We are excited to announce the outcomes from an innovative pilot project to improve food security in the Bronx. Access to healthy food and nutrition is one of the key social determinants of health.
In the Bronx, nearly one in every five New Yorkers is food insecure and at risk for poor health outcomes.
Last year, Public Health Solutions began a project to improve those health outcomes. Over a 10-month period beginning in November 2018, the Food and Nutrition Services Bundle supported 871 food-insecure families with nearly 60 percent of participants screened being enrolled in one or more social services.
About the Food and Nutrition Services Bundle
Together with our partners NYC Health + Hospitals through the Jacobi and Lincoln Hospitals, God’s Love We Deliver, BronxWorks, the Food Bank for New York City, Healthfirst, and Unite Us and with support from One City Health Performing Provider System Innovation Award, we launched the Food and Nutrition Services Bundle (FNS Bundle). It offered screening and navigation services to community food and nutrition resources for food insecure patients at two public hospitals in the Bronx.
The Challenge
Community-based services and resources already exist to improve food security in the Bronx, but they are often fragmented, uncoordinated, or involve complex eligibility requirements. Many providers are unsure about where to refer their food insecure patients, resulting in improper referrals, unsuccessful outcomes, and frustration for both patients and community referral partners.
Our Solution
The FNS Bundle reduces that administrative burden on those in need and healthcare workers to access services. It connects community-based food and nutrition services to critical healthcare and community access points, like public hospital lobbies.
The FNS Bundle includes all the available options in the community and increases the likelihood of a successful connection based on needs, eligibility, and preferences. In the Bronx this included:
- Supplemental Nutrition Assistance Program (SNAP)
- Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
- Medically tailored home-delivered meals
- Food pantries
- Congregate meals
- Individual and group nutrition counseling
- Sources of fresh produce
It’s all powered by an electronic platform, engineered by Unite Us, that enables network partners across multiple health and social services to share information and coordinate care for participants.
Results: Improved Food Security in the Bronx
Through the FNS Bundle, we were able to reach vulnerable populations in the Bronx, help address food insecurity, and improve health outcomes. Of those who participated:
- 37% were older adults
- 76% were on Medicaid or Medicare
- 14% were uninsured
- 21% were pregnant or new parents
The FNS Bundle was also effective in connecting participants to multiple resources through just one encounter. We screened 1,713 participants, 1,598 of whom provided consent and completed the full assessment. These participants then went on to receive 2,199 referrals:
- 86% of referrals made to the network had a documented outcome
- 57% of referrals resulted in enrollment in food and nutrition services
Those in need of emergency food services, like food pantries or soup kitchens, also had increased access. The proportion of participants in need of emergency food resources and who were able to actually access those resources rose from 6% to 56%.
Finally, the FNS Bundle was cost-effective for participants. Although it’s still early, enrollment outcomes suggest a positive healthcare savings return on investment, with an estimated average savings of $625 per participant relative to an estimated cost of $375 per participant in the project.
What’s Next?
The goal of this pilot project was to refine and replicate the Food and Nutrition Services Bundle in other food insecure areas in New York City and beyond.
“When more families achieve food security, we see better health outcomes, decreased health disparities, and major health care cost-savings – in short, improved public health.”
— Lisa David, President & CEO of PHS
With continued support from OneCity Health, PHS has expanded both the scale and scope of the Food and Nutrition Services Bundle: starting in January 2020, our Food Security Specialists will be present in more Bronx locations as well as in the three Health+ Hospitals sites in Manhattan. In addition, the range of partners and services has increased, with the inclusion of diabetes management, in partnership with the hospitals and the Diabetes Self-Management Program run by Health People, and City Meals on Wheels Home-Delivered Meals offered by Lenox Hill, RAIN, Inc., and Neighborhood SHOPP.
While the initial project was successful, there’s still work to be done and improvements to be made as we work toward eradicating food insecurity and developing future community resource networks. The FNS Bundle was a big step in the right direction for the Bronx, and we’re hoping to expand its services and reach in 2020.