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Hello, everyone. Thanks for joining us today to learn more how NHSC members can get involved
with free summer meals through the Summer Food Service Program. We are very excited
to have you with us today, and we thank you for taking your time to learn more about one
of the most fun and important programs in the country.My name is Tony Craddock, Jr.,
and I work in the Office of External and Government Affairs here at the USDA Food and Nutrition
Service. After a brief overview of the Summer Food Service Program, we will hear our dynamic
speakers, which features the St. Mary's Food Bank and the El Mirage Family Health Center,
both located in Arizona; and they will talk about working together as a sponsor and site,
respectively, with SFSP. WhyHunger will then talk about the resources we have to connect
people with SFSP. We have a lot of information to share with you today.We're hosting today's
webinar because we believe you have influence as NHSC members. Your direct contact with
low-income patients makes you great candidates to advocate for the Summer Food Service Program,
to help us feed more kids when school is out. The HRSA health centers where you work can
help serve free summer meals or help promote the program to families that visit your centers.
If your health center cannot serve free summer meals, you can find out what feeding sites
are in your community and make that information available to your patients. Right now, the
Summer Food Service Program is one of the most underutilized government programs but
also one of the most important. It feeds hungry children in summer who don't have access to
free or reduced-price meals when they are in school. There are about 21 million children
in the country eating free and reduced-price school lunches during the school year, but
only 2.3 million of those children eat meals provided by USDA's Summer Feeding Program
when school is out of session. That means there are a lot of children that are not getting
the food they need during the summer when school is out of session. To put it in simple
terms, only one in ten kids from low-income families who are eligible to receive free
summer meals get them. That means nine out of ten kids from low-income families are at
great risk during the summer months of going hungry.So how does the USDA Summer Food Service
Program work? Explained in simple terms, the Summer Food Service Program, or SFSP, is a
federally-funded but state-administrated program that provides free nutritious meals to children
in low-income areas. The USDA Food and Nutrition Service funds the program at the federal level,
and state agencies pass on the reimbursement to organizations called sponsors. In most
states, the state agency responsible for the program is the Department of Education; but
it may be the Department of Agriculture or the Department of Health and Human Services
in a few states. You can find your state contact on our Summer Food Service Program website:
www.summerfood.usda.gov.Sponsors of SFSP are the ones who serve free summer meals, and
there may be different types of organizations such as local government entities, schools,
parks and recreation agencies, faith-based and community organizations, and national
non-profits. All these types of sponsors must enter into agreements with the state agency
administering SFSP to do the administrative work, training, food preparation and monitoring
required in the program. These sponsors handle all these responsibilities so that sites can
focus on feeding children.Summer feeding sites are the places where the kids come to eat
their free summer meals. Sites can be a whole host of different places in the community
such as parks, libraries, schools, office buildings, recreation centers, mobile buses,
hospitals or clinics such as your HRSA site; and these are places where kids naturally
congregate during the summer, and are typically safe places where parents and families feel
comfortable sending their children.First and foremost, the Summer Food Service Program
helps to make sure that children get nutritious food during the summer. Also, summer feeding
sites offer activities for children. The activities at summer
feeding sites can help children and teenagers stay physically actively and mentally engaged
and ready to learn for when the school session resumes in the fall. The program also allows
sites and sponsors to be very creative in the kind of activities that they put on for
the children.So again, to recap the main players in the Summer Food Service Program, first
we have the states. To participant in SFSP, sponsors must sign an agreement with the state
agency. The agency sets forth the responsibilities of the state and the sponsor. So the state
agency is really your go-to contact. This is because every state is different. So to
get the most precise information, you need to go to your state agency. The state is also
responsible for providing training and technical assistance to all sponsors. States want sponsors
to succeed, so they will take every step necessary to assist both new and experienced sponsors.
State agencies also are also responsible for monitoring the operations of participating
sponsoring organizations. More or less, sponsors are the bread and butter of the Summer Food
Service Program and are responsible for a wide range of functions. They accept all financial
and administrative responsibility for their program. They manage the food service. They
also train the sites and arrange meals at each site to make sure that meals meet USDA
nutrition standards.Then we have the actual sites. This is where kids will go to receive
and eat their summer meals. This is what your local communities need more of so there are
more places where hungry children can go eat -- the more options, the better. A feeding
site can be located in a number of places -- indoors and outdoors -- parks, playgrounds,
libraries, public pools, churches, apartment buildings, or again, health centers. You name
it; if it's a public building, it can probably be a feeding site. Most importantly, HRSA
health centers can play a role in this. It is recommended that most organizations that
want to get involved with SFSP start off by being a site. It's much easier than being
a sponsor if you are new to SFSP. This year, you can team up with one or more experienced
sponsors to serve as a feeding site. Your sponsor can deliver the meals to your site
and promote the site to parents and children, then feed and supervise the kids who come
to your health center for free meals. There are several different types of sites and ways
you can be improved; but for today, we are going to cover the two most common sites,
open sites and enrolled sites. Most likely, if you're a HRSA health center, you're going
to be an open site. An open site serves free meals to children of age 18 years and under.
This means if a child walks up to a site, they can get a free meal right there on the
spot -- no enrollment forms, no attendance sign-in sheets, nothing. The site must be
located in a school attendance area where 50% or more of the children are eligible for
free or reduced-price meals. Again, as a HRSA site, you're most likely going to qualify
as an open site. The 50% criteria is based upon school data or census data. Your state
agency can provide technical assistance in making these determinations and to see if
your HRSA health center is in an area that qualifies as an open site. The second type
is an enrolled site. At these sites, typically there is one program going on where only the
children that have enrolled in the program can participate, such as a summer camp. At
enrolled sites, any child just cannot come to get a meal. Only those that are enrolled
to participate in the activity that's happening are fed. At least 50% of the enrolled children
at the site must be eligible for free or reduced-price school meals. You can determine this by looking
at school or census data or by collecting household income applications from the families
of the enrolled children. Again, there are more sites than the two that we are covering
in this webinar, and you can contact your state agency to see what makes most sense
for your organization or program. Sites are run by staff and volunteers. If you are interested
in working as a site supervisor, you must attend training given by your sponsor before
the site opens. The program training gives you information you need to know about such
as, how to serve meals properly; how to count the meals you serve; how to maintain local
security, safety, health and sanitation standards; and how to keep accurate records. This training
will be provided to you by your sponsor. If you have any follow-up questions, your sponsor
will work with you to ensure you that fully comprehend the responsibilities you are about
to take on as the site supervisor. Sites are responsible for ordering and receiving the
meals from your sponsor; ensuring the proper number of complete meals are delivered; ensuring
the correct number of complete meals that are safely served to children 18 years or
younger; ensuring that the children eat their meals on site; not discriminating against
children; and preparing complete and accurate records of deliveries, meal counts and other
paperwork which determine how much reimbursement your sponsor gets. Typically, the sponsor
arranges the meals to be delivered to the sites so the site supervisor does not have
to directly handle the funds that pay for the meals and can focus their efforts on the
actual meal service and activity. You may be wondering, "What if I want to be a little
more ambitious and be a sponsor?" If your HRSA health center wants to become a sponsor,
it's important to know that we recommend that organizations who get involved with SFSP start
out as sites. Then after a year or two, the organization feels more comfortable with the
program and can become a sponsor and take on more time-intensive administrative functions.
The sponsors handle the paperwork, budgeting, training, monitoring and even keep the program
strong through the summers. They have agreements directly with the state agencies where they
take on fiscal and administrative responsibilities to carry out the program to the standards
established by the United States Department of Agriculture. Many ask, "What is the incentive
to being a sponsor?" Yes, there is an administrative reimbursement that comes out of every meal
claimed; and that reimbursement can be used to cover both the operating and administrative
costs of conducting the Summer Food Service Program. However, even though the reimbursement
is nice, there is little to be gained from being a sponsor. The benefits of being a sponsor
go beyond the fiscal incentives. Sponsoring SFSP is a great way for your organization
to expand their reach in the community and help other local organizations that may not
have the knowhow to run a federal program. You can be your sponsor and they can be your
site. Also, it's important to note that you get
a higher reimbursement if you're distributing meals to a rural area or doing self-preparation
of meals. This is key at HRSA sites that may be located in rural communities. Find out
from your state if your area is qualified as rural. Now I'd like to take a few moments
to highlight the At-Risk Afterschool Meals Program which ties into SFSP. Feeding children
during the summer is important; but if you have the capacity and desire to continue this
effort during the school year, this program is available. If you're already participating
in the Afterschool Meals Program, there's a streamlined process that makes the transition
to SFSP relatively easy compared to a brand new SFSP site. Additionally, if you participate
in SFSP and are interested in expanding to summer meals, you can enter into an agreement
with the state. We encourage you to do that as well if you have that ability. When school
is in session, meals and snacks must be served after the school day. Snacks may be served
at any time on weekends and vacations through the regular school year. With state agency
approval, any one meal -- breakfast, lunch or supper -- may be served per child per day
on weekends and during vacations throughout the regular school year. Afterschool meals
may not be claimed during summer vacation unless the at-risk afterschool care center
is located in an attendance area of a school operating on a year-round calendar. And just
for clarification, the Summer Food Service Program is only during the summer. And At
Risk Afterschool Meals is when school is in session and will not overlap with summer.
So SFSP and Afterschool Meals work hand-in-hand to feed children year-round. Children must
be 18 or under at the start of the school year in order to participate in the program.
Teenagers who turn 19 during the school year are also eligible for the entire year. It's
also not just open to teens, but for younger children as well. An eligibility area means
the program must be located in an attendance area of a school where at least 50% of the
students are eligible for free or reduced-price school meals, just like the SFSP requirements.
The program is only offered for area-eligible sites unlike the Summer Food Service Program.
So for example, if your program was operating in an area where a local elementary school
had 50% or more eligible for free or reduced-price lunch but the high school did not, your program
would still be eligible based on the elementary school data. It's not an average or is not
based on district data. There only needs to be one school in your area for you to be considered
area eligible. Programs must be organized primarily to provide care during the school
year. But when school is not in session -- such as afterschool or on weekends, holidays or
vacations -- the programs must provide organized, regularly-scheduled educational or enrichment
activities. For health centers, you could come up with creative sessions to have staff
members host; or it could be something as simple as offering onsite tutoring given from
older students at the clinic. There are a variety of things you can do to substantiate
the educational or enrichment activities at your site. So, how can you help? First, we
need more kids to attend the sites that are out there. Help promote these sites to parents
and children that come to your health center. Download the summer meals fliers in the Handout
section of the webinar. Hang it up in your health center or hand it out to families.
The flyer provides information on how to locate summer feeding sites in the community. Second,
it's not too late to become a summer feeding site. Contact your locate state agency to
see who the sponsors are in your area; then contact the sponsors and see if you can become
one of the summer feeding sites. And here are some USDA resources for you to reference.
Again, these links can be found in the presentation in the downloadable Handouts section of this
webinar window. And now we are going to move on to our first presenter, which is the St.
Mary's Food Bank Alliance. Great, thank you so much, Tony. And thank you, everybody, for
participating in the program. We're honored to be able to spotlight our summer meal program
that's hosted here at St. Mary's Food Bank Alliance. St. Mary's Food Bank is actually
the world's first food bank. We were founded in 1967 by our founder, John van Hengel, to
service the Phoenix Metropolitan Area. So you'll see the map of Arizona in the slides
there. We're sort of in the middle of the state -- that star in Phoenix. But we actually
serve 10 of the 15 counties in Arizona. The entire red area of that map is actually our
service area. We have a facility in the west side of the Phoenix Metropolitan Area in a
town called Surprise, Arizona; and then we have another facility in northern Arizona
in the city of Flagstaff. Those ten counties that we serve make up more than 80,000 square
miles, which is roughly about the size of Indiana. So we have a lot of reach. But our
summer and afterschool meal program is serving solely the Phoenix Metropolitan Area. We call
that program the Kids Café Program that provides Arizona children with what is often their
only meal of the day. So we participate both in the summer meal program that Tony spoke
of, as well as the At Risk Afterschool Meal Program that was mentioned as well. Our summer
sponsorship has grown tremendously. We became sponsors here in Arizona in 2006, serving
just three sites at about 50 meals. And this summer -- as Tony mentioned, we've grown exponentially
-- so we are anticipating serving 80 sites 4,000 meals every day. So we are tremendously
excited to be able to partner here in Arizona with our State Department of Education. Because
of that exponential growth, we kind of experienced our first challenge; and that was space capacity
and volunteer capacity. So when we experienced that first challenge of space capacity, our
solution was to expand our production room in our west side facility in Surprise, Arizona.
So with that expanded space capacity, we're now able to produce about 8,000 meals a day
with the help of about 30 daily volunteers. Utilizing the reimbursement rates, we were
able to hire a Volunteer Coordinator that specifically works to recruit Kids Café volunteers,
and specifically summer volunteers, to help produce and package the summer meals that
we utilize that make the meals. We also utilize inmate labor in collaboration with our Department
of Corrections and our county jail system as well. So our model is a cold meal model.
You can see the sample there of our Kids Café meal, which Terra will talk about. Hi, thank
you for having me. This is Terra Masias. You can see the picture of our cold meal. Everything
is self-contained. The only thing outside of the bag is the required 1% milk that has
to go out to each of the kids. So they're all individually packaged. They're stored
in cold storage units on site until the meal is given to the children by the site coordinator
at our site. So we've done this intentionally to try to make it as minimally labor intensive
as possible. The other thing to point out here is many of our sites -- especially some
of these unconventional sites like our health care facilities -- don't have extra cooler
storage on site. So we have an agreement with them where we will lend them storage coolers.
So we have eliminated that as a barrier. Another challenge that we encountered early on is
the staff capacity for site monitoring and management. We did experience rapid growth
actually once I was hired. So they hired me to be the Program Manager, and then I hired
one Site Specialist. But you can kind of see our internal organization chart. And then
all of our sites have monitoring requirements, and that's a USDA regulation. And you can
imagine what that would entail with 80 sites needing two to three site visits. So what
we implemented a couple of summers ago is a Train the Trainer model where we use volunteer
site monitors. So with our volunteer department, we recruited site monitors and we've trained
them -- so it's kind of a Train the Trainer approach. And they actually pick sites in
the communities where they work and where they live, and they kind of adopted them.
And they would go out and provide the monitoring and onsite technical assistance. We did train
them to come from a strength-based perspective, so they are very solution oriented and not
punitive when they're going out and doing the monitoring. In addition to that, one of
the good outcomes that happened is it really promoted awareness to people in the community
that had no idea that this was going on in their own community. And then the USDA -- in
this year especially -- they've become less restrictive on the monitoring requirements,
decreased mandatory site visits for sites that are in good standing and have a history
of being on the program. So what this has allowed us to do is to focus on front-end
training and coaching and guidance and less emphasis on addressing problems because frankly
there aren't that many problems at the sites. Soon after Terra was hired, I was brought
on board to specifically help grow our Child Nutrition Programs and our Kids Café Programs.
So in my role as our Community Outreach and Agency Development Manager, I built partnerships
and collaborations with schools, community centers, churches, health centers, neighborhood
groups -- anywhere where kids congregate during out-of-school time. So part of the meal reimbursement
rate again is to have this position that I work in. So I work with the sites to enroll
in our program and also help them increase and sustain the capacity, utilizing outreach
materials and toolkits provided by USDA, Feeding America or a national parent organization
and other national partners like FRAC. And we've also created our own bilingual outreach
materials that help sites build capacity. So you'll see in the presentation an example
of the fliers and the billboards that our parent organization, Feeding America, put
out in our Phoenix Metropolitan Area. I work with the sites to think of innovative outreach
utilizing their own tools, like some of the schools that we've worked with have autodialers
that dial parents; and they've promoted their sites like that. And we think health centers
can use that as a similar tool if they send out appointment reminder calls. So we build
strategy community partnerships to recruit and enroll new sites and have great partnerships
with a lot of different sites within our cities and other suburban cities and school districts
here in the Valley. But one of the challenges we experienced was with the downturn in the
economy, which hit Arizona especially hard, it led to a lot of our traditional partners'
budgets being cut, which led to program and site closures that directly impacted us. So
that really forced us to incorporate out-of-the-box thinking and outreach to non-traditional partners,
which led to our partnerships with family health centers. It was really nice because
the summer feeding sites don't have to be structured programs though that is encouraged
to be able to build capacity, and the non-traditional partners really allowed us to really go to
where the kids are in the summer. In Arizona, it's not out of the norm for our summer days
to reach 110+ degrees; so we find it that kids have a really difficult time leaving
the house as you can imagine. So we try to go to where they are and provide them meals
that way. We also know that collaborating with community health centers and also our
local WIC offices was an obvious choice because we know that if a kid misses a meal on a consistent
basis, it has a lifelong effect on their health, their emotional wellbeing and academic achievement.
We know that child hunger is a really complex issue, but we have simplified it to an ABC
model that we know child hunger impacts child appearance, behavior and classwork. We know
that kids who aren't eating and are food insecure lose or gain weight; they have thinning hair;
their skin becomes a bit more fragile; and their growth is stunted. Their behavior is
impacted too. They're a bit more irritable; they're anxious, depressed and unresponsive.
We say they lose that spark that a kid should have in their eye. And that impacts their
classwork. Not eating on a regular basis decreases their cognitive ability, and they have a weaker
immune system. So they are sick more often, they go to the doctor more often, and miss
school so that their classwork is impacted. We also enjoy working with community health
centers because they are often located in high-need areas, and we've proven that through
a market analysis that we've done of child poverty rates by schools and school districts,
as well as the free/reduced lunch rates of schools and districts throughout the Phoenix
area. So we're really going to where the high-need children are. So that's where we've built
collaborations with both the WIC offices in Arizona and with the Maricopa Integrated Health
System, which is one of the sites that will be spotlighted a little bit later. Some of
the strengths that we have with the Maricopa Integrated Health System and WIC collaborations
-- last year we provided more than 200 meals daily. Consistently these families face major
challenges associated and why they're there at the community health centers and WIC. That
was 40 meals daily at El Mirage and 55 meals daily at a local WIC office. Anecdotes were
told to us that the children once they received their initial meal because maybe they were
there for a doctor's appointment, they would come back day after day. MIHS staff noted
the clear public health implications of hungry children, and they saw alleviating hunger
as a health remedy to most of the children's ills. MIHS staff also noted quieter waiting
rooms as child patients and even their siblings ate and enjoyed the free healthy meals. And
then we also know, especially here with our high increased utility bills in the summer
and no breakfast and no lunch being served in the summer because school is out, so these
meals help to alleviate economic hardships that families experience in the summer. And
then as David mentioned earlier, research and data will show you that if kids are eating
throughout the summer, they re-enter school in August ready to learn. Community health
centers and WIC sites are also, as David mentioned, in high-need areas. And most of them in the
Valley -- and we've tracked it -- are on public transportation links; not all, but most of
them are. And they are known places in the community, and they are safe places in the
community. Some of the initial challenges we alleviated, but they were initial questions
to be challenges. Some of the site staff said they were strapped for time. They thought
this was going to be a lot more work, but we encouraged them to do it anyway. We found
out that at the most, it was about 30 extra minutes a day. We also encouraged them to
look for their own volunteers. Some of our sites were using hospital volunteers or nutrition
student interns. The site staff didn't fully comprehend the relative ease to becoming a
summer meal site, and they worried about expenses. "What is this going to cost me? It sounds
too good to be true." Well, it's really not; and we talked to our sites, and really the
only additional expense might have been extra trash bags to throw away the meal items. And
then they were concerned that the kids wouldn't come. Well, as David had mentioned, we provide
all of our sites with a marketing toolkit to help spread the word. Every site we work
with is assigned a site specialist from our end; and those site specialists are ready
to answer and provide technical assistance pretty much on the spot. They are all equipped
with a cell phone. And some of the sites were concerned about the additional paperwork.
Really, it's not a lot of paperwork; like I mentioned before, it's probably about an
average of 30 minutes extra a day -- and that's collectively. So from the sponsor perspective,
which we are, there were a couple of initial challenges. We just didn't know our players;
that was the Arizona Department of Education. So what we did is we had an upfront meeting
with them before we submitted our proposal to talk to them about our intent and our models
and to pretty much get the green light to go ahead and go. Since then we have a dedicated
site specialist who responds quickly to our needs, and then we modeled our site specialists
after the Arizona Department of Education. So it is very important to have a strong partner
state agency relationship. We have regular calls and e-mail communications going back
and forth; and in fact our relationship is so strong that they've asked us to participate
in joint community presentations for the At Risk Afterschool Program and also the Summer
Meal Program. And at the end of every season, they've asked us to participate in a debrief
to talk about lessons learned, and they want our input on how to improve the quality of
the program; and we take that as a good sign. They also offer multiple times a year very
strong trainings and technical assistance. So what this does is when we participate at
these trainings, then we in turn can train and be better coaches and guides to our sites
that we work with. So here with our Kids Café Program and our child nutrition programs,
our vision is to be able to offer multiple solutions for multiple time periods to ensure
that children receive adequate nutrition when it is the least available. So because of our
strong growth, we have been awarded by the State Department of Education here in Arizona
a Desert Oasis award for greatest growth. And that strong collaboration has allowed
us to and energized us to even grow further. So as we mentioned, our goal for this summer
is to offer 4,000 meals daily at about 80 sites. We look forward to collaborating and
growing our partnership with our county hospital network to six sites, serving about 300 meals
a day. And we're excited to be able to work with them and all of our sites to ensure that
they're at as a high capacity, serving as many children as possible, and reducing as
much food waste as possible. Because of our tremendous growth, in collaboration with our
State Department of Education, we're able to introduce new feeding models, including
a hot meal model which you'll see in the picture. We showed you the cold meal model, and this
is a new hot meal pilot that we're reaching out to as well. And because of the great partnership
we have with our State Department of Education, we're able to expand our other programs to
our sites as well. So we have a Weekend Backpack Program that provides three to five meals
and snacks to children in our high-need areas around the Valley. We also expand our Mobile
Pantry, providing fresh produce to families in need at our sites. And then we also encourage
our sites to offer SNAP outreach, SNAP being the Supplemental Nutrition Assistance Program
or the Food Stamp Program. So because of the great partnership and not having to stress
so much about applications or site visits and really harboring on technical assistance,
we're able to deepen our partnership and offer more programs with our existing sites. That
all leads us to really ensure that no child goes to bed hungry so that they can live healthy
and productive lives. So we love that we are able to collaborate with as many sites as
we can in the Phoenix Metropolitan Area and especially in our health centers. We really
can't do it without them. Thank you so much for your attention. Thanks for that, David;
we really appreciate your time for the presentation as well as Terra. So next we're going to go
on to our next presenter, which is the El Mirage Health Center. Thank you and good morning,
and we appreciate this opportunity to share our experience with this wonderful program.
The El Mirage Family Health Center is part of the Maricopa Integrated Health System,
which includes the Maricopa Medical Center and 11 family health centers. The mission
of MIHS is to serve as the health care safety net for Maricopa County and its citizens.
The Family Health Center is located in the Northwest Valley; we're about 33 miles from
the downtown central campus located in Phoenix. Our experience with the Kids Café, the summer
feeding program, started just about a year ago. I was asked by our MIHS leaders if we
were interested in participating in the Kids Café. I learned that this was administered
by the St. Mary's Food Bank Alliance. Having no experience with the programs, I learned
that this was a great opportunity to help those children that are in such need in our
community. It was an opportunity to provide free lunches to the children that come to
our center as well as that live in our community. In considering if we should take this on,
we discussed it; and Dr. Roy is going to share the perspectives which come from the clinician
viewpoint. Hello, this is Dr. Mason Roy. I am the Medical Director of the El Mirage Family
Health Center. I work very closely with Patricia Stradleigh. When Patricia initially approached
me with the idea of offering this in our clinic, which was probably about a year ago, we talked
about it; and then I decided to speak to the other providers in the clinic just to see
how they felt about the idea. The overall response was positive, and specifically we
came up with a few areas that we thought would be positive as an impact to our clinic. Obviously,
probably the most important thing is healthier food choices available during those times
when these children probably would not have that as an option. Additionally, the children
would be coming probably multiple days, if not every day, during the week; and this would
more than likely have them become more familiar with the clinic and be more likely to approach
us with any health concerns. And also these children are brought there by an adult caregiver
or relative, and that would be a possible driver to have those adults, who may not even
be our patients, seek out and come and see us with their own health concerns. Additionally,
we got some positive feedback from the community at large. The Fire Department has indicated
that a large number of their responses are to people who are directly impacted by diabetes,
and we know there's a very close link to that and nutritional choices. Additionally, the
local school nurses showed a lot of support for us possibly having this program available.
And even now, we are already having parents and their children coming into the clinic
and asking are we going to have the program again and, if so, when is it going to start.
In addition to those aspects, there are some obvious health impacts that are likely by
having this available. Obviously, the healthy food choices that are offered to the children
are going to be better than what they would have probably at home, and also this would
likely form to continue this modeling they have of what is a healthy diet. And of course
these kids do influence their parents, their relatives, who may also have health conditions
adversely affected by nutrition. And of course this does add to the idea that prevention
is going to be better than treatment. Poor nutrition, we know, does have several adverse
health outcomes: obesity, possible future diseases, heart disease, diabetes, and obviously
dental is an issue as well. There are quite a lot of issues surrounding childhood nutrition;
but one of the ideas that really struck me was that in the age range of 2 to 18, approximately
40% of the calories that these children get are from added sugars and fats. And that is
just obviously too high. And I'll turn it back over to Trish at this point. Well, it
wasn't long before we agreed that we absolutely had to jump at this opportunity to participate
in the Kids Café. So with that, we accepted this program; and within a short amount of
time, I received an e-mail as an introduction from the St. Mary's Food Bank staff. They
introduced themselves to me and let me know what my site leader responsibilities would
be. I started receiving information and documentation to review and return as needed. At that point,
I was told that we would need to be set up for eight trainings; and I needed to select
the key staff that would be the key players in participation. We do run a very busy health
center. We have four providers, and we have just enough staff to support them including
our MAs and our front office staff. So we looked at who we could best pull to do the
training and participate. And what we decided was the two RNs, me included -- we had more
flexibility than the MAs. We did have one MA that served as a phlebotomist, so we selected
her to participate. We selected one of our front office admin folks, as well as our EBS
who is our housekeeper and our security officer. So those key people with the most flexibility
on their lunch times were selected. And incidentally, most of them are bilingual since we have a
very heavy Hispanic population in our community. Next was a very, very important part; and
key to whether we could take on this program was the room selection. Well, we only have
one meeting room available; and it is off the front lobby, so it was ideal for this
program. So the room selection was done. We then set up, with the St. Mary's Food Bank
program staff, to come in and do our training. This took about an hour to do the training.
We learned about the hygiene of both the staff and those children coming in to participate,
learned about the need for them to wash their hands, to provide the hand sanitizer or access
to a restroom for them to wash with soap and water. We learned that we would need to provide
the gloves to have on as we served the meals and trash bags. We also needed to have a bowl
so that any child that didn't eat their fruit or perhaps the packaged food that they didn't
want to eat they would leave in a bowl that any other child who had eaten their lunch
could then take from that bowl, and the food would be shared and not wasted. They also
provided us with marketing fliers, which we filled out. We posted the times and the start
dates, and we got those distributed throughout our Family Health Center and throughout all
the exam rooms so as the parents were waiting, they could be reading about this and our staff
could be promoting it. As Dave mentioned earlier, we didn't have a refrigerator available to
store the lunches. So St. Mary's Food Bank arranged for delivery of a brand new, beautiful
refrigerator; and together at the site visit, we decided where that would best be positioned,
which was in our staff break room. And then we arranged for that to arrive and be set
up, ready to go. The next key date was the day before we started. We again met; we went
over what the plan would be for the food coordination. We knew that the drop off time for our lunches
would be at 7:00 a.m. I had our security officer prepared to meet the gentlemen, the volunteers
delivering the food. We arranged the table and the supplies. The room that we have is
used for many purposes; but a busy part of it is diabetes education. Since we have a
medical home with over 800 diabetics coming to our clinic, we had a lot of posters -- a
lot of them showing the foot ulcers and things that you really don't want to have up when
the little children are trying to come in to eat these lunches. So we adjusted what
education materials we had out and visible, and we also did a little simple decorating
-- went to Wal-Mart and got a little fish theme. It was a fish with little plastic tablecloths
and happy kind of colors to welcome the children so they weren't scared they were coming in
to see a clinic provider, but they were coming in to have a positive food experience. We
reviewed the work coverage schedules with the staff -- made sure we had the needs of
the clinic covered as well as we were ready for this program to be launched. And we continued
to remind all staff to promote this at every opportunity with our patients and families
coming in. Then the day arrived where we actually started the Kids Café. And here in the right
lower corner you see a photo, and that's our kids' waiting room. We're lucky enough to
have an area where we have a Reach Out and Read grant table that's been donated to us.
We have gently used books that any of the patients visiting our center are welcome to
sit down and read, and they're welcome to take them home as part of the Reach out and
Read program. So as the parents and the children arrive, we welcome them to come in and wait
in our kids' waiting area and read a book. And then we had our designated times; we started
at 11:30 a.m. and we ended at 1:30 p.m. And at that time, we were ready to go. We had
one staff assigned to the room to welcome the children, make sure they had washed their
hands and have them pick their chairs. And then we had a second staff to be the runner
because the meeting room is a little ways from where our refrigerator is. So we had
all positions covered, and our security officer was out front welcoming them and guiding them
to wherever the right place was for them to be. My site leader duties include to supervise
the program compliance. As we all know, in family health centers we have a lot of compliance
expectations. So this fit right in with how we work our day anyway. So it was a matter
of a few more forms that we filled out. We need to adjust the food order daily, and this
is probably the greater challenge because one day you might have a low number coming
in and then the next day they're there with additional friends and family and very hungry.
Of course here in Arizona we have tremendous weather challenges. We have temperatures that
go up to 120, and sometimes we have the summer monsoon storms that come through. So if it's
a heavy rain day, we wouldn't see as many children; but I will tell you that even the
hottest day of the year, the mom's will walk a mile or more with a group of little children
to get here so that they get their lunch. So we adjust the food orders accordingly.
We were always prepared for the inspector because we knew they would come in unannounced
to drop in and make sure we had everything on track. And then my responsibility was to
make sure that the daily meal count sheets were turned in. We had a weekly consolidated
meal count sheet that I would then send in on Friday. And of course we nurses know that
we always check the temperatures in the refrigerator, and we did this daily as well; and I would
send that temperature log in monthly to St. Mary's Food Bank. Lessons learned from this
are number one, room availability is key. Now we are fortunate to have other partners
coming in and using this room; and another partner, again, is the St. Mary's Food Bank
snack employee who is now coming in and offering Food Stamp enrollment in that room. We also
have the WIC staff from the State of Arizona coming in, so I'm needing to really coordinate
times with them so that we have this room ready at lunch for the children to be fed.
We have to also train for backup staff coverage. This is our summer vacation time; so we have
to make sure that when we get the training done that we have the backup staffing plan
in place, to make sure that everyone understands the program compliance responsibilities. As
we got busier through the summer, we started having more and more volume; and maybe one
mom would walk in with six little ones. And they would all want to be there right at 11:30
a.m. to get the first seats. So we had to start coordinating with the regular participants
to ask some of the moms, "Can you kind of stagger out your time of arrival?" so the
children weren't getting into a bottleneck and backed up and getting a little impatient
in our lobby there. So that worked out fine; we just coordinated the times of the bigger
group arrivals. Market, market, market -- now that I know I'm participating again this summer,
then I am going to be getting the flier out to the school nurses. There's a local school
crossing guard who's one of our patients, and she's offered to pass out the fliers as
she's helping the parents and the children across the street. We'll be going to the local
city newspaper where we get free advertising. We're going to have a little article about
the program in there. And again, the school nurses are the biggest advocates. The four
schools right around our health center will all get fliers, so I have no doubt it's going
to be a very busy summer with this program. And going forward, we absolutely look ahead
to another successful summer feeding program as we once again join the St. Mary's Food
Bank Alliance for this summer's Kids Café. Thanks for your presentations, Dr. Roy and
Patricia. We really appreciate it. Lastly, we're going to move on to hear from Christine
Binder from WhyHunger before we move on to our open forum. Thank you so much. Thanks,
everyone, for listening today. I just wanted to introduce you to WhyHunger a little bit.
You can read our mission here. We're an anti-hunger organization that was founded in 1975 by the
late musician Harry Chapin. We are a grassroots support organization and a capacity building
organization, which means that we work with emergency food providers; we're not a direct
service provider ourselves. We work with EFPs, urban gardening groups, farmers, and an increasingly
broad variety of stakeholders. The National Hunger Clearinghouse is one of our programs
here, and the National Hunger Hotline is one of the things that the National Hunger Clearinghouse
does. The hotline has been in existence for15 years, and it's funded in part by the USDA.
What we do on the hotline is refer people in need of emergency food assistance to food
pantries, government programs, Meals on Wheels and other referrals. It has live operators,
and it's free and confidential service that's operated from 9:00 a.m. to 6:00 p.m., Monday
through Friday -- and that's Eastern Standard Time. It's a year-round program, so not just
for summer feeding but for the entire year. If people call us during off hours, we actually
answer their messages and get back to them with the information they need. And we also
are able to collect data, so we know a little bit more about who our callers are, where
they're calling from, what referrals we give, and where they learn about the hotline. So
basically that allows us to be a little bit more intuitive and to respond to any needs
that the community has. So for the past few summers, we've been doing a real big push
for the Summer Food Service Program. Between 2011 and 2012, so that was last summer, we
saw a 260% increase in summer calls. So on the left-hand side, you'll see our year-round
poster; and on the right-hand side, you'll see this year Summer Food Rocks poster with
both our phone number and or website on it. We maintain an online database where you can
also find information about not just summer feeding sites but other emergency food providers.
And here I just wanted to bring up that we are a bilingual hotline. We have bilingual
operators. You can also put these posters up. I believe they are available for download
in the Handouts section; and if not there, you can find them on the Outreach page -- either
our Outreach page or FNS Outreach page. And if you go to our website -- and I'll give
you the link later in this little presentation -- but you can download web banners and also
some PDAs to do some outreach with. So if someone were to call our hotline, we would
give them answers to where they can go to get a summer meal. But if somebody were to
come to our website and click on the Find Food section, this is what they would see.
It's a really powerful tool. We have mapping capabilities, and right now we are collecting
information for open summer feeding sites. Last year we quadrupled our record of summer
feeding sites and had over 18,000 sites in the database; and this year we're hoping to
get even more. So on the left-hand side, you'll see that there is information on how to call
the hotline and then the Search function in the middle. And then if you were to search
for something, this is what would come up. You would scroll down and see many more sites
where someone could get a meal.m And I just wanted to bring up that if you do in fact
open a summer feeding site at your location, we'd love to hear about it. So you can either
register your site with us; give us a call if you have any questions. You can register
them on this website at Find Food; or we have an Excel template, and you can e-mail that
to us. That's located on the FNS SFP Outreach page, and the link for that will be later
in the presentation. And just make sure you give us full information about the name of
the site, the location, hours, dates, contact info. Another resource that the National Hunger
Clearinghouse provides is the Clearinghouse Connection. This is our monthly eNewsletter.
We have 3,500 subscribers on there right now; and you'll find information on not just the
Summer Food Service Program but other nutrition programs -- information for emergency food
providers or about emergency food providers. We look at best practices and try to publicize
those. There is lots of information on funding, news, various resources. And we have a real
emphasis on nutrition and health and food justice. So we're looking at systems-based
approaches to addressing hunger and poverty. I think it's really interesting, and you can
e-mail us to sign up if you'd like to get the monthly eNewsletter. And I also wanted
to bring to your attention Cooking Up Community, which is an 88-page guide that we've written
for nutrition education and emergency food programs. And this may be of interest if you're
thinking about incorporating a nutrition education component into any of your programming; but
there's some stuff on working with children in there. It might be a good resource for
you if you wanted to do that this summer. You can download that on our website. And
then here is just my summary page with all the important info that I spoke to you about
before. You have the phone number for the National Hunger Hotline: 866-3-HUNGRY AND
877-8-HOMBRE. Our outreach materials are available at www.whyhunger.org/outreach; so that's another
place where you can find posters, web banners and PSAs. You can register a single open site
directly into our database; or if you have multiple open sites, you can download the
Excel template and then e-mail that to us. We'll make sure that that gets into our database
so we can refer callers to your summer feeding sites. And if you have any volunteer opportunities
-- if you're looking for someone to help you with your site -- we recommend that you register
those volunteer opportunities at www.serve.gov. It's a great way to find volunteers. Thanks,
everyone, for listening. Feel free to reach out to me via e-mail or via the hotline phone
number if you have any questions. We're happy to help everyone this summer get the word
out about summer feeding. Thank you for that, Christina. We really appreciate your presentation.
And now we're going to move on to the exciting part of the webinar, which is the Q&A session.
So if anybody has any questions, again, remember at the top of your screen there's the Q&A
tab. You can type your questions into there, and I'll try to field the questions on the
floor; and we'll see if the presenters, who are subject matter experts from FNS, can answer
your questions. And I'm going to toss out a few questions for the presenters and allow
you to listen to them talk about their experiences with SFSP so you can hear firsthand from the
people who have their hands into the program about how it works, and hopefully they can
encourage you to participate in the program if you're not already participating. So my
first question is for Dr. Roy. Whenever I see "DO," Doctor of Osteopathic Medicine,
I just get really excited because I know you approach medicine from a different perspective
that's really unique, I guess, relative to just a doctor of medicine. So can you speak
to the value of the Summer Food Service Program from the perspective that you practice medicine
and what it means to you and what you think the value it can offer to children as well
as to the HRSA centers and sites that are not participating in the Summer Food Service
Program right now? Yes, I'll be happy to address that question. Well first of all, let me just
say in general that the training that an osteopathic physician receives is very much equivalent
and then some to what you would typically consider an allopathic or an MD physician.
I think probably the biggest difference is that really our training is we are encouraged
to look at the person as a whole and not just look at an individual disease or an individual
illness. It's to look at the total health of that patient. And this summer feeding program
is a perfect example of that because we're not just looking at, oh well, this child maybe
isn't getting enough food or the correct type of food today; we're looking at the future
and how this child is going to develop and hopefully preventing possible illnesses down
the road. And that's probably the most succinct way I can answer that question. Okay, thank
you. And that's what we're really trying to do with the webinar; we're trying to articulate
that the nutrition and the health piece really go hand-in-hand. So I appreciate your comments
on that. My next question is for both El Mirage and St. Mary's Food Bank. If you can just
speak to the relationship you have as a site and sponsor and the importance of readily
communicating with each other, how your relationship started, and your experiences overall just
in coordinating everything from training --- if you can just broadly speak to that. Sure,
this is David. I can start it off. In my role as a Community Outreach Manager, I outreach
to some of the administrators of Maricopa Integrated Health System to then broaden their
scope and broaden the family health centers. So we got investment by the Chief Medical
Officer and other top administrators. And then from that point, we assigned a site specialist
to each of the sites. And our site specialist usually sends out an introductory e-mail or
phone call and says, "I'll be working at your site. We'd like to go out and do a pre-operative
visit; specifically look at the site and see what your needs are and share the menu, determine
if there's a cooler need, look at the space where the program will be held." And then
that site specialist is in contact with the designee at the El Mirage Center. And that's
then me -- when I had told my leaders that, yes, we wanted to participate; within a day,
I started receiving communications from St. Mary's Food Bank. And they literally led me
through the process: what to expect, what my responsibilities were. They talked me through
so that I wasn't feeling "out there" and not going to be ready for this. So I felt very
comfortable, and I understood what I had taken on here; and therefore I could then go and
talk this up to the staff and start preparing for it. And if I ever had a question -- and
I did -- I had a lot of questions initially. How many meals should I order or I need a
refrigerator, they were there. There was one contact on the e-mail; he was the point of
the e-mails that I always sent questions, and he always answered within the same day
or by the next day. There was never, ever a sense that I was out there alone and what
had I gotten myself into. They were there with me, walking through this with me as we
prepared. And then once the program was up and running, the daily food adjustments -- immediately
they would respond if I needed to cut back because I was having some extra or we were
running out -- I needed more tomorrow -- they were they, they responded. So we truly were
walking this together through the summer. Thanks for that, Trisha. I appreciate your
explanation. My next question is also for you, Trish, if you can speak to the importance
of the activities at your site. As I mentioned in my presentation, food is just one aspect
of the Summer Food Service Program. We're also aiming to enrich the kids' experience
over the summer from a physical and a mental health standpoint as well -- if you can kind
of speak to that briefly. Well, in our kids' area, as was in that little photo, we have
this wonderful program that we participate in -- the Reach Out and Read program. And
the goal of Reach Out and Read is for the parents to learn the importance of reading
to their children, and our providers participate in that as their children come in for their
well-child visit. Also part of the program is we get a little children's reading table
and a bookcase, and we get gently-used books that are placed out in the lobby. And any
child who comes in is welcome to sit at that table, to pick a book or books to look at;
and they're welcome to take a book home with them. We also have a bulletin board that's
on the wall that also encourages reading, and this is also bilingual. So parents are
drawn over to this area because the children now have something to do, and the parents
can relax a bit while they're waiting. Also parents have this very eye-catching bulletin
board that hopefully draws them in to go over and look to see what activities they can do
of reading to the children. So as they come in, they're part of that. And also we have
the education posters in the room that they're eating in, and there is a bulletin board there
that's really focused for children to discourage them from smoking -- the ASHLine Program.
So this bulletin board has a little child standing there like at a fast food market,
and he's standing on his toes trying to look up at some cigarettes that are in the case.
And again, it's bilingual; and it's trying to teach them why they should not be smoking.
And there are some pictures there that I do leave up. They show the changes in the lungs
from smoking; but it's also to catch the attention of the parents to also get up, look at that,
and learn why their child should not smoke. Also in the meeting room, we have all types
of diabetes literature out there. We are in a community that is so saturated with diabetes
from the grandparents to the child. The school nurses have insulin for their Type 2 diabetics
as early as the second grade they tell us. So we use this opportunity. We have pediatric
focus, diabetes education, as well as the parents or the grandparent -- whoever brings
the children in. So this is a grand opportunity to educate them about healthy lifestyles and
also what the end result is of not living a healthy lifestyle. And as they're sitting
there eating their healthy meals, they can really see -- again, as Dr. Roy said -- the
model of what a healthy meal should be. Thanks for that answer, Trish. Right now, there are
a couple of questions that have come in via the Q&A tab. So I'm going to read them off
so everyone can hear them, as well as give the answers. So the first question that came
in was: "As a site, if a sponsor sends 50 meals and you only have 40 people coming to
eat, what has to be done with the extra meals? Are they brought back to the sponsor, or are
they thrown away? What is the correct procedure for this matter?" So the answer for that one
is depends on the meals and your site's ability to store the meals. You can work with your
sponsor to determine the food waste precautions you'll take. So again, it comes back to that
sponsor/site relationship that you establish and the importance of that. Trish and David
and Terra, do you have any comments on that? This is Trish. Per the policy of the program,
we would account for the unused meals daily; and then we would have then packaged up in
the container ready for pickup in the morning when the volunteers brought out the next day's
delivery. So that food was accounted for and returned back to St. Mary's Food Bank. Hi,
this is Terra. The benefit of working for a food bank is that when we pick up those
unused meals, they go right back out into the community as part of our emergency food
boxes. With our hot meals, if there are any left over we do not do that with hot meals
because we don't have a way to pick them up and reheat them and send them back out. So
at the end of the day if we see a family or kids, we send them home with whoever is there;
and we haven't had anybody refuse them. This is David from St. Mary's Food Bank. Some of
our sites have done great things like Trisha does and set up a shared bowl or a shared
table to try to alleviate as much waste and bring back as possible. So if a kid does not
want to eat his orange or whatnot, they can put it in that bowl that's set up or on a
table that's set up so any other kid that is there and wants an extra orange or whatever
the food item is, they can go and get that extra one and perhaps bring it home. I wanted
to comment also, as our program got more popular last summer, some of the older teenager boys
initially were shy about coming in to get a free lunch. But as the siblings were doing
so well, they started showing up; and these were some of the sophomore high school football
players. So they would have their lunch meal and they would wait; and if there was any
left over, then we would serve them the second round because they could go through a lot
of food as we know. So often, the meals would be served to these older boys; and they really,
really appreciated it. They were very hungry. One of the things that one of our counterparts
does, especially with the older kids because it's harder to get them to come to the program
-- sometimes the open feeding sites -- is they were texting. If a couple of teenagers
came and saw that the food was great, they would text their friends; and then before
you know it, there were lots of teenagers coming to eat. So we thought that was a great,
innovative idea. They are more shy because they're sitting there with the little children. So you have to be sensitive
to the older kids. These in particular were boys. You could tell they were kind of embarrassed,
but you know what? One or two days later they were back, and they lost their embarrassment
and became very comfortable and very appreciative of this food opportunity. Thanks for that.
It's really great to hear you all kind of go back and forth with the way that you approach
these questions that our attendees have. Another question that was presented -- this person
said: "I'm a dietician at a federally-qualified health center located in a low-income community.
I also work with the School Board Office of Sponsors at SFSP. The sponsor is one mile
away from the clinic. Would you encourage our FQHC clinic to consider becoming a site?
We offer a childhood obesity camp during the summer, so we would have a captive audience
already." So our answer to that is, "Of course." It's just a matter of you contacting the sponsor
or the state to get things started. And a key feature of your question is the fact that
you have the childhood obesity program; so as we mentioned, the importance of having
activities to keep the children engaged just beyond the food -- so that part is already
taken care of for you. So it sounds like you would be a great candidate for SFSP, and we
hope that you can get it started at your site. Another question that we received said: "Does
anyone feed parents as well during the program?" The answer to that one, a lot of our programs
feed parents through non-SFSP sources of funding. Some sites even charge the adults a small
fee to cover the cost of the meal, and the parents are more than happy to pay that in
order to join their children in eating the meal. So there are a variety of different
ways that you can approach that. But again, Trish, David and Terra, have you experienced
that scenario during your administration of the program before? This is David. Our model
isn't geared to accept payment for our meals. It's specifically for children 18 and under,
and we haven't really encountered a situation where that was too much of an issue. That's
why we're also glad to be able to expand our other programs that do target more of the
family. So our SNAP Food Stamp outreach, incorporating our Mobile Pantry to provide fresh produce
for the families. So offering those other food bank programs helps to address that issue
if it does arrive. And at our site, we did not experience any of the parents asking also
to be fed. I think because we explained to them and the fliers that had been provided
by St. Mary's made it very clear what the ages were. So we didn't have, in our experience,
an issue with parents wanting to eat -- or at least asking if they too could be fed.
Okay, thank you for your responses. I'm going to read off one more question, and then I
think we'll wrap it up for today. In the meantime, I'm reading off some of the questions that
are coming in. I just had two that came in. So I'll throw out another question for the
floor to respond to: "Can you speak to what SFSP means to your community and also the
ability to address any food healthy initiatives or obesity that you already have going on
through your clinics?" Can you speak to that -- anyone feel free to hop on that one? Well,
this is Trish again. We have a high focus on diabetes at our health site. We're a medical
home, and diabetes is our number one chronic disease that we are battling. And we have
over 800 diabetics in our panel. Also my other experience is I go over at times around the
corner to the senior center, and we do free blood pressures over there. And just about
every senior that's there is a diabetic. And of course in the Hispanic culture, the parents
and all generations generally live together. So you know what the grandparents or the parents
are experiencing will be a matter of time that the children are also dealing with the
same diseases due to the nutrition issues. So the opportunity to offer balanced meals
-- it's just wonderful. If this wasn't available to these children, they would probably be
eating Cheetos or tortillas with beans and cheese, which are healthy -- but if you have
the wrong amount and that's all you're getting, then it's going to lead to issues later on.
So it's just such a wonderful opportunity to bring healthy lifestyles and role modeling
to the community. And the great response we've had and the growth that we've had to the program
over the growth of the summer, I know it's just going to continue to bring good things
to our population in this community. And, Tony, I'll just add this is especially the
case for MIHS here in Phoenix; but I know that a lot of community health centers are
really the health care safety net for citizens and our neighbors. And the health centers
serve so many different races and nationalities from very different, diverse cultures and
speak different languages; and a lot of our neighbors are facing really, really difficult
challenges -- like the lack of health insurance, really complex medical problems and really
difficult socioeconomic situations. So we're really proud to be able to address these high-need
communities by our collaborating with community health centers. Thanks so much, Trish. And
we want to thank you again for your attendance on today's webinar. It means so much to us
-- your willingness to sit in and attend and learn more about such an important program
as the Summer Food Service Program. Again, this webinar will be available online at www.summerfood.usda.gov
in about a week or two. And again, if you have any questions, feel free to reach out
to us. Thank you so much to our presenters -- Trish and Dr. Mason Roy from El Mirage
Family Health Center. Thanks again to David and Terra from the St. Mary's Food Bank, as
well as Christine Binder from WhyHunger. You all really are a great group. You're all SFSP
all stars in my book, and you've really added a lot of value to the webinar. So we thank
you for your attendance, and we hope that you all can rock the Summer Food Service Program
for 2013. So thanks. Again, if you need any information, feel free to reach out to us.
I wish you well. Have a good afternoon.