Transcript Older Americans Act Past, Present & Future

Nutrition Leadership
Planning Initiative
February 15, 2007
Senior Nutrition Program
Older Americans Act

1965: Signed into law by
President Lyndon B. Johnson
Medicare and Medicaid was established as part
of the Social Security Act.

1972: Title VII is created authorizing funds for
a national nutrition program for the elderly.
Senior Nutrition Program

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Title VII was established to address problems of
dietary inadequacy and social isolation among
older persons.
Only the Congregate Program was funded.
2004
Senior Nutrition Program
“If the Older Americans Act Nutrition Program
was a restaurant, the sign out front would say,
‘Six billion served’. For 30 years, this program
not only has provided nutritious, healthy meals
to older Americans, but also has touched their
lives by linking them to community services that
allow them to remain independent.”
-HHSA Secretary Tommy G. Thompson
THE PAST
Who were we?
Nutrition Programs in San Diego
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First program established in late 1973.
Nutrition Programs in San Diego
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First program established in late 1973.
Cedar Community Center, now known as
Senior Community Centers of San Diego
Nutrition Programs in San Diego
Between 1973 – 1974
Salvation Army – Mid City & El Cajon
Lemon Grove/Spring Valley
City of Vista
Ramona
St. Charles – Imperial Beach
St. Judes
Santa Ysabel Nutrition Center
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Senior Nutrition Program

In 1978, Title VII was consolidated into Title III
of the OAA.

Home Delivered Meals (Title III C2) began in
1980.
Senior Nutrition Program
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# Meals Served
1978/1979
C1: 829,741
C2: 0
THE PRESENT
Who Are We Now?
U.S. Census Bureau Data
2005 American Community Survey
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San Diego County total population (estimate) –
2,824,259
65 years and over – 310,836
11% of the general population
Who Are We Now?
23 Nutrition Contractors
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Alpine Community Center
Borrego Springs Seniors
City of Carlsbad
Catholic Charities
CFSC-Live Well
City of National City
City of Escondido
City of Encinitas
Fallbrook Senior Citizens
Jacumba Highland Seniors
Mountain Health & Community
Services
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Jewish Family Services
Neighborhood House Association
Oceanside Senior Citizens
Pacific Ed. – Ramona
Pilipino American Senior Citizens
Poway Valley Senior Citizens
St. Jude’s
Salvation Army
City of San Marcos
Senior Community Centers
Union of Pan Asian Communities
City of Vista
Where We Are
Who Are We Now?
Senior Nutrition Program
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59 Congregate Nutrition Sites
18 Programs providing Home Meals.
15 Central Kitchens & On Site Prep Kitchens
6 Private Catering Companies providing meals.
4 Congregate programs serving breakfast &
lunch.
Number of Meals Served
FY
C1
% Change
C2
% Change
00/01
01/02
02/03
03/04
04/05
05/06
877,756
840,451
810,348
776,152
731,466
706,568
---4%
-4%
-4%
-6%
-3%
570,735
602,690
573,943
505,126
489,408
479,069
--6%
-5%
-12%
-3%
-2%
00/01 –
05/06
-21%
-16%
Local Participant Data
43%
57%
2004-05
2005-06
The number of
participants
enrolled in the
programs increases
as the total number
utilizing the
services decreases.
Reported Vehicle Maintenance Cost
FY 04-05
FY 05-06
Grand Total
1
$29,293.00
$32,981.00
$62,274.00
2
$10,493.21
$5,771.77
$16,264.98
3
$4,325.08
$18,498.61
$22,823.69
4
$31,837.00
$31,689.00
$62,274.00
5
$461.52
$461.52
$923.04
6
$861.55
$1,416.26
$2,277.81
7
$1,595.79
$1,303.58
$2,899.37
8
$16,525.00
$5,012.00
$21,537.00
9
$52,428.25
$44,677.30
$97,105.55
10
$24,647.12
$26,053.90
$50,701.02
11
$22,905.00
$26,412.00
$49,317.00
12
$4,495.42
$5,278.74
$9,774.16
13
$57,631.00
$56,928.50
$114,559.50
14
$16,500.00
$16,500.00
$33,000.00
15
$601.32
$601.32
$1,202.64
$274,600.26
$273,585.50
$548,185.76
Contractor
Funding – 5 Year Analysis
3,500,000
3,000,000
2,500,000
2,000,000
C1
C2
1,500,000
1,000,000
500,000
0
FY 00/01 FY 01/02 FY 02/03 FY 03/04 FY 04/05 FY 05/06
Nutrition Results from the
2004 National Survey of Older
Americans Act Clients
Beth Rabinovich, PhD
Suzanne McNutt, MS, RD
WESTAT
[email protected]
2004 National Survey of Older
Americans Act Participants Methodology
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Two-stage sample design
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Representative sample of Area Agencies on Aging
(AAA; large AAAs chosen with certainty)
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Clients sampled within AAAs by service
Questionnaires administered by Westat’s Telephone
Research Center (TRC)
Methodology Continued
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Questionnaire
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Two questionnaires one for HDM clients and the other for
CM clients
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Questionnaires covered the following topics:
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Demographics
Physical functioning (HDM clients only)
Daily dietary intake
Contribution of program to total daily food intake
Consumer assessment of the program
Emotional well being and social functioning
Results
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Weighted Sample Sizes
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Home Delivered Meals Clients = 1,000,662
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Congregate Meals Clients = 1,905,416
7/17/2015
24
Targeting
Variable
1 or more ADL limitations
HDM
69%
CM
Not asked
3 or more ADL limitations
29%
Not asked
75 years of age and older
73%
62%
Household income of $20,000
or less
Household income of $10,000
or less
85%
57%
46%
26%
Self-reported Health
Self-reported
Health
Excellent
Very Good
Good
Fair
Poor
HDM
4%
14%
28%
25%
29%
CM
6%
25%
40%
23%
6%
*NHIS 2003: age 65+, annual income < $20,000
National
Health
Interview
Survey*
9%
21%
35%
24%
12%
Frequency of Participation in the
Meals Program
Frequency
Less than once a week
1 t 2 times a week
3 to 4 times a week
5 or more times a
week
HDM
7%
12%
8%
72%
CM
26%
29%
23%
21%
Proportion of Food that Meals
Represent on the Days at the
Program
Frequency
“1/3 or less”
“1/2 to 2/3”
“More than 2/3”
Home
Delivered
Meals
34%
44%
22%
Congregate
Meals
43%
47%
9%
Contribution of the Home Delivered
Meals Program to Daily Intake
Food Group
Percent of HDM
Percent of CM
clients who only eat clients who only eat
one serving a day and one serving a day
it’s from the meals
and it’s from the
program
meals program
Fruit
38%
38%
Vegetables
32%
34%
Dairy
37%
39%
Grain (1 to 2
servings)
61%
67%
Meat
49%
51%
Beans
36%
37%
Dietary Intake
Food Group
Serving
Size
HDM
CM
1999-2000
NHANES*
Number of Meals Per
Day
2+
94%
91%
Fruit
2+
49%
58%
45%
Vegetables
3+
18%
27%
13%
Dairy
3+
19%
23%
10%
Grain
6+
5%
3%
2%
Meat/Bean
2+
64%
65%
56%
Water
5+
52%
66%
*60+ and income < $20,000
-
-
Dietary Adequacy
70%
67%
61%
60%
50%
40%
27%
30%
20% 12%
17%
10%
0%
HDM
CM
17%
Adequagte
Marginal
Poor
Consumer Assessment of the
Nutrition Program
Overall Rating of the
Meal Program
HDM
CM
Excellent
32%
21%
Very Good
37%
39%
Good
25%
31%
5%
7%
< 1%
2%
Fair
Poor
Results – Self Reported
Outcomes
Self-reported Outcomes
HDM
(Yes, definitely +
yes, I think so)
CM
(Yes, definitely +
yes, I think so)
Eat more balanced meals
86%
78%
Easier to keep special diet
60%
54%
Better able to avoid
sodium/fat
80%
76%
Able to maintain weight
83%
77%
Have something to look
forward to
88%
82%
Can continue to live in own
home
90%
72%
Would recommend program
to others
95%
96%
Results – Social Functioning
Feelings about level of present
social activities
About enough
Too Much
Would like to be doing more
HDM
CM
53%
68%
1%
3%
45%
29%
Social Functioning
Percent reporting an increase in social activities
as a result of program participation
80
70
60
50
Yes
No
40
30
20
10
0
HDM
CM
Summary and Conclusions
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Targeting
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The HDM and CM program meet the OAA’s objectives of
serving those in most economic and social need (e.g., low
income).
The majority of the clients are among the “old” and “oldestold.”
A majority of the home delivered meal clients have functional
limitations.
The nutrition programs appear to make a large contribution
to the dietary status of its program participants.
Summary and Conclusions –
Consumer Assessment of the
Nutrition Programs
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The majority of participants are satisfied with the
nutrition program
The majority of participants report that the program
helps them maintain a healthier diet.
The majority of participants report that the program
helps them remain at home.
The survey data are good for monitoring program
quality.
WHAT’S THE FUTURE?
Future
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Federal funding for nutrition programs will
NOT grow in relationship to population.
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Cost of program operations will continue to
increase. Staff salaries, energy costs,
equipment/vehicle maintenance, food costs.
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Population in need of services will grow.
Nationwide Client Demographics
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Average client is female, 70-75 years of age.
60+ population in 2004 was 434,147. Predicted
for 2010, 60+ population will be 524,319. A
20% increase!
2010: 70-74 y.o. = 79,592
2020:
“
135,593 ( approx. 70%↑)
2030:
“
184,900
Future
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Increase competition for the consumers’ eat out
meal $$$$s. The average per person expenditure
for food away from home was $974.00 in 2004!
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Restaurants anticipate that their take-out
operations will expand in 2006-2007.
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Grocery stores are expanding their ready-to-eat
and meal replacement offerings.
National Successes
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Mather’s – More Than a Café
- Partnership between Mather’s and the Illinois Senior
Center to offer congregate meals in a public café
setting.
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Centralina AAA (Lincoln County)
– Restaurant Voucher Program
Participants attend programs on healthy living and
receive a meal voucher to use at local restaurants at the
time of their choice.
Statewide Discussion Ideas
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Consolidating sites.
Opening new sites in areas with growing senior
populations.
Serving an early dinner vs. noon meal.
Expanding Home Meals to provide 2 meals/day,
i.e. breakfast & lunch or lunch & dinner.
Statewide Discussions
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Delivering hot Home Meals 1/2/3 times per
week instead of daily, using a combination of
hot and frozen meals.
Planning Special Occasion meals in the evenings
or Saturdays to attract a different client.
Having 2nd meals available for Congregate
clients.
Restaurant Vouchers
Local Successes
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Utilization of volunteers to deliver Home Delivered
Meals.
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Use of alternatives for traditional transportation for
senior nutrition program:
1.
2.
3.
Volunteer drivers
Provide bus passes
Provide taxi vouchers
Local Successes
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Receipt of grant funding to replace Home
Delivered Meals vehicles.
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‘Food for Thought’ program – lunch in a
Library – partnership with City of Vista and
San Diego County Library.
Food for
Thought