Introduction

Chapter 1

Introduction

CONTENTS

A. Background

B. Purpose

C. 1998 Collection of SUA Documents

D. Organization of the Toolkit

- Additional Resources
- References

A. BACKGROUND

Under the Older Americans Act (OAA), the Older Americans Nutrition Program (OANP) is the largest and most visible, federally funded community-based nutrition program for older adults. The Nutrition Program is administered by the US Department of Health and Human Services, Administration on Aging (AoA) who provides leadership, coordination and support to an Aging Network that includes 57 State Units on Aging (SUAs), 655 Area Agencies on Aging (AAAs) and thousands of local providers under Title III. The AoA provides Title III-C funds to SUAs to provide congregate and home-delivered meals, nutrition screening, education and counseling, as well as an array of other supportive and health services.

To carry out the responsibilities mandated by the OAA, SUAs are responding to the demographic changes in the U.S. population of older adults. The proportion of older adults is expected to double to about 70 million by the year 2030, reflecting an increase from 12.4% today to 20% (1). The year 2030 represents the demographic milestone when many Baby Boomers will attain the ranks of the "oldest old" (age 85 and older) and large numbers of Gen Xers will themselves reach age 65 (1). All may be eligible for or in need of nutrition services. Furthermore, food insecurity, chronic diseases, and functional disabilities are common to many older adults. At the same time, changes in the health care system and public policy have resulted in earlier discharge of ill older adults from hospitals to home and community-based care. As a result, nutrition service providers need to expand and enhance the delivery of food and nutrition services to meet the increased demand for their services.

The cultural and ethnic composition of the older adult population is also changing. Increasing racial and ethnic diversity requires more flexible, culturally appropriate services. Therefore, SUAs, AAAs and OANPs must embrace their participants' racial and ethnic diversity and heritage. They should examine current services to assure cultural competence and customization to best meet the nutrition, social, and health needs of their diverse communities.

The OANP is grappling with decreasing federal resources, diminishing numbers of volunteers, and increasing and shifting demands for services from congregate meal sites to homes (1). There is evidence that a strong food and nutrition infrastructure is needed among nutrition service providers. The Nutrition 2030 Grassroots Survey (2) revealed that local OANPs want to provide the best services but need considerable direction to do so. The National Policy and Resource Center on Nutrition and Aging (Center) at Florida International University has been providing support to the AoA and Aging Network through training, technical assistance, information dissemination, knowledge building, policy analysis, outcomes measurement and partnership building. The Older Americans Nutrition Program Toolkit was developed by the Center to help OANPs and the Aging Network improve food and nutrition services for older adults nationwide.

B. PURPOSE

The goal of the Toolkit is to assist SUAs in revising and updating their nutrition-related regulations, policies, procedures, and guidelines. The objectives of the Toolkit include:

To provide technical assistance and guidance to the Aging Network,
To identify best practices and emerging areas for planning new approaches to implementing the OAA,
To identify mechanisms for collaboration and partnership building,
To identify resources to improve methods of service delivery, and
To provide continuous, up-to-date information and resources (The Toolkit will be updated regularly).

C. 1998 COLLECTION AND USE OF SUA DOCUMENTS

To begin developing the Toolkit, the AoA regional offices requested all U.S. states and territories to send copies of all current documents pertaining to state policies, procedures, rules, regulations, operational manuals, guidelines and standards for administering OANPs to the Center. A list of 19 topics, along with 103 subtopics (Appendix), was provided to suggest content areas of documents submitted. Forty-four states and the District of Columbia, Guam and Puerto Rico responded, submitting files of existing documents ranging from 50 to about 800 pages, each. The Center maintains the SUA Policies and Procedures: 1998 Collection of Information and requests that new documents be sent as they are revised or developed.

A manual (page by page) content analysis of each states' documents was conducted to code each portion of each SUA document into categories represented by the topic and subtopic list. Descriptive statistics, such as frequencies and percentages, were used to summarize the topics and subtopics.

Limitations in the method of collecting and analyzing State documents for this Toolkit were that some topics or subtopics may not have been identified and counted in the survey or SUAs may not have submitted all pertinent documents. Given these limitations, the SUA Policies and Procedures: 1998 Collection of Information represents a more general, broad-based summary of current Nutrition Program practices. While this Toolkit contains sample SUA policies and procedures, there is the possibility of error or omission of other best practices.

D. ORGANIZATION OF THE TOOLKIT

The Toolkit is organized into the following chapters:

Chapter I: Provides a brief history and explains current issues of the Older Americans Nutrition Program; Describes the purpose of the Toolkit and a summary about the 1998 Collection of SUA Policies and Procedures.

Chapter II: Contains definitions of terms commonly used throughout SUA documents. Many are provided verbatim from Title I of the OAA to provide a framework for using and understanding OANP terminology.

Chapters III-XII: Each chapter is divided into sections that address the main components of the OANP. The following is included in each section:

Citations from the 2000 OAA that provides the legislative foundation for each section and its subsections.
Sample SUA policies and procedures that correspond to the OAA regulations.
Links to additional resources (articles, internet websites, catalogs, state booklets) that SUAs can use to help plan, develop, implement, monitor, and evaluate their nutrition service systems.

Additional Resources

Additional Older Americans Act Aging Services Network Resources are available at:
http://www.fiu.edu/%7Enutreldr/Aging_Network/aging_network.htm

PowerPoint Presentations from the AoA Nutritionists / Administrators Conference (June 2-4, 2002):

References

(1) Wellman NS, Rosenzweig LY, Lloyd JL. Thirty years of the Older Americans Nutrition Program. J Am Diet Assoc. 2002;102:348-350.

(2) Wellman NS, Smith J, Alfonso M, Lloyd J. (1999) Report: The Nutrition 2030 Grassroots Survey. Florida International University, Miami, FL

Updated 01/28/03