Community Servings is a non-profit organization based in Boston, Massachusetts that delivers made-from-scratch meals to critically ill and poor patients and their families. “Most of these people are very isolated and often forgotten,” David Waters, CEO of Community Servings tells Food Tank. Patients tend to lack the energy to shop and cook for themselves, leading them to skip meals or eat highly processed foods. According to Waters, home-delivered, medically tailored meals (MTMs) can help patients meet the dietary requirements and prevent their disease from deteriorating further.
The organization began by feeding 30 people living with HIV/AIDS in two neighborhoods in Boston in the 1980s. “Food became the only medicine or the only intervention. To care for people was to give them calories, while their body was fighting off the infection,” says Waters to Food Tank. Waters was a manager at a four-star restaurant in Boston when he joined Community Servings as a volunteer. And it did not take him long to “really fall in love with” feeding people in need.
In 2004, Community Servings expanded their services both to include more communities in Massachusetts and they are now covering other types of diseases. Today, Community Servings’ chefs, registered dietitians, and volunteers prepare about 2,500 meals a day and 650,000 meals a year for patients living in 21 communities across the state.
“But the complication for us is that our clients have very complex medical diets that they need to follow, oftentimes more than one,” says Waters. According to Waters, it is common that a patient goes through a complex combination of dietary restrictions, for example, to control the intake of potassium, phosphorus, glucose, and vitamin K. To address such complexity, Community Servings looks for commonalities between diets and has now become able to prepare 300 different permutations of meals every day.
“Ultimately we have to ensure the patients that what we are bringing them is exactly what they need to be eating,” says Waters to Food Tank. “When we can bring complex diet that ensures that the patient is going to do better on dialysis for kidney failure or better at the response to chemotherapy for cancer treatment, that’s a really important healthcare intervention.”
By working to prove that their MTM program is helping reduce healthcare costs, Waters hopes to engage more healthcare payers in the program. A study published in the Journal of American Medical Association Internal Medicine recently reported that patients who participated in the Community Servings’ MTM program spent less on healthcare, approximately 16 percent, compared to those who did not participate.
In addition, Community Servings and the Center for Health Law and Policy Innovation of Harvard Law School proposed a healthcare system where food plays a critical role, in their Massachusetts Food is Medicine State Plan. In this system, providers refer patients to a food program that offers MTMs or produce vouchers based on the patients’ needs, and payers reimburse providers and community-based nutrition organizations for the services.
“We really think ourselves part of healthcare,” says Waters. “[It] would be helpful to [payers] in terms of improving health outcomes, reducing hospitalization rates, and lowering costs.” Waters points out that feeding the sick has not been a priority, while meal programs for children and seniors have been made available in the United States. “I think the idea of food is medicine or food in the context of healthcare or social determinants of health is really a major movement forward,” Waters tells Food Tank.
Home delivered MTMs can provide patients with emotional support. “It is to say you are not forgotten. We are there with you and we want to bring you beautiful food,” says Waters to Food Tank. According to Waters, MTMs need to look beautiful to trigger patients’ appetites. “One of the things you lose when you are sick is your appetite,” says Waters. Patients can lose appetite because of things like the side-effects of medications, chemotherapy, and mental health issues. But aesthetically pleasing food can motivate them to eat, according to Waters.
And Community Servings offers a platform for community members to take nutrition classes, talk about food issues, and make a real impact by volunteering. In addition, the organization partners with local farms, farmers’ markets, and other food rescue groups to source the ingredients locally and harness unsold or surplus produce. Community Servings receives about 22.7 tons (50,000 pounds) each year. “It’s through the generosity of the community in time and resources that make that happen,” acknowledges Waters.
Community Servings also trains people who are coming out of the criminal justice system. This 12-week free job-training program provides trainees with opportunities to learn cooking skills from chefs, prepare for the ServSafe test, and receive job placement assistance. The trainees also help the organization prepare meals for the patients.
“We try to leverage the kitchen that provides MTMs in as many food justice directions as possible, without having a mission creep or sort of losing focus. So if we can address prison reentry issues or waste in the food system through the kitchen that’s preparing meals, that’s a really exciting social experiment,” says Waters.