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Part I Introduction to Nutrition Care in Older Adults

states through grants. The program is administered within most states by the state educational agency, but in some states, it may be administered by an alternate agency such as the state health or social services department. However, the child- or adult-care component may be administered by different agencies within a state, at the governor’s discretion. Public or private nonprofit adult daycare facilities that provide structured, comprehensive services to nonresidential adults who are functionally impaired, or aged 60 and older, may participate in CACFP as independent or sponsored centers. For-profit centers may be eligible for CACFP if at least 25% of their participants receive benefits under Title XIX or Title XX. Meals served to adults receiving care are reimbursed at rates based upon a participant’s eligibility for free, reduced price, or paid meals (26). CACFP provides aid to support healthy meals and snacks to eligible adults enrolled in participating adult daycare centers. Meals must meet minimum nutrition requirements as outlined in CACFP meal patterns, based on the Dietary Guidelines for Americans and sci- entific recommendations from the Institute of Medicine.

The program provides meals and snacks to over 120,000 eligible low-income adults annually who receive care in nonresidential adult daycare centers (26).

Senior Farmers’ Market Nutrition Program

The Senior Farmers’ Market Nutrition Program (SFMNP) awards grants to states, US territories, and federally recognized Indian tribal governments to provide low-income seniors with coupons that can be exchanged for eligible foods (ie, fruits, vegetables, honey, and fresh-cut herbs) at farmers’ markets, road- side stands, and community-supported agriculture programs.

Older adults may apply for SFMNP vouchers at state agencies such as the State Department of Agriculture or the State Unit on Aging. The voucher amounts are determined by the individual state agen- cies, not by recipient income levels. “The federal SFMNP benefit level, whether a household or individ- ual, may not be less than $20 or more than $50 per each farmers’ market calendar year, except for certain state agencies that were grandfathered in the SFMNP using a different benefit level. State agencies may also supplement the benefit level with state, local, or private funds” (27).

Supplemental Nutrition Assistance Program

The Supplemental Nutrition Assistance Program (SNAP), formerly the Food Stamp Program, is the

largest of the USDA food-assistance programs; however, only about 30% of eligible older adults participate in SNAP (28). It offers nutrition assistance to eligible, low-income individuals and families and provides eco- nomic benefits to communities. Eligibility for the program requires that the individual’s or household’s gross monthly income not exceed 130% of the federal poverty guidelines and that participants’ assets do not exceed set limits; participants who meet the require- ments set by law are guaranteed benefits. The FNS works with “state agencies, nutrition educators, neighborhoods, and faith-based organiza- tions to ensure that those eligible for nutrition assis- tance can make informed decisions about applying for the program and can access benefits.” States issue SNAP benefits through local, state, or county offices to households eligible to receive them. Clients who are eligible for SNAP receive benefits through an elec- tronic benefit transfer (EBT) card, which can be used like a bank debit card to buy groceries at authorized food stores. Benefits are automatically loaded into the household’s account each month on the designated date, and the cost of the eligible food items is deducted from the household’s account automatically when the card is used (29). There are few restrictions on food purchases, but non-food items, tobacco, and alcohol are excluded. Table 2.2 provides an overview of SNAP benefits. Complete information is available at the SNAP website (29).

Supplemental Nutrition Assistance

Program Education The objective of the USDA’s Supplemental Nutrition Assistance Program Education (SNAP-Ed) is to provide educational programs to aid recipients in making healthful food choices within a limited budget and choose active lifestyles consistent with the most recent dietary advice found in government publications such as ChooseMyPlate and Dietary Guidelines for Americans (30-32). SNAP-Ed is a federal–state part- nership that supports nutrition education for persons eligible for SNAP. Two key federal partners are the National Institute of Food and Agriculture (NIFA) and the USDA FNS. NIFA facilitates communication among federal, state, and local partners and provides programmatic leadership to university contractors for effective nutrition education through the land-grant system (32,33). The FNS encourages states to provide nutrition education messages that focus on strengthen- ing and reinforcing the link between food security and a healthy diet. The FNS determines national policies and procedures, monitors state programs, and reim- burses states for up to half of program costs (32).