food pledge....what you can do
TRANSCRIPT
Maine Health
WorkshopNovember 4th, 2008
Michelle Gottlieb, MEM
www.noharm.org
Healthy, Local, Sustainable Food in Healthcare: Food Pledge and GGHC
The Healthy Food in Health Care Pledge
Bartels Lutheran Retirement Community - IA Fletcher Allen Health Care - VT Good Shepherd Medical Center - OR St. Luke’s Hospital - MN Hackensack University Medical Center - NJ Oregon Health and Science University Hospital - OR Fairview Hospital - MA Cooley Dickinson Hospital - MA Sinai Hospital - MD Baystate Health - MA Advocate Lutheran General Hospital - IL The Center for Discovery - NY Spaulding Rehabilitation Hospital - MA Littleton Regional Hospital - NH Swedish Covenant Hospital - IL Carroll Hospital Center - MD Arroyo Grande Community Hospital - CA Bakersfield Memorial Hospital - CA Barrow Neurological Institute - AZ CA Hospital Medical Center - CA Chandler Regional Hospital - AZ Community Hospital of San Bernardino - CA Dominican Hospital - CA French Hospital Medical Center - CA Glendale Memorial Hospital and Health Center - CA Marian Medical Center - CA Mark Twain St. Joseph's Hospital - CA Mercy General Hospital - CA…………………
Venues for Change
• Patient food• Cafeteria• Catering• Vending Machines• Franchises• Employees
benefits
Start a Conversation About Healthy Food
Create a multi-disciplinary food committee or “team” composed of staff from: Food and nutrition services; Purchasing; Administration; Nursing, and clinicians; Other - public affairs, ethics and quality
improvement personnel.
Menu of Options: Steps to Healthier Food in Hospitals
Purchasing Preferences
• Poultry and Meat Raised Without Use of Nontherapeutic Antibiotics
• Dairy products produced without rBGH• Certified Foods• Locally produced
• HCWH works with all major GPOs• Develops model contract language• Educational content • Training
GGHC Food Service Credits
2008 Revision to Green Guide for Health Care Version 2.2 Operations Section
www.gghc.org
What is the GGHC?
• Self certifying tool kit to steer facilities through greener design, construction and operations.
• Version 1.0 released in 2003 – Review of Versions 2.0, 2.1 and now 2.2
Protect the immediate health of building occupants.
Protect the health of the surrounding local community.
Protect the health of the global community and natural resources.
1
2
3
2002 ASHE Green Healthcare Construction Guidance Statement
foundationaldocument
The design and operation of health care buildings is highly regulated with intense economic and life safety oversight
Health care facilities are often multiple building campuses of varying ages, conditions, systems
24/7 operations with patients in place require intensive coordination and redundancy of all services at all times.
Long ownership mean owners realize life cycle implications of their construction choices.
1
2
3
4
overviewdesign attributes
• Void in the marketplace of health-care specific green building tool
• Core content transfer from existing tools (e.g., LEED®) but need to tailor for healthcare
• Explicit health-based focus
• Sensitivity to an over-regulated sector --> voluntary best practices with no certification thresholds
• Reinforces integrated design as essential
• Bridges design & construction with operational considerations
• Dec 2003 – Version 1.0 Released in Draft Form
• More than 900 registrants downloaded during public comment period
• Steering committee reviewed comments
• Nov. 2004 – Version 2.0 Released for general use in pilot phase
• Sept. 2005 – Version 2.1 Released (operations update and minor revisions to construction)
• January 2007 – Version 2.2 Released (construction update and minor revisions to operations)
•Spring 2008 – Release of Operations Section – Public Comments Close May 16th
History of GGHC
Intent
Documentation
Health Issues
Reference Standards
Credit Goals
Technologies & Strategies
GGHC Credit Organization
18,000+ website registrants• every state in the U.S.• every Canadian Province• 500 new registrants/month• 100+ countries
GGHC Website Registration
Last updated April 2008
GGHC Website Registrant Growth
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
Nov-03
Jan-04
Mar-04
May-04
Jul-04
Sep-04
Nov-04
Jan-05
Mar-05
May-05
Jul-05
Sep-05
Nov-05
Jan-06
Mar-06
May-06
Jul-06
Sep-06
Nov-06
Jan-07
Mar-07
May-07
Jul-07
Sep-07
Nov-07
Jan-08
Mar-08
Release GGHCVersion 2.0 Pilot
Release GGHCVersion 2.1 Pilot
Release GGHCVersion 2.2
gghc website registrant growth
geographic distributionGreen Guide for Health Care Website Registrants
overviewregistration
1. Canada2. Australia3. United Kingdom4. India5. France
6. Malaysia7. Argentina8. Brazil9. South Africa10.Portugal
top ten countries with international website registrants
Current as of January 2007
geographic distributionGreen Guide for Health Care Registered Projects
overviewproject
148 registered projects36,000,000 sf34 states4 Canadian provinces7 countries
green guide project growth
Current as of April 2008
constructionsection
1 – Integrated Design2 – Sustainable Sites3 – Water Efficiency4 – Energy & Atmosphere5 – Materials & Resources6 – Environmental Quality
7 – Innovation & Design Process
2 - 01 - 211 - 63 - 212 - 213 - 240 - 4
12 - 97
Section / Category Name Pre-Req. / Max. Total
operationssection
1 – Integrated Operations & Education2 – Sustainable Sites Management3 – Transportation Operations4 – Facilities Management5 – Chemical Management6 – Waste Management7 – Environmental Services8 – Food Service9 – Environmentally Preferable Purchasing10 – Innovation in Operation
1 - 20 - 90 - 56 - 393 - 53 - 60 - 80 - 142 - 190 - 7
15 - 114
Section / Category Name Pre-Req. / Total Points
• Improve the clarityclarity of credit goals and implementation path.
• Credit thresholds and/or benchmarks for continuous improvement
• Meet the needsneeds of all users.• Those just getting started• Those familiar with LEED rating system• Those wishing to continuously improve their environmental strategies,
pushing the envelope.
• Group credits by departmentdepartment. • Incorporate key external resourcesexternal resources.
• Review the LEED for High Performance Operations• Review for H2E programs
Scope of Work & Goals
• 2008 Revised GGHC Operations Section used LEED as a foundational document.
• 34 of 56 prerequisites and credits in the GGHC Operations section derived from LEED EB.
HighlightsHighlights
• Strategies grouped by department• Reflects most up to date best practices and reference
standards (as of 2008)• Expanded scope: 2 new sections• Emphasis on continuous improvement• Emphasis on Integrated Operations and Education
Overview
Food Service Credits
FS Credit 1: Sustainable Food Policy and Plan FS Credit 1.2: Nutrition FS Credit 2: Sustainable Food Education and Promotion FS Credit 3: Local, Sustainably Produced Food PurchasingFS Credit 4: Reusable & Non-Reusable Products FS Credit 5: Hospital Supported Agriculture: Food and Farm LinkagesFS Credit 6.1: Food Donation and CompostingFS Credit 6.2: Food Services RecyclingFS Credit 7: Food Vendors FS Credit 8: Chemical Management for Food Services
Food Service Operational Credits
FS Credit 1: Sustainable Food Policy and Plan
Intent: Create, promote andimplement practical sustainablefood purchasing policies andplans that support human andecological health. CHW recognizes that
healthyfood” describes not only nutritional quality, but equally by a food system which is ecologically sound, economically viable, and supportive of human dignity and justice, and so; CHW aspires to develop a healthy food system
•Food policy Vision Statement or
•Healthy Food in Health Care Pledge
Achieve FS Credit 1.1: Sustainable Food Policy and Plan
AND
•minimum of one fresh fruit option at each patient meal and at . lunch and dinner, provide a fresh green salad and a minimum of one non-starch fresh vegetable option.
• whole grain options for minimum 50% of grains and breads
• one protein-balanced vegetarian menu option during each meal.
FS Credit 1.2:Food Nutrition
IntentCreate, promote and implement sustainable food purchasing policies and plans that support human and ecological health.
FS Credit 1.2:Food Nutrition
AND a minimum of four of the following practices:
• Wholesome Soup: all patient and cafeteria soups are made from scratch ( excepting canned legumes and tomatoes).
• Meat Free Option: Cafeteria and patient food meat-free one day per week.
•Trans Fats and Healthy Oils: Eliminate all products that contain trans fats AND, create a heart-healthy oils purchasing policy
• Fried Food Elimination: Eliminate deep fried foods from patient menus and cafeteria.
• Nanotech Foods: Develop and implement a policy requiring disclosure and elimination of nanotech additives.
• Food Color and Additives: a purchasing policy and program to eliminate food additives
• Healthy Vending and Snacks
Hold Educational
Event
Post Vision in Facility and on
Website
FS Credit 2: Sustainable Food Education and Promotion
Intent: Create awareness among staff, patients, visitors, service providers, vendors and the community of hospital food service initiatives around sustainability through education programs and constant reinforcement of the benefits to human health.
FS Credit 2: Sustainable Food Education and Promotion
• Upon hire and annually, 1 educational event targeted to the food service department explicitly explaining the link between human health and food production.
• Hold a minimum of 1 educational event annually targeted to hospital employees
And……
Education
FS Credit 2: Sustainable Food Education and Promotion
( Annually 3 of the following) :
•Post and annually update a signed copy of the facility’s Food Policy in a visible site within the hospital and on the hospital website explicitly explaining the link between human health and food production.
•Establish and maintain a program to inform cafeteria consumers of specific product offerings that are seasonal, organic, locally grown, sustainably grown/produced, etc
•Establish and maintain a program to inform patients
•Host special events targeted to patients, employees, and hospital visitors that promote the facility’s sustainable food products and initiatives
•Hold special events (onsite or offsite) targeted to the larger community highlighting the facility’s commitment to supporting healthy, local, seasonal, organic, and sustainable foods and food systems.
Healthy Sustainable Food Promotion
Support certified and
locally produced food
products
FS Credit 3: Local, Sustainably Produced and Food Purchasing
Intent: Improve human andecological health throughpurchase of local andsustainably produced foodproducts.
Credits 3.1, 3.2, 3.3
Credit Goals• Credit Goals
– Measurable • Approved to carry one or more of the listed independent third
party certified ecolabels and/or• Carry one of the listed label claims allowed by USDA or FDA
and/or• Farms, ranches, and production/processing facilities located
within a 200-mile radius of the facility
– Flexible– Reward Incremental Success (15, 25, 50 percent)
FS Credit 3: Local, Sustainably Produced and Food Purchasing
Eco-labels
http://www.greenerchoices.org/eco-labels/
Label Claims
FS Credit 3: Local, Sustainably Produced and Food Purchasing
Label Claim Food Category
“Raised without antibiotics” or ”No antibiotics administered”
poultry and meat
“Raised without added hormones” or “No hormones added”
beef and lamb only
“No genetically engineered ingredients”products made from corn, soy, canola or their derivatives
“rBGH-free”, “rBST-free”, or something to this effect “our farmers pledge not to use rBGH or rBST”/”Our famers pledge not to use artificial hormones”
milk, butter, cheese, yogurt, ice cream, sour cream, cottage cheese
“Grass-fed”products from ruminants such as beef cattle, dairy cattle, lamb
Local Sourcing Strategies
FS Credit 3: Local, Sustainably Produced and Food Purchasing
• Direct relationships
• May be able to use state local food marketing programs*
• Processed foods >50% by weight
• Independent family farms/ranches or cooperatives/networks
Family Farm?• No uniform definition• Few certifications
– Animal Welfare Approved • …one on which a family or individual
– Owns the animals, and
– Participates in the daily physical labor to manage the animals and the farm or ranch operation, and
– Derives a meaningful share of their livelihood from that farm or ranch
– American Family Farmed• Also tied to production practices• Under development• http://www.familyfood.net
Convert to/ maintain use of reusable food
service ware
Choose preferred biobased disposables
Recycled content, unbleached paper
products
Bottled Water Elimination
FS Credit 4: Reusable & Non-Reusable Products
Credits 4.1, 4.2, 4.3, 4.4
Intent: Reduce use of virgin resourcesin food service ware and food service paper products.
http://www.noharm.org/details.cfm?ID=1456&type=document
FS Credit 4: Reusable & Non-Reusable Products
Non Food Service Ware Items
•Eliminate single-use bottled water sales inc. vending/meetings and conferences.
•In cafeteria provide easy access to water derived from local public water supply.
•Provide reusable water containers (for purchase or free)
•Provide clear signage indicating nearest local publicly accessible water fountain. FS Credit 4.4
Bottled Water Elimination and Public Drinking Water Access
IntentSupport environmental stewardship of virgin resources by purchasing reusable and non-reusable products.
CSAs Food Box Program
Sponsor Farmers Markets
FS Credit 5: Hospital Supported Agriculture: Food and Farm Linkages
Intent: Support local and regionalfood production by increasingits visibility in the communityand strengthening localagriculture infrastructure.
FS Credit 5: Hospital Supported Agriculture: Food and Farm Linkages
•Processing and Season Extension Develop and support relationships with at least one local farm, not-for-profit farming organization, and/or meat or produce processing facility to extend the seasonal availability of local food in the facility.
• Food Service Procurement - Coordinate with local farm to match planting decisions with purchasing intentions prior to growing season.
• Farmers Markets - Host and promote local or onsite farmers markets.
• Food Box - Actively promote Community Supported Agriculture (CSA) food box programs. Host CSA pick up locations on-site.
• Hospital Garden or Hospital Farm - Support on-site or off-site hospital owned food producing garden(s) and/or farm(s).
• Urban Garden Program – Provide direct or in-kind support for not-for-profit urban food producing community garden organization(s).
• Conference and Meeting Food Policy – Develop and implement a policy requiring sustainable purchases at all facility-sponsored or -hosted conferences and workshops.
Credit Goals – (minimum of 3 innovation for extra 2)
Compost Food Waste
Develop Food Donation Program
FS Credit 6.1: Food Donation and Composting
Intent: Support food security programs, soil restoration, and waste reduction through food service donation andcomposting programs.
FS Credit 6.1: Food Donation and Composting
Credit Goals
• Develop and implement a food donation program
• Develop and implement a food waste composting program
• Develop and implement food donation and food waste composting written management plans
• Estimate and track pounds of donated food
• Provide controlled areas to facilitate easy removal of food waste, consistent with an Integrated
Compost Food Waste
Develop Food Donation Program
FS Credit 6.1: Food Donation and Composting
Intent: Support food security programs, soil restoration, and waste reduction through food service donation andcomposting programs.
Credit Goals •Glass, metal and plastic • Corrugated boxes, boxboard and paper• Shrink wrap (bagged or baled)• Return pallets to vendors for reuse.
FS Credit 6.2: Food Service Recycling
Intent: Reduce solid waste disposalin landfills and incineratorsgenerated by the food servicedepartment through recycling.
Purchase sustainable
foods, nutritious
foods
Compost
Establish Farm Connections
FS Credit 7: Food Vendors
Intent: Establish facility-wide implementation of healthy, sustainably produced foodservice programs by establishing parallel policies and programs with contracted food service vendors
CBS/AP/iStockphoto
Credit Goals
FS Credit 7: Food Vendors
2 points available
Food Service Credit 8
EPP Cleansers and detergents
Use Integrated Pest Management
FS Credit 8: Chemical Management for Food Services
Intent: Minimize the use of toxicchemicals in the food servicespreparation and service areas,including cleaning chemicalsand pest management.
• Specs listed under GGHC ES Credits 1.3-1.4
• Avoid phenolics and chlorinated cleaners for food service use
Environmentally Preferable Cleaning Products
FS Credit 8: Chemical Management for Food Services
Integrated Pest Management
FS Credit 8: Chemical Management for Food Services
• Scouting and treatment thresholds– No routine treatment – only when pests are present
• Non chemical methods– Good sanitation practices– Structural maintenance – Cultural practices
• Least toxic controls– Minerals, soaps, boric acid – Enclosed baits, crack and crevice treatments
• No treatment while spaces are inhabited
http://www.h2e-online.org/
Adele Houghton, GGHC, [email protected], 512 928 4786
GGHC Steering Committee and Food Workgroup Chair, HCWH
Jamie Harvie [email protected]
Marie Kulick, IATP HCWH Food Purchasing Coordinator
Michelle Gottlieb, HCWH Food Workgroup Co-Chair and New England Coordinator [email protected]
Contacts
Additional Tools and Assistance
• Lists of sustainable producers/review of producer claims
• Fact sheets and general purchasing guidance docs
• Help to draft organization specific policies• Help to draft organization specific language for
RFIs, RFPs and contracts• Provide “experts” for Grand Rounds, food teams• Work with GPOs and distributors• Communication network for health care providers
healthyfoodinhealthcare.org
www.foodmed.org
Breakout Tracks: • Obesity and the Food System • Antibiotics, Arsenic and Poultry • Sustainable Meat Production • Food Waste Management• Farmers Markets and Onsite Gardens• Understanding Food Certification• Food Miles and local procurement• Healthy Vending and Catering• Case Studies
RESOURCES • Health Care Without Harm Food Workgroup www.healthyfoodinhealthcare.org • Hunger and Environmental Nutrition Dietary
Practice Group www.hendpg.com/ • FoodMed Conference www.foodmed.org• Healthy Food Pledge
www.noharm.org/us/food/pledge • http://www.noharm.org/us/food/listserv• Green Guide for Healthcare www.gghc.org