Issue Brief— Health & Hunger in WV: Building Bridges at the Community Level in Boone, Lincoln, Logan by Think Kids WV

2021 ISSUE BRIEF

Health & Hunger Summit Series in Boone, Lincoln, & Logan Counties Building Bridges at the Community Level

Table of Contents

2 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Session One. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Session Two. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Session Three. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Session Four. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Recommendations . . . . . . . . . . . . . . . . . . . . . . . 13 Resources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 About Us . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Fast Facts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Acknowledgments The authors wish to acknowledge Laura Boone, Mark Linville, and Barbara Wessels for their assistance in reviewing this issue brief. We’re grateful to those who served as panelists for the series. Your expertise and insight were invaluable. Panelist names are listed with each session summary. We’re also grateful to the Pallottine Foundation of Huntington for financially supporting this important project. The views expressed in this brief are those of the authors and reflect the discussions held during the series sessions. They do not necessarily represent Think Kids, sponsors, or any institutions with which the panelists are affiliated. BUILDING BRIDGES AT THE COMMUNITY LEVEL

Fast Facts Health and hunger are inextricably linked. Poverty, food insecurity, poor nutrition, and poor health are associated and shared characteristics in West Virginia’s rural counties. Where there is a lack of resources, access to nutritious food, access to comprehensive health care, and a robust safety net to address these health inequities, the community’s health suffers.

Population Estimate 35,000

32,019

30,000 25,000 20,000

21,457

20,409

15,000 10,000 5,000 0

Boone

Lincoln

Logan

U.S. Census Bureau (2019). Boone County, WV [data table]. Quick Facts. Retrieved from https://www.census.gov/quickfacts/boonecountywestvirginia. Lincoln County, WV [data table]. Quick Facts. Retrieved from https://www.census.gov/quickfacts/lincolncountywestvirginia. Logan County, WV [data table]. Quick Facts. Retrieved from https://www.census.gov/quickfacts/logancountywestvirginia.

Poor or Fair Health 30% 25%

29%

30%

30% 24%

20% 14%

15% 10% 5% 0

Boone

Lincoln

Logan

WVA

U.S.

University of Wisconsin Population Health Institute. County Health Rankings & Roadmaps. Accessed May 19, 2021. Retrieved from https://www.countyhealthrankings.org/app/west-virginia/2021/ rankings/boone/county/outcomes/overall/snapshot. Retrieved from https://www.countyhealthrankings.org/app/west-virginia/2021/ rankings/lincoln/county/outcomes/overall/snapshot. Retrieved from https://www.countyhealthrankings.org/app/west-virginia/2021/ rankings/logan/county/outcomes/overall/snapshot.

2021 ISSUE BRIEF: HEALTH & HUNGER SUMMIT SERIES IN BOONE, LINCOLN, & LOGAN COUNTIES

Persons in Poverty

Median Household Income

25%

$50.000

20% 15%

19.7%

18.9%

21.9%

$40,000

$42,345 $36,168

$30,000

10%

$20,000

$10,000

$40,739

Boone

Lincoln

Logan

Boone

Lincoln

Logan

U.S. Census Bureau (2019).

Boone County, WV [data table]. Quick Facts. Retrieved from https://www.census.gov/quickfacts/boonecountywestvirginia.

Lincoln County, WV [data table]. Quick Facts. Retrieved from https://www.census.gov/quickfacts/lincolncountywestvirginia.

Logan County, WV [data table]. Quick Facts. Retrieved from https://www.census.gov/quickfacts/logancountywestvirginia.

Adult Obesity

Food Insecurity Rate

50% 40%

42%

43%

30%

38%

26%

16.8% 16.

18.6% %

Boone

20% 10% 0

Lincoln

16 8% 16.8%

Logan

Boone

Lincoln

Logan

WVA U.S.

Feeding America. 2019. Map the Meal Gap. Accessed May 19, 2021. Retrieved from http://www.feedingamerica.org/hunger-in-america/ our-research/map-the-meal-gap/.

Retrieved from https://www.countyhealthrankings.org/app/west-virginia/2021/ rankings/lincoln/county/outcomes/overall/snapshot. Retrieved from https://www.countyhealthrankings.org/app/west-virginia/2021/ rankings/logan/county/outcomes/overall/snapshot.

BUILDING BRIDGES AT THE COMMUNITY LEVEL

Janell Ray, CEO

A Word from the Pallottine Foundation of Huntington The Pallottine Foundation of Huntington is honored to be a partner in this impactful collaboration of organizations from across the state working to address the challenges of hunger in our communities. This collaboration between key partners – community, city, county, state, and federal – strengthens the capacity of the total health network working to address food insecurity in our state. The Health and Hunger Summit Series is an invaluable tool in fostering continued and critical conversation on this important topic.

Introduction This brief intends to capture in words the discussions and highlights from our 2021 Regional Health and Hunger Summit Series, held in April and May, 2021. The panelists provided a wealth of knowledge on the state of food insecurity, connections between the health care system and local resource providers, nutrition education, and health outcomes in their service areas. Specifically, they explored the successes and challenges to bridging systems in three counties in our state- Boone, Lincoln, and Logan Counties. Intending to expand on these conversations, this report serves as an opportunity to observe, define, articulate, compile, and share prevailing themes and potential policy recommendations to help make the way we collectively work in this intersection between health and hunger, especially on the community level, better. With a collective approach, we can streamline, prioritize, and collaborate to identify gaps and improve systems. While this brief isn’t exhaustive, we hope you will keep it as a reference and join in the continuing conversations.

2021 ISSUE BRIEF: HEALTH & HUNGER SUMMIT SERIES IN BOONE, LINCOLN, & LOGAN COUNTIES

SESSION ONE

Food and Hunger in My Neighborhood Kevin Hall, Interim Director, Rock Branch Facility, Mountaineer Food Bank David Roberts, Family & Community Development Agent, West Virginia University Extension Service Michael Tierney, Executive Director, Step by Step Inc.

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According to Feeding America, 13.5% of West Virginians were food insecure in 2019, and one in five children struggled with food insecurity. Federal, state, regional, and local support services respond to hunger and lack of access to healthy foods, but not always collaboratively or in the same ways. What does the West Virginia food insecurity infrastructure look like as it winds its way down to the community levels in Boone, Lincoln, and Logan Counties? The U.S. Department of Agriculture (USDA) provides food assistance via several different programs and works with the West Virginia Department of Agriculture to help distribute USDA commodities in our state. In addition, it works with our state’s two food banks to distribute food. Both food banks are members of Feeding America, a national system of 200 food banks across the United States. It coordinates with national partners to help food banks get their food. Mountaineer Food Bank (MFB) is the largest food bank in our state and serves 48 counties. Facing Hunger Foodbank serves 12 counties in the southern part of the state. The primary role of food banks is to store and distribute food to programs and pantries. In 2020, for example, MFB distributed around 250,000 pounds of food in Boone County alone.

What is the difference between a food bank and a food pantry? While a food bank is a nonprofit food distributor, a food pantry is a community-level member of the food insecurity infrastructure and provides the food directly to those in need. MFB contracts with over 400 pantries and programs. Facing Hunger Food Bank contracts with 248 partnering agencies. Food banks can also do more than just store and deliver food. Often, they run other programs, sometimes in conjunction with local pantries or partners. For example, both of West Virginia’s food banks operate mobile pantry programs where a refrigerated food truck delivers food at a pre-scheduled time to a community. Community members drive-through or pick up food boxes. These deliveries vary due to time of year, need, and availability. BUILDING BRIDGES AT THE COMMUNITY LEVEL

At their busiest times of the year, MFB schedules up to six to eight mobile pantries a week around their service area. There’s an intersection between the work that food banks and pantries do and the work that health care and social support services do to promote healthy lifestyles. One of the most active partners in this work is West Virginia University (WVU) Extension. It has offices in all 55 counties and is known for its long-running, popular programs like 4-H. It operates family nutrition programs in 40 counties. Several county extension offices offer similar programs that also address food insecurity; you can visit their website to learn what services are available in your area. Often, the food that food banks distribute is meant to have a long shelf life. Because of this, it is usually high in sodium and sugars and sometimes not conducive to a healthy diet. Programs offered by WVU Extension help

individuals make better choices in the food they eat and use the food they may receive from pantries to make healthy meals. For example, programs like Dining with Diabetes help participants cook healthier meals. Now that it is offered vitually, the program has gained a wider audience, since transportation has been a continual challenge to participation. On the county level, and in this intersection between food insecurity programs and nutrition education programs, organizations may collaborate to promote and provide joint programming. How often this happens depends on the community. There are other organizations that are community-based, social support programs that address hunger that are not part of the food bank network of subcontractors, and they may be active collaborators in their community. An example is Step by Step, Inc., which provides youth and adult programming in Kanawha, Lincoln, and Logan Counties. Like many nonprofit organizations, Step by Step’s work requires community involvement for its success. It collaborates with county school systems and housing projects to help deliver food, and it provides

meals in every afterschool program it operates, as well as at its community center. And so, it’s a crucial ally in the work to address food insecurity while not being a part of the food bank’s network. The organization is strategic in employing resources to cover gaps in services. During the session discussion, panelists agreed that the challenge to address food insecurity was still greater than the services available to address it. Improved local collaboration could help identify gaps and create a more synchronized effort to ensure sustainable availability of fresh, healthy food. For example, sometimes, food banks deliver seasonal produce. Could WVU Extension collaborate on classes offering recipes to help cook this produce in healthy ways? Could they cross-promote their programs? Step by Step has seen an increased demand for gardening classes during the pandemic. Would a collaborative approach to promoting gardening help address the lack of healthy food choices in our more rural communities? Could setting up a county-wide Facebook page or a social media site, for example, help bring more of these efforts under the same umbrella? The food insecurity infrastructure seems to have main lines of connectivity on the federal and state levels to the county level. On the county-to-community level, we find a handful of great projects that may or may not collaborate or coordinate services. There is no existing infrastructure to centralize, oversee, or harmonize efforts. Great programs and services can be available and may be well known within the community. Some may remain underutilized. Importantly, when considering the “hidden pockets of extreme poverty,” as one panelist put it, in the rural parts of these three counties, and that transportation is a substantial challenge for those living in these areas, a more targeted approach to addressing their needs would be beneficial. Without a comprehensive approach, it becomes challenging to ensure those living in remote areas without transportation, or without internet connectivity, are not left behind.

2021 ISSUE BRIEF: HEALTH & HUNGER SUMMIT SERIES IN BOONE, LINCOLN, & LOGAN COUNTIES

SESSION TWO

Health and Hunger in My Neighborhood Anitra Ellis, NP, Family Nurse Practitioner, Coalfield Health Center Mark Linville, Chief Marketing and Communications Officer, Boone Memorial Hospital Courtney Reynolds, PA-C, Chief Operations Officer, Southern West Virginia Health System

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West Virginia remains one of the unhealthiest states in the country. Can we address health inequities when we address hunger? Can we address hunger when individuals access health care? Can we build a two-way street to do both? U.S. News and World Report’s Healthiest Communities Rankings ranks every county in the country. The population health category assesses access to care, healthy behaviors, health conditions, mental health and resulting health outcomes within communities. This year, West Virginia scored a little over 11, out of 100, in the population health category. This is a low score, making us one of the unhealthiest states in the country. Boone County scored a six out of 100. Lincoln County scored a nine out of 100, and Logan County scored less than five out of 100. The work to improve the health of West Virginians in these three counties is an ongoing challenge. Research shows that patient health outcomes are greatly influenced by factors outside of clinical care, known as social determinants of health, including economic hardships like food insecurity. It’s often suggested that medical providers screen for food insecurity, and if the patient identifies as food insecure, refer the patient to the necessary community services. But how does this recommendation translate to the local level, knowing that counties are medically underserved, providers have limited time with patients, and importantly, often do not know where to refer patients if they identify as food insecure? What if there aren’t any community

services? How would the provider know if there are food pantries or other programs that address food insecurity in their communities, when there’s no centralized source of this information available? While these questions are complex and require a multipronged response, panelists agreed that communitybased collaboration is key. Dr. Ellis, for example, volunteers at a food pantry in her community in Logan County. Her organization, Coalfield Health Center, has provided COVID-19 vaccinations at the pantry. Through this partnership, she cultivates vital relationships, and she also has an opportunity to talk to patrons about healthy eating. For her, the collaboration provides an opportunity to easily bridge the two systems. In addition, she finds working in the pantry is a great way to build a rapport with potential patients. It helps her become a trusted face within the community. BUILDING BRIDGES AT THE COMMUNITY LEVEL

For Courtney Reynolds, also a medical provider, the community’s main pantry is less than a mile from the Southern West Virginia Health System’s central location in Lincoln County. Patients who identify as food insecure can be directed to stop by the pantry when leaving the health care provider’s office. She believes screening for food insecurity without a direct resource to refer a patient to shouldn’t be problematic, and it shouldn’t stop a provider from screening. That information should affect how the provider cares for and responds to the patient. Screening and talking to a patient about food insecurity and finding ways to access nutritious food, over time, is an excellent way to build trust and honesty between provider and patient. Our third panelist probed a larger question: How can a health care system, not just a provider, address food insecurity?

A centralized agency could do more than serve as collaborative referral support. In Boone, Lincoln, and Logan Counties, a high number of residents are insured by Medicaid. The Medicaid population is less likely to access preventive services, like annual well exams, than other populations. Coordinated campaigns that support and promote each other’s services could help ensure that residents hear consistent messaging that supports care for their health and overall well-being. For example, when an individual enrolls in Medicaid at their local WV Department of Health and Human Resource (WVDHHR) office, they can be referred to local health care organizations that accept Medicaid. The health care organization can screen and refer patients to local services. And importantly, all could have the same list of local agencies that address food insecurity. This centralized agency can ensure all points on this pathway have updated information. The challenges to improving the health of individuals in this three-county area are many and complex. Often health problems stem from poor nutrition. Providers and health care organizations are acutely aware of these connections between good health and proper nutrition, and that food insecurity and lack of healthy foods are foundational, historical challenges affecting these rural communities. Perhaps more public conversations to shed light on the challenges and potential solutions can help facilitate a more collaborative approach.

Boone Memorial Hospital, which provides an array of services, and serves a larger geographic area, works to address food insecurity in the clinical and community setting but finds it challenging to locate those critical community resource providers in their service area. With many medical providers, can a hospital system recommend a protocol to refer patients towards existing community services without a centralized list of these services? As Mark Linville explained, “We need an established lead agency…a continuous, sustainable organization that we can depend on year-round” to identify and collaborate with the hospital.

Until then, each of these three health care organizations continues to address food insecurity and promote healthy lifestyles in their communities. For example, Boone Memorial Hospital runs a Healthy Lifestyle Program. Southern West Virginia Health System holds an annual FIT Camp for kids, and Coalfield Health Center is an active member of Wild Wonderful and Healthy Logan County. We should all play a part in promoting and engaging our neighbors to participate. Our community’s health depends on it.

Is it feasible that this can be a role played by one of West Virginia’s food banks on the county level? A WVDHHR office? A nonprofit willing to serve as the lead agency in its county? Would a state-funded pilot program help assess the feasibility of a statewide network? Clearly, two-way streets at the intersection between the health care system and the food insecurity infrastructure are optimal when connecting patients to services that address the social determinants of health, or social services that can shepherd clients towards utilizing health care services.

2021 ISSUE BRIEF: HEALTH & HUNGER SUMMIT SERIES IN BOONE, LINCOLN, & LOGAN COUNTIES

SESSION THREE

At the Intersection of Health and Hunger Chad Akers, Director, Hungry Lambs Food Initiative Michelle Akers, Program Administrator, The Fresh Start Program Brandi Browning, Director of Community Services, PRIDE Community Services

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Sometimes, around our state, local programs build a ground-up, collaborative approach to respond to its community needs. While it’s hard to know where these great collaborations are happening, we heard from one group in Logan County that has taught us the benefits and challenges of working together. Hungry Lambs Food Initiative is a food pantry that opened in 1991 at the First Presbyterian Church of Logan. It has grown over the years with the support the church and local donors, but the sudden increase in demand due to the COVID-19 pandemic necessitated a move to its new location at the Logan County Resource Center. For years, like many food pantries around the state, Hungry Lambs was staffed by volunteers who were older adults. Because they were a demographic more likely to get sick from COVID-19, they could not continue to keep the pantry open to meet the increased demand for services, which was also created by the pandemic. And so, Chad Akers, a local businessman whose mother was one of the pantry’s volunteers, agreed to step in as director. Hungry Lambs primarily serves Logan County, as well as parts of Mingo and Boone. According to Chad, at the pandemic’s peak, Hungry Lambs averaged 175 to 200 families a month who received food boxes via drive-thru services. In 2020, the population of Peach Creek was estimated at 348 people. It was a surprisingly

high number of residents from Logan and surrounding counties traveling to Peach Creek for assistance. Like many food pantries around the area, Hungry Lambs contracts with Facing Hunger Foodbank. Some of the food it receives is free; some must be purchased. It also orders discounted food from Kroger. And so, there are overhead and operating expenses to keep the pantry viable. The overhead grows as need and capacity increase. With the recent move to the Logan County Resource Center, Hungry Lambs found itself with the opportunity to serve as a community hub for both health and hunger services. Chad described it as “one-stop shopping.” Its community partnerships have included: The Logan County Health Department (which has a remote office in the Resource Center), Coalfield Health Center, the Quick Response Team in Logan County, the West Virginia Food and Farm Coalition, and teams of emergency medical technicians. BUILDING BRIDGES AT THE COMMUNITY LEVEL

Two notable partnerships that were the focus of this panel discussion are with the Fresh Start Program and PRIDE Community Services. The Fresh Start Program began as a gardening project in the Southwestern Regional Day Report Center, funded through the Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP). Since 2017, the program has served Lincoln, Logan, and Mingo Counties. Anyone who is in substance use disorder (SUD) recovery is eligible to participate in the program, and the program helps those in recovery re-engage with their community. As Michelle Akers described it, the Fresh Start Program participants were “some of the most active, reliable volunteers that Hungry Lambs has had during the pandemic.” Like the Hungry Lambs Food Initiative, the Fresh Start Program has expanded in size and services. Once it started growing more vegetables than the participants

could eat, they started donating the vegetables to Hungry Lambs. Soon, they began raising chickens and donated the eggs as well. Hungry Lambs second notable partnership is with PRIDE Community Services, part of the Community Action Partnership— a national membership organization that provides technical assistance, training, and other resources and funded in part through a Community Services Block Grant (CSBG). It is one of sixteen designated community action agencies in West Virginia, and it operates several social service programs in its community, such as in-home services, senior programs, family stabilization, and volunteer services. Its clients complete a screening intake form to identify the services they need. So, the organization is in a pivotal position to identify those who may be food insecure and refer them to appropriate services.

Together, these partners have collaborated on several projects at the Logan County Resource Center since Hungry Lambs move to this location, such as building fruit stands for their Farmer’s Market. In addition, they’ve offered job training for members of the Fresh Start Program that has led to employment opportunities. They have also collaborated with the West Virginia Department of Health and Human Resources for career training opportunities through a West Virginia National Guardsponsored program called Patriot Guardians. While Logan County does not have a county coalition that works to coordinate programs, these organizations have taken the initiative to use these partnerships to their advantage. Panelists agreed that not all organizations with similar missions in the county are interested in collaborating. They also agreed that embracing a collaborative approach to addressing food insecurity and strategies to make more healthy foods available in the community has helped them make great strides in addressing these challenges. Importantly, having all these services in the same proximity has helped them look at health and hunger more holistically. And it has helped address the stigma of utilizing services in several ways. For one, those who were perhaps too embarrassed or ashamed to visit a food pantry could come to the resource center for another program or service. It’s an opportunity to subtly refer individuals to services that, for a variety of reason, they may have been too apprehensive to access— from food insecurity, to health screenings, to COVID-19 testing and vaccinations, to information on substance use disorder and treatment services. Having a “hub” like the Logan County Resource Center is an incredible opportunity and highly recommended by the panel. They also agreed that the constant pursuit of funding to sustain their efforts is a continuing challenge. They wondered whether forming a nonprofit coalition would make it easier to find larger funding sources to sustain their work. Having to piecemeal grant project funding together, and the fear of losing progress and staff at the end of each grant cycle, is an ongoing concern. Writing grants takes considerable time, and not all grant projects are funded. Panelists agreed that building a robust, collaborative, community-level approach to addressing health and hunger is critical and beneficial, but only sustainable when funding is available. They recommended consistent State funding to ensure good projects don’t end when the grants end, creating a vacuum in services in their communities

2021 ISSUE BRIEF: HEALTH & HUNGER SUMMIT SERIES IN BOONE, LINCOLN, & LOGAN COUNTIES

SESSION FOUR

Good Food is Good Health Vandalyn Justice, Social Service Director, The Salvation Army of Charleston Amanda Komorowski, Retail Donation Coordinator, Mountaineer Food Bank Michael Tierney, Executive Director, Step by Step, Inc.

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Like the United Way, Catholic Charities, and the Salvation Army, a few organizations in our state provide services that address both health and hunger across the state. How do these services succeed when there’s no centralized infrastructure? How do they know when and where their services are needed? How can we tie the threads together into a tighter safety net? The Salvation Army provides food, clothing, and utility assistance in seven West Virginia counties, including Boone, Lincoln, Logan Counties. Its Charleston office, which serves Boone and Logan Counties, served food to approximately 900 households, or 1934 individuals, in 2020. That’s impressive, considering its program has a two-person staff. Like other regional programs, many of the services it provides are in counties where it does not have an office. The West Virginia 2-1-1 referral and information service helps them identify this demand. When the Salvation Army receives many food assistance referrals in Boone County, for example, it will schedule a food distribution delivery in that area. Mobile food pantries have a high overhead cost, and this must be considered when planning food delivery to a remote location. At the start of the pandemic, the Salvation Army’s national program provided food to its state offices for free. But now, the state office must purchase the food, and as panelist Vandy Justice

explained, it can “get pricey.” The food itself costs around $4,000-5,000 per distribution. Because the Salvation Army has no “homesite” in Boone or Logan Counties, everything must be shipped there, which increases costs. It’s important to remember that WV 2-1-1 is operated by the United Way and a resource for both organizations and individuals; that’s how they be directed to the Salvation Army. While this resource strives to maintain a comprehensive site of services across the state, if food banks or pantries do not share their information, it is not listed in the 2-1-1 database. And so, the Salvation Army cannot refer its clients to services if it does not know they’re there. It also can’t afford to make regular food shipments to these counties. In Kanawha County, a community group like the Kanawha Valley Collective brings partners together for BUILDING BRIDGES AT THE COMMUNITY LEVEL

a collaborative approach to address homelessness and hunger. But not every county has such a group. If the WVDHHR had more active staff members in county offices who participated in a collaborative approach such as this, it could refer more clients to local resources, as well as help encourage these small organizations to share their information with the United Way’s 2-1-1 database. As mentioned in our first session of the series, food banks can also provide programming in needed communities by partnering with pantries in their network of subcontractors. They can help provide targeted programs if there’s a gap in local services. In Boone County, MFB partners with Shepherds Heart Food Pantry for the Feeding Families Prime (FFP) program. The program is a holistic approach to the traditional food pantry and is free for participants, funded by the state, and focuses on clients with preexisting medical conditions. As previously discussed,

much of the food distributed by food banks and pantries are meant for optimal shelf life and can be high in salt and sugars. They’re not always considered healthy foods, and so, this program is a response to the need to ensure more nutritious foods are available, and attendees learn ways to better prepare healthy options and adopt healthier lifestyles. They also receive unconventional educational opportunities, like Naloxone training. Shepherds Heart Food Pantry is in Whitesville, which is in Boone County, with a population of 21,500. And yet, despite COVID-19 restrictions, they’ve had a robust turnout— sometimes nearly 100 attendees. Often participants are also the volunteers who unpack food from the delivery truck. Notably, a program such as this must rely on an extensive community turnout to keep the program sustainable. It takes MFB a day’s trip to travel to Boone County, and planning logistics can be complicated, considering limited internet and cell service in Whitesville.

MFB and Shepherds Heart Food Pantry partner with WVU Extension to provide educational materials and speakers. The program’s manager, Amanda Komorowski, said that she is always looking for more partners— especially ones who can provide services needed but not found in the community, such as mental health care, adult literacy services, and utility and housing services. She has funding to help expand a community garden project, but as it often happens, she hasn’t found a community partner. All of this harkens back to the need to build local, collaborative responses to health and hunger. Much like panelist Michael Tierney said, “A community garden is everyone’s garden and no one’s garden,” many communities are working to respond to their community’s needs. Sometimes they are not communicating and collaborating to ensure that services aren’t duplicated, and programs are working together to refer individuals to each other’s services. For larger organizations like the Salvation Army and the United Way, it’s virtually impossible to refer those who contact them to community-based efforts when they don’t know they’re there. If done strategically, we could address and prioritize needs. For example, summer feeding programs for students rely on community-based programs to serve as feeding sites. Unfortunately, over the years, the number of these sites has dwindled. Panelists made a few suggestions as to how communities could build better healthy food resource programs on the local level. Programs can utilize the AmeriCorps program, especially AmeriCorps VISTA summer positions. They can also find community partners and apply for grant projects, like mini-grants awarded by Try This West Virginia. This type of project initiates an important dialogue between organizations to identify and prioritize needs and helps them learn to work together. Embracing the spirit of community engagement is critically important to address health and hunger. Engaging folks who want to volunteer in these efforts— especially adolescents and teens— is a critical piece of the puzzle. As many echoed during the summit series, now more than ever, because of the pandemic, food is more plentiful. What we lack is a collaborative approach that “plugs in” all efforts, large or local, into the same system to advance community health and address food insecurity. If we can unite in this work, we’ll build better bridges between health and hunger down to the local level of our rural communities.

2021 ISSUE BRIEF: HEALTH & HUNGER SUMMIT SERIES IN BOONE, LINCOLN, & LOGAN COUNTIES

Recommendations Every county needs an organization that will serve as a collaborative conduit that connects efforts between county-wide organizations serving food and providing nutrition education. This organization can centralize and share community activities— like upcoming mobile pantries and education classes— on a centralized social media page that includes volunteer opportunities to engage the community better. How this can be done should be a discussion with local and state policymakers. The state should incentivize our state’s two food banks to upload their subcontractor lists into West Virginia 2-1-1 database on an annual basis. As this database is the only centralized site of pantries and nutrition education in the state, it can serve the essential function of maintaining a centralized list of state and local programs. In addition, now that the database utilizes the Aunt Bertha platform, health care organizations can connect their electronic health record to the database and better refer patients to local services. Encourage stakeholder dialogues on the county level that include organizations sharing respective strategic plans and funding streams. Far too often, programs find themselves competing for grants or providing duplicative programming, when there’s already more work than we can collectively accomplish. One organization may be restricted to fund an essential component of a project, while another may have funds available. By working together, we can more efficiently address demand and capitalize on our strengths.

Advocacy groups should initiate a statewide dialogue to address the lack of community programs to serve as summer feeding program sites. Lack of transportation is a historical and ongoing challenge to addressing food insecurity in our communities. Without summer feeding sites, many children will not have access to healthy food during the summer months. By working with the West Virginia Department of Education’s Office of Child Nutrition, stakeholders can identify counties in need of sites and target PR efforts to recruit new providers. Create a cross-sectional task force to revisit transportation challenges in our state. While lack of transportation is a persistent challenge, we see little effort on state and county levels to address it. Now, as we transition to a post-pandemic world, it’s a good time to revisit these historic challenges collectively, as well as discuss how virtual programming can be better utilized. The pandemic has taught us that food insecurity can affect any of us. Stigma is a continuing problem, and it inhibits people from accessing services. A statewide, or at least a three-county campaign, to elevate this message and encourage people to utilize the services available to them would help address stigma. Create more youth internships and volunteer opportunities where kids can become meaningfully engaged in programs that address health and hunger. This will help build a greater sense of community, and it will help ensure our food insecurity infrastructure isn’t relying solely on older adult volunteers. BUILDING BRIDGES AT THE COMMUNITY LEVEL

RESOURCES Active Southern West Virginia is a nonprofit providing an ecosystem of physical activity for the residents of southern West Virginia by offering programs led by trained volunteers from within the communities it serves. In 2020, the organization included Boone County in its six-county service area. For a full calendar of events with program updates, descriptions, and driving directions, please visit: https://activeswv.org/calendar/. AmeriCorps NCCC is a full-time service program that covers lodging and travel expenses, allowing young adults to serve on a team and make an impact in communities across the country while gaining valuable leadership skills. BARN Community Center incorporates the first letter of the four non-incorporated communities in the surrounding area: Bruston, Ashford, Ridgeview, and Nellis- to create an acronym for its name. The mission of the BARN is two-tiered: the immediate or emergency needs of people in the community, without judgment via services such as substance abuse recovery, financial assistance for education, and help with things like utilities and transportation until they can get back up on their feet. Boone Memorial Hospital is a critical access hospital. With a 25-inpatient bed count and 24-hour emergency room, the hospital is a medical hub in its community, with a myriad of services and educational and community events such as Food and Toy Drives, Go Red for Women campaign events, blood drives, lunch and learn health education sessions, and an annual health fair. Coalfield Health Center is a rural, nonprofit organization that provides primary and preventive health care services to Chapmanville and the surrounding area. Coalfield Health Center officially began operations in July 2009. As a Federally Qualified Health Center Look-Alike, the center’s services are available to all residents of the area regardless of their income level, insurance status, or residency. Energy Express is a six-week summer reading and nutrition program for children living in West Virginia’s rural and low-income communities. More than 3,000 children statewide gain or maintain reading levels during summer months through creative, colorful, and captivating uses of art, drama, and vocabulary. The program provides children with two nutritious meals each day during the program, helping to ensure our youths are fed each day even after the school year comes to an end. Energy Express is offered in various counties at select locations.

Facing Hunger Foodbank serves 17 counties in three states. It provides canned, boxed, fresh, frozen, and prepared food to nearly 116,000 individuals annually. This food is recovered and secured from restaurants, supermarkets, food distributors, the USDA, farmers, wholesalers, sportsmen, and through food and fund drives. It distributes emergency food through 248 partner agencies and programs, including soup kitchens, neighborhood centers, family crisis centers, and homeless shelters for adults and children. The Fresh Start Program is a comprehensive opioid abuse treatment program, managed by the Southwestern Regional Day Report Center. It accepts referrals from various entities such as probation, home confinement, self-referrals, etc. This program is intended to connect individuals back into their community through various means such as community gardens, volunteering, agricultural and artisan programming, and community engagement. It serves Logan, Lincoln, and Mingo Counties. Grow Appalachia is a community garden-based food security program, headquartered at Berea College in Berea, Kentucky. It is currently in its 12th year of operation and seeks to help as many Appalachian families grow as much of their own food as possible. Hungry Lambs Food Initiative began in 1991 at the First Presbyterian Church of Logan. Back then, a small group of church members would drive to Coal Mountain Food Bank to purchase food. Now, the organization is one of the largest pantries in Logan County and partners with several organizations, including: Facing Hunger Foodbank, the Fresh Start Program, PRIDE Community Services, Coalfield Health Center, and the Logan County Health Department. Mountaineer Food Bank launched in 1981 in Gassaway, due to its central location. It is the largest emergency food provider in West Virginia, distributing over 29 million pounds annually. MFB provides food and other household items to over 480 feeding programs in 48 counties in West Virginia, including Boone County. It is part of the Feeding America network. If you’re interested in volunteering with Mountaineer Food Bank, contact Melissa England, Volunteer Coordinator, at 304-364-5518. Partners in Prevention is a unique model of communities working together to strengthen families and help West Virginia’s children grow up free from abuse and neglect. The Partners in Prevention network comprises 42 community teams across West Virginia implementing

2021 ISSUE BRIEF: HEALTH & HUNGER SUMMIT SERIES IN BOONE, LINCOLN, & LOGAN COUNTIES

various community projects and working together to keep children safe. The network offers family support, resource distribution, educational workshops, and referral to other services when needed. Patriot Guardens is an integrated agriculture and economic diversification initiative of the West Virginia Military Authority that is aligning and mobilizing strategic efforts to provide new economic and employment opportunities. The initiative involves partnerships with West Virginia State University (WVSU) Extension Service, the U.S. Department of Agriculture Appalachian Small Fruit Research Station at Kearneysville, NRCS, West Virginia University, Marshall University, Shepherd University, and landowners and coal operators across the state. PRIDE Community Services is part of the Community Action Partnership, which is an alliance of nonprofit private and public organizations established under the Economic Opportunity Act of 1964. It positively impacts the lives of those in need by bringing together educational, financial, and human resources that support self-sufficiency. The agency currently has approximately 125 dedicated full and part-time employees. The Salvation Army is a worldwide evangelical Christian church with its own distinctive governance and practice. Its offices in Charleston and Huntington provide services to 11 West Virginia counties. It offers a wide range of traditional and social services, and emergency assistance programs, including: financial assistance, prescription assistance, thrift stores, senior citizen services, hygiene supplies, and food pantries. Southern West Virginia Health System is a federally qualified health center with 17 locations serving Boone, Kanawha, Lincoln, Logan, and Mingo Counties. With a focus on family medicine, SWVHS has expanded services to include mental, dental, and urgent care. As an FQHC, it provides services on a sliding fee scale. Starting Points Centers are community resource providers that offer programs and services that support and strengthen families through interagency coordination and collaboration. These services are easily accessible and located within the counties they serve.

Grow Appalachia chapters in Lincoln and Logan Counties are part of a long-term commitment to food security through which it has started over 30 afterschool or summer food programs. In addition, it sponsors over 30 AmeriCorps VISTA and 40 direct service AmeriCorps members each year, both investing in local leaders and bringing new volunteers into the region. Many programs are piloted from the Big Ugly Community Center in southern Lincoln County, founded in 1995. TEAM for West Virginia Children is a nonprofit organization whose mission is to work with communities and families to promote and advance the well-being of children, making their needs and healthy development a priority. Try This West Virginia is a statewide grassroots movement to help knock West Virginia off the top of the worst health lists, community by community. It creates partnerships between local people who want to create healthier communities and a coalition of state-andregional-level groups who can help them do that. Mini-grants to pay for community projects are sometimes available. United Way improves lives by mobilizing the caring power of communities worldwide to advance the common good. It is an international network of over 1,800 local nonprofit affiliates. It has 15 offices across West Virginia. Volunteer WV is the state’s commission for national and community service. It seeks to improve and boost volunteer participation in the state. West Virginia 2-1-1 is a database that keeps accurate and comprehensive data that individuals and organizations can use to find health and human services to meet the needs of West Virginians. Its database allows you to browse hundreds of health and human services online, learn about specific programs, intake requirements, eligibility, operation hours, and more. This information and referral service is operated by the United Ways of West Virginia. WV Community Development HUB is a statewide nonprofit organization that helps communities and sectors come together to set goals for their future and connects them to the rich network of resources they need to meet those goals.

Step by Step Inc. is a grassroots nonprofit organization that has been serving counties across the state of West Virginia for 33 years. Today, it has over 100 people on its payroll and a $1.2 million budget. It provides afterschool and summer programming and mentoring initiatives at over 15 sites across Lincoln, Logan, and Kanawha Counties.

BUILDING BRIDGES AT THE COMMUNITY LEVEL

RESOURCES (continued) WV Family Resource Networks (FRNs) are organizations that respond to the needs and opportunities of the community. Partnering with community members and public and private organizations, the WVFRN members develop innovative projects and provide needed resources for their local areas. Their initiatives demonstrate the network’s commitment to community development in the region. WV Food and Farm Coalition is a 501(c)(3) nonprofit organization that works to build the local food and agriculture system in West Virginia in a way that provides viable incomes for farmers and local foods businesses and ensures all residents have access to locally produced food. Its vision is that West Virginia will be a place where farmers and local foods and agriculture businesses can make a living working within a robust network to grow, process, distribute, and market their products, and that provides healthy, locally produced food to communities. WV Health Connection is a collaborative effort led by the West Virginia Bureau for Public Health, Division of Health Promotion and Chronic Disease. WV Health Connection is a system for patients to discover community wellness programs that are convenient and accessible. To do this, WV Health Connection links health care providers to local chronic disease prevention services and connects patients to health promotion programs. West Virginia University Extension Service is an educational and service outreach program of the university and federal, state, and local governments. It has staff serving all 55 counties. The major programs and services are: agricultural education, master gardeners, 4-H and youth development, nutrition outreach, and childcare development. Wild, Wonderful, Healthy Logan County is comprised of cross-sector organizations working together to create a community health plan. Its vision is to create a culture of health in Logan County to unleash community prosperity.

2021 ISSUE BRIEF: HEALTH & HUNGER SUMMIT SERIES IN BOONE, LINCOLN, & LOGAN COUNTIES

About Think Kids Think Kids is a 501(c)(3) nonprofit organization that launched in 2020 with the goal of using data-driven advocacy to make meaningful change. We work to ensure that generations of West Virginia’s kids grow up safe, healthy, and aspire to do great things. We work to connect parents, guardians, and care providers with resources and services that ensure that kids are raised in safe, healthy communities. And, we inform and promote changes to local policies, systems, and environments to foster healthy living and prevent health inequities. Kids are the most important investment we can make to change the trajectory of poor health outcomes in our state. To learn more, check out our bi-monthly newsletter, our website, and our Facebook page.

About the Pallottine Foundation of Huntington Formed in 2017 by the Pallottine Missionary Sisters, the Pallottine Foundation of Huntington supports nonprofit organizations across the Tri-State community, providing health-related services in nine West Virginia counties, eight Kentucky counties, and three Ohio counties. Its mission is to support transformative health initiatives that empower all individuals to lead lives of optimal health, selfreliance, and self-respect and striving to foster systemic change and collaborative impact in the community.

Think Kids • 4801 Country Club Blvd. • South Charleston, WV 25309 • 304.410.0499

Contact: Kelli Caseman at kelli@thinkkidswv.org

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Issue Brief— Health & Hunger in WV: Building Bridges at the Community Level in Boone, Lincoln, Logan

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Session Four

About Us

Session Three

Resources

Introduction

Session One

Session Two