Tailo ilored ed Me Meals ls Pilo ilot Progr gram Adrian Nunez - - PowerPoint PPT Presentation

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Tailo ilored ed Me Meals ls Pilo ilot Progr gram Adrian Nunez - - PowerPoint PPT Presentation

Nov 17, 2023 269 likes •449 views

Californias Me Medi di-Ca Cal l Me Medi dically lly Tailo ilored ed Me Meals ls Pilo ilot Progr gram Adrian Nunez Director, Health Care Initiatives Who We Wh e Are Project Open Hand is a nonprofit that provides nutritious

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California’s Me Medi di-Ca Cal l Me Medi dically lly Tailo ilored ed Me Meals ls Pilo ilot Progr gram

Adrian Nunez Director, Health Care Initiatives

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Project Open Hand is a nonprofit that provides nutritious meals to seniors and critically ill neighbors in San Francisco and Alameda County Founded, San Francisco, 1985, at a time when the city found itself at ground zero of a frightening and devastating epidemic called AIDS Retired food services worker named Ruth Brinker felt something needed to be done, and she began preparing meals with love from her kitchen and delivered them to seven neighbors with AIDS who were far too ill to cook for themselves

Wh Who We e Are

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Today’s Overview

  • How the Medi-Cal Medically Tailored Pilot

Program came to be

  • How we continue to stay present
  • Our future plans
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What We Know – The Issues

Image sources: FIMC Fact Sheet. www.fimcoalition.org

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What We Know – The Solutions

Image sources: FIMC Fact Sheet. www.fimcoalition.org

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Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Before 201 016

FIMC was forming and research on MTM was being conducted

June 2017 17

SB 97 budget bill was approved by the legislature and signed by Governor Jerry Brown

June 2016 16

California FIMC began to from National FIMC momentum

Octob tober er 2018 18

Today

April ril 201 018

The Medi-Cal Medically Tailored Meals Pilot Program started enrollment

March h 2018 18

CalFIMC Website Launches promoting Pilot Program

Octob tober er 2016 16

Senator McGuire embarked on a crusade to get funding secured in the budget for a statewide pilot program

April ril 201 017

Assemblymember David Chiu sponsored the budget ask in the state assembly subcommittee

History

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Med edi-Cal Cal Med edicall ically y Tailor ilored ed Mea eals ls Pi Pilot lot Pr Program gram

  • Three-year, $6 m

million llion pilo lot t to evaluate the impact of a medically tailored meal intervention on the health outcomes and health care costs of seriously ill Medi-Cal patients.

  • The study will be conducted in seve

ven n countie ties in California – Alameda, Los Angeles, Marin, San Diego, San Francisco, Santa Clara, and Sonoma – by six organ anization izations.

  • The Ca

Califor liforni nia a Depar artment tment of Health alth Ca Care e Services ces (DHCS) has

  • versight over the program.
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Pilot Program Agencies

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The Program

The Medi-Cal MTM Pilot Program is a medical nutrition intervention for high utilizing Medi-Cal beneficiaries with a diagnosis of congestive heart failure (CHF). The intervention is 12 weeks in duration.

  • Who: Discharged from a hospital, SNF, or ED, Medi-Cal patients who were

admitted due to CHF and have a history of being a high utilizer of health care services and/or likely at risk for readmission within 30 days.

  • Inter

terven ention tion Goal: l: Reduce hospital and emergency department 30-day and 90-day readmissions.

  • Cost: No cost to patient. Must be on Medi-Cal.
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The Intervention

Medical ally Tail ilored d Meals s (MTM)

  • 12 weeks of complete nutrition, home delivery

Medical al Nutrit ition ion Therapy py (MNT)

  • Four Medical Nutrition Therapy sessions, 2 in-person

Informa rmation ion & Referral ral Services ces

  • Integration of other social determinants of health
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Medically Tailored Meals

  • Medicall

ically y Tail ilored ed Meals ls are meals that designated by Registered Dietitians as an appropriate part of a treatment plan for an individual with a defined health condition or combination of health conditions. For this program, agency dietitians design meals for by for persons with Congestive Heart Failure guided by the following evidence-based guidelines of the Academy of Nutrition and Dietetics.

  • Nutrit

itio ion conte tent nt shall adhere to the heart healthy guidelines of the Therapeutic Lifestyle Change (TLC) Diet and with the Evidence-based Nutrition Practice Guidelines from the Academy of Nutrition and Dietetics Evidence Analysis Library.

  • The Dietar

tary Appr proache ches to to Sto top p Hyper ertens tensio ion (DASH) H) Diet meal l pattern ern shall be used to ensure nutrition completeness of the overall meal plan, unless medical needs require otherwise.

  • Registered dietitians also coll

llaborat

  • rate

e with kitchen en staff or subcontracted meal preparers to ensure meals adhere to nutrition guidelines and all other meal guidelines noted in this section.

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Medical Nutrition Therapy (MNT)

  • Each client receives clear,

, detaile iled d evidenc ence-based sed plan n of care to ensure achievement of guideline determined medical therapy goals, effective management of co-morbid conditions, follow-up with healthcare team as appropriate.

  • The MNT process is upda

dated d with each of the three (3) subsequent visits after the first.

  • MNT follows the Nutritio

trition n Care e Proces cess s for Medica ical l Nutr tritio ition Therapy rapy and incorporate the program-prepared nutrition education topic and materials. The process utilizes the Academy

  • f Nutrition & Dietetics Heart Failure Toolkit and adopt evidence-based practices into their

MNT as needed.

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Information & Referral Services

  • Make a good faith effort to contact clients that are not

t respon

  • nsiv

sive to to request sts s for MNT sessions and/or missing agreed upon meal deliveries to prevent disenrollment due to missed meals.

  • Through the delivery process, ident

ntif ify and d report t conc ncerns rns to appropriate staff for follow- up, which may include change of address, change of condition, self-neglect, and abuse.

  • Through RD, make a good faith effort to cont

ntact ct medical ical provider ider(s) s) when a high risk for readmission is identified, and if appropriate.

  • Provide information and referral services to clients experie

ienc ncing ing challenge llenges s preve vent nting ing

  • ngo

going ing partic ticipatio tion in the intervention.

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Payment Model

  • Currently fee for service / units of service

– Loaded rate – MTM / MNT / Case Management

  • Considering collecting data to evaluate alternative

payment models

– CPT Codes and rates for MNT and/or MTM

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The Value of a Coalition

  • Shared values and aligned

medically tailored meals interventions

  • Cohort in counties that have the

majority of Californians

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Looking Forward

  • Collective discussions with health plans
  • Standardization of intervention through

accreditation

  • Integration of social determinants of health

services through Archstone Foundation grant

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Website & Twitter

https://www.openhand.org/ @ProjectOpenHand follow us! https://calfimc.org/medical-pilot/ @CalFIMC follow us!