The Washington PostDemocracy Dies in Darkness

Meals on Wheels is ‘not showing any results’ only if you ignore all these results

Reporter
March 16, 2017 at 5:10 p.m. EDT
Office of Management and Budget Director Mick Mulvaney, March 16, responds to questions about Meals on Wheels and after-school programs. (Video: Reuters)

At a news conference Thursday, Mick Mulvaney, President Trump’s budget chief, defended proposed cuts to the Meals on Wheels program, which provides food aid to needy senior citizens, by saying the program is one of many that is “just not showing any results.”

Meals on Wheels is a nonprofit group that receives funding from the federal government, state and local governments and private donors. “We serve more than 2.4 million seniors from 60 to 100+ years old each year,” the organization writes. “They are primarily older than 60 and because of physical limitations or financial reasons, have difficulty shopping for or preparing meals for themselves.”

If that doesn’t clear the bar for “results,” as Mulvaney put it, there’s also been a fair amount of peer-reviewed research on the efficacy of the program.

A 2013 review of studies, for instance, found that home-delivered meal programs for seniors “significantly improve diet quality, increase nutrient intakes, and reduce food insecurity and nutritional risk among participants. Other beneficial outcomes include increased socialization opportunities, improvement in dietary adherence, and higher quality of life.”

Not only that, the programs offer good bang-for-your-buck: “These programs are also aligned with the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services by helping older adults maintain independence and remain in their homes and communities as their health and functioning decline.”

In other words, the programs help seniors stay at home and out of costly nursing facilities. If you’re interested in keeping a lid on health-care costs, the importance of this finding can’t be overstated.

“The average cost of a one-month nursing home stay is equivalent to providing home-delivered meals five days a week for approximately seven years,” one of the studies in the analysis found. How’s that for “results”?

Office of Management and Budget Director Mick Mulvaney spoke about the message President Trump sends with his proposed budget (Video: Reuters)

Also on the cost-containment front, a 2013 study by researchers at Brown University found that in most states, increasing Meals on Wheels enrollment would result in a net savings from decreased Medicaid costs for nursing home care.

More recently, those same researchers conducted a random controlled trial of Meals on Wheels efficacy. The study, which was funded by AARP, enrolled hundreds of seniors on food waiting lists across the United States. Some received daily meal deliveries, others got weekly bulk frozen food deliveries, and some simply remained on waiting lists.

“What we found is that there were statistically significant differences in health benefits among the three groups,” lead researcher Kali Thomas said, “with the highest gains recognized among participants living alone who had face-to-face contact via daily deliveries.”

Those receiving daily meals also experienced fewer falls and hospitalizations, the study found.

“Meals on Wheels sounds great,” Mulvaney said Thursday, but “to take that federal money and give it to the states and say, ‘Look, we want to give you money for programs that don’t work’ — I can’t defend that anymore.”