Big, Fat Problem

The poor health of individuals served by the human services industry is rapidly gaining increased scrutiny and penalty. As one glaring example, people with intellectual and developmental disabilities (I/DD) represent 1% of the Medicaid caseload and approximately 11% of Medicaid’s expenses; such lopsidedness begs for immediate change. Medicaid is essentially on a slippery slope funding non-nutritious foods and then underwriting resulting, costly illness—obesity, diabetes, hypertension, and a variety of additional acute care conditions. Click for My25's Fact Sheet.

Scroll down to learn why human services organizations are rapidly becoming health care entities.

Fat Problem

Choice can no longer mean allowing people supported to eat themselves into a poor quality of life and life-threatening illness. Whether it’s managed care, value-based reimbursement, state clawbacks, or HHS/CMS mandates, providers supporting Medicaid-based populations—particularly those comprising the highest risk and highest cost—will be required to demonstrate better health outcomes. To do otherwise is no longer financially, or morally, feasible; health care costs are starting to outstrip long term services and supports expense. “Free” food and health care are justifiably coming with stipulations related to responsibility. Proof of a simple, better-nutrition outcomes measurement, perhaps such as normalized BMI, will be part of the deal.

People supported in LTSS settings unnecessarily struggle with obesity, diabetes and hypertension at approximately three times the rates experienced by the general population. While pharmacological and environmental complications are a factor to consider, it has been demonstrated that most of these unhealthy conditions are reversible for a majority of the population. In fact, the primary cause behind much of the subpar wellness is simply due to eating the wrong foods in the wrong amounts. And while exercise is always advisable for cardio and toning, health care experts concur that improved wellness can’t typically be achieved—and maintained—unless mealtime habits change.

People supported unnecessarily struggle with overweight conditions

Direct support workers—the first line of health care delivery for most people supported in community-based settings—have not been properly trained regarding wellness, nutrition, and kitchen skills in many instances. Further, there is often a high turnover faction among these staff members, so that once any training is complete the position has turned over. And this personnel pool is often challenged by similar poor health and habits. Additionally, providers are faced with perpetual labor inefficiencies and escalating food and PRN medication costs; all are persistent drains on the operating budget in most organizations.

Many of the same poor-health and minimal-knowledge challenges face caregivers and family members who are helping people supported navigate the day-to-day and their improving health. As a result, even individuals with disabilities who are more independent are typically not armed with healthy habits, understanding regarding nutrition, and safe and appropriate kitchen skills.

In the midst of these big, fat problems and what’s looming on the increased-scrutiny horizon, there is very good news as a result of My25's approach and successes. Click to watch our My25 Overview. Click to watch Brian's Story.


"Obesity and resulting diabetes are the only major health problems that are getting worse in this country, and they’re getting worse rapidly."

~ Dr. Thomas Frieden, Director of the Centers for Disease Control and Prevention

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Watch Brian's Story to learn more about My25's substantial outcomes.

Improved Health

Better health is at the crux of reduced, overall supports.