ABSTRACT
Across the country, hospitals are buying more sustainable food and passing internal policies in support of sustainable food procurement. This reflective essay describes the results of the sustainable procurement goals and policy of the University of California's five health systems from 2009 to 2021. Based on my observations as a staff person in the University of California and my participation in internal meetings with foodservice and sustainability staff, I discuss the evolution of the University of California's sustainable food procurement policy goals and its definition of "sustainable." I describe staff and programmatic support for purchasing environmentally sustainable food and beverages and the growth of the University of California's sustainable food purchases as a percentage of its hospitals' food budgets. This essay also explores staff debates about the sustainability of sourcing poultry with the label of "no antibiotics ever" after a 2020 COVID-19 outbreak at a poultry processing facility in California that led to the deaths of several workers. These debates about labor and working conditions in poultry supply chains from the five University of California health systems offer insights into ongoing challenges and opportunities for institutional food procurement and policy to change the food system utilizing existing supply chains and third-party certifications and label claims. The University of California's experiences also illustrate the ongoing need for farm-to-institution and farm-to-hospital efforts to better integrate values around working conditions in supply chains into sustainable procurement goals.