A Straight Line to Community Wellness

It’s not brain surgery. The shortest path between two points is a straight line. The hard part, however, is identifying the line and following it where it leads.

It’s easy to get turned around and lost on the path from here to there, especially if you’re trying to get from unhealthy to healthy. Sometimes, you need a leader— someone who can see the big picture.

It just so happens that in Maine, the leader isn’t exactly a someone. It’s an institution leading the way towards community wellness by cultivating healthy relationships with small-scale growers around Augusta, Maine.

Point A

Maine General Medical Center is at the forefront in the march towards healthier communities, one of the first in the region to institute such a program.

They work with local farmers to source in-season fruits and vegetables, breads and oatmeal, milk, sour cream, meats, and herbs, which are prepared by Maine General’s accomplished chefs and served to patients, staff, and guests. Providing access to these farm-to-table, nutrient-dense foods supports economic development in the local community, lessens the hospital’s carbon footprint, and combats poor eating habits including reliance on processed foods. This is particularly important in Maine, where 65 percent of the population is obese or overweight.

“We are a community hospital.

When we started on this journey we looked at ways we could be a part of our community,” says Paul Stein, the Chief Operating Officer of Maine General. “Obesity is a problem in our community. It’s a problem that can be traced directly back to the quality of food.”

The Board of Directors at Maine General, the patient care staff, and the food management team, all agreed that sourcing food was an important first step in helping their community get healthy, but it wasn’t going to be without cost. In order to pull this off, Maine General needed to have several things in place. Not the least of which was the growers.

“It got to the point in the first couple of years the farmers weren’t ready for us and couldn’t handle the demand. So we started having meetings before the growing season to let them know the kind of produce and quality we’re looking for. We had to educate our growers,” says Stein.

Conrad Olin

Conrad Olin, manager, Food & Nutrition Services at Maine General Medical Center, holding produce purchased
for serving in the hospital.

Then, there were the government hoops to jump through, and when you’re an institution as large as Maine General, it requires the coordinated efforts of many different people and agencies to get through the process.

“At first, there were some regulatory obstacles. We worked with state, private, and local authorities to make this happen. We hope we inspire other hospitals to buy local. And what does local mean? Going out to the farm.”

For Paul Stein and those on his team, educating the growers meant educating themselves about the community they serve. “Our staff took it upon themselves to go out and do their own inspections of the farm.

Our chefs have such passion for sustainable growing. Our head chef has his own garden and his own chickens.

So he goes out to the farm and helps the farmers understand and follow our process.”

Learning more about the community and the growers paid off when Maine General built a new addition to the hospital in Augusta. “Now we have a walk-in cooler that we created just for the local farm deliveries.

We are also setting up an education program with our new community kitchen. Our goal is to have children from the school up here once a week where they can learn how to cook with locally grown non-processed food.”

“Sourcing local food highlights the fact that we are a community hospital,” says Stein. “We want our patients to know that we’re committed to their health and the health of the community. We have a room service menu. Patients can eat when they’re hungry. Their loved ones can order off the same menu. On the menu we make sure we highlight where the food is coming from. We also run specials during peak season and highlight that for our staff and visitors.”

Stein acknowledges that implementing a program requires a commitment to funding healthier choices.

“There’s an investment with this.

Whether it’s our teaching kitchen, buying local, setting up the mechanism, but it’s all part of a healthy community lifestyle, and we are the community hospital.”

Many Points B

If Maine General’s goal of sourcing locally grown food is Point A, then the people who grow the food are Point B. However, with an institution as big as Maine General, efficiency is key, and Point B was anything but efficient. There were dozens of growers producing hundreds of different crops of varying quantity and quality. Point B needed a point person. Enter Sarah Smith.

Sarah Smith is the manager of The PickUp, a multi-farm CSA that provides produce to Maine General.

Smith’s farm is just one of over 50 that provide CSA members with a variety of locally grown produce, dairy and meat. She’s also the point person for the producers who grow specifically for Maine General.

This is the first season The PickUp has worked with Maine General. In the beginning, Maine general tried to work with a non-profit grocery store, but they didn’t have a way to deliver and couldn’t accommodate Maine General’s needs, so The PickUp stepped in with their delivery truck.

Each week during the growing season, Smith compiles a list from the 15 or so core growers, and sends it to Maine General on Mondays. Each Tuesday, she relays Maine General’s order to the growers, and it’s delivered to the hospital on Wednesday.

Smith coordinates it all, and like Paul Stein and the management of Maine General, she does it by cultivating relationships with people who she may not have previously thought of as collaborators—those who work for large institutions. “The reality is that in a diversified farming operation— the market of the creative culture and healthy choices people—there are only so many of them. In order to expand, we have to start looking at institutions.”

Working with large institutions does present problems for small-scale growers. “The obstacle with insti- tutional selling is that there aren’t tomatoes in Maine in January,” says Smith. “In the summer, there were weeks I couldn’t get enough tomatoes to fill Maine General’s order.”

Then there are the requirements that institutions have regarding food.

“On the open market, consumers will buy smaller or bigger tomatoes, but Maine General needs uniformity because of what they do.”

“We’re finding we all have to plan better and make better use of our resources to make this happen.

There was some training we put our growers through—food safety training, and the hospital comes out to the farms to do inspections. All that will continue and improve as we get used to working together as a team.”

Even as she works to improve the fledgling mechanism, Sara Smith knows there are challenges ahead.

“The challenge and the next big step is to start training the chefs in institutions to work with a more diverse product line. Consumers have to learn to eat seasonally, and chefs are the key to making this happen.”

Smith points out that marketing and branding are important tools that those who prepare local food can use to increase consumer awareness.

“Don’t call it roasted kohlrabi. Give it a different name, and offer free samples,” she says. “This is one of those challenges that will work itself out over time.”

Teaching Nutrition

As a part of Maine General’s overall nutrition initiative, they made the commitment to build a teaching kitchen in the new hospital. Having the teaching kitchen is a huge step in their commitment to showing people how to prepare the local whole foods that they
purchase to serve in the hospitals. They also support financially two farmers markets in the area and produced a film on farmers markets that showed statewide on Maine Public Broadcasting Network and Time Warner Cable. (Right: Who says you shouldn’t play with your food?)

Maine General’s commitment to buying locally has increased opportunities for growers. “Part of expanding into the market is a matter of knowing your farm,” says Smith. “Certain things grow great on certain farms. This model allows farmers to grow more of the things they grow well and still make a go of it. This way, farmers don’t have to grow 60 different crops just to make a living.”

An institution has to be willing to take on a little more work and see the inherent value in what they do.

We hope other institutions will take notice of what Maine General is accomplishing and follow suit.”

Point C

When the order from The PickUp is placed in the cooler at Maine Gen- eral in Augusta, Maine, it is Chef Conrad Olin who will be overseeing the preparation. Like Paul Stein and Sarah Smith, Conrad Olin believes the healthiest food is grown by farmers who have healthy relationships with their consumers. “We needed to have a relationship with the farmers.

That’s why we went to The PickUp.

Sarah has a good relationship with the local growers. We couldn’t go out and buy from every Tom, Dick, and Harry who wanted to sell to us.

Obviously, in a hospital, we have immune-compromised patients. We have to take that into consideration.

That’s why we go out and inspect the farms. So far we’ve looked at about 16. Sarah knows who is using good growing practices. We depend on her to coordinate our efforts and keep us up to date on any issues in the farming community.”

The planning meeting is one of the tools that Maine General depends on to ensure the program continues to work and grow. “It is a great opportunity for local farmers.

The hospital is not going anywhere.

Local growers know they have a solid customer for the next 40 years.

It gives the grower an opportunity for long-term planning. It’s critical that we let the growers know what our volume is what our needs are.

Sara has a meeting in the winter with the growers, and I’ll be a part of that this season.”

While the cost of sourcing locally grown food is higher than buying from traditional institutional providers, Conrad Olin echoes the sentiments of Maine General’s Board of Directors. “It was the right thing to do for lots of reasons. Supporting our local growers. Knowing where our food comes from. The obstacle that we did face was the increased cost of our produce, but with the support of management in regards to our budget, they were on board and expected the budget to increase.”

Points beyond

In 2012, Maine General purchased 16.5 tons of locally sourced food. In 2013, that number increased to 17.5 tons. Paul Stein hopes that other hospitals will consider reaching out to the community that they serve. “Community hospitals should reach out and help the community in ways that promote health and growth.”