Aurora shuttle service aims to connect patients with health care

Originally published on January 29, 2020 by Chicago Tribune. Written by David Sharos.

VNA Health Care Aurora has begun a new shuttle service to bring patients from their homes to its care centers.

Officials from VNA were joined recently by city officials, Aurora Township representatives and executives from Pace Suburban Bus to launch the program.

VNA Health Care is the largest Federally Qualified Health Center in the suburban Chicago area.

Chrissie Howorth, vice president of philanthropy and communications for VNA, said at least a year was spent working with partners to bring the program to fruition.

“The biggest hurdle was finding the funding for this service and there are a number of participants,” Howorth said. “The VNA is dedicated to providing care for those with limited resources and this is a wonderful opportunity to increase our ability to help those who struggle to get the vital health care they need.”

CEO of VNA Linnea Windel said the program would annually cost about $55,000 and that riders would pay a fee of $3 per ride.

“Pace is the major funder of this program and is picking up the shortfall,” Windel said. “The township is going to provide drivers and handle the dispatch, but Pace gave a direct grant worth about $35,000 to fund the program. We’re looking at this as a pilot program, and we’ll see how the first year goes.”

Windel said that the Center for Health Law and Policy Innovation at Harvard Law School reports that every year, “approximately 3.6 million Americans – urban and rural – miss or delay essential, non-emergency medical care because they experience transportation barriers.”

“We know that 12% to 15% of the people that come here have to get rides, take a taxi or walk or bicycle, and we understand transportation is a known contributor for delayed or skipped health care,” she said. “We’re excited to lower the barrier to the care some aren’t getting.”

Pace Executive Director Rocky Donahue confirmed that the $35,000 grant would be reviewed in a year but left little doubt about its future if the need is shown.

“We had a fixed route here before just outside the building and it was cancelled as ridership didn’t warrant it,” Donahue said. “About three years ago the VNA and other constituents came to Pace and asked about the route and we said the data we had about ridership didn’t support it. Since then, the city and the township stepped up and asked us if we’d get involved.

“We know that the majority of the VNA patients are low income and don’t have the time or the transportation to get here,” he said. “It’s not sexy to ride the bus, but if the demand is there in a year and funding is needed, we’ll find it.”

Bill Catching, supervisor for Aurora Township, said the township’s contribution would include drivers and dispatch service as well as providing the vehicle itself.

“We have seven full-time drivers and know this will provide a big service to the community,” he said.

Ald. Michael Saville, 6th Ward, applauded the program in his ward and said that “the City Council and the Fox Valley region have come a long way” in helping those who can’t afford it get the medical care they need.

“People back home that couldn’t get the health care they need now can, and this represents a great collaboration,” he said.

Aurora Deputy Mayor Chuck Nelson summed up the new initiative, calling it “an investment in the community.”

“This thing really started back in August of 2018 when the VNA sent case studies to us after a couple of routes from Pace were eliminated,” he said. “When people are able to come together and collaborate, good things can happen.”

David Sharos is a freelance reporter for The Beacon-News.

Emily Broad Leib named clinical professor of law

Originally published January 28, 2020 by Harvard Law Today.

A national leader in food law and policy, Broad Leib founded the first food law and policy clinic in the country

Emily Broad Leib ’08, founder and director of the Harvard Law School Food Law and Policy Clinic, has been named clinical professor of law at Harvard Law School. She was formerly an assistant clinical professor at HLS.

A national leader in food law and policy, Broad Leib founded the first food law and policy clinic in the country at Harvard Law School. She has used her position to advocate for improvements to the laws and policies that govern America’s food system, including in the area of food waste. She also serves as deputy director of the Harvard Law School Center for Health Law and Policy Innovation.

“Emily Broad Leib is a superb teacher and is internationally respected for her groundbreaking work on food law and policy,” said John F. Manning ’85, the Morgan and Helen Chu Dean of Harvard Law School. “Through her commitment, intellectual leadership, and teaching, she has inspired countless students and attorneys to pursue options within the legal system to improve the food system and enhance the well-being of others.”

“I am humbled by my promotion to clinical professor, and full of gratitude at the opportunity to continue working alongside the committed and inspiring faculty, staff, and students of the HLS community. It has been a pleasure to make my home at such a supportive institution that has provided the resources and vision for me to build the first clinic in food law and policy, to develop opportunities for students to learn and participate in the vital field of food law, and to see the impact the Food Law and Policy Clinic has had and will continue to have on policies that impact the environment, health, and social justice,” Broad Leib said.

Broad Leib joined HLS’s Center for Health Law and Policy Innovation in 2010 as a senior clinical fellow. The following year, in 2011, she founded the Harvard Law School Food Law and Policy Clinic (FLPC), which provides legal advice to nonprofits and government agencies, while educating law students about ways to use law and policy to impact the food system.

Broad Leib focuses her scholarship, teaching, and practice on finding solutions to some of today’s biggest food law issues, aiming to increase access to healthy foods, eliminate food waste, and support sustainable food production. She has published scholarly articles in the California Law Review, Wisconsin Law Review, the Harvard Law & Policy Review, and the Food & Drug Law Journal, among others.

In 2015, she was an inaugural recipient of Harvard University’s Climate Change Solutions Fund. Her project “Reducing Food Waste as a Key to Addressing Climate Change,” was one of seven chosen from around the university to confront the challenge of climate change by leveraging the clinic’s food law and policy expertise to identify systemic solutions to reduce food waste, which is a major driver of climate change.

Under Broad Leib’s direction, FLPC has been advocating for the standardization of date labels since the release of its 2013 report “The Dating Game: How Confusing Food Date Labels Lead to Food Waste in America.” FLPC has also worked with members of Congress on legislation to reform the expiration date system, and Broad Leib testified for Congress on date labels and other areas of federal policy that impact the amount of food that goes to waste. She led work with the two largest food trade associations to implement a voluntary standard for date labels, which will go into effect this year. Last summer, the clinic released a follow up issue brief “Date Labels: The Case for Federal Action.”

Beyond date labels, Broad Leib has led the clinic in supporting food producers, businesses, and government agencies in understanding and improving laws relevant to food waste and food recovery. The clinic’s work has included consulting to government agencies and legislators at the federal level and in nearly two dozen states, and publication of scores of policy reports and toolkits, including Opportunities to Reduce Food Waste in the 2018 Farm Bill (2017) and Food Safety Regulations and Guidance for Food Donations: a 50-State Survey of State Practices (2018) and a number of resources to support states and localities in addressing food waste through policy, including “Bans and Beyond: Designing and Implementing Organic Waste Bans and Mandatory Organics Recycling Laws” (2019) and “Keeping Food Out of the Landfill” (2016).

Drawing on this expertise, in 2019, Broad Leib launched the Global Food Donation Policy Atlas project, through which she and clinic staff and students are partnering with local food donation agencies in fifteen countries around the globe to compare and analyze the laws relevant to food donation, and make recommendations for best practices that can help more safe, wholesome food make it to those in need.

In 2016, she was named by Fortune and Food & Wine to their list of 2016’s Most Innovative Women in Food and Drink. Her groundbreaking work has been covered in such media outlets as The New York Times, the Los Angeles Times, the Boston Globe, The Guardian, TIME, Politico, and the Washington Post. She has appeared on CBS This Morning, CNN, The Today Show, and MSNBC.

In 2016, Broad Leib partnered with colleagues around the country to found the Academy of Food Law and Policy, the first-ever academic association for the growing number of faculty and scholars teaching and writing in the field of food law and policy. She served as the founding co-chair of the Academy’s Board of Trustees from 2016 to 2019.

After graduating from HLS, Broad Leib spent two years in Clarksdale, Mississippi, as the Joint Harvard Law School/Mississippi State University Delta Fellow. She directed the Delta Directions Consortium, a group of university and foundation leaders who collaborate to improve public health and foster economic development in the Delta region. In that role, she worked with community members and outside partners, and with support from more than 60 HLS students, to design and implement programmatic and policy interventions on a range of critical health and economic issues in the region.

Broad Leib’s fellowship work in Mississippi inspired the Mississippi Delta Project, a student practice organization at HLS that provides opportunities for current students to continue advocating for similar issues in the Mississippi Delta region. Broad Leib continues to support that organization as the faculty supervisor. She is also the faculty supervisor for the Harvard Law School Food Law Society.

In 2013, she was appointed deputy director of the Center for Health Law and Policy Innovation. In 2015, she was named an assistant clinical professor of law.

Broad Leib received her J.D. from Harvard Law School and her B.A. from Columbia University.

Meal Planning: The D.C. Food Policy Council Sets Ambitious 2020 Agenda

Originally published by Laura Hayes on January 16, 2020 by Washington City Paper.

Director Ona Balkus talks closing the grocery gap, improving food jobs, and supporting urban agriculture. Ona Balkus is an FLPC alumna and former clinical fellow.

So much goes into feeding a city. From growing healthy food and directing it to food-insecure populations to creating stable careers in the food sector and disposing of food waste in a way that regenerates the soil, the workload can be hard to swallow. 

For decades, government agencies, nonprofit organizations, and community groups were tackling how to increase food access, address health disparities, spur urban agriculture, and stimulate the local food economy in silos. There wasn’t enough synergy to lead to milestone advancements. 

Then in 2014, the D.C. Council passed the DC Food Policy Council and Director Establishment Act, which sought to bring a body of experts together to foster greater collaboration. The FPC fully launched in the summer of 2016 under the direction of Laine Cidlowski

When Cidlowski left the District in June 2018, Mayor Muriel Bowser appointed Ona Balkus as the new FPC director. Balkus previously served on the D.C. Council’s Committee on Transportation and the Environment, where she drafted food-related legislation. As a senior clinical fellow at the Harvard Law School Food Law and Policy Clinic, Balkus provided guidance to food policy councils from across the country. 

“My job is to advise the mayor and the administration on how to strengthen D.C.’s food system in a holistic way,” she says. “That strategic thinking and seeing food as a system wasn’t really happening before.” 

The FPC currently includes 10 mayoral appointed leaders, plus representatives from various District agencies. Dreaming Out Loud Executive Director Chris Bradshaw is one of the longest serving FPC members. He too is optimistic about the year ahead. “We’ve entered more of an actualizing phase of making some of the things that were in the books happen,” he says. “There’s been great momentum and we’re seeing it pay off.” 

To guide their efforts, the FPC organized their 2020 priorities into five categories: food access and equity; entrepreneurship and food jobs; urban agriculture; sustainable supply chain; and nutrition and food system education. City Paper outlined a handful of highlights below and plans to assess the progress made early next year.

Back Locally Owned Businesses Bringing Healthy Food to Underserved Communities

Many of the neighborhoods east of the Anacostia River are considered food deserts. There are still only three major grocers for the more than 150,000 people living in Wards 7 and 8, and there are few sit-down restaurants offering healthy options, especially when compared to the rest of the city. 

Some Washingtonians living in communities east of the river don’t trust big box stores to be part of the solution after Walmart bailed on two projects—one at Skyland Town Center and another at Capitol Gateway.

“Why give more money to Walmart?” Balkus asks. “Why bring in another Safeway when we have a thriving and promising business community of District residents that we can give money to?” 

To further close the grocery gap and build even more businesses with buy-in from the community, the FPC is exploring creating a public-private piggy bank called the “DC Good Food Investment Fund.” It will provide grants, flexible loans, and technical assistance to homegrown food businesses such as small grocers or corner stores participating in DC Central Kitchen’s Healthy Corners program. 

Several such food-related businesses already broke ground or debuted in 2019, proving it’s possible. They include Market 7 in River Terrace, the Fresh Food Factory in Anacostia, and Good Food Markets in Bellevue. 

The FPC will team up with community development financial institutions on the fund. CDFIs invest in businesses that have trouble getting loans from traditional banks. Two local examples are the Latino Economic Development Center and Washington Area Community Investment Fund (WACIF). “They’ve both expressed interest in doing this,” Balkus says. The fund is inspired by the Michigan Good Food Fund and California FreshWorks. 

Bradshaw feels strongly about fostering community ownership, but also notes that the wealth gap will always be an obstacle. (White households in D.C. have a net worth 81 times that of black households.) Nevertheless, he says, “more businesses and cooperatives launching in the community will facilitate jobs and help people be able to stay in the city.” Affordability is key. “If no one can afford the rent for their home or business, then what kind of city do we have?”

When locally owned food projects come to fruition, Balkus says the FPC needs to get better at  informing District residents about their fresh food options. “When we’re out at meetings talking to residents all of these things are always news still,” Balkus says. “We need to figure out a way to celebrate these in a strategic way and make sure businesses are successful when they get off the ground.” 

Help Food Entrepreneurs Bring Made-In-D.C. Products to Market 

Ask budding food businesses what they need to enter the market or expand and they’ll likely list affordable commercial kitchen space, cold storage, and retail spaces to sell their goods. Commercial kitchen TasteLab closed in 2019, making securing a space at alternatives like Mess HallTastemakers, and Union Kitchen even more competitive. 

Opportunities are even scarcer for non-alcoholic beverage makers, some of whom have had to travel to other cities to can their products since the District lacks co-packing facilities. Commercial kitchens built for food businesses don’t always have adequate space for specialized equipment. 

Balkus says she hopes new FPC member Emi Reyes from LEDC, together with Katherine Mereand from the DC Department of Small and Local Business Development can identify more maker spaces in 2020. “Many churches within the city have commercial kitchens they don’t use frequently,” Reyes says. “It could give churches some revenue and use unoccupied space.” 

Convert Food Sector Jobs Into Careers 

One of the reasons people enjoy visiting or living in D.C. is its food scene. The New York Times just named the District the number one city to visit in 2020, citing restaurants as a chief reason, and late last year, Bloomberg called D.C. the most exciting food city in America.

“It intrinsically doesn’t make sense to have this foodie culture and all these amazing restaurants that are surviving off people without adequate career pathways,” Balkus says. “It’s one thing to start at a minimum wage job, but it’s another to retire at a minimum wage job.” 

Reyes agrees and says D.C.’s Latinx population, which supports much of the food industry, in particular doesn’t get the recognition it deserves. She wants to see more Latinx Washingtonians become majority owners of their businesses. DMV Black Restaurant Week, in its second year, also focused on building pathways to ownership for people of color.

The FPC is awaiting the results of a “DC Food Workforce Development Strategy” that will be co-published by the Department of Employment Services and the Workforce Investment Council. It focuses on improving the quality of food sector jobs. “We conducted 15 one-on-one interviews and convened 65 stakeholders for an all-day meeting,” Balkus says. One finding Balkus points to is how employers can increase retention by offering more benefits and promotion potential.

Balkus says she’s encouraged because the study marks the first time the local government has identified food as a standalone workforce sector deserving of attention: “It’s always been lumped in with hospitality, which means hotels,” she explains. “There are unique challenges that don’t exist in hotels.”

Decode The Steps to Starting a Food Business 

A number of District regulations and licensing requirements can stymie a food business’ timely launch. The process is confusing, complex, and costly. Balkus says the first step to cutting through the red tape is understanding all of the requirements for different types of enterprises, from urban farms and cottage food businesses to food trucks and full-service restaurants. “Then we can look at how to streamline it and identify where more resources and expertise is needed,” she says. 

Reconsider The Merits of Having a Centralized Kitchen 

Some cities have a centralized kitchen where meals are prepared for public institutions. The DC Healthy Schools Act of May 2010 included a requirement to build a central kitchen, but it never happened. “[Ward 3] Councilmember [Mary] Cheh was always frustrated about that,” Balkus says. “It never got funded and it wasn’t clear who the agency lead should be.” 

In 2018, the act was amended to have the Office of Planning take on a best practices study to learn how a centralized kitchen could benefit the District. “It looks at how to save money while improving the quality of meals at schools, rec centers, homeless shelters, senior centers, and the jail, as well as how it could be a workforce development tool and how it could support local and regional agriculture,” Balkus says. The study is expected to land in September. 

Nurture the District’s Renewed Focus on Urban Agriculture 

The benefits of urban agriculture transcend merely growing produce to help address food access. Urban farms show kids where their food comes from, bring neighbors together, help the city become more sustainable, and create jobs. Last year saw a major shift in who will oversee various urban agriculture initiatives. 

When the implementation of two key programs created under the D.C. Urban Farming and Food Security Act of 2014 saw further delays due to soil testing technicalities, the D.C. Council moved to change who manages them. 

Cheh successfully moved the Urban Farming Land Lease Program and Urban Agriculture Tax Abatement Program from the purview of the Department of General Services to a newly created Office of Urban Agriculture housed under the Department of Energy and the Environment. A director of urban agriculture will lead the office and overall greening of D.C. Balkus says applications are closed and the hiring process is moving along. 

To aid the city, nonprofits, and community groups operating urban farms, the FPC, together with the University of the District of Columbia, also wants to establish an Urban Agriculture Infrastructure Fund. It would pay for infrastructure necessities such as hoop houses, greenhouses, water hook-ups, and cold storage that can help urban farms thrive.

“These farmers do not need large sums of capital for things that could significantly increase their business revenue and potential,” Balkus says. “There’s a lot of federal money that could go towards this, but it hasn’t made its way to them given our unique set-up as a non-state.” 

In Support of Senate Bill 2453: A Food and Health Pilot!

Originally published by FIMMA, Food is Medicine Massachusetts

On January 22, 2020, only half a year since the launch of the Massachusetts Food is Medicine State Plan the Joint Committee on Public Health gathered for the hearing on Senate Bill 2453An Act Relative to Establishing and Implementing a Food and Health Pilot Program. A diverse group of stakeholders from food and health organizations across Massachusetts attended in the State House in order to convey their support for the Pilot Program.

An Act Relative to Establishing and Implementing a Food and Health Pilot Program was introduced to the Joint Committee on Public Health by Massachusetts Senator Julian Cyr and Representative Denise Garlick. If approved, the legislation will require the Executive Office of Health and Human Services (EOHHS) to establish the Food and Health Pilot Program with the necessary funding to connect MassHealth patients that are both at risk for or suffering from diet-related conditions to one of three Food is Medicine interventions: medically tailored meals, medically tailored food packages, and nutritious food referrals such as produce prescriptions.

Food is Medicine pyramid outlining prevention and treatment

Despite emerging evidence surrounding the efficacy Food is Medicine interventions to improve health and decrease health care costs, access remains limited across Massachusetts. The Massachusetts Food is Medicine State Plan,released in June 2019 by the Center for Health Law and Policy Innovation and Community Servings comprehensively evaluated the need for, current access to, and barriers associated with improving access to Food is Medicine interventions. The initiative found that while pioneering programs exist, structural and institutional barriers—lack of integration into health care referral systems, gaps in research, and lack of sustainable funding—have historically limited the ability of these programs to scale up to meet the growing need of communities across the state.

Food is medicine program map representing physical location of the program headquarters

Implementing a Food and Health Pilot Program will test the ability of our food and health care systems to overcome these barriers, further cementing Massachusetts’s role as a leader in access to care. If enacted, Senate Bill 2453 will:

  • Add to the body of evidence supporting Food is Medicine and provide valuable data on the impact of Food is Medicine interventions on health care costs and outcomes;

  • Enhance the ability of the Massachusetts health care system to provide appropriate nutrition services based on patient need; and

  • Expand access to Food is Medicine interventions in the state.

The legislative sponsor and co-author of the bill, Senator Julian Cyr, kicked off the hearing last Wednesday and spoke to the heart of the Pilot’s mission, insisting that “This program will make Massachusetts the first state in the nation to meet the nutritional needs of patients to survive, heal and thrive.” His heartfelt testimony was followed by a panel of three national leaders in the Food is Medicine space, the Katie Garfield form Center for Health Law and Policy, David Waters of Community Servings, and Dariush Mozaffarian, Dean of the Friedman School of Nutrition Science and Policy who set the stage highlighting the findings in the Massachusetts Food is Medicine State Plan, discussing the inextricable link between nutrition and health outcomes, and reviewing research illustrating the impact of these critical interventions. Fourteen stakeholders provided testimony throughout the hearing representing health care providers, community-based organizations, Food is Medicine consumers, and research centers, all in support of the legislation. 

Massachusetts has always been a national leader in health care policy, especially in state-wide efforts to address the social determinants of health. We have led the way in ensuring universal access to health insurance coverage, and we remain at the forefront of innovative reforms such as implementing value-based reimbursement. However, we continue to struggle with two issues that play a fundamental role in driving both poor health outcomes and health care costs: food insecurity and diet-related disease. During the hearing, Dean Mozaffarian pointed to nutrition as “the single biggest overlooked aspect of health.” He warned that the failure to include nutrition in health care will come at the expense of “American longevity,” and the first step to preventing a reality where “more Americans are sick than healthy” is treating diet-related conditions with better food. 

“This bill means something for all chronic diseases that are impacted by holistic approach to health. I haven’t been sick at all for the past seven months. I thank Community Servings for the work they do to keep me engaged and cared for.” -David Brown,  Community Servings Client

The avoidable costs of food insecurity and hunger in MassachusettsFood insecurity, or the lack of consistent access to enough food for an active, healthy life, impacts one out of every ten households in Massachusetts, and results in $1.9 billion in avoidable health care costs each year. For many households, improving basic access to nutritious foods through programs like SNAP may be sufficient to improve health. However, for individuals living with or at risk for serious health conditions affected by diet, these strategies fall short. These individuals not only need access to nutritious foods but also equitable access to Food is Medicine interventions — foods specifically tailored to address the impacts of their health conditions. 

During the hearing, Katie Garfield clearly laid out the three critical outcomes that the bill will achieve if enacted:

  • Add to the body of evidence supporting Food is Medicine and fill the critical gaps in research on the impact of Food is Medicine interventions on health care costs and outcomes; 

  • Enhance the ability of the Massachusetts health care system to provide appropriate nutrition services based on patient need; and 

  • Expand access to Food is Medicine interventions in the state, addressing funding as a key barrier. 

While pioneering programs currently exist, structural and institutional barriers including lack of integration into health care referral systems, gaps in research, and lack of sustainable funding limit the ability of these programs to scale up and meet the growing needs of communities across the state. To that end, Kumara Sidhartha, the Medical Director of Cape Cod Healthcare, testified that this program’s transformative potential would be found in the “creation and evaluation of a comprehensive program as opposed to the piecemeal programs that exist.”

“We need resources to make this vital connection that would benefit from this pilot program. This helps to build the connection providers have to local sources, medical offices, and food markets so that communities can more readily streamline services to patients and offset bad effects of living in a food dessert. This is a great program because it helps to de-stigmatize the hunger conversation for optimal patient support.” -Representative Mindy Domb

Many of those that testified specifically emphasized the ways in which this program will be able to build upon the newly implemented Flexible Services program in Massachusetts. Under the program, MassHealth Accountable Care Organizations (ACOs) receive funding that can be used to meet the housing and/or nutrition needs of eligible patients. While this innovative program represents an incredible leap forward in Massachusetts’s ability to address the needs of some of its most vulnerable residents, it faces several limitations. The most notable deficiency being the specification that Flexible Services dollars are restricted to address the needs of individual patients; they cannot be used to provide broader support to the patient’s household. In hopes of amending the Food and Health Pilot to address the household level, testimonials stressed the need for expansive funds to optimize the impact of the program and ensure that patients need not choose between prioritizing their health status and feeding their family. Dean Mozaffarian asserted his confidence for this amendment to illustrate medical benefit, relieving legislature concerns in his testimony that, “it would be blind of us not to see that food will be shared” and eliminating the option for household funding poses the risk of diluting the effects of an otherwise successful intervention“when in fact a parent gives food to child or elderly couples share food.”

Senate Bill 2453 will create opportunities to improve access to Food is Medicine interventions in both the short and long-term. The allocation of concrete, direct funds will not only expand current programs to new populations and geographies under the Pilot but also provide critical data that can be used as the foundation for policies and partnerships to support expansion on a much broader scale. Rachel Weil of the Greater Boston Food Bank proudly said that this program will “foster better collaboration to improve the health and lives of the commonwealth population.” While there is much work to be done, this Senate hearing marked an incredible first step on the path to ensuring that Food is Medicine interventions become and are acknowledged as invaluable pieces of the Massachusetts healthcare system. 

Thank you to everyone who testified in support of the Food and Health Pilot Program, including: 


Clinic Students Reflect on “Land Loss, Wealth, and Reparations”

This blog post was written by students Emma Pollack, MPH ’19, and Fred Chung, J.D. ’20.

In the last 100 years, over one million black farmers in the South have been dispossessed of their land. That is a loss of 90% of black land, at least $250-350 billion of wealth and income (10% of current black wealth). The numbers are stark, but they only paint part of the picture. They do not explain why this land was lost; they do not describe the rampant racism within governmental systems; they do not offer a path forward. As students in Harvard Law School’s Food Law and Policy Clinic (FLPC) last semester, we worked on issues related to black land loss, an often ignored topic that is recently grabbing the media’s attention. In October, we attended the FLPC panel on Land Loss, Wealth and Reparations for Black farmers in America, where Dania Francis, Darrick Hamilton, Bryce Stucki and Thomas Mitchell dug into the details on why and how this land theft occurred and what’s next for justice. Here is what we learned.

The evening’s panel opened with an overview of the history and magnitude of black land loss. According to Bryce Stucki, co-author of the New Food Economy’s recent article, black farmers quickly acquired land after the Civil War, primarily in the South. By 1880, 20% were landowners just a decade and a half on from emancipation, and 25% by 1900. By 1910, they held 17 million acres of farmland. However, black farmers with land holdings were increased targets of discrimination—politically and through physical violence—in an already oppressive environment. Studies have shown that landed black property owners were more likely to experience lynchings. Dozens of documented cases show a resulting exodus from counties and towns, after which whites would take over their property. In addition to racism and violence, there are two main reasons for this great land theft.

Reason 1: Industrialization and Discriminatory USDA Practices

The shift in agricultural production after the New Deal towards consolidation and mechanization spelled a formula for decline. Farming turned into a corporate business that relied on government support, but blacks were excluded from loans and other support by USDA county committees controlled by whites. After Freedom Summer in 1964, attempts to get black farmers on these committees failed. For decades, black farmers continued to be denied loans, receive reduced loans or have loan payments delayed to the detriment of their operations. Black farmers continued to lose their land now through financial and legal coercion.

Reason 2: Division through Intestate Inheritance

Another reason for this massive land loss is heirs’ property ownership structures. When a person passes away without a will, their property is divided among all known descendants of the land. As time passes, the property continues to be split among an ever widening pool of heirs.

First, this extreme splintering of the land makes it hard to exercise ownership over the land and use it in all legal ways possible. That includes, for example, developing it, using it as an asset for loans, or subdividing it. For most of these actions, there needs to be 100% agreement among all of the heirs. This becomes incredibly difficult as the land ownership continues to fraction over generations.

Second, heirs’ property is more vulnerable to partition sales; at least one report has suggested that half of black land lost from 1969 to 2001 was due to partition sales. Such partition sales often occur when a developer, or non-hereditary owner, purchases one relative’s share of the land. Once they purchase this land, the non-hereditary owner is able to petition the court and force a partition sale, in which the land may be sold  often at extremely low rates.

Third, without a will or going through probate, descendants inherit the land without clear title. Generally, the USDA requires clear title to land for participation in various programs including loans, commodity support, disaster relief, and crop insurance. While the 2018 Farm Bill makes it easier for heirs to obtain clear titles and access to programs, the historical lack of access has already caused irreparable, or near irreparable, land loss. And, we have yet to see the 2018 Farm Bill policy be implemented.

As Professor Thomas Mitchell noted, black farmers are less likely to have access to estate planning, often due to the same reasons that deter them from availing themselves of other legal resources such as mistrust and a disproportionately small number of attorneys of color. Accordingly, black landowners have felt the burdens of challenges posed by heirs property more acutely than their white counterparts.

A Way Forward?

Professor Mitchell proposed several ideas for preventing the loss of land that heirs’ property owners experience. Beginning in 2010, the Uniform Law Commission introduced the Uniform Partition of Heirs Property Act, headed by Mitchell, to enhance property rights of families, particularly in partition actions, improve access to USDA programs and to increase land ownership. Building off of his original act, Mitchell presented the Uniform Partition of Heirs’ Property Act 2.0, which would change the consent cut-off for decision making from unanimous agreement to a super majority. However, heirs property is just a part of the problem. Any discussion of a just way forward must include a more serious conversation about reparations. The second half of the October 16th panel was devoted to just that.

Criteria for Reparations

First, who should be eligible? Are reparations only accounting for slavery? What about the racist discrimination associated with Jim Crow, the New Deal, and today? Next, how much? Every study of reparations results in a different monetary estimate, from $500 billion to $6 trillion (or between $12.5 thousand per person to $150 thousand per person). Most use the promised 40 acres and a mule as a starting point for calculating the final price tag. After quantifying the cost of reparations, the next question is how will they be financed? Lastly, what form should reparations take? Options include cash payments, investment in social programs, trust funds, an official apology, institutional reform and public education about slavery and racism.

Professor Dania Francis stressed that reparations should not only focus on the history of violent discrimination, but must also address the ongoing discrimination that is found at all levels of government today. Furthermore, without vehicles to invest money back into the community, cash payments will ultimately end up in the hands of incumbent business owners. There needs to be an infrastructural investment to ensure that cash payments produce multiplying effects within black communities.

Professor Darrick Hamilton reiterated the structural and systemic change that must occur simultaneously with reparations in order to reverse the racist state-implemented practices and policies, as well as the modern economic systems built on power, capital, and inequality. He called for an honest discourse on poverty that begins with the acknowledgment of state-sanctioned terror and an Economic Bill of Rights that addresses the racial wealth gap. In addition to material redress, economic value must be reframed to include humanity, morality and sustainability.

Contributing to the Cause

Recognizing the need for more targeted policies that can overcome the inertia of discrimination, leaders in the black farming community have been setting forth concrete proposals for policy change for years to address these issues. Adding to the shock of learning how widespread and for how long these events unfolded, and continue to unfold, we were surprised to see how long such voices have been ignored. It feels as though mainstream society has dismissed civil rights as a thing of the distant past, when, in actuality, the Pigford II settlement payments, providing partial relief at best, were only disbursed after 2010. Despite the brouhaha of certain media outlets about squandering taxpayer money on fraudulent claims, the roughly $2 billion settlement (between Pigford I and II) is hardly a drop in the bucket compared to the real magnitude of the issue.

Our work in the Food Law and Policy Clinic has provided us with the opportunity to review and refine proposals to address some of these ongoing discriminatory policies. There is a difficult line to be drawn between achieving absolute justice for past grievances and balancing that with other considerations such as equity between different disadvantaged groups and timelines. The discontent over the settlements for Native American, Hispanic, and Women farmers that followed Pigford show just how difficult it is. The biggest challenge, as we review the policy options, is crafting proposals that are realistically achievable but still effective and equitable.

We find hope in the fact that these cries are not falling on totally deaf ears. Among the 2020 democratic presidential candidates, Sanders, Warren, Castro, Klobuchar and Bullock have all recognized the importance of this issue. Yet their proposed remedies leave room for improvement. Our Fall semester began with reading an open letter from black farmers to Senator Warren, critiquing her proposed farm plan and stressing the need for more comprehensive policies aimed specifically at black farmers. Our semester concluded as Senator Warren released a revised plan, building off many of the themes highlighted in the letter. As the media continues to report on the injustices black farmers face, we hope action and comprehensive policy will follow.

Watch the full recording of Land Loss, Wealth and Reparations for Black farmers in America here.

The views reflected in this blog are those of the individual authors and do not necessarily represent those of the Center for Health Law & Policy Innovation or Harvard Law School. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.

Harvard Law School clinician testifies in support of Massachusetts food and health pilot program

Originally published January 22, 2020 by Harvard Law Today.

New state legislation based on Center for Health Law & Policy Innovation’s “Food Is Medicine” report

Food insecurity and hunger cost the Commonwealth of Massachusetts nearly $1.9 billion in avoidable health care costs every year.

Today, a team of attorneys from the Center for Health Law & Policy Innovation of Harvard Law School (CHLPI) and Community Servings, a nonprofit food and nutrition program, testified at a hearing on proposed legislation to establish a food and health pilot program in the state of Massachusetts.

Harvard Law School Clinical Instructor and CHLPI staff attorney Katie Garfield ’11 and Jean Terranova, Community Servings’ director of food and health policy, testified before the Joint Committee on Public Health at the Massachusetts State House.

The new legislation, titled An Act Relative to Establishing and Implementing a Food and Health Pilot Program, is the first major result of a report CHLPI and Community Servings released last summer—the “Massachusetts Food is Medicine State Plan.” The legislation, introduced by Massachusetts Sen. Julian Cyr (D-Truro) and Rep. Denise Garlick (D-Needham), provides a blueprint to successfully integrate nutrition services into health care delivery and financing in the Commonwealth—a proven strategy to improve health outcomes and reduce health care costs for people experiencing food insecurity and living with chronic illness.

The legislation would require the Executive Office of Health and Human Services (EOHHS) to establish a Food and Health Pilot Program that equips health care systems to connect MassHealth enrollees with diet-related health conditions to one of the three appropriate nutrition services, with the expectation that health outcomes will improve and cost of care will decrease.

“Massachusetts has long been a national leader in health care policy,” said Garfield in testimony before the committee. “However, we continue to struggle with two issues that play a fundamental role in driving health outcomes and health care costs: food insecurity and diet-related disease. … A growing body of evidence indicates that connecting these individuals to “Food is Medicine” interventions may be an effective, low-cost strategy to improve health outcomes, decrease use of expensive health care services, and improve patient quality of life.”

Published in June 2019, the “Massachusetts Food is Medicine State Plan” is a product of a two-year, community-driven initiative that engaged more than 400 people from across the state. The initiative sought to identify health and food system reforms to improve access to critical nutrition interventions and change the culture and practices of the health system.

CHLPI and Community Servings also launched Food is Medicine Massachusetts (FIMMA), a multi-sector coalition comprised of more than 50 organizations representing nutrition programs, patient advocacy groups, health care providers, health insurers, academics, and professional associations.

CHLPI advocates for legal, regulatory, and policy reforms to improve the health of underserved populations with a focus on the needs of low-income people living with chronic illnesses. Community Servings provides medically tailored, nutritious meals to chronically and critically ill individuals and their families.

FBLE Submits Recommendations to House Select Committee on the Climate Crisis

This blog post was written by Brianna Johnson-King, J.D. ’21, a Fall 2019 clinic student of the Food Law & Policy Clinic.

I joined the Food Law & Policy Clinic to pursue my interest in the intersection of agriculture, the environment, and policy issues. My personal background growing up in Ohio exposed me to agriculture from an early age and has driven my attraction to this work. My semester at the clinic perfectly aligned with these interests and allowed me to analyze federal farm policies, specifically looking at ways to incorporate better environmental or climate-friendly strategies in the farm bill.

Congress passed the most recent farm bill in 2018, but future farm bills can and should go further to incorporate climate-friendly policies. This past fall, the House Select Committee on the Climate Crisis issued a Request for Information regarding climate change and industry responses. Two questions in this request focused on agriculture, such as policy proposals to reduce carbon pollution and other greenhouse gas emissions and maximize carbon storage in agriculture, as well as policies to help farmers, ranchers, and natural resource managers adapt to the impacts of climate change. We, as members of the Farm Bill Law Enterprise, submitted recommendations in response to these questions.

Overall, our recommendations focused on shifting to a perennial agricultural system, especially agroforestry, expanding conservation compliance, and reforming crop insurance. Agroforestry, whether executed by incorporating trees into pastures or cultivating side-by-side rows of trees with rows of non-woody plants, provides many benefits that annual crops do not. These include sequestering carbon, limiting soil erosion and run off, limiting fertilizer and pesticides, and more. Additionally, federal crop insurance impacts millions of acres and many producers. In 2017 alone, 1.12 million individual federal policies were issued¹. Congress should support climate-friendly practices by tying insurance premiums to actual planting risk, based in part on farmer planting practices and soil conditions.

I personally focused on the recommendation to expand conservation compliance, which is a requirement to receive payments from commodity programs and crop insurance. Currently, conservation compliance limits planting on highly erodible land without conservation plans and restricts planting on wetlands². These minimal requirements to comply with conservation measures do not protect the land from soil erosion, nor do they encourage climate-friendly practices. Congress should expand the requirements under conservation compliance by incorporating a list of verified climate mitigation practices. Producers would elect to implement a subset of these practices to meet conservation compliance. The Natural Resources Conservation Service (NRCS) would set the climate mitigation practices and might include cover cropping, perennial crops, buffer zones, agroforestry, conservation tillage, or drip irrigation.

Although expanding the definition of conservation compliance would promote use of climate-friendly practices, we also recommend that NRCS provide additional technical assistance to help farmers implement these practices and improve monitoring of farmers to ensure proper compliance. Given that many farmers could use these practices for the first time, it is essential that they receive support and guidance. Additionally, we recommended that NRCS improve monitoring procedures and change non-compliance penalty policies to ensure conservation compliance requirements are effective.

Agricultural can play a pivotal role in responding to climate change. Federal policies will have a widespread impact in encouraging a range of climate-friendly practices amongst all producers. My part in this recommendation allowed me to grasp the large role the farm bill plays in the agricultural sector and dig down into the details of how farm bill programs operate. The project offered a real-world opportunity to explore my agricultural, environmental, and policy interests, while developing new skills and knowledge in the process. It is exciting to see the House focus on these issues and I look forward to seeing what policies they recommend from their Request for Information.

¹ U.S. Dept. of Agric., Audit Report 05401-0010-11, Federal Crop Insurance Corporation/Risk Management Agency Financial Statements for Fiscal Years 2018 and 2017 Exhibit C 16 (2018).

² 2018 Farm Bill- Conservation Compliance Changes, U.S. Dep’t of Agric., Nat. Res. Conservation Serv., (last visited Oct. 9, 2019).

The views reflected in this blog are those of the individual authors and do not necessarily represent those of the Center for Health Law & Policy Innovation or Harvard Law School. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.

Pakistan Court finds Food Waste Violates Fundamental Right to Life

The Harvard Law School Food Law and Policy Clinic (FLPC) was very excited to learn about the recent decision issued by the Lahore High Court of Pakistan in the case Muhammad Ahmad Pansota vs Federation of Pakistan. In this momentous, first-of-its-kind decision, the Court declared that wasting food violates the right to food and that the Punjab government, which governs the Pakistani province of Punjab, has a duty to take actions to ensure that excess food makes it to those in need. The Court held that the “right to life” under the Pakistani Constitution encompasses the right to food, “including protection against wastage of excess food,” thus finding that the prevention of food waste was necessary in order for the Punjab government to fulfill its obligations under the Pakistani Constitution.

The petitioners in the case relied on several reports and policy memoranda written by FLPC in submitting its initial complaint, and provided these to the court as reference materials. As the litigation proceeded and it became clear that the Punjab provincial government would need to enact laws to reduce food waste, FLPC provided support to the petitioners in the case by offering input on draft regulations, required to be submitted to the court, that encourage donation and reduce food waste in Punjab. This input, along with the previously mentioned FLPC materials, were submitted as supporting documents in the case.

The judgment directs the Punjab Food Authority to enact and enforce these food donation regulations and other laws in order to preserve, conserve, and manage excess food, in accordance with the Pakistani Constitutional right to food. The court also directed the agency to establish a management system to ensure surplus food makes it to those in need, to provide a check on the amount of food being wasted, and to revise and amend any other existing laws required to ensure implementation of this mandate. This is done through a writ of mandamus through which the Court will monitor compliance with the order and require periodic reports from the Punjab Food Authority regarding implementation.

This is the first decision of a court declaring that the right to food includes a mandate to not waste safe, wholesome, surplus food. FLPC is delighted to see the court recognizing the negative impact of food wastage on the environment, the economy, and the people, and the important role of government to ensure the policy climate incentivizes and removes barriers to the donation of safe surplus food to those in need. FLPC looks forward to continuing to provide guidance and support to the petitioners in this case and to the Punjab Food Authority in the development of its food waste regulations, and to highlighting this important decision that gives concrete meaning to the human right to food and the impact of unnecessary food waste on that right.

Senators Toomey and Blumenthal Introduce Bipartisan Bill to Increase Food Donation Nationwide

Senators Pat Toomey (R-PA) and Richard Blumenthal (D-CT) recently introduced legislation intended to boost food donations across the United States. The Harvard Law School Food Law and Policy Clinic (FLPC) enthusiastically supports the Food Donation Improvement Act of 2019 (S. 3141), which addresses key policy changes recommended by FLPC.

The Food Donation Improvement Act of 2019 enhances the coverage of the Bill Emerson Good Samaritan Food Donation Act (Emerson Act), which was passed by Congress in 1996 and promotes food donation by providing civil and criminal liability protection to food donors and food recovery organizations. The Emerson Act provides a broad base of liability protection that was intended to encourage food donations, yet donors are often unaware of the Act’s protections. Many food manufacturers, retailers, and restaurants still cite fear of liability as a primary deterrent to donating food. The Food Donation Improvement Act of 2019 will help to clarify some of the ambiguous terms in the Emerson Act and promote awareness of the Act by delegating authority over the Emerson Act to the U.S. Department of Agriculture (USDA) and directing the USDA to issue regulations clarifying what quality and labeling standards must be met in order for liability protection to apply.

Further, the proposed legislation would extend liability protection in several ways that support modern food donation. For example, it would extend liability protection to donations sold at a reduced price to recipients.  Current law only protects food donation if the final recipient receives the food for free. However, nonprofit organizations that sell foods at a greatly reduced rate, like social supermarkets, can fill a need for food insecure individuals who, for various reasons, are not willing or able to qualify for government assistance or use a food pantry or soup kitchen. The legislation would also extend protection to certain donations given by food businesses directly to those in need, which will increase efficiency, reduce costs, and enable timely use of perishable food. Under current law, food donors are only protected if they give food to a nonprofit organization to distribute it to those in need. Protecting direct donation from food businesses will allow individuals in need to pick up food from more accessible locations right at the source, such as local restaurants, grocery stores, and schools. Food service establishments already have to comply with food safety requirements like training and inspections, which ensures that they have the food safety knowledge to make direct donations safely.

The legislation would also reduce barriers to food donation by requiring USDA to issue regulations to clarify which quality and labeling standards donated food products must meet in order for liability protection to apply. Often food goes to waste because it is accidentally mislabeled. Under the Emerson Act, donated food must meet all labeling requirements to receive protection. At the federal level, such labeling standards include name of the food, manufacturer’s address, net quantity of contents, and an ingredient list (including allergen information); however, compliance with some of these labels are not necessary to ensure that donated food is safe. For example, the ingredient list is important for safety but the net weight is not. This bill would require USDA to determine which of these labeling requirements must be met by donated products in order for liability protection to extend to donors or distributing organizations.

By making small changes to the Emerson Act, this legislation will support big increases on the ground in terms of wholesome food donations. Approximately 40 percent of the food produced in the U.S. goes uneaten, resulting in 63 million tons of wasted food each year. Although much of this excess food is healthy and safe to eat, a significant amount ends up in landfills, instead of on the plates of those in need. Food donation provides a critical link between businesses and organizations with wholesome, surplus foods and the 37 million Americans, including 6 million children, who are food insecure.

The legislation introduced by Senators Toomey (R-PA) and Blumenthal (D-CT) presents an opportunity to both increase food security and reduce the waste of wholesome foods. FLPC is pleased to support this bill, which will clarify the Emerson Act’s coverage, expand its protection, and eliminate burdensome barriers in order to boost food donations. Follow the progress of the Food Donation Improvement Act of 2019 (S. 3141).