Alan Balsam and Sheila Decter

00:03 Sheila decter, I'm 82 years old. Today is Friday, February 5th 2021. I'm recording from Newton Massachusetts. And I have the pleasure of talking with longtime friend and colleague Alan Balsam.

00:23 And my name is Alan Balsam and my age is 69 and this is also Friday, February 5th 2021. I'm calling in from Cambridge, Massachusetts and dumb. My conversation partner is Sheila decter my longtime friend and colleague also.

00:45 Sheila you and I are two of the founders of community servings over 30 years ago during the height of the AIDS epidemic.

00:55 Today Community servings. It's a nationally-recognized provider of free medically taylored meals Tober 3200 clients throughout Massachusetts 92% of whom live in poverty and over 60% from communities of color wheels are scratched made stage from a multimillion-dollar campus in Boston that employees don't eat people.

01:19 Community servings has recently demonstrated that community-dwelling patients with complex medical needs are better when provided with medically tailored meals and nutrition education and significantly save the healthcare system up to 16% in comparison to match controls.

01:39 Well Community servings is very successful and serving folks with multiple health challenges 35 years ago no such program existed here and the AIDS epidemic was exploding

01:52 You were involved from the beginning. So remind us of the context in the late 1980s regarding AIDS and how our program began.

02:03 You know Allen it's so amazing to think back to those days. I worked for American Jewish Congress. And we had a National Conference in New York are we came back from the conference and we were all very concerned about a speech that we had heard a a program American Jewish Congress cared very much about the issues of discrimination and they've done a number of legal cases to prevent discrimination on the basis of various weather on the basis of gender on the basis of age would have you in Massachusetts with passed legislation dealing with discrimination in employment education or what-have-you years back, but now we came back with this knowledge that there was a new form of discrimination and it was against persons who are gay and it was against persons who had HIV or Aids and we talked about it and we wanted to figure out some way.

03:03 Which we could be helpful locally to our surprise one of our officers public interest lawyer was both gay and also was HIV. Why was it a surprise? You have to remember what it was like in the 80s. A lot of people were still in the closet to the use a euphemism of the time because it was discrimination. You were uncomfortable and many business associations in talking about being gay and you definitely were uncomfortable talking about having AIDS people didn't know exactly what age was some people thought if somebody blew at you. I mean this whole more recent over there taking us back in our minds to what it was like when people didn't know exactly what age was so we we made it.

04:03 That we were going to do something and commanded to do so by are Jewish values and I know you're familiar with the same with these the concept of saving a life to sit this out. We needed to be useful. So we put together a task force in the Jewish Community to figure out how we can best help and Fred made a connection for us with a dr. Ken Mayer who is director of The Brown University AIDS program. And he also was the medical research director for Fenway Health. He still is and he came to a meeting and as a result of that meeting people began to understand more about what the illness was how you didn't get it as well as

05:03 And it was it was easier to move forward in to figure out what we could do this discussion after this AIDS task force me to go with our strengths. What was it? The Jewish Community was the most knowledgeable about and in many ways. We were knowledgeable about both building housing and providing meals because both of those were done for seniors in our community. So we started in the issue of Housing and we began to put together all the lots of local housing experts and then we had a found a serious wall. And that was that HUD was not willing to say that aids was a handicapped under their definition. And the reason they said it wasn't a handicapped as everyone that dates was going to die. Anyway, so therefore we're not going to be eligible for HUD money for that reason and congressman.

06:03 Barney Frank immediately went to work on that and it wasn't long before I'd had eight you an understanding that that was not her applications for handicapped housing for persons with AIDS. But in the meantime that slowed us up on the housing front, so we began to concentrate on the food part and I'm afraid that a variety of organizations in the community know that we prepare to work on this and then Holly Ladd was the coordinator of a community the Boston age Consortium, which was making sure that there were people providing the variety of services Holly pull together at the Harvard School of Public Health all the activist organizations who have been talkin about meals for persons with AIDS.

06:57 And it was a very interesting meeting to that point. No one was delivering meals to persons who were home bong AIDS action committee, which was a major supplier of Services of the Living Center in st. Cecilia Catholic Church in Bay Village were doing one night a week communal meal in their facility, but no one was delivering two people at home. So Holly brought together. The only reason we were at the table American Jewish Congress as we said we wanted to do meals so we were there AIDS action committee was there the Department of Public Health John Auerbach was represented and a very interesting group of people and one really has to see them.

07:45 In this core beginning of providing meals and it was the restauranteurs and the restaurant Terrace.

07:53 Had done a major Feast if you will at the Boston Garden and they had done this huge meal lot of people had come brought their families at a time when there was still facing discrimination in public the restaurant chairs were saying that they were these people were welcome in their restaurants and that they thought it was important that food be provided to them and three representatives of the people who have done this major Feast were present when Holly brought us together at the Department of Public Health one was Michaela Michaela Larsen restaurant in later Roca restaurant. He became an important presence as we began to do this and she continued to be an important presidents on the board of community servings for many many years.

08:50 And another person was a gentleman by the name of Ben strohecker and Ben who died just a couple years ago was the owner provider of Harbor Suites in Salem a great chocolatier and he had great enthusiasm and just mention a quotation from his obituary a couple years ago and obituary written by Brian Marquardt of the globe in a reason to discuss again, it tells us something about what that. Was like, so he points out that then strohecker was an AIDS activist became a lead fundraiser for AIDS causes and a persistent voice for awareness and he did so nearly thirty years ago when many people like him straight wider middle-aged businessman only spoke about AIDS when making homophobic jokes

09:47 At night I think Marquardt got it just right here. Ben was way ahead of his time wanting to make sure that the restaurant tours helped to provide meals and 1/3. Remember, I remember I remember been well and what I would say about Ben is he was a true match

10:07 Absolutely, and the third one was a representative of one of the Food Service delivery services, you know, the the trucks that provide the basic supplies to restaurant tours. These guys came into the meeting really hoping that there was a way for restaurants to provide the food and so we sat around the table and it was clear that that was not going to work food coming rich rich food coming and being delivered and being delivered hot restaurant sure is where wonderful at making food, but they weren't in the in the delivery system at that day. We were away before Lyft and Uber and this was just not something they were going to be able to do.

10:55 So we put together a group known as the hot meals Coalition are which of course you would pick you became now and you became very much involved Fred reached out to all the groups he knew in the LGBT community and the Eddsworld American Jewish Congress added all the Interfaith groups education in the anti-discrimination groups and eventually with number 70 people and it was very clear very early on that. We were not going to be delivering restaurant Foods. We needed people who knew about meal planning organization planning and meal delivery and be using some initial grant money from Project bread and combined Jewish philanthropies. We hired or chaquetas to help us do the general planning and return to you Alan as someone who absolutely knew about meal delivery.

11:52 A10 chip killer as you know, that's when I became actively involved. Honestly. I knew very little about HIV AIDS at the time but I did know a lot about meal delivery programs because I ran the elderly nutrition program in Cambridge and Somerville Massachusetts for seven years before moving over to the State Health Department. And as you mentioned there were 70 organizations involved in the Coalition and we had a smaller steering committee that work between meetings, you know, as with most Coalition work great emphasis was put on bringing stakeholders to the table hearing their ideas and proposals And discussing what would be best

12:36 But at the same time there are number of people with AIDS in our group and they pointed out very strongly and very often that people are dying and people need food now.

12:50 It's advocacy was key to our decision to launch a pilot program very quickly partnering with an elder Services meals program the Council of Elders, which operated out of a commissary in the Roxbury neighborhood of Boston. I know these folks very well having run the comprable program and I do their director very well also, so we started delivering 30 meals per week. And in fact, we were building the airplane while we fluid

13:22 Yes, I remember very well. I mean that that needing were the tensions erupted really had thrown all of us, you know, it was pointed. It was it was scary was here we had wanted to as you say build a good airplane make sure that we are on Solid Ground before we launched Community servings, but listening to that point that they're all young men around the around the table listening to them talk about seeing their colleagues and friends died because they hear your direction. We were going to figure out how to get Neil's but we've been had to figure out how we going to get clients. We had seven people around the table and a couple of those were still quite mobile.

14:22 Did not they did not need home-delivered meals at that point in time where we going to get the clients until the first person we hired was an Outreach person. And Janine was wonderful at going to visit doctors and explain to them what we were doing. She visited many of the physician we're dealing with AIDs. That was at the development of a form that the doctors would use in order to ascertain that people actually needed the services and

14:59 And so we began with that delivery yet. You don't remember privacy was still

15:07 So important and I think this is even before we had our state law protecting the privacy of a person who sang we all cared about AIDS action in American Jewish Congress at work very hard to get that law passed so that the insurance companies, for example, we're not notifying businesses. You have one person five persons with AIDS working for you or whatever so that had to be done. Well, so if you couldn't have a public list of who had AIDS and that would have been horrible. We had to find you no more indirect way of finding our clients and who needed the services and which is why we had to hire an Outreach person. Once we Harvey Outreach person. It was clear that we had to have a more sophisticated way of raising money. We could not depend Forever on these initial grants.

16:07 And so we began to talk about more formal fundraising and that's where we had the opportunity to meet our current David Waters who was a key person in our development of Lifesavers. Lifesavers was I a fundraiser which kind of reached back to the restaurant tours to get their help and David was David came to us from upstairs at the pudding was there in a sense of contribution of time upstairs at the pudding was very one of the organization is very involved the very beginning and throughout and the light first Life Savers and event actually brought out many of the restaurant tours who had been involved earlier providing food at this event and the next person we were able to hire then was an executive director and that was Didi catch over who was

17:07 Executive the CEO of community servings for 10 years.

17:14 And I remember eating it upstairs to the pudding that with that was one of the that was one of them both and delicious restaurants in Cambridge at the time and Catherine and the other folks who ran it were just terrific a couple of points here for a second. I want to go back to the Council of Elders, which is the contracted provider of those initial Neil's + 30 meals a week. The Council of Elders was based in Roxbury, which is in the heart of Boston's African-American community and most staff including their drivers came from Nat community.

18:00 Bicester Community servings well with the cognition that HIV/AIDS was disproportionately affect in communities of color.

18:09 You know many AIDS service organizations found the transition to including communities of color very challenging at the time and it led to the split in more than a few organizations community service was very fortunate to avoid many of those challenges.

18:28 The second thing was after launching the pilot program with the Council of Elders. It became very clear to us that the meals being delivered were not the most appropriate for Those whom we served. The mules served to the Elder worth Elders were nutritionally-balanced with an eye toward reducing fat increasing fiber etcetera, but our clients at the time we're offering suffering from wasting disease weight loss and inadequate protein.

18:58 Realizing this and with some seed funding is as you said from the AJC American Jewish Congress and the State Health Department and others. We moved into our own kitchen.

19:08 It's very small kitchen space was generously offered free by Joel Abrams and our friends at the Dorchester house Community Health Center.

19:19 Wow. Yes. I'm remembering you what how tiny that kitchen was as we began to develop those meals.

19:31 We clearly outgrew that space pretty quickly one comment, just back on your subject about our good relationship from very early on with the Multicultural Community. I remember that we started working with the Multicultural Multicultural AIDS task force very very early on as one of the Coalition partners and I remember contrasting that I I can come from New Haven Connecticut years ago and I saw that in New Haven Aid Service that they had to provide had to be provided an into streams. There was one stream that was providing it for white game in and there was another stream providing the services for the black Black and Hispanic community and you know when I inquired about it, why did they need to do to it turned out that in that?

20:31 They didn't have the kind of cooperation that we had at Community servings and needed to have these two separate completely separate Services. We never had that I think you you you just were referring to that in from the very beginning. That was something very very special. I think about Community servings being able to reach out to a great diversity if you will and when we needed more space

21:05 I think that Mayor Menino saw that and recognize that as a great asset of community servings, he was a great supporter those very early years and when we outgrew Dorchester house, we initially our delivery was in a very confined area cuz that's all we felt we could do now as we were increasing deliveries across the city wait, we needed to be able to make more meals and we needed space and Mayor Menino helped us to get the space on Magazine Street or which will become rehabilitated significant significant kitchen and here we were able to to buy commercial size equipment. I remember coming to look at that first big machine great big pots a great big mixers, you know.

22:05 Ever been in a commercial kitchen before so this was all very new to me and I remembered magazine the Magazine Street just it was so beautiful artist to done wonderful Prince soul food all along the hallways grapefruit other things and what are the wonderful things about that isn't had a great big conference room, which allowed for the development of a whole volunteer program, and I don't know maybe you'd like to Allen maybe you'd like it talk about how wonderful community service has been returned with the use of volunteers.

22:47 Well, I mean volunteers are Central to our mission. And before the Copa do I we were we were utilizing volunteers from business organizations from voluntary groups literally scores the volunteers each and every day. And in fact, I think it's fair to say without volunteer support are we couldn't have done what we did at the time or we couldn't do it now.

23:16 Absolutely right in and I I know you are particularly him.

23:23 Wanted to chat to talk about Ryan White in the whole role in which the funding from Ryan White played an important role in the development of meals.

23:37 Well, you're absolutely right and and what allowed us to expand really to the magazine side to the commissary. There was the Ryan White Care Act and for people who don't know what that was Ryan of Ryan White Care Act was a federal funds funding and in a way it was revolutionary because it targeted HIV/AIDS but was also one of the first to recognize what we now turn the social determinants of Health. It allowed for funding of things like Transportation housing and of course most importantly for Community servings food and nutrition services.

24:19 It's kind of forward-thinking was a portent of current trends in Massachusetts and elsewhere with groups like MassHealth, which is our Medicaid Program hear the Medicare waiver program here and also private insurers like group Blue Cross their now funding medically tailored be those provided by Community servings as part of their third party reimbursement.

24:46 So so important history in the way in which that funding allowed for our expansion and I'm sure expansion of other kinds of services across the country. Well, I loved I love the Magazine Street headquarters for community service and had this wonderful old door metal door that an artist had created. It just was beautiful but sure enough the need was so great. But we needed more space. It did not provide us enough storage space race and space to significantly increase. We were doing thousands of meals out of the location. I'm so again we looked and now we actually constructed building and moved to jaw.

25:46 Take a plane and here was a space with significant parking space for sufficient Vans sufficient storage opportunities. And in fact, you know, it was almost two stages we move there and that allowed one expansion and then we expanded on and again another time. I'm just because the need was so great and because we recognized as the ebb and flow has changed and life-saving medicines or device to help people live longer. We found that our

26:30 Home deliveries or sometimes of shorter duration

26:36 For multiple people rather than you know, end-of-life end-of-life kind of food delivery. So we really had the opportunity to do reach out and do a variety of things. One of the things at Jamaica Plain we're able to do with nutrition classes for people in the community and to increase the volume to your services at that point with hundreds of people coming in. I don't hundreds of people to help preparation round-the-clock preparation of foods to help the cooks.

27:16 And all this, you know for American Jewish Congress, which had been in this early roll and the Jewish Community all kind of seemed like an appropriate for work that we were doing because it's such a key part of our values of an expression in Yiddish all the biggest blunt and some people might remember it from the Anderson Sisters years and years ago singing a song but it means to be healthy. And so this whole notion of prevention of illness and Healing The Sick perfecting the world. This was all very important to us.

28:01 I had a vignette I was going to share with you. I don't know if I've ever told you the story. I had occasion to be visiting Margaret Marshall. She was General Counsel of Harvard and I had was just had stood up and was about to leave after a discussion. We had this was before she became Chief Justice of the Massachusetts Supreme Judicial Court, and she asked me then for about 25 years what single thing?

28:35 I have done that. I thought most important in that role.

28:40 And almost immediately I said I thought my greatest Legacy was helping to establish Community servings and little did. I know how much Community servings, you know, when we started it was going to grow and have so many aspects of helping.

29:00 Prisoners to learn about cooking and re-enter the community is cook's food as medicine provider of food be a model for food serving programs all around the country how to do specialized meals never would I have thought that we were going to be going so far?

29:32 And you Alan yet. If you have any what you know, I also I was thinking what you said to them tomorrow good Marshall and I also feel the community servings is one of the most significant programs that that I've worked with in light in my life, you know that you and I are both members of the community servings Board of advisors. And therefore we know that we're looking forward to a. Of growth and expansion now under the leadership of our executive director David Waters as you pointed out he's been involved with Community servings for 30 years.

30:11 You know, we have expanded we've expanded significantly, especially since we began serving the covid-19 patients as you mentioned. We're now provoking medically tailored meal options and our research continues ride by dr. Seth Berkowitz with two new nih-funded studies to build on our prior research and they sneeze latest art. These are going to examine the impact of medically taylored meals on clinical outcomes of individuals with diabetes and individuals with diabetes and HIV.

30:45 Aren't they sustain your vision now include providing 8.5 million medically taylored meals serving 30 thousand clients affected by severe illness while providing 75,000 hours of nutrition education and expanding our teaching kitchen to enroll 500 trainees with multiple barriers to employment.

31:08 When I look back, all I can say is what an amazing journey. This has been.

31:16 You know, it is a theme and in much of Jewish religious readings in the scripture that says he who saves one life is as if want to save the whole world and we look back and we see this movement this development of a program that saved many persons with AIDS now saving many persons with other life-threatening diseases as well and it is certainly carried out that seem as if we've saved the world

31:54 It's been wonderful to chat with you my friend.

31:59 Amen