Originally published in Authority Magazine – May 8, 2022

BY MARTITA MESTEY

In many parts of the United States, there is a crisis of people having limited reliable access to a sufficient quantity of affordable, nutritious food. As prices rise, this problem will likely become more acute. How can this problem be solved? Who are the leaders helping to address this crisis?

In this interview series, we are talking to leaders who are helping to address the increasing problem of food insecurity who can share the initiatives they are leading to address and solve this problem.

As a part of this series, we had the pleasure of interviewing Rigoberto A. Garcia.

Rigoberto A. Garcia, Director of Health Education at Venice Family Clinic On How to Develop Holistic Food Security Practices That Improve Circumstances For Those With Chronic Diseases.

Thank you so much for doing this with us! Before we dig in, our readers would like to get to know you a bit more. Can you tell us a bit about your “backstory”? What led you to this particular career path?

18 years ago, I started my clinical career at Venice Family Clinic, working as a Clinic Coordinator. Initially, I helped exit patients after they saw their clinician. This role was unique to Venice Family Clinic and taught me the workflow of a clinic while helping me understand the many roles Venice Family Clinic plays as a one-stop health system for its patients, offering not just medical care but also dental care, substance use treatment, mental health services, vision screenings, child development classes, health education and street medicine for people experiencing homelessness.

Early in my career and before I started working at the Clinic, I wanted to become a pediatrician. I held an internship at another community clinic as my first step on that path, and ended up acting as the Spanish interpreter for a diabetes education class — almost by accident.

At first, I was just supposed to be the “Vanna White” of the class, showing patients models and how to use them. However, I soon realized that many of the patients were monolingual Spanish speakers. These Spanish-speaking patients would often turn to me for explanations. I knew that I needed to simplify information for these patients, and I started using metaphors and objects around the room to explain complex medical models and concepts that were difficult to translate directly. My intention was to make it easier for these patients to understand the information and make intelligent medical decisions for themselves and their families.

As soon as that first class was over, the patients came up to me and thanked me. Then the nurse who ran the class told me I would be leading the class moving forward. Suddenly, I realized that I had a unique opportunity to translate complicated medical messaging in a simple, understandable way that patients could understand. That was the moment that my career path changed to the public health professional track.

When I started as Director of Health Education at Venice Family Clinic, I managed four staff members and two areas of focus. Today, I supervise 23 staff members and oversee six areas of focus. As I continued along my career, my experience helped me to create programming that kept staff and patients in mind. That foundation allowed me to successfully create new programming and expand the Clinic’s current clinic offerings to better serve our over 45,000 patients from the Santa Monica Mountains through the South Bay.

Can you share the most interesting story that happened to you since you began your career?

This story is both personal and professional: I began my career by meeting my husband.

While working at another community clinic, I managed Title X grants that funded patient reproductive healthcare. At the time, my now-husband oversaw all clinic programs funded through the grant. However, we rarely interacted because he worked directly with our Director of Nursing.

At one of the clinics’ annual conferences during my tenure, the Director of Nursing told me she wanted me to meet someone that she thought was perfect for me. During lunch, she introduced us, clapped her hands and said, “my work is done.”

We went out on several dates, but we both had reservations about dating another person in public health. Would our nightly conversations be focused on healthcare? Would we get bored? Fast forward eight years later, we are happily married and creating change for community clinics and their patients.

Are you able to identify a “tipping point” in your career when you started to see success? Did you start doing anything different? Are there takeaways or lessons that others can learn from that?

I actually can identify a tipping point in my career: Just like the way my career began, I found out almost by accident that I excelled in establishing and leading new programs.

I was working as the Program Manager for Chronic Diseases, and my focus was on diabetes care at the time. I had been working under our Director of Health Education for two years when she came to me and asked if I was willing to take a risk and manage a brand new program.

This new program had to be built from the ground up, with no established process or specific interests to include. I was nervous, but excited at the same time. This was the first time that I had the opportunity to write a grant, create new job descriptions, program budgets and identify grant objectives. I knew it would be difficult, but I believed I could do it.

My Director handed me the reins to run a full, two-year project, which I completed effectively. When the grant ended, our CEO was impressed and took me under her budget. From then on, I kept taking on new programs and found continued success.

Now, in my role as Director of Health Education at Venice Family Clinic, I have been given so many opportunities to build my own programs and have done my best to build on each success. I established the Clinic’s first Doula Program, providing low-income patients with access to trained and certified professionals who begin working with expecting families during pregnancy, provide support during childbirth and offer postpartum education in the first weeks after birth. With the Clinic’s support, I have also established one of the largest food distributions at a community clinic in the Los Angeles area, serving over 6,900 patients and community members each month. We are also currently looking at providing a new line of service to our patients in the form of mobile mammography to help detect and prevent cancer, regardless of patient location.

None of us are able to achieve success without some help along the way. Is there a particular person to whom you are grateful who helped get you to where you are? Can you share a story about that?

There are two people in particular who have been instrumental in my career growth: The first was Debra Rosen, Director of Health Education and Quality Improvement at Northeast Valley Health Corporation. The second person is Elizabeth Benson Forer, CEO of Venice Family Clinic.

While I worked under Debbie, I was young and still learning many aspects of my career. She created a great foundation and was a wonderful mentor. Through her leadership, I learned how to manage multiple projects, create great relationships in the field and complete projects effectively before moving to the next. To this day, I still don’t know how she juggled it all! Most importantly, Debbie allowed me to have a voice in our projects and helped me recognize that having a great team beside you is crucial to becoming a successful leader.

Then there is the CEO of my current clinic: Liz Forer. Liz is not only a great leader. She also represents what healthcare could — and should — look like.

When I first started my career in healthcare, I really didn’t know what to expect from senior management or a CEO. When I met Liz, I realized she is one of a kind — the type of person who will go out of her way for her team. Someone who always does the little things, whether it’s picking up trash someone else discarded, getting down on a knee to wipe the floor or even giving up her office so a colleague can take a private call. Not every CEO will roll up their sleeves to help like that when needed.

Liz is also an innovator. She is never afraid to introduce new services and programs for patients and our surrounding communities if it means improving the quality or comprehensiveness of care we provide. As just one example, I remember the time I passed Liz in the clinic waiting room and she told me that she planned to seek funding for food programming. She sketched out her initial thoughts and asked if I thought we could do it. I told her I thought we could, and just two years later, Venice Family Clinic has become one of the largest community clinics in California regularly distributing food.

Liz exemplifies how a strong leader can create and foster a resilient organization — one that has been successful in ensuring access to care for our patients and communities, even during a global pandemic. Thank you Liz for your leadership. I hope to continue to make you proud of what you have established at Venice Family Clinic.

You are a successful leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

• Ambition: When I started at Venice Family Clinic, I only had 4 staff members. I knew that our Health Education department could do so much more, and, with some help, I’ve been able to grow the department to 23 staff members that effectively provide our patients and communities with health education and a variety of thriving community programs.
  Innovation: As a community health center, we always need to think outside the box. We are regularly challenged to test boundaries and see how we can improve programs and care for our patients in new, unconventional ways — from introducing mobile mammography units for people experiencing homelessness to launching a new diabetes program for low-income patients.
• Humility. Realizing that I am not always correct has gone a long way in my career. As healthcare providers, our knowledge changes with new information, time and experience. A strong program requires strong staff members, and I have not become a successful leader on my own. I am blessed to have had the opportunity to work with amazing people, and I make it a point to show much how I appreciate them and their contributions.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“Fail fast and fail cheap.” That mantra is a great life lesson quote that I picked up at a leadership training, and it speaks to the flexibility required to successfully launch new programs. If something isn’t working, stop and reconsider. This is a lesson I make sure to impart to my staff — not only so they know that not all programs succeed, but also to teach them to embrace failure and learn from past mistakes to improve programs, approach and even themselves.

Ok super. Let’s now shift to the main part of our discussion. Can you describe to our readers how your work is helping to address the challenge of food insecurity?

I think one of the biggest challenges to addressing food insecurity is that many people don’t understand that food is fundamentally medicine. As a society, we need to start recognizing and teaching nutrition as a vital part of health care. Lots of clinicians tend to focus on prescription medications to treat chronic diseases like diabetes and high blood pressure, but we must also take a holistic approach to address all the health and cultural factors that may contribute to disease.

At Venice Family Clinic, we address this issue by using food as a teaching tool. When we talk about food insecurity, we are not just providing fresh nutritious food, but also teaching the definition of a balanced meal and providing curated nutrition and awareness. Our 500+ staff members and almost 1400 volunteers work tirelessly to make sure folks are fed and educated, and the Clinic regularly hosts free, healthy food distributions. We provide core nutritional foods like fresh fruits and veggies, educational cooking classes and personal guidance on the best ways to improve your overall health — especially during COVID-19. In total, the Clinic distributed nearly 2,138,975 pounds of food during the pandemic, and even delivered food directly to patients in need.

Another major challenge is addressing cultural barriers. We say, “eat a balanced meal,” but what does that mean? In the past, the ‘food pyramid’ hasn’t addressed differences in culture and background. By personally meeting with patients and community members, our diverse staff (many of whom are bilingual) can better understand these patients, their backgrounds and their culture. From this understanding, we can better address their individual health needs through foods that they are familiar with and know how to use instead of taking a “one-size-fits-all” approach.

Can you share something about your work that makes you most proud? Is there a particular story or incident that you found most uplifting?

I think a good example is one of our diabetic patients: we’ll call him John. When he first came to us, he had an uncontrolled A1C (a measure of health in diabetic patients) of 11.5. He picked up food from us, received medical advice and participated in nutrition classes.

John is a single dad who cooks for himself. We emphasized meal prep, but we also told John that doesn’t mean you have to eat the same thing all week. Meal prep for John means having dietary options that include different meats, prepared veggies stored in the freezer and necessary nutrition to keep his diabetes in check. It means options that make it simple for John to stick to his nutrition plan.

With the Clinic staff’s continuous support, two weekly meetings and receiving curated food weekly, John significantly improved his nutrition. He started coming to food preparation events, participated in food education and within 9–10 months his A1C went from 11.5 to 6.7 — a huge improvement that significantly reduces his risk of long-term complications from diabetes. Providing food, education and options and then seeing outcomes like this for our patients means the world to me.

In your opinion, what should other business and civic leaders do to further address these problems? Can you please share a few things that can be done to further address the problem of food insecurity?

There are three areas where leaders need to advocate to address food insecurity.

1. Push for reimbursement for food distribution. Whether it be food banks or programs like ours, the reimbursement process is complex and often doesn’t cover the full cost end to end.
2. Advocate for universal documentation of food distribution. Simply put, we need more data on the impact food has on health. If you have diabetes, we can document that we gave you medication and measure your A1C, but the missing link in health is nutrition. There is no data that meaningfully measures the efficacy of preparing meals and providing fresh produce for people experiencing food insecurity, food improvement or distribution. Venice Family Clinic is currently working with population management services to build data sets focused on this information.
3. Collaborate more. Collaboration within the nonprofit world will bring more and better solutions to larger groups of people. Partnerships with other organizations — both local and national — allow us to expand and strengthen the resources we have.

Are there other leaders or organizations who have done good work to address the challenge of food scarcity? Can you tell us what they have done? What specifically impresses you about their work? Perhaps we can reach out to them to include them in this series.

An organization that really stands out is the Los Angeles Department of Public Health. They have taken the food insecurity issue head on. They collaborate with community clinics, including Venice Family Clinic, to secure significant funding to build on their partnerships. They’ve taken community clinic work — which serves over 30 million people across the U.S. and almost 2 million here in Los Angeles alone — and put it into practice, making sure that we provide communities with nutrition education along with healthy food.

If you had the power to influence legislation, are there laws that you would like to see introduced that might help you in your work?

In addition to asking first and foremost for increased federal, state and local funding for government programs like the CalFresh Program, or Supplemental Nutrition Assistance Program (SNAP), which issues monthly electronic benefits that can be used to buy most foods at many markets and food stores, I would focus on two effective building blocks to address food insecurity today:

1. Standardized nutrition documentation: In addition to empowering community clinics to ensure their communities have access to nutritious food and educational resources, more standardized documentation can also help us secure funding. By introducing standardized nutrition documentation, we can follow up on quality improvement measures and show the effects food programming can have on chronic diseases. The more data we have on food and nutrition education, the better we can serve our patients and communities.
2. Reimbursement of food support and creating an infrastructure that incentivizes a zero waste system for food production Up to 40% of food that enters our supply chain ends up as waste. Building a circular infrastructure to minimize food waste would be viable and highly effective to addressing food insecurity.

One example would be incentivizing hospitals to provide their extra meals to community clinics. The challenge, of course, is that many clinics don’t have the fridges, storage space or transportation to ensure these meals reach those in need before expiration. Ensuring that clinics have not only enough food for their patients, but also the necessary infrastructure and equipment to deliver it to them is a real need.

What are your “5 things I wish someone told me when I first started” and why? Please share a story or example for each.

1. Don’t be afraid of the unknown and the road less traveled: In many instances we get too comfortable with the familiar and are afraid to take chances. One thing I learned later in my career is to take those chances. To me, taking those chances means opening the door to new opportunities.
2. Accept challenges and explore new ideas: When we accept new challenges, we are more willing to think outside of the box and explore new ideas. In doing so, we test assumptions, gain a different perspective and often arrive at new options and better outcomes for patients — two things at which community clinics excel.
3. Learn from your mistakes: We all make them. As I said before, “fail fast and fail cheap.” Don’t let pride get in the way if things aren’t going right. Be ready to put your ego aside and recognize the current approach isn’t working so you can better serve patients.
4. Make sure to collaborate: collaborate not only within your organization, but with partners outside of its umbrella. Partnering helps spur strong programming forward and ensure there is less overlap in offerings from nonprofits that serve the same region.
5. Have fun with your work! Early in our careers, the focus is all about being determined and keeping an eye on the prize. Many young people focus on the thrill of completing the tasks as opposed to recognizing the education stemming from the project and enjoying the experience.

You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

We need to provide food to people in need in the same way we do healthcare. Providing more funding to community clinics that distribute food locally would make such a difference in peoples’ lives.

Many community clinics, including Venice Family Clinic, provide blood pressure monitors to patients experiencing hypertension and test strips to patients with diabetes. More clinics need to do the same for patients and communities experiencing food insecurity. Food can have a tremendous impact on many chronic diseases, and I feel that we can make a real difference in population health by providing accessible, nutritious food and food education. At Venice Family Clinic, we are committed to helping our patients get healthy and stay that way by making sure they have access to fresh, nutritious food and resources through local food distributions and nutrition education classes.

Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this, especially if we tag them. 🙂

Dr. Barbara Ferrer, Director of the Los Angeles County Department of Public Health. She has a clear strategic vision for the health and wellbeing of LA County, and I admire how effective she is in overseeing large systems and multiple programs — especially in a County as diverse as Los Angeles. Her work on health equity, reducing health disparities, disease prevention and promoting public health has set an example we all can learn from.

It was a great honor to work with and instruct the Public Health Centers she oversees on how to establish an effective food program. I gave a presentation to them recently, and I was overjoyed to see the food program I launched at Venice Family Clinic used as an example for what the County wants to see in their own programs.

We continue to work with the L.A. County Public Health Centers to increase food insecurity across the County. I would be interested to learn more about what Ms. Ferrer has in mind to increase wellness in L.A. County, and to be able to collaborate with her and other local community clinics to make her ideas a reality.

How can our readers further follow your work online?

Please visit our website, https://venicefamilyclinic.org/ or follow us on Facebook, Twitter, Instagram or LinkedIn.

This was very meaningful, thank you so much, and we wish you only continued success.