Gregory Korte

USA TODAY

WASHINGTON — President Trump's first budget proposal to Congress last week specifically identified steep cuts to hundreds of domestic programs, but Meals on Wheels wasn't one of them.

The popular program — which mainly uses volunteer drivers to provide hot meals to older Americans across the country — doesn't directly receive federal funding. As Trump's budget director, Mick Mulvaney, told reporters Thursday, "Meals on Wheels is not a federal program."

Nevertheless, Meals on Wheels quickly became the poster child for the impact of Trump's budget cuts. Even before the budget's release, Rep. Keith Ellison, D-Minn., tweeted that Trump had called for the "elimination" of Meals on Wheels, and the Congressional Progressive Caucus quickly dubbed it the "Starvation Budget."

The truth: Trump's budget calls for the elimination of one program that some of the nation's 5,000 Meals on Wheels groups rely on: Community development block grants, a $3 billion program that started in the Ford administration to give states and cities more flexibility in how they combat poverty.

But Trump's proposal — known as the "skinny budget" because it's the first, vague outline of a more formal submission to come — is largely silent about the program that provides the vast majority of federal funding for senior services.

"The budget will adversely impact older adults," said Sandy Markwood, CEO of the National Association of Area Agencies on Aging. "We just don’t know how much."

Here's why. The majority of Meals on Wheels programs get most of their federal funding through the Administration for Community Living, an agency of the Department of Health and Human Services that serves the elderly and disabled. That agency has a $227 million line-item for "home-delivered nutrition services."

Those programs are authorized though the Older Americans Act, a law so popular that its renewal passed Congress last year without any recorded opposition. And while Trump didn't single out that specific program, Health and Human Services will receive a 16% across-the-board cut.

"We're very concerned. We’re concerned about the cuts that were explicit in the skinny budget, but we’re also concerned about what we see as the handwriting on the wall with the percentage cuts to HHS," Markwood said. "Some of these details we won't know for a while."

Meals on Wheels America, a national group that represents 5,000 programs throughout the country, said it was bombarded with questions about the budget and could not respond to press inquiries.

The impact is likely to vary from place to place. Every Meals on Wheels affiliate gets money from a different mix of state, local and federal government funds, along with individual donations and philanthropic organizations.

"We like to say that when you've seen one Meals on Wheels program, you've seen one Meals on Wheels program," said Sandra Noe, the executive director of Meals on Wheels of Northwest Indiana. Like many programs, it gets funding from an area agency on aging through the Older Americans Act.

The Department of Housing and Urban Development, which administers the community development block grant program that Trump targeted for elimination, couldn't say how much of that money ultimately flows to Meals on Wheels. It's certainly a small fraction: Social services are capped by law at 15% of the block grants, and the most recent HUD figures show all senior services receive about $33 million.

"We've spent $150 billion on those programs since the 1970s," Mulvaney said, referring to the block grants. And since the federal government started to apply more performance measurements to federal programs in the Bush administration those block grants have been "just not showing any results," he said.

"We can't do that anymore. We can't spend money on programs just because they sound good. And great, Meals on Wheels sounds great. Again, that's a state decision to fund that particular portion — to take the federal money and give it to the states, and say look, we want to give you money for programs that don't work."

But scientific studies have found Meals on Wheels programs are effective in improving nutrition among the elderly. And they're cost effective, because keeping older adults in their homes is less expensive than nursing-home care.

"It's not just a meal, but a wellness check," Noe said. "That volunteer, that driver is able to tune into whether that person's health is failing, or if they’ve fallen or can't get out of their chair. And we’re delivering relief from isolation, and we’re delivering relief to their family as well."

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