CITY COUNCIL JOINT HEARING
PROPOSED DEPARTMENT FOR THE AGING RFP FOR 
MEALS-ON-WHEELS IN THE BRONX
AGING COMMITTEE, COUNCILWOMAN MARIA BAEZ, CHAIR
CONTRACTS COMMITTEE, COUNCILMAN ROBERT JACKSON, CHAIR


NOVEMBER 25, 2003

The Council of Senior Centers and Services of NYC (CSCS) is the central organization representing 265 member agencies providing services to 300,000 older New Yorkers annually. Community-based services include: multi-service senior centers, congregate and home-delivered meals, case management, home care, transportation, adult day services, NORCs, counseling, information and referral for benefits, housing, ESL, elder abuse, educational and cultural activities, intergenerational programs and opportunities for volunteerism.

CSCS wants to thank City Council for their staunch support of senior centers and other services for the elderly. Without the millions of dollars of restorations you have put back into the budget over the past two years, seniors and the services they depend upon, would have been devastated. We would like to especially thank Councilwoman Maria Baez and Councilman Robert Jackson for holding this joint Aging/Contracts Committee hearing today. We are appreciative of the opportunity to testify. 

DFTA is attempting to radically change social policy and meal delivery through the RFP process. This closes the door to public discussion about the efficacy of DFTA’s proposals which is troublesome. We don’t want DFTA to do through the back door, the RFP/contracting process, what they couldn’t accomplish through the front door – budget cuts to elderly meal programs and senior centers.

CSCS shares the following concerns with meals-on-wheels providers in the Bronx and citywide:

The Department for the Aging planned to release an RFP at the end of October, which has been delayed, that will reduce 18 meals-on-wheels (MOW)contracts to 3 in the Bronx claiming that it will save money. DFTA has presented no business plan for implementing this change nor has it reported its projected cost savings. There is no plan for what happens if this “demonstration program” doesn’t work. Coordinating transportation and meals for such a large geographic area and number of meals can be a logistical nightmare. Commissioner Mendez Santiago has announced publicly that he plans to release the RFP at the end of November which would immediately follow this hearing.

Meals-on-wheels has three equally important functions: food, health and safety watchdog role, and linking seniors to other services. The community-based senior center is integral to providing comprehensive human services. This isn’t just about numbers of meals an agency can serve and dollars. This plan could lead to less contractors and more frozen food. It would damage the funding and infrastructure of senior centers and other senior service organizations and lead to a loss of jobs. DFTA has made it clear they plan to do this in all boroughs eventually by stating they have a plan to break the five boroughs into 21 meals-on-wheels regions.

DFTA has stated that it will use cost savings to provide more meals. However, there is no commitment from the city to use any savings for more meals. DFTA has an $8 million food reduction target that NYC’s budget office has required them to meet. This is part of the $75 million streamlining program City Council agreed to in the FY2004 budget adoption on the grounds that no services would be lost. There is concern that the city is looking to help meet the budget deficit by cutting MOW funding. As many MOW come out of senior centers, this is a cut to senior centers.

DFTA has stated that the average $6 per home-delivered meal cost in NYC is “disproportionately higher” than the rest of the country based on survey they did of other localities across the country. According to the chief nutritionist at the Administration on Aging in Washington, there is no national definition of a per meal cost. Therefore, there is no way to compare one locality to another. It is fallacious to do so. Other parts of the country would have to have the exact same cost accounting system as NYC to do this. AOA was not surprised to learn that according to DFTA the average per meal cost in NYC is $6 as costs are higher on the east and west coasts as compared with the mid-west and the south.

Based on our calculations given the information we have, DFTA’s plan is to lower the per meal cost to $5.25 per meal – that’s a 14% cut from the $6 average cost per meal. Obviously, for some agencies with costs higher than $6, this will be an even bigger cut. This is about a $500,000 cut to meals-on-wheels funding in the Bronx. If done citywide, the cut would be over $4 million. Again, these are our estimates as DFTA has not released a cost-benefit analysis of this RFP. What MOW provider can afford to bid for a contract with a 14% cut? The drive to more frozen meals will be budget driven.

According to DFTA, money can be saved through less than 5 day a week delivery and that seniors who get less than a five day a week delivery will receive telephone reassurance. There is no citywide telephone reassurance program. Where will the money to pay for it come from? Additionally, telephone reassurance isn’t good enough. Many seniors will say they are OK when they are not. Only a face to face visit will show what is really going on.

DFTA states that each homebound senior will be assessed by a case management agency as to whether or not they can use frozen meals.
Anecdotal information nationally indicates that only about 25-30% of homebound elderly can use frozen meals. This seems to be about the same percentage reported in NYC by case management agencies. At a recent meeting, DFTA stated that its goal was to get 50% of all seniors on frozen food. What will happen to the assessment role if there is a pre-determined target which is rather high? Each MOW program will have a different mix of those seniors who can use frozen or need freshly cooked food. This will always change with the mix of seniors being served at a particular time. Who will pay for microwaves? What if the health status of the senior changes? Will this create 2 waiting lists - for frozen and fresh food?

The case management system is a fragilely funded and staffed system as it is. Case managers labor under caseloads of 90 per worker, earn an average salary of under $30,000 a year and, like the rest of the aging services workforce, have had no salary increase since April, 1999. DFTA has stated that MOW deliverers shouldn’t be the ones responsible for keeping an eye on the well-being of MOW recipients, but that it should be case managers. This is unrealistic as it is the meal deliverer who sees the homebound person every day. While it is for a short time, it is enough to make sure the person is all right. 

According to DFTA, seniors like frozen food, even preferring it to hot meals. This is based on a small pilot program of under 500 seniors, compared to the 12,00-13,000 seniors receiving home-delivered meals each day and cannot be broadened to reflect what seniors prefer citywide. These seniors were on waiting lists for meals and were carefully screened for receiving frozen meals. While There cannot be one cookie-cutter approach to providing home-delivered meals in NYC especially with the diversity of older New Yorkers.

DFTA has stated that it will make agencies whole. Agencies that lose contracts will be given funding so that their infrastructure will not be hurt. Where will the money come from for this? If DFTA does this, where is the cost savings? Will the money remain after the first year? If the cooks prepare less meals, will their salaries be cut (already low paid with no increase in 5 years)? Will DFTA move later on to make the case that the senior center kitchens don’t have to prepare their own congregate meals? DFTA’s plan would break the Bronx into three districts requiring contractors to provide between 600-900 meals per day. Most current providers cannot bid for contracts this large which raises concerns about DFTA’s commitment to community-based services. Meals-on-wheels has been a locally based program for 30 years designed to meet the diverse needs of local communities.

DFTA has stated that agencies or the City can try to find jobs for kitchen and delivery staff who are laid off. Where will jobs be found? If a large contractor hires some of the staff, where are the cost savings? These are low paid staff with health benefits who have had no salary increase in five years. An article in the November 20th edition of the Bronx Times reported that, according to a recent poll taken by the Food Bank for NYC, 48% of Bronx residents are not able to afford food for their families within three months of losing their job. This is a frightening prospect. Along with the loss of a job comes loss of income, health insurance, ability to feed one’s family and numerous other crises. Homebound seniors will lose a lifeline connection to the world if staff is laid off.

It appears as though DFTA is willing to get take great risks in the name of cost savings. Only those at most risk will be the homebound seniors, staff and the agencies that serve them. CSCS and agencies citywide ask DFTA to reconsider this plan and not release the RFP.

The aging services network has received no “new needs” funding or salary increases in five years. As costs increase due to inflation, agency budgets have fallen behind by 10%. This means that the $300,000 budget a senior center signs for this year is worth $30,000 less than the same budget five years ago. Staff has received no salary increases in five years. DFTA contracted agencies have already taken more than their fair share of productivity savings. Waves of threatened budget cuts and policy changes through the RFP process are making it increasingly difficult for staff to provide the services to older New Yorkers that they are committed to doing. With agencies already operating on barebones budgets, clearly they cannot bid for contracts that reduce funding and are beyond their capacity to compete for.

The proposed Bronx RFP must be delayed until such time that DFTA is able to establish a meaningful planning process done with stakeholders in the field. Prior to the release of an RFP, we recommend that DFTA develops:

• A comprehensive fiscal analysis that includes the number of homebound seniors expected to participate in the frozen food program citywide (including projections for five years).

• A plan and budget to improve training to help case management staff determine whether seniors are eligible to receive frozen meals. Additional resources need to be allocated to case management agencies to take on this additional responsibility as they already labor under caseloads averaging 90 clients per one worker and have received no salary increases in five years.

• The program design and cost to provide a homebound senior with daily telephone reassurance programs, friendly visiting and other measures to regularly communicate with those seniors deemed appropriate to receive onlh weekly delivery of frozen meals.

• Impact on the infrastructure of senior centers and other senior service organizations and job loss. There can be a ripple effect of community service networks. For example, if an agency loses its MOW funding it could lose its funding for the transportation coordinator which provides transportation services other than for MOW.

CSCS is planning to launch a web-based food purchasing initiative in the new year, called the “Marketplace”. Senior centers and other meal providers will be able to receive deep discounts in food and food-related items by going on to this website and looking at competitively priced products. This would broaden the choice senior centers have in where to purchase their food and will reap cost savings. The key here is that the meal providers will remain autonomous in the purchase of food, no one will lose a job and seniors won’t be pushed into frozen meals to meet budget gaps. CSCS is determined to launch this program no matter what happens with this RFP. However, we ask that we be given a chance to make this work. We believe there will be cost savings that programs can use to provide more meals-on-wheels without damaging the infrastructure of the senior centers. This would give City Council, the Bloomberg administration and community-based organizations the opportunity to say that they worked together to provide more meals to seniors without spending additional city dollars in a time of fiscal crisis. This is a better message than the current one of let’s experiment with homebound seniors, senior center funding and infrastructure and loss of jobs in an unplanned venture breeding widespread opposition.

CSCS thanks City Council Aging and Contracts Committee, once again, for holding this hearing that is critical to the future of meals-on-wheels for frail, homebound elderly. We look forward to continuing to work with you to ensure that seniors have the services they need to age in place in their homes and communities with dignity.