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By TRUDY LIEBERMAN Rural Health News Service Published: May 18, 2017 12:00 AM

Federal funding for meals on wheels is on the chopping block. The Trump administration budget blueprint released in March calls for the elimination of two federal block grants: That's money the federal government gives the states for social welfare programs, and those programs include home-delivered meals and meals served in senior centers.

Most of the nation's 5,000 meal programs also rely on money from the Older Americans Act passed in 1965 to fund about 35 percent of the cost of the meals they serve. Those funds are also in jeopardy. The budget blueprint calls for an 18 percent cut to the budget of the Department of Health and Human Services (HHS), which administers the Act, and programs are bracing for more cuts.

Paul Kraintz who heads the senior nutrition program at Meals on Wheels in Martinez, California, says while his program would lose about $67,000 it now gets from one of the block grants, he's really worried about the potential budget cut at HHS. "If they take 18 percent of that, it's going to be big." Why the attack on meals delivered to the elderly, many of whom are homebound, ill, and unable to cook or shop?

At his March news conference, budget director Mick Mulvaney told reporters, "Meals on Wheels sounds great," but to take that federal money and give it to the states, and say, 'Look we want to give you money for programs that don't work' I can't defend that anymore." He claimed the program was "just not showing any results."

Mulvaney didn't say what he meant by results. He didn't have to. His comments were aimed at creating doubt in the minds of legislators who might look favorably on cutting the Health and Human Services funds for use elsewhere in the federal budget. The potential impact on hungry elders was not a high priority. It didn't matter that thousands of seniors on waiting lists for food in communities across the country are, in effect, stuck in a bread line.

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Several academic studies examining meals on wheels programs have challenged comments like Mulvaney's regarding the program's effectiveness. A recent randomized controlled study funded by the AARP Foundation showed significant differences among seniors on waiting lists, those receiving home-delivered meals, and those getting deliveries of frozen foods. Seniors with home-delivered meals reported the greatest improvement in health and quality of life.

In 2013 Brown University researchers found that meals delivered to seniors allowed them to stay in their homes rather than going to a nursing home, and that resulted in a net savings to Medicaid, which pays for about half of all nursing home stays.

Nursing home funding from Medicaid may be in trouble, too, if Congress cuts more than $800 billion out of Medicaid over the next 10 years, which has been proposed. States could have fewer dollars to channel into nursing home care. The picture is bleak for senior services. Thirty-eight states also use Medicaid dollars for home-delivered meals.

None of this makes much sense. The number of people needing food is growing rapidly and has been for decades. Erika Kelly, a government affairs officer for Meals on Wheels America, an umbrella organization for local programs, told me its members are already serving 23 million fewer meals than in 2005, a decline that has resulted in an increase in hunger.

Federal funding has not kept pace with the need. Money from state and local governments and private philanthropy hasn't been able to provide the rest of the money to feed everyone who needs a meal. "The gap has grown so much there's no way private philanthropy will fill it," says Ellie Hollander who heads Meals on Wheels America.

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Philanthropy works only in places where there are lots of wealthy individuals and corporations to tap. In Dallas, donors who can write checks for $1 million or $2 million have helped whittle the waiting list from about 3,000 a year ago to 2,000 today.

What do those still on the lists do? "People have come to us who are literally starving, or they ask family to bring stuff from the food bank. It's whatever they can do to get food into their homes," says Katherine Krause, president of VNA Texas, the agency that delivers the meals.

Programs like those in Pine Bluff, Arkansas, aren't as lucky. There aren't many rich donors or big companies. "It's worse now than it ever has been for funding," says Director Betty Bradshaw.

In 1963 President John F. Kennedy, quoting the historian Arnold Toynbee noted in a special message to Congress, "a society's quality and durability can best be measured 'by the respect and care given its elderly citizens.'"

That respect and care may be threatened if government support to feed the elderly is cut.

Have you or a family member had experience with meals on wheels? Write to Trudy at trudy.lieberman@gmail.com.


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