DISRUUPTED VIRGINIA
Rx for Virginians’ health, one grocery bag at a time

CULPEPER, Va.—On a boiling hot August afternoon, Judith pops into the Free Clinic of Culpeper days before her regular checkup because she feels “a little off.”

An abnormal blood test reveals she is wise to trust her instincts. Still, the staffer on duty assures Judith there is no need to panic—if she balances eating well with taking the prescriptions that regulate her diabetes and high cholesterol.

“Phew,” utters the slender 74-year-old. As a patient since 2018, she is aware that not all medicine comes in vials. That’s why she eagerly follows medical assistant Michelle Rojo to a corner room stacked with cans of meat, beans and fruit, and containers of low-fat milk and yogurt, oatmeal, rice, pasta and more.

“Our patients are like family to us,” Rojo says about the clinic’s food-is-medicine mantra. “We know their stories, their struggles and why it’s hard to change eating and exercising habits. Some just need a little push when they fall off the wagon.”

Rojo, morphing into her personal shopper role, fills a cloth bag with tortilla mix, dried beans, canned vegetables and a pamphlet of low-sodium and non-sugary recipes. Before darting down the hall to retrieve a package of lean ground turkey from the freezer, Rojo reminds Judith about limiting her portions and eagle-eyeing nutrition labels in the grocery store.

Steps away, Judith’s last stop is a table overflowing with fresh tomatoes, greens, peppers, cucumbers, corn and other seasonal bounty harvested from the clinic’s front-yard raised beds or donated by area farmers.

This one-grocery-bag-at-a-time scenario is repeated dozens of times daily at a network of 99 statewide sites where needy Virginians—many with chronic diseases living in food deserts—are “prescribed” the ingredients to prepare healthy meals at home.

The relatively new phenomenon of wrapping food pharmacy services into regular checkups is changing lives in Culpeper—and beyond.

But its continued success is in jeopardy.

Food as medicine is under severe strain due to Trump administration policies shrinking access to food stamps and health care for the poor.

One piece of that bleak equation is that 130,000-plus Virginians — including at least 23 in Culpeper County — are on the verge of losing eligibility for the Supplemental Nutrition Assistance Program. Those cutbacks are mainly because of new work requirements and other changes instituted under H.R. 1 in July 2025, according to Virginia’s Office of the Secretary of Health and Human Resources.

Never mind that Virginia’s food pantries could barely keep up with demand from cash-strapped residents struggling to pay their monthly bills. Shelves are barer because the Trump administration slashed one-quarter of a federal commodities program that provides up to one-third of pantries’ inventory.

“With less food coming in and trying to serve a record number of people, we are in a very challenging environment,” explains Eddie Oliver, executive director of the Federation of Virginia Food Banks. “Stretching resources doesn’t allow us to invest in food pharmacies, which have led to better health outcomes because of their targeted approach.”

In late August, Democratic Gov. Abigail Spanberger issued an executive order directing the state to protect healthcare coverage and food assistance for at-risk Virginians.

While Oliver lauds the governor’s diligence, he said “these gaps are going to be so extreme that it will be hard for Virginia to fully replace the funding we are losing.”

In 2023, his nonprofit joined with the Local Environmental Agriculture Project to launch the Virginia Food is Medicine Coalition. That amalgam of 68 organizations covering academia, advocacy, agriculture, government and healthcare exists to prove that nutrition should be folded into clinical care, not treated as an afterthought.

Culpeper’s food pharmacy originated in October 2024 under the umbrella of the Verona-based Blue Ridge Area Food Bank.

“What I love is that we have a captive audience and the food pharmacy dovetails with what patients are told during their medical appointment,” director Tammy LaGrange says. “One screening question is ‘Do you need food? A ‘no’ answer is rare.”

Last year, it provided groceries for most of the 600 patients seeking health care, 90% of them Hispanic.

LaGrange expects that number to balloon in January when an estimated 1,800 county residents — of 300,000 statewide — are expected to be shut out of Medicaid because of non-compliance with work requirements. But the amount of food will stagnate.

“As somebody doing client education, this is disheartening,” says primary care coordinator Becca Buncie. “I have all this knowledge to share, but not always the resources to make it happen.”

LaGraffe and Buncie, both registered nurses, are already brainstorming how to finagle more food—whether that translates to writing another grant to procure 1,200 eggs or asking for extra from community connections such as John Clark, who has operated Harvest & Hope Farm for eight years.

“We live in a world where there’s a lot of hopelessness,” Clark says. “Food is something that gathers hope around the table.”

Staff pharmacist and volunteer Eugene Triplett, a fifth-generation farmer in nearby Brandy Station, linked Clark to the clinic.

“My grandfather used to give away everything he grew,” Triplett says about sharing his bounty of tomatoes, peppers, greens, peppers, beans and cabbages. “Now I understand why that gave him such joy.”

Triplett, whose mother was a chef, delights in watching patients take a shine to newfangled concoctions such as zucchini lasagna. He’s fond of matching golden beets, spaghetti squash, watermelon radishes and other garden obscurities with recipes “to teach people to experiment with wholesome food outside of their cultural comfort level.”

As Trump-imposed cuts to food stamps and Medicare went through court challenges, LaGrange and Buncie are girding for leaner times.

“My biggest concern is continuity of care,” Buncie says. “If patients show up, we’re going to figure out a way to help them. If they don’t, we’re going to worry.”

Buncie points to the powerful clinical impacts of food pharmacies. Studies reveal that regular clients can significantly reduce their blood sugar, lower their blood pressure and lose weight. Another bonus is steep drops in household food insecurity.

One Culpeper woman, who asked not to be named, is living proof. During her first visit to the Free Clinic in 2018, she told staffers she was terrified that she, too, would succumb to the family curse of diabetes because she was so severely overweight.

Fast forward eight years. The 45-year-old mother explains that trading junk food for food pharmacy fare, an intensive walking regimen and medication have helped her shed 60 pounds.

“Food can be such easy comfort,” she says. “But once you start losing, the aches and pains are less. You just start to feel better and that motivates me to keep going.”

Recently, the clinic prescribed a GLP-1 drug so she could maintain that trajectory and ditch her diabetes-control pills.

These days, the woman’s first question at the clinic is, “Hey, do you mind if I weigh myself?” before hopping on the scale – and eliciting high-fives from staffers.

For her, the low-slung, red brick building housing the food pharmacy is a refuge. She emphasizes how thankful she is for the circle of big-hearted professionals who care so deeply about her well-being.

“I don’t need a medal for what I’ve achieved,” she says. “A kind word is more than enough.”