Kaiser Embraces Family Farmers

SAN FRANCISCO — On Wednesday morning, a white-coated food service worker hoisted a box of cherry tomatoes onto a steel table inside a massive commissary that provides almost 6,000 meals a day to 19 Kaiser Permanente medical centers in Northern California.
There was something revolutionary about this produce box. Written on one end was a Southeast Asian farmer's name, Vang Her, who owns a small farm near Fresno. Also scrawled on it were the words "pesticide free."
While farmer's markets have created robust new markets for local farmers selling directly to consumers, finding an efficient way for these small producers to strengthen their economic clout by also supplying institutional food providers has proven virtually impossible.
No longer.
In August, Kaiser Permanente launched a pilot project to purchase fruits and vegetables from small familyfarmers in California. It's created a novel distribution network that provides fresh, and sometimes organic, produce from small farms at roughly the same cost as that from industrial farms. In the process, even in its first few months, the project has lent more stability to the tenuous livelihoods of the small farmers supplying it.
"What Kaiser is showing is that it can be done," said Anya Fernald, director of food service programs for Community Alliance With Family Farmers, a Davis-based nonprofit that's coordinating Kaiser's locally sourced produce program.
"They're absolutely paving the way," she emphasized. "Their demand has built (distribution) pathways that other institutions can use, too." The University of California, San Francisco and Stanford University, among other institutions, have consulted with her group to explore expanding their purchases of local produce, she said.
The idea to use Kaiser's purchasing power to create new markets for small farmers, while improving produce quality, came from an environmental stewardship council run by Kaiser staff.
On that council was Dr. Preston Maring, a physician in the HMO's Oakland medical center. In 2003, he persuaded management to let him bring a farmer's market weekly to the Oakland medical center. It was such a hit that more than 30 farmers' markets are now held weekly at Kaiser medical centers in Northern California.
The success of Kaiser's farmers' markets, which provide patients, staff and the nearby community with easy access to fresh, often pesticide-free produce, got Maring thinking of other possibilities. Knowing the volume of produce purchased by the HMO — some 250 tons annually — he pushed to give local producers a piece of the business.
Just short of four months into the pilot project, Jan Sanders, national nutrition service director in procurement for Kaiser, estimates that local farmers have provided 40 tons of produce to feed patients in the hospital.
With their chicken-salad-on-whole-wheat-bread sandwiches, patients now get a cherry tomato. Sliced apples from a Stockton farmer and grapes from a small farmer in Madera are added to a fruit plate. Earlier this year, patients got locally grown kiwis, cantaloupes, mandarin oranges and strawberries.
Kaiser's new focus on fresh produce dovetails with its 2003 "Thrive" campaign, which encourages lifestyle changes to prevent disease.
"Within Kaiser Permanente, we're promoting 'Thrive,'" said Eirin Hilton, a registered dietitian with Kaiser who helps oversee food service production at the South San Francisco commissary, which is run by a Kaiser contractor, Food Service Partners.
"We have a real theme message here. When people eat well, then they recover better," Hilton added.
"We really are walking our talk," emphasized Sanders. "Our primary goal is prevention, and our primary goal is to improve the health of our patients and our community."
A portion of the HMO's offerings still consists of prepared foods like pancakes, sausages and Danish pastry. But their presence also reflects patients' preferences, said Hilton. Had the current emphasis on fresh produce begun several years back, the initiative might have faltered, she said.
"There's a whole momentum changing with food and health," Hilton noted. "In the past, if we'd try to do this, we would have had major patient dissatisfaction."
But the growing interest in improving Americans' health through better diets is gratifying to her. "It's a health-care phenomenon that's given us humble dietitians a lot more recognition than we've ever had before," Hilton said.
The role Kaiser is playing in bolstering family farming operations is also a source of pride for Sanders and Hilton. The number of family-run farms also keeps declining statewide, said Fernald.
"These are small farmers that are supporting their families on 100 acres," Hilton said. Farmers from ethnic groups, such as the Hmong — tens of thousands of whom fled to California from Southeast Asia after the Vietnam War ended — get priority for supplying the program, although it's not exclusively minority-supplied, emphasized Fernald, with the family farmers' alliance.
She said 15 family-run farms contribute to the project, and she expects 30 by next summer. Kaiser now spends about $10,000 a month on locally sourced produce, and according to a financial analysis, is only spending $400 more a month than it would by purchasing from a distributor supplied by large farms, Fernald said.
And San Vang, a Fresno farmer who grows cherry tomatoes on his 2-acre plot, is now earning more per box by selling into the Kaiser program, as he has cut the cost of the middleman.
The new market for fresh produce — which will expand to other Kaiser facilities if the pilot is deemed a success — also helped at least one Hmong family salvage its crop this fall, Fernald said.
In October, a packing house in Fresno told nine Hmong families who each had farms growing cherry tomatoes that it wouldn't need their produce any longer, she said.
"Several families pulled out their plants," Fernald, even though they still bore tomatoes. "They just didn't have any other option. They couldn't establish new connections, because it was too late in the season."
But at least one of the families, she said, learned of Kaiser's locally grown-produce project, and has been able to sell its tomatoes into it for the past three months.
"No one's becoming a millionaire off of this," Fernald added. "It's that little edge that helps keep a farmer in business."
And as cherry tomato season in California winds down, Kaiser will turn to Mexico for its supply this winter. Eventually, Fernald hopes to even persuade the HMO to forgo even those markets.
"Go seasonal, like using persimmons on salads in the winter, instead of cherry tomatoes," Fernald said. Sweet potato sticks and dried fruit are another option, she said. Diners, she added, enjoy the variety and novelty.
"If we're able to encourage creativity, we can open up new opportunities for farmers," Fernald said.
But, she recognized, that type of change may take time. Until then, she's content moving "one step at a time."
from The San Mateo County Times