The Maine Department of Health and Human Services says it wants Meals on Wheels delivered more efficiently.
But we have our doubts that DHHS can squeeze more efficiencies out of a decades-old, volunteer-driven system that delivers more than 800,000 meals each year to almost 18,000 people across the state at an average cost of $7.44 per meal — well within the national norm, even for more urban areas.
Maine’s five area agencies on aging have provided meals to seniors in every corner of the state for decades. Now the agencies appear to be part of a move by DHHS to rework operations without any clear reason. DHHS informed the area agencies in a recent letter that it intends to put senior meal services out to bid in time for the successful bidder to take over Oct. 1, 2017.
“Since Title III funds have not kept pace with the burgeoning ranks of vulnerable adults, it is time for a focused look at efficiency in providing these services and we will be pursuing a request for proposal,” Gary Wolcott, director of DHHS’ Office of Aging and Disability Services, wrote to the five area agency on aging directors in the April 14 letter.
The announcement took the agencies’ directors by surprise. After all, DHHS is finishing a new, federally required four-year state plan on aging, and the 75-page document doesn’t mention plans to put meal services out to bid. And DHHS hasn’t informed the agencies that they’re operating inefficiently.
“They’re essentially putting a federal grant out to bid that has no documented deficiencies,” said Noelle Merrill, executive director of the Eastern Area Agency on Aging, which serves Penobscot, Piscataquis, Washington and Hancock counties. “It’s like firing somebody after giving them good evaluations for 40 years. We don’t really understand.”
Samantha Edwards, a DHHS spokeswoman, said the competitive procurement is a state requirement.
“The procurement process produces accountability among providers and ensures that Maine taxpayers receive the best value for the dollars they expend on services,” she wrote in an email. “This is a key priority for the Administration. It is noteworthy that the Department is on track to release 100-125 RFPs this year compared to an average of 30-35 per year when this Administration took office.”
In federal fiscal year 2015, the state chipped in 6 percent of the cost of providing meals — about $372,000 — according to the Office of Aging and Disability Services, while federal funding totaling $4.4 million covered 71 percent. The area agencies on aging collected the rest through voluntary contributions from meal recipients and fundraising.
Most of the federal funding comes to Maine through the Older Americans Act, and DHHS appears to have a fundamental misunderstanding of what the federal law governing that funding allows it to do.
Since the 1970s, the Older Americans Act has designated each state’s area agencies on aging as the entities in charge of dispensing federal funds in order to pay for senior services in their respective regions.
The federal regulations for Title III of the Older Americans Act spell it out clearly — that a state-level aging office distributes senior meals funding to the designated area agencies on aging. “Area agencies in turn make subgrants or contracts to service providers to perform certain specified functions,” read the regulations.
Ultimately, then, it’s up to the area agency on aging to decide whether to put meal services out to bid, not a state department.
There’s an exception in federal law that would allow DHHS to contract meal services out on a statewide basis, but DHHS would have to indicate in its four-year state plan on aging that it thinks it can provide meal services more economically through the contract. DHHS, however, hasn’t shown it has found a more economical way to provide Meals on Wheels, much less indicated as much in the state aging plan it’s completing.
Nationally, the majority of area aging agencies contract out meal services, and most providers are local nonprofit organizations, said Amy Gotwals, chief of public policy and external affairs at the National Association for Area Agencies on Aging. In Maine, however, the area agencies mostly provide meal services directly. In the decades they’ve provided those meals, they’ve built up volunteer networks that keep the meals coming — about 400 for the Eastern Area Agency on Aging and 2,000 statewide, according to Merrill. And mealtimes offer seniors the opportunity to connect with an area agency for any number of other services, from advice on health insurance to help with home repairs to assistance with finding affordable housing. Plus, volunteers doing home deliveries can check in to make sure seniors are safe.
Under federal law, the area agencies on aging are the one-stop shop for information on services for seniors, and meals are a critical part of connecting seniors with those services.
The volunteer network and those points of connection are exactly what a bid process puts at risk when little appears to be wrong with how things are operating, save for insufficient funding to meet a growing need.