The referral process for the food pharmacy is done by nurses during rooming. Nurses screen for food insecurity with the Hunger Vital Sign within the EPIC system (having it in the EMR allows them to do data extraction and patient monitoring). If a patient screens positive – either sometimes or often true, the nurse asks them if they are currently experiencing a food emergency at home. If they are, they are given a shelf stable food box, provided by Second Harvest Heartland, to take home. For all patients screened positive, a referral is made to the community health team who then follows up with the family and walks them through the benefit survey tool to ensure that they are connected to available programs and support systems, such as SNAP and WIC. The patient or family is then either enrolled or put onto the waiting list for one of two food pharmacy tracks:
Track 1: More intensive track for high risk patients. Patients need a physician referral and must be struggling with multiple chronic conditions, or with higher needs, such as getting their A1C under control or getting approved for bariatric surgery. These patients meet one on one with a community health coordinator in the hospital every other week for educational sessions, and go home with 4-5 recipes and ingredients to cook those recipes, as well as additional food from the food pantry. 20 patients at a time in this track.
Track 2: Lower dose intervention. Families attend food distribution events once a month and get 7-10 lbs frozen lean meat and 12-15 lbs fresh produce. In the summer, these events are at a farmers market, where employees also get matching funds to shop (300 employees participate monthly). Cooking classes, budgeting classes, grocery store and farmers market tours are also offered, and 85% of families have completed a class. 100-110 families served monthly.