Policy Analysis of Standards for Institutional Purchasing of Food by State Government

1. Policy Analysis of Standards for Institutional Purchasing of Food by State Government

2. Objective • Identify the problem • Evidence for benefits • Current procurement standards & policies • Stakeholder analysis • Identify and assess policy options

3. Identify the problem • Obesity trends are changing at a rate that exceeds our ability to identify & implement solutions • Higher risk for morbidity, mortality, type 2 diabetes, heart disease, etc • 1/3 of all deaths in WA are due to increased risk of heart disease & stroke • Goal for HP 2010: “eliminate preventable disease, disability, and premature death”

4. Sick care vs Health care?

5. Economic Burden cont. • 25-30 % of a company’ s medical cost is spent on employees at risk for chronic diseases • Medical spending for obese employees is 37% higher • 10 % weight loss reduces medical costs by $2200 - $5300 (CDC) • For every $1 spent on nutritious diets $3 of treatment costs are saved (WIC)

6. Is this evidence enough?

7. Societal & Environmental Factors • Adopting healthful eating requires • Resources, opportunities, living conditions • Interventions should focus on settings were food is • Provided • Prepared • Sold • Served

8. Accessibility & Consumption Patterns • Increase in access & exposure to healthy food leads to • Fruit & vegetable consumption sustained over time • Mediated changes in overall consumption pattern (Jago et al. 2007) • candy and sweet (Denmark national intervention program) • Trying new foods (Dole)

9. Vulnerable Population Served by WA Food Procurement Contract • Vulnerable population: • poverty, violence, inadequate housing, education • Juvenile Rehabilitation Centers • Mental Health Centers • Veteran’s & Soldiers Home • School for Deaf and Blind • Emergency Food Assistance Programs

10. Vulnerable Populations cont. • Subset of the population at increased risk for • Excess weight gain • Poor fitness • Heart disease • According to PSFPI in the UK, diet can greatly influence behavior • Pupils  More alert • Prisoners  Less antisocial • According to the ADA, diet influences • Behavior in children

11. “Healthy Food” Definitions

12. USDA DRIs are determined by the IOM and represents the most recent science on specific macro and micro nutrients. Dietary Guidelines are determined in collaboration with the USDA & DHHS using the compiled DRI’s.

13. Harvard School of Public Health: Healthy Eating Pyramid Claims to be more up-to-date and science based Claims to be less influenced by industry Studies have shown that the Harvard index has higher risk reduction than the USDA Index

14. The new procurement standards for NYC are quite comprehensive. The elimination of trans fat and reduction of sodium are great examples of the depth of these policies . New York City’s Food Standards New York City Standards are based on the USDA DRI’s. -Standards for purchased food -Standards for meals & snack served -Agency& population-specific standards & exceptions Evaluation and monitoring of these programs and regulations will be influential in guiding future procurement policies.

15. Recent legislation focused on redefining healthy foods to promote a healthier school environment. • -State agency food purchasing standards were recently approved and are not yet enacted. These standards are based on the NYC standards with a few minor changes. • -No evaluation has taken place yet. Massachusetts

16. -Half of all food items for sale at schools must be on an approved “better choice” list. -These standards are less stringent than the USDA or IOM nutritional standards. Indiana Iowa -Procurement standards for schools are similar to Indiana but are less strict.

17. Summary of “Healthy Food Definitions” -All of the state procurement standards and regulations use the USDA DRIs and Dietary Guidelines as a scientific basis for comparison. -NYC -Massachusetts -Indiana -Iowa

18. Current Washington Guidelines for Food Procurement

19. Washington State Food Umbrella Contract Procurement Increases purchasing power for state agencies -Vendors must go through a competitive bidding procedure Contact: Shannon MacGuire (360) 902-7284 smcguir@ga.wa.gov

20. Remaining (10-20% of purchases) • Non-Profit Organizations • -Colleges, Universities • -Community and Technical Colleges Purchasers Primary Purchasers (80-90% of all state purchases) -Department of Social and Health Services (DSHS) -Department of Corrections (DOC) -Department of Veterans Affairs (DVA) -The School for the Deaf & Blind References directly from Shannon MacGuire

21. Food Umbrella Contract Facts • Quarterly Evaluation: • $ 2.5M or 9% accounted for food with low nutrient density • Soda, chips, cookie dough, etc • Correctional Institute • Weekly Menu • Dessert 2-3/day • Fruit Drink 2/day

22. Washington State Agencies: Annual Food Budget $25 million w/ out disposables Budget and Spending References directly from Shannon MacGuire

23. Washington’s Largest Food Contract is with Food Services of America Vendors Washington has two Regional Produce Contracts http://www.ga.wa.gov/

24. Current Regulations and Guidelines -Competitive bid contracting is required. -Currently there are no statewide guidelines for food procurement. -Nutritional standards are set by health and nutrition experts within each agency, but major choices are often guided by limited resources.

25. DSHS Food Procurement -$22.4 Million Annual Food Umbrella Spending -4.1 Million Meals Served Annually -Approx. $5.45 per plate Diets are planned to meet or exceed nutrient needs for a 51-70 year old female. Contact: Erin Hamilton (360) 664-6142

26. Dept. of Veteran AffairsFood Procurement -Meals are based on 2200 calories per day using HSPI menu creation which is based on FDA/USDA HACCP guidelines. -”Exotic” foods tend to go uneaten; meat and potatoes are popular. Contacts: Tish Greenfield (360) 725-2206 tishg@dva.wa.gov Theresa Stanton-Grose (Food Manager at Port orchard) 360.895.4348 theresas@dva.wa.gov

27. Department of Corrections Food Procurement -The combined facilities provide 1,434,287 meals per month costing $2.22 per plate ($1.32 food, $0.81 for labor and $0.09 for paper, cleaning supplies, etc). • -Current meals are based on a caloric intake of males at 2,000-3,000 calories per day. • Nutritional guidelines are based on DRIs and IOM. • Contacts: Jay Jackson, Food Program Manager (360) 725-9165 • Brent Carney, agency RD (360) 725-8314

28. Department of Corrections Pilot Food Procurement Projects Washington Department of Corrections has switched to whole grains and offering fresh fruits and vegetables, and buying selected foods locally. -Reduces costs and helps with inmate transition back. -May show improvement offender health, behavior and access to fruits and vegetables Evergreen State College and Washington State Department of Corrections: Sustainable Prisons Project -Reduces costs. -May show improvement of offender health. -Improves access to inexpensive fresh fruits and vegetables.

29. Washington Department of Health: Energize Your Meetings -Encourages healthy and active options for Washington Dept. of Health meetings. -Determined vendors who can provide healthy foods at fixed government rates. -Uses a star rating system to encourage better food ordering.

30. Current Food Procurement Summary -Washington State Dept. of Health: Energize Your Meetings provides healthy and active options for meetings and other state departments may be interested in using the same model. -Lack of resources to purchase healthy foods is a major factor in food procurement for the DOC. For DSHS lack of culinary expertise may cause the cost to increase due to premade food procurement. For the DVA limiting factor is perception of veterans taste preferences. -Pilot Project for the WA State DOC: Sustainable Prisons Project is expected to decrease costs, increase prisoner health and increase access to healthy foods. -Currently there are no statewide guidelines for nutritional standards, and standards are set by individual departments. -Current system uses food purchasing umbrella with strict competitive bidding for state agency food purchasing.

31. Stakeholders • 5 Main purchasers and their advocacy groups • School for Deaf & Blind • Department of Corrections (DOS) • Department of Social & Health Services (DSHS) • Juvenile Detention • Senior Services/Long term care • State Mental Hospitals • Department of Veteran’s Affairs • Agriculture/Dairy Industry • Contractors • Food Services of America (FSA), Charlie’s Produce, Franz Family Bakery

32. Stakeholder Analysis • System changes • Main purchasers already have nutrition guidelines and purchasing system in place • Under challenging economic climate: practicality & sound evidence matters! (PSFPI) • Promote healthy food & sustainability/efficiency • Supporters: Future Puget Sound Regional Food Policy Council, DOC, environmentalists, farming leaders

33. Current Procurement Policies

34. Who To Purchase From? Energize Your Meetings Program -Establishes contracts with specific caterers who are able to supply healthier options. Changes to the Food Umbrella Contract could be made to encourage the use of local vendors. -Dept. of Corrections has found that contracting with Safeway in some cases can be cheaper than using the existing Food Umbrella Contract Local Food Procurement Programs to Use as Current Examples Farm-to-School (Started in WA in 2002), Farm-to-Seniors, and Farm-to-WIC programs. Gardens in Washington Department of Corrections facilities

35. In Norway their nutritional council has had a lot of influence over food subsidies, regulation and taxation since the 1970’s. -This strict regulation has led to 18% decreases in consumption of saturated fat and 10% decreases in blood cholesterol. -Mortality from coronary heart disease was halved among middle aged men. What To Purchase? Similar Nutritional Councils have been proposed in Washington State and the Puget Sound Regional Council just approved the formation of a Nutrition Council Advisory Body. U.S. State Department's -Washington DC headquarters, which will attempt to integrate “healthier and more sustainable food options” and includes a farmer's market into its food offerings. Establishment of Nutritional Councils: Councils act as official guidance to governing bodies. Unequal weight: equity oriented policy responses to the global obesity epidemic. Sharon Friel, Mickey Chopra,DavidSatcher. BMJ 2007;335(7632):1241

36. What To Serve? New York City's food procurement standards -Addresses both purchasing and serving so that the meals ultimately served are healthier. Energize your Meetings Program: -Five Star Rating guidelines help purchasers determine overall quality of meal served Other state guidelines, like in Oregon have focused on improving healthy foods in schools.

37. Voluntary Pledges from the Public Sector • UK Healthier Food Mark • Voluntary standards are set for providers of public sector food • How will it work? • Bronze, silver, & gold for meeting nutrition & sustainability criteria • Self-assessment • Random reviews for compliance

38. Nutrition Education and Labeling UK Simple Labeling System -Might help consumers make better decisions and promote demand for healthy food. Seattle & King County and NYC: Nutrition labeling

39. Centralization of Purchasing Summary WA Food Umbrella Contract Options -Voluntary standards -Local food incentives -Healthy food incentives -Regulation of food standards London Development Agency -Sustainable Food Hub USDA Fresh Fruit and Vegetable program: Started in 2002.

40. Washington Sustainable Food Procurement Initiative Healthy Food Procurement Projects to keep an eye on -Energize your Meetings -Pilot Projects with the WA DOC -Norway Food Council brought big health changes -NYC City-wide agency procurement policy -Mass. State agency procurement policy -U.S. State Dept. agency healthy food standards • Local/Sustainable Procurement • Projects to keep an eye on • -Pilot Projects with the WA DOC • -Farm to School, Farm to WIC, and Farm to Seniors • -London Sustainable food distribution hub. -Procurement Polices Projects to keep an eye on -Food Umbrella Contract requirements -DSHS guidelines -DVA guidelines -DOC guidelines and pilot projects -Other state agency guidelines Procurement Policy Overview Model based on a figure in the PSFPI evaluation document

41. Thank you:-Donna Johnson PHD RD-Nutrition 531 Class-Shannon McGuire (General Administration Office)-Jay Jackson (Dept. of Corrections)

42. QUESTIONS??