Marydale DeBor, founder and managing director of Fresh Advantage®, assists hospitals and other health care institutions to transform their food service and community benefit programs. DeBor is also a lecturer in the School of Medicine at Yale University. 

How did nonprofit hospitals get into the business of addressing food insecurity?
The community benefit requirement, created in 1969, requires nonprofit hospitals to participate in activities and initiatives to improve the health and well-being of the local communities they serve in order to maintain their nonprofit status.

The Affordable Care Act strengthened the requirement to include completing a “Community Health Needs Assessment (CHNA)” for hospitals, in collaboration with public health experts and community representatives, to identify significant health challenges in need of interventions. Per IRS regulations, nonprofit hospitals must take steps to address these issues and evaluate their progress. The strengthened requirement made it clear that community benefit activities extend beyond charitable clinical care to include things like “access to adequate nutrition” and other social determinants of illness.

A majority of CHNAs conducted by nonprofit hospitals over the past five years identified obesity and other diet-related diseases emanating from food insecurity and poor diet as priority needs.

These assessments can provide opportunities for nonprofit hospitals to partner with the U.S. Department of Agriculture (USDA) Summer Food Service Program and other federally funded nutrition programs to address the priority needs.

How can nonprofit hospitals provide free meals to children who need them during the summer?
Hospitals can help close the summer hunger gap by participating in the Summer Food Service Program, which provides funding to serve nutritious meals to children and teens during the summer months when millions lose access to school meals.

Free healthy meals can be served in hospital clinics and cafeterias to children visiting the hospital for appointments or when they accompany family members being cared for as patients. Additionally, the sites can be “open,” thus allowing children in the community to receive a free meal. Furthermore, hospitals can work with the community to bring summer meals to additional sites like recreation centers or parks. These programs also can alleviate obesity and support chronic disease prevention through nutritious meals and physical, recreational, educational, and enrichment activities.

When hospitals participate in the Summer Food Service Program, they engage with their community in new ways and improve child health and well-being.

How can anti-hunger organizations and advocates reach out to nonprofit hospitals about participating in the Summer Food Service Program?
To begin the process of partnering with nonprofit hospitals, check your local hospital’s website to find its CHNA, which must be publicly posted. It can usually be found by using the search function on the main page of a hospital’s website or under the “About” section. The CHNA and the community health implementation plan will enable you to see if a hospital is already participating in anti-hunger or food access efforts and how well they are doing.

Many hospitals list a contact for the hospital’s community health improvement efforts, including their anti-hunger work. If a hospital does not already participate in anti-hunger work, the anti-hunger organizations should reach out to the contact to share information on the child food insecurity rates in the community, and offer information on how the hospital can get involved in the Summer Food Service Program.

Is there an example of a nonprofit hospital that has included the Summer Food Service Program in their community needs assessment?
Hillsboro Area Hospital in Illinois decided to provide summer meals and activities after identifying a summer nutrition gap through its Community Health Needs Assessment (pdf). The meals are prepared in the hospital kitchen by its food service staff and then served to children in the hospital cafeteria. To learn more about the Hillsboro Area Hospital’s summer meals program, check out this short video.

How can hospitals promote the Summer Meal Programs?
Hospitals can inform the community about where children can access summer meals through their website, social media, and press releases. They also can hang flyers and talk to patients. Communication strategies could reach beyond the hospital’s walls to include federally qualified health centers, WIC clinics, and local food banks.

What are other ways hospitals can fight food security?
Hospitals also may be able to operate the Afterschool Meal Program during the school year. Read more about afterschool meals (pdf). Additionally, the Public Health Institute, with members of the Nutrition and Obesity Policy Research Evaluation Network, created a guide(pdf) for hospitals to work with local food systems.