{"id":65249,"date":"2024-06-10T14:34:41","date_gmt":"2024-06-10T21:34:41","guid":{"rendered":"https:\/\/lapost.us\/?p=65249"},"modified":"2024-06-10T14:34:41","modified_gmt":"2024-06-10T21:34:41","slug":"ca-bill-seeks-to-enshrine-medically-supportive-nutrition-as-part-of-medi-cal-coverage","status":"publish","type":"post","link":"https:\/\/lapost.us\/?p=65249","title":{"rendered":"CA Bill Seeks to Enshrine Medically Supportive Nutrition as Part of Medi-Cal Coverage"},"content":{"rendered":"
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By<\/span>Sejal Parekh<\/a><\/div>\n<\/div>\n<\/div>\n
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Participants in Recipe 4 Health have seen impressive results, including decreased indicators of chronic illness. AB 1975 would ensure permanent funding for the program.<\/p>\n<\/div>\n<\/div>\n

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Leer en espa\u00f1ol<\/a><\/em><\/p>\n

Knee surgery in 2021 limited Elizabeth Duran\u2019s physical activity and caused her to gain weight. Duran, 65, took pills for high blood pressure and dealt with her anxiety privately.<\/p>\n

In the fall of 2023, her doctor referred her to a county program, Recipe 4 Health, that delivers fresh produce to her house. Duran, who is Hispanic, credits the program with getting her back on track.<\/p>\n

\u201cI was familiar with Swiss chard and kale,\u201d said Duran, \u201cbut I never would really choose those things.\u201d After learning their nutritional value in the program, she looked up how to cook them.<\/p>\n

Duran said participating in Recipe 4 Health helped her control her blood pressure, sleep better, and reduce her anxiety.<\/p>\n

Since its inception in 2020, Recipe 4 Health \u2013 part of the \u201cfood as medicine<\/a>\u201d initiative \u2013 has connected over 6,000 Alameda residents, 83% of them people of color and more than half Spanish speaking, to healthy vegetables and health coaching. The results are impressive.<\/p>\n

\u201cOne third of our patients with prediabetes and diabetes show a clinically meaningful reduction in their blood sugars,\u201d noted the program\u2019s chief medical officer, Dr. Steven Chen. \u201cTwo thirds of the patients improved their cholesterol indicators, thus reducing heart disease risk\u201d while \u201c44% of our patients are reducing their depression symptoms.\u201d<\/p>\n

Such outcomes can help prevent chronic illnesses and cardiovascular disease which ultimately save healthcare dollars, said Chen. He believes that consistent funding for Recipe 4 Health is critical to its longevity.<\/p>\n

Currently, Recipe 4 Health receives much of its funding from CalAIM, a multi-year initiative that combines federal and state dollars to address social drivers of health, including food and housing insecurity.<\/p>\n

The state Department of Healthcare Services (DHCS) administers CalAIM, and funds local Medi-Cal plans to reimburse programs like Recipe 4 Health that provide medically supportive nutrition.<\/p>\n

DHCS was granted a five-year extension for federal funding for CalAIM, which was previously set to expire in Dec 2021. As he inches closer to 2026, Chen is looking for a stable funding source for his program that does not need frequent renewal.<\/p>\n

This is why he is urging lawmakers to adopt AB 1975, Assemblymember Mia Bonta\u2019s (D-Oakland)\u00a0second<\/a>\u00a0attempt to require Medi-Cal coverage of medically supported food programs. If passed, California would become the first state in the country to require its Medicaid program to cover this benefit. The bill is currently makings its way through the state legislature.<\/p>\n

\u201cToo many Californians, particularly Californians of color, are living with largely preventable chronic illnesses and conditions,\u201d said Bonta, noting her measure would go a long way in advancing health equity in the state.<\/p>\n

A majority of those enrolled in Recipe 4 Health are low-income people of color.<\/p>\n

Every week for 3 months, program participants receive 16 servings of fresh fruits and vegetables, said Sasha Shankar, co-farm director at Dig Deep Farms, which supplies the program\u2019s produce.<\/p>\n

Weekly health coaching, meanwhile, helps participants learn about nutrition, exercise, and stress management, while also helping them set and meet health goals.<\/p>\n

To participate in Recipe 4 Health, Medi-Cal patients in Alameda County need a referral from their primary care provider at participating health centers, which include Alameda Health System, Bay Area Community Health, Lifelong Medical Care, Native American Health Center, and Tiburcio Vasquez Health Center.<\/p>\n

The program is separate from CalFresh, California\u2019s food stamp program, and many patients are able to receive both Recipe 4 Health and CalFresh benefits at the same time.<\/p>\n

Primary care providers can refer patients if they are food insecure, or have a chronic condition such as diabetes, high blood pressure, high cholesterol, heart failure, or stroke.<\/p>\n

Nearly 10% \u2013 roughly 154,000 \u2013 of Alameda\u2019s 1.6 million residents live in homes that experience food insecurity.<\/p>\n

Once participants have been referred by their primary care provider, Recipe 4 Health receives the referral and passes it to the county Medi-Cal plan, Alameda Alliance for Health for authorization. The referral is also forwarded to partners Dig Deep Farms and Open Source Wellness, which provides health coaching. These partners contact the participant to verify contact information before starting services.<\/p>\n

Still, despite its successes the program has not been without challenges. \u201cLiterally a few weeks into the program and the pandemic hit,\u201d said Chen. \u201cWe went totally to doorstep delivery. And then we went to virtual groups.\u201d<\/p>\n

The pandemic had several other ripple effects on the program. As fewer people saw their primary care provider for routine care, fewer referrals were made to Recipe 4 Health.<\/p>\n

Contact information in the clinic\u2019s medical records also became outdated. If phone numbers were not updated in the clinic\u2019s record, referrals would carry that incorrect information to Recipe 4 Health. When that happens, \u201cWe have data to show that drops off significantly,\u201d by as much as 50%. \u201cWrong number, you can\u2019t reach the patient, kind of dead in the water,\u201d said Chen.<\/p>\n

Lack of time or transportation can also prevent people from participating in weekly coaching sessions. In 2023, only 1,105 of 1,949 \u2013 about 56% \u2013 Recipe 4 Health participants attended coaching.<\/p>\n

That has put a strain on Open Source, explained Director Elizabeth Markle, who said Recipe 4 Health is currently seeking to renegotiate its contract with the organization by moving to a fee-for-service model.<\/p>\n

Rising inflation and food costs have also had an impact. Shankar said that Dig Deep Farms was reimbursed $23 per bag of produce delivered to participants in 2023, and that reimbursement rates had to be increased in 2024.<\/p>\n

But compared to the billions California spends each year treating chronic illnesses, Recipe 4 Health\u2019s per-patient outlays \u2013 roughly $785 per participant for the year, based on information provided by Chen\u2019s team \u2013 are more cost effective.<\/p>\n

When critics ask, \u201cHow do we pay for this food?\u201d Chen replies, \u201cWe\u2019re already paying for it. It\u2019s just through our healthcare system.\u201d<\/p>\n

Dr.\u00a0Sejal\u00a0Parekh is a practicing pediatrician and a\u00a0Stanford Health Equity Media Fellow<\/a><\/em>.<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

BySejal Parekh Jun 10, 2024 Participants...<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6,16],"tags":[],"class_list":["post-65249","post","type-post","status-publish","format-standard","hentry","category-ca-local","category-health"],"_links":{"self":[{"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts\/65249","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=65249"}],"version-history":[{"count":1,"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts\/65249\/revisions"}],"predecessor-version":[{"id":65250,"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts\/65249\/revisions\/65250"}],"wp:attachment":[{"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=65249"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=65249"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=65249"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}