Mercury News: California’s push to make people healthy — and save taxpayers money

By: David Gorn, CALMatters | July 9, 2018

Diana Dooley may have led the largest agency in California’s government as secretary of health and human services for the past eight years, a job that led to her current post as Gov. Jerry Brown’s chief of staff — but she’s also a country gal from Hanford, in the Central Valley.

So despite the complexity of running an agency with an annual budget of $144 billion, horse sense told her what was basically wrong with the American health care system:

“One of the biggest problems in health care,” Dooley said in an interview last week, “is we pay for treatment of illness but we don’t pay for the advancement of health.”

That idea is at the heart of the state’s effort over the past two decades to revamp its system for delivering health care to the neediest. The strategy has included a shift to managed care, meshing mental health services with physical care and creating programs specifically to coordinate an array of services so patients don’t have to hunt them down one at a time.

More recently, the state has launched several pilot projects designed to make people healthier overall rather than just treat the pain or discomfort of chronic illness. Taxpayers foot the bill for the care of about a third of all Californians through Medi-Cal, the state’s version of the federal Medicaid program for the poor, spending tens of billions of dollars annually on treatment of chronic conditions.

A five-year, $1.5 billion Whole Person Care initiative, begun in 2016, aims to heal heavy users of medical services and save the state money by keeping them out of expensive emergency rooms and hospitals.

And a pilot program was created last year to use food as medicine — to try to reverse chronic illnesses such as congestive heart failure — in projects across seven counties. Officially launched last month, it’s modeled on a project in Philadelphia that showed a roughly one-third reduction in patient costs.

These two state efforts include:

Continue reading the article. 

The Health Trust Makes Health Partnership Grants totaling over $800,000

For Immediate Release: June 28, 2018
The Health Trust Contact: Maria Garcia, mariag@healthtrust.org or (408) 513-8729

San Jose, CA – On June 27, 2018, The Health Trust Board of Trustees approved four Health Partnership grants totaling $806,498 to support The Health Trust’s mission of building health equity in Silicon Valley. Specifically, the awarded grants will combat older adult social isolation, support the work of the Long Term Services & Support (LTSS) Integration Committee, advance the careers of public health professionals, and increase access to behavioral health services for undeserved youth.

Breakdown of Grants

San Jose Parks Foundation
Research shows that many older adults start facing social isolation and lack of purpose after they retire from work, their kids grow up, and as they start losing friends and loved ones. Research also shows that socially isolated seniors are more likely to experience chronic stress and depression, including conditions like high blood pressure and diabetes. In an effort to provide support and services to older adults and to some of our most vulnerable youth, over the next 12 months and through a $100,000 grant, the San Jose Parks Foundation, in partnership with the Office of the Mayor and Somos Mayfair plan to develop an intergenerational programming blueprint, with the goal of increasing the number of older adults engaged and retained in volunteerism across the city of San Jose by connecting them to youth serving organizations.                                     

Public Health Institute
Through the support of a $555,998 grant, the Public Health Institute will provide individuals the opportunity to advance their professional careers in the field of public health.

Working Partnerships USA
Older adults and adults with functional limitations who require Long Term Services and Supports (LTSS) services are some of our county’s most vulnerable populations. In an effort to provide them the opportunity to age in place, over the next 12 months and through a $75,500 grant, Working Partnerships USA plans to support the work of the Long Term Services & Support (LTSS) Integration Committee. This grant is intended to ensure that the Committee drives key projects, policy, and system changes that will specifically impact older adults and adults with functional limitations, referred to as the LTSS population.

Youth Alliance
During FY17, Youth Alliance engaged in an assessment to understand the health needs of the community and how they could play a role in supporting those community health needs. Building off of the learnings from Year 1, in Year 2, Youth Alliance plans to increase the number of underserved youth accessing behavioral health services. Over the next 12 months and through a $75,000 grant, Youth Alliance plans to contract out with third party payer, Anthem Blue Cross to serve as one of the only health providers of youth specialty behavioral health services. Through this project, Youth Alliance will have the opportunity to diversify its revenue funding stream, and provide a critical health service to vulnerable youth and families in N. San Benito County.

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About The Health Trust
The Health Trust is an operating foundation founded in 1996. Our mission is to build health equity in Silicon Valley. We believe everyone should be afforded the opportunity to be healthy – especially the most vulnerable. To that end, we provide direct services, fund community-based organizations whose work aligns with our mission, and advocate for policies and initiatives that help advance our mission. For more information, visit healthtrust.org.

Health Trust’s Cristo Rey Students Graduate High School

Since 2014, The Health Trust has partnered with Cristo Rey San Jose Jesuit High School’s Corporate Work Study Program. As a results, we’ve had at least four bright and talented students working with us each year.

We are proud to announce that on June 9, 2018, five of our former and current students participated in Cristo Rey San Jose High Schoo’ls inaugural graduation.

Congratulations Alana, Alexa, Adrian, Diego, and Magda!

Below is each student’s college commitment.
Alana  – Cal State Stanislaus
Alexa – Cal Berkeley
Adrian – Saint Mary’s College
Diego – Saint Mary’s College
Magda – San Jose State

Silicon Valley Business Journal: Early experiences with HIV patients helped shape Dr. Lawrence McGlynn’s medical career

By  | June 4, 2018

Editor’s note: This is a profile of one of our eight Excellence in Healthcare winners, who will be honored at a luncheon on Thursday, June 7, at the Silicon Valley Capital Club.

Unless you were there, it’s hard to imagine how scary the early days of the HIV epidemic were for young gay men in San Francisco. An infectious disease that didn’t yet have a name was spreading across the city. Doctors speculated it might be an aggressive new form of cancer.

“I started seeing people in San Francisco who were my age, walking with canes, thin, sick, who had lost a lot of weight and were dying,” said Stanford University clinical professor Larry McGlynn. “Garage sales were all over the place. You’d see young men’s clothing and records, representative of a life that was just starting out. You knew people were dying.”

Doctors were studying the disease, but had not yet developed medication to manage its symptoms. Getting an HIV diagnosis seemed like a death sentence. One of McGlynn’s childhood friends was diagnosed with HIV in the 1980s and committed suicide.

Those early experiences shaped McGlynn’s career. Today, he’s one of a small handful of psychiatrists in Silicon Valley who specialize in treating the mental health of patients with HIV and people who use crystal meth.

His days start early and end late.

McGlynn, 57, splits his week between two clinics — Stanford’s Positive Care Clinic in Palo Alto, and PACE, a public health clinic at Santa Clara Valley Medical Center in San Jose. He estimates he sees somewhere between 10 and 15 patients per day, for sessions that last up to an hour each. On top of that, he also teaches at Stanford.

Continue reading the article at Silicon Valley Business Journal. 

Physicians News Network: Health Trust in SC County Joins California “Food Is Medicine” Pilot Program

Physicians News Network | May 21, 2018

The​ ​Health Trust ​in Santa Clara County and five other nonprofit organizations throughout California are participating in a new “Food Is Medicine” state pilot, a medically tailored meal service with the goal of reducing overall medical costs caused by patients not getting the necessary nutrition.

Project Angel Food launched the three-year, $6 million pilot program to prove medically tailored meals can reduce healthcare costs for Medi-Cal recipients with congestive heart failure (CHF) .

It is estimated that 1 in 8 Americans (42 million) are insecure of the foods they eat and do not eat enough nutrients to sustain a healthy and active lifestyle. Meanwhile, the rate of chronic disease caused by poor nutrition, such as hypertension, coronary heart disease, hepatitis, stroke, cancer, asthma, diabetes and arthritis, is on the rise.

“The purpose of this groundbreaking pilot is to prove our medically tailored meals and medical nutrition intervention can reduce hospital admission rates and healthcare costs within a 12-week period,” according to the announcement. Participants in the pilot will receive 100% daily nutrition, which includes breakfast and two entrees, for three months. They will also be provided with intensive medical nutrition therapy including two in-home visits by a registered dietitian and two follow-up telephone calls.

 This is the first time any state has funded a pilot of this kind. Richard Ayoub, executive director of Project Angel Food, said in a statement: “This new statewide program will usher in a new era for Project Angel Food. At the end of the program, there will be a published finding definitively proving our nutritious meals reduce healthcare costs.”

Published research into a similar project in Philadelphia that delivers three meals and one snack per day every week to low-income people who are in danger of malnutrition during a serious illness showed the meals had an impact on patient quality of life — and also major reductions in hospital costs, catching the attention of politicians in California, according to the Huffington Post. With high rates of food insecurity, chronic illness and Medicaid enrollment, California was looking for a way to bring down the overall costs of Medi-Cal, the state’s Medicaid program, with efforts that have a proven return on investment.

With a significant number of Californians living well below the federal poverty level, those undergoing treatment for breast cancer are often left to choose between their next meal or keeping up with their quickly-accumulating medical bills. They may also forgo healthier meals, opting instead for cheaper canned foods that provide little in the form of nutrition.

“We believe food is medicine and that this food will keep people out of the hospital, thus saving Medi-Cal hundred of thousands, if not millions, of dollars,” said Ayoub.

Read the original Physicians News Network article here.

Livestrong: California doctors are prescribing food to sick people, and here’s why it’s working

By: Leah Groth  | May 15, 2018

The program, launched on Friday by the California Food Is Medicine Coalition alongside Senator Ben Allen (D) and assembly members Blanca Rubio (D) and Richard Bloom (D), will deliver free, custom-prescribed meals to individuals insured by Medicaid and suffering from congestive heart failure (a chronic heart condition that requires strict dietary adherence).

“We provide meals to people who are critically ill and we have seen results where you actually bring down healthcare costs because they stay out of the hospital longer, they adhere to their medication and they don’t go to the emergency room as often,” explains Richard Ayoub, executive director of Project Angel Food, one of the non-profit organizations participating in the new program.

According to Ayoub, Project Angel Food and the other five organizations involved in California’s new pilot program — Ceres Community Project, Project Open Hand, Mama’s Kitchen, Health Trust and Food for Thought — have been delivering meals to sick people for years. Now, their services will be reimbursed through Medicaid.

Continue reading the article. 

NY Times: Cod and ‘Immune Broth’ – California Tests Food as Medicine

By: Patricia Leigh Brown | May 11, 2018

SEBASTOPOL, Calif. — On a foggy afternoon, Diana Van Ry, a retired judicial assistant, dropped by the boisterous kitchens of the nonprofit group where she volunteers to pick up rock cod, cauliflower couscous and an “immune broth” enriched with vegetables and seaweed. She planned to deliver the meals to Brandi Dornan, 46, who is recuperating from breast cancer.

“It’s food I wouldn’t have thought to make myself,” said Ms. Dornan, who started getting the meals during radiation therapy and is grateful for the help. “Wow, bless their hearts.”

The Ceres Community Project — its meals prepared for cancer patients by teenage sous-chefs — is at the forefront of the “food as medicine” approach increasingly embraced by physicians, health insurers, researchers and public health officials.

The group is now participating in an ambitious, state-funded study to test whether providing daily nutritious meals to chronically ill, low-income people on Medi-Cal — California’s version of the Medicaid program — will affect their prognosis and treatment, or the cost of their medical care.

Continue reading the article. 

HuffPost: California Becomes The First State To Prescribe Food As Medicine

In one pilot program, doctor-approved meals lowered health care costs by 55 percent

By: Anna Almendrala | May 8, 2018

Caren Latney was too weak to do simple household chores.

The 51-year-old had been diagnosed with lung cancer and, as she began treatment, struggled to stand over her stove long enough to prepare a meal. She didn’t really want to eat, anyway ― her intensive chemotherapy and radiation left her nauseated and exhausted. But high-calorie, protein-rich meals are essential for cancer patients, who face extreme weight loss, according to cancer experts.

The American Cancer Society recommends eating with other family members to make meals more enjoyable, and has suggestions for caregivers like fixing six to eight small meals, making smoothies and preparing bland foods to keep nausea at bay. But Latney, single with no family and on a fixed income, had no one available to help her prepare food. Insured by both Medicaid and Medicare for her cancer treatment, Latney couldn’t even afford to buy the amount of food required to survive her treatment, much less cook it.

Latney’s lack of social and financial support put her at risk of dying from her cancer treatment. Radiation and chemotherapy can cause patients to lose their appetite or suffer from nausea, causing extreme weight loss that can be life-threatening.

Her clinic was able to connect her with a local nonprofit organization that delivers a complete supply of food — three meals and one snack per day, every week — to low-income people who are in danger of malnutrition during a serious illness.

Eight years later, Latney, now 59, is still receiving the free meals from MANNA, or the Metropolitan Area Neighborhood Nutrition Alliance in Philadelphia, and the cancer has spread from the lung to the liver. But she credits the organization for helping her survive as long as she has.

“To be perfectly honest with you, I would not be here” without those delivered meals, Latney said.

Published research into MANNA’s work showed the meals had an impact on patient quality of life — and also major reductions in hospital costs, catching the attention of politicians in California. With high rates of food insecurity, chronic illness and Medicaid enrollment, California was looking for a way to bring down the overall costs of Medi-Cal, the state’s Medicaid program, with efforts that have a proven return on investment.

The new pilot program, which officially launched Friday with help from state senator Ben Allen (D) and California assembly members Blanca Rubio (D) and Richard Bloom (D), funds six nonprofit organizations throughout California that will deliver free meals to those who are insured by Medicaid and need a specific diet to help them manage their medical condition.

Nutritious, plentiful food plays an outsized role in helping people recover from major illness or live with a chronic condition. In addition to cancer treatment, which requires patients to eat high-calorie meals, people with cardiovascular illnesses may benefit from low-sodium food, while those with type 2 diabetes can better manage their disease with meals that are low in sugar and refined carbohydrates.

Across the country, an estimated one in eight Americans ― 42 million in total ― are food insecure. Not only does this mean that they may be experiencing hunger, but that the kinds of food they do eat are not nutritious enough to sustain an active, healthy life. At the same time, rates of chronic disease caused by poor nutrition are rising, and the more food insecure you are, the more likely you are to have chronic diseases like hypertension, coronary heart disease, hepatitis, stroke, cancer, asthma, diabetes and arthritis.

Despite its importance, food during an illness can often be an afterthought. Crucially, it is not covered by any medical insurance plan. Instead, people like Latney have to rely on nonprofits or charity to help them fill the nutrition gap, and not all cities have organizations that can help.

Organizations like MANNA are sorely needed throughout the U.S. About one in 10 adults on Medicaid has diagnosed diabetes and more than one in four have some kind of cardiovascular disease. What patients eat can have a major impact on their health outcomes.

But there are only 27 member organizations in 18 states and Washington, D.C., in the national Food Is Medicine Coalition, an association of nonprofit organizations that provide medically tailored food to people with serious or long-term illnesses.

Around the time that Latney began receiving her meals, researchers were also collecting data on how MANNA clients’ medical costs compared to other low-income patients with similar medical conditions who did not receive free meals.

They found that recipients of these free meals had average monthly medical costs that were 55 percent lower than Medicaid patients who didn’t get delivered meals. Hospital admission and duration rates were also significantly lower than the control group. Most strikingly, people who received meals from MANNA and were later hospitalized were 23 percent more likely to be discharged back to their homes as opposed to a long-term care or rehabilitation facility when compared to the control group.

Since this small study was published in 2013, all four companies that administer Medicaid locally throughout southeastern Pennsylvania have signed contracts with MANNA to deliver specially tailored meals for select patients with diabetes and cancer in an effort to lower state hospitalization costs.

California, where more than a third of its population is covered by Medicaid and one in eight people aren’t sure where their next meal is coming from, took notice.

Its new 12-week Medi-Cal pilot program will deliver specially formulated meals, as well as in-home visits from a registered dietitian, to 1,000 people with congestive heart failure — a patient group that has one of the highest rates of hospital readmissions within 30 days.

This three-year program will cost $6 million in total, and the money is spread out across six nonprofits throughout California, including Project Angel Food in Los Angeles County.

Richard Ayoub, CEO of the organization, notes that the extremely limiting diet that congestive heart failure patients have to follow would be challenging for people of any income level, let alone people who sometimes have to choose between paying for health care and paying for food.

People with congestive heart failure can have only two grams of sodium — less than one teaspoon ― a day. Any more will encourage the body to retain water, which increases the volume of blood and forces an already weakened heart to work harder. Processed food would be a cheap, convenient choice for these patients, but these products are usually high in sodium.

If the Food Is Medicine pilot program succeeds in demonstrating significant cost savings for Medicaid, known in California as Medi-Cal, the ripple effects could be enormous.

“We believe food is medicine and that this food will keep people out of the hospital, thus saving Medi-Cal hundred of thousands, if not millions, of dollars,” said Ayoub.

If Medi-Cal makes food a health benefit as Ayoub hopes, the federal government could assess the return on investment and conclude that food should be a nationwide Medicaid benefit.

John Baackes,CEO of LA Care Health Plan, one of the public agencies that administers Medicaid insurance in Los Angeles county, praised California’s pilot project as the investment the movement needed to mount a national case for food as a component of health care. He sees the state’s pilot program as one small step in the direction of re-imagining medical care to include social services that affect health, from housing to food security.

“We’re very anxious to see a program like this lead to policy changes,” he said.

As researchers and policymakers wait for the data from California’s pilot project to start rolling in, Latney pointed out that no matter what the return is for the state, the effect these meals will have on people struggling to survive will be immeasurable.

“They want to have not only a meal, but a meal that’s designed for them to survive,” she said. “I think it’s going to have a very, very big impact.”

Read the original HuffPost article here.