teachers Aid Center. Schools that demonstrate compliance with the guidelines of the Backpack Buddy Program will receive increased incentives through the Teachers Aid Program. Compliance lies with successful completion of the monthly report on the due date and successful site visits. Likewise, failure to be in compliance with the Backpack Buddy Program can lead to the discontinuation of shopping privileges at the Teachers Aid Center. Schools that do not have 70% or more of their students on free and reduced lunch; will be invited to Teachers Aid on an invitation basis. For further information on Teachers Aid, please visit the Houston Food Bank website ( or contact the School Programs Coordinator at teachersaid@houstonfoodbank.org. Revised 8/13/15 6

7 Backpack Buddy Food List The food included in the Backpack Buddy program is child friendly, nonperishable, and vitamin fortified. The food sacks are pre-packaged and contain shelf stable product. Here are some examples of the food the participants will receive: Protein: Meat Stews with Vegetables Canned Chicken or Tuna Vienna Sausages Chili Canned Ravioli Canned Spaghetti with Meatballs or Meat Sauce Fruits & Vegetables: Canned Fruit packed in 100% Juice or light syrup Canned Vegetables Grains: Cereal Oatmeal Healthy Snacks: Yogurt Cereal Bars Fruit filled Cereal Bars Pretzels Graham Crackers Granola Dried Fruits Fruit Snacks *Trail Mix *Peanut Butter Dairy: Milk- Regular or Flavored Bottled Water *possible allergen-containing ingredients ** Please be advised- Nutritional Flyers/Child Friendly Toiletry may be found within the food sacks. Please alert your students of the importance of nutrition to reinforce the value of this information. ** Revised 8/13/15 7

8 Program Agreement Name of School Elementary School Address of School Middle School City, State and Zip High School School ISD Grades Served This document is an agreement made between the Houston Food Bank (hereinafter referred to as HFB ) located at 535 Portwall St. Houston, TX and (your school s name) located at (your school s address). By signing this agreement, both parties acknowledge their respective duties and responsibilities related to the administration of the Backpack Buddy Program. Program Partner (school participating in the Backpack Buddy Program) agrees to: The safe and proper handling of food, which conforms to all local, state and federal regulations. Willingness to abide by the policies, procedures, and record keeping requirements of the Houston Food Bank. Staff or volunteers of the program will not engage in discrimination, in the provision of services, against any person because of race, color, citizenship, religion, gender, national origin, ancestry, age, marital status, disability, sexual orientation including gender identity or expression, unfavorable discharge from the military or status as a protected veteran. 1. Please distribute healthy, nutritious food to children free of charge. 2. Identify children that are chronically hungry in your school(s) using the guidelines specified in the Faces of Hunger. 3. Please identify the food allergies the enrolled child may have (peanuts, milk, etc.). Flag their name so that those items will not be distributed to them once sent to the school. 4. Store the food sacks 4 inches off of the floor, away from the wall and 6 inches below the ceiling. 5. The food should be kept in a secure place that is sanitary, temperature controlled, and away from cleaning materials and toxic chemicals. 6. Please distribute food sacks each week (on Friday s, unless otherwise specified due to holidays or school closures) to students with completed permission forms on file. 7. Provide food sacks a minimum of three times a month while the program is in operation. 8. Keep accurate records. Please prepare and submit the completed Backpack Buddy Monthly report each month by the 4 th Friday of the month. 9. Please have the Backpack Buddy Site Representative available for an on-site monitoring visit at least once every two years from the Houston Food Bank. Revised 8/13/15 8

9 10. If you would like to add an additional child because you have available bags, please ensure you are following the criteria as specified in the Faces of Hunger, have a permission form on file and continue communicating to the child that they will be eligible only through the end of the school year or June 10, Please submit this Program Agreement submitted yearly by the school with updated numbers and contact information. 12. Ensure the school and/or program complies with all applicable federal and local statutes, ordinances and regulations. 13. Participating students must be receiving free or reduced lunch. In order to be in compliance with the Texas Emergency Food Assistance Program (TEFAP), If student is not a recipient of free or reduced lunch, the student must have a letter on file from the parent or guardian stating extenuating circumstances or economic hardship(s). 14. Ensure staff and volunteers with direct repetitive contact with children pass a national background check. 15. At least one representative (from each participating campus) will need to receive some form of food safety training, such as ServSafe Food Handler for Food Banking developed by Feeding America and the National Restaurant Association, or an equivalent training. The Houston Food Bank will provide the training to the Backpack Buddy Campus Representative. 16. If you are contacted by any form of media to discuss the Backpack Buddy program please contact the Backpack Buddy Coordinator before granting any interviews. 17. If contact information changes, please notify the Backpack Buddy Coordinator must be notified ASAP. 18. For any questions that you may have in reference to the program, please contact Backpack Buddy Coordinator. We understand that we will receive food from the Houston Food Bank to help us provide food to chronically hungry children. We understand that the food we receive for the Backpack Buddy program can only be used for that purpose. We understand that the food and backpacks cannot be sold, used for other school programs, used for fundraisers, given to staff, or used for any other purpose other than to provide food to chronically hungry children. Food sack items may not be removed, replaced or added unless approved by The Houston Food Bank. Failure to comply with the program requirements will result in the loss of the Backpack program. I certify that I have read the Backpack Buddy Information Packet in its entirety. By signing this agreement, we; the Backpack Buddy Representative and the affiliates at the campus level, acknowledge the respective duties and responsibilities related to the administration of the Backpack Buddy Program. Signature of School Principal Backpack Buddy Campus representative/ contact * Date Date Please print clearly *Backpack Buddy Campus Representative s contact information: Direct phone Revised 8/13/15 9

10 Free Food Sack Allotment Please turn this form in with your signed Program Agreement to the Houston Food Bank to begin your school s enrollment. The form may be sent via to lhorton@houstonfoodbank.org. Name of School Address of School Number of children who receive FREE lunch Number of children who receive REDUCED lunch Total enrollment in your school School dismissal time By signing below, I certify the above information is true and correct. Name: Date: / / 20 Principal s Name: Principal s Address: Food Sack Pick-Up information /Agency information (Please only fill out this section if you will have an agency picking up from the Houston Food Bank on behalf of your campus) Please indicate the frequency of the food sack pick up: Weekly Bi-Weekly Monthly Name of person or agency that will be picking up your food sacks Phone Number Please scan and completed forms to backpackbuddy@houstonfoodbank.org. Revised 8/13/15 10

11 Faces of Hunger The following information was created to help with the identification of the children who are best fit for the receipt of the food sacks. Homeless children should be considered first when identifying recipients of the food sacks. If the homeless children are living in a shelter, they may not be the best reciepients of the food sacks due to the fact that shelters do not allow food to come in from outside of the facility. The following are examples of behaviors that may be seen in children that are chronically hungry: o Rushing to the cafeteria line or showing up noticeable early for breakfast o Consistently cleaning their plate and not carelessly throwing portions away o Lingering around for seconds or asking others for their leftovers o Exhibiting extreme hunger on Monday morning o Lingering around food lines o Consistently requesting snacks or supplements to their meals There is a notable difference between a child that is hungry and a child that is chronically hungry. One must know the difference. When uncertain, look into the situation. Using the behaviors mentioned above would be a good tool. You may see the following changes in children that are chronically hungry : o Behavior changes o Mental changes o Detrimental performance in math and reading o Declination in responsiveness and attention span o Depression o Extreme sleepiness o Mood Swings o Changes in physical appearance o Excessive absences If you need more assitance or have any more questions in reference to this, feel free to contact Backpack Buddy Coordinator at backpackbuddy@houstonfoodbank.org or Revised 8/13/15 11

12 Dear Parent/Guardian: Your child has been selected to participate in the Houston Food Bank Backpack Buddy Program. Here s how it works: Every Friday afternoon at the school your child attends, your child will receive a sack full of nutritious food for the weekend. The food sacks are distributed as discreetly as possible and generally contain enough food to serve one child per weekend. There is no charge for the food sacks to you or to the student. TEFAP rights and responsibilities are as follows: Standards for participation in the Program are the same for everyone regardless of race, color, national origin, age, sex, or disability. You may appeal any decision made by the local agency regarding your denial or termination from the Program. If your application is approved, the local agency will make nutrition education available to you and you are encouraged to participate. If you would like for your child to participate and understand your rights and responsibilities, please complete the information below. Your Child s Name Parent/Guardian Name Grade Date Student s Race White/Caucasian Black or African American Hispanic or Latino Asian Native Hawaiian or Other Island Pacific Islander Other Student s Gender Male Female Family Income (Annual) Less than $15,000 $15,000-$30,000 $30,000-$45,000 $45,000-60,000 $60,000+ I do not wish to share Number of Household Members Participating in the Supplemental Nutrition Assistance Program (SNAP)? Yes No If you have any questions about the program, please contact the Backpack Buddy Representative at your school: School Backpack Buddy Representative Phone Number Thank you, Backpack Buddy Program Houston Food Bank I understand that the food and backpacks cannot be sold or used for other purposes. Should my child no longer need assistance through the Backpack Buddy Program, I will notify the coordinator at my child s campus. Estimado Padres/ Guardián: For supplemental assistance, please contact the Backpack Buddy Coordinator at your child s campus. Revised 8/13/15

13 Su hijo/a ha sido seleccionado para participar en el Programa de Backpack Buddy de parte del Houston Food Bank. Y esta es la manera de cómo funciona: Todos los viernes por la tarde en la escuela de su hijo o hija, su hijo/a recibirá una bolsa llena de alimentos nutritivos para el fin de semana. Las bolsas de alimentos se distribuyen en la mayor discreción posible y generalmente contienen suficiente comida para servir a un niño/a por todo el fin de semana. No hay ningún cargo para las bolsas de alimentos para usted o para el estudiante. TEFAP derechos y responsabilidades de los participantes son los siguientes: Normas de participación en el Programa son los mismos para todos, independientemente de raza, color, origen nacional, edad, sexo o discapacidad. Usted puede reclamar cualquier decisión tomada por la agencia local respecto a su negación o la terminación del programa. Si su solicitud es aprobada, la agencia local hará que la educación nutricional sea disponible para usted y le alentamos a que se animen a participar. Nombre de su hijo Nombre de padres / Guardián Grado Fecha Raza del Estudiante Blanco/Caucásico Afro- Americano Hispano o Latino Asiatico Nativo de Hawaii o de otra isla de las Islas del Pacífico Otro Género del estudiante Masculino Femenina Ingreso Familiar (Anual) Menos de $15,000 $15,000-$30,000 $30,000-$45,000 $45,000-60,000 $60,000+ No deseo compartir Número de miembros del hogar Participa en el Programa de Asistencia de Nutrición Suplementaria (SNAP)? Si No Si usted tiene alguna pregunta sobre el programa, por favor póngase en contacto con el Backpack Buddy de Representante en su escuela: Representante de Backpack Buddy Número de teléfono Gracias, Backpack Buddy Program Houston Food Bank Entiendo que la comida y las mochilas no pueden ser vendidas o utilizadas para otros fines. En caso de que mi hijo ya no necesita ayuda a través del Backpack Buddy Program, notificaré al coordinador de la escuela de mi hijo. Para asistencia suplementaria, por favor póngase en contacto con el Coordinador del Backpack Buddy Program, en la escuela de su hijo. Revised 8/13/15

14 Revised 8/13/15

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