The South Central NY Fruit and Vegetable Prescription (FVRx) Program is a project of the Rural Health Network of South Central New York (RHNSCNY) and made possible, in part, with funding from Care Compass Network. The program was launched as a pilot in 2017 with two primary care offices in Broome County and is continuing to expand, involving 12 sites across Broome, Tioga, and Delaware counties in 2019. To date, 309 individuals have participated in the program, impacting an additional 584 household members.
The FVRx program allows health care providers in the community to write prescriptions for fresh fruits and vegetables. Participants in the program receive vouchers to spend at local farmers’ markets, farm stands, and other retail options – giving additional purchasing power to people who need it most. Participants receive support and education throughout the program, and can attend additional nutrition, cooking, gardening, and chronic disease self-management classes.
“The goal of the program is to provide a strategy for providers, defined broadly as a physician, nurse, dietitian, or someone within the healthcare setting, and community partners to have real impact on food insecurity and how it relates to diet-related chronic diseases,” shares Erin Summerlee, Director of the Food and Health Network, the program of RHNSCNY that oversees FVRx. ” It gives patients a real tool in the form of these vouchers to be able to act on the dietary nutrition advice that they receive and make those real lifestyle changes.”
The short-term goal in having the FVRx program as a resource for clinicians to use as part of their care with patients, or in a community setting with clients, is getting people buying and cooking good food. The long-term goal is a system change which integrates these types of programs into healthcare and creates a structure for referrals to community resources.
The program is designed to be a six-month long program with a total of three visits with their providers. At each visit participants receive a booklet of vouchers. Participants receive a one month follow up phone call after the visit to see how their participation with shopping and cooking is progressing. This way, partners can ensure that people are fully utilizing their vouchers before coming back and getting another set.
Potential participants of the program are referred by either their provider or through word of mouth. For new organizations that are joining the program, the provider generally reaches out to recruit their patients/ clients to join. However, organizations that have been involved for two or three years are seeing a high demand for the program that they typically have a waiting list by the time the program is ready for enrollment. “At this point any site that has been doing it more than a year, doesn’t do any recruitment because there is such a high demand,” says Summerlee. This is one of the biggest challenges the program is facing right now, the interest in the program has reached beyond the number of spaces available in the community.
There is also a waiting list for providers, including different medical specialists such as cardiologists, endocrinologists, diabetes centers, etc. as well as primary care physicians. That demand alone speaks to how the health care industry is seeing the value, need, and impact of the FVRx program on their patients’/ clients’ health.
When an organization wants to become involved in administering the FVRx program the biggest component that needs to be understood and through out is the time commitment necessary. “You really need to have someone on staff who is dedicated to the program,” shares Summerlee. “There is staff time used doing outreach and enrolling people. Then there needs to be someone on site who has time to conduct the three meetings with the participants during the course of the program, including doing the follow up reminder calls. It’s important to make sure there is internal capacity.” It’s also important to identify within the organization what role would be the right fit for administering the FVRx program. “For some of our partners, it’s the Wellness coordinator, the dietitian, or a Community Health Worker. Every organization is going to be different.”
An impact being see through the FVRx program is a rising level of engagement between clinicians and their patients. “Our partners talk about having more engagement with patients which is a large piece of addressing chronic health conditions,” says Summerlee. This is especially true when working with populations that have not historically had high levels of engagement in their healthcare. This impact also reaches relationships between clinicians and community-based organizations. Not only are providers now more aware of food related resources in the community, partnerships are being born from this. For examples, the Lourdes Center for Family Health at 303 Main Street in Binghamton hosts a VINES Farm Share distribution site. This allows people to see their dietitian and redeem their FVRx vouchers at the same location.
Additionally, there is an economic impact being made. Participants have spent over $74,000 on fresh, local and regional fruits and vegetables over the past three years. The FVRx program is helping to support rural grocery stores and local farmers through framers markets, farm stands, and community support agriculture also known as CSAs, which is a weekly box of produce. The Walton Farmer’s Market had to increase market frequency from every other week to weekly in order to keep up with the demand seen after the FVRx program began in Delaware County. Summerlee emphasizes the need for varied purchasing options, “I never commit to saying we can run a program in an area unless we know that there will be shopping options for participants.”
The biggest health impacts associated with participants using the FVRx program are what one would imagine them to be – weight loss, reduced blood pressure, better diabetes management, and A1C levels have all been documented. Other reported impacts included a reduction in use of pain medication as individuals have lost weight, improved food security, and reduced stress. “Most of the comments we’ve received in relation to stress involve a sense of financial relief of having money to buy what they need and what’s healthier for them and their families, ” shares Summerlee.
“Beyond what is already happening, there is a lot of interested in the Care Compass Network region in expanding the program,” says Summerlee. “There are many possibilities to have an even bigger coordinated impact.” A pilot FVRx program is being launched in Tompkins County through a partnership with the Cayuga Center for Healthy Living and Healthy Food for All. The Food and Health Network has been consulting with this program to share best practices and, where there is opportunity, looking for collaborative funding to help expand this type of work. As well, they are working with S2AY, the Rural Health Network that includes Chemung, Ontario, Schuyler, Seneca, Steuben, Wayne, and Yates counties to help replicate the FVRx model.
If you are interested in learning more about the FVRx program, contact Erin Summerlee at firstname.lastname@example.org.