August
9, 2017
Federico
Guzmán moved from Mexico to San Francisco in 1992, fleeing anti-gay sentiment
and searching for AIDS treatment.
He
couldn’t find a job and sometimes went hungry until friends introduced him
to Project Open Hand, a nonprofit organization
that began serving free, nutritious meals to HIV patients in 1985.
The
people there “were like angels from the sky,” said Guzmán, 50, who went home
from his first visit with vegetables, eggs, bread and beans. He continues to
receive medically tailored meals from the group.
Project
Open Hand cooks 2,500 meals and provides 200 bags of groceries to sick patients
every day, part of its mission to help them get healthier and stay motivated to
battle their diseases. The organization has expanded beyond HIV to feed people
with other chronic illnesses, including diabetes and kidney failure, and it
also delivers food to adults with disabilities.
The
state government recently awarded $6 million
to Project Open Hand and similar nonprofits to provide these services to sick
Californians covered by Medi-Cal, the state’s version of the federal Medicaid
program for low-income people.
The
three-year pilot program, which begins in January, was included in the recently
adopted 2017-18 state budget. Project Open Hand will lead the effort, which
involves five other food nonprofits across California.
Through
the initiative, nonprofits will be able to identify heavy Medi-Cal users — in
particular, chronically ill patients who are readmitted to the hospital for
preventable reasons within 30 days of being discharged, said Project Open Hand
CEO Mark Ryle.
The
pilot program will debut at hospitals, doctors’ offices and clinics in San
Diego, Los Angeles, San Jose, San Francisco, Oakland and parts of Sonoma and
Marin counties. It will target locations with a large number of patients who
are hospitalized frequently, said Project Open Hand’s director of
communications, Delfin Vigil.
The
nonprofits will enable doctors to give their patients prepared meals before
they return home. One of the nonprofits will follow up later to schedule
regular food deliveries, Ryle said.
The
meals will be custom-made for each patient’s medical condition.
For
example, a patient with diabetes, who requires a diet low in carbohydrates and
saturated fats, might receive chicken stew with chickpeas, whole wheat couscous
and roasted broccoli.
“If you
provide the food when [patients] leave the hospital, they have a bridge to
health,” Ryle said. “If they get home and there’s no food, they don’t take
their meds. If they don’t take their meds, they fall into this crater of bad
health and they get readmitted faster than they need to be.”
Details
of the project, including the specific hospitals and clinics where food will be
available, are “still in the planning stages,” said Anthony Cava, a spokesman
for the Department of Health Care Services, which administers Medi-Cal.
“Over
the next three years, we hope that this program will help improve the health
and quality of life of Medi-Cal recipients who are chronically ill by providing
them with nutritionally rich meals tailored to their condition,” added Carol
Sloan, a DHCS spokeswoman.
The
department will measure the program’s success by analyzing its participants’
hospital readmission rates, stays at long-term care facilities and emergency
room use, Cava said.
The
experiment aims to replicate the findings of a University of California-San
Francisco study published in the Journal of Urban Health in
January.
The
study, which tracked 52 Project Open Hand clients with HIV and diabetes for six
months in 2014 and 2015, found a 63 percent drop in hospitalization, a 58
percent decline in emergency room visits and a 50 percent increase in
medication adherence among participants.
Because
of the small sample size, the results are not statistically significant, but
the success of the treatment is promising, said Kartika Palar, one of the UCSF
researchers.
The
cost to feed each participant in the study was $1,184 over six months. By
comparison, San Francisco hospitals charged patients an average of $5,761 per
day in 2015 for overnight stays, according to the Office of Statewide Health
Planning and Development.
DHCS
doesn’t know how much money this program might save, but Ryle thinks it could
be a significant amount, based on a study of a
similar effort in Philadelphia. The study showed that the average monthly
health care costs for 65 chronically ill participants dropped by 28 percent
during the first six months they received healthy food, compared with the prior
six months.
Organizations
like Project Open Hand have known for some time that their work “was making a
difference in patients’ lives,” said Dr. Rita Nguyen, a former UCSF professor
now with the San Francisco Department of Public Health.
“There
was a lot of anecdotal evidence that folks were getting stronger, able to take
their medication and doing better overall,” she said.
On a
recent day at Project Open Hand, located in San Francisco’s Tenderloin
district, longtime patient and volunteer Mario Galande took a break in the
staff lunchroom after stocking the shelves of the group’s free grocery store.
Galande,
66, has been working at the nonprofit since he regained the weight he lost from
wasting syndrome, a symptom of AIDS, 20 years ago.
The San
Francisco resident lost 45 pounds before his friend “dragged me to Project Open
Hand.” Once he started getting hot meals delivered daily, Galande recovered
quickly.
“It was
the food that got me going,” said Galande, who began volunteering there soon
after. “I needed to help others.”
Nguyen,
who teams with Project Open Hand on a separate program that provides healthful
meals to heart failure patients after they are discharged from the San
Francisco General Hospital, thinks the Medi-Cal partnership is an encouraging
step.
“I see
it as a huge opportunity for health care to stand up, to say that they have a
role in food security and in healthy eating … rather than relying on purely
medications or expensive procedures to actually keep communities well,” she
said.
Guzmán,
the San Francisco resident who discovered Project Open Hand more than two
decades ago, is now managing his AIDS as a chronic disease. He has eaten the
group’s nutritious meals for 26 years.
“Thanks
to them, I keep my health better,” Guzmán said. “And I can go on with my life.”
Kellen
Browning: kellenb@kff.org,
@kellen_browning
No comments:
Post a Comment