Nourishing Solano County: A Collaborative Vision for Medically Tailored Meals

Oct 25, 2023

By Noah Galgan, Program Manager

Stakeholders meet to discuss how medically tailored meals could work in Solano County

In an era where the healthcare landscape is constantly evolving, the concept of “food as medicine” is gaining traction. The notion that the right diet can be pivotal in preventing and managing chronic illnesses is a scientifically proven fact. A group of Solano County stakeholders is bringing this knowledge to bear on an exciting journey to nourish health through medically tailored meals (MTM).

At its core, an MTM initiative in Solano County revolves around the idea that providing individuals with carefully crafted, nutritionally sound meals can have a profound impact on their well-being and support recovery from serious illnesses. These meals are not just about sustenance; they are about empowerment, about offering individuals the tools they need to take control of their health.

MTM initiatives are gaining traction all over the United States. We have seen many great examples of what MTM could look like through the dedicated work of groups such as the Food is Medicine Coalition. The coalition is an association of nonprofit medically tailored food and nutrition service providers that supports research-based interventions, advances public policy, promotes efficacy research for nutrition services, and shares best practices in providing medically tailored meals. This provided a foundation to build upon, and this is where we started the conversation in Solano County. The Solano Local Food System Alliance hosted an insightful educational panel on medically tailored meals back in February, with speakers from the Ceres Community Project and Project Open Hand. From this panel, the Solano MTM initiative gained a foundational understanding of what medically tailored meals are and opened the door for further discussion.

Solano County Ecosystem of Care

A medically tailored meals program has yet to be fully established in the county, but initiatives are already underway. A diverse group of stakeholders from various sectors have rallied together, all driven by a shared vision. In late April, the group came together to discuss the vision of an ecosystem of care. We realized it is not just about the healthcare providers or the chefs creating the meals — it’s about everyone coming together, recognizing the vital role they can play in this ecosystem, and understanding that they collectively have the power to make an impact. We also realized how complex the legal and logistical framework is for this vision, since it involves insurance, patient privacy, strict healthcare regulations, ingredient sourcing, meal production and delivery, and supporting services. Some of the community stakeholders that have joined the initiative so far are listed below.

  • Healthcare Providers and Administration
    • Solano County Public Health
    • Touro University
  • Culinary Experts, Chefs, and Meal Providers
    • Meals on Wheels Solano County
    • Thistle
  • Local Farmers, Food Suppliers, and Transportation
    • Food Bank of Contra Costa and Solano
    • Food is Free Bay Area 
  • Collaboration, Coordination, and Policy
    • Sustainable Solano
    • Innovative Health Solutions
    • Solano Local Food System Alliance (Includes a wide variety of stakeholders committed to fulfilling the mission of creating an environmentally sustainable, economically viable, socially just and equitable local food system in Solano County. Many of these MTM stakeholders are also Alliance members)
    • The Food Agriculture and Nutrition Network of Solano County (FANNS)

Ecosystem Updates

Thistle – President Shiri Avnery said Thistle is beginning a fourth round of producing medically tailored meals in partnership with Kaiser Permanente for an MTM pilot study. The pilots are a 12-week whole-person care model that seeks to include wrap-around services such as nutrition consults and regular wellness check-ins. Thistle is interested in continuing to be a local meal provider for MTM and would like to participate in more pilot studies to help with development and collaboration for the logistics of an MTM program. One area of discussion is navigating the higher price points of Thistle meals that aim to be whole-food, plant-based meals from California growers. There is an opportunity for meal delivery outsourcing within the county as this would help reduce costs per meal for patients. Also, is there potential for a patient-selected tiered pricing model, where patients can choose a standard plan (covered by insurance) or premium plan (an added cost per meal beyond what insurance would cover). Cultural preferences for MTM is a tension point, and some recipients who are not used to a plant-based diet may find these meals unappealing.

Meals on Wheels Solano County – Executive Director Laurie Hartmann offered an exciting update on a local and state level regarding Meals on Wheels. MOWSC has been in the process of building a new production facility and is ready to break ground after acquiring all necessary funding. The new facility will be on Union Avenue in Fairfield, and scheduled for completion in spring 2024. With this new facility, they intend to include a small-scale commercial kitchen for use by community partners, such as Sustainable Solano for youth culinary instruction. On a much larger scale, Laurie shared about the upcoming work of Meals on Wheels California in the MTM space. MOWCA hosted a learning collaborative with all MOW program directors around MTM initiatives. There is a high probability MOWCA could become a one-stop-shop MTM wraparound service provider for healthcare providers and would potentially distribute administrative roles to leading regional agencies such as Solano County (NorCal Lead). This effort within the MTM space could start as early fall 2024.

Innovative Health Solutions (IHS) – Founding CEO and CFO Norma Lisenko shared an update on the work IHS has been doing and will be doing in the coming months around medically tailored meals. The team is currently wrapping up a 12-week MTM pilot with La Clinica Vallejo, which provided 50 community participants with weekly ready-made meals made by Provisions. While we look forward to the final report from this pilot toward the end of this year, Norma shared the importance of access to culturally relevant prepared foods. All the hard work that goes into a meal to be carefully prepared and transported can end up going to waste if people don’t like the food they are eating. IHS is set to receive additional funding through the Solano County Community Health Improvement Plan (CHIP) to further its MTM efforts over the coming months through a 12-week pilot program focused on maternal health.

Food is Free Bay Area – Through the work of Heather Pierini and Alma Munoz, FIFBA has participated in two separate MTM pilots for IHS. FIFBA actively participated in both pilots in a transportation provider role for MTM meals and grocery boxes. The first pilot was the 12-week program at La Clinica Vallejo for 50 participants: the team provided distribution of refrigerated meals prepared by Provisions and custom weekly grocery boxes to the La Clinica Vallejo distribution site. The second IHS pilot is a 12-week MTM program with Partnership HealthPlan of California, in which ready-made meals were picked up from Thistle and delivered to participants’ homes twice a week, alongside packed grocery boxes. Heather shared that the biggest hurdle in these pilots was creating the necessary logistical infrastructure, including a delivery/logistics app for drivers, a food safety program through the FDA recommendations, food storage/movement equipment for the bagged/boxed foods, limitations of eco-friendly packaging (compostable cardboard packaging was not sturdy enough for participants to carry home). She also shared about their efforts to find a better participant-tracking system for participant meal selection, allergies, and delivery weeks.

Sustainable Solano – Sustainable Solano continues supporting the foundation for medically tailored meals in Solano County through stakeholder meetings and creating an action plan. Sustainable Solano will continue the collaborative work to form an ecosystem of care amidst community stakeholders and clarify roles of each stakeholder in the emerging vision.  Besides the ecosystem’s coordination role, Sustainable Solano sees its participation in the MTM vision through public education programs, especially targeting youth, which can help prevent diet-related illnesses in the future. They continue their public education efforts through monthly cooking classes focused on healthy local food and are set to receive funding under the Solano County Community Health Improvement Plan (CHIP) for three youth wellness internship cohorts. These internships aim to educate Solano County youth about health and wellness through culinary and garden exploration.

Food for Thought

The beauty of collaborative efforts lies not only in celebrating successes but also in collectively addressing the challenges encountered along the way. We have discovered some thought-provoking areas that merit thoughtful consideration:

  • Exploration of the healthcare administration role (HIPPA compliance for patient records, billing, etc.) and capability to operate in the role.
  • How to generate access to additional pilot programs that foster collaboration and open feedback loops through diverse funding channels.
  • Exploration of providing health-forward meals that honor diverse cultural palates.

    These topics will likely be central to an upcoming virtual collaborative meeting around MTM in early January, as well as other topics offered by the partners working together on this process. We invite those interested who see a role for their organizations in these efforts to  reach out to Noah Galgan at noah@sustainablesolano.org to share more about your interest and what you can contribute to the conversation.

    A Step in the Right Direction

    This is just the beginning of fostering an ecosystem of care in Solano County. We are beyond excited to continue in this work and advocate for community-based collaborations for the good of the whole. Each community stakeholder brings a unique perspective and a passionate commitment to this initiative, and together, they are forging a path toward a healthier future for Solano County.

     

    How to Compost at Home

    Sep 15, 2023

    By Patrick Murphy, Program Manager

    Backyard composting often feels like a hobby reserved for those “in the know.” Like sourdough starter and beer brewing, the process seems both too simple and too complex to get started. How do you get from wheat and water to become bread? How do you turn yard waste and food scraps into compost? The answer is planning and time (and bacteria). With a little preparation and some patience, you too can compost your food scraps at home.

    Composting requires a little forethought, some dedicated space, and the diligence to do regular light maintenance. If you can keep a houseplant alive, you should be able to get a compost bin started. The most important thing with backyard composting is to choose a system that will work best for you, which you feel you can sustain long-term. There are two common options for at-home composting, “hot pile” and “vermicompost” (or worm bins).

    A stereotypical “hot pile” composting system uses a large bin and regular aeration to convert organic materials (i.e. food scraps) into compost. This system works very well when it receives a regular supply of organic materials, and is turned often. However your pile will begin to work less and less efficiently if the bin ever has less than a full cubic yard of material in it. Hot pile systems require that you maintain a specific ratio of high-nitrogen/high-carbon scraps in order for the bacteria to break down the material. I would recommend these systems for larger families, or organizations looking to get into composting. Learn more about hot pile composting here.

    A vermicompost system relies on worms to digest and process organic matter to create compost. These systems offer more flexibility compared to a traditional hot pile system. Vermicompost systems can be made in any size, allowing them to fit into more spaces (some people keep their bins under their kitchen sink). Vermicompost systems do require more careful planning than a hot-pile system. While worm bins do not need to be turned, bins need to be emptied more regularly and the worm populations need to be divided to prevent overcrowding. Worm bins also typically cannot be added daily: worms eat in “batches”, so waste needs to be collected and added all as a single, larger quantity. I would recommend worm bins for smaller families, or people who might lack the space or volume of material needed to start a hot pile system. Learn more about vermicomposting here. 

    There are multiple options when it comes to composting at home, make sure you check out multiple methods and choose the one which you feel you’ll be able to maintain the easiest. Consider alternatives to compost like indoor bokashi fermentation, or an outdoor green cone digester. Compost alternatives allow you to avoid most of the emissions created by throwing away food scraps while still allowing you to return nutrients to the soil. Focus less on the total volume of compost produced, and more on ease of use for yourself.

    Tell Us About Your Urban Ag Needs!

    Sep 4, 2023

    By Patrick Murphy, Program Manager

    Installation of a garden bed at Faith Food Fridays in Vallejo

    Sustainable Solano firmly believes that the best community projects are community driven. We believe strongly that solutions and ideas need to come from locals who know their area, the neighborhood, and what they can expect from their community. Most communities are acutely aware of the local problems they face, and may have insightful and unique solutions to solve these issues, but lack the funds to put their ideas into practice. Through our Solano Gardens program, we have encountered many informal groups of interested citizens needing support for smaller urban agriculture projects who lack funds, materials or planning support to get their project off the ground.

    Sustainable Solano is applying for an Urban Agriculture grant from the California Department of Food and Agriculture’s Farm to Fork office. This grant would support the continuation and expansion of the Solano Gardens program, which focuses on creating, renewing and supporting community gardens in Solano communities to create more access to healthy, seasonal produce. The program is currently funded through Solano Public Health.

    The CDFA grant would also allow us to give small, flexible funding to local urban ag projects, which could include a variety of needs, including the creation of a new community garden, revitalizing garden beds, adding chickens or creating a seating space within a community garden. It would open up new opportunities for organizations or groups of individuals that need materials and support. We envision creating a simple, straightforward application and approval process to make it easy to reach out to Sustainable Solano for the help needed to support urban agriculture in your communities.

    This is why we want to hear from you! We want the best possible picture of what types of urban ag projects, what resources and what support your organization or community could use. This will inform our own grant application and help us to create a database of the urban ag needs we could serve through the expanded Solano Gardens program.

    Share Your Ideas & Needs

    Please send your needs, project ideas, questions or suggestions to patrick@sustainablesolano.org with “CDFA Urban Ag Needs” in the subject line.

    Tell us about your proposed project or support needs, who you are, where your project might be located, and anything else you’d like for us to know.

    Re-envisioning Fairfield’s Streets: Youth Air Protectors Present Final Projects Aug. 27

    Aug 8, 2023

    By Alex Lunine, Resilient Communities Program Manager

    Over the course of the past five months, SuSol’s high school Youth Air Protectors have dedicated themselves to learning about the air quality in Fairfield and using their voices to bring the community together to tackle environmental injustices in the city. From spreading awareness at tabling events throughout Fairfield, to helping to facilitate air quality-focused meetings, to leading residents on a sustainability walking tour of downtown, the Youth Air Protectors have been indispensable in the push for a healthier, more breathable Fairfield.

    August marks the last month of this internship cohort, and our students will be presenting their final projects to the community on Aug. 27. Each air protector chose a street in Fairfield with poor walkability and high volumes of traffic, and reimagined them to be more pedestrian friendly, green and promote cleaner air. We believe that if their concepts and ideas were actually implemented, such changes could help to reduce the high asthma rate of Fairfield, mitigate the impacts of the urban heat island effect, and bring our community together on our sidewalks and streets.

    Here the YAP interns share about their final projects. See the projects and talk with the students on Aug. 27!  (Ed. Note: Intern statements are lightly edited for clarity.)

    “I redesigned the intersection of North Texas and Utah Street to make traveling through the area more sustainable. My design includes protected bike lanes and sidewalks, reduced lane sizes to protect pedestrians further, better views, bus stops, and more! I’m a firm believer that walkability is one of the most essential (and undervalued) parts of a sustainable city, and this project reflects that.”
    – Sachi Bansal

    “I decided to choose the street redesign project because after taking a sustainability walk around downtown Fairfield, it became clear that there are a lot of improvements to be made for Fairfield’s roads. The main issues I noticed during the walk were a lack of shade on the sidewalks, the lack of safety for bikers on the bike lanes, and lack of greenery. I wanted to make a drawing of a street where I implemented changes to combat these issues.”
    – Prabhjot Kaur

    “For my project I decided to redesign the street Travis Boulevard. I thought that it had too many street lanes and though it made sense since it leads to a highway, I reimagined it to be in a people-oriented city and worked upon that. Along with changing the street I also changed the buildings and parking lots in a way where it would look more pleasing, and easier to access. I also added wider sidewalks, a bus stop and a bicycle rack so it would encourage public transportation. I hope that Fairfield in the future would incorporate these ideas to create a more sustainable environment while also adding more elements that persuade people to try to live sustainably; like recycling, farming, shopping locally and more!”
    – Esther Lopez

    “I choose to redesign the Pennsylvania Avenue and West Texas Street intersection because it has a lot of potential in terms of walkability. In this model, I hope to show that Fairfield can become more people-friendly even with our current infrastructure.”
    – Hannah Lopez

    “Enhancing Fairfield’s existing infrastructure to be more sustainable is imperative in bettering the lives of residents while promoting an eco-friendly lifestyle. For my project, I chose to redesign the Gateway Plaza, a strip mall located adjacent to the Solano Town Center. Featuring a sizable parking lot with hundreds of parking spaces and minimal walkability, the Gateway Plaza is a motorist’s paradise. Through visualizing how the area could be altered with bikers and pedestrians in mind, I intend to show how changes towards sustainability are realizable in even the most seemingly despairing of locations.”
    – Harjot Singh

    Register for the event here. If you or someone you know would like to sign up for the next cohort of high school Fairfield Youth Air Protectors, starting Sept. 7, apply here. 

    We’re excited to share our greener, more just vision of Fairfield with you and hope to see you there. 

    The Latest from Benicia Community Gardens

    Jul 27, 2023

    By Maggie Kolk, Avant Garden co-manager, Sustainable Solano Board of Directors chair, and happy gardener at Avant

    There’s a lot going on with Benicia Community Gardens, the flagship program that started Sustainable Solano more than 20 years and continues to serve the Benicia community through two community gardens and a community orchard. Here, Maggie shares an update on BCG’s many summer activities and garden bounty. Interested in a garden plot? Learn more and fill out an application here.

    Torchlight Parade BBQ attendees (from left) Sheri Zada, Randi Scott and Alan Zada

    Torchlight Parade BBQ

    The annual Benicia Torchlight Parade BBQ in Avant Garden on July 3 kicked off the summer gardening season with a fun-filled party enjoyed by garden members and their special guests. Delicious dishes creatively prepared by the Avant and Swenson gardeners were enjoyed along with the usual hamburgers, hot dogs, chicken and vegetarian BBQ fare. Several of the Avant Garden members were cheered as they marched up First Street and some of our own Benicia city officials joined in the festivities at Avant after riding the parade route. As usual, a good time was enjoyed by everyone attending our small-town Benicia Independence Day celebration. Kudos to those garden members who racked up volunteer hours pulling weeds and spreading woodchips, which resulted in Avant looking like the crown jewel of First Street that it has become.

    The Share Plot

    Enzo and Slater hold a 6-pound zucchini at Avant Garden

    Zucchini, sometimes the size of small baseball bats (how many five-year-old boys does it take to carry an Avant zucchini?), kale, onions and tomatoes are growing in abundance in the Avant Share Plot. The Benicia Community Action Council (CAC), St. Paul’s Episcopal Church’s twice weekly free dinner program and several Food is Free Bay Area stands are the beneficiaries of our fresh, organically grown Benicia produce. The cooks at CAC, which provides daily free lunches to Benicia seniors, created the most delicious zucchini bread along with a fresh zucchini casserole. Benicia seniors are eating well!

    Monarchs at Avant

    Monarch caterpillars at Avant Garden

    After planting showy milkweed last year in one raised bed and in the children’s tomato bed, several monarch caterpillars were observed during the first few weeks in July. Children visiting the garden find these little gems fascinating and learn about the stages of the monarch life cycle (egg, caterpillar, pupa or chrysalis then the final transformation into the adult butterfly). The metamorphosis typically is completed within 30 days. We are convinced that every monarch butterfly we see at Avant is a result of their munching on our milkweed during the caterpillar stage. As the caterpillar eats the milkweed it ingests a toxic substance called cardiac glycoside, which makes the monarch poisonous to most creatures that would want to eat them, like birds! Monarchs are so brightly colored to deter their predators. Once the early summer monarch butterfly emerges and spreads its wings, it flies off to find a mate and then lays eggs on other (or the same) milkweed plants to produce more butterflies. The butterflies that emerge in the late summer and early fall, rather than search out a mate, fly to Mexico where they spend a warm winter vacation before returning north to find a mate, lay eggs and start the cycle all over again. Nature at its most majestic.

    Upcoming Garden Events

    Stay tuned for upcoming garden events by checking out our calendar. Gardeners are eagerly awaiting their tomato, pepper and cucumber harvests. We are planning a cooking demonstration for August, date TBD. Our Harvest Festival will take place in late September or early October.

    Please stop by an enjoy Avant Garden on First and D streets or Swenson Garden at the Heritage Presbyterian Church on the corner of East Second and Military East. Both gardens are serene spaces bursting with fresh vegetables, herbs and flowers. Remember to look but not touch or take. Each of the garden beds are lovingly cared for and owned by individual gardeners who are growing for their personal use.

    Happy gardening!