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Meal programs reassess aims, structure, funding

Some 35 percent of the Meals-on-Wheels type of programs have been affected by federal budget cuts, says Mamie Lee, president of the private National Association of Meal Programs in Pittsburgh. The cuts will result directly in increased costs for their clients, she claims - particularly in areas where they are least able to pay.

Mrs. Lee, a volunteer like 150,000 others involved in the nationwide programs , spends much of her time generating private funds for the self-help groups. ''This is how we got started in 1954,'' she says, ''with a community-based program in Philadelphia.''

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Since then, the programs ''snowballed'' to include up to 1,500 other organizations around the country, where a minimum of 125,000 meals are provided daily to the homes of those unable or unwilling to cook for themselves. Some 900 of these groups belong to the national association; another 300 to 600 work without the association's help.

Social workers see the home-delivered meals programs as an important component in a growing effort to help clients maintain their independence. Without this and other backup services, many people who are at least partly able to care for themselves would have to go into nursing homes or other institutions , they believe.

Because of the large volunteer staff and support from charities and businesses, most Meals-on-Wheels programs have managed to keep costs low enough so clients could pay the full amount. Exceptions are programs in poverty-stricken areas, where government funds have been used to defray costs. A ''Home Delivered Meals Program,'' developed under federal Title III C 2 to target areas, has been cut this year from $89 million to $57 million, with more cuts expected.

But Mrs. Lee cites other cuts affecting the program in subtler ways. ''The decreases in food stamps mean that some of our clients must pay a higher cost,'' she says. ''Then there's Title V, which we used to employ 54,000 senior citizens as receptionists, drivers, cooks, or intake and outreach people. That program has been cut entirely.'' Senior citizens will continue to play an important role in the Meals program, however, since 70 percent of the volunteers are over the age of 60.

Even Meals programs that use no government funds will be affected, Mrs. Lee believes, since they will no longer be able to refer clients to other, government-funded programs. ''Before, they could tell someone with few funds or particular needs, 'We can't serve you, but they can.' Now 'they' can't.'' She expects the privately funded programs to take on more clients, and in some cases to start waiting lists.

Some of these programs welcome the challenge. Helen Johnson, head of the Meals-on-Wheels of Northern Virginia, operating in a wealthy suburb of Washington, says: ''Money is the easiest thing to get. We're figured into the budgets of many churches, fire auxiliaries, Boy Scout troops, and businesses. It's much harder to find drivers than money.''

Her program never joined Mrs. Lee's organization and uses a minimum of government funds. ''Why should the taxpayer have to pay for this, when it's so easy to get money?'' she asks.

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Mrs. Lee agrees that there are ''many successful models of programs that use only private funds.'' But she warns that those in inner-city areas and among the rural poor ''have a much tougher time raising funds and volunteers. Both have to be found outside the community, usually, and it's not easy to get people to come into those areas.''

She also cautions that ''Meals-on-Wheels should not be the only answer. If you take a widower who has never cooked in his life, it's easy and satisfying to the volunteer to bring him his meals once a day. But it would be far better to send someone in there to teach him how to cook for himself. That takes time, and it takes money, so the government is less inclined to do it. Meals-on-Wheels is the easy answer.''

Better answers can be provided by restructuring the relationship between private and public organizations, she maintains. ''I think in the future you'll find private organizations going to the public and saying, We can provide the volunteers if you provide the resources; or, We can do the intake work if you'll do the cooking.'' Some of this will go on between private programs as well, she thinks.

But Mrs. Lee emphasizes that ''private sources are simply not able to feed the numbers that need to be fed. There ought to be some public support.''

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