The California Advancing and Innovating Medi-Cal (CalAIM) is a mutli-year Medi-Cal waiver proposal that the California Department of Health Care Services (DHCS) plans to submit this Summer to the Centers for Medicare & Medicaid Services (CMS) to succeed the current, and much smaller Medi-Cal 2020 115 waiver. DHCS’s current CalAIM proposal lays out an ambitious framework to transform the state’s Medi-Cal program to improve the quality of life and health outcomes of our population. CalAIM recognizes the variety of health issues that many people have and is designed to advance whole person care approaches that address the Social Determinants of Health, reduce the complexity of the Medi-Cal system, and improve quality outcomes, reduce health disparities, and drive delivery system transformation. Where other Medicaid systems have failed to acknowledge the gaps in the healthcare system, CalAIM seeks to fill in the gaps by targeting social inequities that have left much of the population underserved. One of those gaps is the lack of attention on chronic conditions such as diabetes, heart disease, or depression which may be caused by a social determinant of health like food insecurity. .

In order to maintain a good health, we must make sure people have healthy diets and access to healthy food. Under CalAIM, dietary health issues that are addressed before hospitalization can prevent strain on the healthcare system and keep healthcare costs low. The CalAIM application to CMS provides an opportunity to improve Medi-Cal beneficiaries’ access to healthy foods through the Meals/Medically Tailored Meals/Medically Supportive Food option in the proposal’s In Lieu of Services (ILOS) component.

The inclusion of medically supportive food interventions  like food/produce prescriptions, food pharmacies, and grocery boxes in the CalAIM proposal is revolutionary and would help put California ahead on a budding idea that has already seen great results in other states such as Massachusetts, North Carolina, and Oregon. To support the implementation of the Meals/Medically Tailored Meals/Medically Supportive Food ILOS option, the UCSF Center for Vulnerable Populations, Harvard Center for Health Law and Policy Innovation and SPUR want to better understand what medically-supportive food and nutrition interventions in California are already being implemented in health care settings and what barriers exist to scaling these interventions statewide. They have created a survey to help map California’s exiting Medically Supportive Food and Nutrition infrastructure, which we hope you can either complete or share with relevant partners.

Who should fill out the survey?

• Community based organizations & government departments who provide food based supports and either already do or want to partner with health care.
• Health insurers and health care providers who provide food based supports already or want to in the future.

Why should I fill the survey out?

• To ensure you are represented in a statewide map of MSF&N interventions in California!
• To build connections between health care and food-based support providers.

Okay, where do I go to take the survey?!

• Visit https://ucsf.co1.qualtrics.com/jfe/form/SV_3TM2gEZbsVsVBJz to fill out the survey.

For more information about the survey, you can visit https://www.spur.org/featured-project/medically-supportive-food-and-nutrition. If you have any questions about the survey please contact Jennifer Tong at Jennifer.Tong@ucsf.edu or Katie Ettman at Kettman@SPUR.org.

Organizations such as SPUR, a nonprofit public policy organization in the Bay Area has endorsed the idea, saying, “The need for these food-based interventions in Medicaid has been exacerbated by the COVID-19 pandemic which highlighted many health and social inequities, especially for Black and Brown communities….we support the inclusion of medically supportive food and nutrition interventions as an In Lieu of Services Benefit. Evidence suggests that a broad range of healthy food supports can improve health outcomes and reduce health care costs.” For more on SPUR’s statement, click here.

In addition to the CalAIM opportunity, Assemblymember Bonta has introduced AB 368, which will establish a two-year Food Prescription Pilot to provide medically supportive food to Medi-Cal beneficiaries in three counties, including Alameda County, who have one or more chronic health condition(s) with a focus on eliminating racial health disparities and reducing food and nutrition insecurity. You can find the press release from Assemblymember Bonta’s Office about the legislation, which features quotes by Supervisor Wilma Chan, Dr. Steven Chen, and Dr. Larissa Estes-White.

AB 368 (Bonta) will first be heard in the State Assembly’s Health Committee (likely in early April). Organizational Letters of Support should be received by March 30^th and uploaded through the Advocate Portal: https://calegislation.lc.ca.gov/Advocates/. If you have any questions about AB368 (Bonta), please email Rachel Richman, Senior Policy Advisor, Medically Supportive Food, Alameda County Supervisor Wilma Chan.