The Federation of Virginia Food Banks is leading a coalition of more than 70 public, private, and nonprofit organizations committed to advancing Food is Medicine initiatives in the Commonwealth. We support the proposed 1115 demonstration waiver and ask that it be expanded to include nutrition programs for the target population.

CMS has identified food insecurity as the number one SDOH (Social Determinant of Health) need among Medicaid members nationwide. Five other states have implemented or requested waivers to provide nutrition support to Medicaid member w/ Serious Mental Illness. If Virginia’s goal is “to improve access to community-based services so that the full continuum of care is available to meet the needs of Medicaid members with Serious Mental Illness (SMI)” then food should be included as a defined service category.

 The SMI population is at high risk for food insecurity and therefore more likely to suffer from the associated negative health consequences. A recent meta-analysis shows that adults with SMI were 3.31 (95% CI: 2.03 to 5.41) times more likely to experience food insecurity than comparators without SMI (Smith Et al., 2023). 

The Federation and its partners have significantly expanded our capacity to manage referral coordination and connect patients to services across our statewide network of 1,100 agency partners, including SNAP application assistance and/or direct service delivery. We stand ready to support the successful implementation of the waiver and ensure all Medicaid members have access to the services they need to support healthy outcomes.