In this National Kale Day interview, Marydale discusses two key strategies for transforming institutional food: first, the crucial importance of having the institution’s top leadership understand and promote the changes; and second, moving away from “food court” eating (too many choices, too many calories) to a simplified plant-based menu that uses the tastiest, most nutritious ingredients. As Marydale explains, food costs are controlled when menus feature fewer options and less meat.
As they strive to prove they are benefiting communities under the Affordable Care Act, nonprofit hospitals may become the latest battleground between fast-food purveyors and advocates of healthy—and preferably locally produced—cuisine.
“I am looking for opportunities for you to be the doctors to the world,” said Marydale DeBor, a former Connecticut hospital executive, at the convention for the National Farmers Union last month in Springfield, Mass.
Hospitals have long been a culinary joke, serving unappetizing food of questionable nutritional value to patients while selling fast food that is even more questionable in their cafeterias. Medical-school critics have chastised physicians for prescribing to patients costly drugs to deal with the effects of diseases that arise from bad diets and lack of exercise rather than feeding them healthy food and teaching them to eat better when they leave the hospital.
A drive straight north from New Haven, CT (my hometown) to the shore of Lake Champlain in Burlington, VT (the location of a conference where I was a speaker) on a beautiful August day is sheer joy, given the natural beauty that embraces one travelling north, even if one is not “on a mission.” But alas, I am always on a mission: to engage the health care “sector” in the national movement to reinvent our food system (the subject of my speech at the conference), and to promote New England Farmers Union as an important actor in creating solutions to the food system crisis we face. So, the drive was a bonus and the experience of being a participant and a speaker at the conference was… a gift. I learned that:
DeBor observed that the new federal Patient Protection and Affordable Health Care Act has strengthened the long standing IRS “community benefit” requirement that nonprofit hospitals must meet to justify their nonprofit status. This includes a mandate to perform a “community needs assessment” in collaboration with public health experts and stakeholders in local communities served by the hospital/hospital system and then to develop and implement a plan to meet the identified needs. Since obesity-related chronic disease is a widespread problem and improving food systems and access to healthful foods is now recognized as part of the solution to this problem, farmers should be among the stakeholders participating in the community needs assessment process.
SPRINGFIELD, Mass. — Hospitals around the country should become new markets for farmers to provide healthy, often locally-produced food to comply with their legal requirements under the Affordable Care Act, a prominent health care consultant told the National Farmers Union at its annual convention here this week.
“Hospitals have to demonstrate to the Internal Revenue Service that they are investing dollars into the community that justifies their nonprofit status. This is a time to become engaged as a community advocate for food and what impact it has on the community,” said Marydale DeBor, a former Connecticut hospital executive who now runs a New Haven consulting business called Fresh Advantage.
“I am looking for opportunities for you to be the doctors to the world,” DeBor said.
For the first time in its 111 year history the National Farmers Union will hold its convention in New England and Fresh Advantage’s Marydale DeBor is pleased attend as a member of the New England Farmers Union board of directors and delegate to the national convention.
Marydale will present at a breakout session called “Scaling up to Meet Demand” which will look at how farmers can grow to meet the demand for local foods by expanding and by working with fellow family farmers through cooperatives and other organizations.
The Patient Protection and Affordable Care Act (PPACA) will compel hospitals to promote population health in the communities they serve. Practicing prevention and keeping the general population served healthy will be a necessity as new payment models are adopted by third-party payers and pressure increases to control per capita costs. In addition, specific mandates tied to reimbursement include reducing patient re-admissions within 30 days of discharge.
PPACA also affects health-care sector employers: incentives exist within the new law for wellness programs that can keep an institution’s workforce healthier and more productive while reducing costs.
VIDEO & PODCAST LIBRARY
Recovery is Cooking
From Connecticut Mental Health Center
Plow to Plate
Before Fresh Advantage, Marydale co-founded Plow to Plate. Hear about their successes on All Things Connecticut
Prescribing Food, Part 1: Making Hospitals Healthier
From Heritage Radio Network
Women Addressing Food In Healthcare
From the Yale Sustainable Food Project Podcast