Vermont Legislature SmartTranscripts:

[Emily Perry]: In our region, regardless of their ability to pay. As a rural health provider, Little Rivers recognizes that food insecurity and limited access to healthy, locally grown food are significant drivers of poor health outcomes. Addressing these challenges is central to our work and our commitment to health equity. We are dedicated to adopting food as medicine into our practice. Food as medicine encompasses a range of clinically informed nutrition interventions, such as medically tailored meals, medically tailored groceries, and produce prescriptions designed to address diet related health conditions. These programs integrate nutrition directly into health care delivery to improve outcomes and reduce health care costs. The food pharmacy program that I run at Little River started prior to COVID when one of our physicians recognized that many of her patients were facing barriers that prevented them from being able to access enough food to meet their basic dietary needs. Knowing that their health was significantly affected by this, forged a partnership with Willing Hands, a gleaning organization out of Norwich, Vermont, and started squeezing in slots to her very busy and demanding work schedule to pick up as much fresh vegetables as she could fit in her car and delivering them to patients. She saw what her patients needed for their health, and she creatively found a way to do something about it. But she also knew that it wasn't a sustainable means to address the needs of her patients and knew that so many other Little Rivers patients were struggling with the same unmet need. The story of a physician who I personally greatly admire is one that is uplifting, and it has led to, all these years later, to the food pharmacy we now run, where we are distributing over 1,000 pounds of produce each week, as well as shelf stable items and working with over 100 patients to address the chronic conditions they are facing through dietary changes. This story also gives us a glimpse at some of the many hidden costs that come along with food insecurity and the potential long term cost saving benefits to building a food secure state. I want to say thank you for your clear commitment to the Vermonters Feeding Vermonters. This program is one that truly aligns my values and identity, which have been formed in relation to Vermont as an agricultural state. It is also incredibly important to the many health care organizations like Little Rivers Health Care doing food as medicine work in growing numbers across the state. In establishing the Vermonters Feeding Vermonters program, you have taken a stance for food security in our state in a way that honors our agricultural identity and our need to support our farmers so they can remain economically viable and thrive now and into our future. I know that supporting our local farmers is an essential aspect of food security. Appropriating the additional funds that are needed to support and sustain this program is necessary for it to have the chance to do what it is intended to do. This state investment would create revenue for 200 to 300 Vermont farms and provide fresh local food for our communities. In addition, it would allow the Vermont Food Bank to offer grants to network partners like Little Rivers Healthcare, allowing them the ability to purchase from local and smaller scale farms within our communities. This helps to build lasting relationships and strengthens the collaborative network of all of us doing food security work in our state. We are dedicated to working with our local farms, and grants like these make possible for us to do so. Even with full support for Three Squares Vermont, there is still a gap in food for in food security for our communities across the state. I see these gaps and the impacts they have on the patients I work with every day. I see it in patients who are single mothers and have SNAP benefits that do not cover the cost of the food they need to feed their children. I see it in patients who are working two jobs and make too much for SNAP benefits but are faced with rising medical expenses and other expenses associated to the chronic conditions they are living with. Individuals are struggling to buy the food they need to address the health conditions that they are experiencing, and that, in turn, is costing them more money in medical bills. In this system, it is not only costing our patients, it is costing Vermont's health care system. And investing in these programs through the Vermont Food Bank will decrease the long term associated and widespread cost of food insecurity in our state. Through our partnership with the food bank, we not only have access to free produce and healthy, shelf stable options for purchase, we also have access to essential trainings on subjects such as food safety, we gain access to grant opportunities that we rely on to continue the work we are doing, and we become part of the network that they have created and to sustain across the state. Little Rivers Health Care is just one of hundreds of partners whose programming and efforts are dependent on the work that the food bank does. Along with SNAP, they are the foundation for food security work in our state, so that so many of us rely on as the first line of defense for the patients, individuals and communities that we are working to serve. The food pharmacy uses two measures for enrollment. Our patients are screened for food insecurity using the nationally recognized hunger as a vital sign tool. They are then connected to our care coordination team so that they can talk to them about resources that might be available to them, such as SNAPWIC or their local food shelves, often supported in great part by the Vermont Food Bank, which are the state's first line of defense in addressing hunger and food security. They are additionally screened for certain chronic conditions, which have been the focus of food as medicine initiatives, such as diabetes, hypertension, and heart disease. We know the list of diet related health conditions is much more encompassing, however, and we continue to work towards growing our food pharmacies so we can help more people to improve their health through diet. At Little Rivers, we are showing upwards of eight percent of people screening positive for food insecurity, and seventy five percent of our patients have at least one chronic disease diagnosis. Among the many different aspects of my job, I get to be the boots on the ground delivering food to our patients and working with them to help them improve their diet and, in turn, their health. I get to see patients every week and greet them with big, beautiful boxes of fresh fruits and vegetables, local milk and eggs, and other shelf stable items. We have set up in house food shelves at all of our clinics because our front desk staff are inundated with patients coming to appointments who do not have enough food at home for themselves and their families. This work is made possible by Vermont Food Bank. I am so grateful and blessed to have a profession that I'm passionate about, and getting to hand out nutritious food to those in need is incredibly rewarding for me. Yet being the people on Brown also means that I see the harsh reality that our patients are facing every day. I have to accept knowing that while we are helping to support them getting the food they need to maintain their health, it is not enough. As we work collaboratively with health care partners across the state and in New Hampshire that are building food as medicine programs, we see an important distinction between food access work and food as medicine work. Food as medicine is specifically working to address chronic conditions and disease through medically tailored dietary interventions, while SNAP and organizations like the Vermont Food Bank are leading the way in food access. I'm here today to tell you that every single food is medicine initiative across the state and country needs these organizations to take on food access so that health care organizations like Little Rivers can work with our patients to improve the quality of their diet. Together, I know that we can reach our shared goal of food security. We can drastically improve the health of our Vermont communities, and we can contribute to the economic viability of our farms in doing so. Little Rivers was awarded a subgrant through Bi State Primary Care Association, which focused on addressing health disparities related to the leading causes of avoidable death in rural areas, with diet being one of them. In Vermont, the Department of Health has acknowledged and promoted the three-four-fifty model, which outlines the three behaviors that lead to the four major illnesses, which leads to fifty percent of deaths in Vermont. Diet is one of those behaviors, and half of American adults have one or more preventable chronic disease related to poor quality eating patterns. Through this knowledge and through this initial grant funding, we have been able to build and grow our food pharmacy, and we are continuing to do so with partnerships through the Vermont Department of Health, department Dartmouth College, Center for Advancing Rural Health Equity, Bi State and others. I am asking that the committee appropriate $5,000,000 to Vermont Food Bank for fiscal year 2027, as they have requested. Allocating funds for these reasons will not only ensure that our neighbors are fed, it will allow food as medicine programs like our food pharmacy to succeed and achieve the approved clinical measures through diet intervention that we are working towards. It would allow us to continue to support our farmers. I spent the majority of my earlier professional life working at farms in Vermont as well as Hawaii and have worked in agricultural education and programming before coming to my job at Little Rivers. And it is so important to me that I'm able to support the farmers that feed us all in our state as part of the work that I do today. We cannot have food security without farm security, and the Vermonters Feeding Vermonters program addresses both of these needs. Thank you sincerely for taking this time and for allowing me to speak to you all about these issues that matter so much to me and the individuals that I work with.

[Committee Chair (House, Unknown)]: Thank you. Since we didn't have the camera rolling and recording started, can you just say your name for the record?

[Emily Perry]: Yeah. Emily Perry from Bradford, Vermont. Yeah. Thank you.

[Committee Chair (House, Unknown)]: We had Interesting because this wasn't planned, but we had just heard a little bit about the food and medicine concept, and representative Bos-Londe had mentioned speaking to somebody somewhere at the CSL conference. So very, very timely. Thank you. Thank you, And if you haven't already, could you make sure that we have your written testimony? Absolutely. Thank you. And we'll file that. I'm going to suggest, and Hilary, I know you have your hands full, we need to be on the floor in two minutes, unfortunately. Have you back so that we give you all the time that you deserve and figure out when that might be. If you would rather just say your name now, I wanna impose on you and have to come back if you don't want to, but I want to give you that option anyways. Well,

[Unidentified witness]: let's see. I mean, I did submit my testimony in written form, so you folks are welcome to read it. Also, it's easy for me to zoom in at another time if that that becomes available.

[Committee Chair (House, Unknown)]: Okay. We'll we'll make it available. And I think that it would be helpful for the committee. It it would have been helpful to do it now, but I we're not at full force, and somebody will come looking for us shortly if we're not where we're supposed to be next, which could be awkward. So I apologize.

[Unidentified witness]: I understand.

[Committee Chair (House, Unknown)]: Appreciate your understanding. We'll we'll be in touch.

[Unidentified witness]: Okay. Sounds good.

[Committee Chair (House, Unknown)]: Thank you. Alright. So let's head downstairs

[Emily Perry]: and