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Recent Events

MFSN Quarterly Network Meeting May 1, 2024

On May 1, we held our quarterly meeting of the MFSN with over 100 food and health stakeholders present. Attendees heard about new initiatives and resources from the Network, a spotlight on integrated SNAP, WIC and Medicaid infrastructure, as well as participated in breakout rooms. Sign up for this newsletter to receive an invitation for our next convening in August 2024.

View the meeting recording and slides on our website.

Updates from the Medicaid Food Security Network

Dear MFSN Members,

The Medicaid Food Security Network (MFSN) Co-Design Team has stayed busy over the past two months, from finalizing new MFSN resources to a flurry of activity in the field. Share Our Strength attended the Kaiser Permanente Health Action Summit, featuring the launch of the new Food is Medicine Center of Excellence, aiming to further integrate food and nutrition interventions into Kaiser Permanente’s care model. Representatives from Share Our Strength spoke at the RISE Summit on Social Determinants of Health, highlighting strategies for ways to improve access to care and food security in rural communities. Rishi Manchanda, CEO of HealthBegins, moderated a panel on “Food is Medicine Advances in Healthcare” at the recent Tufts Food is Medicine Summit. And Julian Xie of Benefits Data Trust published a blog piece on the broad-reaching impacts of SNAP “Double Up Bucks” programs. We are thrilled to participate in the growing momentum in addressing the food needs of children and families through Medicaid.

Signed, Co-Designers

Share Our Strength, Benefits Data Trust, HealthBegins

Highlights and New Resources

Feature Story

Addressing the Food Needs of Children and Families through Medicaid-Based Strategies

By the MFSN Co-Designers

Across a series of meetings between December 2023 and February 2024, the Medicaid Food Security Network (MFSN) Co-Designers and Steering Committee created the “Promising Medicaid-Based Strategies to Address the Food Needs of Children and Families” resource. This resource offers a menu of strategies for addressing the food needs of children and families through Medicaid.

This article introduces each of these strategic opportunities, why the MFSN has chosen to highlight them, and brings them to life through specific state-based examples. For the full “Promising Medicaid-Based Strategies to Address the Food Needs of Children and Families” resource, visit the MFSN website. Find more information on the examples highlighted in this article along with many more across other states in the newly-launched Medicaid Food Security Policy Dashboard.

Policy and Program Opportunities

The Managed Care Organization (MCO) Procurement Process

Medicaid agencies may include specific questions in their managed care Request for Proposal (RFP) to assess MCO readiness to effectively implement food-related strategies, including SNAP and WIC enrollment.

In Michigan’s 2023 Medicaid Managed Care Request for Procurement, bidders were required to address questions regarding the managed care organization’s approach to addressing enrollees’ health related social needs (HRSNs) and promoting health equity such as using a data-informed approach to proactively identify enrollees who may have HRSNs and would benefit from social services and describing their proposed approach to working with and supporting CBOs through sustainable financing arrangements to provide social services, such as through partnerships related to community reinvestment.

Food Insecurity Screening and Referral

Food insecurity screening and referral is an essential first step for identifying food insecurity and connecting Medicaid enrollees to food resources.

In Massachusetts, primary care-based social needs screening is promoted and supported through value-based payment subcapitation models. Higher tier practices, which are practices meeting quality criteria to receive increased funds, must meet staffing requirements for roles designed to provide these types of support.

Assistance and Navigation

Medicaid programs could use their pre-existing or new care coordination and community navigation workforce to support connection to food benefits and resources for children and families. This workforce may include Community Health Workers, Promotoras, Community Health Representatives and Patient Navigators who have deep community connections and expertise.

In South Dakota, community navigator agencies are permitted to enroll clients in Medicaid and be reimbursed for services, including navigation and resource coordination for community resources and programs addressing Social Drivers of Health (SDoH). In addition, these agencies may bill some SDoH diagnosis codes as primary or secondary diagnosis codes.

Data, Evaluation and Continuous Improvement

Addressing food security in healthcare requires new data infrastructure to support care coordination and quality improvement strategies to ensure that these programs have the intended impact on health and health equity.

As part of Washington, D.C.’s Quality Improvement strategy, MCOs must identify disparities in health services and health outcomes between subpopulations or groups, identify social determinants of health, and identify the cause of disparities. MCOs must then develop a plan of action and a timeline to remediate the social determinants of health and health disparities and include this plan and timeline in the required reporting to the state.

Investments and Benefits

States can invest in food benefits/resources to supplement and complement SNAP and WIC to meet the health needs of children and families and to further strengthen the local food systems. Avenues include strategies such as 1115 waivers and In Lieu of Services, requiring MCOs to reinvest a portion of their profits, encouraging value added services.

In January 2024, the Centers for Medicare and Medicaid Services (CMS) approved the “New York Health Equity Reform (NYHER)” amendment and extension to New York’s “Medicaid Redesign Team” 1115 demonstration waiver. Through the waiver, HRSN services will be provided to those who “medically need” the service and who are children under the age of six (no chronic condition required), children under the age of 18 with one or more chronic conditions, and pregnant individuals up to 12 months postpartum, among others. Allowable nutrition services include nutrition counseling, home delivered meals (up to 3 meals per day), medically tailored or nutritionally appropriate food prescriptions, fresh produce, and nonperishable groceries. Allowable supports also include cooking supplies necessary for meal preparation such as pots, pans, utensils, microwaves, and refrigerators.

Integrated SNAP, WIC and Medicaid Infrastructure

While many of the strategies above would actively assist individual Medicaid Enrollees in navigating complex systems, state governments can simultaneously work to streamline their benefit systems so that any Medicaid enrollee attempting to access these benefits would have a smooth client experience in applying for and utilizing them – especially in light of the overlapping eligibility requirements between Medicaid and SNAP, and the automatic conferred eligibility from Medicaid to WIC.

In New Hampshire, the SNAP, WIC, and Medicaid programs have a Memorandum of Agreement for data sharing and expedited enrollment. Families receiving SNAP and/or Medicaid are automatically eligible for the WIC program. The WIC agency receives contact information for WIC-eligible households on SNAP and Medicaid; this information is available on a dashboard for local WIC staff and if the household is not already enrolled, WIC staff will initiate an enrollment appointment.

Tools and Resources to Learn More

Visit the MFSN website for resources to support implementation of these promising strategies, including the recently launched Medicaid Food Security Policy Dashboard and Medicaid and Food Security 101 learning series. You can also find the full “Promising Medicaid-Based Strategies to Address the Food Needs of Children and Families” resource on the MFSN website, which provides a deeper dive into each of the strategies outlined in this article.

Other New Resources from the MFSN

Promising Medicaid-Based Strategies to Address the Food Needs of Children and Families

The Promising Strategies document provides an overview of promising strategies that food security advocates can use to collaborate with Medicaid agencies to incorporate food strategies in Medicaid Managed Care (MCO) contracts, benefit design and waivers. These strategies are designed to address the full range of food needs of Medicaid enrollees, especially children and families. The document outlines the business case for Medicaid to address food insecurity and identifies specific tactical strategies/opportunities including: 1. Medicaid Managed Care Organization (MCO) Procurement Process; 2. Food Insecurity Screening and Referral; 3. Assistance and Navigation; 4. Data, Evaluation and Continuous Improvement; 5. Food Security Investments and Benefits; and 6. Integrated SNAP, WIC and Medicaid Infrastructure. Review the full resource here.

Medicaid and Food Security 101 Learning Series

The Medicaid and Food Security 101 learning series is designed to equip viewers with foundational knowledge of Medicaid, with a focus on the role that Medicaid can play in addressing food insecurity among children and families. This series is best for those who are newer to Medicaid or those wishing to learn more about how Medicaid can be leveraged to address food security and social needs. View the series here.

Medicaid Food Security Policy Dashboard

The MFSN Co-Design team reviewed 1115 waivers, Medicaid managed care contracts, and other policy documents from across the country to develop a compendium of examples of how Medicaid is addressing food insecurity among children and families. The result of this effort is the Medicaid Food Security Policy Dashboard, which allows users to search by location and/or type of strategy, review sample language, and connect to source materials for deeper dives. As the focus of this tool is children and families, we excluded programs that would not serve most children and their caregivers (such as programs with very high clinical acuity criteria or programs focused on people needing long term services and supports). In our descriptions of each policy, we included the details necessary to show how the policy would impact this specific population. While this tool is not an exhaustive list of programs and policies that address food insecurity through Medicaid, it does offer a robust collection of strategies for organizations interested in exploring options for addressing food security among children and families through various Medicaid-based channels. View the Dashboard here.

Upcoming Webinars and Opportunities

SDOH Benchmarking: An Inside Look

May 7, 2024

The ACAP Center for SDOH Innovation, in conjunction with partners from Spring Street Exchange (SSX), is proud to present the results of its 2023 SDOH Benchmark Assessment, the nation’s most comprehensive assessment of health plan SDOH activity and progress. This Webinar is free and open to all health industry stakeholders. Register here.

Children’s HealthWatch 2024 Equity Series Kickoff

Food is Medicine: Equity Considerations of this Healthcare Approach to Food Insecurity Thursday, May 9, 2024

This webinar will gather a roundtable of experts to discuss the advantages of Food is Medicine as a preventative health measure and explore alternative and complementary approaches to improve population health and health equity at the policy and systems level. Moderated by Rich Sheward, Director of System Implementation Strategies at Children’s HealthWatch, the webinar will feature a lively discussion with distinguished guest speakers:

Diana Cutts, MD, Co-Lead Principal Investigator and Minneapolis Site Principal Investigator at Children’s HealthWatch, Associate Professor of Pediatrics at University of Minnesota Medical School, and Chief of Pediatrics at Hennepin County Medical Center;
Seth A. Berkowitz, MD, MPH, author, general internist, primary care doctor, health researcher and Associate Professor of Medicine, University of North Carolina at Chapel Hill;
Kofi Essel, MD, MPH, FAAP, Food as Medicine Program Director at Elevance Health.

Apply for the Food is Medicine Coalition’s Accelerator Program by May 10th!

The Food is Medicine Coalition’s (FIMC) Accelerator is an initiative co-led by FIMC, Community Servings, God’s Love We Deliver, the Nonprofit Finance Fund, and the Center for Health Law and Policy Innovation at Harvard Law School.

The goal of the Accelerator Program is to refine, replicate, and broadly scale the medically tailored meal (MTM) intervention to ensure that people living with severe, complex, and chronic illnesses have access to MTM, regardless of where they live or their ability to pay. Nonprofits apply to undergo a 12-month curriculum training program that teaches how to prepare and deliver the high-quality MTM intervention for their communities. Enrolled cohorts participate in a year of online, in-person, and web-based training on operational processes for starting their own MTM program, which includes instruction on everything from kitchen expansion to financial coaching, distribution, and compliance. Cohorts also receive policy assistance to explore state and regional contracting opportunities, as well as guidance for funding opportunities, particularly for vulnerable populations.

In its fifth year, the Accelerator has produced 13 new MTM providers with 4 more in the current cohort. Join this vibrant community of practice by applying now.

Project UP – Unlocking the Potential of WIC and Medicaid to Improve Nutrition and Health

May 13, 2024 2-3pm ET

The Center on Budget and Policy Priorities is hosting a webinar exploring opportunities for state Medicaid and WIC agencies to collaborate to increase WIC participation and improve the health of young children and parents. While Medicaid has historically reached most eligible children and parents, WIC reaches less than half of eligible pregnant people and young children and only 37 percent of WIC-eligible Medicaid enrollees. This webinar will delve into the transformative potential of cross-agency partnerships to address food insecurity and promote healthier communities. Hosted by the Center on Budget and Policy Priorities and Georgetown Center for Children and Families, the panel of experts will discuss effective strategies, best practices, and potential policy implications of fostering collaboration between Medicaid and WIC agencies. Register here.

Webinar Series: Building Pediatrician and Hospital System Capacity to Promote Food Security

May 15, 2024

Please join the American Academy of Pediatrics, Share Our Strength-No Kid Hungry, Children’s Hospital Association, and Food Research & Action Center for the second webinar, Addressing Food Security and Other Social Needs: Tips for Using Human-Centered Design and Clinical Interventions to Help Families, in the five-part food security webinar series, Building Pediatrician and Hospital System Capacity to Promote Food Security. In this webinar you will hear from Leisha Andersen, MD, MPH, FAAP, Kimberly Montez, MD, MPH, FAAP and Shaina Rogers, DO, as they explore why human-centered design is important for creating clinical interventions that support family food security. To register for the webinar series, please click here. For more information on the series, please visit Building Pediatrician Capacity to Address Food Insecurity (aap.org).

Policy Updates

In Lieu of Services Regulations Released

CMS released their Medicaid Managed Care Final Rule on April 22, 2024, which reaffirms the ability of plans to use ILOS to address unmet health-related social needs as well as specifies the scope of ILOS, including reporting and documentation requirements. The rule also imposes a 5 percent limit on ILOS costs as a percentage of the capitation rate for each program. Read the Final Rule here.

California Assembly Bill 1975 Passes Out of Assembly Health Committee

Assembly Bill 1975– Medically Supportive Food and Nutrition introduced by California Assembly member Bonta passed out of the Assembly Health Committee with strong bipartisan support. This puts California one step closer to transitioning food-based interventions in healthcare from pilot to permanent benefits for Medi-Cal recipients. The bill, co-sponsored by SPUR and the San Francisco Food As Medicine Collaborative is supported by more than 150 organizations from across the state. For more information visit the coalition’s website or email kettman@spur.org.

District of Columbia 1115 Waiver Renewal

The Washington, D.C. Department of Health Care Finance intends to submit a 5-year renewal request to CMS for its 1115 Demonstration Waiver. The three goals for the renewal are: 1. Continue to maximize access to quality behavioral health services; 2. Improve health outcomes during transitions to reduce health disparities and drive sustainable transformation through justice-involved reentry and health-related social need (HRSN) services; and 3. Develop and maintain infrastructure to support the delivery of reentry and HRSN services. Learn more.

Colorado House Passes Bill to Pursue 1115 Waiver

On March 5, 2024, the Colorado House Health and Human Services Committee passed HB24-1322, directing the Department of Health Care Policy and Financing to conduct a feasibility study and pursue an 1115 waiver for housing and nutrition supports. Read more.

Minnesota Coalition Urges Senate to Support Bill to Apply for 1115 Waiver

On April 4, 2024, thirty-five Minnesota organizations signed onto a letter urging the Minnesota Senate Committee on Health and Human Services to support HF3639/SF3969, a bill that would direct Minnesota to apply for an 1115 waiver that includes funding for health-related social needs. Read the letter here.

News Digest: May 2, 2024