Hospitals in California’s San Francisco Bay Area are at the forefront of a small but growing national movement to incorporate fresh, local food into healthcare foodservice. This paper presents a cross-section of current farm-to-hospital initiatives in the region, in order to demonstrate what has been accomplished and how. It is intended to help hospital foodservice leaders plan and develop their own local food sourcing practices, and help those outside the hospital setting, e.g. farmers, public officials, nonprofit support agencies, better understand the hospital purchasing environment.