Applicants are expected to demonstrate extensive knowledge and present a proven track record of expertise concerning the nature of nutrition for older individuals and the business of nutrition program administration within the aging network. Individuals, foreign entities and sole proprietorship organizations are not eligible to compete for, or receive, awards made under this announcement.
Background The OAA provides funding to States and Tribal Organizations to support a broad array of services that enable older adults to remain in their homes and communities and assist family and informal caregivers to care for their loved ones for as long as possible. The OAA was designed to serve older adults holistically by providing a combination of supports tailored to the needs of the individual, and no single service by itself is sufficient to guarantee that an older adult will be able to remain at home instead of entering a nursing home or other type of institutional care. Yet it is undeniable that nutrition services, which are the most well-known of all the OAA-funded services, are particularly critical to keeping older Americans healthy and preventing or delaying the need for more costly medical interventions. Both the number of older Americans and the number of older Americans with one or more chronic conditions continue to increase. Multiple chronic diseases and conditions negatively affect quality of life, contribute to declines in functioning and the ability to remain in the community, adversely impact individuals’ physical and mental health, and contribute to increased hospitalizations and health care costs. Many of the most common chronic conditions such as hypertension, depression, poor oral health, cancer, obesity, heart disease, diabetes, and osteoporosis are related to nutrition as a primary prevention, risk reduction, or treatment modality. There is an evidence base that supports providing healthy meals and other nutrition services to improve health and reduce the need for more expensive institutional care. This evidence base for quality nutrition services supports the characterization of the OAA Nutrition Services as our largest health promotion program. Purpose and Goals The purpose of this funding opportunity is to support systematic testing and documentation of innovative and promising practices that enhance the quality, effectiveness and proven outcomes of nutrition services programs within the aging services network. While investments in nutrition services are clearly needed, it is also critical that ACL work with our state, Area Agency on Aging, and local partners to modernize these services and ensure that every dollar is spent effectively. As noted above, research clearly shows that providing nutrition services improves the health of participants and reduces their need for more expensive medical interventions and institutional care. Translating the knowledge generated by this research into evidence-based models for delivering nutrition program services and programs at the community level is essential to ensuring the continued efficacy of these programs while improving their efficiency. Within the OAA programs, ACL has historically used innovation dollars provided under Title IV of the Act as a means of testing new approaches to service delivery and developing replicable models that could then be embedded into the core delivery programs authorized under Titles III, VI, and VII. One example of how this approach has been used effectively is the Title III-D Preventive Health Services Program. Starting in 2003, ACL used dollars provided under the Title IV Program Innovations budget to begin testing evidence-based models for delivering health services in community-based settings across a variety of areas, including Chronic Disease Self-Management, Falls Prevention, Enhanced Fitness, and Medication Management. As these models proved more successful than traditional approaches, States increasingly shifted their funding to provide greater support to evidence-based approaches. Additionally, building and strengthening the business acumen of nutrition providers is of critical importance to ensure that the capacity of the network keeps pace with demand, in spite of limited federal resources. Approaches must have the potential for broad implementation throughout the network and have demonstrated value such as cost savings, addressing a national need, and etc. Applicants must explain how they see this proposal as innovative, explain how broad implementation can be done, and its potential impact on the network. Projects should focus on at least one priority effort to: Create partnerships between Universities and/or other research organizations in collaboration with aging network organizations to develop or test innovative evidence based programs or practices for senior nutrition - examples could include, but are not limited to: Testing or piloting nutrition programs with the potential of meeting Title III-D standards, developing nutrition related promising practices that extend the time people can safely remain in their home, and efforts that focus on enhancing the quality and effectiveness of nutrition programs’ services. Modernize the congregate and/or home delivered meal program infrastructure, delivery mechanisms, and/or marketing and outreach that can be used by the national aging network to ensure that States are able to maximize the return on their investment in nutrition programs and expanding the reach of the OAA target populations - examples could include, but are not limited to: Decreasing food waste, increasing meals served and consumed, decreasing overhead cost, increasing revenues, developing new approaches to volunteer recruitment and retention, increasing person-centered practice models that address nutritional preferences of participants, eco-friendly delivery mechanisms, and etc; Enhance partnerships with health care partners (e.g. oral health, behavioral health, alternative health, and etc) to further demonstrate the network's value in solving local and national problems, and/or increasing business acumen opportunities - examples could include, but are not limited to: Decreasing social isolation, developing effective suicide prevention strategies, promoting the bidirectional relationship between diet/nutrition and oral health in older adults, decreasing fall risk by increasing meal delivery, and targeting people with specific health condition(s) in an effort to decrease overall health care utilization of that population; Advance the use technology within the aging network - examples could include, but are not limited to: Investigating sustainable telehealth applicability for the network, developing web-based ordering systems, improving business practices, improving participants health, and establishing feedback procedures in the aging network. Applicants need to clearly identify one or more of the above priority area of focus in their application.  Lochner KA, Cox CS. Prevalence of Multiple Chronic Conditions among Medicare Beneficiaries, United States, 2010. Prev Chronic Dis 2013; 10:120137. DOI http://dix.doi.org/10.5888/pcd10.12037  Thomas, Kali S and Mor, Vincent. The Relationship between Older Americans Act Title III State Expenditures and Prevalence of Low-Care Nursing Home Residents. Health Services Research 48:3, 1215-1226. June 2013 : http://europepmc.org/articles/PMC3664926