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NOCSPEN Newsletter: Jan 2021

In This Issue

  • Message from the President

  • December Gut Microbiome Webinar Highlights

  • Upcoming Events

  • NOCSPEN/DVD Coram Event

  • Medi-Cal Updates

  • ASPEN Conference

  • CNSC Tidbit

  • Get Involved

  • Latest in the News

Message from the President

As we come to the end of 2020 and begin 2021, there is hope that with two new effective vaccines, we can begin to find a solution to the COVID-19 pandemic.  This event has challenged us, both in our professional and personal lives. Thank you for all you have done to meet patients’ nutrition needs and for your support of ASPEN/NOCSPEN. Nutrition support has made tremendous advancements since the founding of our Society in the mid-1970’s. Many health professionals, however, still do not evaluate patient nutrition needs as they consider diagnosis and treatment. I hope your professional intervention can address this critical component of patient care.

We at NOCSPEN had to curtail some of our activities, but we were able to sponsor two online Zoom® presentations recently, and we have another lecture planned for January.

I want to thank the NOCSPEN Board for their ideas, advice, and suggestions, as they also continued to meet the demands of their professional practices.  Special thanks to the NOCSPEN Newsletter team!  I hope you might consider volunteering to either serve on our board or participate in a NOCSPEN-sponsored conference. Please plan to register for the virtual ASPEN Annual Meeting, which will be held March 20-23, 2021.

I appreciate the opportunity to have served as NOCSPEN president this past year. Thank you for your support and commitment to patient care.


Dan Furtado, Pharm.D., MPA


December Gut Microbiome Webinar Highlights

In December, NOCSPEN hosted a two-part webinar series focusing on the gut microbiome.

Erin Nella, Senior Dietitian at the UC Davis Medical Center dived into the topic of probiotics and provided an excellent presentation on the most recent research and recommendations. The American Gastroenterology Association (AGA) published guidelines on probiotic use in June 2020, which can be found here. AGA had limited recommendations for probiotics due to the need for additional research.  AGA does support the use of certain strains of probiotics for adults with C Difficile, children on antibiotics and preterm infants with necrotizing enterocolitis. Erin’s take home points included the importance of looking at strain specific probiotics for use with certain medical conditions, the importance of a higher fiber diet to positively affect our microbiome and the promising research to support the gut microbiome and neurologic disease management.

Dr. Sean Spencer, gastroenterology and postdoctoral fellow at Stanford who is completing research at the Sonnenburg lab spoke next on the importance of fiber to bring diversity to our gut microbiome. The gut microbiota that live in our colon thrive on complex, high fiber foods due to their transit time ending at the colon. Simple sugars are absorbed in the small intestine, which doesn’t allow for fuel to be provided to the gut microbiota. Dr. Spencer discussed how our microbiome has a vertical lifeline passed down from millions of years and as our lifestyle and diet have changed with industrialization it has changed our microbiome. Research has shown that less industrialized areas tend to have more diverse microbiota, which has been associated with better health. His research continues to support the importance of a high fiber diet for a thriving microbiota and fermented foods to increase microbiota diversity.  Probiotic use didn’t appear to affect the diversity of the microbiome over time, but may have benefits for patients with metabolic syndrome who also eat a more plant based diet. Dr. Spencer concluded his presentation with potential areas for research on how fermented foods may directly affect the microbiota and immune system.

Upcoming Events


Date: 01/19 Tue (7pm) 
Topic: Identifying Malnutrition and Applying Enteral Nutrition
Learning Objectives: 

  • Describe, understand, and differentiate among the three definitions used to describe adult disease-related malnutrition.

  • Understand the clinical and economic consequences of malnutrition.

  • Identify the appropriate application of enteral nutrition (EN) for malnourished patients.

Speaker: Cynthia Reddick RDN, CNSC, National Tube Feeding Manager of Coram CVS Specialty Infusion Services

Venue: Webex 

2021 Medi-Cal Updates

By Brenda R Hansen, MS, RD, CNSC

Every year I look forward to the updated List of Enteral Products. I check to see which new products are approved for coverage – Hello Kate Farms  :)  Hello Functional Formularies  :) .  I then check to see which products have been discontinued.  Farewell to the discontinued ultrapaks and canned items.  There are always a few new coverage requirements to digest. Wow, I was not expecting the 2021 changes.

In 2020 Medi-Cal divided enteral products into 5 Product Categories with subcategories of 22 Product Types, and 7 Product-Specific Criteria defining the age, clinical status, restricted volume needs and number of failed trials of “simpler” formula are required before use of a non-standard formula is acceptable.

2021 EXPANDS the number of Product Types to 75 and the number of Product-Specific Criteria to 137. Check out the Table 1 for a visualization of the changes to Product Types alone. 

I took a quick dip into the December 2020 updated Enteral Nutrition Products. Next I took a DEEP DIVE through link to the List of Enteral Nutrition Products Effective for Dates of Service On or After January 1, 2021 (link available in the Enteral Nutrition Products pdf).

I found expanded documentation needs including when proof of failed trails of “simpler” formulas are needed. There were expanded and, at first glance, confusing age limitations for many Metabolic formulas.  Formulas I’ve considered equivalent, like Peptamen 1.5 and Vital 1.5, mow fall into different Product Types. I concluded the new Product Types and Product-Specific criteria could impact documentation needed by DME companies in order to obtain Authorization. RDs, RNs, PAs and MDs need to be familiar with the differences between the Medi-Cal defined Caloric-restriction, Calorie-dense and Volume Limited formula Product Types.

I share with you the results of my deep dive – a summary of the Product Specific Criteria Changes to Medi-Cal Formulary – January 2021. Please share the 2021 Medi-Cal changes with your fellow RDs, MDs and anyone involved in the enteral referral process.

Click here to view Table 1
Click here to view a more detailed summary of Changes Effective


Get Involved with NOCSPEN

Get involved with NOCSPEN! We are seeking a Vice President,  Social Media Manager and two Newsletter editors.


Primary Role: Assists president in the planning and administration of all chapter activities and assumes presidency in the president’s absence. 

Works closely with president in development/update of the chapter’s strategic plan
Participate in members committee and at least one other key program committee
In the president’s absence, perform the duties of the President
Appoint committee chairs and assist election for the following year prior to the annual meeting.
When possible, represent the chapter to attend leadership retreat in Washington, DC that usually occurs biannually (October). 

Elected By: Board of Directors 
Length of Term: One year

Membership in the chapter and national association 
Demonstrated leadership in a volunteer environment
A commitment to the chapter and its values, and an understanding of the chapter’s objectives, organization, and services
Knowledge of and influence in the chapter’s industry/profession


Primary role: provide information to the members via social media/electronic means (i.e., Twitter, Facebook and LinkedIn).

Key Responsibilities:
Reports to Communication chair. Maintain a dotted line relationship with Membership Chair 
Set up and maintain social media accounts.
Indicate admins/moderators on social media accounts.
Post topics to our social media sites/ website discussion board to generate conversation, share information, educate, or enlighten members and to encourage conversation by monitoring and replying to the discussion thread. Some examples could be posting relevant news/ research on Nutrition Science from ASPEN or other credible organizations websites [e.g. Oley Foundations, American Gastroenterology Association (AGA), Society of Critical Care Medicine(SCCM), European Society of Parenteral and Enteral Nutrition (ESPEN)]
Moderate discussion on social media accounts - clear out spam or other inappropriate posts.
Obtain marketing info from Communication Chair, disseminate information about events (CE events, social gathering) through social media outlets.
Relate any members’ affairs on social media accounts to membership chair.

Term of Office:
One (1) Year, can be reappointed
Voting member

Membership in the chapter and national association
A commitment to the chapter and its values and an understanding of the chapter’s objectives, organization, and services


Primary roles: provide information to the members via quarterly newsletter

Key Responsibilities:
Create quarterly NOCSPEN newsletter in Mailchimp. 
Brainstorm newsletter themes and sections. 
Obtain marketing info from board members, disseminate information about events (CE events, social gathering) through newsletter.
Relate any members’ affairs on social media accounts to membership chair.

Term of Office:
One (1) Year, can be reappointed

Membership in the chapter and national association
A commitment to the chapter and its values and an understanding of the chapter’s objectives, organization, and services

ASPEN conference

  • Facebook - White Circle
  • LinkedIn - White Circle
  • ASPEN Website
December Gut Microbiome Webinar Highlights
A Message from the President
2021 Medi-Cal Updates
Get Involved with NOCSPEN
Upcomng Events
ASPEN conferene
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