CHAPTER 2 | Community-Based Nutrition Services 15 Box 2.2 continued 1915(c) Home and Community-Based Waivers


HCBS 1915(c) waivers are included in Medicaid programs and available to states that make long-term care services available in home and community-based settings. These programs aid distinct groups, such as older adults, those with mental illness, and those with disabilities. Programs can offer both standard medical and nonmedical services.21


Affordable Care Act (ACA)


Enactment of the ACA began to shiſt the health system focus from treating the sick to keeping people healthy. The ACA contains numerous provisions that expand health coverage to Americans, increase benefits, lower cost for consumers, and provide new funding for public health and prevention.22


Administration on Aging ▸ https:// acl . gov / about - acl / administration - aging


Administration for Community Living (ACL)31


Older Americans Act Nutrition Program (OAANP) ▸ https://acl.gov/programs/health-wellness /nutrition-services


The OAANP, also known as the Elderly Nutrition Program, provides grants to support nutrition services for older people throughout the country who may be at risk of losing their independence. Services include both home- delivered meals and healthy meals served in group settings as well as nutrition screening, assessment, education, and counseling.23


Administration for Community Living (ACL) nutrition services


▸ https://acl.gov


The ACL provides grants to states to help support nutrition services for older people. Services include both home-delivered meals and healthy meals served in group settings. The programs provide a range of services, including nutrition screening, assessment, education, and counseling. Programs target adults aged 60 years or older who are in greatest social and economic need. Eligibility is determined by state and local requirements.23


Nutrition Services Incentive Program (NSIP)


▸ https://acl.gov/senior-nutrition/nutrition-services -incentive-program-nsip


In the NSIP, grants are allocated to states, territories, and eligible ITOs. They are intended to provide incentives to deliver nutritious meals to older individuals through additional funding to help providers adjust meal rates for clients in need. The NSIP reimburses area agencies on aging and service providers through a financial supplement for the costs of congregate and home-delivered meals.24


Eldercare Locator ▸ https:// eldercare . acl . gov


The Eldercare Locator is a public service of the Administration on Aging, connecting people to services for older adults and their families.25


Care Settings Within the Community


Older adults live in a variety of community-based residential settings, including private homes, group homes, and assisted-living facilities. Some receive health care services in their home environments. Cor- rectional facilities are also included in this chapter because individuals who are older and incarcerated may have conditions that require nutrition interven- tion. Box 2.3 on page 16 summarizes some care set- tings and the services provided.32


Independent Living


Most older adults (96%) live in their own homes or other community-based housing and want to remain there as long as possible.8


adults who live independently face are as follows:


• Lack of transportation—At some point, most seniors give up their driver’s license and car (if they had one). They depend on public transpor- tation and the kindness of friends and relatives to get where they want to go. Grocery shopping becomes more complicated when older individu- als must depend on others to take them shopping or shop for them. However, grocery shopping has become easier in recent years because many supermarkets and restaurants now offer online


Some issues that older


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