TOWARD TOTAL COMMUNITY HEALTH

Kaiser Permanente’s Comprehensive Food Policy

Loel Solomon, Ph.D., National Director, Community Health Initiatives and Evaluation

CFSC Annual ConferenceVancouver, BCOctober 10, 2006

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About Kaiser Permanente

• Founded in 1945• America’s oldest and largest private

nonprofit health care system • 8.6 million members — 6.5 million

members in California• Over 13,000 physicians representing all

specialties and 153,000+ additional employees

• Operations in 9 states and Washington, D.C. with 37 Medical Centers and 431 Clinics

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Key Elements of KP’s Food Policy

• Ensure healthy food in and around KP facilities• Inpatient food• Cafeterias and coffee carts• Vending machines• Catering• Farmers markets

• Twin goals • Promote a healthy food environment for our members, employees,

physicians and KP communities• Promote a healthy environment through sustainable agriculture

• Build on KP’s heritage in health promotion and success of environmental stewardship in “making the market”

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Why Focus on Food?

• Importance of the food and physical environment on overweight and obesity-related disease

• Increased attention to food practices of healthcare organizations

• Nexus of issues/opportunities• Community food security• Environmental health• Personal health for farmworkers and consumers• Activity-promoting urban forms

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How We Got Here: A Convergence of Interests, Opportunities and Imperatives

KP’s Comprehensive Food Policy

Environmental Stewardship Council

Healthy Eating, Active Living (HEAL)Initiatives

Grassroots advocacyby KP physicians, employees

Weight ManagementInitiative

Thrive Campaign

KP Farmers’ Markets

Employee Wellness

CA Gov’sObesity Summit

ProcurementAnd Supply

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Who Is Leading the Charge?

• Physicians • RDs and health educators• Community benefit leaders• Food service directors• Procurement managers• Administrative assistants

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The Environmental Stewardship Council has brought the pieces together

Food Policy Steering Committee

• Develop vision, guiding principles

• Ensure coordination• Support implementation

Community Food Workgroup

• Farmers’ markets• Community gardens

KP Food Workgroup

• Inpatient food• Cafeterias, vending, catering

Technical Assistance and Support

• Healthcare Without Harm• Broadlane• Prevention Institute• Center for Food and Justice• Community Alliance with Family Farmers

Vending Subgroup

• IATP• PSR• Food Alliance

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Who We’ve Engaged

• Food and Nutritional Service managers• National Procurement and Supply• Environmental Health and Safety managers• Operations Support Leaders • Weight Management Network and CVD Advisory Group• Food policy leads designated by med group leaders (ongoing)• Permanente Federation leaders• Employee Wellness Inter-Regional Peer Group• CHI Inter-Regional Workgroup• Labor-Management Partnership Leadership Team• Inter-Regional Nursing Council• Health Education Peer Group Chairs• National Materials Leadership Team• NFS/Capital Projects and Planning and Design Group• Other interested groups and individuals

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Progress to Date: Community Food

• 32 farmers markets in 5 states• Clinical integration• Farm-to-facility initiatives

• Interstate Farmers Market (Portland)• Produce Packs (Oakland)

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Progress to Date: KP Food

• Healthy Picks vending program• Sustainable and healthy cafeteria

food• rBGH free dairy• Seasonal menu planning• Northern California local sourcing

pilot • RFI/RFP for KP’s national food

contract

Northern CA Inpatient Food Stats:

• 250 tons of fresh produce/year

• 6,000 meals/day; 1/3 fresh produce

Environmental Impact:

• Carbon emissions: 11.12 tons/6.34 tons “overshoot”

• Carbon footprint: 260 acres

• Estimated emissions reduction from modest seasonal menu shift: 20%

KP/CAFF Local Sourcing Pilot: Preliminary Data

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National Food Purchasing and Labeling Guidelines: RFI/RFP

• Offer Third Party certified foods?• COOL labeling?• State/county of origin or preferential local sourcing program?• Seasonality, by state?• Threatened fish stocks?• Annual reporting on OSHA, CWA, CAA violations for meat and

poultry producers?• Plans to track environmental and community health impacts of

suppliers (e.g., non-therapeutic antibiotic use, hormone use, violations, labor practices)?

• % of hog and cattle needs purchased on open market?• Nutritional content/screening of products?• Description of bio-based packaging and food service supplies?

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The Road Ahead

• Release of RFI/RFA• Completion of local sourcing pilot

• Fiscal impacts• Scalability• Reliability

• Farmers market evaluation/sustainability plans

• Systematic learning about innovative practices