Recommendation: The Administrator of ACL should work with other relevant HHS officials to document the department's plan to focus on the specific nutritional needs of older adults in the 2025-2030 update of the Dietary Guidelines for Americans, which would include, in part, plans to identify existing information gaps on older adults' specific nutritional needs. (Recommendation 1)
Agency: Department of Health and Human Services: Administration for Community Living
Status: Open
Comments: HHS agreed with this recommendation, stating that ACL plans to work with the Office of Disease Prevention and Health Promotion and other relevant HHS officials and agencies to document HHS's plans to emphasize the specific and varying nutritional needs of older adults in the 2025-2030 update. HHS also stated that ACL plans to acquire the services of a registered dietician with specialized expertise in older adults' nutritional needs. We will consider closing this recommendation when these efforts are completed.
Recommendation: The Administrator of ACL should direct regional offices to take steps to ensure states are monitoring providers to ensure meal consistency with federal nutrition requirements for meals served in the congregate and home-delivered meal programs. (Recommendation 2)
Agency: Department of Health and Human Services: Administration for Community Living
Status: Open
Comments: HHS agreed with this recommendation. HHS stated that ACL's program and evaluation offices will collaborate on the development of plans to ensure state compliance with federal requirements.
Recommendation: The Administrator of FNS should take steps to improve its oversight of CACFP meals provided in adult day care centers. For example, FNS could amend its approach for determining federal onsite reviews of CACFP meal providers to more consistently include adult day care centers. (Recommendation 3)
Agency: Department of Agriculture: Office of the Secretary: Food, Nutrition and Consumer Services: Food and Nutrition Service
Status: Open
Comments: In May 2020, the Department of Agriculture's Food and Nutrition Service told us that, in an effort to improve oversight of the CACFP meals provided in adult day care centers, it will place a special interest on lessons learned from onsite local reviews that are conducted by states where the adult portion of the CACFP is administered separately by the state department of aging and thus, adult day care institutions are always selected for local onsite reviews as part of their management evaluation. Further, Food and Nutrition Service told us it will commit to sharing this information with other state agencies that administer the CACFP. Food and Nutrition Service estimates completing this action by the end of calendar year 2020. We will review the status of this recommendation upon receipt of Food and Nutrition Service updates at the end of 2020.
Recommendation: The Administrator of ACL should centralize information on promising approaches for making meal accommodations to meet the nutritional needs of older adult participants in the congregate and home-delivered meal programs, for example in one location on its National Resource Center on Nutrition and Aging website, to assist providers' efforts. (Recommendation 4)
Agency: Department of Health and Human Services: Administration for Community Living
Status: Open
Comments: HHS agreed with this recommendation. The agency stated that ACL will award a contract in fiscal year 2020 for a new National Resource Center on Nutrition and Aging to, among other things, centralize information on promising approaches so nutrition services providers can access it easily. We will consider closing this recommendation when this effort is complete.
Recommendation: The Administrator of FNS should take steps to better disseminate existing information that could help state and local entities involved in providing CACFP meals meet the varying nutritional needs of older adult participants, as well as continue to identify additional promising practices or other information on meal accommodations to share with CACFP entities. (Recommendation 5)
Agency: Department of Agriculture: Office of the Secretary: Food, Nutrition and Consumer Services: Food and Nutrition Service
Status: Open
Comments: In May 2020, the Department of Agriculture's Food and Nutrition Service told us that it will take several actions over the next 12 months to address our recommendation. Food and Nutrition Service actions will include holding listening sessions specifically focused on the adult day care side of the program at two national CACFP conferences this year to understand the specific information providers are looking for the address the needs of older adults and identify promising strategies for accommodating those needs; review existing guidance for training opportunities and areas that could benefit from further clarifications; and updating the Adult Day Care Handbook to include promising practice examples to address specific information and concerns gathered from the listening sessions, GAO's report findings, and further clarifications from existing guidance. Food and Nutrition Service also told us it will use multiple channels to ensure the handbook is widely disseminated to state agencies and adult day care program operators. We will review the status of this recommendation upon receipt of additional updates from Food and Nutrition Service regarding the aforementioned actions to be taken over the next 12 months.
