CONCORD — Lawmakers last week heard from nonprofit leaders from across New Hampshire about how a funding crisis has Meals on Wheels programs — and recipients — facing lean times, nutritionally and financially.
The agencies are grappling with demand growing far faster than federal or state funding, often meaning a choice between cutting back meals or overserving their budgets to keep seniors and people in need fed.
“Yes, we are choosing to serve tens of thousands of meals beyond what our contract allows compensation for, but what is the alternative?” Kathleen Vasconcelos, executive director of the Grafton County Senior Citizens Council and vice chair of the New Hampshire Nutrition Network, asked during testimony last Tuesday.
“If we reduce services even further, seniors in New Hampshire will not receive nutritious meals delivered to their homes, will not have a caring person checking on their well-being and may no longer be able to age in their homes,” Vasconcelos said. “Instead, they will enter facilities that will cost the state much more than our services.”
Ten agencies across the state are facing a cash crunch for Meals on Wheels, which are delivered to people at home, and congregate meals served in group settings at senior centers and community hotspots.
Many have sought ways to pare back what they provide, like when the Grafton County Senior Citizens Council eliminated dessert from its menus. Some face the prospect of discontinuing meal service altogether when the money falls short.
The funding crisis has spurred calls from state lawmakers and the governor to shore up the system on which many seniors and low-income residents depend.
Some novel suggestions have asked if groups of seniors can grow some of their own food.
Others were bureaucratic, like an open letter from Gov. Chris Sununu calling on the state’s congressional delegation to try to adjust federal funding formulas.
The subject of the Tuesday hearing was a bill proposed by Rep. David Huot, D-Laconia, which would provide an additional $450,000 to Meals on Wheels providers who are facing a funding shortfall. He noted during the hearing that he is unsure how much money is needed because the $450,000 total is something he came up with on the fly.
But to the groups tasked with serving seniors in their communities, some of the efforts either skirt practicality or fail to fully address the fundamental math underpinning the problem: Demand for meals has outpaced federal funding, and more money is needed to keep people from going hungry.
Jaymie Chagnon, executive director of Strafford (County) Nutrition & Meals on Wheels, said during an interview last week that the agency expects to exceed its state contract by 12,000 meals.
“That doesn’t mean those people aren’t eligible. It means I’m serving what the state won’t reimburse me for,” she said. “We can see that the trend is growing.”
Last year, agencies in the state served nearly 1.6 million meals to about 9,500 people throughout the state, Vasconcelos said. Of that amount, the agencies served 98,300 meals that were not covered by their individual state contracts, which cost them $3.2 million.
In addition to receiving state and federal funding, agencies receive money from counties, towns and cities, other nonprofit organizations, fundraisers, donations, and grants.
Follow the moneyFederal and state funding for home-delivered meals comes from three different sources: Medicaid, for senior citizens who could be in a nursing home, but choose to stay at home and receive services there, including nutritional support; the Social Services Block Grant (part of the Social Security Act), which provides nutritional support for homebound adults age 18 and older who have a chronic condition and are below a certain income threshold; and the Older Americans Act, which provides meals for homebound people age 60 and up who cannot prepare their own nutritious meals, regardless of income level.
While providers can ask recipients for donations, they cannot charge them for a meal, regardless of their income level.
In New Hampshire, 75% of senior citizens who receive services through the Older Americans Act live in rural areas, 15% live alone and 15% live in poverty, according to the nonprofit Meals on Wheels America.
Additionally, 19% of the state’s senior population is dealing with some level of food insecurity. Nationally, more than 60% of home-delivered meals recipients have reported that the meals they receive provide more than half of their total food for the day.
“The idea of remaining fully healthy on one meal a day is difficult to imagine,” said Erika Kelly, chief membership and advocacy officer for Meals on Wheels America, during a phone interview last week.
Programs can also institute private-pay models for home-delivered meals for recipients who could afford it, but they could not use state or federal funding for those meal units.
George Cleveland, executive director of The Gibson Center for Senior Services, based in North Conway, N.H., said the organization has not exceeded its state contract for home-delivered meals in the past and is not on track to do so this year — but he said they are “probably going to come right up to it.”
“The thing is, it only takes a few people to completely skew those figures,” he said.
He testified on Tuesday in support of a bill asking for an additional $450,000 for Meals on Wheels providers, noting that Carroll County is the fastest-aging county in New Hampshire. Even if the Gibson Center is on track for this year, the anticipated population shift has officials wary; they’ve even hired a development director to help drum up financial donations.
Lawmakers and agencies also acknowledged that the national emphasis on aging in place — helping seniors remain in their homes instead of entering nursing homes or other facilities — has contributed to the increase for home-delivered meals. But the rising cost of meals pales in comparison to the cost of residential care.
“It’s easy to get to $100,000 a year in nursing home care,” Executive Councilor Mike Cryans, who testified in favor of the funding bill, said during an interview last week. “I think it’s a program that saves money.”
Liz Sauchelli can be reached at esauchelli@vnews.com or 603-727-3221.