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By Yen Duong

Lucy Bush Carter remembers one man’s 98th birthday well. One of her volunteer drivers for Friendship Trays, Charlotte’s Meals on Wheels program, called her to say “I’m pretty sure he’s on the dining room floor,” Carter recalled.

“By the time I got there, the firemen and all the first responders were standing around him trying to convince him to go to the hospital,” Carter, now the executive director of Friendship Trays, said. The man argued and wanted to wait for his niece, who lived 30 miles away in Mooresville.

Carter walked in and introduced herself.

“He had never seen me but I said, ‘I’m from Friendship Trays, and why don’t you let these nice men go ahead and take you to the hospital, and I will make sure your niece knows where you are,” Carter said.

The man finally agreed to go to the hospital, where he subsequently had surgery for his broken hip and celebrated his 98th birthday with a cake delivered by a Friendship Trays volunteer.

Beyond nutrition, Meals on Wheels programs provide a social safety net for people who cannot cook healthy meals for themselves. Volunteers form connections and relationships with recipients, who then trust the organization, as the 98-year-old birthday boy did.

“It didn’t matter who I was,” Carter said. “He knew that Friendship Trays was a reliable resource and that we do what we say we’re going to do.”

“Part of the reality”

Friendship Trays began in 1976 in the Elizabeth neighborhood of Charlotte, Carter said. Five elderly neighbors could no longer attend a weekly luncheon between four neighborhood churches. A group started purchasing and delivering meals from a nearby hospital to them.

Trays of cooked, sealed food await labeling and distribution at Friendship Trays in Charlotte. Photo credit: Yen Duong

From that modest beginning, Friendship Trays has grown to five full-time cooks who prepare around 700 meals daily with the help of a dozen or so volunteers. Around 1,300 people volunteer with Friendship Trays in the kitchen or as deliverers.

“Food banks are great, but a lot of the people we work with don’t drive so they can’t get to the food bank, and then they’re unable to prepare food the way they used to,” said Alan Winstead, executive director of Meals on Wheels of Wake County. “Having that prepared meal is really a great asset so that then they are getting some nutrition or one good meal a day.”

The program brings meals to around 525 Charlotte-area adults who cannot prepare healthy meals for themselves, and to an additional 200 or so people at adult and children daycare centers.

“At one time, maybe the primary reason that somebody was receiving our meals was that they were elderly and couldn’t get out; now, some people are receiving our meals because they can’t afford food,” Carter said. “That’s kind of a different reason than we originally started with, but that’s part of the reality in our system.”

Friendship Gardens

The program consults with each recipient’s doctor to accommodate dietary restrictions with the program’s in-house dietician. Friendship Trays orders $400,000 worth of food annually from a wholesaler, and also receives produce from their urban farm at Garinger High School and over 100 affiliated gardens through the Friendship Gardens program, Carter said.

“I think what makes Friendship Trays so special to Charlotte is the fact that we have Friendship Gardens [as] a way to bring all different parts of our community together around talking about the importance of local food,” said Erin Brighton, director of the Charlotte-Mecklenburg Food Policy Council, a nonprofit food advocacy group which oversees FoodCorps members who work with Friendship Gardens.

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Since 2012, Friendship Trays has helped operate a mobile market at the downtown transit center, selling produce from the urban farm to people who might otherwise not have access to fresh produce.

“We don’t have farmers markets here that are very easily accessible for people to get in if they don’t have a car… so we are there once a week with fresh produce,” Carter said.

Self-sustainability

Unlike most Meals on Wheels programs, Friendship Trays receives no governmental funds and subsists entirely off of donations and grants. In 2017, Friendship Trays got by with a $42,000 difference between revenue and expenses with their operating budget of around $2 million, according to a summary of their annual federal tax filings.

Winstead said Charlotte, Chapel Hill and Rocky Mount are the only self-sustaining Meals on Wheels programs in North Carolina.

This Friendship Tray was sent out to recipients on Oct. 16, 2018, and served to guests at the annual Friendship Trays fundraiser breakfast. They follow the Friendship Tray founder’s decades-old recipe for the “hopple popple” egg casserole. Photo credit: Yen Duong

Meals on Wheels Wake County received about $1.4 million in funding in 2017 through the Older Americans Act, according to their IRS forms. Friendship Trays has more leeway because it receives no federal or state funding, Brighton said.

“They don’t have to follow these federal guidelines for carbs, vegetables, protein, so they can have a more produce-heavy meal option,” Brighton said.

Even with their office and kitchen space donated, each Friendship Trays meal costs about $7 to produce when you factor in electricity and wages, Carter said.

“We have a few people who pay nothing for the meals, particularly if someone is in the process of applying for disability but hasn’t gotten that designation yet,” Carter said. “There are about as many people paying nothing as pay the [maximum of] $4.50… Fifty-six percent of the people we serve pay 65 cents a meal. That means they are living well below poverty.”

As of 2018, the federal poverty level for a family of one is $12,140. Meals on Wheels Wake County is experimenting with increasing impact by partnering with health insurance giant Aetna in a pilot program, Winstead said. The program connects Meals on Wheels programs in Houston, St. Petersburg, Florida and Raleigh with Aetna Medicare recipients.

“As we deliver the meal, we’re actually doing what we normally do, a check-in on the people,” Winstead said. “If we see a need, then the health insurance company can intervene, trying to get the best health care outcomes at the lowest possible cost.”

“Minor sunshine”

When Mary Jane Ramsey went on her volunteer route the Thursday before Christmas, she bought poinsettias and warmly greeted each recipient with them.

“A lot of these people don’t see anybody else all day long, so it’s just somebody that comes to the door and says hello [and] gives you a smile,” Ramsey said. “I just think it’s interesting to talk to them and put some of what I like to call ‘minor sunshine’ in their day.”

Friendship Trays has one main kitchen and distribution center, with a handful of distribution centers scattered across Charlotte. The green flags on this map indicate Friendship Gardens, affiliated with Friendship Trays. Colored pins indicate driver routes of 4-10 homes. Photo credit: Yen Duong

For some recipients, Friendship Trays is their sole source of nutrition, Carter said. Sometimes the program will deliver shelf-stable foods from a donation drive, for instance, during hurricanes or winter storms. They also provide donated pet food to some recipients.

“Years ago, we discovered this man was feeding his dog with what we were serving him first, so we got dog food and said now, you eat the meal,” Carter said. “For that gentleman, that dog was his lifeline.”

Meals on Wheels programs like Friendship Trays address social determinants of health, the non-medical social and environmental factors that can affect one’s health, Winstead said.

“I think health care providers and health care payers are beginning to really take notice of the role that programs like Meals on Wheels can play in producing good health outcomes,” Winstead said.

UNC REX Healthcare opened a food pantry in its hospital last month, Winstead said. Atrium is in talks to open more food pantries in its hospitals next year, Brighton said.

Build community, battling inequity

Friendship Trays builds up the Charlotte community through a network of volunteers, Brighton said.

“[Volunteers are] not only contributing their time and their effort but also then gaining a deeper understanding of the needs in our community,” Brighton said. “[Volunteering] helps create a dialogue between parents and teachers and students about the fact that not everyone has equal access to healthy food.

“I think it also helps talk about the fact that we have a lot of families with food insecurity,” Brighton continued. “Although Friendship Trays might not be addressing those families, I think it helps add to that conversation on healthy food access and food insecurity in our county.”

Segregation, gentrification and upward mobility are persistent topics of conversation in Charlotte, as NCHN previously reported.

“Charlotte has become so stratified and gentrified that some of the places where we used to serve people aren’t there anymore because they tore down that affordable housing and a lot of the lower-income people have moved out,” Carter said. “That worries me… I think that’s a community challenge that we’re not addressing as well.”

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Yen Duong

Yen Duong covers health care in Charlotte and the southern Piedmont for North Carolina Health News.