Tag Archives for Ellie Hollander

Meals on Wheels Rhode Island: New Strategic Plan Builds Resilience, Growth 

Published in RINewsToday on November 25, 2025

Today, nearly 13 million older Americans worry about having enough to eat, and a 2020 University of Michigan poll conducted during the COVID-19 pandemic found that 56% feel lonely—a level so severe it has been declared a public health epidemic.

Although the historic federal shutdown has ended, reimbursement for local Meals on Wheels providers remains uncertain, warned Meals on Wheels America (MOWA) President and CEO Ellie Hollander in response to the passage of the continuing appropriation ending the federal government shutdown.

According to Hollander, these funding delays caused serious financial strain for 9 in 10 local programs, which depend heavily on federal dollars through the Older Americans Act Nutrition Program. In fiscal year 2024, for the first time in a decade, this federal program was cut.  About 41% of providers rely on it for at least half of their operating budgets, she stated.

Hollander noted that prior to the 43-day shutdown, one in three Meals on Wheels programs had a waitlist, with an average wait time approaching four months—and some stretching to two years. The lingering effects of the shutdown, combined with flat federal funding and recent cuts to SNAP and Medicaid, will only deepen food insecurity among older adults and cause waitlists to grow even longer, she predicted.

Providing Nutritious Meals to Rhode Island’s Most Vulnerable

Meals on Wheels of Rhode Island (MOWRI) is one of 5,000 community-based providers (operating both home-delivered and congregate meal programs) nationwide, serving an estimated two million older adults, in total. Collectively, there are more than two million volunteers and 100,000 paid staff supporting these efforts.

MOWRI is not an affiliate of MOWA and is an independent nonprofit organization.  MOWRI reports a strong fund development portfolio, in addition to federal and state grant through the Older Americans Act and administered by the R.I. Office of Healthy Aging. The organization expects to raise more than $1 million through grants, individual donations, corporate partnerships, events and campaigns this year. Each year, more than 1,500 individuals make a gift to MOWRI.

A Solid History in RI

Founded in 1969 by gerontologist Joseph Brown, MOWRI began by serving hot lunches that met one-third of an older adults’ daily dietary requirements to just 17 Providence seniors along a single delivery route. By 2024, the organization had grown significantly. That year, 472 volunteers drove a combined 398,100 miles, visiting 3,738 clients Monday through Friday across 260 service days. Volunteers delivered 421,553 meals on 90 delivery routes statewide and conducted 328,000 well-being checks and social visits.

 In 2025, MOWRI is serving 77% more meals each weekday than five years ago and has expanded its reach to more at-risk populations in addition to homebound older adults, including pregnant and postpartum women and those living with HIV/AIDS and other chronic illnesses.

Responding to changes in federal funding for nutrition programs, combined with next year’s state economic outlook characterized by moderate revenue growth, MOWRI released its 15-page 2030 strategic plan,  Building Resilience, Deepening Impact, last week. “Our bold new strategy will allow us to extend our reach and improve the lives of even more Rhode Islanders through expanding our role as sector leaders, ensuring sustainable organizational growth, increasing our impact, and driving quality in all that we do,” said MOWRI Board President Christina Pitney in a statement announcing the plan on Nov. 19.

5-Year Plan Expands Nutrition & Wellness for Homebound

According to MOWRI, its five-year plan “utilizes a ‘Food for Service model’ to concurrently tackle food insecurity and social isolation with the goal of reducing loss of independence among homebound and frail older adult Rhode Islanders.” MOWRI’s Home-Delivered Meal Program offers daily, fully prepared nutritious meals to homebound Rhode Islanders delivered right to their door. With the delivery of the meal, the volunteer driver performs a safety-assuring wellness check along with a social visit.

MOWRI’s Emergency Meal Program is a component of the home-delivered meal service.  This program is specifically designed to provide a back-up supply of non-perishable food for clients to ensure that they have access to food if their regular daily meal delivery is interrupted by severe weather or other emergencies.

Eligibility for the traditional Home-Delivered Meal Program requires clients to be age 60 or older or qualify through a state waiver program. Participants must be homebound—unable to safely leave home without assistance—and cannot be enrolled in adult day care or a community dining program on days they receive home-delivered meals. For the Capital City Café Program, clients must be 60 years of age or older, or under 60 and living with a disability or receiving general public assistance.

MOWRI enters the 2030 planning period from a position of exceptional strength, the strategic plan notes, stating that its paid staff and volunteers have delivered more than 21 million meals to date and expanded services statewide, including Block Island. With decades of experience supporting older adults through nutrition, safety checks, social connection, and health-focused programming, the organization is now preparing for its next phase of growth. However, the plan also acknowledges rising service demands, stagnant public funding, and increasing competition, while emphasizing that MOWRI’s strong financial reserves, trusted reputation, and culture of innovation provide the foundation for deeper impact.

Stakeholder input, interviews, data analysis, and national best practices all point to the same conclusion: MOWRI must expand its role in the health, aging, and equity ecosystems while building the infrastructure necessary to sustain long-term progress. The strategic plan suggests that MOWRI’s “More Than a Meal” model evolve into a public health intervention. With changing demographics among the state’s aging and vulnerable populations, the organization seeks to further expand home- and community-based services to persons with disabilities, people under age 60, rural residents, school-aged children, perinatal clients, and those living with chronic illness.

MOWRI also seeks to enhance private-pay options designed for caregivers, individuals living alone, and those recovering from surgery or illness.

Recognizing the Importance of Partnerships

The strategic plan calls for using its existing and new partnerships with hospitals, health care systems, Medicaid providers, and insurers to allow the organization to support hospital discharge planning, chronic disease management, and post-hospitalization recovery. Meanwhile, this plan also foresees standardized health assessments and referral practices conducted during meal delivery, ensuring that staff who have direct in person interaction with clients and volunteers play a direct role in supporting participant health and safety.

The strategic plan calls for providing medically tailored meals that meet both the clinical and cultural needs of clients, elevating MOWRI’s position as a statewide demonstration site for Food-Is-Medicine initiatives.

The organization also intends to investigate nutritional counseling and other health-supportive services that improves medical outcomes and promotes aging in place. Additional priorities of this new strategic plan include the establishing well defined criteria to evaluate new programs based on its organizational mission, fiscal stability, and organizational capacity; strengthening the organization through succession planning, leadership development, expansion of volunteer base,  and targeted recruitment; and adopting organization-wide data systems to improve evaluation and decision-making.

Increased use of the Mobile Meals app will streamline delivery operations along with strengthening communication, enhancing participant monitoring, and supporting healthcare collaboration. Existing and new partnerships with academic institutions expands the organization’s research efforts. A new organizational dashboard can assist MOWRI’s leadership track key indicators and allocate resources effectively.

Finally, the strategic report emphasizes the importance and value of advocacy and its visibility.  As competition from for-profit and tech-enabled providers grows, the organization must elevate its position on policies and clearly communicate the unique value of personal connection, wellness checks, safety monitoring, and culturally responsive services.

Overall, MOWRI says its strategic plan positions the organization for sustained growth and expanded impact by 2030.

“Our future will not be without challenges, and we are focused on ensuring that every Rhode Islander has access to the nutrition, connection, and dignity they deserve,” says Executive Director Meghan Grady.

For more information on volunteering or making a gift to support MOWRI’s statewide impact, please visit www.rimeals.org.

Meals on Wheels Should Be Expanded

 Published in Pawtucket Times, October 25, 2013

            A warm, nutritious meal combined with social interaction can go a long way to putting the brakes to a state’s spiraling Medicaid costs.  According to new study findings detailed in this months issue of Health Affairs by Brown University public health researchers, expanding programs like Meals on Wheels, would save 26 of 48 states money in their Medicaid programs, just by allowing a person to stay in their own homes. 

            Kali Thomas, Assistant Professor of Research in the Brown University School of Public Health, says that if every U.S. state in the lower 48 expanded the number of seniors receiving meals by just 1 percent, 1,722 more Medicaid recipients avoid living in a nursing facility and most states would experience a net annual savings from implementing the expansion.

Put the Brakes to Medicaid Costs

            According to the study’s findings, Medicaid cost savings would be different in every state.  For instance, Pennsylvania would see the greatest net savings – $5.7 million – as Medicaid costs for nursing facility care decrease more than costs rose for delivering the additional meals.  Meanwhile, Florida would see a net cost of nearly $11.5 million instead. Overall, 26 states would stand to see a net savings according to the Brown University Public Health analysis, while 22 would end up spending more.

            Every state would enable more seniors, who could live independently except for meals, to remain in their homes regardless of whether they are on Medicaid.

            Thomas, the study’s lead author, believes the study’s findings can provide guidance for state lawmakers and state policymakers as they hammer out budget funding for home-delivered meals programs, which are conducted under the Older Americans Act.

            “We wanted to provide a roadmap for people,” Thomas said.

             To calculate Medicaid savings, Thomas and co-author Vincent Mor, Brown’s Florence Pirce Grant Professor of Community Health, examined data, including how many seniors in each state receive home-delivered meals and how much it costs each state to provide those meals. She and Mor also took a look at nursing facility and Medicaid data to estimate the number of seniors that Medicaid maintains in nursing facilities who are “low-care,” meaning they may have the functional capabilities to live at home. Finally they looked at the per diem Medicaid pays in each state for seniors to live in nursing facilities.

 Keeping Seniors at Home

             The study findings allowed them to estimate the incremental cost of providing meals to 1 percent more seniors in each state, the number of additional seniors on Medicaid who would no longer need to live in nursing facilities, and how much less Medicaid would have to pick up for the higher level of care in each state.

            The researchers found that the 1 percent expansion nationwide would bring meals to 392,594 more seniors at a cost of more than $117 million. Because 1,722 seniors would no longer have to live in costly nursing facilities paid for by Medicaid, total program savings would total $109 million.

            The reason why the study’s findings indicate that additional food delivery costs outstrip Medicaid savings nationwide, even though most states would save money on a net basis, is that in some very large states with relatively few low-care seniors or relatively low Medicaid per diems, food costs outweighed the resulting Medicaid savings on a relatively large scale.

            “In states like California and Florida where a 1-percent increase in the 65-plus population is a lot of people, it will cost those states a lot more to feed them,” Thomas said.

            But, as she and Mor wrote in Health Affairs, “Our analyses suggest that 26 states with high Medicaid nursing home per diem reimbursement rates, a large proportion of low-care [nursing home residents on Medicaid], and a relatively small population of older adults, could save money.”

            Thomas said states projected to lose money can opt to focus their efforts in ways that are more precise than an across-the-board expansion.

            “We’re not proposing that all states simply increase the proportion of age 65 plus receiving meals by 1 percent,” she said. “But if they were to target these vulnerable people who are at risk for nursing home placement they would likely see more savings. This is a program that has the potential to save states a lot of money if it’s done correctly.”

            Policymakers should consider not only the fiscal implications of providing home-delivered meals, which the study quantifies, but also the impact on individual seniors, said Thomas, who has seen the benefits anecdotally as a Meals on Wheels volunteer in both Florida and Rhode Island.

            Thomas’s research, detailed in this month’s issue of Health Affairs, which was completed last December, is featured in AARP Rhode Island’s award-winning documentary Hungry in the West End. Creator and director John Martin of the AARP

             Rhode Island state office screened the documentary in August at the Meals on Wheels Association of America National Conference in Boston. You can watch Hungry in the West End online at www.aarp.org/hungry.

             Although the quality of life argument is easy to see, other researchers, like Thomas, are closely looking at how the Meals on Wheels program can lower Medicaid costs.

             Based on a study by the Washington, D.C. based Center for Effective Government released in April 2013, every dollar invested in Meals on Wheels today could save taxpayers up to $50 in Medicaid costs down the road.

 Other Benefits of Meals on Wheels  

             Ellie Hollander, President and CEO of the Meals on Wheels Association of America, observes that both Brown University and the Center for Effective Government studies specifically focused on Medicaid savings attributable to nursing homes, but do not take into consideration significant savings that would be realized through reduced Medicare costs as well, through fewer visits to physicians and the emergency room and less hospitalization or reduced readmissions.

             Hollander says, “We have long known that the value of Meals on Wheels goes beyond the social and moral imperative of helping to address the epidemic of senior hunger in America.  “The friendly visit and a safety check are a lifeline enabling seniors to live more independently and healthy in their own homes, which in turn avoids far more costly health care alternatives often paid through Medicare and Medicaid,” she says.

             “The Brown University research proves what our work has long suggested to us: the Home Delivered Meals Program not only makes a positive impact for the senior, it is a good investment for the state as well,” says Executive Director Heather Amaral, Meals on Wheels of RI.

            Another study is in the works to support Thomas’ efforts to closely look at the impact of nutritious home delivered meals.  According to Hollander, a $350,000 grant from the AARP Foundation and the Meals on Wheels Association announced on Oct. 6 will enable Thomas to begin her randomized controlled trial of 600 seniors representing a cross-section of rural, urban, low income and minority populations across the country and a majority of the grant will be used to feed these seniors.            

            In this upcoming study, 200 seniors will receive meals daily, 200 more will receive a delivery of frozen meals once a week and then another 200 will continue on the waiting list as before as a control group. The study will compare quality of life, isolation, and health care utilization among individuals before and after they begin receiving meals and across the three groups.

             Holland says, “Through our generous grant from AARP Foundation, and with Dr. Thomas and Brown University’s help, we will seek to monetize the value add of the “more than a meal” component of Meals on Wheels.”

A Call for Support

            On AARP.org, Kathleen S. Connell, Rhode Island AARP State Director, calls on state lawmakers to take a very hard look at how they fund the state’s Meals on Wheels program.  Connell urges Congress not to put the Meals on Wheels program on the budgetary chopping block as a way to chop the huge federal budget deficit.

            Connell says that “Leaders need to be reminded that Meals on Wheels recipients aren’t unemployed workers waiting to return to jobs that will accompany an economic recovery. They are older retirees living on limited fixed incomes. With the cost of prescription medicines, healthcare and utilities going up, they sometimes can’t afford to eat. Many commonly sacrifice on food because of money worries – real or feared.”

            Connell notes, “Meals on Wheels is a big deal [to seniors]. No one should take it for granted.”

            Herb Weiss, LRI ’12, is a writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.