Chapter 2 Community-Based Nutrition Services

TABLE 2.2 Supplemental Nutrition Assistance Program Benefits October 1, 2015, through September 30, 2016

People in Household

1 2 3 4 5 6 7 8

Each additional person

Maximum Monthly Allotment

$194 $357 $511 $649 $771 $925

$1,022 $1,169 $146

Source: USDA Food and Nutrition Service. Supplemental Nutrition Assistant Program. www.fns.usda.gov/snap/ eligibility#Special%20Rules%20for%20the%20Elderly%20 or%20Disabled. Accessed January 20, 2016.

Commodity Supplemental Food Program

The Commodity Supplemental Food Program (CSFP) works to improve the health of low-income (at or below 130% of the federal poverty income) women, infants, children, and people at least 60 years of age by supplementing their diets with commodity foods sup- plied by the USDA. The food packages are not intended to supply a complete diet but are good sources of many important nutrients (32,34). Packages include a variety of foods such as nonfat dry and evaporated milk; juice; farina; oats; ready-to-eat cereal; rice; pasta; egg mix; peanut butter; dry beans or peas; canned meat, poultry, or tuna; cheese; and canned fruits, juice, and vegetables. Local agencies determine eligibility, distribute foods, and provide nutrition education. The program is not available in every state and may not be statewide in participating states. Additional informa- tion can be obtained at the CSFP website (35).

Emergency Food Assistance Program The Emergency Food Assistance Program (TEFAP) is a federal program (administered by the FNS) that

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supplements the diets of low-income Americans (which includes older adults) by providing them with free emergency food and nutrition assistance. The USDA purchases food, which it then ships to the states; the amount each state receives depends on its population of low-income and unemployed residents. State agencies work out administration and distribution details, select- ing local organizations that might directly distribute to households, serve meals, or distribute to soup kitchens, food banks, and food pantries or other similar local organizations (36). Unfortunately, some older adults continue to go hungry due to lack of eligibility for these programs (which vary by state), absence of knowledge about them, or an absence of transportation to and from such programs.

MEDICARE AND MEDICAID SERVICES The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the US Department of Health and Human Services (HHS) that administers the two national health care programs that benefit about 75 million Americans (37,38). Nearly all adults age 65 and older are covered either partially or totally by Medicare. Unfor- tunately, there is limited coverage for nutrition services; however, within the Patient Protection and Affordable Care Act (ACA), Medicare benefits have been strength- ened in the area of preventive services. Eligible older adults are provided preventive services including annual wellness visits; screenings for diabetes, cardiovascular disease, depression, and obesity; and medical nutrition therapy for the management of diabetes or renal disease. Medicaid is a state-federal partnership that pays for health and long-term care services for low-income older adults, the blind, the disabled, or members of families with disabled dependent children or who meet certain other criteria for need (39). The federal govern- ment provides broad national Medicaid guidelines for each state. The states, in turn, establish their own eligi- bility standards; determine the type, amount, duration, and scope of services; set the rate of payment for ser- vices; and administer the program. As a result, Medicaid programs vary considerably from state to state (38).

Patient Protection and Affordable

Care Act The ACA was signed into law in 2010. Included in the historic law were comprehensive prevention provi- sions, a complete change in thinking from previously. The enactment of the ACA begins to shift the health system from one that focused on treating the sick to one that focuses on keeping people healthy. The act