by Stuart White, Ph.D.

For more than ten years, the Michigan Coordinated Access to Food for the Elderly (MiCAFE) program has paved the way for a select group of seniors in need of nutritional assistance. MiCAFE provides person to person assistance with preparing and submitting an application for the Supplemental Nutrition Assistance Program (SNAP). Formerly known as the Food Stamp Program, SNAP is a program of the United States Department of Agriculture (USDA) designed to address food insufficiency in the country. In Michigan, the Department of Human Services (MDHS) administers SNAP.

Nationally, only one in three seniors eligible for SNAP actually applies for benefits. Since 2001, Elder Law of Michigan (ELM) has worked with the USDA, MDHS, and the Michigan Office of Services to the Aging (OSA) to expand the number of eligible senior households that use SNAP.

MiCAFE has been the focus of several national and state evaluations looking at the viability of its model and its outcomes. The MiCAFE model posits that the way to break down barriers that separate seniors from SNAP benefits involves several key steps:

• Bring the application process to seniors interacting with senior friendly community organizations;
• Assist the senior applying for SNAP with a trained person familiar with the application;
• Support the senior helper with technology that simplifies the application process and reduces the likelihood of error;
• Align the senior applicant with other nutrition and personal resources in the community; and
• Evaluate program outcomes to assure continuous improvement of the program.

Elder Law of Michigan has partnerships with 138 community-based agencies, where a senior may go to complete an application for SNAP benefits, in 34 counties. These agencies include multi-purpose senior centers, senior housing complexes, Churches, health centers, congregate meal sites, local Commissions and Councils on Aging, cultural centers, local government offices, Community Action Agencies, Area Agencies on Aging, and other senior friendly agencies. The agency contributes resources needed to complete a SNAP application, but most importantly it provides a familiar, reassuring environment where a senior feels both safe and empowered.

This partnership has surfaced a need that many outside the aging network may not see. There is a common misconception that the combination of Social Security and Medicare has lifted the elderly out of poverty. Certainly, the United States has made great strides in combating elder poverty with the implementation of these two programs; however, MiCAFE has identified a group of seniors with Social Security and Medicare who have plummeted below the poverty line.

These seniors are women in their 70s and older living alone. They have on average of four to five chronic illnesses that require management with prescription medication. As a result they take between five and six medications a day. More than half of them face food insufficiency every day. In other words they are at risk of malnourishment and have to choose between eating and taking their medication. Their Social Security Income is just north of the poverty line. When their out of pocket medical expenses and shelter expenses are deducted from their income, their net income is equal to 30% of the poverty line or less.

This senior is the typical senior MiCAFE is serving today. Without SNAP benefits, this senior will go hungry. Without MiCAFE, this senior may or may not seek SNAP beneifts.

These seniors need SNAP, but they also need more. Fortunately, the MiCAFE model has taken a comprehensive approach to need. Half of the senior households applying for SNAP through MiCAFE also apply for Medical Assistance benefits which frees up additional household resources needed to remain living independently in the community.  Every senior who applies through MiCAFE is offered the chance to participate in a Nutritional Screening. The screening identifies behaviors that increase a senior’s risk of poor nutrition. Nutritional education materials are available through a MiCAFE site as well as referral to congregate meal sites where nutritious meals are available at no or little cost. A senior applying for benefits through MiCAFE also has an opportunity to participate in a more extensive screening offered through ELM’s Benefits Enrollment and Options Center.  The housing and legal needs of seniors served through MiCAFE can also be addressed through ELM’s Legal Hotline and Housing Counseling Services.

Nutritional need is often the canary in the coal mine. It can signal isolation in need of social engagement. Mental health needs may accompany nutritional neglect. Nutritional decline may be an indicator of decline in the habitability of one’s housing. Food insufficiency in combination with medical illnesses that require proper nutrition may be a predictor of costly institutionalization.

When seniors present, therefore, with nutritional need, senior service organizations are now able to partner with Elder Law of Michigan to respond holistically. The preservation of dignity and choice for our elders require no less a response.

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Dr. Stuart White is a Consultant for Elder Law of Michigan who works closely with the MiCAFE program. Stuart heads SBSR Inc, a Michigan company that equips its clients with strategic business solutions in today’s changing marketplace. As a business consultant, his customers have included government agencies, non-profit organizations in the health and human services arena, institutions of higher education, and small businesses oriented toward service. He has also conducted strategic planning for United Ways, Community Foundations, and non-profit organizations. Dr. White is a guest contributor to this blog.