September 23, 2023

BY RYA JETHA | CalMatters

Each different Friday, the Stockton Emergency Meals Financial institution hosts two stay cooking lessons — one in English and one in Spanish. Final week, Brenda Munoz made a traditional tuna soften with an orange, romaine and dandelion salad.

“Dandelion is totally edible,” stated Munoz, holding the small leaves from the flower. “They’re actually excessive in vitamin A and folate.”

However this isn’t your typical cooking lesson on Zoom and Fb. It’s a part of a “meals prescription” experiment — prescriptions for wholesome meals as a substitute of tablets. Diabetics get a free field filled with fruits, greens, hen breast, quinoa and different nutritious meals delivered to their houses each two weeks — after which can be taught some recipes.

Advocates who need to increase this system throughout California say it may very effectively be a means to enhance continual situations, decrease well being care prices and scale back starvation, all on the similar time.   

It’s geared toward individuals like Shane Bailey, a 72-year-old who served within the Coast Guard who has three coronary heart situations, diabetes, kidney illness, hypertension and ldl cholesterol. A participant within the Stockton meals financial institution’s Wholesome Meals RX Program, she says her way of life has dramatically improved since she started receiving produce prescriptions final yr.

“My major physician is impressed with my ldl cholesterol as a result of they are saying it’s higher than theirs!” stated Bailey, who has began meal prepping utilizing cookbooks from second-hand shops, studying meals labels carefully, and experimenting with totally different sorts of squash and greens.

“My dream is to stay to 95,” she stated. “If we begin youthful, then perhaps individuals gained’t get sick till they’re of their 80s and 90s.”

Diet educator Brenda Munoz prepares a recipe for a traditional tuna soften sandwich after ending a stay cooking session for Wholesome RX program members on the Stockton Emergency Meals Financial institution in Stockton on July 28, 2023. Photograph by Rahul Lal for CalMatters

Meals prescriptions are a part of the “meals is drugs” motion that views nutritious meals as a method to stop, handle, and reverse continual illness. Such packages have been discovered to decrease weight problems, blood strain, and common blood sugar. One examine estimates that incentivizing wholesome consuming may save $100 billion in nationwide healthcare prices over the projected lifetimes of present Medicare and Medicaid sufferers.

Throughout California, a patchwork of meals prescription packages are being examined utilizing a wide range of methods, whereas an bold initiative to reform Medi-Cal and a invoice that failed within the Legislature this session would standardize the trouble.

A California experiment

Initially of 2022, California launched a five-year effort to reform Medi-Cal, referred to as CalAIM, to deal with the foundation causes of ailments primarily based on “entire individual care,” which considers organic, behavioral, social, and environmental elements.

CalAIM encourages Medi-Cal managed well being plans to experiment, permitting them to choose in to offer 14 elective group help providers, akin to housing navigation, assisted dwelling and sobering facilities.

The purpose: Enhance the well being of Medi-Cal sufferers with lower-cost remedies. By the top of 2022, all 58 California counties provided not less than two group providers, whereas 16 counties provided not less than 10 and three counties — Sacramento, Riverside, and San Diego — provided all 14.

Medically supportive meals packages, which embody medically-tailored meals and meals prescriptions, are the third hottest service. In 2022, 6,400 Medi-Cal members used meals packages, the overwhelming majority the extra established medically-tailored meals program.

Katie Ettman, a meals in healthcare professional on the San Francisco nonprofit analysis institute SPUR, stated there’s huge potential for meals packages, contemplating that California has the biggest Medicaid program within the nation with about 15 million individuals enrolled.

However the problem is getting counties and well being plans to start out them.

“The overwhelming majority of them don’t even understand how produce prescriptions work,” stated Brent Ling, director of exterior affairs on the nonprofit Healthful Wave. “So it’s a number of training and knowledge sharing.”

Ingredients for a live cooking session for Healthy Food RX program members at the Stockton Emergency Food Bank in Stockton on July 28, 2023. Photo by Rahul Lal for CalMatters
Elements for a stay cooking session for Wholesome Meals RX program members on the Stockton Emergency Meals Financial institution in Stockton on July 28, 2023. Photograph by Rahul Lal for CalMatters

There are additionally a wide range of meals prescription packages being funded exterior CalAIM. The Stockton program is being financed by the philanthropic Abbott Fund, Kaiser Permanente is funding a take a look at in Los Angeles County, and packages in San Diego County and San Francisco are being funded by their native governments.

The federal Farm Invoice is funding 14 meals prescription checks in California. One is Recipe4Health in Alameda County. What began as a meals pharmacy program in 2019 has developed into California’s most profitable medically supportive meals program that’s built-in into the county’s healthcare system.

This system has 11 websites throughout Alameda County and serves virtually 4,000 individuals in response to Steven Chen, its chief medical officer.

Chen believes the testing throughout California is a vital stage to make the providers a everlasting profit beneath Medi-Cal: “Any innovation begins with fragmentation, as a result of it’s a 1,000 flowers bloom strategy… You need to create sufficient openness as a result of in any other case, it’s only a high down strategy, which by no means works.”

Alameda County screens for meals insecurity and provides individuals who won’t have continual situations prescriptions and well being teaching to forestall ailments like diabetes creating sooner or later.

“There’s so many advantages,” Chen stated. “We’re getting human well being, financial well being, local weather, well being, and fairness all collectively by actually asking the query, “The place does the meals come from?”

A lined profit?

This session, Meeting Invoice 1644 was launched that will have required Medi-Cal to cowl medically supportive meals and vitamin for not less than 12 weeks for eligible Californians.

“I bear in mind opening the fridge and seeing solely celery and peanut butter and my mom telling me we had been on a ‘particular eating regimen’. I didn’t notice on the time we had been meals insecure,” stated Assemblymember Mia Bonta, an Oakland Democrat who proposed this invoice. “Too many Californians, significantly Californians of shade, live with largely preventable continual situations.”

Whereas Bonta highlighted how this invoice would assist the state lower your expenses in the long term, its estimated price was within the tens of tens of millions of {dollars}. With the $30 billion-plus state price range deficit, the invoice was held within the Meeting appropriations committee.

Bonta’s workplace and invoice co-sponsor at SPUR stated that they plan to reintroduce the invoice subsequent yr.

Nationwide momentum for meals prescriptions is rising. Final yr, the White Home launched a nationwide technique on starvation, vitamin and well being that prioritizes “meals is drugs” interventions together with meals prescriptions.

Mixed with grassroots efforts throughout California, the invoice will achieve momentum, Ettman stated.

One profitable native program is in Solano County, the place Wealthy Oliver drives a colourful field truck painted with crates of fruits and veggies to clinic parking tons throughout the week.

“We’re purposely exterior of clinics as a result of we would like sufferers within the clinic to have entry to this,” says Oliver, who’s the coordinator of the county’s “cell meals pharmacy.”

Volunteers pass out food at the Solano County Mobile Food Pharmacy in Fairfield on Aug 1, 2023. Photo by Semantha Norris, CalMatters
Volunteers move out meals on the Solano County Cell Meals Pharmacy in Fairfield on Aug 1, 2023. Photograph by Semantha Norris, CalMatters