 Good afternoon, everyone. This is the House Agriculture and Forestry Committee and the Vermont State House and it is the 2nd of February 2022. And it is the afternoon and we were talking today about food security, which is one of those topics that I'm really interested in. Mostly because I love to eat, but I think we all do. So we're going to kick it off today. We have several witnesses and we're going to kick it off with Ellen Kaler. So Ellen, you want to, you want to start things? Sure. So for the record, Ellen Kaler Vermont Sustainable Jobs Fund and we administer Vermont Farm to Plate. So I just thought I would start off briefly by just providing a little context for why this conversation is getting underway and encourage you to keep the conversation going. There are a few other individuals that I think it would be helpful for you all to hear from. And then I want to, I'll come back after Becca, Becca will walk through a few pieces of a new project that is moving forward within Vermont Farm to Plate that's coming directly out of the strategic plan that we gave you last year. And then Helen and Mary Kate will be speaking from the by state primary care association about why they're involved in this project and what they're seeing on the ground from their perspective. And then I'll circle back at the end and try to put a bow on it all so to speak. We do have a financial ask, and so I want to be able to have a little time at the end to sort of just put that on the table for consideration as well related to this project. Okay. So, so, so, food, food, the notion of food security and the notion of food insecurity right food insecurity is is like is is basically all different types of aspects that relate to hunger, and not feeling that you have you know where the next meal is going to come whether it's your next meal or within the week of just not having a sense of like being being confident that you're going to have enough food for yourself for your family. And as we saw during COVID, we saw a major increase in the number of Vermonters experiencing food insecurity, and there were a number of incredible community responses to that from neighbor helping neighbor to Vermont everyone eats to community pop up meals, all sorts of things. The way the Vermont food bank and hunger free Vermont mobilized their networks to provide more food that the family food box at the agency worked with the emergency operation center to be able to get distributed distributing food to Vermonters in need, like unprecedented situation that happened during that time in response and it's still going on you know Vermont everyone eats still has funding through the end of March, for instance, thankfully. So, you may recall that last year during your session. We talked about this notion of emergency preparedness, and what became evident during the height of the pandemic was that in the state emergency operation center. The agency of agriculture staff were not mobilized the way that other agencies were mobilized, and that got us to thinking about well why not what this is there was so much food related issues that were coming up during the pandemic. Why was the agency not mobilized. They, because they care and they know what to do. They, they started getting involved. Not because they were told to or were expected to be because they knew that was the right thing to do. So as we took a look at the starting to learn more about the framework of around that happens during emergencies. There is this document called the, the agency of agriculture has an annex to the state emergency management plan that provides a to indicates when they get mobilized and under what circumstances, and you all in I believe the housekeeping bill last year requested that the agency look at their annex and consider changes to it that would bring it would would enable them to be mobilized at at future times that made sense related that had somehow had food involved. I would really highly recommend that you if you haven't already to have Diane Boffield and Abby, you know, folks from the agency in, because you all received a report on January 15 from them about what it is that they're recommending, and what they're changing for in terms of their annex. So, so that's one one piece of this is that during times of emergencies, like the pandemic, like tropical storm Irene, other kinds of natural disasters are unplanned for events. There are times when we need to be able to mobilize our food supply in Vermont in order to feed Vermonters. A lot of the conversation that's been happening these days in the Vermont everyone eats task force has been around what have we learned in this process of the pandemic, what has worked well in terms of mobilizing food, where did we fall short. What do we wish we had been prepared better for had we known what was coming at us. What can we learn and put in place for next time. So during the farm to play strategic planning process, we were aware of all this right we were building the plan during the pandemic. So we were watching what was going on with food insecurity rising the work that Meredith Niles was doing at the time, we were surveying Vermonters to see how food insecure they were, look at watching those the trend lines. We were, we were thinking about how do we strengthen Vermont agriculture and Vermont food production overall, and all these conversations were happening at the same time. So what we've, what we ended up putting into the, the strategic plan was what informed it was this notion of, we want to strengthen Vermont's food system and and expand our production, so that we're the all Vermonters are making more locally produced food, right we set a target of to get to 25% local food consumption by 2030. So we want to, we want to. We're going to be implementing strategies and taking action in ways and hopefully making investments in those things that will strengthen our food system, but it's not just at when there's an emergency, it's also at times when there's an emergency. And so in the process of having these conversations with the emergency management folks of folks that are running the emergency operations center and such. What we all started to come to realize is that if we want to have more local food available during times of emergencies, we also have to be planning for and making and manifesting greater food production in non emergency systems, otherwise when we need it, it's not going to be there. So these two things these these these two really married notions of strengthening our local food system distribution of it production of food movement of food around needs to be in more organized and better in place during emergencies. Right, so there's this sort of actor after action planning that the emergency operation center and that everyone needs task force are doing like, okay, how do we, how do we be better prepared for the next crisis we have to work on. But then, what are all the things we need to be doing in non emergency times to strengthen the food system. And that's where the strategic plan comes in. And you may or may not recall, and Becca's going to shine a light on this is that one of the price there was a food security brief in the plan. So you can look that up and read that it's a couple of pager Becca wrote it was the lead author on it with a number of good people. And one of the priority strategies right there's 34 priority strategies one of them is to create a food security plan in Vermont that addresses these fundamental needs of being of being prepared when there are emergencies, but then also strengthening all of our systems so that we get to a place in Vermont where there's no one who's food insecure. Nobody is going hungry nobody is worrying about where their next meal is going to be coming from. That's the ultimate state we want to get to. And so, in the strategic plan. We talked about the need to actually develop a document, a roadmap and action plan specific to food security building in the state. Does that make sense with me on that. Yes. And I've got the Bible here with me. Okay, so you found you found the page that that is on so. So, what I had suggested to representative Partridge was to bring in a number of voices, who are all have a piece of the puzzle, so to speak, of wanting to create this street this food security plan for the state, because it's, it is a, it is a concept that folks at the food bank at hunger free Vermont at the agency of human service a lot of folks that have been doing this work for a really long time are very excited about because it's the kind of thing that we all wish we had been able to do. And we're using this coming out of the pandemic. And we're where the whole the sheer volume of people that that have been food insecure during this pandemic is so front and center for us we know this week we know people that this is impacted, who for the first time in their lives even have been food insecure. So this is the perfect opportunity to really address these fundamental challenges and these fundamental structural issues of why Vermonters are food insecure in the first place. And, when we have emergencies that we don't have, we don't have a worsening situation when it comes to that, because we have a, we have more control over our own food supply, and because we have the systems in place to be sure that we're really taking care of one another. So that's the setup. I'll hand it over to Becca, and then she'll hand it off to Helen and Mary Kate. Great, welcome back. Thank you. Thank you, Ellen. Here I am. I couldn't even unmute myself. Thank you, Ellen, for that introduction. I'm going to go over a bit of what Ellen was reviewing but in talking about it from how the plan is going to look and be developed. So wish me luck here sharing my screen. Okay, are you all seeing my slideshow. Yes, it's beautiful. It's truly incredible. Thank you. So thank you so much for the opportunity to talk with all of you today as, as you know my name is Becca Warren and I'm the farm to plate food security project manager now at the Vermont Sustainable Jobs Fund and as Ellen has reviewed a year ago we released the new Vermont agriculture system strategic plan which has 34 strategic priorities related to sustainable economic development environmental sustainability and healthy local food for all Vermonters. The strategic priority that I'm leading folks to tackle now and that we're discussing today is the this strategy strategy 24 to develop a Vermont food security plan centered around a strong local food system and inspired by community responses to food insecurity and disruptive events. And food security will exist or it does exist when all people at all times have physical social and economic access to sufficient safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life. And the four pillars of food security are availability, access utilization and stability and I like thinking about the pillars because it helps me understand how in Vermont we have a role to play in a lot of these pillars including availability and access. And as we know food security is not a given for almost a third of Vermont households and that reference that Ellen made to Meredith Niles UVM research. She's been leading multiple studies on food insecurity in Vermont during the pandemic and has confirmed that food insecurity has risen in Vermont. And that it impacts Vermonters inequitably, which is an important focus of our work in the food security plan creation. Now household food insecurity we know as a result of social and economic factors that are often beyond the control of individual households, and eliminating it will require a systemic approach a system level approach to ending poverty and resolving other barriers to healthy food in Vermont And this, as Ellen said, of our food security planning is that coordinated statewide action is needed to ensure food security across the state, both in times of crisis as we've been experiencing now but also in times of calm and because another premise that we hold in the planning is that in our strong agricultural sector, Vermont does have a unique opportunity to ensure that food remains available, remains accessible, remains stable and that all our residents are food secure. We believe that it is possible to improve food security. And as you know the COVID pandemic has really unfortunately exposed the fragility and the inequity of the globalized food system and caused increased hunger in Vermont. However, it's also shown what Vermont can do. We haven't been cowed by this pandemic. This is, you know, an incomplete list of the federal and state community programs that have been supporting Vermonters to get food on the table. This has been in the past two years so two things to highlight here that relate to the timeliness of the food security planning is that this list, we know we're looking at federal nutrition programs, innovative community based responses like the, you know, Vermont everyone eats and all the hubs that are participating, the state emergency operations center which has been doing incredible work, the charitable emergency food assistance programs, it looks like a list of separate programs but we know that in fact, this is a list of efforts that in Vermont involves deep cooperation between the state agency staff, the nonprofits, the community volunteers, and the second piece that I believe is vital to our state is that Vermont farms are participating in all of these projects and collaborating deeply with the people who are participating in them. And that just has an incredible promise to me of what we can do as we look forward. So I'm just going to come back to this food security plan priority strategy because it calls out that when we're talking about food security. We want the system to deeply integrate Vermont agriculture, and that we also recognize that climate change is transforming our food system and needs to be planned for and which is why the state climate action plan contains the same priority strategy. We need the food system that ensures food security today. So the Vermonters no longer hungry. They're no longer experiencing poor health outcomes related to poor diet. They're not choosing between food and heat. And as Ellen said that the secure food system we create for today will then support us an emergency so the food security plan will be centered around the thriving food system inspired by community based responses to food insecurity and disruptive events. That will involve food insecure individuals as well as farmers in the plan and look into questions that include affordable housing, health care, transportation, the siting of retail grocery stores, how food is distributed, and ensuring the continued production of food in Vermont. All of these pieces that we know are incredibly important to food access to food availability. We're going to work then to determine what state and regional policies and procedures and plans can ensure that the Vermont food supply is sufficient sufficient to withstand national and global supply chain disruptions. And so we've begun a two year effort, which is held within the farm to play network, but already involves many statewide partners who are typically considered outside the system. And we'll soon involve many individuals and groups who are deeply impacted by these gaps that we have in our food system. And as you know the network the farm to play network works in team approach. And what we're now calling the strategy teams because the group is working on the food security strategy so the strategy team for food security already involves over 80 individuals who are representing themselves and diverse types of professions. It's frankly a little overwhelming when I start having meetings and we'll open up registration, and I'll think maybe 25 people will come and then we'll have 60 folks in the group there's a lot of excitement surroundings project people are. I think even as we were eager to have for the pandemic to come to an end. Part of that eagerness is getting to the point where we can take what we have learned in the past two years, build on the collaborations that have emerged and and plan for the future. And so the planning process itself involves three basic components so one is hearing for Vermonters involving a huge range of Vermont residents in the process of designing the plan and a really robust public engagement process to get input. And the expertise of those who have lived experience with food insecurity and with producing food and trying to get it to those who most need it. There will be a research component. There's a lot of existing research about the causes and enhancers of food insecurity. But the creation of the plan and the planning process will allow us to aggregate this information to gather everything that's already known together and then fill in important information gaps by undertaking additional research is needed. And then we will be creating a food security plan document which might be more accurately phrase the way we're picturing it as a roadmap to food security and Vermont. It's accessible to Vermonters around the state who are in different roles whether they're a food shelf volunteer or a state employee. And I just want to reemphasize here that the central part of the process is to involve Vermont residents who are inequitably impacted by gaps in the food system. Vermonters who are at risk, who are experiencing food insecurity, who are inequitably impacted, they know best what their barriers and needs are. And a plan to resolve food insecurity is going to be most successful with their voices and their expertise. So for that reason, we've included robust stipends in our budget for meaningful participation of these people who have lived experience whether that's within the public engagement process or within the governance of the planning process. I'm really excited about that aspect of what we're planning. And so, when we have a plan in hand what will be in it, you know, like I said it will be probably more of an action plan or a roadmap, rather than a strategic plan like the Bible representative partridge is holding that it might be designed to sit on a desk and is for one particular audience. And this would be for people across the state, as I said, and it will document the wide array of food security organizations and initiatives across statewide to enable people to make connections and to not duplicate efforts. It'll give an overview of the current status of each of the elements of food security in the state and what the barriers to improving them are. An analysis of how these elements will be affected by climate change and what we're anticipating from what we know about the climate science. It will recommend actions for improving food security that have been prioritized in the public engagement process. So really publicly vetted Vermont approved responses to food security what's going to be most successful for people who are living with the issue. And then it'll be accessible for many different kinds of remuners to figure out what their role is. And our focus as we think forward to creating the document is thinking about how will it most be present how can it be presented to lead to action in the most effective way is a big focus of the project and the team. And I just want to be share a personal emotion about this which is that I find this process incredibly exciting. The net of those involved in the strategy team clearly believe we have a unique opportunity right now to solve the food security dilemmas and to once again show what Vermont can do. And the energy is really is really palpable. So that concludes my presentation and thank you so much for this time. Well thank you Becca we really appreciate that. And do what you like to have up next Helen. So, so this planning process brings together many streams of funding sources to pull it together, and very early on, Helen who's been part of farm to plate since the beginning and many different ways and many different groups. So we got very excited about this particular project of building a food security plan for Vermont and so I thought it'd be helpful for Helen and her colleague Mary Kate to share a little bit about how they're thinking about it how it, how, like why does this matter to their organization and and what's their involvement in this project. So I see of Ellen and Helen. I'm Helen Levin, I am the special projects manager for healthcare and food access at by state primary care association and as Ellen mentioned, my colleague Mary Kate moment is sort of here through the wonders of technology she is partially here, partially addressing my healthcare bills and another committee. So we can flag her if we need specific healthcare input she is the Vermont State Public Policy Director for by State primary care. And what I'm going to do here I'll give you a quick background on what my program is working on then I'll hit on some of the key points of intersection with what Ellen was just discussing from our perspective in healthcare. And I recognize that the question of food food access and the future of healthcare in Vermont is also itself a very large topic. So, you know, given that we have time and I'm here if you have any questions on that and also happened happy to entertain those but I will focus on that element of our work that intersects with what farm to plate is working on. And I should add, we are one of the funders of some of their strategic planning work. So, my program is a federally funded program is a strategic planning program it began part time in 2020 became full time over this past summer I was previously the Vermont State Public Policy Director for by State primary care. And the idea behind the food access and healthcare programs that I'm working on is to look at that intersection of food food and food access with the broad rural healthcare systems in Vermont, including looking at programs that are happening in other states and and also in national policy making and how they might play out on the ground here in Vermont given our structure. I should say for for this particular audience we, we are not the same as healthcare without harm we don't look at the sourcing for the food services within a healthcare setting, but we work closely with those groups, we represent all practice types, including those who do not have food services within their program so that's just one distinction to make that we're in a different lane than that. By State primary care association, which is the home for this program represents the federally qualified health centers in Vermont as well as the free and referral clinics. The a hex and the planned parenthood clinics of Northern New England, every state has a primary care association is part of the federal programming to support primary care access to everyone regardless of where they live their insurance status or their ability to pay and that subsidizes, not only access for folks, regardless of financial stability but also ensures that there's comprehensive quality primary preventive care services everywhere in the country. And so that's what our program grew out of federally qualified health centers are well famous in a very small circle of policy geeks for being the first to write food prescriptions in the modern era of health care down in Missouri in the 1960s. But my program does represent all health care practices not only the by state practices. And so when we work on the intersection of food access and health care we think of it as kind of three different buckets that are overlapping within the system so the first is going to be that foundational food security, they were just hearing about from Ellen right and you see that in a health care practice context. Some of the ways that shows up would be screening patients for food insecurity and referring them to community services for food access. Sometimes you see health care practices standing up food boxes or emergency pantries at the clinic so that folks who need food tonight have food available there. And so we get in the national conversation around how we're defining food security and the role that nutrition security has in that we see folks from health care, both having a strong opinion about that. They have lots of opinions about things like the impact of parts of these systems on type two diabetes preference in America right so there's a policy opinion and also an expertise that goes into crafting our approach to food security. So let's also look at community health programs in general prevention you're probably familiar there's a lot of work there in Vermont with lots of well known programs. And this is looking at the idea that we're encouraging people to have healthier eating patterns, more, more produce, more home cooked meals. You see a lot of education programs there, something like CSA and health care or the health care shares are often in that mode of that upstream prevention work. And you also see because of that importance of upstream prevention to health care things like, you know, payers giving grants to farm to school or other prevention grants that are going into local food systems and also healthy eating systems. And then we move through there to the idea of individual health care so now you're going from generally healthy eating patterns for everyone to here's an individual patient. Individual health concerns health goals clinical indicators what are we going to do for this patient to integrate diet and health food into their care and treatment. And that might be often it comes up in the idea of managing chronic conditions or in combination with medication for example to bring down cholesterol levels. But it's also appears in more acute instances for example transitioning out of an inpatient hospital stay back to home what's going to facilitate that transition. So that's more after a new diagnosis as you help a patient adjust to new eating patterns. So that's again tied to the individual and their particular health goals and health outcomes and a common example of this from the food side is if you hear medically tailored meals that's a treatment focused individual prevention that that is growing in its prevalence nationwide. So that individual health care bucket is often where reimbursement conversations live so should food be a component of covered health services, generally gets invoked in that individual health care realm, whereas the USDA programs are more on the food nutrition when you come into, we move out of specialized grants and into standing coverage in national policy. So those are the areas that we look at. And yet the pandemic and just some examples of some lessons learned obviously many impacts across healthcare. But in the area of food security I think that the first thing that folks working on food and healthcare will tell you is that it really highlighted where we are and it's not a good place in terms of diet related health conditions, the far reaching impacts of the site really health conditions the unequal distribution of who suffers from those conditions. The NIH published studies that found that in 2020 COVID-19 hospitalizations 66% of them could be attributed to diet really the government accountability office recently came out with a report that basically took the federal government to task on not having a coherent strategy for dealing with this issue in America and the, and the fall out that we saw with the pandemic but also in the rising costs of health care and the percentage of that which by some calculations the majority percentage of the cost of health care being linked back to diet diet related issues. And just a general takeaway from that I mean, many of us have long since accepted that food and diet has has a lot to do with your health outcomes but something that's really key for me and looking at this and our work that we're doing in the food and health care consortium is just that it underscored a lot of our programming is in prevention general prevention upstream work overall that's what we want in health care we want to get to root causes the systems change to moving upstream to preserve wellness and to invest in that being said, most Americans are no longer at the prevention stage, they now are in the treatment stage for diet related conditions so that that's a that's a significant distinction when you come to how you set up your health care systems to handle this. I know when pandemics is used so much for so many different things but it really is two epidemics that are happening right now. So specific examples that we saw on the ground in terms of disruptions during the pandemic the response and what that might mean for the future I'll just give you three highlights from that connected different areas of our work. The first was there was a disruption to the standard systems that health care practices were using for screening and referral to services these tend to be tied to wellness visits pediatric visits. Second visit patients coming into the office, or now remotely into the office that kind of passive screening works well in general but not when you have your number of patients coming in, you know, gone off a cliff for preventive care, while the rates of food insecurity are rising right now, health care practices also had plenty of other things that they were dealing with at that time so perhaps when you say they shouldn't be the leaders and in connecting folks but they were still engaged in in connecting patients with those community resources, and importantly looking forward in response to the pandemic, there was a lot of work on proactive outreach to patients right you need to engage them. If they're at high risk for COVID to keep them informed, you have systems to engage with patients that don't rely on physically being in the office. You need to do outreach to make sure that people know how telehealth works right. So there was a sea change in that proactive outreach and now we're looking at how that can be tied into ongoing concerns like access to food resources like enrollment to these squares and in fact we're currently planning a pilot to do exactly that to learn from those lessons and utilize these new systems to be more proactive in the outreach to connect with patients and place this food access and these programs to help with food in the context of health. Another thing that happened was of course the burden of keeping up with all the information right there was. It's always difficult in general, but there was lots of new information changing information everywhere including for food access programs, including hours that they were open new programs standing up how do you access those programs. In other practices there are care coordinators who are there to make those referrals and help patients navigate those community services. So we worked with our partners across the state during the pandemic to look at where our practices were accessing information on on what their options were for food access, how to streamline where they were getting their information so that they could have the most up to date information and get it to patients. But this challenge of managing all these different streams of information when working with patients in a care coordinating capacity from the health care perspective. That's going to be an ongoing challenge at some level because they're not only looking at food access we're asking more and more of our health care practices to be navigators and social services to manage social determinants of health to enable patients on everything from financial planning to housing to food access to transportation and connect them with local services. There are only so many brain cells available to if each if each, if each of those elements has 100 different possible programs to go with it is going to be very difficult for a care coordinator to, to work with patients on that and there's an ongoing movement within health care to do these broad screening of social needs and deal with a broad range of social needs. So an ongoing challenge is going to be, how do we make that information flow manageable and useful to the patients so that's something else that we'll be looking at coming out of the pandemic. And then the lesson and possibly the most important one I'm going to spend a little bit of time on. Emergency COVID-19 wasn't is an emergency and it's an emergency that's going on for a really long time. So, it's from a health perspective, what you do to get someone food if if you're supplying a diet for a couple of weeks, maybe a month of disruption and multiple years of disruption. So those are, those are two different things one is really defining your eating pattern and if you're trying to manage a chronic condition a diet related condition which we said at the outset, most people are. Then you've got questions to ask about about how you're going to do this in an emergency response situation and I just want to highlight. That there are programs who do this I'm going to choose one because they are great. And also I just completed a podcast episode going into some details about the meals on wheels program and the area agencies on aging who really nationally have kind of set a standard for integrating food access and nutrition security and health related concerns and healthcare integration in their programming so some elements of those programs that really help in a situation like we're in right now. So about 80% of her monitors who participate in meals on wheels are using that food to manage a health condition that they have and that's true nationally as well that's health holds it statewide and nationally. So meals on wheels program, the guidelines for it are designed to facilitate that so they're nutritionists on staff. You can modify the food to different health needs, and they follow different guidelines for responding to those health conditions. They also provide some amount of care coordination services and coordination with the primary care provider around nutritional needs and managing health conditions. They also provide a, I should say, they also provide one on one nutrition counseling is as needed. They also provide a minimum amount of food so generally speaking when you're using food and food insecurity responses to manage a health condition. If it's a medically tailored meal you want to be providing two thirds of what the household needs for the week. So meals on wheels, not all the way up to that medically tailored level is one third minimum of the food needed for a week so you want to have you need to have a certain volume of food to influence and support the healthy diet. And then another key issue that we look at is reducing additional barriers to access especially if you are going to be working with clients who have a health condition that might limit mobility or make other access. So the transportation to home delivered as well as having congregate settings as an option is really important in that context and those are all things that the meals on wheels programs provide. Now that program has been around for 50 years and it's easy to start to take something for granted after it's been around for 50 years right so when the pandemic comes. There is an instant impact on those programs. The clients they're serving are in the highest risk categories. The meals sites where people are coming together to eat get shut down and now you've got more folks who who need food delivered at home. Because there is that concern about going out into gathering areas and their and public transportation and all these other constraints. That's true not only for where they get the meals on wheels food but the but the other part of their diet right so there's increased food insecurity need. And there's a lot of people who are in the highest risk category for for monitors enrolled in these programs for for many of them. And additionally, meals on wheels is largely volunteer run and their volunteers are also in the high risk category. So now they've got a confluence of factors really reducing their capacity to serve that key role in nutrition services now I should say. Well, and in fact is opening points that we really rallied and and approach this initiative but you know sometimes it takes something like that to make you realize. What will happen if some of these services go away and and how can we strengthen them them outside of pandemic times so they can support us during the pen. During an emergency during a prolonged emergency and serve these health needs so those are some three examples of different ways that we saw disruption and responded and are using that to think about what we're going to do next. And then the last point to the planning and buy seed investing in some of this planning work. For us is a is there's a pragmatism here right we just had a major disruption, lots of federal waivers, lots of changes to programs is gone on long enough that they're that some people are still deep into crisis mode I can't see five minutes in front of me. I think programs have are able to take some strategic distance and start to think through, well what waivers do we want to keep in place. What don't we want to keep in place, what do we learn to make changes and how can we exit this in a way that that sets us up to invest in and learn from these lessons while they're still fresh and with us so we're trying to hit that timing just right with those organizations that do have capacity for the strategic planning for engaging people in the strategic planning. Now is the window to reorganize for this change and and in the world of health care. Change change comes incrementally, not as slowly as federal dairy pricing systems we have changed since the 1930s, but it comes very incrementally and you want that right you want your health care system to be somewhat conservative with people's health and lives. So if there's a opportunity to do the planning do the studies do the research that we're going to need to bolster argument for sustained change in the future will certainly take it and are excited to be able to work with the sustainable jobs fund and farm to play on this opportunity. So that was a whirlwind tour of one little piece of food access and healthcare in Vermont, but I'm happy to take any questions or provide any more information. Fantastic Helen that was, that was, it was a whirlwind tour and thank you so much I was very very interesting. Many do you have any questions for Helen at this point. Tom. The question I don't know for either Allen or Helen, I don't know but in terms of emergency preparedness and the future I know you're still working on the strategy, but do you do envision stockpiled foods. That kind of thing in public buildings. Well, how do you see this working out this this emerges an emergency preparedness and feeding populations that are just out of food because of an emergency. That sounds like an Ellen question more than a Helen question. I can tackle this a little bit unless Ellen you have a no go or respond. No, go ahead Becca. Thank you for the question I think it's a great and logical question I. I would say at this point, I'm not sure I don't, it might. That might be something that Ellen can address whether the state emergency operations plan, which she's been more involved in that end of things might understand where food stock piling falls into hazard mitigation and emergency operations and I know that the mass feeding plan is going to be rewritten and is underway with that. What I would anticipate representative is that that will be something that is investigated in the plan that will understand whether that is a recommendation and that's been effective in the state and in other states. I think there are other forms of ensuring food availability in the category of stock piling that have been successful. It's been shared with me that in Rochester the market there had an agreement, the max market had an agreement with the town. And when Irene occurred, the town in a way had an account with the max and was able to access food on the shelves without having ready money to pay for it and they already had that agreement established as part of the emergency preparedness. So it's another approach to stock piling that's less like green in the warehouse and more looking at like, where is, how can we use existing infrastructure for really rapid response. So, a little bit of my answer is I'm not sure but I do think that component will be collected into the plan and we'll know the answer at that point Ellen do you have any additional information. No, I mean, thanks for bringing up the reminder to say that the, the folks that have been part of the mass feeding operation. We're not quite through the pandemic yet, but the game plan is to do that after action review of everything that they did related to mass feeding and then to update their plan it's part of what you just do is emerges preparedness you. You learn from what you've done, and then you use that learning to revise and update your plans so that when the next emergency comes, you're that much smarter and farther ahead and being able to address what's coming at you. So, yeah, I would imagine that this is a topic that will be discussed but whether we come out with something concrete at the end, it's not yet known. Hold on one sec Tom, I just want to follow up with that's okay. Becca, could you just say again, the town of Rochester, Rochester, or was that Rochester, New York or Rochester. So this is a, this is a, this will probably be the case for me as I go through this project that sort of third hand piece of information that I received from a regional planner. This is one of the members of a qui chi who, when I was, as we've just been investigating town municipalities are using for emergency preparedness related to food. This was an example she shared with me that Rochester Vermont had an agreement the town had an agreement with their max market that in the case of emergency the town would have access to what was on the shelves. And I can't go to any sort of sort of enough information to be dangerous, but I can certainly find out more information if that would be helpful to you at this time. That would be fabulous I'd love to learn more about that and I also remember that during Irene Rochester did this amazing thing where people brought food from their freezers, which were, you know, which were out of commission. And they basically brought it to the end in town they were preparing food, and people are going there to eat, which I thought was just fantastic. You know, made so much sense. Yeah, right. And as Helen said, that works great for a couple of weeks. Like what we had to deal with Irene, but when you have a pandemic that's now almost two years old. It's a whole other thing to then maintain that it's a whole other level of preparedness that needs to be addressed. Absolutely Ellen I just, I thought, well, Roger, what a cool town Rochester is to come up with that idea, you know, and make it happen and feed your people for even a couple weeks. Because a lot of us would have just said, eh, you know, what are we going to do here. Just put all this rotten food on the compost heap and, you know, go on with life. Anyway, great. I just had, I just had another thought. I'm most probably too young to remember this but in the late 50s and early 60s. The schools I went to, and our local town halls basements, whatever were filled with surplus surplus surplus food, but it was food for preparedness, in case of nuclear war food and water, and it was all over the place and it made me think during Irene, the day after Irene hit our town, which is pretty hard, the National Guard was pulling up in these strange vehicles, tracked vehicles into our town, and they're delivering many, many thousands of gallons of bottled water, and we had places for a lot of it, but a lot of it we just didn't have place for. And it had to go to another town and it could have been used in some of the rural areas that just had no electricity to run their pumps and whatever. So this has been done before. I don't know whatever happened to all that nuclear food, but it seemed to work and I was in school. I don't know, I was in those boxes. I was, and I don't know how, how, what it was that kept all those years. They just, it was in the basement of my high school. All the while I went to high school. They're probably still there. Thanks, Tom. John, your hand is up. Go ahead. Thank you. I don't know who anybody I guess can have a shot at answering this, but I'm just talking about food, these really big subjects like food, nutrition, diet, health care, made me think about something that didn't necessarily come up with is that it's so tied to education, and how far people go with their education. And as the example of, if we took all our lawyers and legislative counsel, you know, underpaid for how amazing they are, but, but all highly educated. I guarantee you there's a lot less food insecurity there that if we took, you know, 27 dropouts from, you know, people who didn't graduate from high school. So, you know, when you start thinking about these issues, instead of just thinking about how do we feed people, you get into these huge subjects of like how do we get people further in school and where do you go with that without your heads exploding. In the healthcare perspective, we do know that in Vermont, one of the highest risk factors for chronic conditions is your edgy level of educational attainment that that is quite clear if you look at the CDC date on that. So you see it, you see repercussions throughout your lifetime and also throughout your health span. And from the perspective of how do we integrate food and food access into, into health. There's some amount of teasing out of how much is related to simply income, how much is related to other factors like knowledge about nutrition knowledge about cooking. I don't think law school taught a lot of knowledge about nutrition, frankly medical school doesn't teach that much about nutrition. I've come to discover. So, so when we talk about education components that there's the element of what, what life skills are the new, our new generations learning. How do they engage with food how do they understand what constitutes a healthy diet and ways to make that fit in with their, their lives whatever it, it might be. And then the questions of straight up financial barriers, you have a work schedule where you can't get off work in time to get to the emergency food location at this specific hour at the specific time you know those conflating factors so so we so we take it in to related chunks as we think about how to approach this issue. Do you notice then, you know, sort of generationally, compared to representative box time to now that people are know a lot more about sort of the education of diet and nutrition is it is it improving or is it. You know, we know more for sure. But two things have happened in the last generation or so. There's nutrition sciences relatively young science it progresses some of us remember the dark days and nutritional advice in the 1990s, we're getting past those. There's a lot more information flowing unfortunately some of it is misinformation and bad diets. So the, the ecosystem of information available on what constitutes a healthy diet and then what ties to specific health factors and risk factors is better than it was we also have emerging of lifestyle medicine and culinary nutrition on the health care provider side where there's greater education in that realm as well so so that's the good news. The bad news is that the food environment has changed even more dramatically, and the signals and the pressures towards less healthy food, highly processed food, sugar filled food out ways. By a pretty wide margin those informational educational gains. So the net effect has been disastrous for the incidence of diet really disease. Um, thank you. Other questions. All right, did you, did you all have more that you wanted to ask. Yeah, so you know, I think, I think hopefully this goes without saying but just, you know, you all as the Agriculture and Forestry Committee you're used to thinking about the from farm to plate the way in which food gets produced, it gets processed it gets distributed it gets bought it turns into compost eventually like you're used to thinking of that whole supply chain of food. What the food security planet plan and this action plan that we want to create is more complicated because we are showing where and we're going to be investigating those intersection points between health care between education between distribution, physically getting to a store especially in rural communities, intersection with income distribution intersections with land use planning, like all of that is an housing, and how, where is housing and connection to basic services and grocery stores for instance, all of those things intersect in like overlapping then diagram types in that visually right. So that's part of what makes this project unique is that we're really going to be trying to look at all of the components that would lead to a family of an individual feeling that they were in fact food secure. And, and what are the additional policies programs initiatives investments in infrastructure as well as, as well as programmatic efforts to really bolster the ability of Vermonters to feel food food secure. And that's really the point of this is to get. I know that oftentimes you guys are faced with request, but we're just going to plan we're going to we're going to look at this so we're going to try to like, we're going to plan to plan to plan to plan as Colin Goodridge said last week right. That's not what this is about there is a planning component, but the point of this is to actually be bringing all of these different domains together for the first time. We really try to tackle this question of food security, and it is a long term effort because this is systemic, it's not something that we're going to be able to address overnight. It's probably a generational overall efforts. But we need to start now we have this incredible opportunity that is coming out of the pandemic where we're all much more aware of the magnitude of what we're facing, and what needs to get changed. We had put in a request last September to the agency of agriculture food and markets, requesting a one time allocation of $150,000 to help with this development of this food security plan for the state to do this priority action that came out of the strategic plan. And the agency had been really excited about it, they put it forward in their budget recommend to the governor's office. And unfortunately the governor's office did not incorporate it into the governor's budget that you received a few weeks ago. So I, what I'm want to ask for your consideration is as you're thinking about your, I don't know if it's going to be a committee bill or just sort of what you're going to be getting behind in your request to the house appropriations committee that you consider a request of $150,000 in one time funding from the general fund to be able to support this, this initiative. So we do have funding that we received from the Vermont Department of Health, which they received from the CDC, as Helen mentioned by state has come in with some funding. We've gotten some other foundation funds from the foundation and an anonymous foundation that just sent us a check, which was great. So we do have this $150,000 gap to be able to complete this project. And part of the cost is some some primary research which is what Helen's organizations can be funding some transportation related research and how Vermonters access food. But then we're also going to be providing stipends to people with lived experience to make sure that their voices are really totally incorporated into this work. So this will be wrapped up fully by the end of 2023. And, and we'll be getting to work on, on implementing all of these things that are coming out of this, this work so just wanted to put that on the table for your consideration, and happy to provide any documentation madam chair that might be helpful to you as you guys consider this. And, and I would just encourage you to bring in, you know, people like Jason Goslin who ran the who's the facilitator of the mass feeding group to talk to learn more about what they're doing. And Suzanne Kelly from Vermont Department of Health to understand what they're doing. I'm going to graph from the agency of human services about their connection to the emergency feeding operations. There's a number of people that I provided some names for consideration, having someone from the agency come in. This is a really an unprecedented special one time opportunity to do this work. John sales and from the food bank, you know, have him in to talk about this. They're all involved. And we have a really a great opportunity to come up with something that we can all implement that we're all aligned around and that we're all moving forward fairly quickly on implementing so I'll leave it at that, except if you have other questions. So you said that the ask is now $100,000 could you've made up the other $50,000 in other ways. No, no, the ask is 150. Okay, 150. Okay. Yeah, this is more like this is a much more than 150 project, especially over two years with all the complexities that are involved. And so we've, we've raised everything but 150. Yeah. Okay. Thanks. But it's, it's a one time ask for 150 but it's meant to cover two years of work. Correct. Thanks. John, your hand is up go ahead. Hey, Becca, what, what was the program Abinaki helping Abinaki had never heard of that before. That's a program that is run through the Abinaki band I believe went through the band that's run by Chief Stevens I actually don't know a ton of details about it. I think if you wanted to hear about it I would really recommend bringing those in and I could let them know. If you were interested. There's, it's, there's, are you familiar with the term food sovereignty as a thinking about some really self determination in terms of food access and food resources. Yeah, it was funny representative Yacoboni emailed a couple weeks ago and said what's what's sovereignty. Some constituent keeps pounding me about it my I wrote a back partly about this program a regional food security, but then I realized there's this whole element of indigenous peoples and their food security and sovereignty so there are a lot of complexities there that I would love to hear more about it. Yeah, I think I would want, I can speak very briefly about it but I would really want to be more prepared to speak eloquently to it and you know obviously those who are indigenous or more would be more appropriate to speak about it more fully. So our tribal groups in Vermont are have very high food insecurity rates. And my understanding is that the Abinaki having helping Abinaki program is a project that's really within the tribal groups where they are assisting one another in a mutual support way with food access and food production. I don't want to leave with leave you with only that information, and I can pursue getting more details to you all if that would be helpful. Okay, if you're willing to do that I'd appreciate it. Okay, that'd be great. Thank you. I'm a little distracted because I just found out my brother in law died. There's a lot of family stuff here so I apologize to you all. Very sorry. Thank you. Any other questions for or anything you all want to add. Well, I think, you know, we can have more discussion about the, the ask and, you know, I think, you know, we're really blessed at this time to have quite a bit of money to work with, and it's almost like a once in a lifetime. I think it's a really deep hearing once in a lifetime but it really is sort of once in a lifetime opportunity to, to work on some of these projects that we might not ordinarily think about but from a pandemic and certainly, as we've said a million times reveal a bunch of cracks in our, our various societal structures and this might be this perfect perfect opportunity to bring people together and and discuss this. We can have more of a discussion here and committee and and see if we want to pull together. Ellen what form would it take would it be a committee bill or where we haven't asked up for this or what do I mean we've also got we've got the ask for the forest future strategic roadmap, we're thinking about. Yeah, I think if there is, if do you have, are there any bills related to say, farm to school or universal meals or anything like that because it from a germane, like what would be germane there, that would be a closer fit perhaps of just adding a section to something like that. Linda, do you know if they're doing anything in the Senate about universal meals. All right, well, we'll kind of keep our eyes open for, for something excuse me they have had some customer. Oh they have said they've had testimony. Well we can see if they're, if they're doing a bill maybe we can send it back with a little addition. Yeah, I'm, it's really if you're thinking that it would be helpful to have a very short brief committee bill of like one section that just makes just to do this we could do that but seems like having something that we can attach the request to would probably make it easier to just overall handle. Yeah, we can think about that maybe we'll, we'll consult Michael Brady, who was our, our guru, and we can also, you know, talk about whether we, as a committee want to support this. So, yeah, any other questions, comments. All right, that's the mysterious opening door behind Helen. My cat heard that you were closing as you came in to demand to be pet. Yeah. I have a feeling it was a cat or a dog. Tom your hand is up is that another hand or is that legacy. Something came to my into my mind. Well, Helen was talking I was curious when talking about a healthy food and diet and and health. It's the problem I'm going to say it's a problem. Yes, it is a problem of unhealthy foods. In certain ethnic groups, for example, is if you go into Mexican supermarkets in the southwest to California and Arizona and Texas, you find huge containers of Manteca and lard, and they're being used in a near died and they're not changing. And then you find the in my neck of the woods where I came from, Ludifest, which is to me was a salt and butter cream. And I think some of the healthier cooks of Ludifest added big slabs of bacon and there's no series of African American foods, ribs, etc. that cannot look is are these kinds of things are these initial issues that you're going to have to address in Vermont or don't you see it here is a problem. Those ethnic preferences. Yeah. So you have gone to a important conversation in nutrition and nutritional counseling so they the overall answer. And I should say I'm not a registered dietitian but the overall answer is that the dominant eating patterns that lead to poor health outcomes are sugar sweetened beverages and highly processed highly refined foods. I don't want to to throw modern food industry under the bus to aggressively because it has provided many convenient things, but that is generally speaking the problem so anything that is based more or less on whole and eating in moderation and not drinking your calories is going to be an improvement in any traditional eating pattern will fall into that category so there's programs like the old ways food network in out of the Massachusetts area this basically saying, you know, and, and I realize that there are good reasons related to how we live our lives that we want to not have to make everything from scratch, but at the same time there needs to be a balance there so that's the overall nutrition pattern answers not based on cuisine type as much as it is on that question of whole ingredients and sugar sweetened products and eating the occasional vegetable. All right. Love your cat Helen very. Sean go ahead. Yeah just something I thought of with with Tom's question. It was was the United States, it was our diet much healthier and in a pre pre depression that it is now I mean a lot less range of foods but a lot less processed and sugar drinks to I don't want to take answering away from Ellen and Becca it was problematic for different reasons so you know that's why we see the food assistance programs that we have today coming out of the world wars is that there was insufficient food. And, and we saw it, and now it's reversed right so now now it's too much too low quality food so we had different problems then. All right. Any other questions for Ellen Becca or Helen. I am not seeing any. So we really appreciate you taking time today to spend with us and I look forward to working on this I think it's an important issue, as we want to keep our watchers fed and hopefully with more nutritious local food. And so we really appreciate you sharing your thoughts with us. Thank you. Thank you very much. Thank you so much for the opportunity. Thank you very much. Yeah, take care. All right. Take a break, so you can call your sister or what you do. No, I think I'm good.