The Orange County Health Care Agency serves 3,114,363 people and is headquartered in Santa Ana, CA. Orange County is the third most populous county in California and is sixth most populous county in the nation. The median household income is $71,866, which is higher than that of its surrounding counties, the state, and the nation as a whole. However, despite this income, approximately 400,000 individuals living in Orange County are food insecure.
Food insecurity is defined as the state of not having enough food, uncertain availability of food, running out of food, and consequently choosing to eat low quality food or fast food due to limited options. The amount of food supplied in local pantries often seesaws between having enough and not having enough food as a result of inconsistent donations. The Public Health Officer for Orange County as well as the Director of the Orange County Food Bank, wanted to reduce hunger and food waste by facilitating the donation of wholesome surplus food to pantries. This vision led to the establishment of a public/private partnership called the Waste Not OC Coalition.
WNOC’s Goals and Objectives
1. Educate the public about food insecurity and food donations
2. Increase access of food to those who need it: a) Create a Google Map of all of the pantries in OC and collaborate with OC 211's directory to host it on their database b) Provide healthcare professionals the tools to refer food insecure individuals (via Google Map of pantries) c) Ensure that 1 to 2 new pantries are provided with recovered food per quarter
3. Increase food donations - create the Anaheim/Orange Pilot a) Begin record keeping of pounds of food recovered b) Create a Food Recovery Task Force to follow up with businesses who have been provided with food donation informational material by health inspectors c) Food Recovery Task Force members to be identified and trained by August 2014 (done) d) Ensure that at least 14,000 lbs. food are donated each quarter e) Ensure that five new establishments donate food per quarter
4. Future Goals: a) Establish a central kitchen to break down donated bulk items into palatable prepared meals for donation b) Establish a culinary arts program for troubled youth c) Add public schools in the county to the list of facilities donating excess food d) Create a student food insecurity questionnaire at UC Irvine and Cal State Fullerton e) Support the development of an on-campus pantry if needed
WNOC first met in November 2012. WNOC has called attention to the issue of hunger and provided resources for food producing businesses to donate any excess food to pantries across Orange County. In 2013, WNOC began plans for the Anaheim Pilot project and expanded partnerships with food banks, community clinics, schools, and local agencies. The plan for 2014 was to show success in the Anaheim food recovery pilot and use this is a model for surrounding cities. In mid-2014, the Anaheim Pilot project expanded to become the Anaheim-Orange Pilot. Exact record keeping of pounds of food recovered because of WNOC began in July 2014. The LHD’s health inspectors have reached 789 establishments in Anaheim and Orange from July to August 2014 with food donation “one pagers” dispelling misconceptions about liability issues surrounding food donations. WNOC partners closely with Food Finders, a local nonprofit organization dedicated to collecting and distributing excess food from donors to organizations that serve communities in need. Food Finders, a 501(c)(3) nonprofit that serves Los Angeles County and Orange County, is the official fiscal sponsor for WNOC. WNOC is maintained through weekly conference calls and quarterly coalition meetings which include members of the Orange County Health Care Agency, the Public Health Officer, the Program Manager for the Food Protection Program, the Project Manager for WNOC, Food Finders, the Orange County Food Bank, Second Harvest Food Bank, student volunteers, and the Food Recovery Task Force (a subcommittee of WNOC).
Results
1. 789 food facilities were given food donation information by inspectors from July-September 2014.
2. From July to September 2014: 18.3 tons (36,633 lbs.) of excess wholesome food was redirected to feed the hungry as a result of WNOC. This is equivalent to 30,527.5 meals, using 1.2 lbs. of food to equate to a “meal”
3. 1st quarter: 6 new donors identified (goal was five), 4 new agencies benefited from increases in food donations (goal was 1-2 agencies)
4. More than 18 tons of food donated to pantries over just 3 months
5. Reduction of food waste sent to landfills
6. Greater awareness of the food insecurity problem
7. Identifying individuals who need food via health care professionals
8. WNOC's food donation "one pager" distributed by health inspectors has been adopted by five nearby counties.
www.wastenotoc.org
The Problem
Food insecurity has been linked to lower academic performance, obesity, poorer health, developmental problems, and decreased psychological abilities in children. It is a major public health problem in Orange County, where wealthy cities neighbor poor ones with high food insecurity, a veritable “tale of two cities”. Food insecurity affects approximately 400,000 people as well as 21% of children (1 in 5 children) living in Orange County. In 2013, Orange County was ranked #10 in the nation for counties with the highest rates of childhood hunger according to a Feeding America study. Food producing facilities, meanwhile, dispose of more than 330,000 tons of fresh wholesome food annually.
Most families with food insecure households depend on SNAP (Supplemental Nutrition Assistance Program) benefits, but also rely on nonprofit agencies and local pantries for additional food to meet their nutritional needs. Orange County's Second Harvest Food Bank, "Hunger in America 2014" study (HIA 2014), surveyed 218 agencies and found that “among food programs that reported turning away clients during the past 12 months, 18% of food programs did so ‘frequently’ or ‘occasionally’ because they ran out of food”. The study also found that 25% of the agencies affiliated with Second Harvest Food Bank reported having “somewhat less or a lot less food than needed to meet clients’ needs”. Yet with all this need, food producing facilities such as grocery stores, restaurants, and others throw food away that could have been donated to local pantries to satisfy the need. WNOC conducted a survey to food producing facilities to find out what deters a business from donating wholesome excess food. The unanimous, yet misguided responses were that the health department did not allow food donations and that a business could be held liable for the quality of the donated food. On the other hand, food producing facilities that do donate to pantries are often inconsistent with donations, leaving food pantries with little to distribute at varying times, often citing logistical difficulties. Dr. Eric Handler, the Public Health Officer for Orange County, in partnership with Mark Lowry, Director of the Orange County Food Bank, wanted to bridge these gaps by establishing a public/private partnership called the Waste Not OC Coalition (WNOC).
Target Population
The target population for WNOC includes food facility owners, healthcare providers, and the general population. By partnering with food facility owners, our goal to increase food recovery and redirect food to agencies that need it most. By working with healthcare providers, we want to better identify and treat food insecurity in addition to empowering the community to address the growing problem of hunger.
Past Efforts
Prior to WNOC, agencies fighting hunger in the county worked independently to cater to their respective communities. The OC Health Care Agency, nonprofit organizations addressing hunger, and businesses such as chain restaurants, grocery stores, and other food producing facilities were not collaborating to address food insecurity. Now, as a result of the coalition, these organizations are creating partnerships to combine ideas and multiply their resources exponentially. This dynamic collaboration and relationship-building team will continue to tackle hunger in Orange County.
Current Practice
WNOC is piloting food recovery efforts in the cities of Anaheim and Orange to reclaim, repackage, and distribute usable food. The pilot is WNOC’s first effort to identify sources of recoverable food and motivate businesses to donate food by conducting outreach and connecting businesses to food recovery organizations. WNOC intends to eliminate food insecurity in the county by nurturing partnerships and breaking down the barriers that prevent food donations. The coalition has partnered with more than 20 agencies which include non-profit organizations, businesses, people from all facets of the community, food banks, food distributors, health care agency employees, and volunteers. WNOC focuses on food recovery, food distribution, training, and education by connecting grocers and restaurants to food recovery agencies, connecting people with pantries that provide wholesome food, as well as training and educating donors to handle food safely.
Innovation
WNOC has members spanning across varying sectors to ensure that wholesome food is donated to pantries and provided to those in need. Collaboration often involves changing beliefs and going outside the usual activities expected by a public or private organization. The Program Manager for the county’s Food Protection Program in the Orange County Environmental Health Division and a WNOC member, realized that food establishments incorrectly believed that the health department discouraged food donations for safety and liability reasons. This inspired him to change this misconception by encouraging the health inspectors to go beyond their normal duties to educate and promote food donations. To give some perspective, the county employs 50 inspectors who reach 15,000 food facilities throughout Orange County two to three times a year. Initially the inspectors were reticent to get involved, since they saw themselves playing a strictly regulatory role in the Health Care Agency but soon realized their potential impact on hunger and began their outreach to 789 facilities from July to September 2014. Though not usually involved with addressing the topic of hunger, health inspectors are now the “boots on the ground” for highlighting food shortages in local pantries. Inspectors now tackle the stigma of donating food by distributing brief handouts (“one-pagers”) that address liability concerns to business owners during inspections. These handouts been adopted by five other counties in California.
The goals for WNOC are threefold. WNOC strives to end hunger in Orange County by increasing food donations to pantries, educating the community and increasing access to food.
1. Educate the county about food insecurity and food donations: a) Awareness campaign to community organizations b) Educate healthcare providers about the food insecurity problem and the food insecurity screening tool c) Educate business owners about food donations and liability information via health inspections
2. Increase access to food to those who need it: a) Create a Google Map of all of the pantries in OC and collaborate with OC 211's directory to host it on their database b) Provide healthcare professionals the tools to refer food insecure individuals (via Google Map of pantries) c) Ensure that 1 to 2 new pantries are provided with recovered food per quarter
3. Increase food donations - create the Anaheim/Orange Pilot: a) Begin record keeping of pounds of food recovered b) Create a Food Recovery Task Force to follow up with businesses that have been provided with food donation informational material by health inspectors c) Food Recovery Task Force members to be identified and trained by August 2014 (done) d) Ensure that at least 14,000 lbs. food are donated each quarter e) Ensure that five new establishments donate food per quarter – maintaining sustainability through follow ups and presenting donors with official WNOC window seals on an annual basis.
4. Future Goals: a) Establish a central kitchen to break down donated bulk items that are logistically difficult to distribute on their own (such as a larger-than-usual donation of mayonnaise or beef) into palatable prepared meals b) Establish a culinary arts job training program for troubled youth c) Add public schools in the county to the list of facilities donating excess food d) Create a student food insecurity questionnaire at UC Irvine and Cal State Fullerton e) Support the development of an on-campus pantry if needed
Implementation
WNOC began the Anaheim Food Recovery Pilot in February 2014 following a planning stage than began in mid-2013. The Anaheim Pilot was a city-wide effort focused on identifying sources of recoverable food and educating potential donors to safely redirect food to those in need. Anaheim was chosen for practical reason, in part for its high availability of food producing facilities and large potential sources for food recovery. Orange County Health Care Agency inspectors began to visit facilities in Anaheim and distributed the food donation “one-pager” to educate them in food donation and address liability concerns. This “one-pager” dispels myths surrounding food donations by mentioning the Good Samaritan Food Donation Act and assures potential donors that the health department encourages food facilities to donate their excess food. By mid-2014, this pilot expanded to Orange and became the Anaheim-Orange Pilot because several restaurants wanted to donate food. It was around this time that OC jails received approval to donate its excess food via WNOC, which currently averages about 3,500 lbs. of food every month. At this point in time, Food Finders began tracking the number of pounds of all food recovered attributable to WNOC’s partnerships. Coalition members later expressed the need for a subcommittee to “speak the language” of the restaurant/food facility industry and follow up with facilities that were given the food donation one-pager. By July 2014, the Food Recovery Task Force (a WNOC subcommittee) was created, led by a restaurant owner and stakeholder in the community. It is now composed of business owners who follow up with recently inspected businesses to address any logistical concerns and provide resources to ease the food donation process.
The Public Health Officer also wanted to reach out to the clinics, so health care providers could assess a patient’s food insecurity level. WNOC now promotes the use of a food insecurity screening tool by Hager, et al. (2010), which consists of two questions validated by the literature to accurately identify food insecure individuals. WNOC is currently working with two federally qualified health centers (FQHCs) to implement the tool with the intention that physicians refer their food insecure patients to WNOC’s Google Map of pantries, which provides information about all food pantries in Orange County. Children’s Hospital of Orange County (CHOC) is now including the food insecurity screening tool into its information system for incorporation into intake history and uses the Google Map of pantries to refer patients needing resources. This Google Map of pantries is available on the WNOC website and is also featured on the OC 211 social services directory (211 operates in cities nationwide) which provides links to housing, employment, medical, and financial resources in addition to other services. This collaboration with OC 211 was a direct result of WNOC’s efforts to build constructive partnerships.
Timeframe
The timeframe for Waste Not OC spans five years since its inception in 2012. For the 2014-2015 year, WNOC aims to maintain or exceed the initial objective of 14,000 lbs. of food recovered every three months, though this has already been exceeded (36,633 lbs. of food was recovered in three months). Achieving this definition of “success” will herald the expansion of WNOC beyond the pilot cities of Anaheim and Orange.
Stakeholders
The Food Recovery Task Force’s support has been instrumental in increasing food donations. The Task Force is led by a restaurant owner and community stakeholder who actively participates in WNOC’s meetings and conference calls. It consists of volunteers who donate their time to speak with restaurant operators who have been inspected and informed about the coalition. Because the Food Recovery Task Force is composed of members of Orange County’s restaurant industry, this creates a sense of familiarity and trust among restaurant managers who might be initially reluctant to donate food from their facilities. The leader of the Food Recovery Task Force is actively involved in, and helps steer the coalition in other ways as well. In addition to regularly attending coalition meetings at the Health Care Agency, he meets and discusses food recovery logistics with food facility operators, restaurant managers, owners and other contacts in his network to further WNOC’s goals. WNOC, under the guidance of the Public Health Officer, has also formed close ties with the Program Manager of the Environmental Health Division’s Food Protection Program to oversee that food donation informational material be distributed throughout the pilot area.
Funding
United Way of Orange County awarded WNOC $50,000 in June 2014. Konsept and Locally Grown Collective, two Santa Ana-based art collectives dedicated to social causes, donated $3,293 to WNOC in October 2014. Pick-ups and deliveries orchestrated by Food Finders are operated through the in-kind contributions of volunteer drivers. Other in-kind contributions stem from the Food Recovery Task Force, who donate their time and efforts to easing the process of food recovery. Funding for the Project Manager for WNOC comes from the Orange County Health Care Agency.
References
Hager, E.R., Quigg, A.M., Black, M.M., Coleman, S.M., Heeren, T., Rose-Jacobs, R.,…Frank, D.A. (2010). Development and validity of a 2-item screen to identify families at risk for food insecurity. Pediatrics, 126(1), e26-32. doi: 10.1542/peds.2009-3146
Currently WNOC is at a crucial developmental stage, especially following the launch of the Anaheim-Orange food recovery pilot in February. 1 a-c) The awareness campaign to community organizations is an ongoing project, WNOC representatives such as the Public Health Officer, the head of the Food Recovery Task Force, as well as the Project Manager continue to present WNOC’s efforts to community panel discussions and participate in local activities. 2a) As stated earlier, WNOC’s objective to have local federally qualified health centers (FQHCs) implement the screening tool is a work in progress. Once implemented, it is expected that the following quantitative data will be collected for evaluation purposes: the number of patients screened for food insecurity, the number of patients referred to food resources following determination of food insecure status, as well as the number of patients referred to emergency on-site food sources. Objective 2b) states that 1 to 2 new agencies are to benefit from recovered food every 3 months (every quarter). For the months of July to October 2014, 5 new agencies received recovered food, exceeding our goal for the quarter. 3a) Record-keeping of pounds of food recovered began in July 2014, this record keeping is standard protocol for WNOC’s partner agency Food Finders for all of their operations. All numbers presented in this narrative only refer to food recovered attributable to WNOC’s partnerships. 3b) Food Recovery Task Force members were expected to be identified and trained for follow-ups to businesses by August 2014. This was completed on time. 3c) WNOC had to ensure that at least 14,000 lbs. of food was recovered for the months of July-Sept. 2014. WNOC greatly exceeded this projection by 22,633 lbs and redirected a total of 36,633 lbs. (equivalent to 30,527.5 meals using a measure of 1.2 lbs = 1 meal) during the first three months. 3d) 10 new donors redirected food via Food Finders in the first quarter from July to October 2014, which exceeded the initial objective of 5 new donors per quarter.
The benefits reported by food producing facilities (restaurants, grocery stores, etc.) that have chosen to donate excess food include the following: 1) Businesses find where they can improve their operations and reduce the amount of food ordered as soon as they see how much is being donated 2) Businesses save costs in waste management. One restaurant reported saving money by eliminating the need for an additional waste bin as a result of WNOC’s partnership 3) Businesses gain positive publicity by earning a WNOC window seal for customers to see, showcasing that they donate excess wholesome food. These incentives serve to encourage a sustainable flow of food donations.
The magnitude of solving food insecurity seems daunting at first, but WNOC’s vision is to provide simple resources to address the question of food insecurity that can be readily applied and sustained in any county in the nation. WNOC’s toolkit can be replicated and is a feasible starting point for other counties to begin the fight against food insecurity. The Standard Practices for Community Clinics sheet contains three standard practices for clinics to use, which include screening patients for food insecurity, connecting them with local resources, and providing them with emergency food. The Healthy Food Drive Toolkit is another document that describes food insecurity in the county, contact information to county food banks, a list of suggested healthy donations, description of the food recovery program, an excerpt from the California Health and Safety Code and a description of the Good Samaritan Donation Act, which limits food establishments’ liability when donating food. Each of these documents can be modified to fit any county’s needs. The Program Manager of the Food Protection Program, for example, created a one page informational bulletin (“one pager”) addressing the knowledge gap between food operators and the concern about the liability of donating food. Shortly thereafter, an additional bulletin was created to address another confusing area; expired foods. In doing so, several other counties have taken our template and modified it to brand their own county’s logo and address their own knowledge gap regarding donated and expired foods.
WNOC learned that it is imperative to harness the influence of one person, namely the Public Health Officer, who can pull individuals together and pinpoint important stakeholders in the community as well as motivate and mobilize networks to address food insecurity. Hunger is often perceived as a problem too big, too overwhelming for one department to handle. The point that WNOC wants to make is that the onus should not land solely on the shoulders and resources of the county health department. The solution to food insecurity lies in triaging responsibilities across programs in the county health department, private businesses, nonprofits, and other organizations. Giving each of these players a place at the table to delegate and lead their own efforts is the most effective strategy to end hunger in Orange County.