Proposal Presented for the Master Plan for Aging (#73)
Disclaimer
Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.
Summary
Build an integrated social care delivery system through resource allocation, regulatory and statutory actions with a focus on health equity to enable aging service providers, the existing AAA network, and local health departments to provide Food As Medicine interventions tailored to each community and scaled statewide over a decade. Ensure interventions are culturally appropriate to improve access to nutritious food for high-risk marginalized populations.
Justification
Older adults and individuals with disabilities, particularly individuals of marginalized populations, experience food insecurity, difficulty accessing nutrition benefits, and difficulties accessing healthy food options. These individuals are at an increased risk of poor nutritional diet and worsened medical conditions, which contributes to increased healthcare costs and strain on the aging services infrastructure that provides home-delivered meals to older adults regularly. An integrated social care delivery system with Food as Medicine interventions would improve health equity, reduce healthcare spending, and enable the AAAs to provide nutrition-based interventions to reduce the trend of malnutrition.
Full Proposal
To ensure older adults, individuals with disabilities, and marginalized populations in New York State have access to culturally relevant nutritious food, this proposal would build an integrated social care delivery system with a focus on health equity to enable aging service provides, the existing AAA network, and local health departments to provide Food As Medicine interventions tailored to each community. The capacity of this system will be scaled up through 2035 with aging service providers and the AAA network fully able to deliver nutrition-based interventions and be reimbursable through a variety of payors over time.
- Direct and support aging service providers to identify food insecurity and malnutrition risk and implement Food As Medicine interventions as part of their portfolio.
- Provide infrastructure, funding, technical assistance, and supports for aging service providers and the AAA network to build capacity to equitably participate in healthy longevity Food As Medicine healthcare delivery. Engaging in this initiative can involve partnerships with academic schools and programs which support aging service providers, partnerships with providers and statewide contractors, training for utilization of an evidence-based hunger screening tool, and the creation of a dual-purpose screening for malnutrition and food insecurity which captures nutrition information in both community and healthcare settings.
- The Food As Medicine interventions will meet varied community needs based on cultural, religious, and ethical practices through education, focus groups, and creation of recipe books or videos by each community served to be shared with contractors to create culturally appropriate meals to increase likelihood of participation of underserved areas.
- Partner with technology innovators to expand social networks through existing platforms to support wellness checks, healthy days, and promotion of food and nutrition events.
- Expand the role of the Registered Dietitian Nutritionist to ensure individuals receiving Food As Medicine interventions have access to an appropriate level of medical nutrition therapy.
- Incentivize transportation options for healthy nutrition.
- Develop and expand regular cooking programs at congregate meal sites, older adult centers, and other community partner settings. Provide supplies under the 1115 waiver as necessary. Train physicians and implement malnutrition and food insecurity screenings to be available to community and health services.
- Support Aging Service Providers and the AAA Network to expand its capacity to slow and reverse the trends of malnutrition as well as engage in federal advocacy for the creation of pathways for Food As Medicine interventions and reimbursement which do not exist through Medicare.
- Support access to fresh, local food through community planning, zoning, development and infrastructure, including community gardens and urban agriculture.
This proposal is focused on secondary and tertiary prevention.
MPA Council Commentary
This proposal is categorized as near-term. Components of this proposal are currently being implemented through nutrition initiatives authorized in New York’s most recent federal Medicaid 1115 Waiver amendment, recently expanded Medicaid coverage for nutrition counseling services, funding in the FY24 budget for medical nutrition therapy, expanded funding invested in the FY26 Enacted Budget for services through NYSOFA such as home delivered meals, and other initiatives. DOH and state agency partners will continue to evaluate accessibility to nutritious food for older New Yorkers and individuals with disabilities. Any additional resources or funding allocations to support this proposal would be subject to the annual budget process and available resources.