Exploring Long-Term Care Services- A Matrix of Programs and Populations
Part 1
| Program or service | Description | Population(s) served | Program or service at the Local community |
| Medicaid
|
Medicaid is a shared value health insurance program that provides full or partial health coverage to citizens of the US. The program is available to low-income adults, children, pregnant women, elderly adults, and people with disabilities who meet the eligibility criteria. Medicaid is administered by states as per the federal requirements. States and federal governments fund the program. | The program serves low-income households, elderly adults, and people with disabilities. | It is available locally as Texas Medicaid & Healthcare Partnership (TMHP) Long Term Care (LTC) |
| Child and Adult Care Food Program (CACFP)
|
The programs provide support for children and adults to participating children and adult care homes to enable them to offer nutritious meals and snacks to eligible children and older adults.
Cash reimbursements are provided by the USDA via the program and specific federal governments to eligible care homes to provide foods that meet the recommended Federal nutritional requirements. |
Children aged 0- 12 in childcare centers and day care homes.
Children of migrant workers are eligible through age 15.
Children in emergency shelters, children through age 18.
Adults aged 60 years and above in daycare programs |
The program is available locally as the Texas Child and Adult Care Food Program (CACFP)
|
| Supplemental Nutrition Assistance Program (SNAP)
|
SNAP is a nutritional support program that acts as an intervention to support federal nutritional programs by offering nutrition education and food stamps to reduce food security across communities. The program helps supplement food budgets for needy families to enable them to afford healthy food and move towards self-sufficiency. | Low-income working families
Low-income elderly individuals People with disabilities living on fixed incomes, and Any other eligible individuals and households living under low wages. |
The program is accessible to the local community under the Texas Supplemental Nutrition Assistance Program (SNAP), administered by the Palestine Health and Human Services Food Stamp Office |
| Commodity Supplemental Food Program
(CSFP)
|
The program is federally funded by the US Department of Agriculture. It is administered by the Food and Nutrition Service nationally and at the state level by the Texas Department of Agriculture.
The program aims to improve the health of low-income elderly persons. The program provides diet supplements to people aged above 60 years of age by giving them monthly food bags of nutritious USDA Foods. |
Older adults over 60 years of age
Older adults at or below 130 percent of Federal poverty income guidelines
|
The program is available locally under the Texas Unified Nutrition Programs System (TX-UNPS). |
|
Seniors Farmers’ Market Nutrition Program (SFMNP)
|
The program promotes a routine consumption of fresh fruits and vegetables from farmers’ markets to meet the daily dietary requirements for low-income seniors. The program has helped low-income seniors access locally grown fruits, vegetables, honey and herbs. It has also helped improve the consumption of agricultural commodities through farmers’ markets.
|
Low-income seniors (at least 60 years old from low-income households) | The program is accessible locally under the Texas Senior Farmers’ Market Nutrition Program (Tx-SFMNP) to all individuals who meet the eligibility criteria. |
Part 2
Based on the observations drawn from the analysis of the programs and services available for long-term care populations in Palestine, Texas, I conclude that the community is moving in the right direction. However, the programs do not adequately meet the needs of the long-term care population. The greatest concern for individuals in need of long term care, especially the elderly population, is their access to nutritious food. Access to nutritious food is a basic determinant of the general health of the elderly population (Berkowitz et al., 2018). A majority of elderly residents, especially poor seniors across the United States, are at a risk of hunger and are not being properly nourished. The elderly population, although in need of greater consideration towards their health and nutritional needs in these programs, does not get the required attention. One of the leading reasons for this is the access to nutritional food outlets and fresh produce markets in the Palestine community. Most local nutritional programs do not provide home delivery or mobile elderly pantries, sideling a majority of underserved individuals. The lack of access to foods that help meet the Federal nutritional guidelines may lead to the use of costly care, further affecting their contributions to federal health insurance programs such as Medicaid and Medicare. Research has identified access to food outlets as a factor contributing to ensuring the food security of older people with the ability to improve the quality of life for the elderly and avoid the perception of exclusion (Gajda et al., 2020). Locally, although these programs are administered and funded by the state and the federal government with outreach groups across the Palestine community, a number of people in need of long-term care lack access to such programs.
The greatest reason for such inadequacies is the eligibility criteria for such programs. States require the participants in the major nutritional programs and LTC support programs to be at a provable nutritional risk. Such a nutritional risk is required to be determined by a physician or local agency staff. Some of the programs may not be statewide, and the services provided may be regionally restricted as the states require individuals to reside within the service area of the local agency during the time of application for such benefits. This means that individuals who move out of the local region of residence may be disqualified from such programs in another region. Further, programs such as the Child and Adult Care Food Program (CACFP), Seniors Farmers’ Market Nutrition Program (SFMNP), and the Commodity Supplemental Food Program (CSFP) have set the eligibility criteria for older adults to be above 60 years of age. A majority of the people in need of such programs do not meet such eligibility criteria. For instance, according to Gundersen and Ziliak (2018), younger elderly residents who meet the food insecure classification do not meet age criteria or do not reach older ages, while the eligible elderly are less at risk of food insecurity. The eligibility criteria for programs like SNAP make it hard for deserving elderly individuals and households to receive benefits as compared to non-elderly households. Government budget cuts further threaten to cut out a large number of eligible elderly individuals from accessing LTC nutritional support programs like SNAP (Rosenbaum, 2019).
Although the federal nutrition programs such as SNAP, SFMNP, CACFP, and CSFP do not adequately meet the nutritional needs of people in need of long term care in the local Palestine, Texas community, programs such as the Texas Senior Farmers’ Market Nutrition Program (Tx-SFMNP) and the local Palestine Farmers Market have directly created a market place for agricultural produce from senior low-income farmers. Older adults not only have subsidized access to agricultural produce, but low-income elderly farmers are also provided with a platform to help them monetize their small-scale farm produce.
References
Berkowitz, S. A., Terranova, J., Hill, C., Ajayi, T., Linsky, T., Tishler, L. W., & DeWalt, D. A. (2018). Meal delivery programs reduce the use of costly health care in dually eligible Medicare and Medicaid beneficiaries. Health Affairs, 37(4), 535-542.
Gajda, R., & Jeżewska-Zychowicz, M. (2020). Elderly Perception of Distance to the Grocery Store as a Reason for Feeling Food Insecurity—Can Food Policy Limit This?. Nutrients, 12(10), 3191.
Gundersen, C., & Ziliak, J. P. (2018). Food insecurity research in the United States: Where we have been and where we need to go. Applied Economic Perspectives and Policy, 40(1), 119-135.
Rosenbaum, D. (2019). USDA will fund SNAP for February 2019, but millions will face cuts if the shutdown continues. Center on Budget and Policy Priorities, updated January 10.
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Question 
Complete the Programs and Services Matrix.
Use the matrix to identify five types of programs or services available for long-term care populations.
Exploring Long-Term Care Services- A Matrix of Programs and Populations
Include a brief description of the program or service and identify what populations may be in need of each.
Indicate whether this type of service or program is available in your own community and provide examples, if possible, of each. (My community is Palestine, TX)
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