Successful partnership brings healthier food options to incarcerated individuals

April 21, 2021

By Rachel Ericson (email), DOC Communications, Chris Mornick & Joseph Liu, Department of Health

Starting in 2017, the Washington State Department of Health (DOH) and the Washington State Department of Corrections (DOC) partnered together to bring healthier food and beverage options for incarcerated individuals, a population disproportionately affected by chronic diseases.

DOC and Correctional Industries (CI) provide food service programs through cost effective, healthy, and quality meals to the approximately 14,519 (pdf) incarcerated individuals in the state’s 12 correctional facilities. CI is DOC’s manufacturing branch. It is a unique blend of business and government because it uses private industry tools and techniques to provide a public service. Thousands of incarcerated individuals gain work experience and training as they produce high quality, competitively priced products.

In 2013, the Governor of Washington passed Executive Order 13-06 (pdf) requiring state facilities to provide healthy food and beverages based off the Dietary Guidelines for Americans. These facilities include DOC. Working with DOH, DOC has updated their nutrition guidelines and are integrating healthier options into their commissary and mainline menus.

“Foods manufactured and supplied by CI to DOC facilities are a vital element to maintain consistency of menu items and nutrition statewide. This allows DOC to achieve and maintain compliance with the 2015 Dietary Guidelines for Americans and fulfill the Governor’s Executive Order 13-06. Incarcerated individuals assist with food manufacturing and food service within DOC. In turn, they learn to model pro-social behaviors associated with work ethic and employment,” said Bryan King, DOC food service administrator.

Starting small with the Health Commissary Project

The Health Commissary Project (HCP) was born in 2017. DOH facilitated a workgroup with DOC, CI, and the Statewide Family Council with the goal to improve the nutritional quality of foods and beverages for sale in all 12 correctional facilities’ commissaries. This workgroup came up with the HCP and how to plan, implement, and evaluate it.

The commissary at correctional facilities functions as a store for incarcerated individuals to purchase products, including foods and beverages. Providing healthier options through the commissary is important because it has the potential to positively impact the health of incarcerated individuals. These individuals have a higher burden of chronic medical conditions than the general population.

The HCP:

• Created nutrition standards for products available for sale in commissaries.
• Offered food and beverage options in commissaries that meet those nutrition standards.
• Disseminated educational material for incarcerated individuals about healthier commissary offerings.
• Monitored product sales to ensure their sustainability in the commissary.

As a result, the sale of healthier products, particularly beverages, improved. The HCP showed how providing healthier options alongside education could lead to healthier choices. It also demonstrated how collaboration between DOC, CI, and DOH could lead to nutritional improvements for food programs.

Healthy Food Guidelines

After the successful HCP project, DOH and DOC decided to work together on implementing healthy food guidelines in mainline meals. DOC and CI have implemented standardized menus, healthy practices, and uniform nutritionals (e.g., reduced fat and sodium, higher fiber) to enhance the health and well-being of the incarcerated population since the 1990s by making menu changes that met heart healthy guidelines.

The new healthy food guidelines further updated nutritional guidelines at correctional facilities to now also include:

• Bigger portion sizes of vegetables. Broccoli, tomatoes and sweet potatoes have been added to increase vegetable diversity
• More fruit being served
• More whole grain foods on the menus. Biscuits, tortillas and pizza are being made with whole grains. Brown rice is being served instead of white rice
• More lean and plant-based proteins added to the menu, especially fish and beans
• Less high-salt snacks (such as chips) being served
• Less foods with added sugar being served (such as cookies and desserts)

Chris Mornick, nutrition coordinator at DOH, and Jamie Dolan, who at the time was the food services administrator at DOC, worked together on establishing and implementing the new menu guidelines. Simply releasing the guidelines would not be enough to effectively implement these changes, education would be also be necessary.

Train-the-Trainer toolkit

The Train-the-Trainer toolkit (pdf) is a step-by-step guide designed to help correctional facility staff train others about the Dietary Guidelines for Americans, Executive Order 13-06, and the new healthier menus.

The toolkit was the idea of Dolan and King, who took over for Dolan as food service administrator when she was promoted to assistant director. Dolan and King felt basic nutrition education for both staff and people who are incarcerated was key to the sustainability of menu changes. DOC foodservice administration began using its limited resources in the field to deliver nutrition education, while also rolling out the new menus, but were faced with limited success.

Mornick then worked with an intern from Bastyr University to draft a toolkit and piloted it at DOC’s bi-annual food service managers meeting. She was able to work with the managers to gather feedback, anticipate challenges, develop places of focus, and build trust around the new menu guidelines. The three primary needs for the toolkit were identified:

• Educate staff and incarcerated individuals on good nutrition.
• Share what the Governor’s Executive Order means for them.
• Present the anticipated changes to the food guidelines.

DOC developed three posters based on the training content and printed over 1,000 one-page handouts in English and Spanish for on-site trainings. Facilities are able to use the handouts at orientations for newly incarcerated or transferred individuals. Funding for Mornick’s time and print materials was supported by Centers for Disease Control and Prevention Cooperative Agreement NU58DP006504.

DOH has since provided in-person Train-the-Trainer trainings to three correctional facility supervisors and leadership staff throughout Washington state. More were scheduled but had to be postponed due to COVID-19 restrictions. The hope is to continue this work when it is safe to do so.

Additional materials are also being created. In partnership with the University of Washington, Mornick and three graduate nutrition students are preparing a 30-minute video training to explain the Dietary Guidelines for Americans and menu changes for people who are incarcerated. The video training will be recorded and shared with all 12 correctional facilities.

Impact of Partnership

Providing this education to incarcerated individuals about choosing healthier foods, and the importance of doing so, provides an important “trickle down” effect that spreads to their family members. It creates opportunities for whole families to continue making healthier choices that can affect their long-term health.

Additionally, beyond the training and work experience received, incarcerated individuals have had a valuable role in the partnership, both working in the Research and Development Lab at Airway Heights Corrections Center as well as those individuals who have been able to participate in product reviews and provide feedback. A process that Dolan says is necessary to ensure acceptable product for all “We have been so excited to work with the Department of Corrections to align menus with the Dietary Guidelines for Americans and promote the Dietary Guidelines for Americans to people who are incarcerated. Our hope is that, through access to healthy menus and education, incarcerated individuals can increase both their health and their understanding of good nutrition, bringing these habits back to their families upon release,” said Mornick.

Working partnerships like this between state agencies and stakeholders provides valuable opportunities for continuous improvement. As a result, DOC is able to improve public safety by positively changing lives and DOH continues to work with others to protect and improve the health of all people in Washington state.