[Congressional Record Volume 170, Number 145 (Wednesday, September 18, 2024)]
[House]
[Pages H5432-H5434]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         END SENIOR HUNGER NOW

  (Mr. McGOVERN asked and was given permission to address the House for 
1 minute and to revise and extend his remarks.)
  Mr. McGOVERN. Mr. Speaker, I rise today to highlight a recent article 
in ``Generations Now,'' a publication from the American Society on 
Aging, titled ``Food is Medicine'' and authored by several experts in 
both nutrition and aging services.
  The article makes the case for better leveraging the expertise and 
broad reach of community-based food programs through the Federal Older 
Americans Act Nutrition Program to combat hunger, prevent malnutrition, 
and reduce diet-related chronic disease among older Americans.
  Seniors all across the country and from all walks of life trust and 
rely on Older American Act programs' nutritious meals and community 
connections.
  These programs continue to innovate and bring people together. My 
home State of Massachusetts is highlighted for its efforts to encourage 
more locally grown foods and for partnering with local schools to 
promote intergenerational meals among participants.

[[Page H5433]]

  Mr. Speaker, I include the text of the article in the Record.

    Food Is Medicine--The Older Americans Act Nutrition Program and 
               Community Network Are Vital To Deliver It

(By Shirley Chao, Judy Simon, Laura Borth, Lydia McGrath, Jaime Gahche, 
                Mary Beth Arensberg, and Johanna Dwyer)

       By 2050, the majority of older Americans will have at least 
     one chronic disease or condition, many of which are diet-
     related with important health and economic implications. 
     Diet-related chronic diseases are among the leading causes of 
     death and disability in the U.S., intensifying the interest 
     in food is medicine (FIM) interventions. Malnutrition and 
     increasing food insecurity are also concerns for older 
     adults. New data from the 2022 National Survey of Older 
     Americans Act Participants report that up to 20 percent of 
     Older Americans Act nutrition program (OAANP) participants 
     are at high risk for malnutrition, as defined by unintended 
     loss of weight and poor appetite and a majority of OAA 
     participants report at least one chronic disease.
       Yet, lack of infrastructure linking community-based food 
     programs to clinical and other supportive services often 
     makes it difficult for older adults to obtain the care they 
     need in the place they live--the community. Older adults have 
     the highest rate of dietary supplement use and may turn to 
     condition-specific dietary supplements of unproven efficacy 
     to help prevent or treat disease, potentially delaying more 
     effective care and increasing risks of polypharmacy-related 
     adverse reactions.
       Congress recently required inclusion of reducing 
     malnutrition as part of the OAA Title III Nutrition Services 
     Program's purpose and the Administration on Community Living 
     (ACL), which administers OAA programs, has required OAA state 
     and area plans to include addressing malnutrition. 
     Malnutrition's causes are many and include inadequate intake, 
     disease, or a combination of these and other factors. It 
     occurs in those who are under- as well as overweight. The 
     OAANP helps to combat older adult malnutrition. Indeed, the 
     U.S. Community Services Preventive Task Force recommends 
     ``home-delivered and congregate meal services for older 
     adults living independently (i.e., not residents of senior 
     living or retirement community centers) based on sufficient 
     evidence of effectiveness showing reductions in 
     malnutrition.'' For home-delivered meal services, CPSTF found 
     sufficient evidence of effectiveness for increasing energy 
     intake and improving health-related quality of life and well-
     being.
       The OAA's national network of community nutrition programs 
     is vital for ensuring that older adults receive the 
     nutrition-related supportive services and information 
     necessary to better deal with their health conditions. 
     Further, the OAANP provides a strong foundation to support 
     FIM for older adults in the community setting and it aligns 
     with U.S. Department of Health and Human Services (HHS) FIM 
     principles.


        OAANP Exemplifies FIM and Aligns with HHS FIM Principles

       The most expedient approach to building a viable and 
     accountable community-based services infrastructure for FIM 
     is to leverage the OAANP's broad expertise and network. The 
     OAANP reaches and serves Americans in all locales and from 
     all socio-economic and racial/ethnic backgrounds. The OAANP 
     has the technical knowledge and federal/state administrative 
     experience with local programs to ensure that federal and 
     state monies are spent in both a cost-effective and 
     accountable manner. In addition, through serving nearly 1 
     million meals a day and regularly forging links with clinical 
     providers to combat malnutrition/diet-related diseases, the 
     OAANP's capability is invaluable for guiding FIM services in 
     collaboration with the private sector including foundations, 
     universities and research institutions, employers and others.
       Greater prevalence of diet-related chronic disease and 
     increasing food insecurity--including in U.S. households with 
     older adults--were driving factors leading to the 2022 White 
     House Conference on Hunger, Nutrition, and the resulting 
     National Strategy on Hunger, Nutrition and Health. Interest 
     in and actions related to the FIM approach continue to grow 
     in the U.S., with support from a variety of private and 
     public sector funding streams including several new Centers 
     for Medicare & Medicaid Services (CMS) initiatives.
       The HHS Office of Disease Prevention and Health Promotion's 
     framing language describes FIM as encompassing a broad range 
     of approaches that ``promote optimal health and healing and 
     reduce disease burden by providing nutritious food--in 
     conjunction with human services, education, and policy 
     change--through collaboration at the nexus of healthcare and 
     community.'' It identifies five FIM principles. The OAANP 
     shares these goals and offers the benefit of federally 
     required oversight and quality assurance. Specifically, the 
     OAANP provides a framework to support these principles in 
     community dwelling older adults in the following ways:
       (1) Recognizes that nourishment is essential for good 
     health, well-being, and resilience:
       Nutrition is a fundamental health issue for older adults 
     because poor nutrition--particularly protein calorie 
     malnutrition--can lead to poorer health outcomes and risks 
     for other health conditions including frailty and disability 
     as well as increased healthcare costs. ACL requires OAA state 
     plans to include addressing malnutrition, based on the OAA 
     intent for the nutrition program to reduce hunger, food 
     insecurity, and malnutrition; promote socialization; and 
     enhance well-being through improved access to nutrition and 
     other disease prevention/health promotion services.
       The National Survey of Older Americans Act participants 
     indicates that 70 percent or more of OAANP participants have 
     reported eating healthier foods because of the program and 
     over 80 percent report that OAANP meals help them remain 
     independently in the community. A programmatic evaluation 
     found congregate meal program participants had less 
     likelihood of a hospital/nursing care facility admission or 
     an emergency department visit. A recent U.S. Senate Special 
     Committee on Aging report detailed the ``OAA Nutrition 
     Program has increased access to healthy and affordable food 
     for older adults, helping to combat hunger, foster social 
     connectedness, promote healthy aging, and prevent adverse 
     health outcomes.''
       (2) Facilitates easy access to healthy food across the 
     health continuum in the community:
       While the OAANP may often be overlooked as a critical food 
     access recourse, it plays a significant role in providing 
     nutritious meals to community-based older adults. In 2019, 
     the OAANP delivered 223 million meals to 2.4 million older 
     adults through 5,000 community providers across the country. 
     While many are familiar with hospitals referring patients to 
     ``meals on wheels'' after hospital discharge to help with 
     recuperation, the OAANP is modernizing its approaches to meet 
     the needs of current and future older adult populations with 
     a particular focus on underserved communities. For example, 
     by offering online nutrition education, food truck meals and 
     pop-up meal sites in under-resourced areas, culturally 
     appropriate meals, and restaurant partnerships, OAANP 
     innovations help reduce barriers to accessing OAANP 
     nutritious meals and other services.
       (3) Cultivates understanding of the relationship between 
     nutrition and health:
       The OAANP services not only include meals but also 
     nutrition education, nutrition assessment and screening, and 
     additional supports like supplemental foods. Further, 
     appropriate social services and healthcare referrals are 
     offered based on person-centered needs. OAANP providers have 
     solid foundations with registered dietitian nutritionists 
     (RDNs) as staff who can ensure nutrition quality, food 
     safety, and provide nutrition education. In some settings, 
     and when funds and nutrition care pathways are in place, RDNs 
     also provide medical nutrition therapy (MNT) directly to OAA 
     participants. In addition, OAANP providers work closely with 
     other medical professionals, hospital discharge staff, and 
     community care coordinators during care transitions. The 
     OAANP draws on objective, evidence-based nutrition research 
     and information from multiple federal agencies including the 
     National Institutes of Health Institute of Aging and Office 
     of Dietary Supplements, the Food and Drug Administration, 
     USDA, the Veterans Administration, the ACL Nutrition and 
     Aging Resource Center, as well as from other organizations.
       (4) Unites partners with diverse assets to build sustained 
     and integrated solutions:
       The OAANP operates across all states. Its strength lies in 
     its ability to provide critical services that address 
     numerous issues faced by older adults, including 
     malnutrition, food insecurity, chronic disease, and social 
     isolation. The OAANP is positioned to act as a vital link 
     connecting older adults with help from other organizations, 
     such as health clinics, food banks, and USDA's Supplemental 
     Nutrition Assistance Program (SNAP) Senior Farmers Market 
     Nutrition Program (SFMNP) and Commodity Supplemental Food 
     Program. For example, the Massachusetts OAANP was identified 
     as the Commonwealth's largest provider of nutrition and 
     health services according to a FIM community inventory. The 
     OAANP encourages the use of locally grown foods and 
     arrangements with schools and other facilities serving meals 
     to children to promote intergenerational meals. It also 
     serves as a lead agency in developing protocols to procure 
     qualified providers and hold vendors accountable to ensure 
     nutrition and food safety standards are followed.
       (5) Invests in the capacity of under-resourced communities
       The OAANP focuses on underserved communities including 
     persons with the greatest social and economic needs, those 
     who are lower income, live in rural areas, and/or are members 
     of minority communities. It also has the capability of 
     expanding service delivery models to support state/community 
     waivers and FIM initiatives.


OAANP Fits Well in the Strategic Framework for a National Plan on Aging

       The U.S. Interagency Coordinating Committee on Healthy 
     Aging and Age-Friendly Communities recently released 
     Department of Health and Human Services (HHS) plan, Aging in 
     the United States: A Strategic Framework for a National Plan 
     on Aging. It raised awareness of key aging issues and also 
     outlined goals for supporting older adult health and well-
     being. Nutrition is included as one of the healthcare/
     supportive services older adults need to improve ``health and 
     well-being across the lifespan'', ``age well in the 
     community'', and ``advance their quality of life.'' Further, 
     nutrition is among the important services listed as helping 
     older

[[Page H5434]]

     adults remain in their ``desired homes in the community.'' 
     The OAA is specifically identified in that document as a 
     ``major vehicle for the organization and delivery of social 
     and nutrition services.'' As states move to develop and 
     implement their own OAA and multi-sector aging plans, 
     policymakers and stakeholders will benefit from engaging with 
     the OAANP and its experienced staff, to maximize the health 
     and well-being of older Americans.


                              Conclusions

       The OAANP is holistic in scope and national in scale and is 
     experienced in providing FIM-aligned interventions to older 
     adults in the community. Building on its proficiency in 
     collaborating and linking with community-level programs/
     providers and its existing framework for standards, 
     monitoring, and enforcement, local providers can help ensure 
     an accountable and scalable community services infrastructure 
     for broader and widely impactful FIM initiatives. The OAANP 
     also has data, evaluation, and research expertise that could 
     benefit FIM studies with older adults. Finally, policymakers 
     can look to the OAANP as a valuable partner for helping 
     develop and implement federal and state plans and legislation 
     that support older adults in aging well and for helping 
     communities employ successful nutrition and health 
     initiatives now and into the future.

  Mr. McGOVERN. Mr. Speaker, the Older Americans Act Nutrition Programs 
play an integral role in our efforts to end hunger now.

                          ____________________