As a global pandemic rages and food insecurity rates rise, the California Food Policy Advocates (CFPA) are working tirelessly to increase not only the number of eligible older Californians enrolled in the CalFresh program, but also the benefits they receive.
CalFresh, known federally as SNAP – the Supplemental Nutritional Assistance Program or Food Stamps – acts as both a positive public health intervention and economic stabilizer. It also has a critical role to play in supporting California’s immediate and long-term response to COVID-19.
Jared Call, CFPA’s in-house advocate, says a three-year, $350,000 grant that Archstone Foundation awarded to CFPA in 2018 supports efforts to simplify a complicated system to ensure that older adults are eligible for, understand, and can easily receive the benefits they need to avoid food insecurity.
And under a separate Foundation grant, CFPA will work with the California Office of Health Information Integrity (CalOHII) to widely disseminate the soon-to-be augmented State Health Information Guidance (SHIG). The SHIG provides private and non-profit organizations authoritative, non-binding data sharing guidance based on real-life scenarios of care coordination.
The grant will enable CFPA to promote best practices and help to reduce fear and confusion over data sharing that is aimed at increasing older adults’ access to food. Given the new era of technological innovation, as well as rising food insecurity, CFPA will use CalOHII’s guidance to move toward equitable access to data sharing by removing barriers and improving capacity for data sharing at the state level.
Archstone Foundation also awarded $71,466 over 15 months to CalOHII to support the SHIG augmentation, adding new categories including data sharing for issues that more directly affect older adults, including public health, homelessness, and food insecurity, as well as issues for minors and foster children, individuals living with HIV/AIDS, and people living with developmental disabilities. (For more information, read Supporting the Exchange of Health Information to Benefit Older Adults.)
Using his “food policy chops” from working on CalFresh and SNAP programs, Call rattles off statistics about rising food insecurity and low CalFresh participation rates. When it comes to eligible individuals enrolling in food security programs, California consistently ranks in the bottom five of all states: Three in 10 eligible Californians do not receive CalFresh benefits. And among eligible older adults, enrollment is even lower: Fewer than two in 10 receive benefits they are entitled to.
At the same time, food insecurity rates are rising. According to the UCLA Center for Health Policy Research, food insecurity rates increased 21% from 2001 to 2016. Call notes that COVID-19 unsurprisingly has exacerbated these issues, particularly among households of color.
According to the Census Household Pulse Survey conducted in the last week of June and first week of July, Black older adults were four times more likely to be food insufficient and Hispanic older adults were three times more likely to be food insufficient than white older adults. Given that California’s population is racially/ethnically diverse and aging rapidly, Call says that “if we don’t act in a dramatic way, a larger share of the growing number of low-income older adults are more likely to suffer from hunger and food insecurity.”
Simplifying the Process, Expanding Options
Call works with Kameron Mimms-Jones, a social worker who brings an additional ethnic/racial lens to CFPA’s work, on the organization’s major campaign to increase CalFresh eligibility and enrollment among older adults. “The aging process is not the same across all ethnicities and races,” Mimms-Jones says.
In addition, there are systemic issues that have resulted in people turning away entitlements. For example, immigrant populations tend to not receive entitlements. To address this, CFPA is involved in Food for All, a program that provides nutrition benefits that California immigrants are not currently eligible for due to federal restrictions. While this is not an age-restricted program, Mimms-Jones explains that CFPA is positioning itself in the greater conversation of poverty by ensuring access to entitlement programs for these individuals even before their advanced years, so they can have increased access to and participation in federal nutrition programs across the life-course.
With the Foundation’s support, CFPA aims to modernize and simplify the CalFresh application process. While there is a short application available online, the current paper application for CalFresh is 18 pages long. This will be replaced with a simplified version for older adults who want or need to sign up for CalFresh on paper.
In addition, CFPA will ensure the CalFresh application is accessible to people of all languages and literacy levels. In its current form, translations for CalFresh applications are not always accurate or tested with native speakers. In fact, according to a study by a UC Berkeley graduate student, “the gap in CalFresh participation among eligible individuals could almost be entirely closed if non-English-speaking participants participated at the rate of English-speaking participants,” Call says.
CFPA also strives to ensure that no one “slips through the cracks” by eliminating extra and unnecessarily burdensome reporting requirements. Progress is already being made, as the USDA recently waived an annual reporting requirement for households with people over age 60 and no earned income — alleviating about 600,000 households of this additional burden.
CFPA realizes that CalFresh in its current form is not a panacea nor is it the only option. People may not have the ability to prepare their own food and the current CalFresh structure does not allow for hot food purchases or a delivery fee.
However, CFPA is working to expand purchasing options and partnerships with vendors to allow for subsidized delivery, especially in light of COVID-19. CFPA aims to cross-enroll individuals with other services in addition to CalFresh. As Call explains, “People may want a home-delivered meal, but they should also be able to get CalFresh for other items they need.”
Adding in the equity lens again, Mimms-Jones points out, “to be 65 and to be age 96 are two very different worlds, and we also have to recognize in California how different the terrain is from rural to city.” For example, people with access to food delivery may only have access to fast food delivery in their area, which may not benefit them as much as having access to healthy food options. Recognizing this, CFPA is able to have conversations with advocates to share what works for them and the populations they serve, allowing them to take a holistic approach to nutrition services.
From Disaggregated Patchwork to Hub
CFPA convenes on regular basis with other organizations working on these issues, as they strive to create a hub for connecting people to services beyond nutrition — including health care, low-cost internet, or phones.
Creating a hub would allow people to tell their story one time and to then be connected to a full array of services, without having to navigate through a patchwork system that is disaggregated and difficult to understand. Though CFPA focuses on CalFresh, this hub can also connect low-income older adults to other nutrition services they may be eligible for, like Meals on Wheels, Medically Tailored Meals, or the underutilized Senior Farmer’s Market Nutrition Program. By working with other organizations, CFPA can leverage this collective power to educate legislators and encourage change.
An important consideration in creating this hub is information sharing and protection, which is increasingly being emphasized for older people. Information sharing can benefit older adults by providing them and their advocates with information that ensures that they have access to the resources they need.
Yet, authorizations are often needed on multiple occasions, even if the client is giving permission to the same person. That’s where the recent grant to support CFPA’s work disseminating the augmented SHIG comes in. By engaging government, health care, and social services stakeholders to develop use cases related to care coordination and information sharing between health and behavioral health providers and community-based nutrition programs, the SHIG will provide easy-to-understand guidance. CFPA and other advocacy organizations, as well as health and social service providers, will be able to apply this guidance to access information that can be used to enroll individuals in programs they are eligible for, but may not know about or may have difficulty navigating the enrollment process.
Mimms-Jones emphasizes that simply increasing awareness of programs can be beneficial, but it is especially important to consider programs through a lens of diversity, equity, inclusion, and even ageism. She cites the federally funded Senior Farmer’s Market Nutrition Program as an example of a program that is not only underutilized, but is also not accessible to all communities.
“CFPA situates itself as part of a greater movement as we think about access to fresh food and vegetables and informed healthy eating for older adults,” Mimms-Jones says.
It is important to bring these programs into marginalized communities, and to understand that access to food security has intergenerational benefits. CFPA aims to measure the progress of these federal nutrition programs, not just through quantitative documentation of participation rates, but also by gathering qualitative information about experiences and how they can be improved. In doing so, CFPA can ensure that these programs are accessible to individuals across racial/ethnic, and age spectrums.
Carly Roman, Archstone Foundation intern, also contributed to this blog post.