Taking Healthcare by Storm: Industry Insights with Cyndi Kirkhart

In this captivating episode of Taking Healthcare by Storm, delve into the world of expert insights as Quality Insights Medical Director Dr. Jean Storm engages in a thought-provoking and informative discussion with Cyndi Kirkhart, CEO of Facing Hunger Foodbank in Huntington, West Virginia. 

If you have any topics or guests you'd like to see on future episodes, reach out to us on our website. 

This material was prepared by Quality Insights, a Quality Innovation Network-Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication number 12SOW-QI-GEN-092724-GK

Transcript

Welcome to Taking Healthcare by Storm, Industry Insights.

The podcast that delves into the captivating intersection of innovation, science, compassion, and care.

In each episode, Quality Insights Medical Director, Dr.

Jean Storm, will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists, and brave patients navigating their own healthcare journeys.

Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania, and the nation.

Subscribe now, and together, we can take healthcare by storm.

Hello, everyone, and welcome to Taking Healthcare by Storm.

I am Dr.

Jean Storm, the Medical Director at Quality Insights.

And today, we are honored to have Cyndi Kirkhart, the CEO of Facing Hunger Foodbank, under her leadership, the food bank has become a vital resource in West Virginia, providing nutritious food to nearly 130,000 individuals each year.

Through partnerships with restaurants, supermarkets, and various organizations, Facing Hunger collects and distributes a diverse array of food items, from fresh produce to prepared meals.

Cyndi and her team are not only alleviating hunger, but also empowering local organizations to further their missions.

They serve a vast region across West Virginia, Kentucky, and Ohio.

Facing Hunger Foodbank is a beacon of hope for countless families, and I am excited to talk about what Cyndi and her team are doing to combat food insecurity and improve health outcomes in West Virginia.

Cyndi, thank you so much for joining us today.

Oh my gosh.

Thank you.

That's quite a build up.

And even though I remain excited about our work every day, listening to you kind of reflect on our work, I'm even more excited.

If it could be possible.

Yeah.

So you're going to carry me through to the weekend.

Good.

So let's jump in.

Tell us how you came to do what you do.

Well, you know, I'm originally from the Huntington area, but in a rural community, about 15 miles outside of Huntington.

So daughter of Marshall, you know, but I had always known, my mom really raised me with what we refer to as a servant chart.

We didn't have a lot.

And, you know, on occasion, we would rely on our local church, who would bring a food box and, you know, support us that way.

My mom always worked, but, you know, things sometimes were very difficult.

And so I came up, you know, and knowing that I wanted to be in a life of service, and one of my first positions out of Marshall was at Branch's Domestic Violence Shelter as a shelter worker.

And that has, you know, was the foundation for a career, many years of social service work, community mental health work.

And so it kind of was a full circle moment, you know, when I landed at the food bank.

I had been at Legal Aid and was a patient advocate there.

And, you know, someone called me and said, hey, you know, we'd like for you to interview for the food bank.

And I said, I don't know how to run a warehouse.

And the board chair at that time said, I don't either, but I can run the food bank.

So I feel like I have worked with the same people in various, you know, needs and what we refer to now, social determinants of health.

And now this is the most basic of needs, food.

Absolutely.

So you are from West Virginia.

Your heart is there.

Always.

Yeah.

And, you know, I did the typical with folks from, you know, young people in particular, West Virginia.

You want to see other places.

So I lived in Atlanta for a while and worked in an outdoor wilderness treatment center for juveniles.

And then I moved to Florida.

And, you know, probably in 1998 I came back.

And I've been here ever since.

And I did move across the river for love.

And, you know, so we have a farm over in Ohio, but I'm West Virginia's strong man every day, every day.

Yeah, the strongest people are from West Virginia, absolutely.

So tell us about Facing Hunger Foodbank.

Okay.

So I started there in 2014 and walked into a food bank that had a team of 13 people.

We had come off a difficult period and were highly under-resourced.

But we were doing some real basic programming.

Backpack programming was a pretty big deal for us.

We had, at that time, 1,250 kids in Lincoln County, West Virginia that we served.

We were doing just the minimum, to be really honest with you.

We have few food resources.

The Department of Ag USDA programs did not have a lot of food.

And since that time, we really committed to how can we best serve the communities at the center of our work.

Now, you know, I have a team.

We will add our 50th person here just within the month.

Our programs have grown significantly.

And rather than to kind of survive with our food resources, we're thriving.

We've developed those retail relationships that you referred to.

We have, you know, now everyone talks about Dollar General.

But let me tell you, Dollar General and as many communities as those stores are in that we serve, they also donate a good amount of not only shelf-stable, but their fresh products to our agency-enabled, you know, agencies and local pantries are picking up from those stores.

So we went from under 3 million pounds of food to, you know, we're topping 16 million pounds of food.

And, you know, the thing I'm most proud of is, we're at probably 85 percent of foods to encourage, you know, those healthy, lean protein, fresh produce, fresh fruit, and a lot of that's supported by our Medically Tailored Food Box program, which is a grocery food box with the addition of produce and lean protein, and when we can, green protein.

So we're like growing for them.

Yeah.

And those foods are so very important with chronic disease, which we're going to talk about in a little bit.

I wanted to talk just a little bit about the pandemic, and in your opinion, did food insecurity worsen during the pandemic, and has food insecurity returned to pre-pandemic levels now?

Okay.

So the food insecurity rate during the pandemic almost immediately increased by 50 percent.

And surprisingly, some of our outlying counties that have always had high unemployment rates and high poverty levels, I didn't see a 50 percent increase there.

I saw that 50 percent increase in like, Cabell County, and clearly, we are in partnership with Mountaineer Food Bank in Kanawha County.

So all of the food service folks that suddenly were unemployed, created just a huge demand for us.

And, man, we weathered through that and really pivoted to get as much food as possible.

And as you might imagine, we received so much support from the community because hunger suddenly became a very real thing.

Not only had people lost their jobs, it was very difficult to access food because production went down and there were real challenges with logistics.

And frankly, we have maintained about a 24 percent increase year over pre-pandemic since that time because of inflation.

And again, the challenges of building back the economy after the incredible impact of that pandemic time.

Yeah, it still continues to be a challenge.

So do you feel that food insecurity is linked to other social determinants of health like lack of education and poverty?

Oh, absolutely.

Absolutely.

People talk a lot about, well, people can make better decisions.

So West Virginia is like number one in obesity.

And people say, well, how can people be overweight if their food insecure?

It's the quality of food that they can afford and that they can get.

If you're eating a lot of waste calories, or you're eating products that you can afford, that's really going to impact your nutrition.

And then ultimately, all of those other areas of your life, transportation, is huge.

Housing is huge.

We see such a broad variety of folks who access our services, folks that are in recovery, who are actively recovering.

We have a healthy workforce development for second chance and fair chance folks.

So we see a lot of folks who are in mobile, are seniors.

We have a high senior population of West Virginia.

At one point, West Virginia is on track to be the greatest state in the nation by 2030.

That's not that far away.

And I am, and when I talk about those people, I am those people.

I'm 63.

So with the geography that we have, the rural and remote communities, senior benefits never are enough anyway.

And then if you can't get into the food, you buy what you can get.

Access to healthy food in a lot of communities is not available in a lot of places.

So we have found that our medically tailored food box program, along with our Senior Commodity Box Program, is providing incredible nutrition to our most vulnerable populations.

And folks who by nature of lack of health care have developed some chronic disease.

And these food boxes are healthy foods that are generally more costly to purchase.

So we're seeing really some big gains on people's self-management of chronic disease because they have the right foods at the right time, and they are able to help themselves.

Yeah, and I really want to delve into those medically indicated food boxes.

But talking about individuals with chronic diseases, I don't think many people link food insecurity with individuals with chronic diseases.

So do you feel that individuals who have chronic diseases, let's say especially in West Virginia, do these individuals experience more food insecurity?

I absolutely believe that.

And we've been doing that programming since 2017.

So I really feel pretty well-versed to be able to speak to that.

You know, I mean, in your heart, sometimes you feel a certain way, but then to really spend time talking to these folks that are diabetic or have chronic heart disease, and you know, the cancers that prevail in our state, as well as, you know, just the challenge of a healthy diet.

You know, I'm hearing those folks say, I feel like I would have done better if I had had access to the, you know, to food.

You know, and that means a lot of different things to a lot of people.

You know, as folks have gotten older, they've reported that they couldn't open up things or they couldn't cut things.

And so that limited their choices to pursue better diet.

So I think it goes hand in hand, frankly.

Yeah, and you know, when we think about rural areas, I think a lot of people think about rural areas, maybe there's a lot of farms, so they don't link rural areas to food insecurity.

So do you see that in West Virginia, that there's a lot of food insecurity in rural areas?

I do.

And you know, people say, well, there are so many people that farm and they raise gardens.

In a lot of areas in the coal field, there's not a lot of flat space for a lot of gardening, right?

You might be able to do a little small thing.

You know, the big box stores took away a lot of the smaller grocery stores even like that I grew up with as a kid.

So local convenience stores have kind of stepped in to be the grocery stores in rural communities.

And things cost a lot more, because they are not buying at the same volume that a bigger box store can buy.

Transportation is an issue.

People would love to go to grocery stores, have a wider selection and a variety of products.

But if you can't get there, you know, you're kind of stuck with what you can access in your community.

And we see a lot of that, I mean, I've had a call from folks that a pantry was within two miles of where they live.

But they're caring for grandchildren in some cases, or they have mobility issues.

So they would have to walk.

And yeah, the vision of someone walking along a road with a toddler, and you know, like a walking device to help them stay steady, and then to carry food back, that's very challenging.

You know, we've been just really developed a high home delivery focus.

And you know, even in those instances, we're maybe able to get closer to home, because our vehicle can't get up the holler to actually pull up in front of the house.

So we're walking up to try and get where we agree to, we'll deposit the food, we'll be there at two o'clock.

If you can have someone meet us there, it's an approved proxy.

So, so many challenges in rural communities that kind of illustrate the experience of West Virginia, wild and wonderful.

Yeah, absolutely.

Transportation and just, yeah, being able to traverse the roads is a major challenge.

You bet.

So, you know, we think about SNAP benefits, and I think a lot of people think, oh, SNAP benefits just allow people, you know, to not experience food insecurity.

So do these SNAP benefits help all individuals who are experiencing food insecurity?

No.

No.

First and foremost, you know, SNAP benefits are an incredible resource.

West Virginia has a high utilization rate of SNAP benefits, but a lot of people will not access SNAP benefits because, you know, West Virginia, as you talk about how strong we are, we're all so prideful.

So a lot of seniors, as an example, who are raising their grandchildren and great-grandchildren, still will not apply for SNAP benefits and are, you know, trying to cover the food needs as well as all the other needs of those children, grandchildren, great-grandchildren, on their same level of benefits.

And frankly, SNAP benefits is basically $1.40 a meal per person in the home.

And that is not a lot, you know, every year in September, this is Hunger Action Month, I do the SNAP challenge.

And so I, you know, for a week live on the $1.40 a meal, so three meals a day, so it's $4.20.

And it's very hard.

And I think I know quite a bit about how I can, you know, shop very efficiently.

But it really cuts back on how much protein you have in your diet.

Meat has been so expensive for such a long time.

You know, people talk about, oh, well, people buy other things with their SNAP benefits.

They buy what they can afford with those benefits.

And while it is a valuable program, it is not meant to offset the entire nutritional needs of a family, because folks just can't afford it.

But if we didn't have SNAP benefits, they're providing like 12 meals.

Yeah, it's basically the one meal I can, because of, you know, that additional resource for families who continue to use the pantries and our resources through mobile pantries and that type of thing.

Yeah, and I think that's, you know, a lot of people maybe should do the SNAP Challenge and see how they live for a week.

What did you say?

$4 and change a day?

Yeah, yeah.

That may mean.

Yeah, you think, oh, I'll give up my coffee.

Oh, I'll give up my diet coke.

No, you're giving up a lot more.

Yeah.

I mean, I do a lot of peanut butter and, you know, sweet potatoes and, but meat is a minimum.

I mean, it's like a real treat, right?

Yeah, absolutely.

So let's talk about the programs that you are involved in.

So tell us first off about the backpack program.

Oh, my gosh.

I, 5,000, right around 5,000 kids a week are served with our backpack programming in partnership with either direct distribution from the food bank and our schools and the folks that we partner with.

We have some churches and individual groups that support backpack programming in their communities.

But we make it a full commitment that kids get six meals, so breakfast, lunch and dinner for Saturdays and Sundays, snacks, fruit juices, fruits, vegetables, and self-sable milk.

On the holiday weeks, you know, West Virginia is an example.

The week of Thanksgiving, there's no school because it's deer season.

So on holiday weeks, we send out more of a family pack because we understand that those families rely so heavily on the school meals during the regular school year.

When those school meals are gone, then you've got hungry kids during the day at home, and we want to ensure that their resources match the demand as it were.

So we're in seven of our counties in West Virginia and make deliveries so that the food is on site and is either aggregated by school volunteers, or in some cases, we actually pre-package the backpack.

They're not in actual backpack.

We tried that early on, and we couldn't get the kids to bring the backpack back.

So they're packaged in plastic bags, and then they are discreetly distributed to kids prior to the weekend.

I will tell you that some kids love the food so much that by the time they get on the school bus, they've already kind of busted into it.

And in those circumstances, we actually have the bus drivers who will partner with the school and distribute the backpack as the child's getting off the bus.

So at least we get it towed, so that they'll have those resources over the weekend.

That's so amazing, and I don't think many people think about what's going on over the weekend.

I mean, just so essential, falling through the cracks.

You know, Jean, I will tell you, when I was a kid, we really didn't know, I didn't know that we were poor.

I think right now, children are very aware of the financial situations of their families.

They understand that they don't have resources.

I think that has created the situation in which kids really grow up fast.

I could tell you countless stories of high school and middle schoolers who are really looking out for their younger siblings.

I could tell you a story about a six-year-old who was stealing ketchup packs.

So he could take home for his little brother and make tomato soup by putting up with hot water.

You know, our commitment to backpack programming is first and foremost, if you're focused on your stomach because you're hungry, you can't focus on the future and you can't learn.

We did a survey in Lincoln County at one point, and I, having been in behavioral health for years, was so surprised that the number one thing that teacher saw was improved self-esteem for the kids that got backpacks.

And it was because they were seeing the world not so much as a less than and deficit, but that people were caring about them.

And I could sob and cry saying to Steve that people were looking out for them, and then they felt better about themselves because somehow they felt more worthy.

And I mean, a bag of food to be able to do that, then we might have have a chance to lift kids to their potential, and their capacity versus that we stifled it by not giving them the tools to grow with.

Yeah, absolutely.

So let's talk about the Commodity Supplemental Food Program.

Tell us about that.

Well, that is a USDA program that is for seniors, qualifying seniors 60 and above.

And it is about 40 pounds of food.

It's a monthly food box that has protein, grains, vegetables, fruit, fruit juices.

You know, a variety of products that really are so beneficial to our seniors.

If there is a couple and they both qualify in terms of income and it's a means-tested program, then each individual gets a food box.

And they get that box regardless of any other emergency food assistance that they receive.

So that's an incredible program.

And for the state of West Virginia, you know, when we started the program in 2017, there were 30,000 seniors, 16 and above, that will qualify for the program.

That number has grown to 57,000 seniors.

And we're barely scratching the surface of how many that we serve.

Collectively between the two food banks, you know, we're in about 12,500 seniors across the state.

And you know, we every year qualify to increase that caseload because we appeal to USDA.

And look, we have, you know, the Farm Bill as a resource to fund that programming.

And every five years, here comes the Farm Bill.

And you know, we're, we have to advocate and fight hard for funding for that program and the Emergency Food Assistance Program.

So, West Virginia has a high demand.

And every year, we just keep pushing to get as many more caseloads, you know, folks added to our opportunity.

But it's a lot for the people on it, but there's still a lot of people we could serve.

Yeah, always, always more.

So, I'd love to talk about something that I just, I am so very excited about.

Tell us about the medically indicated food boxes.

I could talk about this with you all day long.

And you may have to rein me in.

I know where your heart lives on this.

I am right there with you.

I went to a conference, I think, in 2015.

And Massachusetts had done a pilot project about these medically tailored food boxes.

So, it was basically groceries that would be provided to folks with chronic disease.

In 2016, you know, I started talking with the folks at Campbell-Hanginton Hospital.

What, yeah, then became a Mountain Health Network, and it's now a partial health network, about how we could implement a program like that across, you know, their network of services.

And the opportunity came up with presenting us healthcare for folks on dialysis and end-stage renal disease.

So, that was my very first foray into that program, because I did not know that folks with end-stage renal disease, in many cases, require double the protein of, you know, typical adults.

And so, I got a Benetton Foundation grant, and we served in that grant period 827 folks with end-stage renal disease, and started to, you know, we followed their diet, you know, of low, no sugar, you know, low fat, followed all of the requirements.

It basically also fits the CMS requirements.

And started seeing incredible increases with albumin levels, and risk their responsivity to their treatment.

And then, you know, with every good thing, there's that other side of the blade, which is when the grant funding ran out, we also started to see, you know, the decreases because their health wasn't being supported by that food.

So I have shaken every bush, written every grant since that time to provide these food boxes in partnership with local healthcare partners, Marshall Health Network, Valley Health Systems down here, Southern West Virginia Health System, Family Medical Care, Williamson Health and Wellness.

And we're, you know, about 1500 program participants a month that we're taking in that good selection of fresh produce, frozen lean proteins, and then self-stable products that are diet compliant to help them self-manage their chronic disease.

We expanded it actually to the Edwards Comprehensive Cancer Center because we also understood that folks receiving cancer treatment needed additional nutrition and in many cases could not afford, like the supplemental protein shakes, the soft diet requirement.

So we have found some great partners to provide the food to best support these folks in pursuing optimal health with the resources to do that.

And we've seen across the board a reduction of about 25 percent in unscheduled medical interventions.

So like they're not crashing out and having to go to the emergency room.

We're seeing weight loss where it's indicated, weight increase, you know, especially with some of our cancer care folks.

Blood pressures have improved and A1C level, you know, being a little better managed.

And so, you know, I can't talk enough about the impact of food on, you know, just being the best medical treatment that we could offer.

And that's the most, it's the least expensive medical intervention.

And we've started serving kids to help them with healthy weight attainment.

And some of the young folks that were being kind of identified as pre-diabetes.

Yeah, food is medicine, most definitely.

Food is medicine, and it's such a better alternative than the medications and the needle sticks and all the things.

And yeah, West Virginia, we're Appalachian and we like our food.

And part of it has really been about re-educating people and the emotional attachment to food.

You know, if you grew up eating these things and you have such fond family memories, I'm talking a lot to our grandparents and saying, but we want you around to help raise your grandkids.

And, you know, we can make new memories.

And really educating about, I didn't know what savory was, you know, and seasonings for a long time because I had the typical Appalachian diet.

And it's been amazing to educate and orient people to new ways to prepare things and new seasonings and all those things they didn't know what to do with, you know, fruits and vegetables and squash and things like that.

And it's transformative.

And it's been a blessing.

And I hope with some efforts with some statewide partners that we'll be able to bring that programming to everyone, not just the people who are lucky enough to live where we have funding for it.

Yeah, most definitely.

So if people want to get involved and help, can they help and what should they do?

Well, you can help in so many ways.

First and foremost, if you're aware of a local pantry, you can be right there in your community and help your local pantry.

That's typically, you know, are all operating off of volunteers.

You show up, you can help distribute, you can donate food, you can donate your time, talent, treasure.

Second, you can help the food bank because we are serving, as you've referenced, 130,000 souls who rely on us in a variety of capacities.

You can call us at 304-523-6029.

You can go to our web page, facinghunger.org.

We have tabs about how you can help or where you can get help.

Again, time, talent, and treasure.

We love our volunteers.

We box up our CSFP boxes, our MIFV boxes.

So the way we can do that is with volunteer time.

We can always use money.

$1 provides non-meals because of our buying power.

Or, you know, you want to come in and help us do all kinds of things.

You know, office work or we have so many things that we have benefited from the people in the communities to come and help.

So there are so many ways to help out.

Yeah, most definitely.

And I hope people will.

So last question, I ask all of my guests, if you were in charge of health care in the United States, what is the first thing you would do?

Are you going to get me in trouble with this?

I feel like I could get in trouble with this.

I promise you won't get in trouble unless you say some curse words.

We'll just beat them out.

Okay, well, I'm not going to do that, but I will always fall down on the side of access to health care is key.

So we have to make it affordable for everyone.

If people have access to well visits, to just to have a doctor, and they are accessing that with the intention of valuing their health and well-being, then that really decreases the cost of health care when they show up and they are so sick that the interventions are the highest that they can be.

So I won't say the word socialized medicine, but I will say that we have to come up with a way for everyone to have access to appropriate health care, regardless of what that looks like for seniors, for children, for working families, for women.

We have to have access and it has to be affordable.

And I think right away that will encourage people to take better care of their health because every day, I see people who are making hard decisions.

They can't buy medicine because they need to buy food.

They can't pay for really high co-pays or deductibles because they have to buy food, they have to provide housing, they have to get to work.

So, that is the thing.

We have to find a way for everyone to have access and for it to be affordable.

It is not a privilege.

It has to be considered a right.

I will agree.

As common sense, I don't think that's controversial at all.

You know, it appears it can be.

It's a fact.

It's a fact.

And, you know, I say that from someone that has very conservative donors who talk to me about enabling people.

And I'm saying, you know, I'm contributing to people having better health.

And then that helps your bottom line for, you know, how much you as an employer pay for health care.

So it all is interconnected, similar to how we are in the world, right?

We're all connected and we all have value.

And I think that the availability of those basics for everyone reminds people and keeps them thinking about that they can contribute and be a part of everything that we do to make where we live a better place.

Yeah, absolutely.

Wonderful message to close with.

Cyndi Kirkhart, she's the Chief Executive Officer of Facing Hunger Foodbank.

Thank you so much for joining us.

I wish you well in your continued endeavors.

Thank you, Dr.

Jean.

The same to you.

Be well, continue to share our messaging.

And I'll look forward to listening to your work.

Thank you.

Be well.

Bye-bye.

Bye-bye.

Thank you for tuning in to Taking Healthcare by Storm, Industry Insights, with Quality Insights Medical Director, Dr.

Jean Storm.

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If you have any topics or guests you'd like to see on future episodes, you can reach out to us on our website.

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So until next time, stay curious, stay compassionate, and keep taking healthcare by storm.