The New England Regional Collaborative for Food is Medicine

Bi-State Primary Care Association has been actively addressing food insecurity and integrating nutrition into health care across Vermont. Through the Vermont Food Access in Health Care (FAHC) Consortium, they have collaborated with three Federally Qualified Health Centers (FQHCs) to implement various programs aimed at improving access to nutritious food for patients. Each FQHC designed a food program that was unique to their communities for patients that have Cardiovascular Disease (CVD) or are at risk for CVD or other chronic health conditions and screen positive for food insecurity. The Consortium implemented three evidence-based models: Medically Tailored Meals, Produce Prescriptions and a Social Grocery Store model. More information on each program can be found on our website. To assess impact, Bi-State tracked patient eligibility, enrollment, and participation, monitoring a dashboard of CVD risk indicators, such as blood pressure, A1C, and cholesterol. Additionally, Bi-State is one of six organizations that comprise the FAHC Network. Bi-State convenes the Network on a quarterly basis and tracks the main goals of the Network: to increase food and nutrition insecurity screening and referrals, expand upon evidence-based food and nutrition programs and disseminate knowledge learned via webinars, trainings etc. The Network is focused on building capacity to develop and implement policies, secure project funding and directly support the transformation of foods role in health care at the local and statewide levels. Bi-State hosts the www.vtfoodinhealth.org website, to provide information to professionals on food insecurity, food as medicine and food access programming in VT. Bi-State also hosts a Food Access Peer Group for VT and NH FQHCs to discuss food programming within the health care system.

Representatives:

Kristen Bigelow, Senior Program Manager, Health Quality Food Access and Health Care Network Director

Jamie Rainville, Manager of Special Projects

Community Care Cooperative (C3) is a Federally Qualified Health Center-led Accountable Care Organization and Management Services Organization, based in Massachusetts. As an ACO, our activities involve Health Related Social Needs (HRSN) Screening, referrals to community resources to address those needs, and administration of the MassHealth Flexible Services Program (2020-2024) and the HRSN Services Program (2025+). Specific to Flexible Services, C3 engaged with 7 social service organizations to provide MTMs, food boxes, food vouchers, produce prescriptions, and nutrition education. During the 5 years of Flexible Services, we enrolled ~16,000 members in nutrition programs. For the new HRSN Services, C3 is offering MTM, Medically Tailored Groceries, and Medically Tailored Food Vouchers.

Representatives:

Kim Prendergast, Vice President for Policy & Strategy

Annie Pham, Director of Social Health

Crystal Adams, Program Evaluation Manager

The Center for Health Law and Policy Innovation (CHLPI) works to address gaps in access to Food is Medicine services by integrating them into health care delivery and financing. We advocate to establish sustainable funding streams for these services, enhance research and evaluation efforts, and improve the infrastructure that Food is Medicine services rely on such as food insecurity screening, HIPAA-compliant data sharing, and nutrition education for medical and oral health professionals.

Representative:

Katie Garfield, Director of Whole Person Care, Clinical Instructor, Health Law and Policy Clinic

Community Servings is a Massachusetts-based nonprofit providing home-delivered Medically Tailored Meals and nutrition services throughout Massachusetts and Rhode Island. This year, the agency will home-deliver over 1.2 million scratch-made meals to people with diet-related critical and chronic illnesses like HIV/AIDS, cancer, diabetes, kidney disease, and more. The agency is also a co-convener of FIMMA, a Massachusetts-based Food is Medicine coalition, and a leading member of the national Food is Medicine Coalition (FIMC), both of which advocate for the reimbursement of MTMs and related nutrition interventions into healthcare payment delivery models.

Representatives:

Jean Terranova, Senior Director of Policy and Research

Colleen Forrest, Senior Research Dietitian

Dartmouth Health has an emerging Food is Medicine program, directed by Chelsey Canvan as the Manager of Dartmouth Health’s Center for Advancing Rural Health Equity. Currently, Dartmouth Hitchcock Medical Center offers food pantries to its food insecure clients and is now looking to incorporate food is medicine practices into the health care they provide.

Representative:

Chelsey Canavan, Manager, Center for Advancing Rural Health Equity

The Food is Medicine Institute is a university-wide collaborative effort based at the Friedman School of Nutrition Science and Policy, bringing together experts from across disciplines with other local and national collaborators to advance food is medicine research, training, patient care, and community and policy engagement. Tufts is the leading academic institution globally for advancing FIM, engaging in multiple large FIM interventional trials in collaboration with health care systems, extensive policy and comparative effectiveness analysis, and more. The first-of-its-kind Institute serves as a catalyst to drive change, improve health, reduce health disparities, and create a more equitable and resilient health care system that recognizes the power of nourishing food.

Representatives:

Dariush Mozaffarian, MD DrPH, Director

Kelseanna Hollis-Hansen, Research Assistant Professor*

Shannon Timlin, Executive Administrative Assistant*

All Institute faculty

*NERC administrative leads

Representative:

Lauren Fiechtner, MD, MPH Senior Health and Research Advisor; Director of Nutrition at MassGeneral Hospital for Children

Our Healthy Eating Active Living team within the Center for Health Improvement at MaineHealth (a non-profit integrated healthcare system serving 75% of the population of Maine) oversees Food is Medicine initiatives across nine hospitals in Maine and Carroll County, New Hampshire. Our initiative includes three hospital based food pantries, two chronic disease self-management programs that include medically tailored groceries, food insecurity screening and connection to food access resources across all primary care and inpatient departments, and research around healthy food prescriptions.

Representatives:

Carrie Gordon, MD, Pediatrics

Emily Kain, Senior Program Manager

Emily M Walters, Let’s Go Program Director

At Mass General Brigham, FIM is a component of an overall system-wide Nutrition Equity strategy.  The strategy encompasses the four pillars outlined below:

1. Foundations of food security – this includes screening for food insecurity and connecting patients to food resources including SNAP/WIC
2. Address health outcome disparities – use nutrition strategies, including FIM, to close clinical disparities in hypertension control.  (e.g., MTM program for patients with hypertension)
3. Community Investments – MGB funded >$8M in nutrition-focused community programs.  This includes teaching kitchens, medically tailored meals, etc.
4. Advocacy – MGB has a dedicated Government Affairs role to advocate for equity-related issues, including nutrition

Representatives:

Priscilla Wang, Associate Medical Director, Primary Care Health Equity

Anne Fox, Senior Program Manager

Emma Steinberg, Pediatric Hospitalist, Chef, Pediatric Culinary Medicine Champion

Dr. Mirsky is also the co-founder and Medical Director of the MGH Revere Food Pantry and Teaching Kitchen, which is the first plant-based food pantry in the country and also features a state-of-the-art teaching kitchen. The MGH Revere Food Pantry and Teaching Kitchen is currently the only brick-and-mortar food pantry and teaching kitchen in the Mass General Brigham enterprise and serves as a testing ground for innovative Food Is Medicine strategies to address nutrition insecurity and chronic disease.

Representative:

Jacob Mirsky, MD, Primary Care; Assistant Professor of Medicine, Harvard Medical School; Assistant CME Course Director, MGH Benson-Henry Institute for Mind Body Medicine

Project Bread is a food security organization dedicated to ending hunger in Massachusetts.  We have engaged with the healthcare sector as a critical partner for ending hunger for over 10 years. We receive referrals to our FoodSource Hotline for individuals who need assistance being connected to federal nutrition assistance programs like SNAP. We are able to pre-screen individuals and assist with enrollment as needed. For the last five years Project Bread has provided direct services to MassHealth members as a Health Related Social Needs (HRSN) nutrition service provider for ten Accountable Care Organizations. Through this program we offer members, a food benefit card, cooking classes, nutrition counseling, procurement of essential kitchen supplies and connectivity with federal assistance programs.

Representative:

Jennifer Obadia, Senior Director of Health Care Partnerships

Representatives:

Michael Paasche-Orlow, Professor, Vice Chair

Kimberly Dong, Associate Professor Public Health and Community Medicine

Tufts Medicine Integrated Network (TMIN) is part of the Tufts Medicine Health system whose mission is empower people to live their best lives. TMIN is comprised of private practice and employed physicians, who are both community and academic providers who have come together as equal partners in governing our Network and building healthy communities. We are organized as one unified Network but with an operating focus on geographic regions where local care teams convene in clinical councils to ensure we can best manage risk and outcomes at a neighborhood level. We define success as appropriately moving care out of hospitals, not into hospital beds. Our Network makes possible our vision to deliver care close to where people live, work and play.

Representatives:

Jenny Chiang, Senior Vice President of Community Engagement and Market Growth

Kerry O’Shea, Executive Assistant

UMass Chan Medical School’s research on Food is Medicine centers on our role as the official independent evaluator for MassHealth’s Section 1115 Demonstration, which allows Medicaid dollars to cover medically tailored meals, produce prescriptions, and medically tailored groceries. Our research involves quasi-experimental methods analyzing changes in healthcare costs, utilization, and health outcomes, in addition to qualitative interviews with Food is Medicine participants and health systems to better understand experiences with the services. We are currently collaborating with several Massachusetts Food is Medicine providers, MassHealth, and academic partners like Tufts University on multiple ongoing studies.

Representatives:

Kurt Hager, Assistant Professor, Division of Epidemiology

Matt Alcusky, Associate Professor, Division of Epidemiology

The Yale-Griffin Prevention Research Center (Y-G PRC) is part of a network of 26 academic research centers funded by the Centers for Disease Control and Prevention (CDC). The Y-G PRC is based at the Yale School of Public Health and Griffin Hospital, and is led by Principal Investigator Rafael Pérez-Escamilla, PhD, with co-directors Kathleen O’Connor Duffany, PhD and Beth Comerford, MS. The Y-G PRC Food as Medicine (FAM) Hub collaborates with multiple Connecticut and national partners to co-design, implement, and evaluate FAM programs, and to develop and disseminate tools for researchers, health providers and administrators, and community-based health practitioners investigating and implementing PRx programs. We convene interest holders to share learnings and maximize collective impact, and our scientific findings continue to inform practice and policy. Our efforts aim to improve access to healthy foods through the  incorporation of  community co-design and engagement, which is crucial for ensuring programs are both effective and respectful of the communities they serve. We currently collaborate with partners on four produce prescription programs around Connecticut.

Representatives:

Kathleen Duffany, Assistant Professor of Public Health (Social and Behavioral Sciences)

Beth Comerford, Co-Director

Katherine LaMonaca, Assistant Director of Research and Evaluation, PRC & Community Alliance for Research and Engagement (CARE)