Academy Priorities Highlighted in Overview to Senate HELP Committee on Older Americans Act

The Academy continues to advocate for Older Americans Act programs, which is the primary vehicle for delivering social and nutrition programs to older adults. On March 19, 2024, the Academy submitted the following for consideration to the U.S. Senate Committee on Health, Education, Labor and Pensions:

The Academy of Nutrition and Dietetics appreciates the opportunity to share priorities for the Older Americans Act (OAA) with U.S. Senate staff members in preparation for reauthorization of the Act. Representing more than 112,000 registered dietitian nutritionists (RDNs), nutrition and dietetic technicians, registered (NDTRs), and advanced-degree nutritionists, the Academy is the largest association of food and nutrition professionals in the United States. We are committed to accelerating improvements in the nation’s health and well-being through food and nutrition.

In the 2020 reauthorization, malnutrition reduction was named an official purpose for OAA nutrition programs and has become a routine part of program participant screening. The Academy seeks continuing improvement on:

• Effective screening and referral to nutrition counseling and medical nutrition therapy provided by RDNs;
• The provision of nutrition counseling, especially to those in areas with limited access to services; and
• Reaching more participants with medically tailored meals and culturally appropriate meals. 

With the current interest in Food as Medicine initiatives, it is an opportunity to celebrate the success of OAA nutrition programs and to consider how to better serve participants. Given that MNT services are covered by Medicare for those with diabetes and renal disease, improved coordination with Centers for Medicare & Medicaid Services (CMS) could allow for this service to be covered through Medicare. Currently, access to nutrition counseling competes with funding for meals. Improved coordination by CMS and Administration for Community Living (ACL) could open the door for medically tailored meals that better meet the needs of those diagnosed with diabetes and renal disease. There are inconsistent and limited efforts to ensure those that qualify for medical nutrition therapy (MNT) are provided the service.

We strongly encourage improvements in care transitions and efforts to ensure that as seniors return home from hospital stays that meals are resumed in a timely manner. Malnutrition identified during hospital stays can continue to be addressed by meal providers with registered dietitian nutritionists on staff.

Finally, the Academy encourages the consideration of the high percentages of persons with disabilities who participate in OAA programs: 24% of those ages 65 to 74 years and 46% of those 75 years and older present with disabilities. Transportation to senior centers for those who participate in congregate meal dining needs to be improved and expanded to ensure eligible seniors can participate in meal and other beneficial programs and connections.

To achieve these priorities and others, the Academy will join with other organizations to assure adequate levels of funding for nutrition programs. We look forward to continuing engagement in the process.

The Older Americans Act authorizes providers of congregate and home-delivered meal programs to offer nutrition education and screening, assessment, and nutrition counseling. As primary prevention and health promotion, nutritional counseling has been found to lessen chronic disease risk and to address nutrition problems that can lead to more serious and costly conditions and adverse events. When provided by registered dietitians, nutrition counseling and other forms of MNT, including nutritional assessment and nutritional therapy services, can slow the progression and reduce symptoms of chronic diseases.

Given the positive impact of nutritional assessment and counseling, both on health outcomes for older adults and on health care costs, the Academy supports the inclusion of language in the reauthorization of OAA that ensures that qualified nutrition staff, including registered dietitians, is included at the local, regional, state and federal levels of the aging network so that cost-effective nutrition services and evidence-based programs result.