Marimn Health Produce Prescription Program - The Coeur d’Alene Tribal Health Authority dba Marimn Health, a Federally Qualified Health Center on the Coeur d’Alene Reservation in Plummer, Idaho, requests funding under the IHS Phase 2 Produce Prescription Pilot Program (P4) to establish a sustainable, clinically integrated produce prescription program serving Marimn Health patients experiencing food insecurity and diet-related chronic disease. This program builds directly on Marimn Health’s existing Idaho Department of Health and Welfare Produce Rx program, which concludes in September 2026, ensuring continuity of services for currently enrolled patients while expanding reach, benefit value, and program scope under the P4 model. The purpose of this project is to demonstrate and evaluate the impact of a produce prescription program on the health and well-being of Marimn Health patients and their families. The program will reduce food insecurity, improve dietary health through increased consumption of fruits, vegetables, and traditional foods, and promote whole-person health and well-being. Marimn Health will connect health care providers with local and Tribal food systems to deliver monthly produce prescriptions, paired with culturally grounded nutrition education, traditional food access, and gardening and cooking programming that reflect Marimn Health values and practices. Eligible participants will be identified and enrolled through clinical and community referrals based on clinical and socioeconomic factors, including a positive food insecurity screen using the Hunger Vital Sign tool and a diagnosis of diabetes or hypertension in Year 1. Enrolled participants will receive a monthly produce prescription valued at $65, issued as a book of seven vouchers, six $10 vouchers and one $5 voucher, redeemable at the Benewah Market, the One Sky One Earth farmers market, and contracted Native-owned traditional food vendors. The flexible voucher design allows participants to redeem benefits weekly throughout the month. Nutrition education, cooking classes, and traditional food cultivation and preparation programming will be delivered in partnership with University of Idaho Extension and the Coeur d’Alene Tribe’s community garden network. Letters of support have been secured from the Idaho Department of Health and Welfare and the University of Idaho Extension, with additional partner commitment from Benewah Market. The program will serve 65 participants in Year 1, scaling to 125 participants by Year 4 as additional populations, including prediabetic patients, elders, immuno-compromised individuals, and cancer patients, are phased into eligibility. Marimn Health expects to achieve measurable short-term gains in nutrition knowledge and access to healthy and traditional foods; intermediate gains in fruit and vegetable consumption, food security status, and prescription redemption rates; and long-term reductions in food insecurity prevalence alongside improved clinical indicators for diabetes and hypertension. The program will collect and report baseline and follow-up data on program participation, food access, dietary behaviors, nutrition knowledge, and indicators of health and well-being, including community-defined measures, to support program evaluation and inform future program development. Through this work, Marimn Health will strengthen Coeur d’Alene Tribal food sovereignty and establish a sustainable produce prescription infrastructure that endures beyond the pilot period.
