This is a report of the National Academies' Institute of Medicine (Food and Nutrition Board), published here by permission. This report seeks to evaluate the use of various dietary assessment tools and to make recommendations for their use in identifying individuals who are at dietary risk.

This report describes how the Direction Card system works; the process undertaken by ODJFS and its EBT vendor to design, develop, and test the system; the implementation process and experiences; and the cost of system design, development, and implementation. Volume 2 of this report compares the ongoing administrative costs of system operations and system levels of benefit loss and diversion with those of on-line EBT systems and the Dayton pilot.