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The Coalition for Nutrition Services in Health Care Reform - Position Statement Preventive, therapeutic and rehabilitative nutrition services comprise an essential, though often under- appreciated component of health care. Appropriate nutrition is important to all stages of the life cycle from prenatal care and iafancy to long-term care of the elderly, from developing healthy eating practices and cholesterol screening to high-tech interventions requiring specialized nutrition support services. It is the position of The American Dietetic Association. American Public Health Association, American Society for Clinical Nutrition, American Society for Parenteral and Enteral Nutrition, Association of Faculties of Graduate Programs in Public Health Nutrition, Association of State and Territorial Health Officials, Association of State and Territorial Public Health Nutrition Directors, Center for Science in the Public Interest, National Association of WIC Directors, The Oley Foundation, and the Society for Nutrition Education that: • Quality health and nutrition services must be available, accessible and affordable to all Americans. • Quality nutrition services are essential to meeting the preventive, therapeutic and rehabilitative health care needs of all segments of the population. • Any b•sic benefits plan must include the following nutrition services: screening, assess- ment, counseling, treatment for individuals receiving primary care, acute can, outpatient services, home cate, and long-term cate. • Quality nutrition services must be reimbursable and provided by qualified professionals. • Nutrition intervention and education programs that promote health and prevent disease are fundamental to health cam reform and must be funded. • Nutrition services should be coordinated with supplemental food programs and other food assistance programs and be delivered in a variety of settings that are both traditional and innovative. 'If yotr are among the rvo our of rhne Americans who do nor smoke or drfnk acessively, your dwiee of diet can influence your losg-term health prospects more than ary other aaion you might take.' (Ihe Surgeon Gerreral's Report on Nunirion and Health, 1988.) Nutrition programs that promote health and prevent disease must foster personal and community responsibility for healthy behaviors and lifestyles and be delivered in primary care, public health and community settings. To mazimine the benefit, these nutrition programs must meet the needs of the vulnerable and frequently underserved segments of our population, assure access to a nutritious diet, be culturally appropriate, and be included in preventive care, maternal and child health care, and in health care services for older Americans. Nutrition services which prevent or ameliorate malnutrition can avert chronic illness or the need for expensive hospital care. For persons suffering from serious illness, specialized nutrition support services such as enteral (tube) and parenteral (intravenous) feeding can save lives, as well as promote healing and reduce the length of hospitalization. A quality health care system must be available, accessible and affordable; contain mechanisms for monitoring and evaluating the public's health; assure that providers of nutrition cam programs and services are qualified and have advanced training or education in nutrition; use clinical and applied research to improve health care practice; and maintain a comprehensive federal, state, and local public health infra,st:ucture to protect the community's health.

The Coalition for Nutrition Services in Health Care Reform 725 15th Street. N.W.. Suite 82Q,,Washinaton. D.C. 20005 The American Dietetic Association 1225 Eye Street, NW, Suite 1250 Washitqcon, D.C. 20005 (202) 371-0500 Contact: Pattl Blumer American Public Health Association 1015 15th Street, NW, 3rd Floor Wasi~OOn, D.C. 20005 (202) 789-W00 CoantacC Jeff Jacobs American Society for Clinical Nutrition 9650 Rockvale Pike Bethesda. MO 2081441929 (301) 530-7110 Contact Steve Sdhlaffino American Society for Psrenteral and Enteral Nutrition 8630 Fenton Street, Suite 412 Slver Spriny, MD 20910.3805 (301) 587-6315 Contact Ed Bernstein Association of the Faculties of Graduate Programs in Public Health Nutrition 1215 West Cumberland Avenue, Room 229 Knocvile. TN 27996-1900 (615) 974-5445 Contacx Betsy Haughton Association of State and Territorial Health Officials (c/o) Association of State and Territorial Public Health Nutrition Directors 150 Tremont Street Boston, MA 02111 (617) 727-9283 Contact Ruth Palombo Center for Science In the Public Interest Suite 300 1875 Conneadcut Avenue, NW Washington. D.C. 20009 (202) 332-9110 Contact Michael Jacobson 711e Oley Foundation 215 Hun Memorial. A-23 Albany Medical Center Albany, NY 12208,3478 (518) 445-5079 Contact L.enore Heaphey National Association of WIC Directors 1627 Connecticut Avenue, NW, Suite 5 P.O. Box 53405 WashinQton, D.C. 20009,3405 (202) 232-5492 Cortact: Doug Greenaway Society for Nutrition Education 2001 Kilebrerr Drive. Suite 340 Minneapoiis, MN 55425 (612) 854-0035 Contac* Darlene Lansing T/If .UA/KM DIi/tibC .4to00nE1p1 . II/IM/wNl PUOft I1/NHI AliOCNti0/1 . Mw/MM SOp11ty 10/ CkVIC/i/ /W/dftf0ff •./1AMii1e/1 .ti'O~ (1/ ti/Mql1w/ NI/ ERtNr/ Mraioi.w 0 A.sa".n.l Mw FieudEier e1 Gmd»N Aoprw nu in AjOie )fwAtA Ntrtntisn . Asspiai.w./ SbM sM Tii+it«r/ lNaap OMiei.lr 0 A.rorbi.e .I Sorb.nd Toritai.l A0Afie H..RA Mvoition Oreotws . Gntw /or Seirw. (n M. NtOMe Ma.retr . M.dorr/ Araoai.oisw o/ WIC Qir.cprs • TA. O4Y f.uwNWn 9 S.eii.ty hr /Wtiiesw fiMreaaisn