Progress 09/01/18 to 08/31/21
Outputs
Target Audience:Mainstreaming Food Access targeted residents living in low-income housing developments in Franklin County where 40% of households live on less than $25,000/year, patient households of the Community Health Center of Franklin County, as well as patients of three health clinics participating in the Boston Children's Hospital Accountable Care Organization in Franklin, Hampshire and Hampden Counties. Census tracts in and around Greenfield have poverty rates of 15% to 25%, and the USDA's Food Desert Locator identifies them as low income (LI) and low access (LA). A Community Health Needs Assessment by Baystate Franklin Medical Center (based in Greenfield and serving Franklin County) identified four principal factors affecting health in the area: poverty (lack of resources to meet basic needs), lack of housing, lack of transportation, and food insecurity/food deserts. Patients participating in Just Roots programming through the Boston Children's Hospital Accountable Care Organization are 45% white, 55% other including: 25% Puerto Rican, 12% Hispanic, 3% Black and representation of Asian, Cape Verdean, Caribbean, Dominican, Trinidadian, Peruvian and Cuban. 60% of patients identify their ethnicity as Hispanic; 38% identify as not Hispanic, and 2% as other. All Boston Children Hospital participants are living with income levels and/or life qualifying scenarios that qualify them for MassHealth (Medicaid/Medicaid expansion/CHIP). The target audience was engaged where they live and receive their healthcare. For safety after the arrival of the pandemic, doorstep delivery of all associated programs was made available. Locations where the audience was engaged included The Community Builder's housing development, Leyden Woods; two Greenfield Housing Authority locations, Oak Courts and Elm Terrace; delivery to doorsteps in Franklin, Hampshire and Hampden counties; and in downtown Greenfield at the Community Health Center of Franklin County, where a significant portion of patients are deemed "low-income." Changes/Problems:The pandemic continued to have significant impacts on theprogram. However, in-person CSA and Feastivals were done through delivery and drop-off so people continued to receive the healthy food as planned. What opportunities for training and professional development has the project provided?
Nothing Reported
How have the results been disseminated to communities of interest?
Nothing Reported
What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
During this period, we hit a new maximum shares distributed per month. The 319 CSA shares delivered in December 2021 almost quadrupled 83 shares delivered in December 2019. The additional 125 shares from two new ACO partnerships which came on line during this period were a key part of this growth. These partnerships, plus the continuing work with World Farmers continued to support produce delivery as well as administration and patient care. Wrap-around service support continued to include enrollment and SNAP support, delivery, education, resource connection and workshop opportunities. Nutrition education, cooking education and wellness resources continued to be distributed with each CSA. On the back end, the project team continued to refine a new Salesforce database to meet HIPAA compliance and referral needs.
Publications
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Progress 09/01/20 to 08/31/21
Outputs
Target Audience:Mainstreaming Food Access targeted residents living in low-income housing developments in Franklin County where 40% of households live on less than $25,000/year, patient households of the Community Health Center of Franklin County, as well as patients of three health clinics participating in the Boston Children's Hospital Accountable Care Organization in Franklin, Hampshire and Hampden Counties. Census tracts in and around Greenfield have poverty rates of 15% to 25%, and the USDA's Food Desert Locator identifies them as low income (LI) and low access (LA). A Community Health Needs Assessment by Baystate Franklin Medical Center (based in Greenfield and serving Franklin County) identified four principal factors affecting health in the area: poverty (lack of resources to meet basic needs), lack of housing, lack of transportation, and food insecurity/food deserts. Patients participating in Just Roots programming through the Boston Children's Hospital Accountable Care Organization are 45% white, 55% other including: 25% Puerto Rican, 12% Hispanic, 3% Black and representation of Asian, Cape Verdean, Caribbean, Dominican, Trinidadian, Peruvian and Cuban. 60% of patients identify their ethnicity as Hispanic; 38% identify as not Hispanic, and 2% as other. All Boston Children Hospital participants are living with income levels and/or life qualifying scenarios that qualify them for MassHealth (Medicaid/Medicaid expansion/CHIP). The target audience was engaged where they live and receive their healthcare. For safety after the arrival of the pandemic, doorstep delivery of all associated programs was made available. Locations where the audience was engaged included The Community Builder's housing development, Leyden Woods; two Greenfield Housing Authority locations, Oak Courts and Elm Terrace; delivery to doorsteps in Franklin, Hampshire and Hampden counties; and in downtown Greenfield at the Community Health Center of Franklin County, where a significant portion of patients are deemed "low-income." Changes/Problems:Non-COVID Challenges COVID presented major challenges for institutional purchasing of local frozen produce during the 2020-21 school year and the FCCDC was unable to distribute any frozen produce to Franklin County Schools due to budgetary and distribution challenges. However, due to a longstanding partnership with Springfield Public Schools, which are located just south of Franklin County, the FCCDC was able to freeze and sell 10,800 lbs of produce to Sodexo food service, which serves 63 schools and 25,000 kids in the Springfield school district. As a result of a farm to school panel hosted by Chicopee Public Schools, FCCDC has established a strong partnership with Marty's Local, a local food distributor who delivers to many schools and other businesses in Franklin County and the Pioneer Valley. Local K-12 schools are now able to order frozen local veggies via Marty's Local if they are able to meet minimums. Meeting minimums does continue to be a challenge for local schools and FCCDC will continue working with local food system partners to get frozen veggies into existing distribution channels for those schools. Other challenges include that fewer meal and DIY kits were distributed this year than planned for, and with restrictions on programming from outside agencies at the housing developments, fewer low income housing residents participated in the CSA program. With a year of practice under our belts, distribution utilizing Covid-safe guidelines functioned more smoothly this year, but still required constant attention to guidelines especially as Covid fatigue set in. COVID Related Challenges The COVID-19 pandemic continued to have a considerable impact on program delivery during this reporting period. As with last year, Just Roots took action to ensure participant safety during in person training and pickups. However, a resurgence in COVID cases in the community during the summer led to an re-emergence of hesitation for public social activities. This was particularly true for the North Quabbin region, where Just Roots has long had plans for significant expansion. In particular, COVID has stymied progress in the area of disseminating program models to other Federally Qualified Health Centers (FQHCs). However, we have initiated contact with Hilltown Community Health Center and Community Health Connections of Fitchburg, both FQHCs, and will begin conversations at appropriate time. Finally, COVID presented major challenges for institutional purchasing of local frozen produce during the 2020-21 school year and the FCCDC was unable to distribute any frozen produce to Franklin County Schools due to budgetary and distribution challenges. Additionally, Just Roots has had decreased participation of housing development residents during COVID. Covid's lockdown created significant obstacles and community anxiety to maintain the close relationships cultivated over the years with housing residents. With in-person block parties and on-site workshops being less available, membership numbers waned, and Just Roots continues to explore ways to rebuild connections within the communities. What opportunities for training and professional development has the project provided?Training Just Roots continued to receive inquiries from other farm/food organizations seeking to better understand the opportunities to migrate their CSA programs to accessible programs and to understand how to enter into partnerships with healthcare. Just Roots gave of its time and expertise freely, supporting a # of organizations including Mill City Grows, Sustainable CAPE, Wellspring, All Farmers, Dicks Farm Market and Agri-Organics. Professional Development Just Roots completed the Innovation Accelerator course which connected them to a variety of funders, thought leaders and business entrepreneurs. Participation broadened the staff capacity for business development, learning the components of developing a product, exploring market potential and going to market. The course also provided broadened awareness of the Just Roots model. How have the results been disseminated to communities of interest? Just Roots has presented on its program featuring integration between food and healthcare systems to a # of audiences including MA Food System Collaborative annual forum, Charlemont public forum, Shelburne Women's Society, Hampshire County Food Policy Council, Franklin Food Policy Council, MDAR annual conference, Healthy Eating Community of Practice, Food Is Medicine Massachusetts Coalition and Leadership Pioneer Valley; and provided updates on its program to a group of 18 ACOs and participating Social Service Organizations that are piloting food/health programs under the SSO Preparatory Fund managed under the Department of Public Health in MA. Just Roots Executive Director and Associate Director provided 4 public testimonies supporting bills related to Food Is Medicine, SNAP, Food/Health integration/research and emergency safety nets. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
General Food Distribution Between September 1, 2020 and October 31, 2021, over 650 households received CSA shares. 185 households utilized SNAP to pay for their shares, an additional 76 families utilized the sliding scale created for lower-income families who do not have or choose not to use SNAP for their shares. Finally 250 members enrolled through ACO partnerships, utilizing MassHealth (Flexible Services dollars) to cover their shares. Much of the growth of this year was driven by partnerships with Boston Children's Hospital Accountable Care Organization (BCH ACO), Partners ACO, as well as an all-time high number of participants receiving shares through the Community Health Center of Franklin County (CHCFC). Community Supported Agriculture (CSA) distributions continued outside the CHCFC with food demonstrations and a walk up market to allow access for CHCFC member participants and other members with limited transportation options. Just Roots also formalized partnerships with World Farmers to supply produce to food insecure patients of the healthcare system beginning in September of 2021 with a contract that runs through 12/31/2022. This partnership specifically impacts patients living in Plymouth County Massachusetts. The partnership secures a market for the food grown by the 300 refugee and immigrant farmers that grow on shared land through World Farmers. Food distribution was bolstered by freezers placed in CHCFC. CSA shares so far have not exceeded the existing freezer space and CHCFC will continue to monitor use and demand for frozen shares which are being used for immediate distribution in conjunction with medical and/or dental visits at CHCFC. Also, five Feastival-on-the-Go community meals led to 1019 individual meals and 309 DIY kits being distributed. Additionally, nutrition and diabetes education sessions were conducted for participants. Due to a longstanding partnership with Springfield Public Schools, which are located just south of Franklin County, the Franklin County Community Development Corporation (FCCDC) was able to freeze and sell 10,800 lbs of produce to Sodexo food service, which serves 63 schools and 25,000 kids in the Springfield school district. As a result of a farm to school panel hosted by Chicopee Public Schools, FCCDC has established a strong partnership with Marty's Local, a local food distributor who delivers to many schools and other businesses in Franklin County and the Pioneer Valley. Local K-12 schools are now able to order frozen local veggies via Marty's Local if they are able to meet minimums. Meeting minimums does continue to be a challenge for local schools and FCCDC will continue working with local food system partners to get frozen veggies into existing distribution channels for those schools. Farm and Product Partnerships Another key area of success was in aggregating food from other local sources. Just Roots aggregated local food from 22 local farms and or fisheries, spending $144,858.42; aggregated local food from two local farm stores, spending $11,171.38; and aggregated local food from one local food aggregator, spending $39,176.04 as of December 17, 2021. As has already been mentioned, Just Roots piloted its PEAS model with World Farmers via its partnership with Partners ACO, beginning in July of 2021 and serving 100 food insecure patients of the ACO in Brockton, MA. This partnership connects the food grown by World Farmers' 300 refugee and immigrant farmers to a secure and new market paid for by healthcare. The 2021 contract made possible through Just Roots is $74,469.48 and the 2022 contract which is further expanded with Boston Children's Hospital ACO in addition to Partners ACO is $425,017.07, reaching an additional 100 patients with year round access to the JR clinically proven CSA model. This partnership is the model Just Roots will use to welcome additional farm partners to meet expanded patient populations across Massachusetts in subsequent years. During the 2021 season, the FCCDC continued to work with ten farms to make value-added products to be sold in CSAs and at farm stands/stores. These included crushed tomatoes, peach and tomato salsas, pickles, pesto and frozen vegetables. The Valley Veggies retail-pack program has been very successful; it has led to 4 new distribution partnerships and $64,000 in sales during the last year. We continued to partner with Marty's Local for distribution and have developed additional partnerships with FoodConnects, Farm Fresh Rhode Island and the Worcester Food Hub. who were able to get our products to more underserved communities, and other mobile markets and farm stands throughout Massachusetts. Finally, FCCDC once again sourced produce from local farms to make value-added products for Just Root's winter CSA and for the freezer at the Community Health Center mentioned above. We established two new farm partnerships for this program, including Riquezas del Campo, an immigrant led cooperative farm in Hatfield MA and Pitney Meadows Community Farm, an educational farm dedicated to regenerative practices in Saratoga NY. Just Roots also took action to build local farm and community support services. Participation continued in the Innovation Accelerator program, a course for non profits to accelerate a business idea and pitch to potential investors. The course work included extensive research on healthcare and farmer needs, and resulted in the building out and refining of the core offerings and financial structure of PEAS. PEAS stands for Promote, Enroll and Support. This program is designed to train communities (such as farms, Social Service Organizations, and municipalities) how to work together to transform traditional CSAs into accessible CSAs operating as health intervention programs. The new partnership with Partners ACO is being used to pilot the PEAS model whereby a farm partner external to Just Roots is brought in to grow and distribute local food to food insecure patient families in Massachusetts. The Innovation Accelerator work was used to finalize partnership details with World Farmers. This partnership will support over 300 immigrant farmers associated with the nonprofit World Farmers and deliveries of CSA shares to food insecure patients of select healthcare clinics began in July 2021. Contracts with BCH and Partners ACOs are solidified for 2022 with broader expansion planned for subsequent years. Participation in Innovation Accelerator also led to a secured grant for building and design planning as well as additional vans for distribution, cold storage and an additional heated greenhouse - all to improve the Just Roots barn/facilities building efficiencies and capacity for more year round growth/distribution. Health Promotion The CHCFC has seen several successes in the area of health promotion this year. They hired staff to do diabetes education and secured space in a chest freezer that holds CSA shares for distribution in conjunction with medical and dental visits. Additionally the CHCFC has distributed eligibility criteria for Senior farm share programs to medical and dental teams as well as case management Community Health Worker (CHW) members. The CHCFC identified the food insecure patients and will work with Just Roots to identify processes for data tracking such as cholesterol measures that can be tracked over clinically significant time frames to indicate potential benefits of access to a CSA. Just Roots received referrals from Partners ACO for 50 new food insecure CSA members for delivery that began in September 2021. Initial outcomes were promising as positive attitudinal results were reported on CSA members surveys. A majority of members, 77%, reported increasing fruit and vegetable consumption and 45% reported an improved attitude towards eating vegetables. Also, 41% of members also reported improvement in both physical and mental well-being.
Publications
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Progress 09/01/19 to 08/31/20
Outputs
Target Audience: Mainstreaming Food Access targeted residents living in low-income housing developments in Franklin County where 40% of households live on less than $25,000/year, patient households of the Community Health Center of Franklin County, as well as patients of three health clinics participating in the Boston Children's Hospital Accountable Care Organization in Franklin, Hampshire and Hampden Counties. Census tracts in and around Greenfield have poverty rates of 15% to 25%, and the USDA's Food Desert Locator identifies them as low income (LI) and low access (LA). A Community Health Needs Assessment by Baystate Franklin Medical Center (based in Greenfield and serving Franklin County) identified four principal factors affecting health in the area: poverty (lack of resources to meet basic needs), lack of housing, lack of transportation, and food insecurity/food deserts. Patients participating in Just Roots programming through the Boston Children's Hospital Accountable Care Organization are 45% white, 55% other including: 25% Puerto Rican, 12% Hispanic, 3% Black and representation of Asian, Cape Verdean, Carribean, Dominican, Trinidadian, Peruvian and Cuban. 60% of patients identify their ethnicity as Hispanic; 38% identify as not Hispanic, and 2% as other. All Boston Children Hospital participants are living with income levels and/or life qualifying scenarios that qualify them for MassHealth (Medicaid/Medicaid expansion/CHIP). The target audience was engaged where they live and receive their healthcare. For safety after the arrival of the pandemic, doorstep delivery of all associated programs was made available. Locations where the audience was engaged included The Community Builder's housing development, Leyden Woods; two Greenfield Housing Authority locations, Oak Courts and Elm Terrace; delivery to doorsteps in Franklin, Hampshire and Hampden counties; and in downtown Greenfield at the Community Health Center of Franklin County, where a significant portion of patients are deemed "low-income." Changes/Problems:Non-COVID Challenges The suspension of the HIP program in late February and the inability to run standard outreach and engagement due to the pandemic led to a drop from 36 low income housing members in Q1 to 18 at the end of Q4. This contrasts with a slight increase in participating CHCFC households and the substantial addition of ACO households. With total shares boosted by BCH members this year, it is difficult to compare years 1 and 2 directly, but the program is reaching beyond the goal of 150 with the expanded geography by serving an average of 180 households at the close of Q4. Additionally, CHCFC has confirmed the cooler originally intended for use with this program has been deployed for other purposes, though efforts are underway negotiating the use of the freezer units as well as the possible funding to purchase a larger, more long term storage freezer to allow a greater volume to be offered to patients at the conclusion of a visit during which food insecurity has been identified. Both housing partners on the project continued without a Resident Service Coordinator position throughout the duration of this reporting period. While the pandemic has certainly also played a very significant role in the need to change our goals and outcome expectations, the lack of support and resources from the Resident Service Coordinator position has limited the reach of this program and required a much more significant lift from the Just Roots team. Despite this, residents are still eager to participate. It is our hope that the housing developments invest in this position for the final year of the project but that remains out of our control. However, the lack of key staffing resources in these housing site disrupts the model we aimed to achieve with housing buy-in on the management level. COVID Related Challenges In general, the pandemic limited the amount and depth of in-person contact between the project team, the participants, and other community members. The inability to hold community meetings or table at events, or have conversations that would organically develop relationships and program participation from Just Roots being present at the housing developments and at the CHCFC can be seen in the drop in participation. Revised distribution plans still let the team distribute CSAs, and for some community members, the new delivery option allowed them for the first time to participate. The shift in how the Feastivals and CSA are being operated during COVID-19 was unfortunately not a democratic decision -- while the team is committed to making decisions in collaboration with community, this was a "top-down" decision and the team did its best to involve and communicate with residents and participants proactively during these shifts. Though in-person health screenings were put on pause, the project team was still able to provide nutritional and safety resources in share boxes. The project team had promising results from member surveys regarding decreases in food insecurity and other participant benefits, and tracking food security through Health Needs Assessments continued (albeit a bit more slowly) at the CHCFC. Additional tracking by the CHCFC around local food consumption and its impact on client health took a back seat to COVID-related service shifts and planning, as well as a lack of in-person visits. And while Just Roots has been leveraging the research study (a key attraction to the BCH partners), the CHCFC has focused its energy on its pandemic response, and implementing its Health Needs Assessments. What opportunities for training and professional development has the project provided? Training residents in taking over administration of the program has shifted. This process is in part due to a lack of Resident Service Coordinators, and in part due to their feedback on what pieces they have interest and ability to manage at this time. During this reporting period, residents stepped into leadership roles around evaluation. They were critical in providing and gathering input about how the team builds the winter boxes and about improvements for the upcoming season. Leaders created menu plans and spearheaded cooking of dishes on the community meal days. Resident leaders met with Just Roots and established new ways of taking on leadership roles during COVID. Leaders shifted to managing doorstep delivery and communication delivery about changes due to the pandemic. Resident leaders continued delivering CSA shares and providing feedback from the community to Just Roots staff. Their roles are relatively limited given leaders' increased need to be supervising their children at home, and because many of the elements that they have led historically (spearheading meal creation for community meals, leading cooking demos at CSA pickups, setup and breakdown of distributions) are on pause during the pandemic to follow COVID safety guidelines. How have the results been disseminated to communities of interest? Just Roots presented at the annual conference of MA Food Systems Collaborative in November 2019, presenting their research outcomes and linkage to the impact and potential for the Accessible CSA share model. Just Roots presented on the Accessible CSA model as a panelist for Harvard Pilgrim Healthcare Foundation during the third quarter of this reporting cycle which drew more than 100 participants from the New England region. Just Roots held 1:1 calls on the Accessible CSA model with MA non profits including: Mill City Grows, Shape Up Somerville, Nourishing the North Shore and Littleton Community Farm. Additionally, Just Roots spoke with a consultant of a non profit in NH working to launch an accessible CSA program. Just Roots CSA program model was featured in a publication by Food Is Medicine MA, Case Study - Voices From the Field in June 2020. Just Roots worked with the Center for Health, Law and Policy Innovation (CHLPI) of Harvard Law School on a CSA project which included a scan for CSA programs and a look into their impact and potential as a health intervention program. A brief was drafted and is due for publication in 2021. Just Roots remained committed and active in core food, farming and hunger groups including Food Is Medicine MA and the Coalition to End Hunger. Just Roots has leveraged its membership with these groups to share information on the CSA model integrated with health and housing with members and stakeholders. What do you plan to do during the next reporting period to accomplish the goals? In the final year of the grant the project team will focus on activities designed to strengthen areas of success beyond the final year of the grant. The work seems especially important at this time due to a 59% increase in food insecurity in Massachusetts since COVID-19 broke. To build on prior success and address food insecurity and current pandemic restrictions the project team plans to pivot frozen product sales plans from local school districts to retail establishments, where community members will be able to take advantage of the expansion of the MA Healthy Incentives Program (HIP) to purchase produce. Additionally, some of this frozen product may be able to be purchased by and distributed through the local food bank. The HIP budget expansion, once approved, will also allow us to increase outreach efforts in the difficult-to-reach low income housing development population. The project team plans to assess existing relationships with the housing developments to better understand their capacity and needs as distribution sites. The team will also collect participant data to better understand the impact of increased food access and security on participants and continue to adapt services to meet the needs of vulnerable populations during the COVID-19 pandemic. Feastivals will continue to be held to provide prepared meals and nutrition education in accordance with COVID-19 guidelines to ensure continued access to food, health and skill development. The project team is borrowing best practices as the CHCFC works with a new farm partner in Orange, MA to expand fresh food access to its patient body at its Orange health center location. The Franklin County CDC's Western MA Food Processing Center will continue to expand the packaging of local frozen vegetables so they can be delivered as part of CSAs, mobile markets and to retail stores in low-income areas. Since schools are purchasing less, the pivot from bulk packaging to retail packaging allows residents of all income levels to still have access to this healthy local food year round. The partners will also remain active as steering committee members of the Food Is Medicine MA coalition, as its definitions and standards for food-focused health interventions (which Just Roots helped shape) are disseminated throughout the state in 2021, leveraging the expertise gained through the project to-date to inform the expansion of like models.
Impacts
What was accomplished under these goals?
Food Distribution and Farm Partnerships By the end of the project year, the team was delivering about 180 shares to members through health and housing. 60 of these shares were through low-income housing and CHCFC members and 120 were to Boston Children's Hospital (BCH) Accountable Care Organization (ACO) members, a partnership that expanded the model built with the CHCFC to another healthcare system spanning three counties in western MA, and increasing the racial diversity of the population served. The project team exceeded the goal of two farm partnerships in the second year by having partnerships with seven farms, with nearly $50,000 spent on buy-ins that can alleviate negative events and the variety of produce available to members for serving a culturally diverse group of members. The team also worked with the C3 ACO to distribute vouchers to food insecure patients of the CHCFC and other clinics that are a part of the C3 ACO. During this reporting period, the project team was able to establish new partnerships with local farms and made food purchases from 20 local farm partners this year. The team has also made progress toward incorporating recipes and meals that cater to participants from diverse cultural backgrounds, particularly for Hispanic/Latinx and Russian households. Seven farm partners allowed the project team to aggregate 6 products for flash freezing, four of which will be present in the upcoming winter CSA share. Additionally, 3000lbs of tomatoes were aggregated for the production of crushed tomatoes. FCCDC also partnered with local distributors to sell 13,000 pounds of flash frozen local produce to K-12 schools. The FCCDC is now producing 7 products in 12oz packs for the retail market. In addition to producing retail packs for Just Roots CSA, the team will produce and manage distribution to local farm stands, general stores and small grocers. The FCCDC team also launched a formalized Value-Add Program for farms this past harvest season. Featuring 10 recipes, the team promoted the program to farms and booked 12 value-add productions between June and October, including items like peach salsa, jalapeno salsa, crushed tomatoes and pesto.Throughout, the team has remained focused on aligning its actions to its values and plans to support purchases from BIPOC farmers in 2021. Wrap-Around Services and Health Partnerships Before and after COVID-related disruptions, the project team was able to provide a variety of services to community members beyond CSA shares. Specifically, they supported healthy eating by including fun and simple recipes and ingredients, storage and cooking guidance, stories from the farm, and logistics support through text reminders, phone calls, emails, and in-person (outdoor, safely distanced) meetings. They also provided COVID-safety information throughout the first few months of the pandemic. Prior to COVID-19, the Feastivals were providing a meaningful way for people to learn and share recipes, cooking techniques, and good connection over time in the kitchen and time spent at a dinner table. Resident leaders stepped into chef roles, leading neighbors in family recipes that Just Roots worked with them to adapt the vegetables of the season. After COVID-19 ruled out the possibility of Feastivals, the team shifted to preparing farm-fresh meals at a community kitchen and offering delivery and outdoor pick-up. 200-300 people were fed with these meals people were fed with these twice-monthly meals, and each meal came with DIY Cooking Kits (instructions and ingredients) as well as a voucher to the Just Roots farm stand so participants could learn how to make one of the meal's dishes again at home on their own. The project team also worked to provide nutrition screening and education through contacts with the CHCFC. The team was able to implement referral systems and processes to connect patients of the CHCFC and Boston Children's Hospital ACO to the Just Roots CSA, following HIPAA-compliance. Both the CHCFC and the BCH Community Health Worker teams are resourced to direct patients to Just Roots programming. Two significant partnership opportunities emerged in the 2019-2020 project year. First, the new partnership with BCH allowed the number of shares distributed to more than double, from 76 in the first quarter to 180 in September 2020. Second, opportunities emerged to provide support to the North Quabbin, Hampshire, and Hampden communities. Team members also report having important networking contacts with other Federally Qualified Health Centers that might provide opportunities to disseminate lessons learned from this project, and a new CEO of the CHCFC is very excited about Social Determinants of Health (SDOH) and community integration. Furthermore, there is an opportunity to directly integrate questions about food consumption and insecurity into patient electronic health records.
Publications
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Progress 09/01/18 to 08/31/19
Outputs
Target Audience:Mainstreaming Food Access targeted residents living in low-income developments in Franklin County where 40% of households live on less than $25,000/year. Census tracts in and around Greenfield have poverty rates of 15% to 25%, and the USDA's Food Desert Locator identifies them as low income (LI) and low access (LA). A Community Health Needs Assessment by Baystate Franklin Medical Center (based in Greenfield and serving Franklin County) identified four principal factors affecting health in the area: poverty (lack of resources to meet basic needs), lack of housing, lack of transportation, and food insecurity/food deserts. The target audience was engaged where they live and receive their healthcare. Locations where the audience was engaged included Leyden Woods part of the Community Builders and Oak Courts, part of the Greenfield Housing Authority, as well as the Community Health Center of Franklin County, whose patients are primarily working poor residents of the county (75% low income). Changes/Problems:Issues for HIPAA compliance were identified when developing processes for tracking clients of the CHCFC that were given CSA vouchers and nutrition prescriptions. Greenfield Gardens, 1 out of 3 housing complexes in the proposal, was unable to continue participating in the project. This resulted in fewer than CSA farm shares than anticipated. In addition, two of the Resident Services Coordinators have left their positions at the housing partners locations, leaving the burden of programming and marketing to staff of Just Roots and to the management of the housing partners. Back office services - The approach to meeting this metric has changed. Therefore, additional outside funding is being sought to support this shift, and will hopefully be realized in the first quarter of year two of this grant cycle. If this happens the pilot program will be created and run in year two/three. All other associated metrics for this goal should therefore be adapted accordingly. Frozen products were not yet available in year one which eliminated the need to procure a chest freezer. Once product is available and depending on demand this item will be procured. CHCFC will work with Just Rootsto understand if the location for the chest freezer is best suited at the Health Center or to be available during distributions of other produce which take place at CHCFC. What opportunities for training and professional development has the project provided?Training for housing complex residents was shifted to leadership roles rather than administrative management. Five resident leaders were onboarded during year one and participated regularly at CSA distributions, helping to promote, run and support the program. Training included promotional activities (door knocking and flyering), Program Management (set up and break-down, greeting customers, explaining the program/offerings, wrap around service preparation, collecting survey data, etc.) and Accountability (communicating scheduling needs, showing up on time and completing shifts). How have the results been disseminated to communities of interest?Presentations have been made to the following audiences: MDAR Harvest New England regional conference Northeast Association of State Departments of Agriculture Greater Quabbin Food Alliance Franklin County Interfaith Council Franklin County Chamber of Commerce Franklin County Resource Network MA Legislative Tour held prior to the Public Oversight Hearing Food Is Public Health, Greenfield, MA Regional meet ups of Food Policy Councils of MA Quarterly meetings of the Franklin County Food Council Community Benefits Organizations Task Force of the Food Is Medicine MA (FIMMA) What do you plan to do during the next reporting period to accomplish the goals?Together with the FCCDC, Just Roots put together a program featuring shelf stable and frozen products including storage crops which would be packaged together as an off-season local food option. Pricing was still being determined and marketing designed. Enrollment for the "Deep Winter" CSA farm share will begin in the early part of year 2 of this grant cycle with distributions beginning in January 2020, and offered monthly until June. Produce from multiple local farms will be used in the production of value added shelf stable items for distribution beginning in winter 2020. In addition to produce, Just Roots will continue to work with the farmers to supply protein (sustainably raised meat and non meat products), eggs and honey. New conversations with additional farmers who can supply even more diversity of protein are beginning October 2019 with plans for distribution in fall/winter 2020. The FCCDC purchased from 7 local farms to produce frozen and value added products.
Impacts
What was accomplished under these goals?
The Mainstreaming Food Access into Permanent Health and Housing Programs project has positively impacted the lives of the target audience, strengthened the network of stakeholders, and increased the services provided by the stakeholders. This project is a continuation of previous work that is directed at improving access to local fresh food for low income residents of Franklin County, MA. A refrigerated box truck was purchased and retrofitted to serve as a mobile market which reached target audiences in health and housing locations during this first reporting period. Over the first year of the project 58 CSA farm shares from mainstreaming sites were enrolled while a total of 100 low income shares were provided. Planning to roll out the "Deep Winter" CSA shares was completed during year one with a start date at the beginning of year 2. Year-round programming offered in low income housing communities brought residents together with health and food sector resources aimed at improving access to and consumption of local healthy foods, promote community building activities and relationship with local health and farm/food resources. Time was invested into identifying and building the infrastructure and systems necessary to complete the program's target goals over the life of the grant (primarily focused on systems within the healthcare sector). Structural improvements were made to the barn at Just Roots, literally establishing a stronger foundation upon which to build. Finally, progress was made towards establishing relationships with local farmers able to assist in the demand needs associated with extending the season, offering locally grown food year-round. Overall, the program team has been cohesive and attentive to the goals we have set out to achieve. Enroll and retain 150 new year-round CSA members in affordable housing complex and the CHCFC. 58 total CSA farm shares were enrolled, impacted an estimated 174 individuals each week for the 20 week program. Thanks to the mobile market both CSA members and the public (other residents and patients of mainstreaming sites) were able to participate in the purchase of local produce. Mid-season results show the following: 89% increase daily intake of local produce 48% decrease empty calorie consumption 27% report improvement to weight and or blood pressure 33% report increase energy levels 29% cook with friends/family more often 51% feel more confident cooking 60% report improved general well-being 41% report improved mental well-being 56% made a new meaningful connection to a new person Food Insecurity was reduced from a reported 54% to 17% Train and transfer program responsibilities to residents and housing administrators. Please see related notes under challenges but we are pleased to report success with bringing on resident leaders to help promote and run the on-site programs in low income housing sites. Leaders gained skills in marketing and promotion, set up and display as well as sales and the offering of wrap around services (program components). Expand the number of local farms contributions to rising food demand from low income households. Just Roots held meetings with key staff of the Department of Transitional Assistance (DTA) related to expanding the # of CSA farms that offer shares to SNAP customers in MA. Just Roots also helped initiate a semester project through the Center for Health, Law and Policy Innovation (Harvard Law), a student run project focused on the potential for CSA growth as accessible shares in MA. Extend the CSA to cover a full year. While the new year-round CSA will launch in the second year of the grant cycle, the plans and materials were designed during year 1. Plans include: a three box share (two in November and one in December) made up of local winter greens, herbs, storage crops, etc. and accompanied with a tool-kit to aid families in the storage and use of their share. The Deep Winter share will run Jan - May 2020 and will be offered to mainstreaming sites. Included in this share will be a combination of fresh produce, storage crops, shelf stable V/A products and locally frozen produce. Quantify the healthcare savings associated with nutrition education and diet interventions. While we can show reporting that demonstrates reduction in food insecurity through two survey mechanisms (Just Roots surveys and CHCFC data), we are unable at this time to quantify healthcare savings as enough time has not lapsed. The Mainstreaming Food Access program aims to demonstrate its replicability Through dissemination efforts, we continue to raise awareness for our work and involve key partners and stakeholders in future plans for replication.
Publications
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