Candace Young, MSImproving the Food Environment

Through Food Procurement StandardsOctober 19, 2012

“Ensuring that everyone has accessto nutritious, affordable food.”

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• Founded in 1992; non-profit based in Philadelphia, Pennsylvania

• Program Areas:

o Supermarket, Grocery Store, and Healthy Food Retail Development

o Healthy Corner Stores Initiative

o Farmers’ Markets

o School Nutrition Education

o Public Policy to Improve Food Access in Underserved Areas

o Consulting and Technical Assistance

The Food Trust

Improving the Food Environment Through

Food Procurement Standards

Today’s Discussion

• Review rationale for government food procurement standards

• Examine case studies of food procurement standards

• Discuss challenges in implementation & brainstorm strategies to overcome them

• Questions & Discussion

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OVERVIEW: Food and Beverage Strategies for Obesity Prevention

• Increase availability of healthier food & beverage choices in public venues

• Improve affordability of healthier food & beverage choices in public venues

• Restrict availability of less healthy foods and beverages in public venues

• Institute smaller portion sizes in public venues• Discourage sugar-sweetened consumption

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SOURCE: Keener, D., Goodman, K., Lowry, A., Zaro, S., & Kettel Khan, L. (2009). Recommended community strategies and measurements to prevent obesity in the United States: Implementation and measurement guide. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.

What is “Food Procurement Policy”?

• Works for change at individual and environmental levels

• Policy officially adopted by federal, regional, state or local government or government agency

• Establishes requirements or standards for food purchased, provided, or made available by government entity

• Sets maximum (“not to exceed”) or minimum standards for foods and beverages

• Standards established / enforced by public health authorities

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• Guide Published by U.S. Centers for Disease Control (CDC)

• Policy Development

• Policy Implementation

o Potential Barriers and Solutions

• Monitoring & Evaluation

SOURCE: Centers for Disease Control and Prevention.

Improving the Food Environment Through Nutrition Standards: A

Guide for Government Procurement. U.S. Department of Health

and Human Services, Centers for Disease Control and Prevention,

National Center for Chronic Disease Prevention and Health

Promotion, Division for Heart Disease and Stroke Prevention.

February 2011.

http://www.cdc.gov/salt/pdfs/DHDSP_Procurement_Guide.pdf

I. Policy Background

II. Policy Development

III.Policy Adoption

IV.Policy Implementation

V.Policy Monitoring & Evaluation

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Phases of Food Procurement Policy

• Assess Food Service Needs of Affected Agencies:�Take inventory of agencies and settings that purchase,

serve, sell, distribute or contract out food service(e.g., Worksite cafeterias and vending machines; Schools; Hospitals; Meal service (seniors, day care centers, after school programs, prisons, group homes); Concession stands; Meetings hosted / funded by jurisdiction)

• Assess the Following:� How many meals and snacks are served?� Who are populations served? (i.e., children, elderly, etc.)� Where is food served?� Do settings prepare (cook/heat) food or contract food services to outside

entity?� What existing policies / standards are already in place? (i.e., healthy

vending, healthy meeting guidelines, cafeteria standards)

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PHASE I: Policy Background

Draw upon findings from needs assessment when deciding on policy language. Policy language should address the following:� What departments/food service settings are covered? Any exempt?

� How will standards be phased in (i.e., by agency, by contracts, by food items/categories, phased in deadlines)?

� Will standards be defined for categories of food items (i.e., milk, meat, cheese, snacks) or by meal allowances (e.g., ⅓ daily sodium in lunch)

� Will standards be piloted in one venue and then expanded to all agencies?

� Will standards be the same or tailored for different departments?

� Who will oversee implementation and enforcement of policy?

� What is timeline for implementation?

� What are penalties for non-compliance?

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PHASE II: Policy Development

• In developing policy language, identify stakeholders and build a team:

�Core team: • Public health department staff

• Staff from other departments who will implement or be affected by policy

• Representatives from executive office and purchasing/procurement dept.

�Workgroup or advisory committee:• Food contractors, food service vendors

• Subcontractors / agencies that provide food

• Representatives from advocacy organizations, health care providers and nutritionists; community members affected by health disparities

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PHASE II: Policy Development

• Food procurement policy can be adopted through a variety of mechanisms:� Administrative regulations, executive order (NYC & Mass), legislation

• Consider what is feasible (practically & politically) based on: � Number and types of settings that serve food and the baseline nutrient levels of

food

� Willingness of key decision makers to pass / stakeholders to support policy

� Resources, including staffing, available for implementation and enforcement of the policy

� Feasibility of making changes to the policy language at a later date

� Be prepared to defend policy (health data; potential benefit; costs)

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PHASE III: Policy Adoption

• Practical Considerations:

�Which departments have nutrition staff and purchasing experts in place?

�How will staff be trained on food procurement policy, purchasing and menu development?

�How will technical assistance to food service staff be provided?

�Which departments / staff will enforce standards?

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PHASE IV: Policy Implementation

1. Determining resources needed for implementation:� Staffing – at a minimum : Food policy coordinator (25%+);

Project coordinator (100%); Nutritionist (50%+). � Training and technical assistance � Food costs - begin by investigating potential changes with current food

contractors / vendors

2. Working with the settings that must implement the policy:� Designate a point of contact in each department, program, or food service

setting (10-25% time)� Develop trainings for different audiences� Develop resources (e.g., standard contract language; lists of food items that

meet standards; handouts/visuals; recipes)

3. Ensuring compliance with the policy:� Who will ensure compliance? � What documentation are agencies required to submit to coordinating dept.?

(menus, nutrient analyses of menus, lists of purchased products?)� How often do reviews occur (monthly? yearly? new menu cycles?)� Who administers penalties?

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PHASE IV: Policy Implementation

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PHASE IV: Policy Implementation (Training Needs)

• Methods to evaluate program:

� Get baseline data before policy implementation begins!

� Tracking levels of nutrients in meals served, such as in a nutritional analysis of agency’s menus

� Measuring changes in types of purchases and costs

� Recording program costs (time, money, and materials spent to implement the policy)

� Measuring changes in the health of participants

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PHASE V: Monitoring & Evaluation

• In September, 2008, Mayor signed Executive Order 122 to establish New York City Food Standards for: � Standards for Meals/Snacks Purchased and Served – standards apply to all

foods purchased and served by City agencies; over 270 million meals and snacks served annually at schools, senior centers, homeless shelters, child care centers, after school programs, correctional facilities, public hospitals, and other New York City agency facilities and programs

� Standards for Beverage Vending Machines – cover all beverage vending machines contracted by City agencies

� Standards for Food Vending Machines – cover all food vending machineson City property

SOURCE: http://www.nyc.gov/html/doh/html/cardio/cardio-vend-nutrition-standard.shtml

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CASE STUDY: New York City

Challenges & Solutions: FOOD COSTS

For community programs, the expectation that they must provide meals and snacks while staying within limited budgets is a significant factor in driving orders towards low-quality food. The cost of healthy food and local food is typically prohibitive for facilities and community organizations providing meals to vulnerable populations.

How could you improve nutrition standards without exerting undue economic burden on programs?

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There is sufficient support to implement policy that revises nutrition standards in your jurisdiction. However, there is resistance from providers and local food service facilities. They are skeptical about changing menus, are concerned about compliance, fear increased costs, and worry that healthier food service options won’t appeal to people they serve.

How do you work with providers to make necessary changes in meal planning?

Challenges & Solutions: RESISTANCE AMONG PROVIDERS

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Your jurisdiction’s food procurement policy task force seeks to have a broad impact on diverse settings (e.g., employee cafeterias, correctional facilities, schools, child care centers, public hospitals, senior centers, parks). These programs serve people of all ages and different backgrounds.

How can nutrition standards be written so they apply broadly and equally to foods purchased and served in multiple facilities and sectors?

Challenges & Solutions: REACH ACROSS DIVERSE SECTORS

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In order for revised nutrition standards to be established in your community, existing food service contracts need to be addressed. Many providers have existing contracts that hinder implementation of the policy. The contracting process and constraints on food costs often force agencies to award contracts to the lowest bid.

How can programs modify procurement processes while working within existing contracts?

Challenges & Solutions: MODIFYING EXISTING CONTRACTS

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Your local health department has had difficulty mobilizing support from other public agencies in your jurisdiction to negotiate healthier vending contracts. Other agencies count on vending revenue as their only source of unrestricted funds for special events and they worry people will go elsewhere for soda and junk food.

How do you accomplish availability of healthy vending machines in public facilities?

Challenges & Solutions:VENDING MACHINES

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In your community there are many small growers and producers that are not connected with agencies that purchase and serve food. They often produce on a smaller scale than what programs require.

How can local producers get linked into local procurement channels? What mechanisms could you develop to address these gaps?

Challenges & Solutions:DISTRIBUTION SYSTEMS / SMALL PRODUCERS

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THANK YOU!cyoung@thefoodtrust.org