PORTLAND — At Oregon Health & Science University recently, the lunch offerings included sandwiches made with organic chicken breast — locally sourced — on focaccia bread, baked locally and delivered daily. Plus salad made from local greens. Not a pre-packaged, mass-produced item in sight.
This is hospital food?
Providing minimally-processed, nutritious food at a hospital, where the clientele includes patients, doctors and nurses, medical students and visitors, seems like a solid idea. And OHSU, the teaching hospital that employs 13,700 people and has one of Oregon’s biggest economic footprints, was an early adopter of the practice.
The greater impact, however, could be to what a recent study referred to as “Ag of the Middle.” That is, the farmers, ranchers and processors who are too big to make a living selling solely at farmers’ markets and CSAs, but too small to compete at the commodity level.
The study by Ecotrust, a Portland non-profit, identified institutions as a prime market opportunity for middle-sized producers.
Ecotrust estimated Oregon’s hospitals, schools, prisons, assisted living facilities and other institutions serve 40 million meals a year.
Institutional food service departments have immense buying power and purchase large quantities, the report pointed out. Even a relatively small tweak toward buying more Oregon grown and processed products would have a “significant ripple effect across the domestic food system,” the Ecotrust report said.
It paid off for a pair of Northeast Oregon cattle ranches. Carman Ranch in Wallowa, in partnership with McClaren Ranch, sells about 1,000 pounds of beef and bones a week to OHSU. The ranches take about five cows a week to a processor in Brownsville, 90 miles south of Portland, and sell the hospital 500 pounds of ground beef, 200 pounds of rounds, 100 pounds of steaks and 200 pounds of bones for soup and broth.
Cory Carman, a fourth generation cattle rancher, said the relationship has been “phenomenal.” OHSU accounts for 20 to 25 percent of the ranch’s annual sales and is by far the ranch’s biggest account, she said. The business would be “much smaller” without OHSU’s consistent demand for quality and quantity.
She said producers pursuing such relationships must understand they require patience, collaboration and flexibility on both ends.
“The biggest lesson is having that anchor customer,” Carman said.
Carman said OHSU approached her out of the blue when it was looking for grass-fed beef to serve the thousands who are at “Pill Hill,” as the campus overlooking Portland is known, every day.
Fernando Divina, OHSU’s executive chef, said the complex counts about 10,000 food transactions a day at nine outlets within the facility, including cafe and snack kiosk sales and 1,200 meals delivered to patients’ rooms. OHSU’s annual budget for food and beverages is about $5 million, and the hospital made a conscious decision to walk its health talk by seeking out local producers, preferably organic.
“We want to buy everything regionally, if possible,” Divina said. “That’s our goal.”
It isn’t a simple process.
Scott Cochrane, OHSU’s food purchasing agent, said large institutions such as schools often have tight budgets. It’s often cheaper for them to buy the volume they need from large distributors. To purchase in bulk locally at a competitive price point, institutions may have to ask multiple growers to aggregate their production.
“I know they all want to, but there’s a point where they can’t cut their own throat,” Cochrane said. “There’s a lot of willing participants on the outside of the circle who can’t get in.”
Eecole Copen, OHSU’s sustainable foods program coordinator, acknowledged it takes more work to buy food from smaller producers.
“You have to commit to being OK with dealing with multiple vendors,” she said. “The whole system is based on willingness.”
She and others refer to this type of purchasing as a larger version of Community Supported Agriculture, or CSA. It’s ISA in this case: Institutional Supported Agriculture.
Copen said the payoff is a strengthened regional food system.
“We need more farmers,” she said. “That’s about food security, growing the local economy, jobs, income.”
OHSU’s first foray into the local food scene was establishing a farmers’ market on campus. It’s now in its ninth year and serves as an incubator for growers who eventually reach the point where they can sell wholesale to OHSU’s food services department.
The idea isn’t just a Portland foodie thing. Good Shepherd Medical Center in Hermiston, about 180 miles east of Portland, buys vegetables from Finley’s Fresh Produce, berries from another local grower, and pork and chicken from suppliers across the border in Washington. All of the beef purchased by the hospital is raised within 50 miles.
Nancy Gummer, Good Shepherd’s nutrition services and diabetes education director, said she began buying locally about 10 years ago.
Gummer said she wanted to quit buying meat from animals treated with antibiotics or raised in confined feeding operations. It took 10 years to find chicken she felt comfortable feeding hospital patients, staff and visitors.
In addition to buying local, Gummer avoids purchasing products that contain artificial colors, flavors or other additives. Her food budget is about $500,000 annually.
“We feel what you eat has the biggest impact on your health,” she said. “Food that’s really healthy for humans is going to be grown in healthier soil, and handled and processed in a way that has less impact on the environment.”
Gummer said.
Increased institutional buying of locally grown and processed food can reshape the food system, said Amanda Oborne, vice president of food and farms for Ecotrust and the lead author of the “Ag of the Middle” report.
Producer and buyer have to make some adjustments, however, Oborne said.
Institutions have to be flexible enough to partner with farmers and “take what they’ve got when they’ve got it” and pay promptly, she said.
They also should increase their frozen storage space so they can buy in bulk when things are in season and use them over time.
Farmers “have to be able to think like a bigger operation,” she said. They need proper insurance coverage and must comply with food safety regulations.
“Those are barriers for institutional buyers,” Oborne said. “That liability related stuff has to be in order.”
Institutions can’t afford to have employees standing around chopping, slicing and dicing vegetables, she added, and producers should look for creative ways to provide some of that minimal processing.
To fill big institutional orders, farmers can coordinate crop planning and combine production with neighbors, she said.
“This is a partnership and we problem solve together,” she said. “That’s the mindset to bring to it.”