Monroe County Meals on Wheels plans to provide superior nutritional support to any adult individual in Monroe County who is unable to shop and/or prepare meals for themselves, due to physical or mental disability, thus allowing them to remain safe and independent in their homes. We receive the majority of our referrals through our county Area Agency on Aging; however, we have a sizeable private client base. While their meals are priced on a sliding scale, no one is denied meals because of an inability to pay. With government dollars stretched thin and the size of the older adult population growing in our county, we aim to address the needs of the whole person. Through case management, including a psycho-social assessment, a home safety inspection, and other assessments, we assist our private clients with their needs outside of nutritional support. To combat social isolation, we have a telephone buddy program. Our pet program provides pet food, cat litter, and other tangible pet needs on a monthly basis. Grants have allowed us to expand this program to include wellness checks and immunizations. In 2019, we plan to launch an oral hygiene program since oral health is closely tied to an individual's ability to eat wholesome food.

We typically serve over 200 clients a day. Our meals come from Meals on Wheels of NEPA, who follow state nutritional guidelines for older adults. Their driver transports the meals to our office in special containers that maintain heat and cold. We provide a hot and a cold meal to each client primarily five days a week over 11 routes; some clients also receive predelivery of weekend meals. These schedules may be further modified if a route gets too long and needs to be split. Our volunteers, who deliver using their own cars without any compensation, are the backbone of our delivery service. We rely on nearly 300 volunteers to help up deliver meals over routes that can often run 70 miles in our rural county. They arrive at our office, we load up the containers, and off they go to delivery the meals with a smile and a friendly word for the clients. When they return, they let us know if a client is not feeling well, doesn't look right, has someone new living with them, needs assistance with some other need, etc. Our volunteers are the "eyes and ears" for us, the clients' families, and the Monroe County Area Agency on Aging. In the last few years, we noted our private pay clients had more and more needs not being met outside of meals. Unlike the Area Agency on Aging clients who have built-in case management, our clients had only been receiving nutritional support from us. With a new case manager, we are now able to provide services similar to the Area Agency on Aging in terms of assessing our clients' multiple needs and coordinating with their families to procure needed services. The case manager is working to develop more in-house programs to address some of these additional needs that are not being met by other services within our community.

Our agency runs efficiently with minimal staff. The Executive Director primarily does development and executes the strategy set forth by the volunteer board. The Office Manager/ Volunteer Coordinator primarily ensures that routes are maintained, clients are being served, and volunteers are scheduled. She is assisted by an administrative assistant. Our part time pet program and special events coordinator runs our pet program and works with the board to promote and execute fundraising events. Our part time case manager evaluates all private pay clients and assists our county Area Agency on Aging with their referrals. We work closely with Meals on Wheels of NEPA to develop menus that are appealing and nutritious for our clients. The kitchen also responds positively to clients' concerns and requests. Our agency has a reliable volunteer pool managed by a coordinator who is very in tune with the volunteers in terms of scheduling appropriate routes. Routes are designed to promote volunteer and food safety, as well as to make the process as efficient as possible for the volunteer. All of our clients receive some subsidy towards the cost of their meals - even the Area Agency on Aging clients. To help fund the difference, we rely on individual donations, which we solicit through two appeals a year. We also receive grants and do some fundraising.

We conduct an annual survey of our clients to determine how much they rely on our meals and volunteers for their nutrition and safety. In addition, we ask questions about improved health and whether they have experienced a positive weight gain or loss, depending upon their circumstances. Other indicators are how long clients remain on the program, an indicator of their ability to remain in their home; and how often they are off because of hospitalization, which is an indicator of whether the nutritional support is helping them maintain or improve their health. We also track how often a volunteer becomes the first responder to a crisis within the client's home.

In the last three years, we have grown our program from 150 to over 200 home-delivered meal clients. In addition, we now provide congregate meals to four senior centers, thereby providing nutritional support to an additional 60 individuals a week. We implemented case management services to private clients, added veterinary care to the pet program, expanded the amount of pet food to be delivered, obtained an agency vehicle to relieve the burden on employees' vehicles if they have to fill in for a volunteer, added a telephone buddy program, and provided internship opportunities to public health students at East Stroudsburg University. We are active participants of the Pocono Mountains Hunger Coalition, with our executive director serving as co-chair. Among the coalition's goals is to start a community kitchen which will also prepare our meals. Currently our meals are prepared out-of-county and trucked in. Having our meals made locally will keep the county funds within the county; provide some local jobs; allow us to incorporate produce from our local farmers; and allow Monroe County Meals on Wheels to have full control over diets and menus.