Addressing Food Insecurities. August 30, 2017 Workshop F 10:15 11:45

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Addressing Food Insecurities August 30, 2017 Workshop F 10:15 11:45

Addressing Food Insecurities Marjorie Katz Facilitator Paul Hepfer The Health Trust Anna Owings-Heidrick Humboldt County Randa Johnson Encompass Santa Cruz Barbara Vassell and Danelle Del Rincon - Stanislaus County

California s Integrated Plan Goal 2: Increasing access to care and improving health outcomes for PLWH in California Goal 4: achieving a more coordinated statewide response to the HIV epidemic

Connecting Food to Better Outcomes Food insecurity is generally defined as having limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways (Gates 2014). The lack of nutritious foods is associated with increased hospitalizations and emergency room visits among HIV positive individuals. Food is Medicine Coalition in California showed that by providing medically appropriate food to unstably housed clients (3 meals x 7 days for six months), adherence to antiviral therapy increased from 47% to 70%.

Introduction to Pilot How we cooked this up

Vendor Selection Criteria Selection criteria included but not limited to: Quality of Food Flexibility of payment and ease of invoicing Availability of food delivery to both counties and throughout California Capability to serve multiple subscriptions under one account Customer service ability to quickly provide assistance

Hello Fresh

Diet To Go

Amazon Prime Pantry Water Canned beans Olive oil Salt & pepper Oatmeal Almond butter Veggie pasta Fruit cups Various spices (basil, oregano & garlic powder)

Logistics 1. Contracting 2. Ordering 3. Delivery Confirmation 4. Communication to Vendors

Selection of Pilot Partners Counties/ Agencies Humboldt County Napa County Ryan White Clients 1.Within the last 30 days, I worried whether my food would run out before I could get money to buy more.* 2.Within the last 30 days, the food I bought just did not last and I did not have money to get more.* *USDA U.S. Household Food Security Survey Module

North Coast AIDS Project Anna Owings-Heidrick, Senior Health Education Specialist Humboldt County Department of Health and Human Services, Public Health, North Coast AIDS Project

North Coast AIDS Project

Humboldt County

Quotes from clients: This is saving my life. Helped financially and nutrition. There is no grocery store here and you have to drive either 12 miles or 60 miles. The price is sometimes ridiculous. So this program (Hello Fresh) really helps me with that. It s just enough for me since it s only me that s living here. I cooked the Cesar salad yesterday for dinner and now I m going to eat it for lunch. I have no negative comments. It s absolutely wonderful. I wouldn t get by without it (Hello Fresh). Especially with the financial issues. I eat all of the food. I split the portions to make a lunch and dinner. And I only eat proteins and lots of vegetables.

Pilot Project To Date 35 Number of Clients Receiving Meals per Month 30 25 20 15 10 21 32 29 30 30 27 26 26 27 27 24 25 25 Napa Humboldt 5 0 11 6 0 January February March April May June July August

Since receiving HelloFresh my life and how I feel physically, mentally, and emotionally, has improved tremendously. Every Tuesday I receive a box from HelloFresh, I always get so excited when Tuesday comes. HelloFresh has truly changed my diet, my way of life, and my palette. I don't know how I would feel without HelloFresh. "I had to deal with a lot but this is 100% excellent. It's helping with my health and I've decided to quit smoking. I want to be healthier." When I didn t know how to cook, I was cooking and eating horribly, but now it s wonderful and perfect. I gained 5-7lbs in good weight. It makes me feel so much better and much healthier. I sleep better. Eating those good foods, I have way more energy!

Contact Information Paul Hepfer Vice President of Programs The Health Trust Paulh@healthtrust.org 408.961.9845 Anna Owings-Heidrick Senior Health Education Specialist Healthy Communities Division, Public Health Branch Humboldt County, DHHS aowings-heidrick@co.humboldt.ca.us (707)441-5568

Santa Cruz AIDS Project/ Encompass Community Services Randa Johnson, M.A., M.P.P. Client Services Supervisor

Feed Two Birds

Step 1: Encouraging people to try unfamiliar vegetables or: What in the world do you do with kale? Two to five minute interventions toward better nutrition and health. Chop it up and put it in soup. Steam it, and eat it with vinegar. Sautee it with garlic and oil.

The produce in the pantry offers a great opportunity to: Introduce clients to highly nutritious food, encouraging clients to cook at home more Reduce food costs Decrease salt, oils, trans fats and empty calories Make friends, contribute to the wider community and potentially gain job skills.

Job Training program/ Volunteer opportunities

Reducing HIV Related Disparities and Health Iniquities by improving access to quality food and fun!

Funding Community donations cover the cost of share boxes Free produce from the Santa Cruz Farmers market picked up by volunteers at the end of the market. Supplemental HCP funds buy an additional CSA share box. Participating agencies are required to bring volunteers to 2 volunteer events.

Contact Information Randa Johnson, Client Services Supervisor Santa Cruz AIDS Project/ Encompass Community Services Randa.Johnson@encompasscs.org 831-588-9259/ 831-427-3900 x 3533 Darrie Ganzhorn Executive Director Homeless Garden Project PO Box 617 Santa Cruz, CA 95061 831.426.3609.12

Stanislaus County Presented by Danelle Del Rincon, Community Health Worker II Stanislaus County HIV/STD program, Public Health Department- Health Services Agency

HIV Care Program Ryan White funded program Uninsured and underinsured clientele Program guidelines Supplemental Grant awarded

Contact Information Danelle Del Rincon Community Health Worker II Stanislaus County HIV/STD program Public Health Department- Health Services Agency 209-558-4169 direct line Ddelrincon@schsa.org

Food is Medicine Coalition Purpose: To advance public policy that supports access to food and nutrition services for people with severe and/or chronic illnesses To promote research on the efficacy of food and nutrition services on health outcomes and cost of care To share best practices in the provision of medically tailored meals and of nutrition education and counseling.

Food is Medicine Coalition Improved Nutrition 64% decrease in food insecurity 27% increased frequency of fruit & vegetable consumption Improved Mental Health 23% reduction in symptoms of depression and distress about chronic illness 6% decrease in internalized HIV stigma Improved Diabetes Health & HIV Health Adherence to diabetes medications increased by 21% and HIV medication by 50%

Medically Tailored Meal Pilot Three year $6 million pilot project to evaluate the impact of medically tailored meal intervention on the health outcomes and health care costs of seriously ill Medi-Cal patients. The study will be conducted in seven counties in California Sonoma, Marin, Alameda, San Francisco, Santa Clara, Los Angeles and San Diego by the following organizations: Ceres Community Project Food for Thought Mama s Kitchen Project Angel Food Project Open Hand The Health Trust

Medically Tailored Meal Pilot Medically Tailored Meals are meals approved by an RDN that reflect appropriate dietary therapy based on evidence-based practice guidelines. Diet/meals are recommended by an RDN based on nutritional assessment and/or by a health care provider to address medical, symptoms, allergies, medication management and side effects to ensure the best possible nutrition-related health outcomes. Proposed Outcomes: Decreased acute care use Reduction in health care costs

Addressing Food Insecurities Questions??