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In 2010, the U.S. Department of Agriculture (USDA) Food and Nutrition Service (FNS) funded pilot projects in three States (New Mexico, Pennsylvania, and Washington) to explore the issue of low SNAP participation among older adults. The aim of the pilots was to expand access to SNAP for a narrowly defined group of people who were already seeking to connect to public assistance programs for specific medical costs. The states linked SNAP caseload data to medical assistance program data to identify potentially eligible people who were not yet enrolled in SNAP. The states then worked with these clients to help them access SNAP by (1) assisting them with SNAP applications and/or (2) simplifying enrollment procedures. The pilots focused mainly on reaching elderly clients, but some also served people with disabilities who were enrolled in programs to cover their medical costs. To evaluate the effects of the pilots on SNAP participation, FNS contracted with Mathematica Policy Research to conduct a multiyear, multimode study. The pilot projects in all three states had positive effects on SNAP applications and approvals among the target population. The effects varied widely in percentage point magnitude because of a wide range in the size of the target populations, but were small in real terms. The cost of serving these populations also had a wide range. The report describes these effects and costs, as well as program implementation and lessons learned.