Friday, May 4, 2012

Nutrition for Older Adults

Every day thousands of seniors throughout the United States receive meals through the Elderly Nutrition Program. In FY 2009 almost 242 million meals were served to around 2.6 million people. Although this is a federal program, it is delivered by local providers. The way in which the funds for the meals actually make it down to the providers and then to the seniors is unique compared to other federal programs.

The Older Americans Act (OAA) was passed around the same time as Medicare and Medicaid, in 1965. It was passed because there was a need to provide community social services for seniors. Today, the OAA is the main vehicle for organizing and providing social services and meals to older adults. The goal is to help keep them healthy and independent so that they can remain in their homes as they age. The types of services provided include: meals, job training, senior centers, caregiver support, transportation, health promotion, benefits enrollment, and many others.

Programs are delivered through a national network of 56 State agencies on aging, 629 area agencies on aging (AAAs), 20,000 service providers, and 244 Tribal organizations. The picture from the National Resource Center on Nutrition, Physical Activity, and Aging provides a nice snapshot of this structure.
The Elderly Nutrition Program (sometimes called the Senior Nutrition Program in MN) is by far the largest program funded through the OAA. In FY2011, $817 million (or 42 percent) of the $1.932 billion for OAA funding was spent on the nutrition services for seniors. Two categories of meals are provided - congregate meals and home-delivered meals. Congregate meals are meals provided to seniors in many different settings, such as senior centers, community centers, adult day care centers, and senior living centers. Home-delivered meals are meals provided to seniors in their homes. Home-delivered meals are commonly called meals on wheels. Generally, the only eligibility criterion is that a person must be 60 years of age or older to qualify for a meal through the nutrition program. In Minnesota, the program provides 3.3 million meals to 78,000 people annually in their homes or at a congregate setting.

The Administration on Aging awards these funds to the 56 State units on aging using a formula. The formula is based on the State’s share of the population over age 60 and contains a floor funding amount. The MBA (Minnesota's State Unit on Aging) awards funds to 7 AAAs using a formula as well. This formula is based on the population 60, low income 65+, minority 60+, 65+ in rural areas, and population density of 65+. Finally, the AAAs awards contracts to local nutrition providers to cook and deliver the meals to seniors. 

The intergovernmental fiscal relations may be a little difficult to understand, but the structure seems necessary given the type of service provided. The AAAs and the local providers who serve meals to seniors on a daily basis really know their clients and understand their needs. Having regional AAAs who are specifically tasked with providing services and supports to seniors is a major reason for the success of the Elderly Nutrition Program and other OAA programs.

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