2. Who Are We?
Coalition of over 60 national, state, and local stakeholders and organizations, including community, healthy aging, nutrition, advocacy, healthcare professional, faith-based, and private sector groups
Share the goal of achieving the recognition of malnutrition as a key indicator and vital sign of older adult health risk; work to create policy change toward a greater emphasis on screening, detecting, treating and preventing malnutrition

3. Formed with just a handful of nutrition and aging groups
Almost two years old
Formed with just a handful of nutrition and aging groups
There has been great interest from the community at large in this issue, and as it has grown, we have grown with it
History

4. What Have We Done? Held webinars and a Congressional advocacy day
Submitted comments to CMS
Supported malnutrition electronic clinical quality measures
Written a review article on malnutrition in federal policy

5. GAO Report Request
US Sens. Murray and Casey have filed a request with the Government Accountability Office to determine if federally funded programs meet the nutritional needs of the older adults they serve.
Older Americans Act nutrition programs
SNAP
Senior Farmers Market Program
Commodity Supplemental Food Program

6. We also have participated in national, state and local conferences
We have worked on malnutrition measures and activities in Massachusetts, Ohio, Virginia, and Florida
And, our biggest project to date, the National Blueprint: Achieving Quality Malnutrition Care for Older Adults, was released in March 2017
What Else?

8. Contributing Factors of Malnutrition among Older Adults Illustrate the Need for a Coordinated, Comprehensive Solution

9. To Respond to this Need, the Blueprint Was Developed by the Malnutrition Quality Collaborative
Convened by Defeat Malnutrition Today, The Collaborative is a multi-stakeholder partnership of nutrition, healthy aging, and food security experts represented by the following types of organizations:
Healthcare Quality Experts
Government Agencies
Patient Advocacy Organizations
Older Adult and Aging Societies
Medical Professional Societies
Health Systems
Industry
Community-Based Non-Profits

10. The Malnutrition Quality Collaborative Has Two Main Objectives
To advance health and quality-of-life outcomes among older adults by increasing national awareness of malnutrition.
To engage national, state, and local healthcare stakeholders to take action to better prevent, identify, and treat malnutrition. 1 2
Through the Blueprint, The Collaborative aims to support development of comprehensive strategies to improve malnutrition care across all care settings for older adults

11. The 4 Goals and Supporting Strategies of the National Blueprint: Achieving Quality Malnutrition Care for Older Adults
Goal 1:
Improve Quality of Malnutrition Care Practices
Goal 2:
Improve Access to High-Quality Malnutrition Care and Nutrition Services
Goal 3:
Generate Clinical Research on Malnutrition Quality of Care
Goal 4:
Advance Public Health Efforts to Improve Malnutrition Quality of Care
Establish Science-Based National, State, and Local Quality Goals
Identify Quality Gaps in Malnutrition Care
Establish and Adopt Quality Malnutrition Care Standards
Ensure High-Quality Transitions of Care
Integrate Quality Malnutrition Care in Payment and Delivery Models and Quality Incentive Programs
Reduce Care Coordination and Financial Alignment Barriers
Strengthen Nutrition Professional Workforce
Evaluate Effectiveness and Impact of Best Practices on Patient Outcomes and Clinical Practice
Identify and Fill Research Gaps by Conducting and Disseminating Relevant Research
Track Clinically Relevant Nutrition Data
Train Healthcare Providers and Administrators on Malnutrition Care Quality
Educate Older Adults & Caregivers on Malnutrition Impact, Prevention, Treatment and Available Resources
Educate and Raise Visibility with National and State Policymakers
Integrate Malnutrition Care Goals in National, State, and Local Population Health Management Strategies
Allocate Education and Financial Resources to HHS and USDA- administered Food and Nutrition Programs
Goals
Strategies

12. Achieving These Goals Requires Action Today
Several important steps can be taken immediately to improve malnutrition care across the care continuum
The Blueprint recommendations highlight cross-cutting actions for key healthcare stakeholders:  
National, state, and local government agencies
Healthcare practitioners, healthcare institutions, and medical professional societies
Individuals, families, caregivers, patient advocacy groups, and aging organizations
Public and private payers
Achieving These Goals Requires Action Today

13. A Sampling of Relevant Items from the Blueprint…
Make checklists available that can evaluate if older adults or their family members may be eligible for nutrition services through the OAA
Seek to be included in research efforts conducted by institutes, associations, or other organizations
Develop and distribute malnutrition-related educational materials for older adults and caregivers
Conduct awareness campaigns about malnutrition
Educate older adults and caregivers on “optimal nutrition” and provide resources to access nutrition services

14. It Requires Collaboration
Implementing the Blueprint’s recommendations requires collaboration across these various sectors as well.
Without collaborative work going forward, it will be impossible to implement comprehensive solutions to the crisis of older adult malnutrition, which is what this issue requires—a coordinated, carefully integrated approach.
It Requires Collaboration

15. State Activities
Ohio: Created a malnutrition commission through legislation; has named members and had first meeting
Massachusetts: Created a malnutrition commission through legislation; is naming members
Virginia: Added malnutrition to list of existing Aging Commission responsibilities
Florida: Creating own advocacy coalition in partnership with the state

16. Advancing Policies for Quality Malnutrition Care in Older Adults: A State Legislative Toolkit
Released this summer
Posted on defeatmalnutrition.today
Meant for use in state legislation/advocacy

17. Farm Bill
$100 billion/year bill that governs a large number of both agriculture and nutrition programs.
Reauthorization is due next year; last reauthorized in
Programs for and including older adults:
Supplemental Nutrition Assistance Program (SNAP) (4 million seniors—but only 42% of those eligible are participating)
Commodity Supplemental Food Program (600,000 seniors)
Senior Farmers Market Nutrition Program (800,000 seniors)
Child and Adult Care Food Program (74,000 seniors)
As with other programs, there are strong concerns about potential funding cuts.

18. There has been a battle for maintaining funding for SNAP in particular.
From FY16 to FY17, there was a cut from $80.8 billion to $78.4 billion.
The President’s FY2018 budget proposal cut SNAP deeply over ten years, and both the House and Senate have maintained those cut levels for FY2018 appropriations bills—a cut of almost $5 billion.
Hunger groups and coalitions like the Food Policy Working Group and the Food Is Medicine Coalition, as well as the Defeat Malnutrition Today coalition, are advocating on behalf of keeping SNAP intact.
This will be a crucial focus of the 2018 Farm Bill Reauthorization.
SNAP Funding

19. Academy of Nutrition and Dietetics and Avalere Health submitted four malnutrition electronic clinical quality measures to CMS in 2016
In August, it was announced that CMS would consider adding these measures “in the future”
Advocates have already started discussions with CMS about future efforts
CMS: Quality Measures

20. Other Agency Actions/Potential
Working to get older adult malnutrition recognized as objective(s) in HHS’s Healthy People 2030
ACL continues to study the issue of malnutrition

21. Potential Administration Concerns
Government consolidation—will government cutbacks hurt the effort to make older adult malnutrition a top priority?
Scaling back on quality measures, as was hinted at APOE and discussed in a Politico article, could also be in the cards
There has been a Request For Information for the CMMI, which could possibly harm innovative efforts around malnutrition screening and prevention… But, could also be an opportunity to expand these efforts?

22. Congressional Champions
Looking for new Congressional champions
Senate Aging Committee is very interested in this issue (Sen. Gillibrand on Aging and Ag)
Need interest from the House (Rep. Espaillat E&W; Lowey and others Approps; Sean Patrick Maloney, Faso Ag)
Please contact your representative today to tell him or her how important this issue is!

23. Join Us In Helping to Defeat Malnutrition
Determine the role you can play to improve the quality of malnutrition care among older adults! Access the Blueprint by going to: And check out your handouts for more information!
Join Us In Helping to Defeat Malnutrition