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 to people aged 60 and older. The program is the largest component of the act, accounting for $814.7 million, over 44%, of the act's total FY2014 funding of $1.871 billion. 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 2006, Congress enacted P.L. 109-365 , which extended the act's authorizations of appropriations through FY2011. However, Congress has continued to appropriate funding for OAA activities. The 113 th Congress may consider reauthorization of the OAA and as a result may modify existing authorities, including those related to the nutrition services program. This report describes the nutrition services program authorized under Title III of the Older Americans Act. Purpose

The Older Americans Act Amendments of 2006, P.L. According to USDA analysis of Current Population Survey (CPS) data, 8.8% of U.S. households with one elderly member were food insecure in 2012, defined as households reporting low or very low food security. Nutrition Services Program

The Administration on Aging (AOA) in the Administration for Community Living (ACL) within 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 persons with the greatest social and economic need, with particular attention to low-income older persons, including low-income minority older persons, older persons with limited English proficiency, older persons residing in rural areas, and older persons at risk for institutionalization. Home-Delivered Nutrition Services

Home-delivered nutrition services (commonly referred to as "meals on wheels") provide meals and related nutrition services to older individuals with priority to homebound older individuals. In FY2014, of the total $814.7 million appropriated for the Title III nutrition services program, $438.2 million was for congregate nutrition (54%), $216.4 million for home-delivered nutrition (27%), and $160.1 million for nutrition services incentive grants (19%) ( Table 1 ). When adjusted for inflation, the total amount of funding appropriated for OAA nutrition services has decreased substantially over the past two decades ($814.7 million for FY2014 compared to $1,052.4 million in FY1990). This decline in relative funding has been experienced by the congregate meals and NSIP programs, while funding levels for the home-delivered meals programs have increased over the same time period. Overall, this reduction in purchasing power has affected the number of meals served, which declined by 21.1 million meals (or 8.6%) from FY1990 to FY2011, the most recent year for which data are available. Meals Served

In FY2011, more than 223 million meals were provided to older adults (see Table 2 ). From 1990 to 2011, the number of home-delivered meals served grew by 35%, while the number of congregate meals served actually declined by 40%. The following sections discuss several issues for congressional consideration, such as measuring unmet need for nutrition services, additional funding flexibility, and increased cost-sharing.
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 2012, a reported 8.8% 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 $814.7 million in FY2014, accounting for 44% of the act's total funding ($1.871 billion). In 2006, Congress enacted the Older Americans Act Amendments of 2006 (P.L. 109-365), which extended the act's authorizations of appropriations through FY2011. However, Congress has continued to appropriate funding for OAA activities. The 113th Congress may consider comprehensive 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 low-income minority older persons, older persons with limited English proficiency, older persons residing in rural areas, and those at risk for institutionalization. In FY2011, the most recent year for which data are available, more than 223 million meals were served to just under 2.5 million people; 61% were served to frail older people living at home, and 39% were served in congregate settings.
Of the total $814.7 million appropriated for the nutrition services program in FY2014, $438.2 million was for congregate nutrition (54%), $216.4 million for home-delivered nutrition (27%), and $160.1 million for nutrition services incentive grants (19%). When adjusted for inflation, the total amount of funding appropriated for OAA nutrition services has decreased substantially over the past two decades ($814.7 million in FY2014 compared to $1,052.4 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 35% from FY1990 to FY2011; the number of congregate meals served declined by 40%. 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 OAA Title III, including the program's legislative history, purpose, and FY2014 funding level. 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 the status of Older Americans Act reauthorization, measuring unmet need for nutrition services, additional funding flexibility, and increased cost-sharing.