Nutrition programs for older adults face service cuts

WASHINGTON — Programs that feed older, homebound adults are instituting waiting lists amid budget crunches, rising costs of food, growing demand for their services and funding cuts from the government.

Combined with the end of COVID-19 era aid, local groups are finding that they can no longer serve the same number of people, resulting in difficult decisions about next steps.

“This is a huge challenge for our network,” said Josh Protas, chief advocacy and policy officer at Meals on Wheels America, a national organization that supports local organizations delivering meals to homebound individuals, mainly older adults.

Meals on Wheels is among the groups pushing for funding increases through the appropriations process for programs funded under the Older Americans Act, a decades-old law first signed by President Lyndon Johnson to support adults as they age in their communities.

One in three Meals on Wheels programs has a wait list, with an average wait time of three months.

“The vast majority of them recognize that there are more seniors in need in their communities that they’re not able to serve, in large part because of a lack of adequate federal funding,” Protas said.

Higher demand

The population is getting older. Over the next decade, people 65 and older will represent 22 percent of the population, compared to 17 percent in 2022.

They are at a unique risk for going hungry because of fixed incomes, social isolation, lack of access to transportation and health conditions that make it difficult to cook or shop for groceries.

Almost 7 million seniors were “food insecure” — or didn’t have enough to eat — in 2022, and more than 9 million could be by 2050, according to Feeding America.

Meals on Wheels or similar programs are almost ubiquitous. Many have been around for more than 50 years, providing a source of nutrition and social contact to people who can’t leave their homes and helping them age in place. Programs served 206 million home-delivered meals and 55 million congregate meals in fiscal 2021.

But the demand has outpaced the ability of programs to serve people in their communities.

“We have 12,000 people every day who are turning 60, and as a society, we haven’t really reckoned with the changes that are necessary to address those needs,” Protas said.

Current legislation

Congress has recognized the need for more funding for the programs. But budget pressures have made that difficult.

The Senate Health, Education, Labor and Pensions Committee — on a bipartisan basis — approved in July a reauthorization of the Older Americans Act, recommending to appropriators an increase of 20 percent each for the home-delivered and congregate meal programs.

Still, the Senate Labor-HHS funding bill, advanced by the Senate Appropriations Committee in August, would level-fund those programs in fiscal 2025. Meanwhile, the House appropriations bill would cut the nutrition programs by 1.6 percent.

The Older Americans Act funds several different programs intended to help older adults age in place, but its most well-known ones are related to food services: one for home-delivered meals, another for meals served in congregate settings, like senior centers, and the Nutrition Services Incentive Program, which allows programs to purchase fresh, local produce, dairy or proteins for meals.

While home-delivered meals and congregate settings received increases in fiscal 2024, the nutrition services incentive program received a cut, surprising advocates.

The program is intended to incentivize states to serve more meals because the amount of money it gets is based on how many meals it served the previous year.

“If you’re discouraging incentives, you’re actually lowering meal counts at the end of the day,” said Robert Blancato, president of the National Association of Nutrition and Aging Services Programs.

Overall, funding to the nutrition programs was cut by 0.8 percent in fiscal 2024 and states received about $10 million less in appropriations from the federal government in fiscal 2024 than in fiscal 2023.

That cut, plus growing demand for services, cuts to state budgets, the end of COVID-19 aid and inflation has put pressure on local service providers and the people who count on them.

The 2021 COVID-19 rescue package alone nearly doubled the amount the government typically spends on home and congregate meals, allowing organizations to reach people they couldn’t before.

Local programs

Now that the money is gone, groups have to make difficult decisions about who to remove from their programs or dropping the number of meals people receive per day, or creating wait lists.

“During the pandemic, the demand definitely shot up, and so did government funding… but then that funding went away, and the demand didn’t,” said Adam Porter, director of Sound Generations Meals on Wheels based in Seattle.

The organization has had a wait list since February 2023. It currently has 1,423 people on it, more than the number receiving meals through the program.

Food costs have also increased by 25 percent from 2018 to 2023, according to the Bureau of Labor Statistics.

“It continues to go up and funding isn’t, so we’re reducing the number of meals we can serve,” Porter said.

In Pennsylvania, the Monroe County Area Agency on Aging, which is responsible for doling out Older Americans Act funding to local partners, has had a freeze on new clients entering the program since July 2023.

Its primary partner — Monroe County Meals on Wheels — had to seek out a grant to avoid instituting a waitlist after the state passed flat funding for senior services programs.

The organization enrolled people on the waiting list into its private pay program, which is based on a sliding fee scale, to ensure people weren’t going without needed meals. It received a grant to cover the costs of the meals for people who can’t afford it.

“We’ve been dependent on community support and grant funding to try to fill that gap because the alternative is a waiting list of our own,” Alyssa Koeck, executive director of Monroe County Meals on Wheels in Pennsylvania.

“We’re working very, very hard to make sure that we do our best to prevent that from happening because we know, especially with the cost of living, that having nutritious, affordable meals is so critical to our clients.”