The family had driven from out of state, hoping a world-renowned neurologist they heard was on staff at Children’s Hospital Los Angeles would treat their baby’s unexplained seizures.

As the hours dragged on, and the parents stayed bedside, they were clearly exhausted.

“Our team gave them crackers and juice,” said Mona Patel, MD, chief integrative delivery systems officer at the Children’s Hospital Los Angeles and associate professor of clinical pediatrics at the Keck School of Medicine, University of Southern California, both in Los Angeles, recalling the incident from 7 years ago. The staff also provided a voucher for a local food pantry, she recalled.

That was the extent of the help.

“And for me, that was unacceptable,” she told Medscape Medical News. She couldn’t expect the mother and father to leave their baby and go to a food pantry. When Patel learned they had little money, she bought them a meal. It was her professional turning point. Food insecurity “is not something you can ignore as an institution,” she said.

If a similar family would arrive at the hospital today, the options for help would be much different, she said, because of the program she and others have been building.

As food insecurity — defined as being uncertain about the ability to acquire enough food to meet one’s needs — has become more common, it’s now described as “one of the most pressing social drivers of health affecting children today,” according to the Children’s Hospital Association (CHA).

Food Insecurity: More Need, More Awareness

“Screening for food insecurity in the hospital setting has become a standard practice at many children’s hospitals because it allows care teams to identify families and connect them to the resources they need,” said Torey Mack, MD, CHA’s chief medical office, CHA, Washington, DC, in an email to Medscape Medical News.

Food insecurity is linked with higher rates of chronic illness, hospitalization, and other health issues; about 1 in 7 children live in families with food insecurity.

Pediatric hospital physicians have taken notice, expanding their help for inpatients as well as outpatients and their families. Programs range from basic services such as referrals to food banks to extensive onsite programs, backed by solid community partnerships, that sometimes include onsite convenience stores or ready-to-go emergency food kits.

Medscape Medical News asked Patel and three other physicians who help organize hospital-based food insecurity programs for details on how they set up the program, where they got support and how they keep it going and growing.

Children’s Hospital Los Angeles: Know the Need

Knowing the extent of the need is crucial.

“We’re a safety net hospital,” said Patel. Approximately 75% of patients in the main health center are on Medicaid, she said.

Screening has expanded since 2022, she said, with about 70% of patients now screened with a health-related social needs questionnaire. Food insecurity is high on the needs lists, with 12% of patients overall meeting the definition, but 15% when just inpatients are tallied, Patel said.

Five years ago, she said, about 15% of patients met the definition, but it was “on paper” computations and not as reliable as the current information-gathering system.

Now, the food-is-medicine program would provide much more than the family with the seizing baby received. It includes a convenience store on site, with fruits, vegetables, rice, legumes, pasta, cereal, crackers, baby food, and other needs. Community partners include the LA Regional Food Bank and several others. Another partner is Rick’s Produce Market, and its “Farmer Rick” also provides farm-to-table education.

The store accepts Supplemental Nutrition Assistance Program (SNAP) and Electronic Benefits Transfer benefits.

OSF HealthCare Children’s Hospital: Find Community Partners 

Screening of inpatients for food insecurity began in February 2023, but now has expanded to outpatients, said Monica Joseph-Griffin, MD, a pediatric hospitalist at OSF HealthCare Children’s Hospital of Illinois and visiting professor of clinical pediatrics at the University of Illinois College of Medicine, both in Peoria, Illinois, the program’s “physician champion.”

“I had support from nursing, quality and safety, and residents and medical students were on our team, as well as case management.”

They screen using the Hunger Vital Signs, a validated tool in widespread use. If a patient and family screen positive for food insecurity, they meet with a case manager to determine the need and the family receives an emergency food kit, said Joseph-Griffin.

The percent who screen positive has been running around 5%-6%, she said, “but I still feel like we are not catching everyone.”

Joseph-Griffin said she senses the parents’ stress about both health and finances.

“We just like to take one worry off their plate and hopefully put some food on it,” said Joseph-Griffin.

Families get a kit that will feed a family of four for about three meals, she said. Community partners make it work, with Midwest Food Bank the current partner. The hospital provides funds for the food kits through its foundation and hospital officials work with the food bank staff to provide a mix of breakfast foods, protein-rich food, vegetables, and other healthy options.

The kits are kept in a central location in the hospital. Once a need is identified, a healthcare provider calls in the order, and the kit is sent up where it’s needed.

For long-term help, the hospital partners with findhelp.org, putting together a resource sheet that gives information on how to find food and other resources. It’s zip code specific and kept up to date with options for several languages.

“As pediatricians,” Joseph-Griffin said, “we like to fix things. Some things are not fixable. But this at least provides just a little relief in a time of stress.”

Nemours Children’s Health: Tap Those Volunteers

Recently, the issue was hard to ignore. Many patients, especially inpatients at discharge, began to mention that they didn’t have food at home.

“Our social work team is a fantastic team but there was never going to be enough of them to address this need,” said Laura Chilcutt, MD, medical director, medical-social impact, Nemours Children’s Health, with hospitals in Orlando, Florida, and Wilmington, Delaware.

“What we did was recruit a bunch of undergrad premed students who need time working with families as part of their application process for medical school,” said Chilcutt, who works at the Florida location.

Thus was born the Family Resource Center, officially opening in May 2024. Families can go there, on site, where volunteers sit in 4-hour shifts. The volunteers maintain a database of resources, built up to include not just food but housing and other services. The volunteer team has risen to 40, with 30 typically working at a time.

If a patient on admission is found food insecure, a referral is made to the volunteer center. A volunteer will go upstairs to the patient with a bag of food if needed, Chilcutt said. “We essentially purchase the food at cost from Second Harvest,” Chilcutt said, referring to food and meal distribution charity. The bags include enough shelf-stable food for a family of four for a week.

“I order a pallet at a time — so 85 bags of food every couple of months,” she said. For ongoing help, the families are given information about the closest food pantry.

Texas Children’s Hospital: Inhospital Food Bank Representative

The food insecurity program at Texas Children’s Hospital, Houston, has taken a different approach recently, said Claire E. Bocchini, MD, an infectious disease specialist and population health advisor there and an associate professor of pediatrics at Baylor College of Medicine, Houston, and is much more successful.

Instead of simply giving families phone numbers of food banks and other resources, about 5 years ago the hospital brought a member of the Houston Food Bank on site.

“As we screen families and identify families who would like support for food, our social workers are now able to put in a referral to a food bank representative,” Bocchini said, via the patient’s medical record. The food bank representative gets the referral, then meets the family at the bedside or phones them, whichever the family prefers.

With this approach, “we are able to connect 80%-90% of those who request support,” Bocchini said, much higher than the previous approach, which < 10% of families used.

With hundreds of food banks in the Houston area, the food bank representative finds a convenient one for emergency supplies, then helps families with resources such as applying for SNAP.

“We don’t want anyone to be hungry at the bedside or at home,” Bocchini said.

Patel, Chilcutt, Bocchini, and Joseph-Griffin reported having no disclosures.