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SF groups behind push for healthy food as health-care benefit

Natalia Gurevich, San Francisco Examiner


A consortium of San Francisco health officials and nonprofits is pushing for California legislators to permanently enshrine access to nutritious food as a covered benefit under the state’s Medicaid program.

The California State Assembly Committee on Health will consider Assembly Bill 1975 in a hearing next week. The legislation, sponsored by the San Francisco-based Food as Medicine Collaborative and introduced by Oakland Assemblymember Mia Bonta, would make a pilot program that provides “medically supportive food and nutrition services” — including meals — a permanent benefit for Medi-Cal recipients.

If passed, the program would become permanent starting in 2026.

Founded in 2015, the Food as Medicine Collaborative seeks to bridge nutritional gaps for The City’s low-income and minority communities. The coalition now represents dozens of community clinics, food nonprofits, businesses and health-care systems in San Francisco, aiming to improve nutritional-food access and affordability.

Medical and health professionals have increasingly pushed the concept of “food as medicine,” or the notion that nutrition and diet play a significant role in managing, treating and preventing chronic health issues. The concept is especially important in The City, where a survey last year found that 30% of households with children struggled with food insecurity, meaning they lacked access to enough food to meet their nutritional needs.

Fifty-seven percent of Medi-Cal recipients were food-insecure, as were 77% of Black families.

These issues can lead to chronic health problems, including hypertension, heart disease and diabetes. A recent study by UCSF found that Latino children were more likely to develop fatty liver disease in food-insecure households. These challenges are compounded by the high cost of living and increasing wealth gaps in The City, which many local organizations part of the collaborative aim to fix.

“Here in San Francisco, one of the largest issues that we face is the affordability,” said Katie Ettman, the food and agriculture senior policy manager for the San Francisco Bay Area Planning and Urban Research Association, a local nonprofit public-policy think tank that is a member of the Food as Medicine Collaborative.

“Rent eats first — You can’t look at your landlord and go ‘Yeah, I’m just going to be $50 or $100 short this month,’” Ettman said. “But you can go to the grocery store and make a different choice to save a couple of bucks.”

Enrollees in the San Francisco Health Plan, The City’s Medi-Cal provider, can currently receive the nutritional food benefits that Bonta’s bill seeks to make permanent. Cissie Bonini, the executive director of EatSF, said this allows Medi-Cal patients to receive guidance from their own physicians, which might not be as personalized in other settings.

“It’s a huge difference to be able to have your food-security intervention happen in the clinic or have it come from having that conversation with your doctor,” she said.