Thank you, Mr. Chairman, for inviting me to testify today. I am Dr. Mary Jane Koren and a geriatrician by training. Most of my career has been devoted to serving the elderly, particularly those with serious chronic conditions. I have taken care of residents living in nursing homes, made home visits to patients living throughout the Bronx as the assistant medical director of the Montefiore Home Health Agency, and later was appointed to be the director of New York State’s Bureau of Long-Term Care Services. Currently, I am a vice president at The Commonwealth Fund, an independent, private foundation located in New York City that is working toward a high-performing health system. The grantmaking program I manage is aimed at improving long-term services and supports, particularly for people covered by both Medicare and Medicaid—also known as "dual eligibiles"—and for those transitioning from one level of care to another.
No matter which hat I’m wearing—geriatrician, policymaker, or grantmaker—my goal is to help frail older adults maintain their independence and well-being. The program I speak of today, Title III–C of the Older Americans Act, Nutrition Services, is one of the simplest, yet most effective programs to help low-income seniors stay in their homes and out of hospitals and nursing homes. You have heard today from both federal and state policymakers and from program administrators. I will therefore try to give you a different perspective. Based on my professional background and frontline experience caring for elderly patients, I’ll briefly cover four areas. First, I will discuss exactly why hunger, or undernutrition, is so common in this population; second, talk about the consequences of undernutrition both for patients and for rising health care expenditures; third, describe how home-delivered and congregate meals can help low-income seniors, their families, health care providers, and policymakers, especially in a time of constrained resources; and last, make several recommendations to strengthen these programs.
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