U.S. Navy Special Operator 1st Class Brandon Peterson delivers food to an elderly resident in 2017 through the Meals on Wheels program as part of Minneapolis/St.Paul Navy Week. Public domain photo by Mass Communication Specialist 2nd Class Pyoung K. Yi
Many older adults have benefitted from senior nutrition programs like Meals On Wheels. But the wholesale reorganization of the Department of Health and Human Services and looming Medicaid budget cuts are putting more seniors at risk of going hungry than ever before.
Meals on Wheels, the more than 50 year-old program that is part of the Older Americans Act, ensures low-income older adults have access to nutritious food. Thousands of local programs enlist volunteers to deliver food to at-risk, frail, homebound seniors. The decimation of the Administration for Community Living — the agency that oversees senior nutrition and other vital aging programs — has left this program and others in limbo, according to Meals on Wheels America Chief Advocacy and Policy Officer Josh Protas.
Protas encourages journalists to highlight the impact programs like Meals on Wheels are having in their communities and to also reach out to local programs for compelling personal stories that can bring hope to a bleak situation. “When people understand the realities of the level of need and the difference that Meals on Wheels programs make, it’s more difficult for them to turn their backs and advocate for making cuts.”
Why this matters
On March 27, the Department of Health and Human Services announced that most programs currently under the ACL will be divided up between the Centers for Medicare and Medicaid Administration for Children and Families and the Office of the Assistant Secretary for Planning and Evaluation. Others will be significantly curtailed, or eliminated. Many specifics have not been announced, so programs serving older adults are in limbo, bracing for significant budget shortfalls.
Now, many local programs are at serious risk of funding cuts, leaving millions of vulnerable older people at risk of not receiving vital nutritional support, Protas said. Without these services, not only will more people go hungry, but it could lead to worse outcomes and potentially earlier death.
It’s also not clear how critical functions will be managed with the remaining staff. The organization has yet to see any plan for how existing funding for OAA nutrition programs will be administered, or how to ensure continuity and avoid a disruption in services. The reorganization of the ACL also means the loss of tremendous technical expertise and institutional knowledge that ensure federal dollars get to local Meals on Wheels programs, Protas added.
“If there is a delay in reimbursements for services that have already been provided or disruption of funding, that will force programs that are already stretched beyond the breaking point, to cut back, potentially curtailing services,” Protas said.
More than just food
Meals on Wheels serves more than 2.4 million seniors, providing about 251 million meals annually. More than a third of Meals on Wheels programs have long waiting lists and strict eligibility criteria. Protas estimates there are at least another 2.5 million vulnerable older people in need of nutrition services, but haven’t signed up for the program, a situation that will worsen if funding remains flat or is cut.
“We’ve been deeply concerned about the wait that millions of seniors face, who desperately need nutrition assistance, social connections, life-saving supports that our programs are able to provide, but just don’t have sufficient funding,” he said.
Meals on Wheels is about more than just the food. Often, the volunteers who deliver the food are the only human contact a homebound older adult experiences all week. Volunteers conduct wellness and safety checks, and can help connect seniors to other social services.
About 37% of funding for local nutrition programs comes from Meals on Wheels America through Older Americans Act money; a combination of private donations, city, state, and other federal dollars make up the rest. Reauthorization of the Older Americans Act was cut from the December budget reconciliation process, so they’re currently operating at 2024 levels, but inflation and the current economic outlook has eaten into their purchasing power.
Significant cuts to Medicaid and the elimination of the Social Services Block Grant program, an important source of funding for some Meals on Wheels providers, are being considered as part of the budget reconciliation process. Losing this funding would be “devastating” for local service providers, Protas said.
He also explained that many of these proposed changes are done under the guise of cutting costs and improving efficiency, but investments in Meals on Wheels programs save the government money. “We can feed a senior for an entire year for roughly the same cost as one day in the hospital or 10 days in a nursing home.”
Many older adults struggle with food insecurity
Almost 7 million older adults were food insecure in the U.S. in 2022, according to the National Council on Aging. Federal cost cutting will likely impact SNAP, the Supplemental Nutritional Assistance Program and Social Services Block Grant program, putting even more pressure on Meals on Wheels. SSBG funding is a critical source of funding for many Meals on Wheels programs — in some cases, it’s the only federal funding provided.
One such program is based in Abilene, Texas, part of Representative Jodey Arrington’s district (R-TX19). Arrington is the chair of the House Budget Committee, and architect of some of the budget reconciliation plans. This particular program receives almost half of its budget through block grants. They do not receive OAA nutrition program money, so if the block grants were to disappear, it would be catastrophic, according to Protas. The program would have to discontinue service for roughly half of the seniors they help, including many in rural communities outside of Abilene.
With potentially disastrous cuts on the horizon, Protas said policymakers need reminding from journalists about the transformative difference that the organization makes in the lives of seniors and the lives of volunteers. “We’ve been doing this for more than 50 years, so there’s deep expertise, a track record, and evidence-based research that validates the impact that we’re having.”
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