Harvard Health Law Lab Unveils Triumphs and Hurdles in California Medicaid’s Innovative Program Addressing Health-Related Social Needs

New case studies illuminate benefits and challenges of the CalAIM Community Supports program and encourage adoption of similar policies nationwide.

The Health Law Lab at the Center for Health Law and Policy Innovation (CHLPI) of Harvard Law School, in partnership with California’s Medically Supportive Food & Nutrition Steering Committee, released the final case studies in a series of five focused on California’s efforts to expand access to and coverage of nutrition interventions and other services for people enrolled in Medicaid. The series supports efforts to incorporate nutrition interventions and other social needs into Medicaid and reports operational and logistical hurdles. 

The leading risk factor for death in the US is poor diet, numerous negative health outcomes are associated with food and nutrition insecurity, and people from systemically underserved communities are disproportionately affected by these burdens. Yet, the healthcare system is generally not able to respond effectively.  

Medically Supportive Food and Nutrition (MSF&N) interventions, such as medically tailored meals, medically tailored groceries, produce prescriptions, and food pharmacies, offer promising solutions to these challenges. Research shows that these interventions save money, improve health outcomes, reduce food insecurity, and address health disparities. Despite these benefits, the availability of sustainable funding poses a significant obstacle to widespread adoption of these services.  

In response, in January 2022, California launched its five-year Medicaid waiver, called California Advancing and Innovating Medi-Cal (CalAIM), to create access for MSF&N and other health-related social services. California calls these services Community Supports. The program provides nutrition services to Medicaid enrollees with diet-related conditions and other risk factors through partnerships between California’s managed care health plans and community-based organizations (CBOs). 

The case studies released today, part of a series titled Building Partnerships to Advance Nutrition in California’s CalAIM Waiver, focus on two partnerships:  

1. Between Vouchers 4 Veggies, a nonprofit program that increases access to and affordability of healthy foods for low-income individuals and families, Health Net, a health plan serving Medicaid enrollees in 31 counties, and El Concilio, a CBO primarily serving high-risk individuals and families from Hispanic communities in the Central Valley (see case study here); and  

2. Between the Ceres Community Project, a CBO that provides medically tailored meals and groceries to people with serious illnesses, and  Partnership HealthPlan of California, which serves Medicaid enrollees in 14 counties (see case study here). 

“The case studies released today, as well as the others in our series, demonstrate that providing coverage through Medicaid for health-related social services, which are typically not covered, is possible nationwide,” said Erika Hanson, Clinical Instructor for the CHLPI and its Health Law Lab. “We encourage health system leaders in California to draw on the lessons learned from the five partnerships we’ve highlighted and adopt best practices in their own community-focused partnerships. We also hope that leaders in states across the country will implement similar programs, providing sustainable funding for nutrition services and improving health equity and outcomes.” 

“To make the most of the next three and a half years of California’s five-year Medi-Cal waiver, we must look to those who have championed providing Community Supports to learn how more organizations can do the same. In particular, providing the full spectrum of Medically Supportive Food and Nutrition interventions will enable California Medicaid patients with a variety of needs to access food-based services and see their health conditions improve,” said Paloma Sisneros-Lobato, Food and  Agriculture Policy Manager at SPUR, co-convenor of the Medically Supportive Food & Nutrition Steering Committee.   

The other case studies in the series highlight the following partnerships:  

• Alameda County Recipe4Health and Alameda Alliance for Health 
• Project Open Hand and Contra Costa Health Services 
• Project Angel Food and L.A. Care Health Plan 

The case study series is made possible through the support of the Kaiser Permanente National Community Benefit Fund at the East Bay Community Foundation.