Editor’s note: This solutions journalism article is part of a series of stories called “Feeding Solutions” about efforts to address hunger and health issues in Kansas.
More than a year ago, Denise Schmitz found herself in a rut.
With a busy schedule, her nights were spent eating frozen pizzas or fish sticks, and staying sedentary, except for a couple of times per month when a friend wanted to walk around Hoxie and chat.
Schmitz and her doctor knew it was time for a change. Last year, she was enrolled in a yearlong Food is Medicine program as a Type 2 diabetic with high blood pressure and gut issues.
Today, she’s 30 pounds lighter, is sleeping more soundly, feels better mentally, has learned to read labels to find gut-happy foods and has seen her A1c — an important marker of blood sugar control — drop by 3 points. If she keeps exercising and maintaining a healthy diet, she should be off her blood pressure medicine by August.
“It was a great program — especially for us older people, because we are used to cooking mashed potatoes with chicken and noodles,” Schmitz said. “We can’t eat that way anymore. We need to eat better.”
For clinicians at AmberMed Clinic in Hoxie, the county seat of Sheridan County, roughly 80 miles northwest of Hays, her transformation is both personal and clinical proof of a broader shift in care.
Denise Schmitz of Hoxie lost over 30 pounds with eating better, walking and light workouts.
A prescription beyond pills
Food is about more than nutrition — it is increasingly being recognized as a form of treatment.
Across the United States, chronic disease is the norm rather than the exception: Three in four adults have at least one chronic condition, and more than half live with multiple ills, according to the Centers for Disease Control and Prevention. Poor diet is the leading underlier of death in America, and is directly related to malnutrition and chronic diseases such as cardiovascular disease, Type 2 diabetes, obesity and some cancers, according to the National Library of Medicine.
In Kansas, health care costs tied to chronic disease are projected to reach $371 billion between 2016 and 2030.
Traditional care models tend to intervene after diseases develop, relying heavily on medications and procedures. Food is Medicine aims to intervene earlier — or alongside treatment — by addressing diet as a root cause.
According to the Tufts University Food is Medicine Institute, the approach integrates “food-based nutritional interventions into health care to treat or prevent disease,” often combining medically tailored groceries or meals with counseling and ongoing support.
“The problem we’re trying to solve is more at the moral imperative, human level,” said Elizabeth Burger, Sunflower Foundation senior vice president of programs and strategy. The foundation, based in Topeka, has provided nearly $2 million to help support the Kansas Food is Medicine Initiative. (Disclosure: The Sunflower Foundation provided financial support to The Journal in 2025.)
“On a very practical level, the money we’re spending on chronic disease could be so much better spent on so many other things, including at the front end with better nutrition.”
Monica Reuber of AmberMed stocks the food pantry and organizes the recipe cards at the food pantry in Hoxie.
What it looks like in a rural clinic
At AmberMed Clinic in Hoxie, providers identify patients with conditions such as diabetes or hypertension and enroll those ready to commit to lifestyle changes.
Participants like Schmitz receive:
Regular fresh produce boxes and shelf-stable items through the Kansas Food Bank.
Nutrition education, including grocery store tours and label reading.
Weekly, then monthly, coaching from integrated health specialists.
Peer support from fellow participants.
Clinically, the approach works to improve access, increase knowledge and reinforce behavioral change over time, all while using and collecting data to demonstrate outcomes.
Jodi Dumler, the clinic’s integrated health director, says the results mirror what research suggests: Patients report eating more fruits and vegetables, drinking fewer sugary beverages, and feeling better overall. Clinical markers — particularly A1c — have improved.
From a provider perspective, these outcomes matter. Lower A1c levels reduce the risk of complications such as neuropathy, kidney disease and cardiovascular events. Even modest improvements can significantly alter long-term health trajectories and health care costs.
However, delivering this model in a rural setting presents challenges. Limited grocery options, higher produce costs and long travel distances complicate access for those without reliable vehicles or are on fixed incomes.
“We have a small grocery store (in Hoxie) … but we don’t have a lot of options for produce,” Dumler said. “It’s kind of like paying organic prices for fruits and veggies if you get it locally in our grocery store, versus if I went to Walmart.”
That makes partnerships with food banks, public health departments and community organizations essential.
Schmitz says the program’s support network has reinforced clinical guidance.
One additional outcome of the program has been its social impact.
In Hoxie, a county seat town of just over 1,000 residents, participants have built a support network around healthy living. They share food, coordinate grocery trips and help one another access resources.
For Schmitz, this peer connection has reinforced clinical guidance.
The program, she said, “was a social event that you learn. … We all give each other grief.” It helps to keep everyone accountable.
From a clinical standpoint, this matters. Behavioral change — especially around diet and exercise — is notoriously difficult to sustain in isolation. Social accountability and community reinforcement improve perseverance, much like group-based interventions in other areas of medicine.
Reinforcement takes many forms. Participants have even collaborated to build raised garden beds for those with mobility challenges and assisted with food deliveries for neighbors who can’t lift heavy boxes.
It’s health care, but also something more — it’s simply what you do when you live in a rural community and care for your neighbors.
Ruth Figueroa, clinical assistant at Genesis Family Health, unloads foods for the food pick up in Dodge City.
A second rural model: Lessons from Dodge City
While Hoxie’s program highlights tight-knit rural collaboration, a parallel effort in southwest Kansas shows how Food is Medicine adapts to a very different community.
At Genesis Family Health in Dodge City, providers serve a culturally diverse and sometimes transient population, including many immigrant families working in agriculture and meatpacking.
“It’s really about taking care of the whole person, and food is medicine is a wonderful way to assist that — and for some people, it’s that entry point to care,” said Angela Moore, chief operations officer of Genesis Family Health, a federally qualified health center that offers medical, mental and dental care.
Clinicians there quickly learned that access alone wasn’t enough. Patients sometimes struggled with unfamiliar provisions included in the Kansas Food Bank heart-healthy food boxes. In response, the clinic shifted to providing culturally relevant education — offering cooking classes that transform traditional dishes into healthier versions, teaching portion control for traditional foods like rice and tortillas, and encouraging family participation — while selecting culturally appropriate shelf-stable food, when available from the food bank.
This approach reflects a clinical reality: Adherence improves when care aligns with a patient’s cultural context and daily life. By involving entire multigenerational households, providers reinforce behavioral change beyond the individual patient, improving long-term outcomes.
Still, challenges remain. Most participants speak Spanish and benefit from instruction from medical assistant Ruth Figueroa, the bilingual leader of the Dodge City program. However, Hispanics who speak dialects other than hers must coordinate schedules in bringing a translator, often a family member, to join the biweekly visits or phone calls.
Plus, a mobile workforce can make it difficult to maintain continuity of care and track long-term outcomes.
Figueroa does her best to meet patients where they are by keeping her office hours open and coordinating visits and food box pickups at times that participants can meet, which sometimes fall over her lunch hour.
She said it’s worth it to keep her patients on track and thriving.
Despite these hurdles, the Dodge City program has seen meaningful engagement and remains a notable example of how Food is Medicine can be tailored to diverse rural populations. It’s been so successful that it’s been extended to the Genesis Family Health location in Liberal, supporting an entirely uninsured population.
Figueroa does her best to meet patients where they are by keeping her office hours open and coordinating visits and food box pickups at times that participants can meet, which sometimes fall over her lunch hour.
Scaling Food is Medicine across Kansas
Hoxie is one of several pilot sites in the Kansas Food is Medicine Initiative. Since 2021, programs have operated under federally qualified health centers in Dodge City/Liberal, Hoxie, Lawrence, Newton, Pittsburg and Wichita.
Early data suggests the model is making a measurable difference in helping people better manage chronic diseases. In each of the two measured phases, participants saw a roughly 60% improvement in hemoglobin A1c levels while reporting improved mental health.
Clinics also saw reductions in food insecurity and helped connect patients to longer-term support, such as the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and local food systems, said Carlie Houchen, Sunflower Foundation director of health systems.
Still, scaling the model remains complex.
When the Sunflower Foundation started its work, there were no published models on how to do Food is Medicine in rural communities, Burger said.
Among the challenges were workforce shortages, such as staffing providers and registered dietitians; the transportation of food and patients over long distances; limited healthy food resources; and inconsistent reimbursement structures.
Because Kansas has not expanded Medicaid, the state cannot leverage certain Medicaid pathways to fund these programs broadly, making them heavily reliant on grants and philanthropy.
AmberMed’s program this year, for example, offers scholarships to ensure access for those who cannot afford participation. It is also preparing for the Sunflower Foundation’s funding to stop.
“We’re really trying to figure out what we can do to make something work within the insurance system that we have,” Dumler said, which includes sliding-scale fees paid by patients and finding programs that are reimbursed, such as billable encounters with community health workers, behavioral health specialists, health coaches and physical therapists to keep participants active and the program afloat.
There are signs of progress. Federal initiatives and pilot programs through insurers are beginning to explore reimbursement for nutrition-based interventions, especially for high-risk populations.
Some of that broader national momentum has been supported by federal lawmakers representing Kansas through the Accountable Produce is Medicine Act, co-sponsored by Rep. Sharice Davids, a Democrat, and the Medically Tailored Home-Delivery Meals Program Pilot Act, co-sponsored by Sen. Roger Marshall, a Republican.
Burger said the Kansas program’s data was also used to inform part of the Rural Health Transformation Program, under which the federal government awarded Kansas the initiative’s sixth-largest grant, nearly $222 million.
“Food is Medicine will be a component of that grant,” she said. “And so we see that as a big success, as some early catalytic work is now maybe helping to take this to scale.”
“It’s a major change. I am so appreciative,” Schmitz says of the Food is Medicine program.
A preventive future
Clinicians increasingly see Food is Medicine not just as treatment, but prevention.
AmberMed is expanding into hands-on cooking classes led by a local chef and exploring programs for children and families — interventions designed to shape dietary habits early in life.
To help carry out this work, its clinic recently received $50,000 in intervention funding from the U.S. Department of Agriculture’s Produce Prescription Program, under the Gus Schumacher Nutrition Incentive Program.
It aims to provide healthier food during wellness visits involving the children of low-income parents, including those eligible for SNAP or Medicaid, who are managing or at risk of diet-related chronic disease. AmberMed Clinic plans to work with local schools and family programs to create a local food hub and expand access to fresh produce.
As part of its work through the Sunflower Foundation, Sheridan County also opened a healthy food pantry at the county health department for patients who need additional food. The pantry showcases whole grain, lower-sugar and lower-sodium options, paired with recipe cards created by the health department.
Statewide partnerships are also growing, aiming to align health care, food systems and policy around a shared goal: making nutritious food a foundation of health.
“We are clear-eyed about the challenges of food is medicine,” Burger said. “It is not a magic bullet. It’s not going to solve all of our problems in either the food system or the health care system. But we do see it as a viable strategy to bring those two systems together in a way that improves the health of Kansans.”
One patient at a time
For now, the model is still evolving — built program by program, patient by patient.
For Schmitz in Hoxie, the impact is already clear.
“It’s a major change. I am so appreciative,” she said of the program. “Because I really, truly, don’t think I would have taken the time and found and done this on my own if there wasn’t a program.”
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Dining and Cooking