Enid Borden Addresses Washington Reauthorization Listening Forum

Remarks of
Enid A. Borden, President and CEO
Meals On Wheels Association of America
Delivered to Kathy Greenlee, Assistant Secretary for Aging
U. S. Administration on Aging
At the Washington, DC, Reauthorization Listening Forum
February 25, 2010

Good morning Madame Secretary, and participants from throughout the aging network. It is a pleasure and an honor to be here today representing senior nutrition programs. I commend you, Madame Secretary, for your leadership on issues affecting seniors in the United States in general; and, in particular, I applaud your beginning this dialogue well in advance of congressional action on the reauthorization of the Older Americans Act. Doing so focuses our attention on matters that have an impact on the lives of our nation’s elderly everyday, not just during that period of time when legislators turn their attention to the statute. And these Listening Forums allow us to discuss serious matters directly, openly and, I hope, in a manner informed by the needs of people that Older Americans Act programs do and should serve.

As you just heard, I am Enid Borden, the President and CEO of the Meals On Wheels Association of America, or MOWAA as we call it. MOWAA is the oldest and largest national organization representing those who provide nutrition services to seniors who need them. Our mission is clear and straightforward – “to end senior hunger by 2020.” Those last few words represent a newly-adopted mission statement for MOWAA. Our singular vision is driven by conviction. It is also compelled by the tragic fact that the number of seniors facing the threat of hunger in this great land is not only unacceptably high, but also – and this is despite the heroic efforts of some 3500 senior nutrition programs funded through the Older Americans Act– it is growing. Yes, growing.

Some of you may be asking why I am talking about hunger when the topic for this panel is “Prevention and Wellness – Healthy Aging.” Simply stated, good nutrition is a bedrock of both of those. Or, put another way, prevention and wellness cannot exist side-by-side with hunger and malnutrition and poor nutrition. It is impossible. That means prevention and wellness and healthy aging are simply out of reach for many seniors. Because they are at risk of hunger.

That brings me back to the unacceptable fact of increasing numbers of these folks. MOWAA believes that several factors account for this increase in senior hunger and hunger risk. Some of them you know well and have heard frequently discussed. . .like the significant growth in the number of individuals age 60 or older, fueled by the Baby Boom; or ever-increasing food costs; or the state of the economy in general. We have no control over these. But there are other factors that we can mitigate. Some of these are factors that, MOWAA believes, may be unintended consequences of the Older Americans Act in its current state. Let me reiterate what I just said, because it may be both a new concept and a provocative one: the current structure of the Older Americans Act may be contributing unintentionally to the rise of hunger risk among seniors in America.

This morning I intend to back up that bold statement not with emotion and anecdote, but with data. Then I will propose changes to the Older Americans Act that MOWAA is convinced will enable senior nutrition programs across the United States to serve more meals to more seniors. Doing so will begin to shift the trend, even if only incrementally, toward fewer, not more, hungry seniors. The two major recommendations that I will put forth are simple, and are simply designed to reduce hunger risk among our nation’s vulnerable elderly.

Before I describe them, I want to articulate some assumptions, which I trust we all accept:

1. Food is a basic necessity;

2. There is a direct, and scientifically demonstrable, relationship between nutrition and health;

3. Good nutrition contributes to the prevention, treatment and/or delay of onset of many of the most common chronic medical conditions in the elderly, such as hypertension, diabetes, and obesity, for example; and

4. Hunger is a disease, and we have the cure for it today.

 

If we agree on those four fundamental points, then I hope that we can agree that the Older Americans Act should be one of the primary vehicles through which we deliver the cure to the deleterious disease called hunger – and prevent so many other diseases as well. I hope we will agree that we need to make changes in the Act during reauthorization that will contribute more effectively to the eradication of hunger.

Let me provide a brief background about the basis for MOWAA recommendations for change, as well as the data sources that support those recommendations. In 2007 the MOWAA Foundation commissioned outstanding researchers from the University of Kentucky’s Center for Poverty Research and Iowa State University to conduct a study entitled “The Causes, Consequences and Future of Senior Hunger in America.” That groundbreaking study was released at a hearing of the U. S. Senate Special Committee on Aging in March 2008. The findings were helpful to our understanding of the extent of senior hunger in the U.S. They were also discouraging. The researchers found that in 2001, 1 in 9 seniors, or 5 million older individuals, faced the threat of hunger. The next year we engaged the same researchers again and asked them to update the national study with additional years of data, as well as to give us a state-by-state look at the incidence of senior hunger in America. The second study was released in November of last year at a briefing of the House Hunger Caucus. To say that those findings were discouraging is an understatement. They were, and are, morally unacceptable. By 2007, there had been a 20 percent increase in the number of seniors facing the threat of hunger, with the number growing from 5 to 6 million seniors.

What does this have to do with the Older Americans Act? Taken in isolation, probably nothing. Put in a context, quite a lot. You see, MOWAA took the state-by-state data from the study and then we overlaid program information and results taken from the National Aging Program Information System (NAPIS). This NAPIS data is available on the AoA website.

Here is what we found:
In FY 2007, the year that corresponds with our hunger numbers, 21 of the top 25 Senior Hunger States – that is, those states that have the highest rates of senior hunger –transferred funds from Title III C, senior nutrition, to Title III B. Only 12 of the bottom 25 Senior Hunger States made such transfers.

We believe the evidence is compelling and clear. Allowing transfer of funds from Title III C to Title III B is having a serious adverse impact on the health and well being of vulnerable seniors across this great land. It must be stopped. So, there you have our first recommendation. Eliminate the authority to transfer funds from Title III C to Title III B, and vice-versa. This is not a new position for MOWAA, but it is one for which we will advocate with renewed vigor – because what was once a surmise is now supported by the data.

In the past those who opposed this anti-transfer recommendation have primarily raised two arguments against it. The first is that the amount of transfer has remained relatively constant over time. We do not understand the relevance of that statement, even if it were accurate. But it is not. Over the course of the most recent three years for which we have data, net transfers into Title III B from III C have grown significantly from approximately 9.6 percent, or just over $33 million dollars, to about 11.4 percent or nearly $40 million. That is real growth and that lost nutrition funding could have furnished hundreds of thousands of additional meals at a time when hunger risk is growing.

The other argument was that the funds transferred from Title III C to III B were being used to directly support nutrition services and to provide access to such services. That, too, is inaccurate. Other national data available through AoA clearly and unequivocally dispute that claim. I do not have time to share the details of these findings today, but MOWAA will do so in the near future.

Our second recommendation for changes in the Older Americans Act is also related to the issue of transfer. We propose the consolidation of Titles III C 1 and III C 2 into a single Title III C. This would eliminate the administrative burdens of intra-title transfers. States, Area Agencies on Aging and Senior Nutrition Programs could more easily direct nutrition dollars to areas of greatest need. There would be no change in what entities are eligible for funding, who could receive services, how clients are served, etc. Both congregate and home-delivered meal programs would continue to have access to these dollars, and the process of directing them where they need to go would be simplified.

The adoption of these two recommendations would entirely eliminate transfer within the Act. MOWAA believes this change would benefit not only nutrition programs but also every other program and service funded under Title III. It dispels myths associated with transfers that have held us all captive – namely, that the resources provided to programs under the Act have been sufficient, and that transfer authority allows States and localities to direct surplus funds from one service to another. You and I know there are no surpluses, but the case is harder to make as long as transfer exists.
 
We call upon you, Madame Secretary, and the entire aging network to stand with us in this modernization of the Older Americans Act. For our part, we pledge to stand with you in taking our individual and collective cases to the Hill to request adequate funding levels for all Title III services and for the Act as a whole. Right-sizing, I think you have called it. We are right there with you.

It is our understanding that some participants at your Listening Forum in Dallas last week suggested that the age of eligibility for OAA services be raised from 60 to 67. Let MOWAA go on record today as strenuously opposing this doubtless well-meaning suggestion. Our objection rests not on a preference, or on tradition, but firmly on the facts once again. Both of our hunger studies showed that, holding all other factors constant, age – that is, being between 60 and 64 – was a primary risk factor for hunger. In fact, a 64 year old senior is one third more likely to be at risk of hunger than an 84 year old.

And it is with these young old that prevention begins and is most effective. And that returns us to MOWAA’s mission statement and the four fundamental principles on which we agree. And to the subject of this panel. Prevention and Wellness and Healthy Aging. A positive triumvirate. Notice that there is no place for senior hunger, or even the risk of it, in that lineup. There is no place for it in America. Please stand with MOWAA in taking the pledge to end senior hunger in America by 2020. We can take a giant leap in that direction now and in 2011 by asking Congress to enact these straightforward changes to the Older Americans Act.

In closing, I’d like to thank you for giving me the opportunity to speak to you – before you break for lunch – in behalf of those who will go without this meal, and one tomorrow and the next day as well.