The Johns Hopkins Center for a Livable Future (fiscal sponsor: Farm to Table, Inc.)

Food systems planning is a collaborative process among farmers, retailers, consumers, nonprofits, health systems, and government to develop priorities and implement practices that shape how regional food systems operate.

It can result in improvements like changes in food procurement at public institutions, revisions to urban gardening codes, and better access to local food, which in turn have a positive impact on food security and health. NYHealth is supporting eight food planning groups in New York State that are developing tailored regional food systems plans. The funding enables these alliances to put plans into action by hiring dedicated staff, speeding up coalition building, seeking community and resident input, and communicating to stakeholders about the positive impact of food planning on local food systems. In 2023, NYHealth awarded The Johns Hopkins Center for a Livable Future a grant to provide capacity building and technical assistance to the eight food planning groups.

Under this grant, Johns Hopkins will accelerate the development of local food system plans, support the regional planning groups to secure funding for sustainability, and position the cohort as a collective voice to influence statewide policy change. It will provide individual and group technical assistance to the eight regional food planning groups to ensure planning and strategies are action-oriented. Johns Hopkins will match each food planning group to a peer food policy council and facilitate discussions, site visits, and sharing of best practices. It will also support the cohort in developing a shared policy agenda to advocate for State and federal policy changes and make recommendations for a statewide food plan.

 

Healthcare Association of New York State, Inc. Healthcare Educational and Research Fund

Our health systems are not prepared for the complex health needs of patients ages 60 and older, who will make up 25% of New York State’s total population by 2040.

Older adults encounter barriers to care and experience avoidable harm from overmedication, preventable falls, and treatable cognitive concerns. The Age-Friendly model provides a standardized approach for providing high-quality care to older adults centered on the “4Ms”: What Matters, Medication, Mentation (i.e., care for delirium), and Mobility. When implemented together, the 4Ms result in significant improvements in patient experience and quality outcomes. In 2019, New York State set an ambitious goal to designate 50% of its health care sites as Age-Friendly. Recently, the Governor issued an executive order that mandates the establishment of a New York State Master Plan on Aging where the Age-Friendly Health Systems model is recognized as a cornerstone of the effort. In 2020, NYHealth awarded the Healthcare Association of New York State (HANYS) a grant to support the launch of the initial phase of a New York State Age-Friendly action community. In 2021, NYHealth awarded HANYS a second grant to build upon and continue this initiative. New York State is now more than halfway toward reaching its goal of achieving Age-Friendly recognition among 50% of health systems; however, under-resourced hospitals in upstate and rural regions have faced barriers to participation. In 2023, NYHealth awarded HANYS a third grant to continue scaling and operating the Age-Friendly Health Systems action community while laying the groundwork for statewide scaling and sustainability.

Under this grant, HANYS will work with at least 50 new and returning hospital systems, federally qualified health centers, and skilled nursing facilities across the State to achieve Age-Friendly recognition. HANYS will provide individualized technical assistance, group coaching sessions, and tools to put the 4Ms into practice. Sites will test out changes like prescription modifications, care coordination, and end-of-life conversations; use data to monitor outcomes; and submit required documentation to achieve recognition. HANYS will also facilitate partnerships among health care sites, area agencies on aging, and community-based organizations and establish a well-built referral network, including social services options, for older adults. Partners will craft joint strategic plans to improve care transitions and workflows. Finally, HANYS will work with sites to make the business case for sustained investment in the 4M framework. It will disseminate findings among health system leaders and policymakers to advocate for widespread adoption of Age-Friendly care across the State, including as part of forthcoming initiatives like the State’s Master Plan on Aging, Medicaid waiver, and value-based payment models.

The Food Pantries for the Capital District

People with uncertain access to food have lower diet quality, higher rates of diet-related disease, and higher health care costs.

Medically supportive food and nutrition services, known as Food Is Medicine (FIM) services, can reduce the severity of these problems, improve health outcomes, and reduce food insecurity. FIM services include a spectrum of interventions that provide tailored food assistance to people living with certain chronic illnesses or risk factors and that serve as a link to the health care system, typically through a referral or prescription. In New York State, existing FIM programs are limited in reach, scale, and range of services covered. However, there is growing interest from a variety of stakeholders to expand and study FIM interventions. Many commercial health plans have designed and launched their own FIM coverage models; New York State Medicaid is also taking steps. Under a pilot program, New York Medicaid has allowed health plans to pay for non-medical services like meals when medically appropriate and cost-effective. In September 2022, the State submitted a proposal to the federal government for a multibillion-dollar Medicaid demonstration waiver that would allow Medicaid to pay for social service coordination, including FIM. The Food Pantries for the Capital District (Food Pantries) FIM coalition played a lead role in advocating for the integration of FIM services into the waiver and for Medicaid to cover registered dietitian services. Groups across New York State are preparing to make the most of broader Medicaid coverage for FIM services; however, many of these organizations need better understanding of FIM best practices for launching, operating, collecting data, and demonstrating return on investment. In 2023, NYHealth awarded Food Pantries a grant to support organizations in designing and researching medically tailored grocery programs that can be scaled and reimbursed across New York State.

Under this grant, Food Pantries will launch an accelerator program to help organizations learn the operational, policy, and contracting mechanisms needed to run and scale up medically tailored grocery programs. It will recruit community-based organizations operating feeding programs across a range of populations. Food Pantries will provide organizations with technical assistance to standardize practices for implementing medically tailored grocery programs. It will train participating organizations on technology, referral systems, and security measures. Participating organizations will track the outcomes of their FIM grocery programs, including foods distributed by type, volume, and source. Health care partners will share data to help determine the effectiveness of the program models, and Food Pantries will analyze the data. Food Pantries will disseminate findings among the New York State FIM coalition, New York State government agencies, and social and health care partners.

Natural Resources Defense Council

Through agencies and institutions, New York State municipalities annually purchase and serve hundreds of millions of meals to individuals with incomes below the federal poverty level and at a higher risk of food insecurity.

 

Given their massive scale, public institutions can leverage their purchasing power to procure foods of higher nutritional value. The Good Food Purchasing Program (GFPP) builds upon the purchasing power of institutions to improve food quality, lower costs, and support local agriculture. Adopting GFPP can encourage better food purchasing practices that align with nutrition, local economies, environmental sustainability, valued workforce, and animal welfare. GFPP also creates opportunities for small farms and suppliers who traditionally have had less capacity to compete for institutional contracts. Cities like New York City and Buffalo are already implementing GFPP. Yet, broader statewide adoption is currently limited by State procurement policy, which requires municipalities to select the lowest-cost bidder, often neglecting factors like nutritional quality. In 2023, NYHealth awarded the Natural Resources Defense Council (NRDC) a grant to strengthen the campaign for statewide adoption of the Good Food Purchasing Program.

 

Under this grant, NRDC will partner with Community Food Advocates and GFPP coalition partners to educate stakeholders on policy changes that would enable municipalities to choose food that might be higher priced but contains more nutritional value. NRDC will also provide legal support on State procurement policy to build upon the coalition’s knowledge of legal obstacles municipalities face when purchasing food. NRDC will educate policymakers, coalition members, and industry actors on the actual legal and on-the-ground impact of New York State adopting GFPP, including benefits for producers and suppliers.

The Legal Aid Society, Inc.

Inadequate dental care and poor oral health are linked to a range of physical, psychological, and quality-of-life issues.

Tooth decay and loss, gum degeneration, and mouth infections—when left untreated—can increase the likelihood of conditions like heart disease, diabetes, respiratory ailments, and malnutrition. New York State is 1 of 14 states that offer extensive dental benefits under Medicaid as an optional covered service, but it has historically limited coverage of dental implants, replacement dentures, root canals, and crowns.  Beginning in 2024, New York State’s Medicaid program will provide coverage that better reflects current standards of care and a comprehensive dental benefit. While the policy change is a big win, its impact depends on recipients, dentists, and advocates understanding the rule changes and recipients’ rights. In 2023, NYHealth awarded the Legal Aid Society (LAS) a grant to provide education and technical assistance to dentists and consumer advocates to ensure they understand the Medicaid rule changes, patients’ rights, and how to access newly covered services.

Under this grant, LAS will develop educational materials, provide in-person and virtual trainings, and monitor the rollout of expanded coverage. In consultation with the New York State Department of Health (NYSDOH), LAS will create training materials to inform dental clinic staff and Medicaid managed care plans about the new Medicaid coverage. The materials will provide clear information about how to interpret and implement the new rules, submit for coverage, and seek legal assistance for patients and what to do if Medicaid denies coverage. LAS will conduct training for all dental sites that serve Medicaid patients. It will partner with consumer advocacy groups and social service providers to raise awareness about expanded coverage and information about New York State’s dental provider network, and it will disseminate educational materials through a series of webinar trainings, media, and dental conferences. LAS will track and monitor information on the number and types of technical assistance requests and fair hearing topics and decisions. It will work closely with NYSDOH to create a feedback loop to share trends and information. NYSDOH will incorporate these findings into its ongoing training and oversight of Medicaid managed care organizations. LAS will operate its Access to Benefits helpline to respond to questions about coverage from providers and patients. It will also provide Medicaid recipients guidance on requesting hearings and appeals to challenge Medicaid denials of newly covered dental services.

Manatt, Phelps & Phillips, LLC

The use of telehealth skyrocketed in New York State during the COVID-19 pandemic.

While telehealth has tapered off some, it is here to stay as an option for patients. Research shows that telehealth can expand access to care, lower no-show rates, increase patient satisfaction, and improve patient outcomes. However, uneven telehealth use during the pandemic has exacerbated—not reduced—disparities in health care access. Since the Public Health Emergency (PHE) expired in May 2023, the State and federal government have been reconsidering telehealth policies. In some cases, commercial and public payers are considering removing coverage for phone visits—a primary way that many patients of color and low-income patients access telehealth. The end of the PHE offers an opportunity for New York State to recalibrate telehealth policies to capitalize on successes and address pain points. Careful examination of telehealth policies is needed to ensure that all patients have equitable access to primary care. In 2023, NYHealth awarded a grant to Manatt, Phelps & Phillips to examine emerging telehealth policies, regulations, payments, best practices, and case studies to recommend changes that will preserve and expand equitable access to telehealth in New York State.

Under this grant, Manatt will produce a comprehensive and up-to-date analysis of telehealth in New York State. It will interview stakeholders, representing diverse perspectives and expertise, to generate a State-specific understanding of issues and opportunities in telehealth policy and identify case studies on high-impact telehealth service delivery models. Manatt will also analyze the telehealth policy landscape at the State and federal levels to find examples of effective policy solutions from other states, with a focus on promoting equitable access. It will delve into State-specific telehealth issues including coverage and reimbursement; virtual care modalities; regulations; originating site requirements; and policies affecting access to telehealth services. In addition, Manatt will present data on telehealth utilization to demonstrate uptake of telehealth across the State and highlight remaining gaps and disparities in access. Data will depict trends before, during, and after the PHE and be disaggregated by patient demographics, payer type, and care specialty, as available. Manatt will disseminate its findings to the media, policymakers, providers, consumers, advocates, and other health care-decision makers across New York State to inform timely policy conversations.

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