LOWELL -- Patients like Linda Malonson fall in a dangerous middle ground, not old enough to qualify for Meals on Wheels but too ill to shop and cook for herself.

The 52-year-old suffers from COPD, or chronic obstructive pulmonary disease, a progressive disease that makes it difficult to breathe. It makes her unable to work, 10 years after being diagnosed.

A referral from an oncology social worker at Lowell General Hospital introduced her to Community Servings, a Boston-based nonprofit that delivers prepared foods once a week. It provides a lunch, snack and dinner for each day of the week, with the exact mix of food individualized if a client has special dietary needs.

Malonson, a mother of five whose husband died 18 years ago, has now been receiving meals from Community Servings since 2011. Each Tuesday, van driver Warren Murray and volunteer Toni Frankin stop by at noon with enough food to help feed Malonson and her daughter and granddaughter who live with her.

"This is about the only thing that I qualify for," Malonson said.

Community Servings has expanded quickly in recent years, now covering 18 Massachusetts cities -- mostly immediate suburbs of Boston -- and last year serving 425,000 meals to more than 1,400 clients. That was a 13 percent rise in meals from the prior year. Lowell, which Community Servings has covered for three years, had a 9 percent increase.


"I've been doing this for 24 years," Community Servings CEO David Waters said. "It was very hard to get the attention of anyone in the health-care world until two years ago."

Now places like Lowell General Hospital and the Lowell Community Health Center refer patients to Community Servings as a way to get healthy meals at the right portions. More than nine out of 10 Community Servings clients live in poverty, according to the company, a slice of the population that otherwise might turn to cheap fast food or prepackaged foods that aren't as healthy as fruits, vegetables or meals that cost more.

"I really can't say enough about the program," said Heidi Parker, an oncology social worker at Lowell General. When dealing with patients who often have difficulty making ends meet, she said she refers "as many as I can."

In all, about 200 centers refer patients to Community Services, "almost like writing a prescription," Waters said. The meals are free to those receiving them, with costs picked up by charitable groups or a patient's health insurance, and some food donated by fishermen and farmers. Clients qualify based on their illness, mobility and other factors that would make it difficult to shop and cook for themselves.

Community Servings has fit into a niche, the only provider of its type in New England, according to the company, and one that serves those not old enough to qualify as seniors for Meals on Wheels. The company first considered itself anti-hunger but now also focuses on maintaining good health for its clients, Waters said.

"If you're too sick to leave home to go to the grocery stores or food pantry, there is no other option beyond Community Servings," he said.

About one-third of Community Servings clients are senior citizens, with an average age of 45. The cost of feeding each client is $20 a day.

All meals are made from scratch in the company's kitchen in the Jamaica Plain section of Boston, with entrees frozen to be easily cooked again for a meal. Food packages also include a loaf of bread and carton of milk, along with soups, salads and snacks like yogurt. The exact mix of foods might depend on a client's dietary needs.

Malonson, the Lowell resident, struggles with COPD, which causes emphysema and has been struggling to quit smoking.

"It's pretty hard to quit," she said, showing the nicotine patch on her right arm. Of her disease, she said "it got so bad I couldn't even breathe."

Murray, who's been delivering for Community Servings for 14 years, has built a friendship with Malonson.

"It's tough in Lowell to always get the help you need," Malonson said. Of Community Servings, she said, "they're very good to me."

Murray has gotten to know residents, and the cities the nonprofit serves, well.

"I don't need a GPS like I used to," he said with a laugh.

Follow Grant Welker on Twitter and Tout @SunGrantWelker.