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Administration on Aging (AoA)

Nutrition Services (OAA Title IIIC)

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The Purpose and Functions

The purpose of the OAA Nutrition Program is to:

  • Reduce hunger and food insecurity among older individuals,
  • Promote socialization of older individuals,
  • Promote the health and well-being of older individuals, and
  • Delay adverse health conditions for older individuals.

The Nutrition Programs are authorized under Title IIIC of the Older Americans Act. They fulfill their purpose by providing access to healthy meals, nutrition education and nutrition counseling.

The Nutrition Programs are targeted to adults age 60 and older who are in greatest social and economic need with particular attention to:

  • low income older individuals,
  • minority older individuals,
  • older individuals in rural communities,
  • older individuals with limited English proficiency, and
  • older individuals at risk of institutional care.

The Nutrition Programs are funded (in part) by the Administration on Aging (AoA), part of the Administration for Community Living, which administers the Older Americans Act. About 5,000 nutrition service providers together serve over 900,000 meals a day in communities all across the United States.

The Nutrition Programs are also funded by:

  • state and local governments,
  • foundations,
  • direct payment for services,
  • fundraising,
  • program participants’ voluntary contributions (of time and/or money), and
  • other sources.

For more information on the purpose of the Nutrition Programs, see the Older Americans Act Section 330.

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Benefits of the Nutrition Program: A Research Brief

The Older Americans Benefit from the Older Americans Act Nutrition Program (PDF, 385KB) research brief discusses findings from AoA’s recent National Survey of OAA Participants. The research brief:

  1. Describes program requirements
  2. Discusses the link between nutrition, health, and the ability of older adults to remain at home
  3. Describes the high-risk population served
  4. Shows participants’ perceptions of the positive impact programs have on their quality of life

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Nutrition Quality Standards (OAA Section 339)

The OAA requires that all meals served using OAA funds must adhere to the current Dietary Guidelines for Americans (DGAs), provide a minimum of one-third of the Dietary Reference Intakes, meet state and local food safety and sanitation requirements and be appealing to older adults.

Because the Nutrition Programs are state administered, each State Unit on Aging has the responsibility and authority (Section 305) to implement the nutritional standards (Section 339) to best meet the needs of the older adults that they serve. For example, a state may choose to use their funds to provide meals that focus nutrient standards on prevalent statewide chronic disease(s) or predominant health issue(s) affecting older individuals. In practice, some states may require that menus for the meals served using OAA funds be developed using nutrient analysis, a meal pattern or a combination of both.

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Did You Know? OAA Nutrition Program Facts

The Older Americans Act (OAA) is a flexible law that allows states to tailor their programs to meet the needs of the older adults in their states/communities who are in greatest social and economic need. This Did You Know? document (PDF) presents general information about the OAA nutrition program that may be surprising to some and brand new to others. In many areas the OAA gives states the authority to add other requirements beyond those in the OAA. That means that some practices that might be allowable under the OAA and perhaps discussed in this document could be handled differently in some states or local areas. State and local variances are NOT covered here. This document only reflects myths and truths about the OAA nutrition program from a federal perspective.

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Congregate Nutrition Services (OAA Section 331, sometimes called C1)

The Congregate Nutrition Services section of the OAA authorizes meals and related nutrition services in congregate settings, which help to keep older Americans healthy and prevent the need for more costly medical interventions. In addition to serving healthy meals, the program presents opportunities for social engagement, information on healthy aging and meaningful volunteer roles, all of which contribute to an older individual’s overall health and well-being.

The Congregate Nutrition program serves individuals who are age 60 or over, and in some cases, their caregivers, spouses and/or persons with disabilities.

Services are not intended to reach every eligible individual in the community. Services are targeted to those in greatest social and economic need with particular attention to:

  • Low income individuals
  • Minority individuals
  • Older individuals in rural communities
  • Older individuals with limited English proficiency
  • Older individuals at risk of institutional care

Recent data from the National Survey of Older Americans Act Participants illustrates that Congregate Nutrition Programs are effectively targeting services, as evidenced by:

  • More than half of the participants are 75 years or older
  • The average age of a participant is 76 years old
  • 58% of the congregate participants indicated that one congregate meal provides one-half or more of their total food for the day
  • 77% of the congregate participants indicated that they eat healthier as a result of the meal program
  • 76% of the congregate participants indicated their health has improved as a result of eating at the lunch program

For more information on Congregate Nutrition Services, see the Older Americans Act Section 331.

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Home-Delivered Nutrition Services (OAA Section 336, sometimes called C2)

The Home-Delivered Nutrition Services program of the OAA authorizes meals and related nutrition services for older individuals who are homebound. Home-delivered meals are often the first in-home service that an older adult receives, and the program is a primary access point for other home and community-based services.

The Home-Delivered Nutrition program serves frail, homebound or isolated individuals who are age 60 or over, and in some cases, their caregivers, spouses, and/or persons with disabilities.

Services are not intended to reach every eligible individual in the community. Services are targeted to those in greatest social and economic need with particular attention to:

  • Low income individuals
  • Minority individuals
  • Older individuals in rural communities
  • Older individuals with limited English proficiency
  • Older individuals at risk of institutional care

Recent data from the National Survey of Older Americans Act Participants illustrates how the Home-Delivered Nutrition Programs are effectively targeting services:

  • 69% of individuals served by this program are 75 years or older
  • The average age of a participant is 79 years old
  • More than 60% of participants indicate that the single home-delivered meal provides one-half or more of their total food for the day
  • 91% of participants indicate that the Home-Delivered nutrition program helps them to stay in their own home
  • More than half of all participants live alone

This program provides much more than food; it provides a wholesome meal plus a safety check, and sometimes the only opportunity for face-to-face contact or conversation for that day. For more information on Home-Delivered Nutrition Services, see the Older Americans Act Section 336.

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National Resource Center on Nutrition and Aging

The National Resource Center on Nutrition and Aging (NRC) is one of the many ACL funded Resource Centers. Resource centers provide information primarily geared toward professionals and when possible for consumers as well. The NRC supports the aging services network’s nutrition programs. The NRC’s mission is to disseminate information on how to build the capacity of the aging nutrition services network and increase the network’s integration into a home- and community-based service system. For more information, visit the National Resource Center on Nutrition and Aging.

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Nutrition Services Incentive Program (NSIP, OAA Section 311)

The Nutrition Services Incentive Program (NSIP) provides grants to states, territories and eligible tribal organizations to support the Congregate and Home-Delivered Nutrition Programs by providing an incentive to serve more meals. States, territories and eligible tribal organizations can choose to receive their grant as cash, commodities (food) or a combination of cash and commodities. For more information on the Nutrition Services Incentive Program, see Older Americans Act Section 311.

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Performance and Outcome Information

AoA collects and reports on the performance of all OAA programs (to include the nutrition programs) through the State Program Reports (SPR) component of ACL’s National Aging Program Information System. The SPR serve as a critical data source for measuring each OAA program’s performance. ACL uses the reported information for a variety of uses to include use in ACL’s Congressional Justification. In practice, States may choose to access the State Program Reports (SPR) for intrastate or interstate comparisons. For example, a state may want to know if they are serving more or fewer home-delivered nutrition program participants when compared to another state. For this type of information or any other data queries, visit AGing Integrated Database (AGID). For more information on the specific national or state specific performance outcome information, visit State Program Reports. States, Area Agencies on Aging or providers seeking to develop measures to assess their own program’s performance are encouraged to visit Performance Outcome Measurement Project (POMP).

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Federal Funding

AOA issues grants for Congregate Nutrition Services and Home-Delivered Nutrition Services programs to states using a formula (Section 304) defined in the OAA. The formula is largely based on each state’s share of the U.S. population aged 60 and over.

AoA issues grants for the Nutrition Services Incentive Program to states, territories, and tribal organizations using a formula (Section 311) defined in the OAA. The formula is based on the entity’s percentage of the total number of meals served in the prior federal fiscal year. For more information on the federal funding for the nutrition programs, see Funding Allocations to States and Tribal Organizations.

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Programmatic Evaluation

The Administration for Community Living (ACL) is conducting a three-part evaluation of its Title III-C Older Americans Act Nutrition Services Program.

  • Part One titled: Process Evaluation of Older Americans Act Title III-C Nutrition Services Program (PDF, 948KB) provides information to support program planning by analyzing program structure, administration, staffing, coordination, and service delivery. In addition, it also evaluated the interactions between the many levels and types of organizations that provide congregate meals, home-delivered meals and collateral services under the Older Americans Act Nutrition Programs. This evaluation has been completed and the Nutrition Program Process Evaluation webinar and handouts (PDF) are available.
  • Part Two titled: Older Americans Act Nutrition Programs Evaluation: Meal Cost Analysis (PDF, 667KB) estimates the costs of program operations, the most important being the cost of the congregate and home-delivered meals provided using Title III funds, and to examine cost variation within the program by cost component and program characteristics. A Process Evaluation and the Meal Cost Analysis webinar and handouts (PDF) are available.
  • Part Three titled: Client Outcome Study will assess program effectiveness, as measured by the program’s effects on a variety of important outcomes (including nutrient adequacy, socialization opportunities, health outcomes and, ultimately, helping older adults avoid institutionalization) through comparing program participants’ outcomes with those from a matched comparison group of eligible nonparticipants. The Client Outcome Study is currently underway.

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Useful Links to More Information

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Last Modified: 8/16/2016