WHEREAS, Too many Californians, particularly Californians of color, are living with preventable, diet-related health conditions that severely impact quality of life and reduce life expectancy; and
WHEREAS, Access to adequate food and nutrition plays a key role in preventing and managing diet-related health issues and can significantly improve health outcomes and reduce health care spending; and
WHEREAS, Medically supportive food and nutrition, commonly known as “food as medicine,” are food-based interventions integrated into health care used to prevent, treat, and reverse diet-sensitive medical conditions; and
WHEREAS, Providing the full spectrum of medically supportive food and nutrition interventions, including medically tailored meals, medically tailored groceries, medically supportive groceries, produce prescriptions, healthy food vouchers, food pharmacy, and nutrition education, allows health care providers to appropriately match service to patients’ needs, and enables patients to transition between more and less intensive levels of care as their health needs evolve; and
WHEREAS, California has recognized the critical role of nutrition and its influence on health outcomes and health equity through its inclusion of medically supportive food and nutrition interventions, including Medically Tailored Meals/Medically Supportive Food Community Support services, in the California Advancing and Innovating Medi-Cal (CalAIM) Initiative; and
WHEREAS, An evaluation conducted by the State Department of Health Care Services (DHCS) that examined the cost-effectiveness of medically supportive food and nutrition under CalAIM found that implementation of these services led to reduced health care spending, with an 18.7 percent reduction in costs for inpatient services, a 6 percent reduction in costs for outpatient services, and a 20 percent reduction in per-member, per-month emergency room costs; and
WHEREAS, Examinations of similar medically supportive food and nutrition programs in other states also demonstrate reduced health care spending, including a 23 percent reduction in hospitalizations and a 13 percent reduction in emergency department visits in Massachusetts, and an average savings of $85 per patient per month in North Carolina for patients receiving interventions addressing health-related social needs, such as food; and
WHEREAS, Medically supportive food and nutrition services have been successfully implemented under Medi-Cal, with nearly 200,000 patients having accessed these services in a 12-month period, making them the most utilized Community Support services; and
WHEREAS, The delivery of high-quality medically supportive food and nutrition interventions is driven by contracts with community-based providers who offer culturally relevant and patient-centered services, uphold high nutrition and quality standards, and collaborate with other local organizations and health care providers to support overall patient health; and
WHEREAS, Prioritizing the sourcing of high-quality food from California regenerative and organic farms and ranches, including from socially disadvantaged or beginning farmers and ranchers, offers multiple cobenefits to human health, California’s economy, and the environment, helping to reach California’s climate goals by 2045; and
WHEREAS, Updates to DHCS guidance informed by stakeholder feedback, including service definitions, coding, and eligibility, have improved implementation; and
WHEREAS, Despite the proven benefits of medically supportive food and nutrition, these services are optional under CalAIM, meaning that managed care plans must voluntarily opt in to providing them, leaving Medi-Cal beneficiaries vulnerable to losing access to these critical interventions and putting eligible patients who have yet to receive care at risk of never gaining access; and
WHEREAS, For medically supportive food and nutrition services to securely remain available to Medi-Cal patients in the long term, they must transition from optional services under CalAIM to fully covered, permanent Medi-Cal benefits; and
WHEREAS, Until medically supportive food and nutrition services can transition from CalAIM services to standard Medi-Cal benefits, they can continue to be offered to patients through federal In Lieu of Services (ILOS) authority, which grants managed care plans the ability to cover medically appropriate and cost-effective alternatives to traditional Medicaid benefits; and
WHEREAS, By fully embracing medically supportive food and nutrition as a critical and strategic investment in health outcomes and health equity, California has the potential to transform the health care system, reduce health care costs, and lead the nation in tackling root causes of health disparities; now, therefore, be it
Resolved by the Assembly of the State of California, That the Assembly recognizes the critical role that medically supportive food and nutrition plays in reducing chronic disease and advancing health equity; and be it further
Resolved, That the Assembly calls on the State Department of Health Care Services to leverage ILOS authority to direct managed care plans to prioritize offering the full spectrum of medically supportive food and nutrition interventions until these services can become fully covered, permanent Medi-Cal benefits; and be it further
Resolved, That the Assembly calls on the State Department of Health Care Services to prioritize transparency, accountability, and continuous improvement of medically supportive food and nutrition services by regularly updating implementation guidance, undertaking ongoing data collection and publishing evaluation reports, and actively soliciting stakeholder feedback to inform these updates; and be it further
Resolved, That the Assembly calls on managed care plans to promote quality, medically supportive food and nutrition implementation by ensuring that patients have uninterrupted access to a broad array of medically supportive food and nutrition services, prioritizing contracts with community-based nonprofit food providers, ensuring that reimbursement rates are regularly updated and responsive to provider needs, and prioritizing sourcing from California organic and regenerative farmers and ranchers; and be it further
Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the Governor of the State of California, the State Department of Health Care Services, California Medi-Cal managed care plans, and to the author for appropriate distribution.