Statement in Support of In Lieu Medicaid Services for Nutrition Programs

Food is a healer, and it builds resilience. Both of these qualities are absent in populations who live with food insecurity and the malnutrition that comes from consumption of unhealthy food products. The proposal by the Michigan Department of Health and Human Services to fund evidence-based nutrition programs deserves to be implemented for the best interests of patients we serve in our primary care practices, as well as the broader population in urban Detroit who are afflicted with chronic diseases like hypertension and diabetes, which are related to poor and inadequate diets.

Authority Health offers primary care services at four sites, serving a predominantly Medicaid population. Our patients range in age from infancy through old age. Food insecurity is documented among a large number of these patients.

We applaud the progressive program enhancement represented in this offering and look forward to its implementation. Without question, the proposed “in lieu of services to cover nutrition services” will result in improved health and reduce the future need for medical services beyond primary care. As noted below, we recommend clinical guidance with food products so as to maximize their utility and sustainable dietary practices.

Specific programmatic comments:

• Produce Prescription: Authority Health was an early proponent of the food prescription concept (Fresh Rx) and became a provider at our Popoff Family Health Center, serving a low-income population on Detroit’s Eastside. This initiative has positively improved the health behavior of our chronically ill patients. Unfortunately, funding for that program is reliant on philanthropic support, which is insufficient for long-term nutritional intervention.
• Medically tailored home delivered meals would enhance the Fresh Rx program, especially during the cold weather months when fresh Michigan produce is not available to our patients.  Our current Albert Schweitzer Fellow provides fresh food supplies and nutritional counseling for young mothers. This concept would be enhanced with medically tailored home delivered meals. The Fresh Rx and maternal health programs could be sustained through Medicaid in lieu of service funding.
• Healthy Food Pack: Similarly, the healthy food pack would apply to maternal health, families of young children, Fresh Rx, and older adult patient populations who are food insecure or malnourished. It should be noted that provision of fresh food without instruction and guidance may lead to discarding unfamiliar products or inability to prepare them without adequate education/information.
• Healthy Grab and Go Products for SNAP recipients: Authority Health is administering a three-year, neighborhood-based nutrition education and promotion program aimed at augmenting grab and go behavior in convenience stores. By extending this program to fast food consumers we would reach a segment of the population that might not be addressed through other means.

Loretta V. Bush, MHSA

President and CEO

Authority Health

313-871-3751

lbush@authorityhealth.org