Across the country, hospitals are teaming up with local growers and producers to make changes in the food service industry and local food economy. The time is right for farms and hospitals to connect to provide patients and staff with the most healthy and fresh foods available.

Community Food Security Coalition


The time is right for the development of farm to hospital programs. Given the increasing popularity of buying food products directly from local farmers, as well as the heightened concern about human health and quality of food in hospitals, there has never been a better time to buy locally.

The nation’s hospitals have a mission to promote both the health of their patients and the communities in which they are located. But step away from operating rooms and labs into hospital cafeterias and kitchens, and the health mission often seems overlooked. Even as the nation faces an epidemic of obesity and diet-related illnesses such as diabetes and heart disease, many hospitals, searching for ways to cut costs, are offering fast food meals and junk food-filled vending machines. Linking local farms and hospitals can improve the freshness, quality, and nutritional value of hospital food while opening new markets for small and medium sized farmers.

Coordinating an institution’s health mission with food procurement can be done in a number of ways. Examples include: purchasing locally grown products like fruits, vegetables, meat, and dairy for use in patient and cafeteria meals, hosting a farmers’ market or CSA (community supported agriculture) programs on hospital grounds, or creating hospital gardens as places of calm and healing.

By supporting a localized food system, hospitals can help reduce the ecological impact of the agricultural sector by decreasing the number of miles that food travels from farm to plate, thereby reducing carbon dioxide emissions, air pollutants, and use of fossil fuels. By choosing sustainably produced foods, hospitals can also lower patient and staff exposure to pesticides, herbicides, hormones and non-therapeutic antibiotics in meat. As small sustainable growers continue to be challenged by the conventional food system, connections between hospitals and local farms can provide a boost to local farm economies. Hospitals, with their health promotion and prevention objectives and strong community ties, represent a tremendous opportunity to expand farm to institution connections.


1. Start a conversation about healthy food with nutritionists, food purchasers, physicians, and hospital administrators.

2. Develop a food purchasing policy that addresses health and environmental concerns.

3. Work through your existing supplier and distributor to purchase local farm products.

  1. Contract with a group purchasing organization, distributor, or food service provider that supports healthy food.
  2. Buy directly from local producers.
  3. Become a fast-food free zone.

7. Limit use of vending machines and replace unhealthy snacks with healthy choices.

8. Host a farmers’ market or CSA on hospital grounds.

9. Model local, nutritious, sustainable food at conferences, meetings and workshops.

10.Create hospital gardens to grow fresh produce and flowers.

Excerpted from Healthy Food in Health Care: A Menu of Options. By Health Care Without Harm.


Below are some issues farmers need to address if they want to explore selling to institutions:

1. Product Consistency and Communication

Larger institutions are typically used to relying on large, dependable food service providers and may have limited resources and staff available to process orders. Be clear about the products and quantities you estimate will be available and when; and if possible, provide hospital food service staff with a seasonality chart so they can better plan their menus. To increase variety and fill production gaps, consider working with other growers. If product volumes will be short, abundant, or cosmetically damaged, let clients know as far in advance as possible. Making the effort to personalize your service will demonstrate your concern and care for the client.

2. Delivery

Delivery systems that coordinate product pick up and delivery from several farms to a local hospital can be helpful in reducing the administrative work for the hospital. Few hospitals have the capacity to pick up product from a farm or farmers’ market, and most hospitals are wary of receiving deliveries from multiple trucks. Find out what channels the hospital currently uses to purchase their food products (such as a distributor) and explore the possibility of working through these channels.

3. Pricing

When determining prices, try to maintain consistency throughout the season, barring any natural disasters or large market fluctuations. Do your best to project a price which reflects costs of production and profitability but allow space for discounts due to volumes or other such negotiations. Additionally, make invoices clear, concise, and readable, and try to maintain the same billing layout throughout your wholesale relationship. Keep in mind that institutions typically pay below retail prices and may take up to 1-3 months to pay for goods received. Many institutions will require growers to hold at least $1 million of general liability insurance. Working through an existing distributor or farmer cooperative may allow you to circumvent this issue.

4. Regulations and Food Safety

Hospitals are beholden to certain regulations regarding food preparation, handling, and processing due to the nature of their work. Growers should be mindful of HACCP (Hazard Analysis and Critical Control Points, to learn more visit: http://, JCAHO (Joint Commission on Accreditation of Healthcare Organizations), and other healthcare related food regulations. In order to address some food safety concerns, growers might consider documenting their farm’s policies and practices concerning:

– Field Harvesting
– Washing/Packing Line
– Loading, Storage, and Transportation – Water Usage
– Worker Health & Hygiene


Across the country, hospitals are teaming up with local growers and producers to make changes in the food service industry and local food economy. The time is right for farms and hospitals to connect to provide patients and staff with the most healthy and fresh foods available.

To learn more and read case studies of hospitals purchasing locally grown foods in North Carolina, Oakland, Vermont, Iowa, and San Antonia download Healthy Food, Healthy Hospitals, Healthy Communities from the Institute for Agriculture and Trade Policy at htto://

Many resources are available to hospitals and growers interested in the healthy hospital food movement. For more information contact:

Center for Food & Justice (323) 341-5099

Health Care Without Harm

The resources referenced in this brochure, and many others, can be downloaded at Health Care Without Harm’s website.

Sample Institutional Policies can be found on the Food Alliance website:

To find a CSA or other local food resources in your area visit,

Developed by the Center for Food & Justice, a division of the Urban & Environmental Policy Institute at Occidental College. To learn more visit: (323) 341-5099 |

In partnership with the Community Food Security Coalition. To learn more visit:

Special thanks to Health Care Without Harm, Community Alliance with Family Farmers,
the Growers’ Collaborative, Kaiser Permanente, and the Institute for Agriculture and Trade Policy.

Photo by Leslie Moore: Drawings by Joe Linton

Funded by the United States Department of Agriculture Farm Service Agency


Author: bryan nettles