CHLPI Presents on Food is Medicine at the Presidential Advisory Council on HIV/AIDS

On May 25, 2016, team members from the Center for Health Law and Policy Innovation attended the 59th Presidential Advisory Council on HIV/AIDS (PACHA) Council Meeting, where CHLPI’s Faculty Director Robert Greenwald moderated the panel discussion “Food is Medicine: The Case for Integrating Food and Nutrition Services into Health Reform.” Panel participants were Dr. Sheri Weiser, Associated Professor of Medicine, Division of HIV, Infectious Disease and Global Medicine at the University of California, San Francisco; Sue Daugherty, RD, LPN, the CEO of MANNA; and CHLPI’s Sarah Downer, a clinical instructor on law at the center.

Dr. Shari Weiser presented on the latest research demonstrating the link between food insecurity and health outcomes, especially for people living with HIV/AIDS, and the impact of food-based interventions on health outcomes. Sue Daugherty presented on MANNA’s cutting edge partnership with a local Medicaid Managed Care Organization that provides medically-tailored, home-delivered meals to Medicaid recipients in Pennsylvania. The partnership is so successful that the Managed Care Organization has seen costs decrease by 36% among meal recipients and the Secretary of Health in PA is looking to expand access to medically-tailored meals statewide in Medicaid. Sarah Downer presented on policy reforms in Medicaid and Medicare that will drive integration of food and nutrition services in order to meet the triple aim of improving patient outcomes, improving populations health, and reducing cost.

IMG_6139Following the panel presentation, the PACHA adopted a resolution that recognized the crucial role that food plays in prevention and treatment of HIV/AIDS and calls on the President and Department of Health and Human Services to direct the Centers for Medicare & Medicaid (CMS) to expand coverage of medically-tailored meals in Medicare and Medicaid and include food and nutrition services in all demonstration models developed by the Center for Medicare & Medicaid Innovation.

Robert Greenwald was also recognized by the Council for his five years of service as a member of the council. He is pictured here with PACHA Chairperson Nancy Mahon, JD.

 

Read the report Food is Medicine.
Read the Food is Medicine Advocacy Toolkit.

Federal Court Requires WA Medicaid to provide HCV Cure to Patients

Today federal district court Judge John C. Coughenour handed patients diagnosed with Hepatitis C virus an unmitigated victory, ordering coverage by the Washington Health Care Authority, the state Medicaid agency, of a cure for Hepatitis C, treatment needed by thousands of Washington Medicaid enrollees.

The patients had sued the Washington State Health Care Authority to get treatment with direct acting anti-viral medications, a newly approved cure for Hepatitis C. But the Washington state Health Care Authority limited access to the cure to only patients whose liver had been irreparably damaged by the disease, even though the scientific evidence shows that the cure is more effective and produces better health results, the earlier it is provided. The plaintiffs argued that forcing Medicaid enrollees to wait until their health worsens violates clinical guidelines of the American Association for the Study of Liver Diseases (AASLD). “[C]linicians should treat HCV-infected patients with antiviral therapy with the goal of achieving an SVR [sustained virologic response or cure], preferably early in the course of their chronic HCV infection before the development of severe liver disease and other complications.” See http://hcvguidelines.org/full-report/when-and-whom-initiate-hcv-therapy (emphasis added).

Judge Coughenour ruled that the Washington State Health Care Authority’s rationing policy violates the federal Medicaid Act, which promises that low-income patients on the program may have access to medically necessary treatment. He ordered that the Health Care Authority immediately stop applying its rationing policy. He ordered the agency to return to providing coverage for prescription medications to treat Hepatitis C without regard to the extent of a patient’s liver damage.

HCV is a communicable disease that causes chronic inflammation throughout the body of those infected and can lead to serious liver damage, infections, liver cancer and death. At least 20,000 people in the United States die each year due to liver disease caused by HCV. After one of plaintiffs’ counsel, Sirianni Youtz Spoonemore Hamburger filed similar lawsuits against Regence, Bridgespan and Group Health, all three private insurers eliminated similar exclusions from their health insurance policies. Washington state Health Care Authority, however, refused to do so, prompting the Plaintiffs’ Motion for Preliminary Injunction.

“This Order will save lives,” said Rick Spoonemore of Sirianni Youtz Spoonemore Hamburger, one of the plaintiffs’ counsel in the case. “The State’s exclusionary policy was put in place for one reason only – to save money. But saving money should never come at the expense of the health and lives of any patient, even if they are low-income and on Medicaid.”

“Thousands of Washington Medicaid enrollees infected with Hepatitis C virus can now get the cure they need,” said Amy Crewdson of Columbia Legal Services. “WHCA should never have put in place rationing of this treatment in the first place, as it had been sued for this same Medicaid violation before.” The State’s Medicaid Agency had been sued on at least two other occasions for attempting to impose cost-based rationing in its Medicaid program, in a case called Mead v. Burdman and a later contempt motion in the same matter.

“Medicaid programs across the country should consider Judge Coughenour’s Order and change their practices before they also get sued,” said Kevin Costello of the Center for Health Law and Policy Innovations at Harvard Law School. “Rationing policies like the one used by the Washington Health Care Authority are in place in dozens of states across the country. All of those policies are likely improper as well.”

View the preliminary injunction here.

View media coverage of the court’s decision:

 

 

FLPC Director Testifies in Front of House Agriculture Committee

On Wednesday, May 26, 2016, the Director of the Harvard Food Law and Policy Clinic, Emily Broad Leib, provided testimony at House Agriculture Committee Hearing on Food Waste from Field to Table. Members of the House Agriculture Committee heard from a variety of witnesses from industry, academia and the private sector who shared their efforts and initiatives in place to address the issue of food waste across the food chain.

View video of the hearing:

Read the full text of Emily Broad Leib’s testimony here.

FLPC Welcomes Food Law and Policy Clinic 2016 Summer Interns

The Harvard Food Law and Policy is pleased to welcome the following interns working in the clinic for the summer.

Jabari BrownJabari Brown is a rising 3L at University of Oregon School of Law, and a member of the executive committee of the Food Law Student Network. He in interested in urban gardens, food policy, and the promotion of socially responsible agribusiness practices. His undergraduate thesis at UC Berkeley focused on geochemical analysis of soils to determine urban garden viability. During his first year of law school at University of Oregon, he facilitated a symposium on urban agriculture. He enjoys cooking and exploring new recipes.

 

Alyssa headshotAlyssa Chan is a senior at Harvard College studying Chemistry and Earth and Planetary Sciences. She first became interested in food justice and sustainable food while working on an organic farm and winery in Argentina. Since then she has continued to be involved with food issues through volunteer work at local community gardens and The Food Project, as well as related coursework (food law and policy and human rights issues related to the US food system). She is excited to learn more about legal and policy oriented solutions at the Food Law and Policy Clinic this summer.

Robin ChengRobin Cheng is a rising third-year student at University of California, Davis School of Law pursuing a career in food law and policy. He received a B.Sc. in Chemistry from Beijing Institute of Technology in China and a Master’s Degree in Food Science from University of British Columbia, Vancouver, Canada. Prior to law school, Robin worked in different sectors of the food industry with a focus on food regulatory compliance and quality assurance. Working as a law clerk since last summer, he has been exposed to a variety of regulatory issues, including product labeling challenges, water waste in the food industry and cruelty to animals. He will be studying abroad at University of Lausanne, Switzerland in Fall 2016.

Goliath-headshotGoliath J. Davis, IV just finished his first year at the University of Florida Levin College of Law. Before law school, he co-founded a nonprofit organization, Citizens for a Sustainable Future, to address food security and environmental justice issues in African American communities.  On the rare occasions when he has free time, he enjoys running, zip lining, and Octavia Butler novels.

 

Dunyak PhotoErika Dunyak is a law student at Case Western Reserve University in Cleveland, Ohio. At CWRU, she is involved in the Food Law and Policy Society, the Student Animal Legal Defense Fund, and Lambda Legal Student Association. Throughout law school, Erika has worked with the Office for Sustainability at CWRU, the City of Parma (Ohio) Law Department, and the New Agrarian Center. Prior to beginning law school, Erika received a B.A. in International Studies and German from the University of Dayton in Ohio focusing on Global Environmental Sustainability. Erika hopes to be part of the revitalization of America’s Rustbelt through urban agriculture and the local food movement.

Meaghan Jerrett is a second-year student at Georgetown University Law Center. Before moving to DC, Meaghan worked for HowGood, a food sustainability social enterprise, and for the New Orleans Food & Farm Network, a food justice nonprofit. She also spent a year with legal services in the wake of the 2010 BP Gulf oil spill and taught English to college students in central China. She currently serves as a Research Assistant on social enterprise and nonprofit law. Meaghan graduated from Colby College with a double major in government and religious studies. She is thrilled to be interning at FLCP!

CHLPI Welcomes Health Law and Policy Clinic 2016 Summer Interns

The Center for Health Law and Policy Innovation is pleased to welcome the following interns working in the Health Law and Policy Clinic for the summer.

Bobby_Dale HeadshotBobby Joe Dale III is a rising 3L at the University of Houston Law Center in Houston, TX. In December 2011, he graduated with a B.A. in French from the University of Mississippi. In Summer 2015, he received the University of Houston Health Law and Policy Institute’s first Congressional Fellowship to serve as Health Legislative Fellow in Congressman Gene Green’s Washington, D.C. office. He has also worked as a legal intern for Tahirih Justice Center and a law clerk for an immigration law firm. During law school, he researched and helped draft legislation to expand Medicaid coverage for telemedicine and telemonitoring services to elderly individuals and individuals with special healthcare needs. He later testified before the Texas House Committee on Public Health in support of this bill. Upon graduation, he hopes to pursue a career in public policy research and advocacy with a focus on legislative or regulatory affairs.

Sarah Gregory graduated from the University of Chicago in 2014 with a bachelor’s degree in Bioethics and Classical Philosophy. After working in a patient-centered medical home on the south side of Chicago, she decided to pursue her JD at Loyola University Chicago School of Law. She is a member of the Health Law Society and a Beazley Institute Fellow, and volunteers at the Legal Council for Health Justice, and will graduate in 2018.

Luke headshotLuke Haqq is a rising third-year law student at the University of Minnesota Law School. He is Senior Articles Editor of the Minnesota Law Review, in which his work on public health and adolescent reproductive rights will be published this fall. He is also pursuing independent research on genomics and neonatal litigation as a Consortium Student Scholar at the Consortium for Law and Values in Health, Environment and the Life Sciences. Prior to law school, he obtained graduate degrees from the University of California, Berkeley and the University of Edinburgh, with undergraduate studies at Northwestern College in Minnesota. He has a sustained commitment to the public interest, having spent summers working at non-profits including the Public Health Law Center and the Center for Victims of Torture. Outside of school, he plays in a band and roasts his own coffee.

Nabihah headshotNabihah Maqbool is a rising second year law student at the University of Chicago. She completed a masters in public health and undergraduate degrees in Biology and Political Science from the University of Missouri. She has worked as a researcher for the Center for Housing Policy, CommonHealth ACTION, and the Midwest Alliance for Health Education. At the law school she is on the board for the Human Rights Law Society, the Law Women’s Caucus, and the Dean of Students Advisory Board. Her interests include the intersection of Human rights and health, and the advancement of health equity using legal and policy tools.

Version 2Shreya Patel is a rising 3L at Michigan State University College of Law. She is dedicated to expanding healthcare access to underprivileged populations. Her past experience includes interning at New York Legal Assistance Group, a pro-Bono organization for low income New Yorkers, where she worked on administrative hearings for Medicare, Medicaid, SSI, and SSD. She was also part of a team of students who have worked to facilitate free health screenings for hundreds of residents across Michigan and Ohio. In her free time, she enjoys watching reruns of the West Wing and doing Sudoku puzzles.

Abigail_WoodsAbigail Wood is a rising third-year student at Saint Louis University School of Law. She will be receiving a certificate in health law from SLU Law’s Center for Health Law Studies. She has participated in the National Health Law Moot Court Competition and the National Health Law Transactional Moot Court Competition. During her time at SLU Abigail has been involved with the Grass Roots Advocacy course. This course focuses on addressing specific health policy issues within the state of Missouri. Prior to law school Abigail received her degree in Public Health from DePaul University in Chicago. It was her experience of working on health policy issues at the AIDS Foundation of Chicago that inspired her to ultimately attend law school.

CHLPI Faculty Director Quoted in Philly.com Article on HCV

On Sunday, May 22, 2016, Philly.com printed the article How sick must hepatitis C patients be to get help? The article, written by Don Sapatkin, looks at Medicaid’s refusal to provide access to the cure for Hepatitis C for Pennsylvania residents suffering from the disease. The article includes a quote from CHLPI’s faculty director Robert Greenwald, and information from CHLPI’s litigation director Kevin Costello.

The week before the article was published, the Pennsylvania Pharmacy & Therapeutics Committee recommended that the state’s Medicaid program remove all restrictions to the cure and pay to treat all patients infected with hepatitis C.

Excerpt from article:

“‘A disenfranchised, vulnerable community was one where they could draw the line,’ said Robert Greenwald, a Harvard law professor and coauthor of a study last year that found most states were rationing hepatitis C treatment. ‘A person with Alzheimer’s on Medicaid would have family who would not tolerate not getting the cure,” he said, if one became available.'”

Read How sick must hepatitis C patients be to get help? in full.

Read Kevin Costello’s testimony to the Pennsylvania Pharmacy & Therapeutics Committee  on removing restrictions to medication access.

Media Coverage of FLPC’s Report on Date Labels and Proposed Legislation for Standardization

On Wednesday, May 18th, Senator Richard Blumenthal and Representative Chellie Pingree introduced companion bills to standardize food date labels across the United States. FLPC just released data from a national survey (conducted with the National Consumers League and Johns Hopkins Center for Livable Future) that illustrates how consumer confusion over date labels impacts the amount of food waste nationally, and leads to 84% of consumers throwing food away when the date passes. When consumers misinterpret these indicators of quality as indicators of safety, the amount of food that is discarded greatly increases, which is bad for consumers’ wallets, the food system, and the environment. 

Below is media coverage of the proposed legislation and report:

Senator Blumenthal and Representative Pingree Introduce Companion Bills to Standardize Date Labels

Written by The Harvard Food Law and Policy Clinic

Today, Senator Richard Blumenthal and Representative Chellie Pingree introduced companion bills to standardize food date labels across the United States. We at the Harvard Food Law and Policy Clinic (FLPC) enthusiastically support these bills. We have been working since the release of our 2013 report, The Dating Game: How Confusing Date Labels Lead to Food Waste in America (published in partnership with the Natural Resources Defense Council), to push for standardization of date labels. A recent report by the collaborative group ReFED, Roadmap to Reduce Food Waste by 20 Percent, found that standardizing date label is the single most cost effective of twenty-seven solutions to reduce the 40% of food that goes to waste each year in the United States.

A major contributor to this food waste is the failure of the current date labeling system: with the exception of infant formula, there are no federal standards for date labels. In the absence of federal law, states have enacted a dizzying variety of date label laws. This has led to hardly any consumers being able to identify what date labels mean, which causes consumers to throw away perfectly good food and some states to even ban or restrict past-date food sales. But these dates are generally not intended to communicate safety information; instead, they signal a manufacturer’s estimate of how long food will taste its best. Unfortunately, consumers mistakenly believe that these dates are indicators of safety and many report throwing food away once the date passes, due to fear of safety risks. FLPC just released data from a national survey (conducted with the National Consumers League and Johns Hopkins Center for Livable Future) that illustrates how consumer confusion over date labels impacts the amount of food waste nationally, and leads to 84% of consumers throwing food away when the date passes. When consumers misinterpret these indicators of quality as indicators of safety, the amount of food that is discarded greatly increases, which is bad for consumers’ wallets, the food system, and the environment. 

The proposed legislation is a great step forward and will benefit many American families while preserving our environment. The bill’s central proposal is the standardization of date labels through the use of a dual label system, which would provide clarity by reducing the available labeling language to two phrases: one quality date indicator and one safety date indicator­. The legislation would allow manufacturers to include a date indicating a food product’s quality, as long as the date is indicated by the standard phrase “best if used by.” Because quality is subjective, the use of a quality date would be optional. Under the legislation, a safety date, indicated by the standard language “expires on,” would be required on a small group of foods identified by the FDA and USDA as being those that could become less safe after the date. Our recent consumer research found that 70% of consumers already believe “best if used by” indicated quality, and 54% believe “expires on” is intended to indicate safety.

In addition to the standard label language, the legislation will standardize laws surrounding sale and donation of past-date foods. Food banks, soup kitchens, and non-traditional food recovery models all rely heavily on food donations, including donations of wholesome past-date foods, to serve food insecure Americans. In the current labeling system, 20 states restrict or prohibit the sale or donation of past-date food. For example, Montana requires that milk bear a sell by date that is 12 days post-pasteurization, and bans sale or donation of milk after that date, leading to thousands of gallons of unnecessary waste (to see a recent FLPC video about this, visit www.notreallyexpired.com). The proposed legislation would eliminate laws like Montana’s that bar the sale or donation of food past the quality date. However, states would still be allowed to prohibit the past-date sale or donation of foods bearing the “expires on” safety label.

Finally, and importantly, the legislation would direct the FDA to coordinate with USDA and the FTC to ensure that date labels are standardized across products, and would require those agencies to support this legislation with a consumer education campaign. In order for the new labeling system to have its intended effect, consumers must understand what the labels mean. Since date labels have been unregulated for so long, public education about the meanings of the new labels will be particularly important. As government agencies charged with protecting consumers, the FDA and USDA are in a unique position to reduce confusion around date labels and ensure successful implementation of the new law.

Senator Blumenthal and Representative Pingree’s legislation offers the chance to create a monumental change in the consumer confusion surrounding date labels and the unnecessary food waste that results from this confusion. Food waste contributes to lost income at the household level, a reduction of food available for those in need, and tremendous environmental impacts. Reducing the amount of wholesome food wasted in the U.S. will improve the environment and increase food security. FLPC is pleased to support this bill, which will bring much-needed clarity to this country’s date labeling system.

FLPC Receives News Coverage on New Survey and Report on Date Labels

On May 11, 2016, the Harvard Food Law and Policy Clinic, National Consumers League, and Johns Hopkins University Center for Livable Future released their findings from a national survey on consumer perception of date labels in the report Consumer Perceptions of Date Labels: National Survey. The survey aimed to understand the extent to which consumers are confused about date labels, whether they throw away food after the date passes, perceptions about whether labels are federally regulated, and which labels most clearly communicate quality and safety, for purposes of standardizing the language.

Below is media coverage of the report and survey:

 

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