In March, President Trump released his budget blueprint for the year of 2018. Much of the ensuing public debate focused on proposed cuts to social services, with Meals on Wheels at the center of that conversation.

Meals on Wheels delivers freshly made, healthy meals to seniors and other homebound persons across the United States. Operating through a network of more than 5,000 local groups, Meals on Wheels is able to provide 218 million meals to over 2.4 million people annually. The organization relies on a combination of public and private support to carry out their services, and much of that public support comes from federal grants.

Food Tank had the chance to sit down with Karl Robillard, Director of Marketing and Communications at Meals on Wheels San Francisco, to discuss the crucial role that the organization plays in the San Francisco community, proposed budget cuts, and the consequent media frenzy.

Food Tank (FT): Before Meals on Wheels was established, what would happen to elderly people who were incapable of making or accessing food?

Karl Robillard (KR): This actually came up recently. We’re about to celebrate our 50th anniversary here in the city, and we’re putting together ideas for how we want to acknowledge that. So we were thinking back to what it was in 1970 that prompted Meals on Wheels to first start in San Francisco.

And the reality is there was a neighbor who hadn’t seen this individual’s neighbor for a couple of days. So when he went over to check on the neighbor the person had died, and had actually been deceased for several days. And that was sort of the canary in the coalmine, if you will, around changes in our society, that older folks were now living alone.

And without a service like Meals on Wheels—where we check on people everyday, we knock on the door, we see how they’re doing—it leaves people who are elderly, or sick in any way, very vulnerable when they’re living all by themselves.

And from that point it just took on a very grassroots fashion to make sure that people were checking on folks that are older, but also then providing the nourishment, the food that they would need to be able to live independently.

FT: Can you share a personal story about the impact that Meals on Wheels has had on a particular individual, family, or community?

KR: In the month of March we celebrate and honor the Older Americans Act, and this month it was in its 45th anniversary since it was enhanced in 1972. And as part of that celebration we direct public attention to serving meals, and we really try and get not just our regular volunteers, but lots of different folks to get out into the community and deliver meals.

This year what we did was we put out a challenge to a lot of companies who work in the Mid-Market District of San Francisco. When I say the Mid-Market District, it’s key in that that’s where Twitter, Dolby, companies like Zendesk, Pintrest, Uber, all these companies have moved in there in the last five years. So we put a challenge out to those companies: come out, see for yourself what it is we’re doing.

And where it’s become a really interesting juxtaposition is you have these companies that are just doing amazingly well for the most part, and they are living side-by-side with some of the most poor and destitute people, most vulnerable in the city. Whether they be homeless or whether they’re a homebound senior living in a very small, single occupancy hotel, with no kitchen, with no bathroom,very isolated in that sense.

So we brought about 60 of those volunteers and delivered 250 meals in the span of one afternoon. And my personal story is we went into one of these buildings and it’s a very different reality than even just walking around the street. These buildings are very crowded, they are oftentimes in a state of disrepair, or they are not ideal places to live. They were never designed to be permanent housing, they were designed to be temporary housing. But we were kind of going through and knocking on doors and delivering meals.

The one I remember the most clearly was a man, probably in his 70s. We knocked, and it’s a loud building, and we could just hear this muffled sound in there. And it wasn’t clear whether the sound was “come in,” you know, you don’t want to just walk into someone’s home. So we knocked a second time, kind of heard the same muffled sound, we knocked a third time, finally there’s this exasperated sort of “come in.” So we enter, and you walk in the room and it’s again, tiny, it’s seven feet by seven feet, and the guy was so sick he could not get out of bed. And he had been trying to tell us to come in, and even just the energy expended to say those two words was completely exhausting to him.

And it was just one of those situations where—this was two days before Trump announced his budget proposal—I kept thinking to myself, what does someone like that do? He lives by himself, there’s no evidence that he has family or friends checking on him, and here he is lying in a bed he can’t even get out of.

And so us coming in, walking in and saying hello and seeing how he’s doing, is such a lifeline. That very acute vulnerability people experience is something that I think is so very important to have programs like Meals on Wheels that are really looking out for folks like that.

FT: As it has grown, what are some of Meals on Wheels’ greatest achievements?

KR: I think one of our greatest achievements is simply keeping up with the changing demographic. In 2007, we served 532,000 meals over the course of the year. And then as baby boomers begin to age into retirement, that has really changed the entire age demographic around the country, but particularly in San Francisco. In 2016, we delivered 1.725 million meals, so that’s over three times the amount of food and meals we were delivering a decade before. That’s startling.

The very first year of the baby boomer generation is from people who were born in 1946, so all of those people are turning 71 this year. And what that means is here in San Francisco, if we were to compare the number of seniors in 2010 to 2030, twenty years later, there will be 100,000 additional seniors in the city.

So we are living in a city and a society that’s aging and I think Meals on Wheels has done a really phenomenal job to simply keep up with that. And we do that by ensuring a waitlist of 30 days or less. We really work hard to get people on our service as soon as we can.

FT: Based on the budget blueprint, what is the potential scope of the proposed funding cuts?

KR: You know, the truth is we honestly have more questions than answers right now. Because the budget is a proposed budget and it has to go through Congress, so we don’t know if anything that’s included would stay in the way it was originally proposed.

One of the reasons we feel more optimistic at Meals on Wheels is that we do receive such incredible bipartisan support. Actually some of the very first people to push back on the budget were very strong Republicans, many of whom backed Trump in the election. So they came out very strongly to say, we do not want to see any funding cuts to Meals on Wheels. Meals on Wheels was enacted by a Democratic President in 1965, Lyndon Johnson; it was enhanced by a Republican President, Nixon in ’72; and since then it has really enjoyed bipartisan support.

With that being said, it is very scary, because whether or not you are looking specifically at Meals on Wheels, or whether you’re looking at the environment of social services and the funding to support our network of social services, based on the proposed budget we are looking at unprecedented cuts.

And this is where it’s scary. Let’s say in a best-case scenario, Meals on Wheels does not lose a dollar, right? There are so many other entities that will, that we would feel the burden of trying to compensate for many other organizations that are potentially going to lose funding. There is no way to look at this budget and feel optimistic if you’re in the business of social services.

But if you want to be a little bit more specific and look specifically at simply Meals on Wheels, we have roughly a US$14 million annual budget, and that includes some in-kind donations but it includes primarily financial contribution. About half of that comes from private philanthropy, so US$7 million is coming from entities that are not related to any level of government.

The other half, the other US$7 million, is coming from a combination of federal, state, and city dollars. And of that US$7 million, about 25 percent is coming from federal sources. So you’re looking at roughly US$1.75 million a year that is directly coming from federal sources.

What would be some of the most immediate impacts of the proposed defunding of Meals on Wheels?

KR: If in the worst-case scenario they just cut all that federal funding we would be looking at basically a 25 percent loss in our budget. That has to come from somewhere, or we have to reduce services.

So let’s just assume—and again I think it’s really important that these are hypothetical answers—let’s just take it as a pure math situation and say okay, we have to cut out 25 percent of our meals, right? That’s severe, that’s a devastating cut to a program that has needed to grow a lot faster. Even at a stable growth rate that would be pretty devastating, but given that we are exponentially growing, it adds even more urgency to that situation.

It would be very painful, we’d have to be considering cutting different routes, and delivering less than we do normally, and less safety checks, and more people at home without the nutrition, without the general social services that are going into keeping them independent.

Here’s one other way of looking at it, and I think this is where Meals on Wheels really has an extremely strong case to make. For an elderly person, it costs the same amount of money, whether it be from federal, state, or private funding, to provide an entire year’s worth of meals and wrap-around services, that it does one day in the hospital.

So say we have to cut a route, hypothetically. One of those seniors falls, gets taken to the hospital, which would have been preventable had we been checking on them and feeding them. One day in the hospital is already going to take and absorb the same budget as it would for an entire year of their meals. And that budget will come from health and human services, they will get treated, and the money will be spent one way or another.

So we’re really not going to save ourselves any money by cutting this service, we’re just going to make people a lot more vulnerable. Let me share one other number with you, if we had to cut 25 percent of our meals, we would be cutting 430,000 meals a year, based on our current level of delivery.

FT: Without this service, what alternatives do elderly people have in accessing a healthy, secure food supply?

KR: I think the alternatives are a lot more expensive. They are earlier advanced care in the form of a nursing home, live-in support, which is very expensive and many people can’t afford it, or premature hospitalization. Those are really, in the absence of Meals on Wheels, you’re looking at that kind of treatment.

Because there really isn’t anybody, there is no other entity. There are 5,000 Meals on Wheels programs around the country, in small towns, rural areas, and then major cities. We serve 360,000 seniors in the city of San Francisco, but it’s in the millions when you’re talking about it on a national level. So there’s no entity that is even remotely close to being able to fill in that gap.

FT: Is there anything else that you would like the public to keep in mind when it comes to Meals on Wheels?

KR: The whole other side of this is the media frenzy. The amount of misinformation that was being broadcast during this whole story was very alarming. Anywhere from the headline that Meals on Wheels is being cut, which isn’t true, to Meals on Wheels is only receiving three percent of its funding from the federal government, which is absolutely not true. And to be honest that was basically Fox News going to Meals on Wheels America’s website.

Meals on Wheels America is a tiny office of roughly ten people that is responsible for our nationwide advocacy. And we are a membership driven program, so each Meals on Wheels contributes $150 a year, to basically help fund this advocacy arm for homebound seniors around the country. But they are one tiny program, and they only get three percent of their funding because they are not actually feeding people. They’re advocating for the health and independence of homebound seniors.

There are 5,000 Meals on Wheels on Wheels programs around the country who are getting anywhere from a third to one hundred percent of their funding from the federal government. So to say that it would only be three percent is totally untrue.

And I think it’s just a reminder for people to really read beyond a headline. You cannot trust, even a news source many times, that they are delivering accurate information. And so it’s incumbent upon a media consumer to really research this issue on their own, to discover what is really a far more factual answer than what you are going to see or read in a quick, breaking news headline.