12 CHAPTER 2 | Community-Based Nutrition Services
The framework encompasses reducing costs, improv- ing population health and the overall experience, and health care team well-being.22 The ACA has affected older adults in several ways. Under Medicare Parts A and B, there are extra benefits such as free screenings and preventive services and improved prescription drug coverage (closing of the “donut hole”). Additional cost savings are available through Medicare Advantage programs.22
Administration on Aging Older Americans Act Nutrition Programs
The Administration on Aging (AoA) Older Americans Act Nutrition Programs (OAANP), also known as the Elderly Nutrition Program, provide grants to support nutrition services for older people nationwide who may be at risk of losing their independence. The Administration for Community Living (ACL) directs the AoA. Services include both home-delivered meals and healthy meals served in group settings, such as senior centers and faith-based locations (eg, Meals on Wheels and congregate meals). These programs also provide additional services, including nutrition screening, assessment, education, and counseling, and provide a link to other community- and home- based services, such as home health aides and trans- portation. Participants must be aged 60 years or older, and eligibility is determined by states and local entities. Services are intended for individuals with the greatest social and economic needs.23 Nutrition services are authorized under Title III-C of the Older Americans Act (OAA). The OAA was designed to promote the general health and well- being of older individuals, and services aim to achieve the following:
• reduce hunger, food insecurity, and malnutrition of older adults;
• promote socialization of older individuals; • promote the health and well-being of older people by assisting them in gaining access to nutrition and other disease prevention and health promo- tion services; and
• delay the onset of adverse health conditions resulting from poor nutritional health or seden- tary behavior.
Services are not intended to reach every individual in the community. Programs target adults aged 60 years or older who are in greatest social and economic need, with particular attention to the following groups:
• low-income older adults, • racial and ethnic minority older individuals, • older adults in rural communities, • older individuals with limited English profi- ciency, and
• older adults at risk of institutional care.
The OAA requires that all meals served using OAA funds adhere to the current DGA, provide a min- imum of one-third of the Dietary Reference Intakes (DRIs), meet state and local food safety and sanitation requirements, and be appealing to older adults. Because services are state administered, each state unit on aging has the responsibility and authority (OAA §305) to implement the nutritional standards (OAA §339) to best meet the needs of the older adults that they serve. For example, a state may choose to use its funds to provide meals that focus nutrient standards to prevalent statewide chronic diseases or predominant health issues affecting older individuals. In practice, some states may require that menus for meals served using OAA funds be developed using nutrient analysis, eating patterns, or a combination. Reauthorization of the OAA is necessary to ensure continued funding, along with updates, provisions, and flexibilities in program management.
Congregate Nutrition Services
The Congregate Nutrition Services section of the OAA authorizes meals and related nutrition services in congregate settings, which help 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 engage- ment, information on healthy aging, and meaningful volunteer roles, all of which contribute to the overall health and well-being of older individuals. The Con- gregate Nutrition Services program serves individuals aged 60 years or older and, in some cases, their care- givers or spouses and persons with disabilities.
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