Innovations in Nutrition Programs and Services - Statewide Research

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Title
Innovations in Nutrition Programs and Services - Statewide Research
Opportunity ID
332358
Center
AOA
Primary CFDA Number
93.045
Funding Opportunity Number
HHS-2021-ACL-AOA-INNU-0092
Funding Instrument Type
Cooperative Agreement
Expected Number of Awards Synopsis
2
Length of Project Periods
36-month project period with three 12-month budget periods
Project Period Expected Duration in Months
36
Eligibility Category
State governments,County governments,City or township governments,Special district governments,Independent school districts,Public and State controlled institutions of higher education,Native American tribal governments (Federally recognized),Public housing authorities/Indian housing authorities,Native American tribal organizations (other than Federally recognized tribal governments),Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education,Private institutions of higher education
Additional Information on Eligibility
Successful applicants will be expected to have demonstrated knowledge and a proven track record of expertise concerning the nature of nutrition for older individuals and the business of nutrition program administration within the Older American Act (OAA) aging services network. Applicants must be an OAA Title III recipient, or have a signed letter of commitment from a key partner that receives Title III funds.  Foreign entities are not eligible to compete for, or receive, awards made under this announcement. Faith-based and community organizations that meet the eligibility requirements are eligible to receive awards under this funding opportunity announcement.
Estimated Award Date
Funding Opportunity Description

Background
Overview of the Senior Nutrition Program (SNP)
The Older Americans Act (OAA), administered by the Administration for Community Living, (ACL) provides funding to support a wide array of home and community-based services (HCBS) within a long-term services and support system. The purpose of these services is to maximize the independence, well-being and health of older adults and allow them to live at home for as long as possible.

The OAA Senior Nutrition Program (SNP) helps older Americans remain healthy and independent in their communities by providing meals and related services in a variety of community settings (including congregate facilities, such as senior centers) and via home-delivery to older adults,. ACL funds services in all 50 states, the District of Columbia, and five territories through a network of 622 area agencies on aging and more than 7,000 local nutrition service providers through Title III [1]. Services are provided to adults age 60 and older and spouses of any age in Title III programs. The OAA creates an option for programs to offer meals to limited, additional populations; further eligibility criteria are determined by states and local entities. [1] In addition to the Title III program in states and territories, the OAA funds nutrition services for American Indians, Alaska Natives and Native Hawaiians. Native American Nutrition and Supportive Services, Title VI, provides grants to over 276 eligible tribal organizations to promote the delivery of Nutrition and Home and Community-Based Supportive Services to Native elders through Title VI [2] In Title VI programs, the tribal organization determines eligibility age.

The purposes of the SNP are to: a) reduce hunger, food insecurity and malnutrition, b) promote socialization, and c) promote health and well-being by delaying the onset of adverse health conditions and assisting individuals in gaining access to nutrition and other disease prevention and health promotion services that delay the onset of health conditions resulting from poor nutritional health or sedentary behavior. Socialization approaches enhance the opportunity for human connection. Services target older adults who are low-income, minority, rural, those with limited English proficiency and those at risk for institutionalization.

The SNP includes congregate and home-delivered meals, nutrition screening, assessment, counseling and education, as well as opportunities for social engagement. Meals are required to meet the 2020-2025 Dietary Guidelines for Americans as well as the Dietary Reference Intakes. OAA programming is person-centered and provides a mix of services to meet the widely differing needs of a diverse population of older adults.[3] These services help older adults maintain their physical, mental and social health and manage nutrition-related diseases such as heart disease, hypertension, and diabetes.[4,5] SNP participants benefit from information on healthy aging and access to additional HCBS services such as transportation, benefits counseling, physical activity programs, and evidence-based workshops (eg, chronic disease self-management, falls prevention, etc). Additional purposes of OAA services, including nutrition services, focus on addressing the social determinants of health, which are defined in Healthy People 2030 as "the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks". Social determinants of health include access to healthy food, food security, social connectedness and availability of community-based nutrition programs. [6]

State Units on Aging have the responsibility to develop policies, procedures, guidance and technical assistance for nutrition service implementation. While a State Unit on Aging may delegate some of this responsibility to Area Agencies on Aging (AAAs) or Local Service Providers (which may also establish further detailed policies and procedures), statewide policies have an inherent ability to impact the respective state’s population’s health status.

It is critical that ACL work with the aging services network to validate and/or test new models, especially in light of COVID-19, to modernize services to ensure that nutrition services are achieving their intended outcomes, and that every dollar is spent effectively to ensure the sustainability of these services. Translating the knowledge generated by this research into evidence-based models for delivering the SNP and programs at the community level is essential to ensuring the continued efficacy and efficiency of the nutrition programs.

Coronavirus Impacts
Due to the coronavirus 2019 (COVID-19) pandemic, the SNP has experienced significant transformations in service types and delivery methods, as well as a surge in numbers of persons served by the program. Stay-at-home orders, illness and heightened vulnerability of older adults to the virus– along with the closing of many workplaces, senior centers and meal sites – has and continues to greatly impact the SNP eligible population, as well as the SNP workforce (including volunteers), resources (food, protective equipment, etc), services (groceries, grab-and-go meals, etc.) and operations (delivery frequency, virtual programming, data collection, etc). Guidelines and information regarding these changes, as well as funding and financial requirements, are fully detailed at the ACL website. [7,8]

COVID-19 has shifted service delivery almost exclusively to home delivered meals. ACL is therefore interested in applications which propose potentially successful approaches of transitioning to and sustaining congregate meal programs, and provision of nutrition education for this funding announcement.

Purpose and Goals of this Announcement:
The purpose of this funding opportunity is to verify the effectiveness of SNP innovative policies created during COVID-19 in order to improve health indicators among those served or the capacity of organizations to provide services. Project goals and outcomes must relate to the OAA SNP intents (specifically: 1) reduce hunger, food insecurity and malnutrition, 2) promote socialization (socialization approaches enhance the opportunity for human connection), and 3) promote health and well-being by delaying the onset of adverse health conditions, through the provision of meals and associated nutrition services to vulnerable older adults who are in greatest social and economic need.). Proposed policies must have strong potential for replication by the aging services network and sustainability using OAA Title IIIC-1 funding.

Applications should include detailed descriptions of the development and implementation of statewide policies that support transitioning to and sustaining congregate meal programs and delivering impactful nutrition education.

“Statewide” Title IIIC-1 policy is defined as policy which impacts the Title IIIC-1 nutrition program services or operations of all SNP providers throughout a state, or territory, as applicable; statewide policies may address how Title III organizations coordinate with Title IV grantees to serve native elders.

Examples of potential project ideas are listed below (not an exclusive list, offered for context):

Statewide malnutrition screening policies for congregate meal participants, and related referral mechanisms to HCBS services based on social determinants of health including diet, socialization and health/well-being. Planned outcomes demonstrate how addressing OAA intent areas create cost-savings to the wider community (eg, reducing caregiver or older adults’ workplace sick days, enhancing state or local tax base, reducing fire and emergency services visits, etc).
Policies regarding use of media, assessment frameworks, and partnership models created during COVID-19 which identify and transition home delivered meals recipients, including those in tribal areas, to congregate meal sites, while demonstrating impact on socialization, diet quality and health/well-being.
Policies for effective in-person, hybrid, and virtual nutrition education and socialization standards for congregate meal providers.
Policies which support new congregate meal program models that leverage COVID-19 food delivery and program implementation that bring all aspects of the OAA intents to new populations, especially those targeted by the OAA. For example, outreach and services for native elders being served by Title III programs, through Title VI grantees who collaborate by informing culturally appropriate menu design and nutrition education.
Implement COVID-19 learnings and policies on training curricula and certification standards for staff and volunteers to deliver nutrition education, health and well-being, or socialization interventions (appropriate for skill level) to congregate meal clients, including for those who transition from home delivered meals.

Innovative policies selected for evaluation must align with health equity approaches [9] and the OAA by targeting services to underserved older adults with greatest social and economic need, to permit such individuals to remain in home and community-based settings. The at-risk population should include older adults who formerly participated in the congregate nutrition program and other community-based programs, whose activity levels, access to healthy food, as well as opportunities to connect socially with others, grocery shop, obtain medical care, and exercise may have declined or changed significantly during COVID-19. These individuals, who previously were vigorous and independent, may have experienced declines in nutritional health, food security, physical capabilities, mental health and social connection.

Applicants’ proposals must focus on creating partnerships between Universities, Tribal Colleges and Universities (TCUs), or other research organizations in collaboration with aging services network organizations to test innovative programs or practices for the SNP. Testing and evaluating efforts should focus on enhancing the quality, effectiveness and sustainability of older adult nutrition programs services, in times of emergencies but also sustainable during non-emergency situations.

Note: An applicant should consult ACL programmatic evaluations of the SNP [10], the National Survey of OAA Participants [10], relevant national datasets [11,12] and the Inter-university Consortium for Political and Social Research (ICPSR) [13] when preparing its application.

Projects funded through this announcement must:
Focus on validating Title III policy innovations implemented since the start of COVID-19. Applicants should ask themselves the question, "Is this statewide policy truly innovative and what difference has it made for individuals or organizations?" when conceptualizing ideas. Applicants should also reference previously funded ACL Innovation in Nutrition projects to prevent duplication of efforts [6].

A separate announcement (HHS-2021-ACL-AOA-INNU-0084) invites Innovations in Nutrition Services and Program applications with a focus on Community Research projects.

[1] Administration for Community Living. Nutrition Services. https://acl.gov/programs/health-wellness/nutrition-services
[2] Administration for Community Living, Services for Native Americans, https://acl.gov/programs/services-native-americans-oaa-title-vi
[3] Administration for Community Living, Program Evaluations and Reports, https://acl.gov/programs/program-evaluations-and-reports#
[4] Administration for Community Living, Aging and Disability Networks, https://acl.gov/programs/aging-and-disability-networks
[5] Administration for Community Living, Innovations in Nutrition Programs and Services, https://acl.gov/programs/nutrition/innovations-nutrition-programs-and-s…
[6] Department of Health and Human Services Office of Health Promotion and Disease Prevention. (2021) Healthy People 2030, Social Determinants of Health. https://health.gov/healthypeople/objectives-and-data/social-determinant…
[7] Administration for Community Living, Coronavirus 2019, https://acl.gov/COVID-19
[8] Administration for Community Living, Programs, Survival Guide: Navigating COVID-19 Guidance for Those Administering Title IIIC Programs. https://acl.gov/programs/survival-guide-navigating-covid-19-guidance-th…
[9] Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Health Equity. https://www.cdc.gov/chronicdisease/healthequity/index.htm
[10] Administration for Community Living, Program Areas, Health, Wellness and Nutrition, Nutrition Services (Programmatic Evaluation). https://acl.gov/programs/health-wellness/nutrition-services
[11] Administration for Community Living, AGing, Independence, and Disability (AGID) Data Portal, Aging and Disability Data Files. https://agid.acl.gov/DataFiles/
[12] US Department of Agriculture, Agricultural Research Service, Research, Datasets. https://www.ars.usda.gov/research/datasets/
[13] Inter-university Consortium for Political and Social Research, https://www.openicpsr.org/openicpsr/

Award Ceiling
600000
Award Floor
400000
Due Date for Applications
Date for Informational Conference Call

Last modified on 03/31/2021


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