Good morning, everyone.

I'm at large councilmember Christina Henderson.

I'm calling this public hearing of the Committee on Health to Order.

Today is Wednesday, March 25th, 2026.

The time is 9.31 a.m.

Uh, we are in room 412 of the John A.

Wilson building, and this is a hybrid hearing with public witnesses testifying uh both virtually and in person, and our government witnesses testifying in person.

Today we will consider three bills before the committee, and I'll start by giving a brief description of them in the order that we're going to consider them.

Uh first is Bill 26-523, the streamlining Medicaid Credentialing Amendment Act of 2025.

Um I introduced this bill alongside Council Members Alan, Bonds, Lewis George Fruman, Nadeau Parker, Robert White.

It would require the Department of Health Care Finance to develop a single application process for providers seeking to be credentialed or recredentialed with a managed care organization to provide Medicaid services to district residents.

It would also set time frames and notice requirements for the Department of Health Care Finance to respond to applications.

Bill 26-593, the lowering the cost of prescription drugs act of 2026.

I also introduced alongside Council Members Alan and Doe and Pinto would authorize the mayor to establish a drug discount program by entering a cooperative purchasing agreement with the prescription drug discount program for the purpose of lowering prescription drug costs for district residents.

It would expand the authority of the Food Policy Council to evaluate food procurement practices along district government and change their requirements for annual reporting by the Food Policy Council.

So we'll turn to our public witness testimony.

Um just as a reminder, everyone has three minutes to testify.

Our outreach to DHCF highlighted that our member community health centers face a burdensome and duplicative credentialing process.

Providers must submit applications separately to each managed care organization, creating delays that compound workforce shortages and limit patient access to care.

The Streamlining Medicaid Credentialing Amendment Act of 2025 incorporates our recommendations on centralizing credentialing, provisional credentials, timely notices, transfers of credentialing and inclusion of subcontracts and subcontractors and vendors.

DCPCA also recommends that the legislation allows for delegated credentialing agreements between DHCF and qualified entities.

The proposed legislation incorporates core principles of efficiency, transparency, and continuity.

We appreciate the committee's responsiveness to stakeholder input, and we look forward to continuing to work in partnership with DHCF and the Council to ensure smooth implementation of these reforms.

Regarding B 26593, Lowering the Cost of Prescription Drugs Act of 2026, DCPCA appreciates the committee's attention and action to reduce prescription drug costs for district residents.

We look forward to working together with council to secure savings for residents and for community health centers using tools such as Array RX and the 340B program, which provides access to essential medications for health center patients and supports community health center chronic disease prevention and treatment services.

DCPCA intends to follow up with written testimony for the record.

Thank you for the time and I welcome questions.

Great, thank you.

Ms.

Clark.

Good morning, Chairperson Henderson and staff.

My name is Rachel Clark.

I currently serve as co-chair of the Food Policy Council's Sustainable Supply Chain Working Group, and I'm formerly of GW's Redstone Center.

I'm here to testify in support of the Food Policy Council Procurement Amendment Act of 2025.

For the past several years, one of the working group's priorities has been to improve district food procurement through the purchase of more nutritious, sustainable, and local and regional food, what we collectively refer to as values-based procurement.

Each year, the district spends tens of millions of dollars on food to serve children, seniors, and other vulnerable residents.

How we spend those dollars determines not only the quality of meals, but also whether we support local businesses, strengthen regional supply chains, and reduce our environmental impact.

The district has made several commitments toward these values, such as adopting the Good Food Purchasing Program at DCPS and signing the Cool Food Pledge.

However, it has struggled to shift its purchasing behaviors to fully realize those goals.

Two years ago, we partnered with the Redstone Center to examine procurement policies and practices in the district to identify barriers to values-based procurement.

The research was released in a 2025 report that identified challenges in our food procurement system at every stage of the process.

Solicitations are often unclear and do not consistently reflect the district's food goals, even those required by law.

Evaluation processes lack food sector expertise and do not reliably select the strongest vendors.

The district often pays premium prices without ensuring high quality results.

Contracts lack clear, enforceable standards for value values-based procurement, and there's no centralized system for tracking performance or ensuring accountability across agencies.

The result is a system where we're spending significant public dollars without consistently getting what we want.

This legislation is a practical, necessary step toward addressing these challenges.

The creation of a procurement program within the Office of Food Policy will bring much needed expertise, coordination, and accountability into food procurement across district agencies.

It will empower the office to support agencies in developing stronger solicitations and contracts, contribute subject matter expertise to evaluation decisions, establish clear citywide food procurement standards, and track performance and outcomes across the district.

This bill will help create a system in which we can make real progress on the district's food-related goals for nutrition, local purchasing, and sustainability, and leverage district-wide procurement toward better outcomes and even cost savings.

We already have evidence that this approach works.

Through an 18-month federal grant, the district funded a temporary procurement position within the Office of Food Policy.

In just six months, that role has helped DCPS and DOC strengthen upcoming contracts to improve nutrition and local sourcing, convened agencies to align procurement practices, and identified opportunities for joint purchasing that could reduce costs.

This is exactly the kind of progress that this bill would make permanent, but it will not continue without sustained funding.

Thus, I urge the committee to advance this legislation so the food procurement work already underway can continue.

The district has made strong commitments to building a healthy, equitable, and sustainable food system, but without fixing procurement, we will continue to fall short.

Thank you for the opportunity to testify, and I'm happy to answer any questions.

Thank you.

Alex.

Good morning, Chairperson Henderson.

Thanks for convening today's legislative Schmorgis board.

My name is Alex Moore, and I'm testifying today on behalf of DC Central Kitchen.

As you know, we have served the DC community for 37 years and been a proud partner of the district in fighting hunger, improving school nutrition programs, establishing healthier corner stores, and creating hundreds of good food jobs for DC residents.

We thank the committee for considering the Food Policy Council Procurement Amendment Act and strongly support this act becoming law.

In our view, this bill helps translate what has worked well in some areas, such as school meals across the district's array of food related programs and populations in need.

Thanks to the hard work of many in this building and on the Food Policy Council, the district has earned its reputation as a leader on food policy innovation.

However, we have all seen instances when DC's food dollars were awarded and spent in ways that did not always reflect the established laws and commitments of the district, often because DC's own food policy experts were not part of the contractual and grant making processes of many agencies.

This law fixes that missed connection and ensures that DC's food policy brain trust can bring that brain power to bear when taxpayer dollars and DC values are at stake.

What do those taxpayers pay different vendors for lunches served to children at a DC public or charter school?

Or to those same children at a park in the summertime, or to a senior at a community dining site, or a striving mother at a family shelter.

If those costs are different, why?

Is one meal healthier or fresher or more well reviewed or better for the environment or more productive for our local economy than others?

If so, are we learning as a city how to build on what's working and move away from what's not?

The simple answer is that without this bill, we won't have good answers to these questions, and it's long past time that we did.

Additionally, based on our experience, our written testimony lays out some further suggestions, and I'll touch lightly on a few of them here.

First, we applaud the bill for calling out school meals, jails, and shelters as priorities for positive change.

We believe that other nutrition programs, such as those serving summer youth programs and senior citizens would also benefit from the type of knowledge sharing and consistent evaluation proposed by this bill.

We further encourage the committee to explicitly name DC based nonprofits among those that would be included alongside CBEs and other important local stakeholders in its definition of a quote, wide audience of high quality prospective vendors.

Let's also ensure that better practices are practical.

If we want more small businesses, nonprofits, and local farms to participate in district contracting, this bill's reporting requirements will have to reflect the finite staffing and resources of such groups as well as the prices offered by the district.

And finally, let's be sure we're raising the floor and closing backdoors in our food system.

We know that in practice, major multimillion dollar food procurement decisions have been made through emergency procurements, letter contracts, and retroactive approvals.

We would support language that requires agencies to inform the Food Policy Council when such measures are being taken on food related contracts to ensure adequate transparency and alignment with relevant laws and standards.

DC Center Kitchen welcomes the addition of this bill to our food policy landscape, and I'm happy to answer any questions you might have.

Thank you.

Thank you.

Ms.

Butami.

Thank you.

Good morning.

My name is Anita Butani.

I am a small business owner, longtime DC resident, and the founder of Bright Day Pediatric Therapies, a center serving children with developmental needs.

I have personally navigated credentialing with all four DC Medicaid MCOs, and I am here in strong support of the streamlining Medicaid Credentialing Act.

Do not be mistaken.

The central problem this bill addresses is not accidental or benign administrative neglect.

It is the economics and financial realities that can make limiting access to care profitable for an insurance company.

Let's lay out those economics.

DC's Medicaid MCOs receive monthly health risk-adjusted capitation payments covering each of their enrollees.

The MCO receives these payments regardless of whether their enrollees get care or not.

So, for example, every day that a child with autism sits on a waiting list for speech therapy.

That's a day that the MCO collects revenue for that child without having to pay for that child's actual care.

Since MCOs cannot control the demand for or the price of care, they can manage profits by capping the supply of care.

And the current regulations allow them to use credentialing to do it.

This is not an accidental oversight by MCOs.

It's deliberate, and it's a waste of taxpayer funds.

Maryland and Virginia have passed laws to control these perverse financial incentives, and DC should too.

Here's what makes this bill especially smart.

DHCF already runs and funds an excellent credentialing process, the process to get a DC Medicaid ID.

And every provider must complete this process before MCO credentialing can even start.

DHCF collects the same information as the MCOs, but does it faster and better.

DHCF completed credentialing for us in under 30 days.

Incorrect items triggered immediate notifications and allowed us to make quick responses.

By contrast, the MCO credentialing process can only be described as an administrative dumpster fire.

One MCO took over a hundred and twenty days to issue their standard contract.

Then they told me it would take an additional 180 days to countersign their own contract.

Meanwhile, as an employer, we are paying licensed clinicians who cannot serve patients.

When DC strangles employers like that, those employers go to Maryland or Virginia, where regulations keep payers in line.

Further, from a good government perspective, there is no reason for MCOs to waste health care budgets duplicating a process that DHCF already does better.

Three brief asks to make this bill even stronger.

First, add contracting timelines.

Credentialing is only half the battle.

There are no limits being enforced on how long MCO contract contracting can take.

We need a 30-day statutory deadline with Disby empowered to hold payers to it.

Second, use DHCF credentialing data to power a real provider directory.

Stressed out families should not have to wade through 100 providers who no longer live in DC to find one who has availability.

DHCF's data can resolve this in a simple way.

Three, strengthen Disby's enforcement tools.

Disby does outstanding work when it knows there's a problem.

But families managing a child's complex needs and small business healthcare providers don't always have the bandwidth to file complaints about large insurance companies.

Make it easier to report, and make sure Disby has the tools and budget to act.

This bill will expand access to critical health services, and its costs will be more than covered by the tax revenues, jobs, and economic activity it generates in terms of new providers entering the district.

I urge a favorable vote.

Thank you.

Thank you.

Thank you so much to this panel of witnesses on the variety of topics that were raised.

Your testimony was excellent, sort of, I think succinctly outlining what some of the challenges are.

When we were prepping for this hearing, and one of the things I sort of asked was what could our MCOs possibly be asking that's different than what DC Health asked when you had to be licensed as either a facility or as a doctor or nurse or whatever.

What could MCOs possibly be asking that's different than what healthcare finance asked when you had to be licensed or credentialed with them to even be part of the Medicaid program?

And I was coming up short.

Were there any differences?

Did they ask anything that either of those two entities didn't already ask?

I'm just going back through.

So three out of the four MCOs did not ask anything different.

One MCO did ask for a list of um uh technicians who practice under the licensed provider as a with I which I think is a reasonable starting point in the particular area that we're in for contracting.

But again, this is nothing, it was literally a duplication of everything that DHCF asked for, but it was requested in a wildly disorganized way.

We had uh four times our paperwork had to be resubmitted to multiple MCOs.

And if you think about this, I mean we're starting, but if you think about from DC Primary Care Association, every time that you have a new provider join, you have to go back through this process for that new provider.

So if I'm hiring somebody, let's say I hire them 90 days out, hoping and praying that they will be credentialed by the time that they start.

What can actually end up happening is that you have a licensed provider that has moved to the district and cannot actually practice because the company they're working for is a Medicaid serving business and the MCOs haven't yet done their process.

Yeah.

Um, Ms.

Pollard, I don't know if you wanted to add anything more to that.

I mean, I think for the primary care side of things, right?

Uh it is fairly unique in that you often might have providers who are coming in and out of a practice and this you essentially have to start over every time.

Absolutely.

That she she's spot on one.

Um, not necessarily anything as but to confirm that that is absolutely true.

Okay, okay.

Um I was hoping that one MCO might testify.

Um I don't see they'll probably come and say they want a meeting later.

Um, well let's talk about food.

Um thanks so much, Ms.

Clark and Mr.

Moore for um testifying um on this.

Um Mr.

Moore, I find it interesting.

I mean, you you called out DCPS in particular.

Are they doing this better than everybody else?

You know, I I think school food gets a lot of attention for a variety of reasons.

There are so many kids and families who count on it.

If you look at the trajectory of progress that we have seen across vendors across DCPS self-operated services, DCPS is probably the most regulated, carefully monitored food service provider contract that we have in DC, right?

And you're dealing with a lot of very complex, it's federal money, it's local money.

There are customizations happening at each school for kids with a variety of dietary needs.

And by and large, I think that the again the trajectory in DC has been very, very encouraging over the last 15 years that we've been involved with that work.

Yeah.

Except for when you talked about the last minute nature of a lot of our food contracts, DCPS is like a culprit.

And they'll admit that, right?

They'll do a letter contract.

Um, they'll submit or they'll submit a count uh submit a contract to the council like the week before recess and say, well, if you guys don't approve it in the week, the kids won't eat on the first day of school.

Um we do oppose hostage taking um in the food space.

I just want to be clear about that.

Um Ms.

Clark, you know, I I think your testimony brought up something very interesting in terms of like we did this whole report.

It talked about how the district is paying premium prices, but no one is evaluating whether or not we're actually getting better quality for what we're paying.

Can you say more about that?

I mean, it's not just, I mean, Alex kind of touched on this too.

We're paying wildly different per meal prices across agencies, and the agencies don't really know what the others are getting and for what, and so that's been some of the convening work that's already started that could be helpful as agencies like enter into contracting and evaluate the bids that they're getting.

But how could that possibly be if that I mean, with some like take DCPS out of it, take public charter schools out of it?

Everybody else who's doing food, they don't have independent contracting authority.

So this is all going through the Office of Contract and Procurement.

It is.

So in theory, if I were running the Office of Contract and Procurement, there would probably be a teen of contract specialists.

Now, maybe I'm speaking logically here.

You would have a team of contract specialists who specialize in food.

So, yes, that is what we thought might make sense, but that is not how it works in practice, right?

The contracting specialists work on an agency or cluster basis, and so they're often not um communicating at all with other agencies that are purchasing food, and they do and they're you know also responsible for buying paper or buying gas or whatever, like it's not like they have a sub a subject matter area that they specialize in.

And that is what I think the you know, people who are uh advocating for values-based procurement in the district are hoping the food policy um office can contribute is someone with eye, like food policy um and food contracting expertise that has eyes on all of these contracts because right now that isn't happening at OCP.

Um, but this discussion is just sort of like the way we're doing it is inefficient.

Correct.

And it can be inefficient within the same contract, right?

You can have one contract that says we expect you to have cost-saving mechanisms that use federally provided commodity foods.

Right.

And show us how you're gonna comply with the good food purchasing program.

And it's on the vendor to figure out and in the bidder to say, this is how I think I would do that.

But there isn't necessarily clarity even on those who might be reviewing the proposal saying how are you reconciling these different tensions that exist in different existing regulations and laws and agency priorities?

Sure, but even on that front, we are then relying to hope that whoever the contracting specialist is understands the standards that we have for each contract that's laid out.

Um I think the bill is a good idea.

I mean, I think yeah, we wrote it.

But I'm also sort of thinking like, is that gonna fully solve the issue?

I I think we have a much bigger picture contract, like contracting procurement mess in the district, and I'm happy to follow up on some of the things because when we did this report, you know, we were focused on food procurement, but when you look at food procurement, you learn a lot about procurement.

Yeah, right.

And I think one of the things that really struck me was that when we pass, when this council passes the law, a lot of the time it will have implications for procurement because we do almost all of our work in the district through procurement, or we spend like half of our funds on like through contracts.

And there's really not a process in place to ensure that like a law that gets passed is translated into a solicitation and a contract.

Um so you know, it might get there years later, um, but it's certainly not happening happening quickly.

And we saw that in the food context specifically, but it's happening, you know, all over the place.

Okay.

All right.

I don't have any further questions.

Thank you so much to this panel witnesses.

If you haven't provided your testimony for the record, please be sure to do so.

Thank you.

All right, we're gonna go to our next panel.

Uh Leah Caslez, uh Celia Madolfo.

Elizabeth Davis.

Anayas Washington.

Okay.

Is there anybody here who um expected to speak in person?

But I didn't call your name.

Okay.

Leah, when you're ready.

Good morning, Chair Ferson Henderson and committee staff.

The Streamlining Credentialing Act is smart legislation that utilizes the law to reduce administrative burden on providers by requiring a centralized and standardized credentialing system for managed care plans through DHCF.

The district's current system allows each MCP to conduct their own credentialing process.

Therefore, providers are first enrolling in DHCF and then must navigate each MCP's separate process for credentialing, which creates unnecessary duplication, delays provider onboarding, and increases administrative costs.

This reality is reflected across provider types, including in behavioral health and maternal health.

For example, doolas are impacted by this chaotic system.

While there are 27 dualists and 10 doola groups enrolled in DHCF, a majority of them are not enrolled in MCPs, with each MCP having a max of four doolas enrolled and only one doula group enrolling in each in one MCP.

You will hear from DULAS today on their experiences with this.

The Streamlining Credentialing Act is a step forward to improving the process in which providers like DULAS credential with MCPs.

However, we want to ensure doulas and other providers are included in the streamlining process.

The current language of the bill requires that providers have a valid district professional or occupational license.

There are many providers that do not have licenses, but instead have certifications or registrations.

Therefore, we ask this language to be expanded to minimally include certification and registrations that are covered by the Health Occupations Revision Act, which include doulas, registered dental assistants, registered pharmacy technicians, and hopefully community health workers in the future.

We encourage the committee to consider two other opportunities for streamlining.

First, we ask the committee to explore if there are opportunities to streamline not just credentialing, but also the billing process to allow providers to address challenges with navigating complex and inconsistent reimbursement from MCPs.

Similar to credentialing delays and complications in billing can and do result in providers opting not to accept public health insurance and thereby reduces accessibility to care.

Streamlining credentialing act will further build on this work and continue to improve the district's Medicaid system.

Additionally, while thinking about streamlining opportunities, we also encourage the agency to think of the impact the carbon of behavioral health services into managed care could have to further streamline the district's health system.

We are encouraged by recent feedback from the executive that there are viable steps DHCF and other executive agencies can make, can take to move the district forward in making the carbon a reality and improve access to services for DC residents.

We ask this committee to continue to work with the executive to understand what steps can be taken this year to begin implementation of the carbon.

Thank you for the opportunity to testify.

I welcome any questions the committee may have.

Thank you.

Ms.

Davis.

Good morning, Chair Person Henderson and members of the Committee on Health.

My name is Elizabeth Davis, and I'm the Senior Director of Government Relations at the DC Hospital Association.

Thank you for the opportunity to provide testimony on B 260523 streamlining Medicaid Credentialing Amendment Act of 2025.

DCHA and our members share the goal of ensuring that Medicaid patients have access to robust provider network compromised of highly or comprised, excuse me, of highly qualified and licensed providers.

However, the provider credentialing process can often be complex and time consuming, particularly when individual providers must navigate multiple and duplicative processes across managed care organizations.

While hospitals and other health care providers typically utilize the National Committee for Quality Assurance and CQA to verify provider credentials, each MCO conducts their own credentialing review and approval process via the Council for Affordable Quality Health Care.

DCHA supports B 260253 because it creates a centralized process for individual providers seeking to be credentialed or reconditional with a managed care organization.

We know that several states have already taken steps to reduce duplicative credentialing requirements, including Ohio and Nevada.

Both states have implemented centralized credentialing systems that allow providers to complete a single process recognized across all managed care organizations.

This process allows information to be securely stored within their state's provider network system and shared with all MCOs, therefore eliminating redundant submissions and reducing administrative burden for providers and facilities.

As the committee continues to consider this legislation, we encourage continued collaboration with the provider community.

DCHA remains committed to partnering with the district district in the Medicaid program and improve access to care for all residents.

We appreciate the committee's attention on this important issue and look forward to continuing to work with you on policies that reduce administrative barriers and support patient care.

Thank you for the opportunity.

Thank you.

Max Broadway.

Hello, uh Councilmember Henderson and committee staff.

I uh appreciate you taking me.

Sorry to uh be running late.

Um I'm excited to share on behalf of the DC Good Food Purchasing Program Coalition uh our support for the Food Policy Council Procurement Act of 2025 as a coalition of over 30 organizations in the District of Columbia committing to transforming the way public institutions purchase food to create a transparent equitable food system.

We're enthusiastic for the proposal outlined in the bill.

Um for the sake of time, I'm gonna skip over why we like it and just share some recommendations uh that we have as well.

Um first of all, we see um a huge benefit in requiring that GFPP, there's GPP participation for all food serving agencies.

And so, you know, the bill currently does not mention the good food purchasing program.

This is a missed opportunity.

GFPP is the district's most comprehensive equity-centered framework for values-based procurement, one that already aligns with the bill's goal of improving nutrition, sustainability, local businesses, labor conditions, animal welfare, and equity.

GFPP is a framework designed to be flexible and allow agencies to self-determine, making an ideal citywide standard, including GFPP in the bill would allow DC to expand beyond DCPS, and finally enroll many of the other agencies that serve meals every day.

A simple amendment requiring agencies to participate in the standard with Opposite Food Policy providing technical support would ensure consistent standards across government.

And you know, earlier you asked about uh food DCPS compared to other agencies, and I have quantitative um data on that.

Um initiate a citywide baseline assessment.

So GFPP begins with a baseline as the first step in the iterative process of values-based procurement, starting with the baseline, set goals, track progress, celebrate success.

Um right now, the district has no comprehensive understanding of what food it buys from who or what with what impacts.

The bill should explicitly uh direct Office of Food Policy to direct a citywide GFPP baseline assessment across all food serving agencies.

As the adage goes, you must measure to manage.

This is foundational to helping the district set goals, measure progress and hold vendors accountable.

Uh, fourth, require next require agencies to submit procurement data to office food policy.

This bill currently requires the office to compile and track food purchasing data, but does not require agencies to provide that data.

This is a structural gap that will undermine the entire purpose of the legislation.

Procurement is currently fragmented and opaque, making accountability nearly impossible to fix this.

The bill must clearly state that all food purchasing agencies are required to submit their procurement data to OFP in a standardized format on a regular schedule.

As we've seen with green food purchasing, delayed or incomplete data can hinder application of a law.

Um the committee can further streamline coordination by centralizing food procurement efforts in the Office of Food Policy.

Um and then also it'd be great to have a public dashboard for transparency.

Um transparency and accountability are two central pillars for creating market shifts that would support equity.

And so having a public dashboard that could track contracts, vendors, and food purchasing trends, show progress towards GFPP values, allow residents, advocates, and vendors to understand how public dollars are being spent, build trusts and accountability across agencies, would be a low-cost, high impact amendment that aligns the bill's goals with the district's broader commitments to open data and equitable governance.

Um we would just generally like to say that you know, passing this bill with the amendments would show our city as a leader in providing values-based food to children and adults throughout our public institutions.

Thank you.

Thank you.

Um thank you so much to this panel of witnesses.

Um highlighted very important and interesting points.

Um Leah, we um I just wanted to say, so you brought up in your testimony about um making sure that um part of the healthcare workforce that just registers as opposed to his license be included, and that's something that we definitely talked about.

Um we'll certainly ask um health care finance um questions about that.

We know that this has been a particular challenge for smaller um workforce like Doulas.

Um frankly, I'm sure I don't think he's testifying today, but we've heard about some of the issues in the dentistry profession as well, trying to get folks um cleared with all three of the providers.

Um, when we have if we if we have a practice, particularly in a field like dentistry who wants to serve Medicaid patients, we should be doing everything we possibly can to make sure that they can, given the small numbers that we do currently have.

Um so this just sort of makes sense um from across the board.

Um Ms.

Davis, you talked about Ohio and Nevada having introduced this already, or in uh you said introduce, but have they gone ahead and implemented it completely?

It's my understanding that they have it implemented okay just um last year.

Have you heard any feedback from providers in those jurisdictions or the associations that are over there in terms of whether it worked?

Yeah, I have not heard any feedback.

Um, but um, through conversations um with the other association, healthcare associations, we've heard of positive feedback in Ohio around the centralized um credentialing.

Okay.

All right.

Well, I don't have any further questions for this panel.

Thank you so much for being here.

We're gonna go to our virtual witnesses.

Um, so heads up to the virtual folks.

You'll have to affirmatively accept our invitation to become a panelist.

Um we're gonna do six um in our first panel.

Um Heidi Murphy from the Oregon Health Authority from the state of Oregon.

I know it's early, Heidi.

So thank you.

Uh Molly Rodorin from the food food supply chain for the city of Philadelphia.

Uh Derek Sykes from Community of Hope, Marion Newsom from Community of Hope.

Uh Amelia Keeler from the Center for Science and the Public Interest, and Umar Mohammed from Dreaming Out Loud.

Again, there will be a little box that pops up that says uh would you like to be promoted?

You do have to say yes to become a panelist.

Okay, um I see Heidi.

So when you're ready, Heidi.

Can you hear me?

Yes, I can hear you.

I I can't see you, but I don't know if that's on purpose, but oh, hold on.

No, I'm sorry.

There we are.

Um good morning, Chairperson Henderson and Council members.

Thank you for the opportunity to provide testimony today on behalf of ArrayRx.

My name is Heidi Murphy, and I'm operations manager with ArrayRX within the Oregon Health Authority.

Array RX is a collaboration of state partners using their collective purchasing power to offer uh pharmacy solutions to public entities grappling with increasing cost of prescription drugs and the lack of transparency in the pharmaceutical supply chain by providing transparent and value-based pharmacy solutions that are overseen and administered by states for states.

Array RX focuses on true program transparency where stewardship of tax dollars is the highest priority.

There's been some questions posed about the Array RX card, and I'm here today to address these.

Um I did provide more details and further data in my written testimony if I don't make it through all these questions.

The first question was what cost savings has Connecticut and other states seen since implementing ArrayRX?

So Connecticut launched the Array RX card October 2nd, 2023, and through December 31st, 2025, Connecticut residents have seen a savings of 2,860,141 dollars with an average savings per claim of 260 dollars.

For comparison, Oregon, one of the founding states of ArrayRX, provides card users with an average savings of 214 per prescription.

So for the same time frame, Oregon residents have seen a savings of 2,904,730.

Through 2024, Array RX represented over 1.34 billion dollars in annual for pharmacy purchases across Oregon, Washington, Nevada, Connecticut, and Ohio.

And this number has increased with Arizona joining us uh during October 2025.

Currently, there's nearly 136,000 enrollees in the Array RX card among all of our participating states.

The second question: what were challenges in implementing the program?

And I'd say the challenges have been marketing the Array RX card.

Funds are limited for advertising and staff to do outreach to increase awareness of the card.

Third question: how has Connecticut or other states' participation in Array RX changed since first joining?

Well, it's a as the awareness of Array RX spreads, more people within the state sign up, and over time more people have used the card for a discount on their medications.

When Connecticut first joined, they started off really strong with 10,355 people registering for the card during the first month, and they've steadily gained traction over the past two years, with membership currently at 25,671 enrollees.

Question number four: how has Array RX helped states in their goal of lowering the cost of prescription drug prices across four states in 2025, excluding Arizona that I mentioned joined in October 2025?

Array RX Card members save 19,720,195.

So I do appreciate you allowing me to provide this opportunity to testify today.

And I didn't get through all the questions, but the answers are in my written testimony.

Thanks so much, Heidi.

I'll have some follow-up questions.

Molly by two dollars.

Hello.

I'm coming online now.

Apologies.

Thank you.

Hi there.

May I start?

Yes, when you're ready.

Thank you.

Good morning.

I'm Molly Reardon.

I'm a food systems planner who has held a role similar to that which the Food Policy Council Procurement Amendment Act would create.

I testify in support of the act because it will add a staff position that will be critical to managing the complexity of public procurement of food.

From 2017 to 2022, I worked as the Good Food Purchasing Coordinator for the City of Philadelphia's procurement department.

That role required compliance with a slew of regulations, including city and commonwealth public procurement rules, city and federal nutrition requirements, the local economic development and sustainability goals of our mayor's office, and the unique needs of our departments of parks, homeless services, prisons, and human services.

That role was critical to advancing the food policy agenda of the city of Philadelphia through procurement, a powerful but all too often opaque process.

I managed food purchases, yes, but a lot more too.

For example, I created a contractual agreement between the city and a for-profit composting company to open the first urban commercial composting site in the Commonwealth on unused parks department land.

In exchange, the company provided free compost pickup to the city's 100 plus recreation centers and delivered finished compost to the Parks Department's community garden program.

To do that, I liaised between the Parks Department, Law Department, Zero Waste Commission, Streets Department, and State officials.

And the role was critical to developing a project that continues to yield results and reduced costs for city agencies and residents.

Unfortunately, because that role was not protected in any sort of uh legislative act.

Um, the city of Philadelphia ran out of funding.

I left, and the work slid, slowing the city's food policy progress.

The District of Columbia has already shown its commitment to addressing district priorities through food policy.

But food policy, especially procurement policy, needs someone that holds specialized knowledge to navigate many departments and rules to find common solutions that meet the district's goals.

I previously worked for the Center for Good Food Purchasing, where I had the opportunity to work with DC public schools food service and contracting staff.

I was then and remain impressed by DCPS staff's ability to navigate complex regulatory, contractual, and supply chain management obligations while providing food for DCPS's students.

However, it is very helpful as I've seen both in my role at the Center for Good Food Purchasing and previously working at the City of Philadelphia to have staff in place that can oversee changes needed to procurement rules.

I've seen over and over that jurisdictions have the most success in using food as a lever for change when they have staff in positions to make that change.

Adding this role to through the act will make you all leaders nationally in doing so.

So thank you for considering and hopefully for advancing the Food Policy Council Procurement Act Amendment Act.

Thank you, Molly.

Derek.

Good morning, Councilmember Henderson and members and staff of the community on health.

Just a note this is supposed to be a joint uh testimony with Mary and Newsom, who's not been promoted as a presenter, uh, but I'll continue.

Uh my name is Derek Sykes.

I'm the Vice President of Finance and Operations of Community of Hope.

I'm here today with my colleague, Senior Director of Patient Billy, Mary Newsom.

Community of Hope is a nonprofit Federal Quad Five Health Center and homeless service provider.

We provide medical, dental pharmacy, and behavioral health services along with the robust robust set of maternal and child health care services at our three health centers in DC.

In 2025, Community of Hope provided housing support to about 1,650 households and served about 15,500 patients in our health centers.

At Community of Hope, we believe the effective partnership between health centers and Medicaid MCOs is crucial to ensuring that district residents have access to high quality health care services that give people a chance to live long healthy lives.

The streamlining Medicaid Credentialing Amendment Act of 2025 would not have been possible without the collective advocacy of DC Health Centers or the collaboration from council, and we're hopeful that the legislation will address the existing issues, enabling health centers to continue to deliver high quality care and improve access to care for patients.

I'll pause for a second to see if Marion has been able to Okay, I see Marion on Marion if you'd like to jump in as well.

Good morning, Chair Anderson.

I want to say thank you, and we're incredibly excited to see the district taking this step to consolidate this process for keeping our delegation status.

This legislation will help relieve some of the delayed access to our many of our centers and reduce the administrative burden.

At our health centers, the Medicaid credentialing challenges have impacted providers on boarding and bullying physicians.

We are required to submit the same application to multiple MCOs and receive that information for the approval within anywhere within 30 to 90 days.

This act will help reduce that time frame as far as the rosters and having one particular form as opposed to having the you know multiple forms and multiple systems.

Thank you for taking action and thank you for allowing me to testify today.

And if possible, I'd like to just hop back in and just provide more context as well.

Umelines for processing providing credentialing approvals have not been consistent, and it depends on whether health centers have uh delegated credentialing or not.

Community of hope has been able to have delegated credentialing with through the MCO, so not all of them, um, nor any of the sub vendors.

So having a centralized approach will assist it with the MCOs that we've not been able to get delegation, as approvals for new providers may take up to 90 days.

Um, currently, our billing staff are left keeping track of the status of pending applications for weeks or even months, increasing both the administrative burden as well as lost revenue as our providers are actively seeing patients uh during this period.

So even if we have not fully been credential with the uh with the MCOs, we do continue care as we don't want as we want to continue to have access for our patients.

Um, we're hopeful that the implementation of the legislation will relieve the both the administrative burden for billing staff and allow providers to begin seeing patients sooner and allow health centers to maintain financial stability.

Uh, during a time when health care resources are strained and margins are getting tighter, is it more important now than ever to help close these gaps?

A decrease in credentialing approval timelines from 90 days to 30 or less would drastically decrease financial strain on the health centers.

Um, collaboration amongst the health centers, MCOs, and Department of Healthcare Finance will be crucial for the effective implementation of this legislation, and community of hope stands ready to assist in this endeavor.

However, we do recognize for this to be successful, the Department of Healthcare Finance will need the appropriate funding and the infrastructure to support this.

Um, we thank you for the opportunity to provide testimony today, and we're available to answer any questions.

Thank you.

Thank you.

Amelia, good morning.

Morning.

Thank you.

Good morning, Chair Person Henderson and members of the committee.

Thank you for the opportunity to provide testimony in support of the Food Policy Council Procurement Amendment Act of 2025.

I'm here today on behalf of the Center for Science of the Public Interest, CSPI.

Founded in 1971, we are an independent DC-based nonprofit that advocates for evidence-based and community-informed policies on nutrition, food safety, and health.

Together with our DC Good Food Purchasing Program, GFPP, coalition partners, we have spent the past eight years advocating for values aligned food purchasing in DC's schools, jails, hospitals, shelters, elder care facilities, and other institutions.

GFDP prioritizes community health and nutrition, local economies, environmental sustainability, valued workforce, and animal welfare, along with principles of equity, transparency, and accountability.

CSPI supports the Procurement Amendment Act and strongly encourages the council to amend the bill to establish GFP as the district's food procurement framework.

Across the U.S.

food service institutions spend over 125 billion annually, and DC agencies spend over 62 million on food procurement.

Currently, food procurement is not being leveraged effectively as a tool to address climate change, sorry, climate and equity goals in DC.

The district's failure to meet these commitments is due to a variety of factors, including flawed procurement solicitations and vague contract requirements.

The Procurement Amendment Act would help resolve these challenges by giving the Office of Food Policy the capacity and authority to support agencies in advancing value-space purchasing.

DC, along with 98 institutions and 13 local coalitions in 39 cities across the U.S.

has adopted the good food purchasing program because of its credibility, flexibility, evaluation measures, and widespread recognition.

The program's food standards were developed and reviewed by national, state, and local food system experts.

However, DC Public Schools is the only DC agency participating in the program.

Establishing GFP as a district's procurement framework would strengthen the bill by anchoring it to a gold standard national program and streamlining and implementation of GFP across DC institutions.

In 2022, the Center for Good Food Purchasing analyzed the impact of values aligned purchasing on 15 institutions that are enrolled in GFP.

Estimated impacts included a 12 million dollar increase in local sourcing, $4 million in local wages generated, a carbon footprint reduction equivalent to taking nearly 6,000 6,000 cars off the road, and a $15 million increase in produce purchases.

The analysis also revealed a 13% reduction in chronic disease risk, a 5% reduction in mortality risk, and a $1 million reduction in health care costs for the populations served.

With this legislation, DC has an opportunity to expand its commitment to values aligned food purchasing and to continue being a national leader in this space.

Please pass the Food Policy Council Procurement Amendment Act of 2025 to better leverage the purchasing power of taxpayers in the district and support access to healthy, sustainable, and equitably sourced food.

Thank you.

Thank you.

And I don't see Umar.

Okay.

Thank you so much to this panel of witnesses.

I do have some follow-up questions.

So my understanding, so ArrayO ArrayRx works with uh Navidis as the pharmacy benefit manager and Moda as the administrator.

How would participation work if DC pharmacies are not currently contracted with uh Nativis?

Uh yes, uh so Navitas Health Solutions um is a nationally recognized, transparent, independent, and full disclosure PBM that we work with alongside Moda Health.

Um so we do the contracting um through it's called an IGA, which is an intergovernmental agreement.

Um so that would provide the contracting um to work with Moda Health and Navitis through Array RX.

Okay.

Um you also mentioned that all participating states within RARX car programs, they charge a small administrative fee to members at the point of sale.

Does this mean that when someone um uh sorry um does RARX make a profit off this administrative fee after staffing and administrative costs?

No, we're nonprofit, um, and that's just a small administrative fee that's paid at the pharmacy counter and it's paid over time.

Okay.

Um what does the administrative fee go to help cover?

Is that just you know, just regular administrative pieces or is there something special?

Correct.

It it um goes it provides staffing for my position.

Um I work to implement all the IGAs for all the states that we work with.

Um, and then it also funds um our DOJ um advice that we receive on those IGAs.

Oh, okay.

Can you say more?

So um DOJ is, I guess, advising.

Oregon Department.

Right.

Oh, I'm sorry, say that again.

Oh, I'm sorry, I was just gonna say Oregon uh Department of Justice.

Oregon Department of Justice, not federal.

Got it.

Okay, just gonna clarify.

And that's just um advising on the intergovernmental agreements.

Yes.

Correct.

Okay, all right.

Great.

Well, thank you so much um for being here.

Um I have some questions for um Molly, if she's still here.

Yes.

Okay.

Um so uh thank you so much for taking the time to be here and sort of speak a little bit about um how this worked for the city of Philadelphia.

What challenges did you all or did you encounter in the role and what can we learn from some of those challenges in our drafting and implementing of this legislation?

Absolutely.

I think that the biggest challenge in Philadelphia was shifting the minds of people who had been involved in procurement of food or food-related uh services for decades.

Um procurement is a really technical and sometimes really entrenched department.

That's not a bad thing.

People have a ton of knowledge, but it does take a little bit of imagination to achieve food uh food system-related goals through procurement.

And so being able to articulate that this is a priority for the district through this legislation would be really helpful.

Um, it will also be helpful for a person who would be in that role to be networked with others who are doing similar work around the country.

Um, there's a lot of sharing between uh different procurement departments who are trying to achieve uh food-related goals through their purchasing, whether it's ingredient purchasing or the types of service contracts that I was trying to highlight.

Um, but the nice thing is it's all public, so it's easy to learn from one another.

Um, but really showing that this is a priority so you can help to shift the mindset out of doing the way things have always been done is going to be helpful, I think, for someone who's in that type of role.

Okay.

Um you talked a little bit about the compact uh compact, the composting uh initiative that you were able to get done.

Were there other examples of progress?

And I guess um you're no longer in that position, but has it maintained uh since your departure?

Uh yeah, I can give you uh another example of success that's specifically food purchasing related, and then I will also talk about where it's at now.

Um related to food purchasing, one of the biggest challenges for um our agencies is uh receiving food, especially uh fresh produce that uh is high quality, meaning that it's going to last over the course of a week or longer.

Um, that they're not getting stuff that's gonna rot right away.

When you buy the lowest cost food, um, you end up with food that goes bad.

The same is true for us when we go to the grocery store.

It's not uh it's not rocket science.

So being able to have someone in place, like I was to develop contracts that prioritize um food quality that prioritize on-time delivery, that prioritize transparency about where that food is coming from, all of that actually helps the departments to save money over the long term because they're not having to do eight different rounds of inventory and throw stuff out.

Um, and they are not having to go back and forth with the vendor over getting credit.

So it really ends up being a cost savings for, for example, our juvenile justice services center in the long run.

That was a really great success.

Um, the procurement work in the city of Philadelphia has stalled, but because of the role that I played in the way that I interacted with our urban agriculture director um and other people who were doing food security policy work in the city of Philadelphia, different um people and um in other agencies within the city, um, we were all able to contribute to the City of Philadelphia's urban agriculture plan, which includes long-term changes to food procurement in it.

So even though the role has gone away, there is a uh roadmap and a runway to continuing that work through staffed positions.

But I will say that the lack of a staff position, and I've heard this from my colleagues um at the city of Philadelphia since, has meant that um there have not been any additional advances on food procurement in particular, because there's no one there to push it day by day.

Okay, that's super helpful.

Um, and definitely sort of underscores sometimes all you you need that FTE, you need somebody to sort of always be um pushing that drumbeat.

Um I don't have any further questions for this panel.

Thank you to Derek and um Marion for being here, as well as Amelia.

If you go please provide your written testimony for the record if you haven't done so already.

All right, we're gonna go to our final panel of public witnesses, and then we'll turn to our government folks.

Uh Lester Franklin, Daniel Rosen, Coalition for Carcer Nutrition, Tom Madougal.

Amy Nellman's from uh Center for Good Food Purchasing, Stacey Snealing, Adrian Craig from Animal Welfare Institute, Crystal Jackson and Carolyn Vaughn.

Again, you'll need to affirmatively accept our invitation to become a panelist.

I'll also mention um our folks can't promote you if we can't read your name.

So if you have um a nickname, a cutie name, um, or just like your initials, if you can please modify your name so we can uh see who you are.

Okay, I see Lester.

So Lester, why don't you go ahead and get started?

I was making sure you guys can hear me.

Yes.

Good morning, Chair Person Henderson, members of the council.

My name is Lisa Franklin.

I serve as the procurement manager at Dreaming Out Loud.

Uh Dreaming Out Loud itself as a community-based organization.

Um food systems working to expand access to healthy food, improve health outcomes, support entrepreneurs, and build generational wealth, particularly in communities east of the river.

Our work sits at the intersection of food access, public health, local agriculture, and economic development.

And we are grateful for the option to share our perspective today.

Uh dreaming now allows effects and improved food purchasing practices across the district.

And we appreciate the council's attention to how public procurement can advance the healthier communities and support local uh economies.

We encourage the council to include a citywide food procurement assessment, being meaningful to uh beat before meaningful reform can occur.

The district must understand what food is currently being purchased, where it's sourced, which communities and businesses benefit from those purchases and where gaps exist.

Uh this assessment should include a clear commitment and timeline for initiation, ensuring that progress begins in a timely and transparent way.

Transparency.

Um critical to building a more equitable procurement system, streaming ally and credit the district to establish a public procurement dashboard that tracks food purchasing data across agencies.

Uh the tool would all allow residents, policymakers, stakeholders to understand where public food dollars are being spent, which businesses are participating in procurement, how procurement decisions support health, sustainability, and local economies.

Excuse me.

Um thank you for the opportunity to testify for your leadership in the closest policy today.

Thank you.

Uh Mr.

Rosen.

Good morning, Sharon Anderson.

And thank you for convening this hearing.

My name is Daniel Rosen.

I'm award one resident, a return citizen incarcerated at the DC Jail formerly and coordinator of the DC Jail Food Working Group.

I speak today from personal experience in strong support of the Food Policy Council Procurement Amendment Act.

The district spends more than $62 million annually purchasing food across agencies, including DCPS, DBH, and DOC, and others.

That is enormous purchasing power, and right now, the vast majority of it prioritizes lowest cost at the expense of public health.

This bill would change that by giving the Office of Food Policy the tools to advance values-based procurement across the government.

I want to focus on one agency where this change is most urgently needed, the DC Department of Corrections, probably the second largest food purchaser besides schools, serving over $2 million two million meals a year.

I ate the food there for about a year, and a 2025 audit and a 2023 survey confirmed what those of us who lived it already know.

Residents reported meals spoiled, moldy, or contaminated, while the food vendor was paid seven or eight million dollars a year, and getting and they're getting ready to renew this contract this year.

Those are dollars that could have been spent more effectively if values-based procurement processes were in place and could have even stayed in DC's local economy instead of being awarded to a multinational corporation based in Pennsylvania.

Typical jail meals procure promote poor health outcomes such as diabetes and can lead to a lifelong sentence of diet-related disease long after someone comes home.

This is the direct consequence of a procurement process that values only the lowest bid.

So please tell me, why are we sending DC taxpayer money to Pennsylvania?

Just to produce worse health outcomes.

To save a few dollars up front.

The Redstone Center report identified exactly why this persists.

There's no process for translating the district's values into actual contracts and solicitations.

The Office of Food Policy has begun to address this, and in the first six months of their recent federal grant, they worked with DOC on upcoming contract renewals to incorporate language encouraging better nutrition and local sourcing.

And they did so while incorporating the voices of local food systems experts.

This is real progress, but it will stop without permanent locally funded authority.

I'd also encourage the committee to strengthen the bill by specifying the good food purchasing program as the district's values-based framework, which is already in use at DCPS.

Applying it to DOC and other agencies would anchor procurement reform to a nationally credible gold standard program.

The Montgomery County Department of Corrections just next door won an award for incorporating good food purchasing principles, sourcing over 20% of its local of its total spend locally, including virtually all dairy and bakery products.

So why isn't DC's DOC doing the same thing or even trying?

The people in DC's jail are district's residents, same as the kids in our schools.

But we feed them or fail to feed them shapes.

Who walks back out that door and back into our communities?

I urge this committee to pass the bill, fund it fully, and ensure DOC is held to the same food standards we expect elsewhere in distinct in the district government.

Thank you.

I'll be happy to answer any questions.

Thank you.

Tomorrow Thank you, Chairperson Henderson and members of the committee.

Thank you for the opportunity to testify today.

Forgive me from testifying from my car.

My name is Tom McDougall.

I am the father of three young children.

I'm a 15-year resident of Ward 6.

I'm a food systems activist, and I am the founder and CEO of 4P Foods.

4P Foods is a values-driven regional food hub.

Uh originally started in Southwest DC, now headquartered in Warrington, Virginia, that exists to buy food from hundreds of farmers throughout the Mid Atlantic, serving public institutions throughout the district and the greater region.

I'm here in strong support of the Food Policy Council Procurement Amendment Act of 2025.

As you know, the district spends more than 62 million dollars each year on institutional food purchasing.

That purchasing power represents one of the most effective tools available to strengthen community health, to support regional farmers, to improve supply chain transparency, and to advance our collective climate goals.

If and only if it's aligned with clear values-based procurement standards.

Right now, too often procurement decisions default to lowest cost rather than best value for our residents, our workers, our farmers, and our collective environment.

This bill helps fix that by giving the Office of Food Policy the authority and structure needed to translate the district's existing commitments into real purchasing practice.

From our experience, which now spans 12 years in the mid-Atlantic, working across institutional supply chains.

I could say clearly and proudly that local and regional farmers and producers are ready, willing, and able to serve district agencies.

But they need procurement systems designed to include them.

As an example, today, as a food hub, we are already supporting values-based institutional procurement across the region, including 642 public schools in the state of Virginia, 17 major universities from Maryland and North Carolina, major hospital systems like Children's National Hospital and the Veterans Health Administration based in Baltimore with our food as medicine programs.

This work is already happening at scale.

It approves that this approach can be done, is being done, and with the support of this legislation, the district can already can accelerate its ability to do the same.

This legislation helps create that pathway by improving transparency, strengthening solicitation design, bringing food expertise into evaluation panels, and enabling agencies to track outcomes across nutrition, sustainability, and local economic induct.

I also encourage the council to anchor this work in the Good Food Purchasing Program Framework, of which once upon a time I served on the executive committee for the district, which provides a nationally recognized structure for implementation and accountability across agencies.

This bill turns commitments the district has already made into measurable action.

On behalf of 4P Foods, the hundreds of farmers that we serve and the tens of thousands of families we serve every month.

Thank you again for your leadership and for your time today.

Thank you, Tom.

Uh Amy.

Oops.

Can you hear me?

Yes.

Wonderful.

Um, well, good morning, Chair and members of the committee.

Thank you for the opportunity to uh share our experience today.

My name is Amy Nelms, and I'm the policy manager for the Center for Good Food Purchasing.

The center leads the Good Food Purchasing Program a nationally recognized metrics-based framework that supports public institutions to use their food dollars for public good.

Since its launch in in Los Angeles in 2012, the program's reach has expanded to nearly 40 jurisdictions across the country.

GFPP evaluates an institution's food purchasing alignment with six core values: nutrition, local economies, environmental sustainability, valued workforce, animal welfare, and accountability equity and transparency.

Through data reporting and technical assistance, we support institutions in using their purchasing power to build towards a more just and resilient food system.

Washington, D.C.

is a leader in values-based procurement.

The sustainable DC plan reflects strong alignment with the good food purchasing values, and DC public schools demonstrated their leadership by completing a GFPP assessment in 2018 for the 2018-2019 school year with a second assessment forthcoming.

DC is also supported by a robust coalition of local partners, many of which I've seen on this call today, and experts who are ready to convince continue advancing this work.

We're encouraged by the great potential of the Food Policy Council Procurement Act of 2025.

We celebrate the committee's commitment to strengthening transparency and accountability in food purchasing.

These goals are central to the GFPP program.

Consistent assessment and reporting are essential, not only for tracking progress, but for enabling collaboration with community partners who can support DC to meet its sustainability and equity goals.

As you consider this legislation, we urge the committee to more fully integrate and align with the Good Food Purchasing Program.

This would support DC to build on existing momentum, leverage established tools and expertise, and continue to ensure consistency across local agencies and institutions to drive impact.

By engaging partners such as the DC Good Food Purchasing Coalition, the Center for Good Food Purchasing, and DC public schools, the district's leadership would be fast-tracked by access to over a decade's worth of local procurement and national partner knowledge, as well as effective technical assistance tools and support.

Acting in concert with a large network of like-minded cities would grant the district collective influence on policy and market barriers to ensure that the $62 million it spends on in annually on food is leveraged to share or advance shared priorities, supporting local economies, advancing environmental goals, and improving food quality at institutions across the city.

Stronger alignment will enhance coordination, provide operational guidance for institutions, and improve transparency for the public, positioning DC as a national leader in values-based food procurement.

Thank you for your time and consideration.

Thank you.

Stacy.

Okay, I don't see Stacey.

Oh, yep.

Oh, there you are.

There you are.

Yep.

So thank you so much.

And thank you for everyone and their testimony.

It's been really interesting.

And I think I'm just going to add just added support for the Food Policy Council's Procurement Amendment Act of 2025.

My name is Stacey Snelling.

I'm a professor at American University, so perhaps that's unique.

Not many universities are testifying, but I lead the Healthy Schools Healthy Communities Lab here, and we're very focused on food systems.

I've worked closely with the Food Policy Council to guide my team's work in supporting a more equitable and resilient DC food system.

Like the Food Policy Council, my lab tracks national food system policy actions and best practices.

Values-based food procurement is a powerful strategy being used across the country to use taxpayer dollars to advance equity, public health, and environmental sustainability.

While the distric district has made strong commitments to advance this work without a centralized system, it will be challenging to achieve these goals.

By strengthening healthy food purchasing policies, the district can expand access to nutritious options for residents who rely on city-supported meal programs, whether they be children, people in shelters, seniors, or those incarcerated.

I work with the district in evaluating the Healthy Schools Act in 2010.

And while nutrition and food sourcing standards exist for our schools, more work is needed to extend these same standards to other district agencies.

This can have a significant impact on the health of our city by improving nutrition quality, reducing diet-related chronic diseases, and ensuring that residents who rely on public meals receive food that supports their long-term well-being.

Leveraging the over $60 million that the district spends on food, the district has the opportunity to boost the local and regional economy and increase the resiliency of our food system by supporting local, urban and regional agriculture, supporting local food jobs, and mitigating risk incurred by the disruption of national chains.

The Food Policy Council can fulfill this crucial and needed role of fostering interagency collaboration and transparency.

And so, in summary, I believe this legislation can make a law, can be made a law in the district as it will allow the district to ensure its work in existing communities.

So thank you so much, and I welcome any opportunity to engage further.

Thank you.

Adrian.

Yes.

Good morning, Chair Henderson and members of the committee.

Thanks for the opportunity to speak to you today.

My name is Adrian Craig.

I am a staff attorney and policy associate with the Animal Welfare Institute, which is a national nonprofit organization based here in Washington, D.C.

I am also a resident of Ward 7 of the district.

I'm testifying today in support of the Food Policy Council Procurement Amendment Act as a member of the DC Good Food Purchasing Program Coalition, or GFPP.

The Animal Welfare Institute has been able to advise the coalition on matters related to animal welfare purchasing value of the GFP framework.

Others have spoken to you about how important this bill is to effectively implement DC's values-based procurement commitments.

I would also like to voice my support in particular for the recommendations of the GC, sorry, the DCGFPP coalition.

In particular, we hope that this bill will be amended to specify GFPP as DC's values-based food purchasing framework.

It has proven itself as a credible and flexible values-based procurement program, which DCPS is already implementing.

With this amendment, the district will expand the values already described in the bill.

All five values of the GFPP framework are important, but I'd like to highlight the importance of animal welfare as a value.

Farmed animals and farmed animal welfare is an important value for DC residents and Americans generally.

This is something that is consistently proven in public perception polling.

Consumers care about the conditions in which the animals they consume are raised.

For example, a recent study completed by AWI and Harris poll found that 77% of dairy consumers say that they would be less likely to purchase a product from producers that did not provide appropriate pain relief prior to routine painful procedures.

The importance of this value is also reflected in its relevance to the other stated values.

Higher welfare practices are tied to more responsible environmental management practices.

And it is undeniable that poor animal welfare practices create disease reservoirs and transmission pathways that threaten public health.

Animal welfare and health are inextricably linked to human health.

And so the animal welfare value is consistent and complementary with the values existing in the bill.

I ask that you please apply all of the GFPP values, including animal welfare, to all of DC's food serving agencies.

We also request that the committee include in the bill an initiation of a GFPP assessment for all of the city's relevant agencies, a requirement that the agencies send their procurement data to the Office of Food Policy and the implementation of a dashboard to increase transparency around contracting and suppliers.

Thank you for your support of the Food Policy Council Procurement Amendment Act with the chains changes requested.

I appreciate you listening in for your time today.

Thank you.

Thank you.

Crystal.

Hi, good morning, greetings.

Um greetings to the Committee on Health and Councilmember Henderson for hearing me once again.

I am Crystal Jackson of a Queen Mama Doula Services, a Medicaid Doula provider, also representing the Ward 8 Health Council Maternal Health Working Group.

I have testified before this committee on a few occasions since 2023, requesting that you don't forget your doulas and B26-0523, streamlining Medicaid Credentialing Amendment Act of 2025, is very much so in support of DULAS.

Currently, once DULAs have completed the enrollment process with the healthcare finance, which still is not doula friendly, we are then eligible to enroll with a managed care plan.

I endeavored to enroll with the four MCPs.

I've been successful with only two because it's so burdensome.

And each process required submitting signed contracts and often duplicative items from enrolling with healthcare finance.

Overall, it took more than a year to complete with 80-day processing times in between each document submitted, which created delays in providing care to do the care to families utilizing Medicaid.

It would appear that B26-0523 would directly address this confusion and help to avoid delays by creating a simplified process so doulas can more easily navigate those first steps of becoming a Medicaid doula.

It would create less paperwork and administrative burden, which is a win, especially for individual providers like DULA's.

It would be very important for the agency to have clear communication when this switch occurs.

There's been significant work to address the confusion of enrollment and credentialing, and that should continue.

However, if a dual is trying to enroll after January of 2027, we will need different guidance and support.

And so we ask that the agency work with Dula partners to support implementation of this simplified application, particularly with the Lula community, right?

Don't forget your DULAs.

Additionally, in reading the language of this bill, it states upon determination that the provider has valid district professional or occupational license to provide healthcare services to which the credentialing would apply.

We're certified, and so we suggest that this language be expanded to include professional or occupational license or applicable certification.

So doulas are not left out of this process.

And also, for your consideration, while we're talking about streamlining credentialing and reconventionaling, we also want to consider billing because each uh MCP uses a different billing platform.

So it would be nice if that could be streamlined as well.

We ask this committee to continue to engage with Doolas and the Doula Learning Action Collaborative to understand if there are further supports.

Thank you for the time to testify and not forgetting your doulas, and I welcome any questions.

Thank you.

Okay, I don't see Carolyn, but I do see La Monica.

Good morning, Councilmember Henderson, members of the committee and staff.

My name is LaMonica Jones, and I'm the director of DC Hunger Solutions.

Thank you for the opportunity to come before you to provide testimony regarding the Food Policy Council Procurement Amendment Act of 2025.

Value-based procurement is essential to the work of DC Hunger Solutions as it ensures the purchasing decisions reflect our commitment of building a system that centers food sovereignty, food justice, equity, and economic opportunity.

Rather than focusing solely on cost or convenience, values-based procurement prioritizes how food is sourced, who benefits from local food dollars, and the broader impact on communities experiencing hunger and poverty.

As a member of DC Good Food Purchasing Coalition, we stand committed to transforming the way public institutions purchase food to create a more transparent, sustainable, and equitable food system.

This commitment within institutional food procurement is already taking shape with several government agencies.

For example, since adopting GFPP standards, DC Public Schools has made strides to improve institutional food procurement across several core values, including nutrition, local economies, and environmental sustainability as required by the Healthy Student Amendment Act of 2018.

Some of the notable attributes of this work include providing more plant forward meals and conducting monthly taste tests for new plant-powered menu items.

This progress is especially significant given the scale of the district's investment in food procurement.

The district spends more than $62 million annually to purchase food for several of its institutions.

Our local food dollars have the potential to do far more than provide meals.

They have the potential to shape the local economy, influence food access, and determine who benefits from public investment.

The bill also creates an opportunity to strengthen the role of DC Food Policy Council by granting to granting the authority to monitor and guide how public dollars are spent across the food system.

Doing so will help agencies develop solicitations and contracts that meet all applicable district laws and standards, require more vendor transparency, and corporate best practices for nutrition, sustainability, and local food procurement, ensure solicitations reach a wide audience of high quality prospective vendors, and compile food purchasing data by tracking the impact of food purchases across all agencies.

The shift to a more structured reporting framework paired with expanded authority reflects a forward, a move forward toward deeper, more strategic accountability rather than simply tracking activities.

The Food Policy Council is positioned to assess outcomes such as whether procurement dollars are reaching local producers, supporting fair wages and food jobs, or strengthening urban agriculture as a tool for healthy food access.

The district's significant investment in food procurement, its commitment to values-based procurement through the Good Food Purchasing Program, and the strength and oversight proposed in the Food Policy Council Procurement Act Amendment Act of 2025 represents a comprehensive approach to addressing hunger and poverty by aligning excuse me by aligning how local dollars are spent with clear values around equity, sustainability, and economic opportunity and ensuring those investments are guided by strong accountability mechanism, the district can move forward beyond short-term solutions to create lasting structural change.

Thank you for the opportunity to provide testimony.

Thank you.

Hi, thank you.

Can you hear me?

Yes.

Okay, great.

Thank you, Chairwoman Henderson and you know, I really appreciate you proposing this act, uh, the Food Policy Council Procurement Amendment Act.

And I am a resident of Ward 3.

I'm a member of the Food Policy Council.

You swore me in.

Thank you very much.

And um I've been a farmer for my entire career.

Uh, first for two decades in Maryland, um, and now here on a much smaller scale inside the district.

And more to the point, I'm now um purchasing produce as well and distributing that produce and also purchasing prepared meals from local producers and giving that away in our community here from the ARC in Ward 8.

So I'm just speaking from this perspective of somebody who is doing on a much smaller scale than the district does uh some food procurement.

And I take uh a lot of extra time to purchase food directly from farmers, and I also purchase our prepared meals directly from small businesses that are here in DC.

And I can see the difference that it makes to these businesses, and I can see the difference that it makes to the people who are getting the food.

Um, so I just I'm encouraged by this act, and I really want DC, um, which is so much bigger than our our little operation um to make like this much bigger difference to all of these different um participants in the system.

Um, just to give you an example, uh, I was chatting with a farmer who we'll be purchasing from who's in Brandywine, Maryland.

She has a small farm there.

And she was pointing out her trailer that she lives in, and that, you know, in order to cook dinner, um, she has to put her stove in the bathtub.

And so then when she wants to take a shower, she has to like move all that stuff and then take a shower.

So she was saying to me, like, no, this contract you're giving me for this produce that you're gonna buy is really important because I want to build a house for me and my mom to live in.

And um, and then we take her produce, this these delicious collared greens, and the our neighbors here in Word 8, they are looking at this fresh produce and they see the difference.

They're really excited by the extra taste and nutrition, and they're excited to go home and prepare it.

Um we get a lot of compliments on how fresh the produce is.

Um, so it really matters.

It's really um, you know, I'm not really testifying to like the details of the law or how it will be implemented.

That's for other people.

I just really want to reinforce um the part of this is like bringing joy and business success and health um to district residents.

Um I wanted uh oh, and that's all.

I'm out of time anyway.

Thanks so much.

Thank you.

Um thank you so much to this panel of witnesses.

A lot of um interesting things were covered and and some of the support pieces, um, we were certainly uh it's good to hear sort of people kind of coalescing around um particular ideas about this.

Um I want to ask Mr.

Rosen if you're still here and see Mr.

Madugle had to go, but I think he was driving.

Uh Mr.

Rosen, um, thank you for so much for your testimony and for for being here.

Um, you know, oftentimes when we talk about all of the various entities which purchase food, um it's a little not a little, it's quite embarrassing to say that um the Department of Corrections like pays the least amount of money per meal than anybody else.

Um and then everyone often acts very surprised when we get testimony um attorneys or individuals who are at in the custody of DOC when they talk about the quality of the food.

But if we're only reimbursing like a dollar and seven cents a meal, yeah.

Bread, baloney, a slice of cheese.

Um, and and folks think that we're sort of exaggerating on this.

Um you talked a little bit in your testimony.

I'm I'm assuming that sort of this coalition that you're part of is nationwide.

And have you seen two separate things?

Okay, I'm sorry.

I was just gonna say ask like have you seen other jurisdictions kind of move in a different direction.

Yeah, I appreciate that question a lot.

Um I I right now coordinate what's locally just referred to as the jail food working group, with just a collection of local and national organizations.

Um I also have my own nonprofit focusing on carceral food systems nationally.

Um but the the local working group has been in existence for about four or five years, and I think had had has had limited success.

I think um what you just said is important.

The the places where we've seen progress in jails or prisons, what we tend to see is enabling policy like values-based procurement legislation.

Yeah, um, or policy that allows that kind of that that really forces agencies like corrections um to do a little bit better and not just look for lowest price.

Yeah, when we when we look for lowest price contracts, um the Department of Corrections will tell you that they spend about 250 per meal, but it's not what they spend per meal.

That's what the hand arrow mark um per meal and I think we see a portion of that end up on trays, and it usually ends up in the form you just described.

Um baloney um for lunch on a daily basis, and the department will tell you that that is that they're addressing it, that they're doing better, that they're you know, not feeding baloney every day, but I talked to folks inside still.

Talk, please.

I mean, I would encourage you to talk to Commissioner Cunningham, um the ANC commissioner inside the jail.

He'll tell you exactly what he's eating every day.

And yeah, the outcomes are not a surprise.

We you know, we we certainly can't feed people um as well as our values would dictate on the kind of money we're allocating toward this, and especially when almost none of those meals include nutrient-dense foods, fresh produce of any kind, um, and and um are really just the we feed people there in all the ways that we know are unhealthy at this point.

I mean, I will say this.

Um, when we look across at cost, um while DOC is one of the lowest and not the worst.

I mean, frankly, we've had these conversations with Department of Human Services.

What we what we are paying per meal in our shelter system.

Um, it's certainly not offering the same type of right.

We have a lot of diabetics, and yet the meals that we're offering are certainly not speaking to that.

So we have individuals who are unhoused, and then um their dietary situations are exacerbating their medical situations.

Um, it's just so very you know, it's kind of all connected.

Um, Miss Reardon who um Molly who testified earlier when she talked about when you have higher quality produce, it lasts longer.

Right?

And so if you're going for the cheaper item, yes, um, either one you're wasting more.

Um, or two, it's not lasting in the same amount because the head of lettuce is going bad in two to three days as opposed to being able to last at least a week.

Um and uh I don't know.

I wish we kind of understood this more uh across the country um in terms of our food practices.

We could be keeping those dollars um in the local economy and purchasing better food for the dollars that we're that we do have and not um spending all of that money on essentially you know, corporate profit and overhead.

Yeah.

Okay.

All right.

Well, um, I don't have any further questions for this panel.

If everyone can make sure they please provide the written testimony for the record.

Um, we're gonna do like a really quick five minute break and then we're gonna um come back to our government witnesses.

Thank you.

Okay, we're back.

Um, gosh, it's so good when I get to see all of my agencies in the cluster.

So we start with healthcare finance, then we're gonna do DC Health, and then we have office planning.

Um, we're gonna start uh with testimony about the Medicaid credentialing bill.

Um we have Melissa Bird who is the senior deputy medicate director.

Um she's joined by uh a colleague if you just introduce yourself for the record.

Oh Melissa pulled you up here and was like, nope, you're sitting at the table today.

Good morning, Council Member Henderson, Lisa Truett, I'm the director of the healthcare delivery management administration at the Department of Healthcare Finance.

Okay, thank you, Lisa, um, for being here.

Um as you guys know I have to swear you in, so if you could raise your right hand do you swear under firm under penalty of law that the testimony about to provide to the council of the district of Columbia and this committee is the truth of the whole truth and nothing but the truth.

Great.

All right, Melissa, when you're ready.

Um I'm gonna take because we're the first agency we're the favorite, but who knows.

Um good morning, Chairperson Henderson and members of the committee on health.

Um as you stated, I'm Melissa Bird, senior deputy director and Medicaid director of the Department of Health Care Finance.

I am joined today by my colleague Lisa Truitt, who, as she noted, is director of the health care delivery management administration that has direct oversight responsibility of our DC Healthy Families Managed Care Program, the largest of our managed care programs at the agency.

I'm here today to provide testimony on behalf of the the Department of Healthcare Finance on Bill 260523, the streamlining Medicaid Credentialing Act of 2025.

The bill requires the mayor to direct the agency to develop and implement a single consolidated and exclusive application process for providers seeking to be credentialed or recredentialed with a Medicaid managed care organization.

If a provider is in network with all five of the DC Medicaid Managed Care Organizations, the provider must complete the credentialing process five times, once for each of the MCOs.

In my testimony today, I'll provide a brief overview of Medicaid provider enrollment versus credentialing and then discuss the proposed reforms in this bill.

Providers seeking to participate in the Medicaid program are required to complete the provider enrollment process.

Enrollment is a separate and distinct process from credentialing.

The Medicaid and CHIP Payment Act and Access Commission or MACPAC defines provider enrollment as the process by which states determine whether providers are eligible to deliver services.

It distinguishes this against credentially, where credentially is the process whereby to determine whether a provider is qualified to deliver care to the plans' enrollees.

I go into more detail in my written testimony on what falls under provider enrollment.

For Medicaid Managed Care Credentialing, the current contracts for our largest Medicaid Managed Care Program, DC Healthy Families Program, defines credentialing as the process of formal recognition and attestation of a provider's current professional competence and performance through an evaluation of a provider's qualifications and adherence to the applicable professional standard for direct patient care or peer review.

Credentialing verifies, among other things, a provider's license, experience, certification, education, training, malpractice, and adverse clinical outcomes, clinical judgment, technical capabilities, and character by investigation and observation.

DHCF expects managed care plans credentialing policies to comply with standards set by the National Committee for Quality Assurance, or NCQA.

The NCQA standards are considered best practice and aim to assist managed care plans in developing high quality provider networks.

In addition to NCQA standards, DHCF requires managed care plans to credential providers prior to becoming MCO network providers, conduct a site visit for all primary care provider and behavioral health providers before providing services, ensure the provider credentialing process is completed within 120 days upon the receipt of all required documents, and re-credential providers at least every three years.

As part of the credentialing process, MCOs gather the following information, including but not limited to licensure status, their specialty or subspecialty, board eligibility or certification, operating hours and office location, panel status, are they open or closed to new patients, languages spoken, and reported incidents.

Providers have expressed their concerns about their record current requirement that each managed care organization credential provider seeking to participate in the provider networks.

They've cited administrative burden, as you've heard today, and the opaqueness of the credentialing processes and have suggested that a centralized process would ameliorate these issues.

In response, DHCF began research and analysis to understand what it what centralized credentialing requires, what other state Medicaid programs have implemented centralized credentialing and how.

DHCF understands that Bill 0260253 aims to streamline the managed care credentialing process by shifting the responsibility for credentialing from each MCO to the agency.

Through this centralized process, providers would credential through DHCF, and once approved by the agency, the provider would be considered credentialed for purposes of networking with any of the Medicaid MCOs contracted by the agency.

The legislation requires that a temporary credential be issued within 30 days of a completed application submission, and the temporary credential allows providers to render and be paid for Medicaid services.

DHCF does not currently have any mechanism to implement centralized credentialing.

As highlighted earlier in my testimony, the provider enrollment process is distinct from credentialing.

There is additional information to collect and verify, additional site visits to conduct and re-credentialing occurs on a more frequent basis than provider enrollment.

To implement a centralized process, DHCF would have to likely engage an outside vendor, coming at a cost to the district.

While there could be some cost shift from the reduced administrative requirements to the managed care organizations, it's unlikely sufficient to cover the cost of procuring a standalone vendor.

Additionally, DHCF estimates that implementation would take at least one year, which makes the proposed effective date a January 1st, 2027 challenging.

Finally, while the agency has concerns about the agency has concerns about allowing for a temporary credential.

Ultimately, if a provider is denied but has been paid for services rendered under under the temporary credential, the district would have to return federal funds associated with a provider payment and pay 100% local funds.

There are other options that could improve the current credentialing process.

They include establishing protocols for coordinating exchange of information to expedite credentialing process across the managed care program.

This could include the creation of an interactive tool for tracking all newly credentialed and re-credentialed providers utilizing existing sources within the agency, such as our MMIS or eligibility systems.

DHCF could amend the managed care contracts and allow that once a provider is fully credentialed by one health plan, the process is expedited and accepted by another.

While this option is not centralized credentially as we've discussed today, it can address some of the provider community's concerns about administrative burden.

Ms.

Chairman and members of the committee of health, this concludes my testimony on the proposed legislation.

The district appreciates the value centralized credentially could provide, particularly for reducing administrative burden for providers.

It's important to consider the financial feasibility along with competing priorities, such as the implementation of key one big beautiful bill act requirements over the next year.

Thank you for the opportunity to testify, and we are pleased to address your questions.

Thank you.

Thank you so much for being here.

I do have some follow-up questions.

So in your testimony, one of the things you talked about was that if you if healthcare finance were to do this, there would now be additional things that you would need to request or collect.

And then I think you also mentioned an additional site visit.

Why?

So for right now, um for provider enrollment, we require a site visit for, I think it's just um we have providers at three different risk levels, I think moderate, mid, and high, and our site visits, I believe, are only for those that are considered high risk, which are likely DME providers and home health agencies.

So we don't do a site visit across the board.

Um in the testimony I spoke on how credentially and some other the requirements we had or site visits for primary care providers or behavioral health providers, that would be additional to what we do today.

Okay.

Um but as I sort of mentioned earlier, by the time a provider gets to you all, they've already gone through DC Health to be licensed, no.

Yes, ideally, and if they haven't, then they're not going to be enrolled as a provider.

Right.

So I'm I'm trying to understand why the additional need to do the additional streamlining, right?

If they are licensed as a health care facility, right?

Let's let's say if you are the facility, not the provider individual practice.

But if you when licensed as a health care facility, then you've gone through DC Health's entire process and they have said yes, we determine that your facility has met all of the requirements and is safe.

Check.

So why then is there an additional site visit necessary to check again all the things that DC Health just checked for?

On the primary care side and behavioral health side, um, Lisa, I don't know if you can fill in otherwise, we'll have to come back, but on the high risk provider side for just generic Medicaid provider enrollment, um, it's an ad it's a requirement through the federal government for those that are classified as high risk.

Yeah.

I mean, but you said DME, so durable medical equipment, that's not necessarily high risk in terms of patient safety, that's high risk because fraud, most likely.

Yeah.

Okay.

Ms.

Truett.

No, I was just gonna reiterate what um Melissa said that it's the federal requirement.

So even though they've gone through the enrollment on the managed care side.

So that's what I'm speaking to.

So on the managed care side, even though the provider has gone through the enrollment process to enroll as a Medicaid, the DC Medicaid provider, the credentialing part of it requires a site visit.

That's not something that we established.

That's a requirement, a federal requirement to confirm all of those elements that's in the regulations for credentialing a provider into the managed care network.

Okay.

I guess I'm just trying to understand if health care if DC Health already did the visit, why do you guys have to come back?

Or why can't you share information?

I don't I don't have an answer for that.

I don't know if that's something that's ever been considered.

I just know that it is the responsibility of the health plan to validate that.

I don't know if at this point does receiving information from another party is acceptable.

It could be that it's necessary for the health plan to validate those all of those items that's required on their own, or if they're contracting with someone themselves to do it on their behalf.

But it I I don't I don't know if that's ever been considered.

Because like if we even take it from the perspective of a primary care, um, you know, Ms.

Pollard was here earlier.

Okay.

I've got better Bureau Health.

Um I have been licensed by DC Health.

I'm already enrolled as an MCO, but now better Bureau Health.

I want to hire Dr.

Byrd, but she needs to go through the process.

I have I'm I'm doubtful that the MCO is going back out to check out better Bureau Health because you already checked me out.

I'm just adding her.

Well, just as Melissa said, not every provider that enrolls as a Medicaid provider receives a site visit.

The health plans are required to do a site visit on everyone.

Right.

But what I'm saying is the health plans certainly aren't doing a site visit every time I add an individual provider to a practice that's already with them.

If it's a practice, most likely there's some sort of a delegated agreement.

And through that process, the health plan is depending on the delegated entity to provide all of the qualifying information to get them through the credentialing process.

Okay.

Of our MCOs, how many of them do delegated?

I mean, community of help hope, excuse me, testified that they have only delegated authority for one of the plans.

Yeah, well, it depends upon the relationship with the plan, the plan um prior history.

So that's where the credentialing piece goes comes into play, where quality of care is being considered.

So if there's some prior information that the health plan has, or um, you know, it just depends on the need for the health plan, the the provider type based upon the number of beneficiaries enrolled in the health plan.

So there are various variables where it can be.

I I see someone on the outside looking in thinking that it's a clear-cut situation, a clean situation, but there are various variables that the health plans consider when they're working with the provider community or negotiating or whatever term is being used for the purpose of enrolling into their networks to be able to administer services or render services to their enrollees.

Okay.

And it would be helpful if any of the health plans had testified today.

Yes, Mr.

Well, I was also gonna say one thing that we can do is look at um, like I don't know the licensure requirements under DOH for a provider off the top of my head, but we can certainly do the crosswalk and look at the timing of licensure, what's incorporated in that process versus re-licensure versus how what we require on the health care finance side, because we're not gonna check all the same things that DOH checks when we see that they have a license, right?

But we can see where there's duplication or where it's um streamlined.

I would also the other thing that popped in my mind from your questions is the um the frequency in which those like site visits happen.

I suspect we might be there more often for obviously a high risk or that the plans might be there more often.

I don't know what kind of site visit is required or under a DOH license.

So I think those things are looking at again where they align, where they don't align, and the timing of each.

Yeah, I mean I I'm looking at this from the perspective of each of the stakeholders, right?

Obviously, for a stakeholder of me as a patient, I'm gonna be able to get into a doctor when I need them and not be on a wait list for six, seven months that, right?

If I'm running a practice, it is also a small business.

I need providers if I'm gonna do that.

So I also don't want them waiting 120, 180 days just to go through a process.

From a regulator, you want to make sure that we're number one, meeting all the federal requirements and also ensuring that you're not licensing someone who would be, or excuse me, credentialing or giving someone a Medicaid ID who is going to be susceptible to fraud and also not provide quality care.

But I think for my side, I'm like, I feel like there's an easier way for us to do this.

We just need everybody talking to each other so that I'm not having someone is not having to produce six packets of the same document and to varying degrees of success or over sight, because I think Ms.

Shrewitt, you you would probably agree with me and I said all of our plans are not necessarily made equal from their administrative back office uh strength.

Um the bill does not currently define what constitutes a completed application.

Um, their differences across the MCOs.

Um can we work with you all to determine like what does a completed application look like or what it would look like from a health care finance standpoint to make sure that somebody is in QA in CQA compliant, accredited.

Accredited.

Okay.

Um we're doing the contracting for the MCOs.

Um, like you know, when we do the RFPs or RFA, I can't even remember which one we do, but you know, give us your information and and give us your best offer.

Do we ask in that process what's your process for credentialing?

It depends on what we've experienced the prior contract period.

We try to focus on things that um we know we might need to improve and we want to get some fresh information from any new entries, potential entries into the program.

Okay.

So the evaluation factors that you're referring to, they're based on what we want to know for uh the new program, especially if we put in some programmatic changes.

We uh typically put in some questions that would help us to understand how uh uh either a returning health plan or a new health plan would be able to administer the program.

So credentialing, I don't recall that being a question.

And we were doing solicitations repeatedly for quite for a for a while.

I do I know that were some questions around provider network management, but I can't remember which solicitation it was.

Uh I know it probably would have had to occur before the last one we did in 2021.

Okay.

There were questions around network um development, and that would have included how they're credentialing providers and bringing them into the network.

Because I think it would be interesting to see how just how different are all of the MCOs going through the credentialing process.

Um we asked uh at some point before this hearing to get for all of the MCOs to provide us with their lists or like to provide us with their process.

Um not everybody followed the instructions as provided, you know, back office administrator strength.

But for the ones who did, um, you know they're relatively similar, some of it is a little bit different, but no one is asking for wildly different information.

So I feel like there's there's gotta be a way um to ease the timeline.

Do we evaluate based on like um do we monitor how long it's taking?

Yes, there is we have a staff person who has started a process.

I think when we started this conversation a little bit before we started this conversation, she's monitoring the length of time it takes for uh a provider to be credentialed with a health plan.

And as you know, you mentioned it earlier, overall they have 120 days to do that.

Um if it's taking longer than that, she is aware of that.

Uh typically it's because as we've said before, all of the information isn't provided through the application process.

Um sometimes the licensor is expiring within a certain time frame, and so the process can't be completed.

Uh I believe as as I was looking in the standards a couple of days ago, and I'm not gonna say this right, but essentially when um a provider is uh uh seeking to uh credential and enroll with the um health plan, the everything has to be current at least 180 days before the expiration date.

And so if someone is what is that, six months?

So if someone has something their licensure or something is is expiring within um three months or something that they can't start that process until they get the the newly um updated version.

And again, that's a federal requirement, that's not a health plan or DHC.

Yeah, but now I need y'all to really talk to DC Health because DC Health has its own limits of you can't renew up until a certain point.

So let's say my license is about to expire six months, but DC Health is saying, hey, you can't renew to the three months now.

I've got a problem where I can't I can't work um until DC Health lets me like um even start that process, which I will take some time.

Man, I I don't know.

Being a doctor in this city seemed difficult.

They can continue to work, they just can't newly enroll into to the health plan until they are we've got over 400,000 residents as you know on Medicaid, right?

So yeah, I could work, but who's gonna hire me if I can't accept a Medicaid patient in the city, right?

If how how am I gonna work in a practice if I say, oh no, I can only see the private insurance or the those who can self-pay?

No, no.

What I was saying is um, and maybe you're talking about new new new providers or folks just getting into the field.

What I'm saying is if you're an existing provider, the process would continue.

But if you're just newly enrolling as a health plan provider, I'm saying that continue continue can continue to happen based upon what you just said.

They can enroll and work with other carriers.

But yeah, if it's just a newly a person who's never enrolled with the health plan before, I understand that side of it.

But if the provider is just being re-credentialed, yeah, yeah, they can continue to provide the services, it's just that they have to make make sure that that that the licenses and everything is provided within the appropriate time frames.

But I hear what you're saying, that is something that we need to consider as well.

Um I don't know what that means as far as um maybe sending some questions to NCQA and you know, talk about what some of the challenges are for the District of Columbia and see if those are some options for consideration.

But um, yeah.

Yeah, I mean, but it's less likely that in in QCA is going to change their sorry, the acronym, you know what I'm talking about.

Um it's less likely that they are going to change their um procedures.

DC, it might be easier for DC Health to change when they allow for someone to come up for renewal.

Right now they're doing renewals based on your birthday, right?

But you know, it may not always align in terms of the time frame.

So y'all in all in the same cluster, just we could pick up the phone.

We could figure this out.

Um, so we heard some testimony around the process um might leave out provider types that require certification and registrations.

So like they wouldn't their um doulas, for instance, dental assistance.

That's not a licensure type, they're just they have to certify or register.

Um does healthcare finance have any concerns around expanding the scope of professionals to be credentialed to include those individuals, or those workforce types rather.

Well, they for provider enrollment purposes, they already have to go through the provider enrollment process.

Um I can't say yes or no on the credential aids because quite honestly, like I don't understand what that nuance is for them, but it would certainly um more than um willing to look into it.

I have seen it at a couple other states um where I think you know more non-traditional providers such as doolas are exempted or outside of that credentialing process, I think.

Like they just do it through fee for service.

Um, but we can follow up on that and and better understand it.

Okay.

You mentioned in your testimony, and we know from um research and prior testimony there are a couple other states that already do the streamlining credentialing.

Do they all use a third party?

Um I think Ohio does.

I know North Carolina's um at least their policy papers said that they would be um procuring, they call it a credentialing verification organization.

Okay.

Like what we don't do right now is like um, as our operations director would call it, like we look at your license and we confirm that, but we're not doing like the primary source document.

And I don't know if this is something that DOH does, but we're not looking at oh, you did go to medical school, this is where you went to medical school, this is your that component.

So that's the one of the areas of credentialing that comes into play.

That's not something that the Department of Healthcare Finance does today.

Luckily for you, DC Health does do that part.

So they do check to make sure you graduated from where you said you uh went to.

Um the bill would allow for healthcare finance to grant the temporary credentialing, and you mentioned some concerns about this.

Um what are some other scenarios?

What's an alternative?

Well, I think a couple things.

One, we could collect information from the plans to see what's their rate of denial to see how much is it a real real issue, right?

If it's a a one-off, if it seldom happens, then I would probably have less concerns.

Um and then other alternative alternatives for temporary credentialing.

Well, I don't support temporary credentials.

You could say that yes, yeah.

Yeah, well, some of the say why or why you why you have concerns about temporary yes.

Because there have been real life situations where a provider hasn't come started rendering services and um the provider began to reimburse the provider for the services, but the credentialing process was not completed.

The required information was not submitted uh to the health plan.

So subsequently, the provider is no longer able to render those services, and those funds have to be recouped from the provider.

And so it's just a cumbersome process when we don't go through the entire credentialing uh platform so that the provider is set up and we don't have to worry about going back to retrieve any funds because of the NCOP.

Was there a time when I guess we did temporary for the MCO or like allowed for grace period?

I remember when uh a health plan was in receivership, I believe, and um I think a new health plan was coming in.

I don't remember the specifics.

I'm old, so I don't remember the specifics, but I know that there was a period to try to get uh a new health plan that was coming in to be up and ready to uh get providers credentialed into the network.

There was a brief period when that happened.

Okay, all right.

Um would healthcare finance support public reporting of credentialing timelines and approval rates by the MCOs to increase transparency on this process?

I would have problems, yeah.

No problems.

No problem.

Okay, sorry, I'm we were talking back and forth, so I was asking questions but without marking them off, so I'm just trying to make sure I I'm clearing on my side.

Um so there was this bill back in the day in 2002.

The health insurers and credentialing intermediates intermediaries, uniform credentialing act of 2020 and two.

So, like we've had this conversation before.

Um the bill mandated that health insurers and credentialing intermediaries in the district use a standard application for credentialing and re-credentialing health providers.

Have we been following this law?

I'm not aware of it.

Oh I mean, I became aware of it when this conversation started a couple of weeks ago, so I was not familiar with the law.

Okay.

It probably was more Disby needing to work with healthcare finance on this front.

Um because it doesn't just go for Medicaid, it's for anyone.

So this would be a Department of Insurance Securities and Banking question.

Yeah.

And we've been in discussion, or they've started to engage not only the associations but us as well on that.

Okay.

What's the what's the ramp up time?

Well, I can say North Carolina and their uh policy paper, um, their expectation was 24 months from procurement to uh implementation to operal I can't say that operationalization of um single credentialing.

I definitely think we need at least a year.

And I'm thinking more in terms of January 1, 2027 is a significant date for us in terms of Medicaid work requirements and some changes coming online um and working through those.

So additional time would be helpful.

I don't think a January 1, 2027 implementation date is feasible.

I don't think we'd be posed for success there.

We have excellent time as you guys are making updates to the DCA system to go ahead and tack on an additional project.

Um kidding, I know uh I know Tamika is looking like don't say that um at her computer screen if she's watching this.

Um have you guys ever had a conversation with the MCOs about fast tracking credential processing for certain type of provider types that are like we have a desperate need, so we need to move faster.

I can't say that using that scenario.

I I will say that it I think you've heard this.

It does not take 120 days for every provider to be credentialed with the health plan.

Uh I've heard averages from 30 to 45 days depending on the information being all of the information being provided.

I think, and I I might have read it in one of someone's testimony.

I think there's a distinction between completing the credentialing process and then the provider is enrolled into the health plans, I'll just say payment system based upon whatever the the what do you call it, the the rates, whatever's been established as the reimbursement rates for the services rendered.

I think that might be something different from the credentialing, and maybe it's all being considered as one thing because at the end of the day for the provider, it is one thing.

Yeah.

But but I think the credentialing process in most cases, it is a little bit quicker if everything's provided, but then adding whatever is in the provider agreement, adding that into their system so when that provider begins to uh bill for services that the information is properly set up in the system to reimburse the provider at the uh agreed upon rates.

Yeah, I mean, I think you're right, those are two different processes, but for the provider.

Okay, I got credentials.

That's cute, but like if I can't get paid, then I think that's one area we can put a little bit more attention on that timing.

So you've done the credentialing realistically, how long is it gonna take for this to be set up in your system?

Is this something that's done in-house here locally at the health plan, or is this something that is happening through either their parent company or another entity they may be contracting with for those purposes?

Uh I have answers to some of that, but uh I don't have anything uh that I think would be relevant to share today.

Okay.

Okay.

Um you mentioned an alternative of um perhaps exploring that if um a provider is able to get credentialed with one MCO then apply to all the others.

How long would that take?

I guess that's a rewrite of the entire contract.

Or no.

No, no, no, not the entire contract.

It would be an amendment.

Um if we can get back to you on that one to to give a realistic uh timeline.

I think it was last year, but I fear it could have been a little bit longer than that.

That's what I thought too when I was doing.

I was like, oh, it's longer than I thought.

Um so we were looking at the single excuse me, centralized credentialing, um, different barriers with that on the cost, et cetera.

But then um, the team also explored what are other options that, like I said in the testimony, kind of moves the needle forward, does take off some of that burden.

Um, I don't think in the options we had a timeline specified at that point, but we can go back and pull something together in the next couple of weeks and give you a sense of what we think that will take.

Okay.

I'm not saying that's the BL and all, because that definitely also puts um people talk.

So they're gonna go to the MCO that they think moves the fastest, um, which would add additional it wouldn't add addition.

You're getting what I'm saying that yes.

Plans could be strategic, and I'll hold back until the other plan does it, and I just get my check mark.

Yes.

Yes.

Through that, yes.

Yeah.

Um, so it's it's not a it's not a panacea, but it might be something to help um in the in-room.

Um is there anything I haven't asked you that you guys want to mention for the record?

I don't think so.

Do you know?

We're good.

Awesome.

All right.

Um, Director Bird and Ms.

Truitt, thank you so much for being here, and we'll go on to our next individual in the hot seat.

All right.

Uh Khalil.

Hassa from uh state primary care office at DC Health.

Okay.

Uh if before you begin, I need to swear you in.

If you can raise your right hand, do you swear or affirm under penalty of law that the testimony you're about to provide to the council of the District of Columbia and this committee is the truth, the whole truth, and nothing but the truth.

I do.

Great.

When you ready?

Good morning, Jefferson Henderson, council members, and committee on health staff.

My name is Khalil Hassam, and I'm the director of the State Primary Care Office within DC Health's Community Health Administration, also known as CHA.

On behalf of Mayor Muriel Bowser, I appreciate the opportunity to testify on the lowering the cost of prescription drugs act of 2026 and to share DC Health's perspective on the bill.

DC Health supports the bill while noting further solutions are needed to make prescription drugs more affordable.

The rising cost of prescriptions have become a financial burden nationwide.

Thus far in 2026, 27% of U.S.

adults did not fill a prescription, and 19% have skipped a dose or rationed medication due to the cost.

When residents cannot afford to take medication as directed, consequences can include worsening health conditions, avoidable complications, and higher total health care costs.

This practice further jeopardizes individuals' health, particularly for those with chronic illnesses, as cost-related barriers to medication use are associated with 8 to 18 percent greater rates of chronic disease-related deaths.

Addressing the costs of prescriptions is closely aligned with DC Health's mission to protect and promote the health of all district residents.

The consortium offers multiple programs to member states, such as the workers' compensation services program, the school employee pharmacy benefit program, the prescription drug voucher program, as well as the discount card program, which is the focus of this legislation.

The prescription drug voucher program provides vouchers to individuals who are in correctional institutions or state hospitals that they can use to fill medications at no cost.

Array RX's workers' compensation services program works to keep costs down for injured workers who have medication therapy as a part of their treatment plan.

On the other hand, the discount card program offers uninsured or underinsured residents, discounts up to 80% off of the usual and customary price for generic and 20% off brand drugs for any FDA approved and select over-the-counter medications at participating network pharmacies.

State directed discount cards like Array RX are different from other discount cards and that they are exclusively oriented around public benefit.

One such example is the way state-directed discount cards can work to ensure continued pharmacy access.

Given the rise in closure of independent pharmacies and high need areas, state-directed discount cards can mitigate this by enhancing reimbursements for independent pharmacies.

Array RX reports that at the close of 2025, just over 130,000 members signed up for the program, and 51,000 of those members use the discount card.

The company reports that total savings for members were upwards of 19 million dollars on prescription costs.

Due to recent and anticipated changes to public insurance benefits in the district, an estimated 20,000 residents may find themselves uninsured or underinsured.

Many of these district residents will still need medications, and this program would allow them to use the discount card at participating pharmacies, increasing the chances of them being able to afford their prescription medications.

As an example, the average price for the generic version of a cholesterol mo cholesterol lowering medication without insurance is $34.

However, with the discount card, individuals could pay as little as $9.

The discount card has the potential to reduce barriers to health care and protect the health and wellness of district residents.

Successful implementation of the discount card program will require will require close collaboration with independent and retail pharmacies.

In wards five, seven, and eight, which represent much of the district's health professional shortage areas, independent pharmacies outnumber retail pharmacies.

Specifically in Ward 8, 53 53% of pharmacies are independent, and 20% are retail pharmacies.

Further, studies demonstrate that limited access to pharmacies in lower income neighborhoods can increase cost barriers, leading individuals to forego filling their prescriptions.

This means that residents in wards five, seven, and eight are less likely to use their medication as prescribed due to lacks at lack of access to a pharmacy.

Implementation of the program would need to account for pharmacy reimbursement and access concerns, especially for independent pharmacies who have smaller profit margins and struggle to compete against large chain pharmacies.

The states that participate in the drug discount program have heard concerns from pharmacies that the discount cards will cut into their profit margins.

Given that there is a higher prevalence of independent pharmacies and lower income wards, DC Health wants to limit the negative impact of pharmacies, especially those that are independent.

DC Health understands the impact that rising prescription costs can have on district residents and is exploring policy solutions that reduce this burden.

Well, this bill will likely make medications more affordable for those that are uninsured and underinsured.

It does not fully address the drivers of prescription drug costs.

DC Health looks forward to collaborating with the committee to find additional solutions to keep prescription prices transparent and affordable.

Thank you for providing me with the opportunity to testify.

Thank you, Director.

So, you know, this bill is kind of interesting in that we're just giving authorization for the mayor to join the program.

We don't necessarily prescribe all of the various um pieces here.

But I think in your testimony you raised some excellent points of number one, there's more work to be done to bring down prescription drug costs.

And two, we really have to consider how this interplays with independent pharmacies in the district given their prevalence in certain parts of the city.

Have you all had any conversations with any of the other jurisdictions that already participate in the program?

We have.

What's their feedback?

About implementation, challenges.

Yeah, so the number one thing that they've advised us is it's important to have staffing for this program.

Okay.

This program is helpful, but if nobody knows about it, nobody uses it.

Right.

So the marketing piece, or is it something further?

It's the marketing piece, ensuring that both residents are aware of this program, and that is achieved through a number of means, including talking directly with residents, but also leveraging key partners like healthcare providers.

Yeah.

That's one piece of it.

And the other one in terms of implementation is as I mentioned earlier.

Some states are using special designation of critical access pharmacies, and that is the mechanism that they use to provide higher reimbursements to independent pharmacies.

Okay.

Okay.

From DC Health's perspective.

Uh, what's a reasonable timeline for implementation for this to become operational?

Let's say like everything goes well and you not that I'm promising an FTE, but like let's say we did the thing that you wanted and you had that.

How long would it take for this to actually sort of become operational?

That's a good question.

I would have to get back to you on that.

Okay.

All right, let's follow up on that.

Um, would the participation require residents to enroll or would the benefit be automatically available to anyone in the district?

Residents would need to enroll.

It's a fairly simple process, just like any other drug discount card, and there's a few that are available in the district.

And from their perspective, they walk into a pharmacy, a participating pharmacy, give the code, and the pharmacy knows what to do from there.

They apply the discount immediately.

Yep.

And the residents able to pay the lowest available price that they could with that discount card at the time of purchase.

Okay.

Would you all be then recommending, or I guess advising in terms of our setting up the program that we do the uh you something something very specific?

You had a phrase for the independent pharmacies.

Critical access pharmacy.

Yeah, critical access pharmacies.

Would you say that we would need to we should provide that designation in certain parts of the city or no?

It it is an important part of the implementation to consider the negative financial impacts to independent pharmacies.

Okay.

And DC Health does not currently have that authority.

And so that would need to be part of the conversation going forward.

Oh, you do not currently have that authority.

Okay, that's that's important for us to know.

If we're gonna might as well go ahead and take care of that if we're gonna move this forward.

Um outside of um an FTE, are there any costs that the district would incur to participate in the cooperative agreement?

FTE and then cost for marketing is what other states are advising.

Right, but is there any other sort of administrative cost that there's no other administrative cost as the Heidi had testified earlier?

There's a small cost for running the program.

Right, but at the point of sale.

It's at the point of sale.

Okay.

Um there any uh liabilities to us joining?

Not so far as I've seen.

Okay.

Um there's questions around access and if it it needs to be done with implementation, considering all of the partners.

And so talking closely with other agencies in the cluster to determine where this program could live, and talking with the deputy mayor's office.

Yep.

And then talking closely with pharmacies about their experience and the ability to be mobile and dynamic in our approach is very important.

This is what other states have advised us.

All right.

Um do we think from our estimation of how this would be in terms of utilization?

Do we I guess I'm sort of answering my own question here because you already said like this really depends upon marketing and outreach and what we've seen in other sort of DC health-related programs.

The ones that get marketed very well, particularly in the sort of target population.

So what I'm thinking of right now is just sort of like um Pro Produce Plus, for instance.

It's kind of like uh overlapping populations of probably a lot of seniors who would want to use this program.

Produce plus is marketed incredibly well.

It's a lot of it is happening through word of mouth, but nonetheless, they've got a wait list, right?

And so if we do the marketing piece on our side very well, you would have a lot more uptake.

But if we don't do the marketing piece, utilization would probably be very low.

That's correct.

I I'll paint in broad strokes for you.

We understand that other states, in other states, it's about 10% of their population has signed up for the drug discount card program.

Okay, and about 10% of that 10% end up utilizing the service in any given year.

Okay.

So in the district.

10% sign up, and then 10% of the 10% actually use it.

Yeah, that could look like of the district's approximately 700,000 residents, 70,000 with some aggressive marketing, aggressive marketing may sign up for the program.

Right.

And about 7,000 use it in a given year.

Okay.

That's a good estimate.

Um let me see.

Uh would this require coordination with other agencies?

Absolutely.

This is part of the process working with Department of Healthcare Finance and Disby and other agencies as appropriate.

Okay.

Um is this duplicative of any of the current programs that we currently have in place?

There's no other similar state program in the district, although there are other discount card programs that operate in the district.

Right, but not state operated.

Not state operated.

Yeah.

Okay.

Okay.

Is there anything else you want to say for the record that I didn't ask you?

Yeah, I think that this is an important piece, but it's just one part of one input into the landscape.

And so affordability is one piece, but residents still need access to a healthcare provider who can prescribe those medications.

Yeah.

Access to a multidisciplinary care team that can take care of and support individuals with chronic conditions and multiple needs.

Is there areas where DC Health is already working?

And so this is it's important to just consider the system in which affordability exists.

Yeah.

Well, not just affordability, but also access.

Um we've had testimony from some of our independent pharmacies in the past, and I know that it's a struggle for them, um, particularly given the reimbursement rates for some of them to even just keep their doors open.

Um, you know, I I can have a prescription all day long, but if I have to drive across town to fill it, then did it really work for me?

Uh so as I say with all of our pieces of legislation, I'm not um nine naive to think that anything that we're doing is gonna solve 100% of the problem.

But if we can be moving us in the right direction, then I think it's worth a conversation.

Awesome.

Well, thank you so much.

Thank you for your questions.

Thank you.

All right.

And our final but mighty last government witness for today.

Uh Caroline Howe, who's the food policy director at the Office of Planning.

Hello.

Okay.

Um, I need to swear you and your colleague in.

So if you can raise your right hand, do you swear or affirm under penalty of law that the testimony you're about to provide to the Council of the District of Columbia and this committee is the truth, the whole truth and nothing but the truth.

I do.

Great.

When you're ready.

Good morning, Councilmember Henderson and staff of the committee.

My name is Caroline Howe.

I serve as DC's food policy director, and I'm pleased to testify today regarding the Food Policy Procurement Act of 2025.

Today I'm going to start by providing some context on the district's food procurement landscape, highlight our team's existing work on food procurement, and end with some specific comments on the act itself.

I'd like to start by grounding us in the realities of the district's current food purchasing.

As you've heard, the district spends $62 million annually on food across multiple agencies with millions more in indirect contracts where food is one of many services offered.

This purchasing primarily happens in eight agencies, each of which has different standards and processes and many different requirements to meet.

A core goal of the DC Food Policy Council has been to advance a more sustainable and equitable food system, and our purchasing is a key part of this.

The district has multiple pieces of legislation and several voluntary pledges signed by Mayor Bowser around values-based procurement.

You've heard it a number of times before today, but I will just define values-based procurement refers to using purchasing power to expand impact through local sourcing to support local economies, improve nutrition, reduce food-related carbon emissions, and improve workforce compensation conditions.

The Green Food Purchasing Amendment Act and the Environmentally Preferable Products and Services Program are both managed by the Department of Energy and Environment and set targets for lowering carbon emissions of the district's food purchases.

And nutrition and local purchasing requirements for schools specifically, incentivized by the Healthy Schools Amendment Act and Healthy TOTS Act, are overseen by the Office of the State Superintendent of Education.

And then DCPS, as you've heard already, has signed on to the Good Food Purchasing Program, which sets additional requirements and goals across the food values for the agency and their vendors, one of the main factors in their progress, as you've heard today.

However, there is no centralized support structure in place to help all agencies meet these environmental, nutrition, and local purchasing requirements simultaneously, nor to assess our progress.

At the same time, there's also no central place for the district to evaluate opportunities for cost savings associated with our meal programs and opportunities to move towards the district's commitments at the same time.

The Office of the City Administrator identified this need and brought the analytical power of the lab at DC to identify opportunities for cost savings in food purchasing.

And in 2024 and 2025, our team worked closely with the lab at DC for their analysis of both the district's grants and contracts for our food purchases.

Throughout 2025, we've continued to work with the Office of the City Administrator's Good Government Team to identify opportunities where we can save the district money while also achieving values-based procurement.

Multiple agencies have been tasked with next steps from this work, but maintaining momentum without requirements and legislative authority remains challenging.

So why the food policy team?

Seeing again that our food purchasing is a critical part of achieving that vision of a sustainable, equitable, and healthy food system.

We've been tracking all food-related legislation and district-wide commitments that I've spoken to and manage the processes funded by council for two separate analyses on the benefits of a central food processing facility.

Our team has also been convening food procuring agencies in a procurement community of practice since early 2025 to share best practices for improving institutional food quality via our food solicitations and contracts.

In September 2025, with funding from the USDA resilient food system infrastructure grant, the food policy team was able to bring on a full-time staff person with food procurement expertise to really focus on how the district's own food procurement can help build a resilient food system.

This addition to the team has allowed us to increase our focus on procurement with some immediate wins I'd like to share with you and potential for significant advances over the long term.

For example, having this increased capacity has allowed our procurement community of practice to meet monthly rather than quarterly, accelerating the exchange of dialogue between agencies.

It has also advanced substantially our work on central food processing.

Again, since 2014, district agencies have been exploring how central food processing could move us towards these values through bulk purchasing, processing, and preparation of district meals with the potential to enable more regional food sourcing, create more nutritious and less processed meals, and ensure more resilience in the district's food chain.

Over the past five months, with our fully focused food procurement policy analyst, we worked with the Office of the City Administrator to conduct a financial analysis that built off of the 2023 study that Council funded.

In that study, we were able to evaluate spatial and infrastructural needs, but with this, we were actually able to dig into costs of each agency.

We could not have completed this without the capacity provided by our federal funding, given all of the other priorities we're balancing.

Additional staff capacity has also allowed us to support multiple agencies and the Office of Contracting and Procurement to begin the use of OCP's V Street warehouse to share food service supply storage.

And this is now underway with aluminum trays used for food donation.

Sharing this warehouse for more supplies can help district agencies purchase larger volumes of food service supplies at lower costs and make the most of limited storage space in district kitchens.

OCA has done an incredible job to catalyze this work, and all participating agencies have gathered and shared lots of essential data, but capacity within our team has allowed us to do data analysis that agencies did not have the capacity to do alone.

I'd now like to shift from the work our team has done to talk specifically about the act itself, including some opportunities and questions.

The goals of the bill to advance values-based procurement are very aligned with the mission and work of the food policy team.

You've heard that from many of our witnesses.

And we strongly support the desire to codify the commitments to values-based purchasing in legislation.

We see immense value in increasing procurement data transparency, and having one agency collect that procurement data that could be used for reporting on nutrition, sustainability, and local sourcing, will streamline the work both for reporting agencies and those responsible for reporting on that impact.

Given the work our team has done on food procurement, we are eager to continue it.

I want to be very clear that this year's progress on procurement has been possible only because of our federal funding, which ends in 11 months.

At that point, without legislation and additional funding, we'd have to make tough choices about priorities.

I'm deeply proud of all of the work of the Food Policy Council and team that I testified about before you last month.

We cannot continue to make progress on our existing priorities and add in the responsibilities in this bill without additional resources.

I want to recognize a couple of other questions and concerns, both that have been raised today related to this legislation.

First, this legislation asks the food policy director to report on data that would come from other agencies without explicitly requiring those agencies to provide the relevant procurement data and without explicitly setting any goals for our procurement progress.

Both the food policy team and the food purchasing agencies would benefit from clarity on priorities, performance indicators, and accountability mechanisms.

Second, given that the food policy team is currently legislated to focus on data analysis, food policy and food systems planning within the Office of Planning.

Some may question whether responsibilities outlined in this bill are best suited for the food policy director and team within that current structure.

Lastly, we recognize that adding new reporting requirements for vendors can be a burden for small and local businesses, undercutting the Act's goals to support those very businesses.

Data partners like the Good Food Purchasing Program can perform the analysis on supply chain values without the need to burden small vendors with that task.

The district will need to prepare to structure contracts and budgets that incentivize both transparent reporting and our food purchasing values.

Now, the other portion of the bill looks at the Food Policy Council's reporting requirements, and I would like to touch on that.

This legislation would change both the content and frequency of the food system assessment, which is timely given national changes to data collection and reporting around food security.

We've been increasingly working to share our food systems data in real time as agencies report out in oversight, as our partners release hunger data, and as Department of Employment Services and the Restaurant Association of Metropolitan Washington release their jobs reports.

And as the USDA and other federal workforce agencies report their own data.

By releasing data as it comes and developing a live data dashboard to display this information, we hope to be able to provide council and residents more real-time information, which would be complemented by this deeper report every three years.

I am deeply excited to see council focusing on food procurement and grateful for the motivations behind this legislation to expand values-based procurement in the district that are behind this act.

My team and I are happy to be of service as council decides the best way to proceed.

I appreciate the opportunity to testify today, and I would be glad to answer any of your questions.

Thank you so very much.

Okay.

Some of these questions are just very technical for the bill, if we just need to ask them.

And then others are about some of our larger goals around sort of food.

I was sort of reflecting, though, in your testimony and the conversation we were, we spend 62 million dollars on food.

And that doesn't, I mean, and that's just like that's across eight agencies who are all probably doing it a little bit differently.

Correct.

Or very differently to varying degrees of quality, varying degrees of variety in terms of offering and I don't know, I feel like in some ways we could just be doing this better.

When I was committee director for committee on education, um, we would do these like school lunch tours.

We just like pop up out of school, uh, see what you're serving that day.

Um, some were better than others, and some were very surprised to see us on those days.

But I feel like in some ways we probably should do that across all of the all of the agencies that do food deserve a pop-up.

I agree with you.

Have you tried the food at all of the agencies who do the food?

I have tried the food at many of our agencies.

I will say that at DOC, we're not able to eat with the other residents or DYRS.

Um, but I certainly can say, even across our schools, which obviously share many of the same legislations, but different vendors and different sites, the I agree with you that the quality ranges enormously.

Okay.

Um just on a very technical piece.

So uh part of the bill um decreases the reporting requirements for the food policy council, and I don't want anyone to be alarmed and that we're like lessening pieces, but right now you're required to do an annual report on this um district's food systems, and this would require um every three years, which I think would allow for us to get a more comprehensive picture of all of the different pieces.

But is this something that you guys are comfortable with and does this would this better align us with other jurisdictions who have similar reporting?

I really appreciate the question.

And in the end of my testimony, tried to touch on that.

We really have been releasing so much data, and I do want the public listening that we are committed to continuing that, that we have been developing a data dashboard that would show more of this information real time, that we are consistently in our council meetings sharing what we are seeing, and as we're seeing interesting or alarming data trends change.

That said, having our we were one of the only food policy councils amongst our peers who were having to create a deeper assessment and report every year.

And the reality of both that data assessment, the writing and the reviews is that was taking about three to six months of a staff person's time, which we talked about this uh last uh last month, but with a limited capacity, that was just so much writing and analysis that was taking away from us being able to deliver on that in the course of the year.

Um, and so most of our peers do an every three-year larger food system assessment uh that is really getting at some of those national policies that have changed, and I think what allow us to be providing more holistic recommendations while, of course, still setting our priorities every year and still doing that priority setting based on data.

Okay.

Of the food policy of the food contracts you all have analyzed, um, because you're already involved a little bit in in the procurement space.

This bill would put you more in the middle of the mix without agencies sort of questioning your authority to be able to be in the mix.

Um, how many of our agencies would you, or our contracts rather, are currently meeting the district's laws for nutrition sustainability and local business requirements?

Like what percent?

That is a wonderful question, and I would love to get back to you on the exact percent.

However, I will say that we have this is the first time, thanks to our food procurement policy analyst, um, that we've actually been able to have a live contract tracker that is really looking at all food contracts in the district, and that includes those included in that 62 million, also where food is a subcontract, and while it's not touched on explicitly in this bill, we've also been tracking the grants that the district is funding that is also providing food to residents.

We provide an additional large volume of food through many DC health programs and other partner grants that are giving money to grantees to distribute food as well.

So we're tracking both the contracts and grants.

The nutrition requirements, I think there's also a real question in terms of while the contracts themselves and the RFPs, the request for solicitations are meeting those requirements for the most part, there is not a lot of oversight in terms of whether the food we're actually receiving are meeting those requirements.

On the back end, yeah.

On the back end.

So we may say and require that, for example, both DCPS and DPR now have in their contracts uh a that there are no food additives, uh a certain list of additives, dyes, and prop highly processed foods, and yet are we really checking and verifying that there are no menus on the back end?

Exactly.

Um, to your knowledge, does Office of Contract and Procurement have anyone on staff who specializes in food contracts?

No.

Do we have anybody who has expertise in nutrition or understanding the district's laws on food?

Not to my knowledge.

I will say this was touched on in one of the um responses earlier today.

But the way that OCP, many of their contracting professionals certainly have experience and have have managed these food contracts for many years, but they are also managing all of the other procurements for that agency in that cluster.

So to say that they have food procurement experience equal to paper and technology and all of the other things that those agencies are purchasing.

Yeah, but I kind of see it as right, like if um ONA is doing the procurement for uh DACL and I'm doing the procurement for DPR, um, food is not my part of our everyday piece.

So when I receive back solicitations and somebody's gonna charge me, you know, um $4 for tomatoes to be included in the menus, how do I know that I'm getting ripped off and that DPR's um solicitations are coming back at like $1.50 a tomato, right?

So I feel like in those types of things, there's a lack of efficiency, but also sharing of information.

And and frankly, I think probably some of these vendors know that they could get away with it because there's not that conversation that's happening back and forth.

I think that's one of the most valuable parts of this community of practice and and that does really require staff time to facilitate.

But within the community of practice to have within each agency, the person who is managing that program who is looking at the invoices coming in, they often may not have the time to check and see.

And we've been able to, with getting more of that information, to say, you know, not only is potentially one agency paying more for tomatoes than another, but an agency might be paying more for tomatoes in one month to another.

And of course, that makes sense when we're off season uh tomatoes, maybe not the best example, but um, when we're looking at how we are paying for a given product over the course of the year, having someone who is able to look at that data across agencies and even within agencies over time, can not only save us money, but also help us achieve these values.

And I think that's really important in this budget environment to recognize that the kinds of interventions we're proposing could substantially save the district money while also improving the quality and all of the other values of the food we're receiving.

Okay.

Um if a vendor uh fails to meet standards, um, you know, right, we we said a certain thing in the solicitation of what we require.

To your knowledge, has there ever been any repercussions?

Not to my knowledge, or in sort of the documentation that you've seen.

We I one of my frustrations with this government as a whole, nobody ever writes anything down.

Right.

We uh we we lend out a contract.

We have issues with the vendor, right?

Something, you know, you installed my HVAC, and then six months later, my HVAC was broke, and then the next person who came in, right?

But then nobody writes it down.

So then that vendor keeps being able to bid.

And then it's it's it's a cycle.

It's the same with people.

I've got agencies who I know y'all need help.

And then nobody in the entire agency, 900 people, nobody's on a performance improvement plan.

Everybody's performance plan, they got superior.

Houseway.

So, like, we gotta write it down.

So I agree.

With that aside, that was my PSA.

I appreciate that.

And I do think that it is very relevant in food contracting and that will be and and why having this contract tracker, which to my knowledge had not existed either in OCP or any of these agencies to really say, these are when the contracts are renewing.

How are we actively working?

And I think we are so used to saying each contract is a year, we are able to extend it for up to five years, but there are very few contracts that we have ever ended after three years, for example.

We've always, because it is so challenging at the moment to go through that contracting process, that I think we are missing the opportunity to really be evaluating our vendors and seeing improvement and seeing improvement based on you know whether it is what you did with the committee on education and actually doing taste tests in places, but also having resident feedback.

And to my knowledge, while many of our agencies do surveys, we all do them differently.

We don't need to be reinventing the wheel in terms of the kinds of questions and the kind of feedback we're getting in those taste tests, and then actually seeing that go back and change what the vendor is actually serving or what the vendor is sourcing.

And I think that ties to another thread that came up when hearing from Molly in from Philadelphia in thinking about what really are the ties between how we're really looking at the waste we're generating at different agencies.

One reason why I'm so excited about this falling within the food policy team, because we look at all parts of the food system.

We really are able to think about how are we working with our local producers to produce more of what is relevant?

Our other jurisdictions have been able to work with local farmers to say, yes, we want you to be growing smaller apples so that we can serve them to smaller kids in our schools.

Um and similarly, with food waste, by working with DPW and DGS to do food waste audits that are not just about what amount of waste you're generating, but what is showing up in that waste bin, that is one of the best kinds of feedback we can get back to our vendors to say, look, every baloney sandwich, for example, is ending up in the trash can.

That is a waste of even the small amount of money that we're providing for those meals.

Yeah.

Um it's larger piece across as well.

Um the bill calls out meal programs at schools, jails, and shelters in public testimony.

Um we heard a recommendation that summer youth uh programs and senior center meals also explicitly be included.

Do you agree with this suggestion?

I love the fact that in district legislation including means both what is listed as well as others.

That said, I think it certainly would help to be able to explicitly call out those other kinds of meal services.

Um, and I'd be happy to follow up with a list of all of the places where we are serving institutional food.

The act also does explicitly call out institutional food, and I think for that reason, we might not think about what is our summer meal programs that are being served at rec centers or other things that aren't in our mindset of what an institutional food looks like.

But I think that's again why I also have named the idea of how we're looking at grants, and I'm very grateful for having a focus on procurement that we can align both to our contracts and to our grants.

But our summer meals grant, sorry, is not a grant.

It is not a grant, it's a subcontract.

But things like our medically tailored meals, are those are set up as grants with TC Health.

Um, and I'm thrilled that because of having this capacity within our team, we've been able to work with DC Health to include that this year the equitable food access initiative grants do include a provision for 10% local sourcing, which is a massive win that I'm thrilled to be able to celebrate today.

Great.

Um your analyst is sitting next to you.

Mm-hmm.

Hi.

If you could just introduce yourself for the record.

Hi, my name is Scal Shiff Moman, and I am the food procurement policy analyst on the food policy team in OP.

Okay.

Um, you've been here for a little bit of time now.

You've got 11 months left.

Like, what are the biggest insights that you've discovered in terms of your digging?

Because you've been digging, like uh in terms of all these various contracts and things.

Um, there is a lot of there's a lack of standardization.

Um, there is a way to make contracts and make that process of asking for specific values in contracts were streamlined and more clear to vendors and in the way that we work with them so that it's not a burden for our our large vendors, but it's also not a burden for our small vendors, and there's a lot of opportunities to be able to do that.

So I think definitely supporting with the solicitation and contracting process, each agency is doing it drastically differently.

Um, and I'm I'm learning that um and really trying to dig through and make sense of that.

Okay.

Have you all sort of explored this issue of oftentimes with our food contracts, we either are getting them in a letter contract, a social contract, an emergency contract.

Like they knew somebody was going to have to eat, and they knew when the contract was up.

Yes.

And I'm happy to take that.

I think one thing that I'm also very excited that we've been working on, both with HCMA and with Cush's help with all of the other agencies to really think about how we make sure that when we true truly do have an emergency, DBH's kitchen fire meant that they could no longer be preparing meals on site.

How are we prepared in the case of an emergency to ensure that we are still meeting all of the legislative requirements and that we are prepared in that case to either have an emergency contract already prepared or to have everything we need to ensure that we are still getting value for it and that we are as quickly as possible moving back to our regular contract?

So I'm very excited to be able to, by the work that Cush F has done, and that we hope to continue to do to be able to compile these best practices, set language, to really be able to have contract information, will make our emergency contracts better, but also thanks to the tracker to really ensure that we're able to have some accountability.

We are we know which contracts are ending at the end of this fiscal year.

When is that RFP coming out?

How can we ensure that we're proactively having a conversation about how to improve that contract for the next round?

Okay.

Um the collaboration that you do now with Office of Contract and Procurement.

How's it going?

So I am really grateful for our, I think the warehouse, while I think many people would say, well, you're talking about aluminum pans, how is this really furthering food procurement?

However, by piloting something that was donated to the district, in this case aluminum pans, which allow DCPS to be donating food that's left over at the end of lunches to our food distribution partners.

Um obviously that's creating lots of other values, but it's also a low stake pilot for us to really think about how we could lower the cost for lots of our our money and food purchasing is actually going to, yes, the bulk of it is going to staff, then our actual food, but quite a substantial amount is going to things like cleaning supplies or our basic the equipment that's needed every day for cooking and serving, um, especially in our context like the jail or DYS DYRS where people are receiving food in their spaces.

So I think that's been really productive to be able to have something really positive to be working on with OCP, to be building those relationships and building that trust, that we are committed to all of the same things that they are in terms of meeting our regulatory requirements, re meeting our CBE requirements, um, and keeping costs low while also moving towards these values.

So I think that's been a really positive development.

I also am thrilled that while we have had a vacancy for um when the Green Food Procurement Act was passed, um, it it included a position both at DOEE and one at OCP, which remained vacant and and still does.

However, um, with EPS, the environmentally preferable products and services, um, they have hired an EPS lead at OCP, and that's been great to be able to work with someone, and of course, they're covering again, not just food and not a food expert, but are at least uh a person for us to be able to be communicating with.

The other reason why this legislation creating authority in our office would give us in some cases um direct authority to be able to have those conversations, but also, for example, we're struggling to get access to the past system to be able to look at contracts for the information that Cush needs to be able to do this analysis, and that's a place where having this legislatively we are required to be able to do this would make the that quite a bit easier.

Yeah, um, the information that's in past is way more than what they send over in sort of the council packets.

There used to be a time that council receive way more detail on contracts, like um, they would send us a packet, but then you would have to like go down to the secretary's office to request the whole thing because they didn't copy it for everybody.

Right.

This was also in the COP before we got digitized around here.

Um the good old days.

Uh one of the things that I'm also kind of enticed by is this requirement or that food policy director would also be responsible for helping to ensure that the food food-related solicitations go to a wider array of potential vendors.

So DC Central Kitchen testified, Alex testified earlier that local nonprofit organizations often do not receive the notice of solicitations and are also treated the same as for profit companies in the in the process of um going through the solicitation process.

Do you agree with this assessment that like we we could do better in terms of our outreach more to local nonprofits who might be able to provide the services?

100%.

And I think that the I I also really appreciate Alex naming the fact that our nonprofits who are in some cases are really driven by values-based food procurement, are not treated the same as CBEs, don't get those additional bonus points, despite the fact that they are creating jobs in our local economy for the most part are meeting all of those other CBE requirements in terms of having leadership, 50% of staff, 50% of income coming from within the district.

So I think that's of course broader than just food, but is so relevant in the food context given that so many of our food players in the district are nonprofits structurally.

And I think in terms of outreach for solicitations, I'm really grateful for the fact that again, thanks to the work of the food policy team, we were able to work with DPR when DPR released their summer, their summer meals bid several years ago to at the very least consider how we could split a bid.

So rather than asking people to provide 20,000, asking one vendor to provide 20,000 meals across 45 sites, how could we ask for but that would enable a smaller business to be able to compete to say, can you provide 300 meals across these four sites?

And those kinds of conversations, which do take time, which do take uh systems change in terms of contract administrators at different agencies being open to working with seven different companies instead of one.

But that kind of thing, so structuring both the contracts so that we can reach more small businesses and then doing the outreach to reach more small businesses.

And that's something my team is really well situated to do, both around contracts, but also we do the same thing for grants to make sure that grants in the district, thinking about DOEE's sustainable crop block grant, which is a very specific grant program, but where we for the last several years have been able to do outreach to make sure that organizations that aren't typically considering this are recognizing where they could fit in.

Yeah.

Um, even in sort of the nonprofit food space, um, DC Central Kitchen, they have one of the DCPS uh contracts, and I went to one of their sites and it was like Ron Brown High School.

Yes, they serve this curried cauliflower that lives rent-free in my head.

That's how it's been a number of years.

And like the kids ate it up.

And it's it's just sort of in that sort of space, right?

And this isn't to sort of take a dig in terms of the um more national companies, but some of our local nonprofits, they have a better understanding of um the culture of not even just DC, but like what is the flavor profile that students at that particular school would be interested in, and how do you kind of like slide it in something new where they probably wouldn't have eaten the cauliflower normally, but you curry that cauliflower in it it's a whole different experience in your mouth.

Absolutely.

And and that's one of the reasons why I really appreciate the way that the legislation is set up to broadly name the values because I think it does give us an ability to think about what are the values most important to the district, where cultural relevance is a huge one.

And so Seattle has included that as one of their six procurement values, that cultural relevance is one of the values we look for in our contracts.

Um, and I think that that is really important and relevant.

I also think that again, DC Central Kitchen is an example.

There are real benefits within a for-profit business model with the supply chains they're able to tap into.

But because of the work that DC Central Kitchen does with distributing so much produce through the district, they're able to get a lot of very values-aligned local purchases of produce at costs that would be challenging for other organizations to achieve.

And so our nonprofits have those different benefits, and depending on what we're looking for in a contract, it is really important to ensure that we're at the very least letting them know about the contracts and in the best scenario, evening the playing field, that any organization that can provide these meals, regardless of their incorporated structure, can be in play.

Yeah.

Okay.

Is there anything that I haven't asked you for the record that you wanted to mention?

Yes.

I'll keep it, I'll keep it brief.

Um, but two of the things that I did want to name that I think very briefly came up in Tom's um Tom's testimony was this fact that currently the district looks at lowest cost contracts in all of our contracting.

And so the leverage that we have and what is it discussed in the bill is recognizing how can we incorporate more standards into our contracts so that we are still looking for the lowest cost provider, but that is meeting these baselines.

But other cities have started looking to and and states looking to how do we contract on a best value basis or having performance-based contracts.

And I think the Redstone report really looked at how some of those larger changes to our contracting could really move us to achieving more values, but fundamentally getting more for our money.

So, for example, I'm thrilled that DCPS and DPR now have removed all of those particular additives and dyes.

If we were to apply that across the district, it would mean we wouldn't serve baloney any longer because of the processing and dyes and additives that are in baloney.

And while that would be a small win for DOC, um, I do and for the um for the the folks who spoke earlier, I think that that would be significant and would allow us to be getting a much better value than we currently are.

Thank you.

Um, that concludes today's hearing.

Um, I want to thank all of the witnesses who testify today, all of the agencies who participated.

We don't often have three different agencies with us, but I like my clusters.

So um, thank you guys for being here.

The record will remain open until 5 p.m.

on Wednesday, um, April eighth, twenty twenty-six for the public to submit written testimony.

Um, you can submit your statement on the council website at DC Council.gov backslash hearings.

Um like I said, that ends today.

Um, the Committee on Health will reconvene next week on Thursday, April Second, for a public round table on some nominations for the Board of Nursing as well as the Board of Funeral Directors.

Um, there is no further business in front of this committee for today.

Um, the time is twelve thirty one PM, and this hearing is adjourned.

Thanks, everyone,