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The Older Americans Act Nutrition Program Sets a New Table
posted 03.04.2014

By Jean Lloyd and Holly Greuling

Health matters. So does nutrition. What should a quality nutrition program offer? Good food? Good friends? Improvement in how you feel? Help in staying home? The Older Americans Act Nutrition Program (OAA NP) offers all those things and more. At the Administration on Aging (AoA), an agency within the Administration for Community Living, we are focusing on what we offer during March—National Nutrition Month.

These comments from older adults illustrate that the OAA NP delivers more than a meal.

  • “My doctor thought that your meals would be best for me because it is more variety than I’d cook alone. Anyhow, I am not able to cook at all.”
  • “The companionship and fellowship, as well as the nutritious meals keep me getting up in the morning, getting dressed and to the site to eat.”
  • “My husband needs lots and lots of help … If it wasn’t for meals I wouldn’t be able to continue taking care of him in our home.”
  • “I had major surgery. I feel these meals are big step toward keeping me from going to a nursing home.”

As we set a new table for long-term services and supports, it is helpful to reflect on the integral role that adequate quality meals and nutrition services plays in the lives of older adults. These services are more than a meal. They promote health, decrease the risk of chronic disease, assist in managing chronic disease and aid recovery from recurrent hospitalizations. Designed to address problems of food insecurity, promote socialization and promote the health and well-being of older persons, the OAA NP can reassure long distance family caregivers through safety checks and offer needed respite for in-home caregivers.

The OAA NP delivers congregate and home-delivered meals, nutrition education and nutrition counseling in all 50 states, 6 territories and 256 tribes through a network of more than 5,000 local nutrition service providers. The meals meet the Dietary Reference Intakes (Institute of Medicine) and the Dietary Guidelines for Americans (Secretaries of Health and Human Services and Agriculture). Aging services providers are preparing to meet increasingly diverse older population needs by including soup and salad bars, food item or menu choices, ethnic meals, therapeutic meals (meals that change content such as diabetic, low sodium or meals that change texture for people who have had a stroke) and restaurant voucher programs.

Grants from the AoA include separate funding for congregate and home-delivered nutrition services. In addition, the Nutrition Services Incentive Program (NSIP) provides supplemental funding for food products such as dairy, meat, fruits, vegetables and grains. The NSIP funding cannot be used for other program expenses such as salaries, equipment or meal preparation. To expand the OAA NP’s reach, states, area agencies on aging and local nutrition programs also access non-federal funding. In fiscal year 2011, 56 percent of the total expenditure for congregate meals and 69 percent of the total expenditure for home-delivered meals came from non-federal sources. Additional funding includes public sources such as state, county and city funding and private funding such as contributions from older adults, foundation grants, and local fundraising as well as volunteers. To bolster current funding, some nutrition service providers and/or area agencies on aging are becoming much more business oriented and socially entrepreneurial by contracting for third-party payments or selling meals to non OAA NP participants through fee-for-service arrangements.

The OAA NP was designed to serve adults who are ages 60 and older. However, participants are primarily older than age 75, often low-income, live alone, are in poor health and functionally impaired. For the majority of both congregate and home-delivered program participants, the meal that they receive five days a week provides a half or more of their total food for the day. Data from the 2012 National Survey of OAA Programs participants indicate:

  • 40 percent of congregate and 60 percent of home-delivered participants have 6 to 14 chronic health conditions;
  • 29 percent of congregate and 51 percent of home-delivered participants take from 6 to 23 medications daily;
  • 50 percent of congregate participants have at least one limitation in everyday activities such as preparing meals or grocery shopping and 29 percent of home-delivered participants have three or more limitations in activities such as bathing, getting dressed and toileting.

Data from the 2012 National Survey of OAA Programs indicate that participants value these services:

  • 92 percent of congregate and 88 percent of home-delivered participants rate the meal as good to excellent;
  • 86 percent of congregate and 89 percent of home-delivered participants state that the meals help them feel better;
  • 75 percent of congregate and 89 percent of home-delivered participants indicate that program participation makes them feel more secure;
  • 60 percent of congregate and 92 percent of home-delivered participants state that the meal enabled them to live at home;
  • 96 percent of congregate and 95 percent of home-delivered participants would recommend the program to a friend.

Adequate nutrition programs not only provide more than a meal, and support frail elders and their caregivers at home, but also a recent study indicated they may decrease state spending for long-term services and supports. Research by Thomas and Mor published in Health Affairs found that if all states had increased by 1 percent the number of adults ages 65 or older who received home-delivered meals in 2009, total annual savings to states’ Medicaid programs could have exceeded $109 million. The projected savings would result from decreased Medicaid spending on older adults with less care and-or fewer limitations in activities of daily living who would no longer require nursing home care. In other words, elders who have enough to eat would be less likely to end up in a nursing home.

During March National Nutrition Month, join us in celebrating the OAA NP, AoA’s largest health promotion program. The OAA NP provides more than a meal; it provides a basis for social, health and long-term protections for all older adults.

Sidebar

Older Americans Act Nutrition Program - Federal Fiscal Year 2011

 

Congregate

Home Delivered

Participants

1,656,585

856,471

Meals

88,587,614

139,150,000

 

Federal Fiscal Year 2014 Appropriations

Congregate

Home Delivered

Nutrition Services Incentive Program*

$438,191,000

$216,397,000

$160,069,000

*Nutrition Services Incentive Program provides supplemental funds for food only.

To learn more, visit The Administration for Community Living and the National Resource Center on Nutrition and Aging.


Jean Lloyd and Holly Greuling are both national nutritionists with the U.S. Administration for Community Living/Administration on Aging. 

This article was brought to you by the editorial committee of ASA’s Healthcare and Aging Network (HAN).

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