1. Be Sugar Savvy/Rethink Your Drink Initiative Be Sugar Savvy/Rethink Your Drink Initiative A Public Policy Success Story Presented By Bonnie Broderick, MPH, RD May 2010 SCC Cities Association

2. The Value of Combing Social Marketing and Educational Campaigns with Policy Making Allowed education and discussion to take place and helped to get greater buy-in from community partners and leadership. Connected individual behaviors to creating an environment that supports health. Helped to create an environment with greater acceptance, and did not eliminate people’s right to choose.

3. Local Educational Campaign “Be Sugar Savvy/Rethink Your Drink” began as a public health campaign called “Soda Free Summer”. Developed by our sister county, Alameda, in recognition of the role that sugar plays in our individual and community health. The campaign was adopted by BANPAC (Bay Area Nutrition & Physical Activity Collaborative), which expanded the educational and social marketing to the Bay Area region, including Santa Clara County. The County BOS proclamations and media were done across the region. The Steps to a Healthier Santa Clara County program, within the Public Health Department, expanded the initiative further to include wider community reach, organizational, and policy change.

4. The Santa Clara County Board of Supervisors adopted the Be Sugar Savvy/Rethink Your Drink Policy which covered all county facilities, employees, contractors, and contracts. Policy ensures that all beverages served (or vended) at county facilities, meetings, or county sponsored functions, will meet defined beverage standards. County dollars cannot be used to purchase sugar-sweetened beverages by county programs, nor by county contractors. Includes beverages that are served free of charge to individuals and groups participating in county department or program (unless specifically exempted by BOS policy or by the County Executive. Santa Clara County Board of Supervisors Adopted Policy

5. A. Water (with no additives) B. 100% fruit juices with no added sugars, artificial flavors or colors (limited to a maximum of 10 ounces per container) C. Dairy milk, not-fat, 1% and 2% only (no flavored milks) D. Plant derived (i.e. rice, almond, soy etc.) milks (no flavored milks) E. Artificially-sweetened, calorie-reduced beverages that do not exceed 50 calories per 12-ounce container (i.e. teas, electrolyte replacements) F. Other non-caloric beverages, such as coffee, tea and diet soda Approved Beverages* (as adopted by the Board of Supervisors on 10/22/08) Note: In event of an emergency or in light of medical necessity, these requirements would be waived. *Standards based on Santa Clara County’s Vending Machine Policy.

6. Board of Supervisors (BOS) makes referral to the Public Health Department (PHD) to look at the feasibility of implementing both a beverage policy and an educational campaign. PHD reports back to the Health and Hospital Committee (HHC) of the BOS and then the full Board. The BOS approves plan for studying the feasibility of implementing such a policy. PHD reports back to HHC, then BOS, with feasibility study that includes an implementation plan. The board accepts the feasibility study and unanimously approves adoption of the beverage policy and the plan for its implementation throughout county departments and facilities. The Process 2007, October 2008, April 2008 October

7. Feasibility Plan PHD surveyed six major Santa Clara County departments and programs including Social Services, Corrections, Mental Health, Probation, and VMC (the county hospital) to determine if this policy was feasible. Findings revealed no “undue hardship”, from a business perspective, and no arguments were made against the prospective health benefits. In departments and programs in which the County acts as food service provider, what is the feasibility that all drinks served would adhere to the beverage criteria? Feasibility of adding the criteria to language in contracts and agreements for service whenever beverages are served at county sponsored events, meetings or in county-owned facilities?

8. Feasibility Plan (continued) Inclusion of “Be Sugar Savvy/Rethink Your Drink” educational messages and promotional materials in county departments, facilities, and at county-sponsored events? Provisions for staff training on specifications made to county purchasing departments and those departments’ staff involved in processing county agreements for service and contracts. Distribution of updated nutritional specifications for beverages served at county sponsored meetings and events to all Department Directors so that staff can be properly notified. Posting of educational materials that visually depict the nutritional specifications for beverages in conference rooms and other facilities that are frequently utilized for county sponsored meetings and events. Exploration of other policy initiatives relative to being a “Sugar Savvy” county.

9. Implementation Plan Notification by County Executive to all Department Heads on the newly adopted beverage standards to be used in all county facilities and for all county sponsored meetings and events. Language incorporated into contracts, agreements for service, and applications for the use of county space. Procurement updated policies and included policy language into all boiler plate purchase orders. Implemented social marketing and education campaigns to inform employees and contractors, and to explain the benefits of the policy change.

10. Implementation Plan (continued) Social marketing campaign included the following: Ongoing technical assistance offered to County Departments. Calls received from Parks, Senior Nutrition, and others. Educational packets sent to all departments - packets included cover letter about the policy change, the new policy, a letter from the CEO, how to sign up for department-specific trainings, and Rethink Your Drink handouts and posters. Rethink Your Drink Educational Sessions offered to all interested departments and their staffs. Targeted/encouraged participation by staff involved in contracts and purchasing for their departments.

11. Lessons Learned Get to know your purchasing system experts. Engage those groups, individuals, and departments, especially those who make food (beverage) decisions and purchases, early in the planning process. Search for and get to know existing organizational committees. For example, the Sugar Savvy Referral was presented at the Nutritional & Wellness Committee, but the Food Service Procurement Committee was initially overlooked. Educate yourself about your purchasing/procurement infrastructure. Strategies may need to be adjusted depending on whether your system is centralized or decentralized.

12. Sugar Savvy Next Steps in Santa Clara County Sugar Savvy Post implementation survey of departments as part of our evaluation of the initiative. Participate in the regional Bay Area Nutrition & Physical Activity Collaborative’s (BANPAC) initiative this year, and continue to provide ongoing education. Share the policy work we have done to date with others in the county, region, state, and nation. Continue to partner with other localities and agencies, to share, learn, and bring back best practices to Santa Clara County. Establish food standards for county-sponsored meetings, events and …

13. Bonnie Broderick, MPH, RD Chronic Disease & Injury Prevention Director Santa Clara County Public Health Department (408) 793-2706 Bonnie.Broderick@phd.sccgov.org Lori Martin, MS, RD Steps Program Manager Santa Clara County Public Health Department (408) 793-2706 Lori.Martin@phd.sccgov.org Marty Fenstersheib, MD Health Officer Santa Clara County Public Health Department (408) 792-3798 Marty.Fenstersheib@phd.sccgov.org Contact Information Laura Jones Health Policy Aide, Supervisor Ken Yeager Santa Clara County Board of Supervisors (408) 299-5040 Laura.Jones@bos.sccgov.org