Hoosier Harvest 365 Hospital Delivery Program Expansion

Final report for ONC20-080

Project Type: Partnership
Funds awarded in 2020: $38,000.00
Projected End Date: 12/31/2022
Grant Recipient: Hoosier Harvest Market
Region: North Central
State: Indiana
Project Coordinator:
Amy Surburg
Hoosier Harvest Market
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Project Information


The Hoosier Harvest Market, a mutual-benefit farmer owned co-operative, aims to expand their Hoosier Harvest 365 Hospital Delivery Program (HDP), which was deployed in Hancock County in 2018. The HDP was established by a small group of farmers as a way to expand their product offering into a wholesale market while providing fresh and healthy produce for the community. The HDP partners with local hospitals allowing physicians to “prescribe” vouchers for a bi-weekly bag filled with fresh produce. 

The goal of the HDP Expansion is to deploy the program in Decatur County with new producers while partnering with Decatur County Memorial Hospital. The project will expand the educational outreach by providing additional hands-on cooking demonstrations in partnership with Greensburg Community Schools to increase exposure and awareness of local food options for food-challenged students.

This 18 month project will create sustainability for the participating farms by providing them with a new market opportunity along with a pre-planned and predictable order for their produce. This project also eliminates food waste from over-harvesting when demand is low, increasing production efficiency through effective planning, which results in higher income and greater market exposure for the farms involved.  

2021 update 

Due to COVID, the project has been extended until the end of 2022.  

2022 final summary 

The entire landscape of local food changed in 2019/2020 due to the COVID outbreak.  Hospitals were overwhelmed and focused entirely on combatting the pandemic.  Many of them lost significant amounts of money due to surgery reschedules and shut downs.  Because of this, we saw a drop in the interest of continuing the "extras" of employee wellness benefits through healthy food consumption. Decatur county hospital created an employee store during the height of the pandemic and we helped them stock it, but they didn't want to continue the food bag delivery program.  Margaret Mary Hospital and Hancock Regional continued to work with us as they were able.  We were recruited to help deliver vegetables to high risk patients in 2020 and by the end of 2021, most of the extra grant money the hospitals had received for this service was gone.  They struggled financially and discontinued their programs.  That was when our co-operative also had to shift focus.  We offered home delivery to our retail customers during the pandemic and continued to operate the Batesville sub-hub.  Through 2022, we worked on building up the Batesville location and regaining some of the food access projects that were throttled at the end of 2021.  We worked primarily with Margaret Mary hospital in Evansville throughout this project as well as continuing to work with Hancock Regional on a limited basis during the grant.  As things return to normal, we're seeing a bit more interest in the food delivery programs again, having secured partnerships through the GusNip grant with the Marion county health department and through another produce prescription grant obtained by Hancock Regional hospital.  Overall, the interest in the programs is still there.  We are working on how to increase participation and knowledge for the participants.  Cooking classes help a small percentage of our recipients, however participation is very much socially driven (the same small group of people would always come, but that group rarely expanded throughout the program).  Hancock Regional is now adding more interaction with a dietician to the program which we hope will increase utilization.

In addition, our Value Chain Professional in Batesville also opened a new site at the Batesville Intermediate school in 2022.  We hope to see this connection help with community outreach, connecting with the employees and families at the school.  Her report is included here. 

SARE Final Report

HHM-SE has been growing and changing in many ways during the last 3 years.  When the SE market started we were using Dotty’s bulk food as our aggregation and pickup site.  In September of 2022 the store closed so we were forced to find a new “home” for our weekly market activities.  One of the board members of the Food & Growers Association is a teacher at the Batesville Intermediate School.  She was able to connect us with her principal.  As a result of this connection we were able to move the market to the Intermediate school.  This move has brought new customers including staff members and families from the school.  Unfortunately our number of weekly orders has stayed consistent and not grown significantly with the new customers.  There are 4 pickup sites in the SE area plus home delivery in Batesville.  HHM has reopened pickup locations in Greenfield and will reopen the Hancock Wellness Center sites in February.  5 new vendors have come online with the market over the grant period.  There are 3 more that will start selling in the next couple of months.

Pam Rieke 
President and Value Chain Coordinator 
Batesville Food and Growers Association


Patty Lange Fischer also increased community awareness by holding several events in the southeast area to raise awareness for the food access project.  She hosted a fundraiser, getting matching funds from LCEF to sponsor an increased number of bags for our most food insecure participants.  Pam worked with the food pantry to identify these patients, distribute the bags and invite them to the Cooking Matters classes to learn more about how to use the vegetables they received.  Approximately 10 patients participated in this program regularly through its duration in 2021.

From the perspective of farmer impact, the addition of a food hub in Decatur county has been a great opportunity for sales access to the farms in that area. Here are letters from three of our participants.  They reflect the increase in access seen across the board - also reflected in the letters gathered for the 2021 report.   DianeArmondupdateletter sare_followup2023 Arnoldfarmupdateletter

Overall, our project was aimed at increasing market access for more small farms in the rural southeast Indiana area.  We achieved multiple significant connections in the area, increased local food awareness and sales for our new farmer members.  We will continue to operate the Batesville hub to continue to increase access for all of our farmer members. 

Project Objectives:
  • Expand the HDP program as a year-round sustainable project in Decatur County
    • This will result in an increase in revenue for the HHM and increased sales of 5-10% for each identified farm  sare_followup2023
  • Continue to operate the Batesville hub, working with food access programs and giving the farmers in that area additional sales outlets
  • Partner with at least four new agricultural producers in Decatur County
  • Increase knowledge/purchase habits of fresh produce by prescribed patients and the community
  • Share findings through HHM website, social media and public presentations


Click linked name(s) to expand/collapse or show everyone's info
  • Oak Hawk
  • Kathy Cooley , RD
  • Pam Rieke


Materials and methods:

This project was designed to expand markets for farmers by increasing wholesale sales opportunity through participation in a multi-producer CSA program delivered to hospital patients identified by the partner hospital through Hancock Harvest365 prescription produce program. Farmers participating agreed to provide specified amounts of produce through the season to fill the bags.  The primary data point measured for farms was the sales increase from this new market expansion.  In 2020, we filled 45 bags per week for Hancock Regional Hospital in central Indiana.  Some of the southeast farm products were used in this project as well as in the newly created southeast hub.  In the southeast region, Hoosier Harvest Market created an agreement with the non-profit Batesville Food and Growers association to share resources.  We established a new aggregation site at Dottie's Bulk Foods in Batesville and partnered with Margaret Mary Hospital to deliver produce boxes through their Cooking Matters class.  Participants in the class received a weekly box with a recipe and learned to cook the contents of their box.  15 boxes per week were delivered from June 2020 through September 2020 with this program.  In addition, Margaret Mary and the Batesville Food and Growers Association was awarded a John A Hillenbrand Foundation grant to provide up to 30 boxes per week starting in October of 2020 (grant documents attached) JAH Foundation grant application_FGA_part_1 (1)JAH Foundation grant application_FGA_part_2.  They have partnered with the Hoosier Harvest Market to deliver these boxes over the next two years.  In spring of 2021, farmers participating in these projects will meet to coordinate the delivery and agree to provide weekly produce amounts to fill the boxes.

The news of our program has also reached the Marion County Health department.  In 2021, the Marion County health Department will be applying for the Gus Schumacher Nutrition Incentive Grant Program program grant to fund box delivery to patients of Eszkenazi Hospital with their ProduceRx program - a very similar program to Hancock Harvest365.  As long as they are able to obtain the funding for the boxes, Hoosier Harvest Market will be partnering with them to procure the produce from our member farmers, expanding our program in to Marion county and partnering with another hospital/governmental entity to do so. Here is the outline of the new partnership: 


# of Participants per year (average each round)

Length of program


Year 1 (2021 – 22)

135 (45)

4 months (one box per month)


Year 2 (2022 – 23)

210 (70)

4 months (one box per month)


Year 3 (2023 – 24)

270 (90)

4 months (one box per month)







Produce Rx runs every 4 months in Rounds, so the participant reach will be divided out to about 3 rounds a year.  So in the () is the average number of participants each month that we will need produce boxes for each round.  We will provide dates based on the formal program completion.  The produce boxes will be following a 4 month formal nutrition education program where they received incentives to spend at retail settings for fresh fruits and vegetable.  So our proposed expansion for our Produce Rx Program is an 8 month program (4 months of monetary incentives and 4 months of receiving local produce from HHM). 

Research results and discussion:

In its first 9 and 1/2 months of operation, HHM-Southeast has generated $24,900 in increased
revenue for participating farmers in the southeast and central Indiana region, including $7,000 in revenue from Harvest365 box sales.  Southeast Indiana farm participants have seen an increase of $8900 in sales through the new hub going to their region.   Additionally, southeast Indiana farmers are able to send products to the Indianapolis hub through through back hauling.  Producers that have chosen to participate in the Indianapolis regional sales have seen an additional $7900 in revenue through that market opportunity.  SoutheasttoIndySales salesbyproducersouthestdistribution

Box program participants:
Arnold Farm
Lobenstein Farm 
Michela Farm 
Armonds Harper Valley Farms 
Good Seed Garden
Hen A Ben Farm 

Southeast retail and wholesale sales participants (not in the Harvest365 program, but selling through the new hub)
Beneker Farm 

Central Indiana Farm participants in the southeast Harvest365 program

Berry Goods Farm LLC 
Garcia's Garden 

Other central Indiana members are participating in sales through the southeast co-op but are not in the Harvest365 program.

Note: Most members of the Hoosier Harvest Market Food hub are classified in the very small farm (under $25,000 in annual revenue) category.  These sales numbers would represent at least a 5-10% increase in sales for these farms.  In 2020, due to the pandemic, many of these farms sales were also significantly curtailed by the farmers market closures.  Opening the southeast hub and offering online retail sales with delivery during this time period allowed multiple farms to continue production as planned and even increase retail revenue over their typical farmers market sales.


2021 update 

In 2021 we worked on building our bag program to those in need.  Participants in the program were identified by the dieticians at Margaret Mary hospital as being people who's health condition would benefit from the addition of more produce - with type 2  diabetes being the primary condition targeted.  Participants were also self identified as food insecure.  The referred patient would get in contact with our coordinator, Pam Rieke, to sign up for an initial 10 weeks of once a week bag pick up.  If they continued to participate in the program and pick up their bag weekly, they could extend their participation to 20 weeks.  Bags were provided free of charge through a supporting local grant. Attached is a spreadsheet showing contents and value of the weekly bag as well as numbers distributed.  Bags typically included both healthy meat and vegetable items, all sourced through local producer members of the Hoosier Harvest Marketsare grant data.  

During the year, we also decided to open the program up to more food insecure in the population by working with the same dietician to identify clients of the Batesville Food Pantry.  We found that those participants were generally more active in the program, having already self identified as food insecure and begun working with the food pantry.   For 2021, we had 39 total participants, 20 of whom continued with the program for the entire 20 weeks. About 50% of those clients were identified by the hospital and 50% by the Batesville Food Pantry.  We also offered a cooking class using the contents of the bag.  The dietician at Margaret Mary would create a recipe based on the contents of the bag each week so it was included for all participants and then they (or another member of the Food and Growers Association) would cook the recipe for the class that week.  Cooking classes were offered quarterly in the beginning of the year and then moved to weekly.  We only had 4 people who attended consistently, although other bag program participants would attend sporadically.  We offered different times for the classes, trying both afternoon and evening times to try to accommodate different work schedules.  Instructors included the dietician from Margaret Mary Health and members of the Food and Growers Association.  

In February of 2022, Patty Lange Fischer put together a chili supper to fundraise for more bag support and raise awareness of the food program in the community.  She raised approximately $500 to support the purchase of more bags to give to individuals identified by area churches as food insecure.   

Overall, the expansion of this program has shown several patterns that were consistent in both the Hancock Healthy 365 program and the Margaret Mary Bounty Box program.  The first consistent pattern we see is that there is generally a lot of interest in the beginning and that the program creates a small number of committed patients.  Those patients who have a health issue and are committed to eating better are more likely to utilize the program consistently and are willing to learn new habits.  A relatively low percentage of participants have the time to make this commitment.  The second is that their health data is minimally affected by just a weekly produce box.  It is the author's opinion that they would need to participate for more than one or two years and/or have further dietary counseling with access to low cost produce on a consistent basis to really make measurable change.  That being said, we have found in both the Greenfield program and the Batesville program a core group of participants who create their own community around the program and the cooking class, participating in just about every class offered and consistently picking up their bag.  In the Greenfield program, we saw participants networking with one another and those who were too sick to come get their produce would often have one of the other participants help pick up their food and bring it to them.  They created a supportive community around their food.  We also saw a strong connection between some of the participants and farmers who supplied the produce for the box.  In spite of Hancock Hospital ending their support of the produce bags at the end of 2020, several of the committed participants came to the farmers market in 2021 to purchase produce from the farms who had been supplying them the year before.   


From the farmer perspective, these bags continued to increase their sales and connection to their local community.  Attached are letters from Good Seed Garden and Armond's Harper Valley Farm describing some of the impact this program and sales through the establishment of the Hoosier Harvest Market hub in southeast Indiana had for them.sare_followup2022Armand sare letter 02172022 HHM_sare_impact_letter_arnold_farms



Participation Summary
6 Farmers participating in research

Educational & Outreach Activities

3 Curricula, factsheets or educational tools
12 Published press articles, newsletters
1 Webinars / talks / presentations
1 Other educational activities: Community chili supper.

Participation Summary:

1 Farmers participated
2 Ag professionals participated
Education/outreach description:

Hoosier Harvest365 poster

Indiana Small Farm Conference Poster Presentation - Amy Surburg created a poster outlining the project to date, and the measures taken to modify distribution during the COVID19 pandemic.  Poster was submitted for presentation during the forum at the Indiana Small Farm Conference online March 4-6 2021. 

Cooking Matters Classes - delivered to patients participating in the bag delivery program through Margaret Mary Health.

2021 - Awareness/outreach event (see attached summary from Patty LangeFischer)

Chili Supper Hoosier Harvest Market (1)

Learning Outcomes

7 Farmers reported changes in knowledge, attitudes, skills and/or awareness as a result of their participation

Project Outcomes

7 Farmers changed or adopted a practice
4 Grants received that built upon this project
3 New working collaborations
Project outcomes:

The 6 farm participants all saw an increase in revenue for 2020 at an average of 5%.  

In 2021, participating farms were reporting average increases of 10% in revenue.

Objective of at least 4 new participant farms was exceeded.  We have 7 new farms participating in Southeast Indiana.  



Produce Rx programs are gaining in popularity across the country right now as we address supply chain issues and focus on developing more local food systems in the wake of the effects of COVID19.   Our hope is that this work will show not only the positive impact community collaborations have on those in need but also on the growth of local businesses as well.  The main participants in this project saw average growth rates around 10% even with a small introductory program.  More work needs to be done to figure out how to increase consistent participation of the community members to impact their health in a positive way.  We think that more focused counseling with dietitians and more awareness/access to locally produced goods would further this work.  Utilizing a food hub model also allows the local farm community to pool their resources to increase available quantity and economize on aggregation and transportation. 

Information Products

Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture or SARE.