Can the Local Food Movement Scale Up to Meet the Demand of Hospitals and Other Big Purchasers?
Continued from previous page
The company’s guaranteed supply (which evades the vagaries of weather and season thanks to its global reach) is crucial for menu planning. It takes a team of dieticians to develop targeted diets for St. Joe’s patients. Patients with kidney disease can’t have black beans, and heart patients can’t exceed two grams of sodium per day. Changes can take weeks of planning and paperwork.
The widget-like standardization of food sourced through the conventional supply stream also helps hospitals meet exacting federal dietary guidelines. Broadline distributors sourcing from poultry giants like Tyson and Perdue can deliver entire pallets of chicken breasts that are each within a fraction of the targeted four-ounce weight. In contrast, locally sourced chicken breasts might come in a four- to eight-ounce range, requiring staff to mete out perfect portions.
Gordon Food Service is part of the hospital’s contract with Entegra, one of a handful of powerful national Group Purchasing Organizations (GPOs) that act as a gateway between hospitals and the companies they buy from. Hospitals commit to purchasing 80 to 90 percent of their food budget through their GPO. In turn, the GPO pools hundreds of hospitals’ buying power to negotiate lower prices and secure rebates, often with the most recognizable names in the food business. GPOs source through broadline distributors like Gordon, SYSCO and US Foods, whose shipping and stocking requirements can be significant barriers to small and mid-sized farmers and local food companies seeking to plug in to the supply chain.
Although scores of hospitals across the country are achieving new food goals through creativity and commitment, it often requires swimming upstream against entrenched contracts, efficiency constraints, and cost restrictions. “You have to remember,” Kendall says, “it’s a business.”
But the business of hospitals is also to protect people’s health. Within the healthcare sector, there has been an explosion of interest in enacting that mission through foodservice departments. St. Joe’s is one of 400 hospitals nationwide that have signed the Healthy Food in Health Care Pledge that articulates this approach. Generated by the nonprofit coalition Health Care Without Harm, the pledge states that healthy food is not just about the back-of-the-package nutrition facts but must come from a food system that is environmentally sound, economically viable and socially just.
Like the first hospitals to ban smoking on their grounds, St. Joe’s is putting its moral weight behind societal change through its new food initiatives. “It’s not just about the food we serve,” says CEO Rob Casalou, “it’s about the message, the symbolism of it.” The hospital has revamped menus to incorporate seasonal produce, switched to rBGH-free dairy products and lunch meats produced without antibiotics or added hormones and reduced meat servings as a way to model healthier choices and reduce greenhouse gas emissions. The most dramatic evidence of their commitment is the twenty acres of St. Joe’s sprawling property that have been plowed under to create an educational farm. The crops are incorporated into patient meals and cafeteria offerings, and patrons can pick up a bag of fresh fare from a farm stand in the hospital lobby each Monday.
Hospital-grown food is as local as it gets, but St. Joe’s has more expansive plans. Along with over 100 hospitals in the state, they are aiming for twenty percent of their food purchases to be Michigan grown by 2020 in alignment with the Michigan Good Food Charter. How that food gets to the hospital may determine whether it upholds the values often assumed to be inherent to buying local—creating a diverse food system with decision-making power closer to the ground and with money in a greater share of hands. “Local” has been imagined as an inoculation against the co-optation of big agribusiness because it’s about changing the structure of the food system rather than substituting sustainable for conventional products. But can the values implied by the farmer-to-customer handshake of a farmers’ market transaction be maintained when the supply chain lengthens, when price becomes less negotiable, or when product standardization comes into play?