CITY COUNCIL PUBLIC HEARING
COUNCILMAN JAMES VACCA
CHAIR, SUBCOMMITTEE ON SENIOR CENTERS
DEPARTMENT FOR THE AGING’S MEALS-ON-WHEELS CONCEPT PAPER
MARCH 3, 2008

CSCS has reviewed the DFTA meals-on-wheels concept paper and discussed it widely with our members across the city. We are not opposed to change, but rather see the need for a planning and implementation process that does not rush into a new structure. The overall rfp process needs to be slowed down to ensure that any restructuring is successful for seniors and the agencies that serve them.

CSCS recognizes the need to grow the capacity of the MOW program to serve the expected growth in MOW recipients. There are some senior center kitchens that are close to or have maxed out on the number of meals they can provide. However, it doesn’t mean the city needs to stop using the valuable resource of these local kitchens altogether. Rather than closing kitchens, it would be more prudent for the city to invest in building the capacity of these kitchens.

Additionally, there are legitimate concerns about the Bronx Senior Options program and we ask for a full discussion of how to restructure what exists there as well. DFTA implemented the program as a pilot implying it could be changed as lessons were learned. It is fair to say that lessons have been learned and changes should be made accordingly as we will discuss.

On February 20, 2008, CSCS held a membership meeting attended by 100 representatives of agencies from all the boroughs. These are the concerns raised:

1. Need for MOW regions designed and operated by community-based nonprofit senior service providers: The concept paper allows for only 10-20 MOW contracts in all five boroughs. This is a dramatic reduction from the existing 97 MOW contracts citywide. Currently there are two contracts in the Bronx (originally was slated to be 3) and 94 in the other boroughs. The Bronx went from 17 contracts to 2 in 2005. The Bronx already has two and Staten Island one. That leaves a maximum of only 17 regions (contracts) for Brooklyn, Queens and Manhattan all together. 20 regions would be 800 meals per contract; 30 regions would be 600 meals; 45 regions (a 50% reduction in contracts) would be 400 meals per contract.
   
   In terms of lessons learned in the Bronx, mentioned previously, a MOW program structured that would allow lead nonprofit senior service organizations collaborating with other community-based organizations could accomplish:

   1. meet diverse tastes of the elderly population

   2. no mandate as to percentage of frozen meals – it is one option among others. This allows seniors community by community to choose hot or frozen meals without the structure of the program driving the outcome

   3. provision of therapeutic meals (diabetic, low salt, etc.)

   4. collaborations with other community-based meal providers, nursing homes or hospitals, or caterer.

This would ensure that the city does not impose requirements that aren’t in the best interest of seniors. We need to look at the needs of individual seniors, not just thousands over large regions. Lead nonprofit senior service organizations would coordinate the MOW program – both the meal preparation and delivery aspects. In the Bronx, there is only one caterer and the nonprofits only do the meal delivery service. Similar to the Bronx model is the Philadelphia MOW program, touted by DFTA, provides the same meal to all seniors without attention to diversity. NYC is a leader in its MOW program structure by being community-based and moving in that direction would be a step backwards.

2. New structure relies heavily on two day a week delivery of frozen meals to work: This would structure a MOW program that relies heavily on two day a week frozen meal delivery. While having frozen meals as a part of the MOW program, we are concerned that the hot meal five day a week program will become increasingly unaffordable because of the structure of big regions and inadequate funding. To its credit, DFTA did pick up funding for the 1800 meals formerly funded through Citymeals. However, going forward there is no new city funding being added to the MOW program by the city which will result in waiting lists. It could also result in a heavy reliance on a two day week delivery service driven by budget and not need.
   
   The CSCS Hunger Study, funded through City Council, “Hunger Hurts: A Study of Hunger Among NYC’s Elderly”, recommends full funding for MOW in order to eliminate waiting lists once and for all. We urge City Council and the Bloomberg administration commit to an uncapped program that will ensure that any senior assessed as eligible for MOW will get a meal on day one.

3. Many senior center kitchens are very efficient already: Senior centers now providing both MOW and congregate meals will lose their MOW funding. They still have to pay the cook and other staff the same salary. Other fixed costs will continue. The senior center kitchen is efficient – produces both congregate and MOW at a low cost and has a built in meal distribution system – gets meals out locally and at a low cost.

4. Per meal allotment not given: DFTA doesn’t state what the per meal allotment will be. In the Bronx, they started at $5 a meal in 2005 which was so low the Bronx ended up with only two contracts instead of three because agencies couldn’t afford to bid for the contract (especially if they were unionized). According to review of this program by the Independent Budget Office, the cost is now up to about $6.50 in the Bronx and citywide so it is unclear where the savings are as this is comparable to the per meal cost citywide.

5. Social isolation - loss of human contact: If seniors aren’t receiving five day a week hot meals, we have consistently stated our concern that there is a loss of human contact and relationship formed between the meal deliverer and client. There are endless stories of how meal deliverers go out of their way to help seniors by purchasing extra things like milk, groceries, a newspaper, etc. They have found seniors sick or on the floor and saved lives. Big regions don’t allow for any human relationship to form – there are too many meals to deliver. Any MOW structure needs to retain its locally based capacity – it is a lifeline to frail, homebound seniors.

6. Real commitment through funding to provide services addressing social isolation is needed: DFTA’s concept paper tacitly acknowledges that human relationship is an integral part of the MOW program by stating that it views home-delivered meals as consisting of 3 components – food, delivery, and provision of social contact. During the time the Bronx program was put into place the Department for the Aging insisted that no relationships were developed between meal deliverers and clients as the visit was too short. Community providers and advocates maintained it was quite the opposite and apparently DFTA now agrees. However, the concept paper states that vendors may be asked to work with other agencies to provide friendly visiting and telephone reassurance – all with no new funding. Even if volunteers are used for some of this, it takes time, staff and money to organize volunteers. This concerns us because we need a realistic commitment to the provision of these services, not an unfunded mandate – in the end, it is the isolated senior who suffers.

Thank you for the opportunity to testify today. CSCS greatly appreciates City Council’s staunch support as seen by your broad array of funding for senior services and support of community-based services. We are always ready to work with you to ensure that seniors can age in place in their communities with well designed and funded services – and most of all, with dignity.