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Thursday, January 17, 2013

Older Americans Act: Title III Nutrition Services Program

Kirsten J. Colello
Specialist in Health and Aging Policy

The elderly nutrition services program, authorized under Title III of the Older Americans Act (OAA), provides grants to state agencies on aging to support congregate and home-delivered meals (commonly referred to as “meals on wheels”) programs for people aged 60 and older. The program is designed to address problems of food insecurity, promote socialization, and promote the health and well-being of older persons through nutrition and nutrition-related services. In 2011, a reported 8.4% of U.S. households with one elderly member were food insecure, defined as households reporting low or very low food security. As the largest Older Americans Act program, the Title III nutrition services program received $816.3 million in FY2012, accounting for 43% of the Act’s total funding ($1.913 billion). In 2006, Congress enacted the Older Americans Act Amendments of 2006 (P.L. 109-365), which extended the Act’s authorization of appropriations through FY2011. However, Congress has continued to appropriate funding for FY2012 and FY2013 OAA activities. The 113th Congress may consider reauthorization of the OAA and as a result may modify existing authorities, including those related to nutrition services.

The Administration on Aging (AOA) within the Administration for Community Living (ACL) in the Department of Health and Human Services (HHS) administers the nutrition services program, which includes (1) the Congregate Nutrition Services Program, (2) the Home-Delivered Nutrition Services Program, (3) and the Nutrition Services Incentive Program (NSIP). For the congregate and home-delivered programs, services must be targeted at older persons with the greatest social and economic need. Particular attention is paid to low-income older persons, including lowincome minority older persons, older persons with limited English proficiency, older persons residing in rural areas, and those at risk for institutionalization. In FY2010, the most recent year for which data are available, almost 237 million meals were served to just under 2.6 million people; 61% were served to frail older people living at home, and 39% were served in congregate settings.

Of the total $816.3 million appropriated for the program in FY2012, $439.1 million was for congregate nutrition (54%), $216.8 million for home-delivered nutrition (27%), and $160.4 million for nutrition services incentive grants (20%). When adjusted for inflation, the total amount of funding appropriated for OAA nutrition services has decreased substantially over the past two decades ($816.3 million in FY2012 compared to $1,019.9 million in FY1990). This decline in relative funding has been experienced by the congregate nutrition and NSIP programs, while funding levels for the home-delivered nutrition programs have increased over the same time period. As a result, the number of home-delivered meals served has outpaced congregate meals, growing by 41% from FY1990 to FY2010; the number of congregate meals served declined by 35%. The faster growth in home-delivered meals is partially due to relatively higher growth in federal funding for home-delivered meals over that time period, as well as state decisions to focus funds on frail older people living at home.

This report describes the nutrition services program authorized under Title III of the Older Americans Act, including the program’s legislative history, purpose, and FY2012 funding levels. It also provides information on service delivery requirements and program data regarding the number of meals served and program participation. The report briefly discusses former and more recent efforts to evaluate these programs. Finally, the report identifies selected issues for federal policymakers, including measuring unmet need for nutrition services, the effects of the economic downturn, additional funding flexibility, and increased cost-sharing. 

Date of Report: January 9, 2013
Number of Pages: 16
Order Number: RS21202
Price: $29.95

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