Issue Brief: Envisioning a New Future for Congregate Meals

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Issue Brief May 2021

Envisioning a New Future for Congregate Meals

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Institute Initiative

O ne year ago, the COVID-19 delivery, while exacerbating the need for this service. As a result, communities, families, and providers quickly adopted new, creative ways to continue providing nutritious meals, and found ways to keep connected with clients and community members. pandemic dramatically altered traditional congregate meal Sponsored by the AARP Foundation, the American Society on Aging and SAGE convened leaders from public,

nonprofit, and private sectors to discuss what has been learned in this new landscape, and to brainstorm possibilities for a new future for congregate meals. This issue brief highlights innovative strategies and ideas that emerged throughout these meetings, and offers actionable possibilities inspired by the conversations. We hope this will spark ideas and inspiration among providers, funders, and partners as communities reopen.

New York City Department for the Aging Commissioner Lorraine Cortes-Vazquez As the pandemic worsened, the New York City Department for the Aging team pivoted from op- erating as a hyperlocal community-based system to a centralized system, while preserving cultural and religious food preferences, and increasing the number of people served. Hallmarks of NYC’s new model included: • Partnering with halal, Latin, kosher, pan- Asian, and other cultural and ethnic food providers to ensure that the diverse food needs of older New Yorkers were being met, in addition to partnering with private deliverers such as DoorDash. • Amplifying existing wellness programs, including geriatric mental health services and case management, and forming new partnerships to expand virtual and tele- phone-based wellness and social interac- tion programs. • Preserving boundaries between this new model and existing home-delivered meal programs. Commissioner Lorraine Cortes-Vazquez offers three policy challenges to solve as we envision the future of congregate meals: • COVID-19 has exposed the need for more community-based services and for monies directed there. We need to collectively call for legislation—federal and local—to shift long-term dollars toward home- and com- munity-based services. • Ageism holds our current funding levels in place, which allows people to be dismissive of the needs of older people. We need a national anti-ageism campaign to combat this. • The pandemic has fundamentally changed the way services will be provided. Congre- gate sites of the future will be very different than the Older Americans Act–created sys- tem. We need policies to serve and satisfy the vastly diverse older population.

Scoping the Challenges and Solving for the Future Three major challenges to congregate meal programs introduced or exacerbated by the pandemic include the ability to continue connecting social interaction with meal services , bolstering access and logistics to safely deliver services, and arranging stopgap funding, as well as sustainable longer- term funding mechanisms . CHALLENGE: SAFELY CONNECTING SOCIAL INTERACTION AND MEAL SERVICES Congregate meals are more than a meal—they can be effective opportunities for social connection. For many older adults, congregate meals provide the only socialization they may have in a day. Unfortunately, the COVID-19 pandemic made it unsafe to gather together and share meals.

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Challenges Brought to Light • Dramatic increases in numbers of people who need and want services • Staying or becoming more culturally responsive • Keeping existing centralized food systems intact, to avoid conflating with shorter term solutions • Quickly forming partnerships with brand-new partners • Understanding who is being served: what they need and want, and what resources they have • Thinking outside of the box and establishing varied service models that work for people in different situations • Reaching and helping people who may not see themselves as needing services • Creating and maintaining centralized data systems, and ensuring data integrity • Preventing, or at best managing, short- and long-term health issues caused by social isolation • Finding right-size physical locations with the right features • Recruiting and retaining volunteers to meet demand • Ageist beliefs about dependency that make it easy to “dismiss” importance of/ funding for services • Unequal access to broadband, devices, and know-how creates a digital divide in virtual programming

Solution: Preserve Connections and Find Allies How do we solve for this now, while creating a stronger future for congregate meals? Preserve human connections, seek out new allies and partners, and acknowledge the full continuum of financial and social resources available among those you serve. • Advocate with local governments and partner with food providers to ensure that emergency food reflects the culture, needs, and preferences of the local community (i.e. kosher, halal, vegetarian, gluten-free, etc.).

• Establish partnerships with food pantries, local restaurants, food delivery companies, or grocery stores to procure supplemental culturally and nutritionally appropriate food for those who are most food insecure. • Beware the digital divide and always

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include telephone options. Consider telephonic conference lines for conversation and connection or event group texts to expand access to programming. • Partner with local age-friendly community groups to host socially distanced meals in age-friendly outdoor spaces. • Create and offer programming that • Use social isolation screening tools to measure the impact and the efficacy of services in decreasing social isolation. • Host a “hack-a-thon” in partnership with other agencies serving older adults or other age populations to identify out-of- the-box solutions to ensure those hardest to reach can access food. CHALLENGE: ACCESS AND DELIVERY LOGISTICS The pandemic disrupted people’s ability to gather together in one place for meals and social interactions. As a result, sites are struggling to find delivery drivers, connect with older adults, and recruit volunteers as they try to bring meals to individuals. Challenges Brought to Light encourages organic community connection, such as dinner and a movie. • Dramatic increases in the number of people unknown to agencies who are in need of food and consequently require enrolling in services • Reaching rural areas and frontier areas • The need to bring services to people, instead of bringing people to services

• Supply of equipment (e.g., vehicles) and volunteers needed • Addressing multiple needs during one “visit” or delivery • Maintaining HIPAA standards and other privacy concerns, particularly among those in need of meals who may have medical issues • Reimagining and repurposing what a community center will look like • Solving “last-mile” delivery barriers • Digital divide—access to devices, connectivity • Delivery efficiency—“batching” deliveries Solution: Usable Databases, Capacity, Delivery Services and Flex Funding How do we sustain this, while building a better future? Build usable databases, people and systems capacity, suitable delivery services, and flexible funding. • Create solution-focused task forces and partnerships with government entities and public insurance providers, as well as with communication and technology

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Challenges Brought to Light • Already-stretched budgets, decreases in funding even before COVID-19 • How to quickly set up new payment models to allow for private-pay options, then refine and sustain them • Securing funding after emergency- authorizations expire • Identifying new or non-traditional funders, and making a business case for funding • Replenishing special set-aside or rainy- day funds • Empirically showing value, return-on- investment • Sustaining increased demand and enrollments • Funding internet access, hardware, software, and technical assistance • Breaking down funding silos, paying for holistic service approaches • Funding data collection, analytic, and reporting systems • Attracting, establishing, and sustaining public-private partnerships

providers who may support this work. • Survey the constituent base (electronically and telephonically) to identify those who may be nutritionally insecure or hungry (and its impact on their overall health), but may not see themselves as needing food, and use that data to focus delivery on those in the greatest need. • Conduct outreach through partnerships with organizations (dedicated email blasts, leveraging social media, developing referral pathways) in food deserts and food insecurity hot spots to promote your organization’s emergency food programming and distribution. • Develop partnerships with non- traditional food delivery methods (food trucks, produce trucks, community- supported agriculture, farmers’ markets, school meal programs, etc.) to offer low- cost access to older adults. • Look for underused transportation assets, such as jurisdictional vehicles or school buses, that can be used to deliver meals. • Collaborate with employment offices to connect with people who may be recently or temporarily unemployed and could help with home-delivery. CHALLENGE: FUNDING Innovations and new partnerships have formed during the pandemic through mechanisms like flexible budgets, but may not be sustainable over time against increased demand.

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We’re grateful for the time and expertise of these working group members: Uche Akobundu , Director, National Resource Center on Nutrition and Aging; Senior Director of Nutrition Strategy, Meals on Wheels America Cynthia Banks , Former Chief of Staff, American Society on Aging Bob Blancato , Executive Director, National Association of Nutrition and Aging Services Programs Jackie Budilov , ProgramManager, AARP Foundation Autumn Campbell , Director, Public Policy and Advocacy, National Association of Area Agencies on Aging Leanne Clark-Shirley , PhD, Vice President, Programs & Thought Leadership, American Society on Aging Lorraine Cortés-Vázquez , MPA, Commissioner, NYC Department for the Aging

Solution: Consistent Messaging on Hunger and Isolation, Private Pay, and Partners How to sustain new funding sources and mechanisms over time, while creating new payment models for the future? Advocate using consistent messaging about hunger and isolation, include solutions such as private pay options, and gather partners who have a stake in addressing social determinants of health. • Enable data-sharing across organizations to maximize the utility of data collection. • Partner with emergency services (i.e., fire departments, healthcare clinics, police precincts) to promote an organization’s emergency food programs. • Partner with local departments of education and youth programs to identify students for volunteer opportunities (to fulfill high school community service requirements). • Partner with corporations, employers, and tech businesses (cellular, etc.) to request donations of gently used tablets or laptops that the organization would otherwise discard after upgrades; or seek donations of refurbished tablets, smart phones, etc., from cellular providers. • Amplify news coverage of how meal services have kept local restaurants and other businesses open. Inspiring Resources • Rethink intergenerational programs and physical distancing with Generations United . • Make your business case with The SCAN Foundation ROI Calculator . • Host a virtual Dinner + Oral History event with StoryCorps Connect .

Paul Downey , President/CEO, Serving Seniors Lynn Faria , Executive Vice President, SAGE

Melinda Forstey , Chief Operating Officer, Serving Seniors Peter Kaldes , President and CEO, American Society on Aging Keri Lipperini , Director, Office of Nutrition and Health Promotion Programs, Administration for Community Living Sandy Markwood , CEO, National Association of Area Agencies on Aging Shireen McSpadden , Director of the Department of Homelessness and Supportive Housing Wanda Mitchell , Director, Community Relations, Philadelphia Corporation for Aging Najja Orr , MBA, President & CEO, Philadelphia Corporation for Aging Pallavi Podapati , GRADFutures Scholar, American Society on Aging Lisa Marsh Ryerson , President, AARP Foundation Jennifer Sinnott , Vice President of Health and Social Services, Serving Seniors Lauren Steingold , Head of Strategic Initiatives, Uber Health David Vincent , Chief Program Officer, SAGE Edwin Walker , Deputy Assistant Secretary for Aging, Administration for Community Living Karen Washington , Assistant Director of Community Engagement, Philadelphia Corporation for Aging Steven Wilkinson , Senior Director, Programs and Services, SAGE Elizabeth Winn , Assistant Director for Health and Nutrition Services, Philadelphia Corporation for Aging Walter Woods , CEO, Humana Foundation

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