Senior Nutrition Programs’ Response to COVID-19

Senior Nutrition Programs’ Response to COVID-19

Many older adults rely on federally funded programs that provide nutrition and other supportive services in order to live independently in their communities. Amidst the ongoing Coronavirus Disease 2019 (COVID-19) pandemic, older adults as well as those with certain chronic conditions are at higher risk for severe illness if infected with the virus. Guidance from the Centers for Disease Control and Prevention (CDC) recommends that older adults stay home, among other precautions. Some state and local officials have issued more stringent guidance that older adults self-isolate at home or issued stay-at-home orders for the general public. The COVID-19 pandemic will likely affect nutrition programs that many older adults rely on for their daily nutrition intake. For example, nutrition services at group meal sites may no longer be available or accessible. Alternatively, other nutrition services, such as home-delivered meals (e.g., "meals on wheels"), may be in greater demand as older adults adhere to recommendations to stay at home.

This CRS Insight provides information on the COVID-19 response for nutrition programs authorized under the Older Americans Act (OAA) and administered by the Administration for Community Living (ACL) under the U.S. Department of Health and Human Services (HHS). For information on COVID-19 and food assistance under the U.S. Department of Agriculture (USDA), see CRS Insight IN11250, USDA Domestic Food Assistance Programs' Response to COVID-19: P.L. 116-127 and Related Efforts.

Older Americans Act Nutrition Programs

The OAA Nutrition Services Program provides grants to states and U.S. territories under Title III of the act to support congregate and home-delivered nutrition programs (i.e., meals served at group sites such as senior and community centers or schools) for individuals aged 60 and older. In addition, the Nutrition Services Incentive Program (NSIP) provides funds to states, U.S. territories, and Indian tribal organizations to purchase food or to cover the costs of food commodities provided by the USDA for the congregate and home-delivered nutrition programs. A separate program under Title VI of the act provides funds for supportive and nutrition services to older Native Americans through funds awarded to tribal organizations. The Nutrition Services 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.

As the largest OAA program, the Nutrition Services Program received $936.8 million in FY2020 under P.L. 116-94, the Further Consolidated Appropriations Act, 2020, which accounts for 45% of the act's total funding of $2.1 billion ($266 million for home-delivered nutrition, $510 million for congregate nutrition, and $160 million for NSIP). States and territories receive separate funding allotments for each program based on a statutory funding formula. The Supporting Older Americans Act of 2020, P.L. 116-131, enacted on March 25, 2020, extends the act's authorizations of appropriations through FY2024.

Under OAA, states and U.S. territories have authority to transfer up to 40% of their allotments between congregate and home-delivered nutrition services and can request waivers to transfer of up to 10% of additional funding between these programs. In addition, OAA provides states authority to transfer up to 30% of program funding from the Supportive Services Program to the Nutrition Services Program.

COVID-19 Response

On March 13, 2020, the President declared that the ongoing COVID-19 pandemic is of sufficient severity and magnitude to warrant an emergency determination under §501(b) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act; 42 U.S.C. 5121-5207). The emergency exists nationwide. Under the declaration, states, U.S. territories, and tribes may consider requests for a declaration of a "major disaster" under §401(a) of the Stafford Act.

A major disaster declaration under the Stafford Act triggers disaster relief authority in the OAA should a state (including a U.S. territory) or tribe (OAA Title VI grantee) request and receive such declaration. Specifically, OAA §310 (42 U.S.C. 3030) provides authority for states to use any portion of funding made available under any and all sections of the Act for disaster relief provided to older individuals. According to ACL, OAA §310(c) allows states to use existing funding made available under Title III Part B, Supportive Services; Part C-1, Congregate Nutrition; Part C-2, Home-Delivered Nutrition; Part D, Preventive Services; and Part E, National Family Caregiver Support for disaster relief without the need for states to submit a separate application, transfer request, or request for a waiver. ACL states,

This means that a state may use Title III-B, C-1, C-2, D, and/or E funds for any disaster relief activities for older individuals or family caregivers served under the OAA, which may include, but are not limited to

--providing drive through, take out, or home-delivered meals,

--providing well-being checks via phone, in-person, or virtual means, and

--providing homemaker, chore, grocery/pharmacy/supply delivery, or other services.

Similarly, according to ACL guidance, OAA §310(c) provides authority for tribes to use any portion of funds made available under any and all sections of the act for disaster relief for older individuals without the need to submit a separate application, transfer request, or request for a waiver. States and tribes are required to track certain expenditures and number of persons and units served.

OAA §310 also provides limited amounts of disaster assistance to reimburse states and tribes for responding to presidentially declared major disasters (see funding announcement). On March 16, 2020, ACL stated that the agency is not accepting applications for disaster assistance related to COVID-19 through this announcement, but will provide additional information about funding available directly from ACL.

FY2020 Supplemental Funding

On March 18, 2020, the President signed P.L. 116-127, the Families First Coronavirus Response Act, which provides a total of $250 million in supplemental funding for OAA nutrition services ($80 million for congregate nutrition, $160 million for home-delivered nutrition, and $10 million for nutrition services to Native Americans).

On March 27, 2020, the President signed P.L. 116-136, the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which provides an additional $500 million in supplemental funding for OAA nutrition services ($480 for congregate and home-delivered nutrition, and $20 million for nutrition services to Native Americans).

Many older adults rely on federally funded programs that provide nutrition and other supportive services in order to live independently in their communities. Amidst the ongoing Coronavirus Disease 2019 (COVID-19) pandemic, older adults as well as those with certain chronic conditions are at higher risk for severe illness if infected with the virus. Guidance from the Centers for Disease Control and Prevention (CDC) recommends that older adults stay home, among other precautions. Some state and local officials have issued more stringent guidance that older adults self-isolate at home or issued stay-at-home orders for the general public. The COVID-19 pandemic will likely affect nutrition programs that many older adults rely on for their daily nutrition intake. For example, nutrition services at group meal sites may no longer be available or accessible. Alternatively, other nutrition services, such as home-delivered meals (e.g., "meals on wheels"), may be in greater demand as older adults adhere to recommendations to stay at home.

This CRS Insight provides information on the COVID-19 response for nutrition programs authorized under the Older Americans Act (OAA) and administered by the Administration for Community Living (ACL) under the U.S. Department of Health and Human Services (HHS). For information on COVID-19 and food assistance under the U.S. Department of Agriculture (USDA), see CRS Insight IN11250, USDA Domestic Food Assistance Programs' Response to COVID-19: P.L. 116-127 and Related Efforts.

Older Americans Act Nutrition Programs

The OAA Nutrition Services Program provides grants to states and U.S. territories under Title III of the act to support congregate and home-delivered nutrition programs (i.e., meals served at group sites such as senior and community centers or schools) for individuals aged 60 and older. In addition, the Nutrition Services Incentive Program (NSIP) provides funds to states, U.S. territories, and Indian tribal organizations to purchase food or to cover the costs of food commodities provided by the USDA for the congregate and home-delivered nutrition programs. A separate program under Title VI of the act provides funds for supportive and nutrition services to older Native Americans through funds awarded to tribal organizations. The Nutrition Services 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.

As the largest OAA program, the Nutrition Services Program received $936.8 million in FY2020 under P.L. 116-94, the Further Consolidated Appropriations Act, 2020, which accounts for 45% of the act's total funding of $2.1 billion ($266 million for home-delivered nutrition, $510 million for congregate nutrition, and $160 million for NSIP). States and territories receive separate funding allotments for each program based on a statutory funding formula. The Supporting Older Americans Act of 2020, P.L. 116-131, enacted on March 25, 2020, extends the act's authorizations of appropriations through FY2024.

Under OAA, states and U.S. territories have authority to transfer up to 40% of their allotments between congregate and home-delivered nutrition services and can request waivers to transfer of up to 10% of additional funding between these programs. In addition, OAA provides states authority to transfer up to 30% of program funding from the Supportive Services Program to the Nutrition Services Program.

COVID-19 Response

On March 13, 2020, the President declared that the ongoing COVID-19 pandemic is of sufficient severity and magnitude to warrant an emergency determination under §501(b) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act; 42 U.S.C. 5121-5207). The emergency exists nationwide. Under the declaration, states, U.S. territories, and tribes may consider requests for a declaration of a "major disaster" under §401(a) of the Stafford Act.

A major disaster declaration under the Stafford Act triggers disaster relief authority in the OAA should a state (including a U.S. territory) or tribe (OAA Title VI grantee) request and receive such declaration. Specifically, OAA §310 (42 U.S.C. 3030) provides authority for states to use any portion of funding made available under any and all sections of the Act for disaster relief provided to older individuals. According to ACL, OAA §310(c) allows states to use existing funding made available under Title III Part B, Supportive Services; Part C-1, Congregate Nutrition; Part C-2, Home-Delivered Nutrition; Part D, Preventive Services; and Part E, National Family Caregiver Support for disaster relief without the need for states to submit a separate application, transfer request, or request for a waiver. ACL states,

This means that a state may use Title III-B, C-1, C-2, D, and/or E funds for any disaster relief activities for older individuals or family caregivers served under the OAA, which may include, but are not limited to

--providing drive through, take out, or home-delivered meals,

--providing well-being checks via phone, in-person, or virtual means, and

--providing homemaker, chore, grocery/pharmacy/supply delivery, or other services.

Similarly, according to ACL guidance, OAA §310(c) provides authority for tribes to use any portion of funds made available under any and all sections of the act for disaster relief for older individuals without the need to submit a separate application, transfer request, or request for a waiver. States and tribes are required to track certain expenditures and number of persons and units served.

OAA §310 also provides limited amounts of disaster assistance to reimburse states and tribes for responding to presidentially declared major disasters (see funding announcement). On March 16, 2020, ACL stated that the agency is not accepting applications for disaster assistance related to COVID-19 through this announcement, but will provide additional information about funding available directly from ACL.

FY2020 Supplemental Funding

On March 18, 2020, the President signed P.L. 116-127, the Families First Coronavirus Response Act, which provides a total of $250 million in supplemental funding for OAA nutrition services ($80 million for congregate nutrition, $160 million for home-delivered nutrition, and $10 million for nutrition services to Native Americans).

On March 27, 2020, the President signed P.L. 116-136, the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which provides an additional $500 million in supplemental funding for OAA nutrition services ($480 for congregate and home-delivered nutrition, and $20 million for nutrition services to Native Americans).