WASHINGTON, April 8, 2015 – Look for the nation's hospitals to be increasingly fertile ground for producers to sell fruit and vegetables at farmers markets or via other direct local marketing.

Why? The medical centers are getting more incentives – even from the Internal Revenue Service – to support healthy living in their communities, including by improving access to healthful food and nutrition education for the poor.

Hospitals or medical centers are natural partners for USDA’s expanded effort to make sure Americans include plenty of fruits and vegetables in their diets. This year, the department is continuing about $36 million in annual grants that provide seniors and low-income households coupons to buy fresh produce at farmers markets and other food outlets.

And now, via the 2014 farm bill, USDA has started doling out matching grants to a wide range of nonprofits and public agencies to find projects that help participants in the Supplemental Nutrition Assistance Program (SNAP) buy healthier food. It handed out $31.5 million this month in the new Food Insecurity Nutrition Incentive (FINI) program to fund projects in 26 states.

In 2016 and 2017, the funding will be $20 million annually and in 2018, $25 million. The Washington State Department of Health, for example, will get $5.9 million over four years to offer a range of incentives, coupled with nutrition training, for SNAP recipients to buy more fruits and veggies from supermarkets, farmers markets or directly from farms.

Such programs have been cropping up for years. A nonprofit called Wholesome Wave, for example, partnered in recent years with USDA, corporations, hospitals and others in several states to offer coupons that double SNAP benefits for those buying at farmers markets.

This year, The Farmers Market.co, a group of eastern Virginia farmers markets, will begin using $20,000 from Mary Washington Hospital in Fredericksburg, plus $69,500 from USDA's FINI, to pay the costs of activating electronic benefits transfers (EBTs) that can handle SNAP coupons, and doubling the value of those coupons in at least six more area farmers markets, along with providing nutrition education for participants.

In the Martinsburg, West Virginia, area, the Jefferson and Berkeley medical centers are taking a similar tack, pledging $30,000 to double the value of SNAP benefits for purchases of fresh fruit, veggies and other foods bought at area farmers markets. Their program includes a team of volunteers doing nutrition training with recipients. “We're set to go this year,” says Mark Cucuzzella, the family physician leading the project.

This year, the Internal Revenue Service has added a further incentive for hospitals to “ensure adequate nutrition” in their communities. Its action stems from an Affordable Care Act requirement that hospitals, in order to keep their nonprofit tax status, submit “community health needs assessments,” to document charitable services and outreach to help their communities stay healthy. In finalizing its regulation, IRS added food aid, nutrition education and related activities to what hospitals can include when reporting on such community service. (Previously, only things like providing free medical services to poor people were included.)

Help with community nutrition is hardly a new role for hospitals, says Julie Trocchio for the Catholic Health Association of the United States, the nation's largest nonprofit hospitals group. CHAUS wrote its first community health needs assessment in 1989, she says, and its member facilities participate in many ways: One of them, Saint Joseph Mercy Health System in Michigan, for example, even owns a small farm to grow organic produce and teach good nutrition habits.

“We've been doing it all along,” Trocchio says of hospitals' outreach efforts in local nutrition. But she says, “We were glad to see the IRS adding this incentive.” Good nutrition is a critical part of fighting heart decease, diabetes, obesity, strokes and more, and the new nudge on tax status will help, she says.

Gus Schumacher, a former USDA under secretary who serves as vice president and founding board member of Wholesome Wave, estimates the total value of community health needs outreach reported by the non-profit hospitals at near $20 billion a year, based on past IRS reports. If the hospitals put just 1 percent of that into boosting fresh produce purchases, “that's pretty chunky,” he says.

Elizabeth Borst, chief executive of the Farmers Market.co, says she's already planning with another area hospital to sponsor bonus SNAP benefits at more farmers markets. But she points out that Virginia has 240 farmers markets and only 80 are set up to handle EBTs, the vehicle used to double SNAP benefits. The expanded IRS regulation means the hospitals “have latitude now to fund these programs. We hope more health care operations step up and get involved in nutrition in their communities,” she says.


[This article first appeared in our April 8, 2015 Agri-Pulse newsletter. If you aren’t a subscriber or don’t download our Wednesday newsletters, you’re missing out on stories such as this one.]


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