To be considered for funding, applicants must 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.
The OAA provides funding to States and Tribal Organizations to support a broad array of services that enable seniors 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 seniors 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’ health, and contribute to increased hospitalizations and health care costs. Many of the most common chronic conditions such as hypertension, 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 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 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.
Examples of innovative and promising practices that enhance the quality and effectiveness of our nutrition program could include service products that appeal to caregivers (such as web-based ordering systems and carryout food products), increased involvement of volunteers (such as retired chefs), consideration of eating habits and choice (such as variable meal times, salad bars, or more fresh fruits and vegetables), new service models that improve the quality of meals (testing variations and hybrid strategies) and other innovations to better serve the younger generation of consumers whose needs and preferences are different. Through this program, funds may be used to help develop and test additional models or to replicate models that have already been tested in other community-based settings.
Projects should focus on a number of priorities, including efforts to:
Modernize the infrastructure and delivery mechanisms in use by the national aging network to insure that States are able to maximize the return on their investment in nutrition programs, both in terms of number of meals and seniors that they are able to serve and in terms of the impact that these programs have;
Instill, increase, and then maintain consistent quality in meals and nutrition services through collaborative efforts among State Units on Aging, Area Agencies on Aging, and local nutrition service providers;
Develop pioneering approaches that bridge the gap between clinical and community services to demonstrate value;
Leverage Medicare benefits (such as Medical Nutrition Therapy) to generate revenue;
Improve quality, service and effectiveness of providing meals and other nutrition services to meet the special nutrition needs of ethnically and culturally appropriate diets as well as religious needs of a diverse communities;
Utilize new food and food service technology and equipment as well as foodservice personnel (such as chefs) to reduce costs, improve service and delivery, and add value;
Enhance communication through effective use of health IT and other techniques to improve business practices and establish quality feedback procedures to report outcomes to the entities at risk for meal recipients’ health care costs; and
Develop innovative ways to use existing nutrition sites for other health promotion activities that could receive sustainable funding outside the OAA and, likewise, develop innovative uses of existing nutrition sites as multi-purpose community sites and cafes for the broader populations and needs in the community;
Test the effectiveness of pilots that address the incidences of malnutrition and/or health care utilization and the programs ability to show interventions have positive outcomes and plan to publish in a peer review journal;
Promote innovative, evidence based practices for senior nutrition aimed at enhancing the quality and effectiveness of the nutrition programs’ services.
 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