1. Addressing Hunger Through Referrals Maryann McLendon
Introduce yourself
Thank you for this opportunity to speak with you today because of the important role you can play in decreasing hunger- a problem that impacts one in five families in CO. Hunger is a silent epidemic- you can not tell by looking if children or families are experiencing hunger. There are signs of hunger which you probably all see in your daily work
We want to help you respond to the needs of your communities.
Addressing Hunger Through Referrals
Maryann McLendon

2. Objectives
The goal of this presentation is to have you leave with a clear understanding of:
Partnerships
Best Practices / Lessons Learned – System Improvements
Evaluation / Impacts
Resources

3. Hunger Free Colorado
Colorado’s leading anti-hunger organization exists to end hunger in Colorado.
Initiatives:
The Food Resource Hotline
SNAP(Supplemental Nutrition Assistance Program) Outreach
Policy and Advocacy
Systems and Policy Changes
Hunger Through My Lens
Colorado Food Pantry Network
Hunger Free Colorado leads efforts to connect families and individuals to food and nutrition resources, and to create positive changes in systems, policies and social views, so no Coloradan goes hungry.
We launched in 2009 from a merger of the Colorado Anti-Hunger Network and the Colorado Food Bank Association, with funding support from The Denver Foundation and Kaiser Permanente. Hunger Free Colorado brings a unified, statewide voice to the issue and solutions surrounding hunger, with a goal to ensure all Coloradans have access to affordable, nutritious food.
Our SNAP outreach initiative includes on-site application assistance, our statewide food resource hotline, county volunteer program at the Department of Human Services and our SNAP training to community partners.
In addition to our SNAP Outreach Initiative, we also focus on Policy and Advocacy. Hunger Free Colorado works on the federal, state and county levels to streamline business processes and adopt best practices that will help alleviate hunger throughout the state.
Hunger Through My Lens is a project that we have worked on with participants to photograph their perceptions of what hunger or food insecurity is to them. The participants take pictures and then travel with the exhibit to explain their stories to attendees.
Food pantries in Colorado now have the opportunity to join a statewide network and invest in improved collaboration, organizational efficiencies and collective action, so fewer people have to worry about when or where they will get their next meal. They are collectively working towards:
Improving governance structures for each food pantry
Improving food pantry operations to better meet the need of those they serve
Fostering change through collective action
Through taking this training and implementing application assistance at your organizations, we can do better and, together, ensure no Coloradan goes hungry.

4. Partnerships 15 Medical Providers 11 Non Medical Funding
25 Sub Clinics / Hospitals
11 Non Medical
Funding
Developing Relationships
We currently have 26 referral partnerships and half consist of medical organizations. We gain interest every month of new organizations that are interested in beginning this referral system.
In 2011 Kaiser helped to fund our food resource hotline. We had a pediatrician from Kaiser that sat on our board. It was through the relationship between our President and this Pediatrician, that the idea of screening for food insecurity came about.
A grant was written by our President, Kathy Underhill and Kaiser and the Denver Foundation both helped to fund our hotline. Grants are written every year to help fund the hotline. We receive some reimbursement from the state on the applications that we complete for SNAP. We are working towards medical providers supplementing a portion of our staffing needs for the hotline.
By 2012 Physicians at Kaiser was screening for food insecurity and letting patients know about our services on the hotline. Kaiser started handing patients our hotline cards.
With having Kaiser as a sound partner, we have been grateful to have another pediatrician, Dr. Sandy Stenmark, continue to being a bridge for us and the medical community. Through her medical expertise and her relationships with other medical professionals, we have engaged with many more organizations that are implementing the referral program.
To offer our services through our hotline, we also needed to establish relationships with the counties and with the state. Because we offer applications for SNAP over the phone, we had to build a contract with Food Nutrition Services in order to take telephonic signatures over the phone. We have designated staff that has access into the Colorado Benefits Management System, which is the software that eligibility technicians use when accessing client cases.

5. Our Services Connect to food resources Applications for WIC
Applications Supplemental Nutrition Assistance Program (SNAP)
The navigators provide referrals to agencies that offer meals and boxes of food. We serve the entire state and offer services in English and Spanish. Our 1100 resources are updated every 6 months, through the help of volunteers. All navigators are trained to understand the eligibility rules and requirements of all the federal nutrition programs.
If we find that a client is eligible for food stamps (SNAP) and/or WIC, then we will offer an application over the phone. We look up their case numbers in the state management tool, determine which benefits they are already receiving and link their case to a new application for benefits in the online application, we call PEAK. We walk clients through the process of expectations that will be made of them, help with ongoing cases and offer redeterminations and change reports.

6. Identify food insecurity with the client
Referral Process
Identify food insecurity with the client
Complete the fax referral and send to the secure fax line or capture client contact information and send to Hunger Free Colorado daily/bi-monthly
Benefit to completing referrals: Outreach increased connection from 5%→85% .
If you call with the family or send a fax referral to an agency, this will ensure more families are connected to resources.
Some organizations will send the referrals throughout the day, while others may send them bi-monthly or once a month. We have found that by waiting to send referrals, the navigators don’t seem to reach as many clients. It is better to send referrals at least by the end of each day. The patient will be easier to reach and connect with.
Through our partnership with Kaiser, we have found that handing patients cards is ineffective. We went from a 5% reach to 85%. All clients are called three times and then mailed or ed resources, so that number makes up for 15% of the referrals received. The most effective way to connect patients is by completing a referral form.

7. Screening for Food Insecurity
Questions to ask
“When was the last time you worried that you would run out of food before you had money to buy more?”
“Medication and healthy food can be expensive, but both are important; would you like information on resources that can help stretch your budget?”
These validated questions for individuals and families will identify those that need resources – think of it as a menu – choose what’s most comfortable or applicable for you or the situation.
What are the opportunities to use these questions? – screen all during registration and screen families with children showing red flags- behavior problems, learning problems, frequent illnesses, headaches…
Tips on how to ask

8. Hunger Free Colorado Fax Form
Organization________________
Date: _____________
Person requesting resources Name: __________
Address: __________
Best times to call? Morning Afternoon May we leave a message?________
Preferred phone: _____Alternate phone: _______________
Language: English Spanish Other: __________________
____ Yes, I would like food assistance. A Hunger Free Colorado staff member can call me Date: __________________
Instructions for Referrers
Please Fax this Patient Fax Referral Form to:
Questions about Hunger Free Colorado: Please call
Confidentiality Notice: This facsimile contains confidential information. If you have received this in error, please notify the sender immediately by telephone and confidentially dispose of the material. Do not review, disclose, copy or distribute.
This is an example of the information asked on a referral form. However, this can be tailored to meet the needs of each organization. A referral does not need to necessarily be completed, in order for us to connect to the client. If your organization would prefer to capture the client information in an Excel format, for example, then you can send us referrals that way as well.

9. Evaluation / Impacts Reporting Surveying Determining Impacts
Reports are created each month by Hunger Free Colorado sent to the medical providers. The information includes what resources were provided to each of the patients and the results of what occurred with the SNAP applications.
Currently, Hunger Free Colorado is working with Kaiser to develop a survey that will measure food insecurity. We are trying to determine if the resources that we provide to clients is aiding them, so they are no longer food insecure or if food insecurity has improved.
Hunger Free Colorado also has a MPH student that will be creating a strategic plan with the medical partners on how to measure health impacts. This may be done through surveys or social determinants.

10. Resources and Material
References
Flyers
Referral Form
We can provide case studies, the referral form currently used.

11. Contact Us for More Information
Hotline Maryann McLendon

12. Questions? Comments?