California to Pilot a Program to Bring Meals to Low-Income Residents with Chronic Illness

by Cameron St. Germain

Part of the Food Policy Snapshot Series

Policy Name:

Medically Tailored Meals Pilot Program, California

Location:

California

Population: 39,250,017 (2016, US Census)

Overview:

In 2017, California passed the country’s first statewide “medically tailored meal” bill. The bill tasks the State Department of Health Care Services to create a program that provides specially prepared meals to low-income recipients of Medi-Cal (California’s Medicaid program) who suffer from certain chronic illnesses. These healthy meals are intended to meet individuals’ specific nutritional requirements based on their medical conditions and symptoms.

Progress to date: N/A

Program/Policy Initiated:

The bill was signed into law on July 10, 2017, and the program will go into effect on January 1, 2018.

Food policy category:

Social and economic equity

Program goals:

The program aims to improve food security among low-income Californians who suffer from chronic illnesses. Specifically, the program is intended to reduce:

  • Hospital readmissions.
  • Admissions to long-term care facilities.
  • Emergency room utilization.

How it works:

Participants are required to meet all three criteria in order to be considered eligible for the pilot program. They must:

  • Receive health care through Medi-Cal.
  • Have one of the following chronic conditions: congestive heart failure, cancer, diabetes, chronic obstructive pulmonary disease, or renal disease.
  • Live in one of the following counties: Alameda, Los Angeles, Marin, San Diego, San Francisco, San Mateo, Santa Clara, or Sonoma.

Participants in the program will have up to 21 meals per week delivered to their door for 12-24 weeks. The State Department of Health Care Services will partner with local nonprofits experienced in feeding the state’s needy population. Together, these nonprofits form the Food is Medicine Coalition. Organizations from the coalition will use their experience to prepare and deliver healthy meals tailored to meet the medical and nutritional needs of their recipients.

California has budgeted $6 million in state funds to finance the pilot project but intends to seek supplemental federal funding.

Why it is important:

Nutrition is an important part of chronic disease management. However, not everyone has consistent access to nutritious food. According to a study from the Harvard School of Public Health’s Department of Nutrition, very few low-income individuals consume the recommended amounts of whole grains, fruits, vegetables, fish, and nuts. Meanwhile, on average, they exceeded recommended amounts of processed foods and sugar-sweetened beverages. Unhealthy dietary habits such as these are often linked to inadequate nutritional education, access to healthy foods, and purchasing power.

Although the program covers several diseases, it may be instructive to look at one example. A study from the University of Alabama at Birmingham clearly shows the relationship between poverty, nutrition, and chronic kidney disease. Foods high in added fat, sugar, salt, and refined grains, which often make up large portions of diets among low-income individuals, can result in inflammation, increased blood pressure, and obesity. All of these conditions put even more strain on the kidneys of those suffering from renal disease, potentially leading to kidney failure.

Evaluation:

At the end of the pilot program, the State Department of Health Care Services will analyze data collected by Medi-Cal to determine the effects that the program had on participants’ health and wellbeing.

Learn more:

https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB97

Point of Contact:

California Department of Health Services Office of Communications

[email protected]

916-440-7660​

Similar practice:

Inspiration for the program came from a study conducted in Philadelphia through the nonprofit organization MANNA (Metropolitan Area Neighborhood Nutrition Alliance). The trial conducted by MANNA showed a 55% reduction in health costs among patients who received medically tailored meals compared to the control group.

References:

https://www.census.gov/quickfacts/fact/table/CA/PST045216

http://www.fimcoalition.org

https://www.ncbi.nlm.nih.gov/pubmed/23034960

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291540

https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB97

http://www.mannapa.org

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