Introduction

to the Older 

Americans Act

Thank you for helping ensure older Americans get the 

services they need to stay healthy. The included fact 

sheets serve as an introduction to the Older Americans 

Act and are designed to help you in your role. 

Use these sheets in whatever way you see fit – whether 

it’s printing them out and hanging them in your office 

or using them as a training resource for your staff. 

They’re a good reminder of available older adult health 

services, funding, and more.

If you’d like more information, please consult the 

Overview of Older Americans Act Title III Programs: 2018 

Summary of Highlights and Accomplishments.

Again, thank you for all you do!

This project was supported in part by grant number 90PPNU0002 from the U.S. 

Administration for Community Living, Department of Health and Human Services, 

Washington, D.C. 20201. Grantees undertaking projects with government sponsorship are 

encouraged to express freely their findings and conclusions. Points of view or opinions do 

not, therefore, necessarily represent official ACL policy.

Source: Overview of Older Americans Act Title III Programs: 2018 Summary of Highlights 

and Accomplishments
Older 

Americans

Act

The Older Americans Act (OAA), enacted in 1965, was the 

first federal-level initiative aimed at comprehensively 

addressing the need for community social services 

for older adults. The act supports a range of essential 

home- and community-based services. This is done 

to help as many older adults live as independently as 

possible in their homes and communities.

States must target “older individuals with the greatest 

social need, with particular attention to low-income 

minority individuals, older individuals residing in rural 

areas, low-income individuals, and frail individuals.”

The Older Americans Act has created an infrastructure, 

known as the national aging services network, that 

coordinates the delivery of comprehensive home- and 

community-based supportive services in every state.

• 56 State Units on Aging

• 244 tribal organizations, two

native Hawaiian

organizations

representing 400 tribes

• 629 Area Agencies

on Aging (AAAs)

• 20,000 local

service providers

AT PRESENT, THE NETWORK 

CONSISTS OF:

Title III of 

the Older 

Americans Act

This section provides grants 

to states, tribes, and territories 

to advocate on behalf of 

older persons and their 

family caregivers, and to 

coordinate programs for them. 

It covers supportive services, 

such as case management, 

community services, in-home 

services, transportation, 

information and referral, and 

legal assistance.

This section also covers 

nutrition programs, such as 

home-delivered meals and 

congregate meals; family 

caregiver support; and health 

promotion and disease 

prevention services.

Source: Overview of Older Americans Act Title III Programs: 2018 Summary of Highlights 

and Accomplishments
Older 

Americans 

Act : Title III

The Older Americans 

Act: Title III

provides grants to states, tribes, and territories to 

advocate on behalf of older persons and their family 

caregivers, and to coordinate programs for them by 

providing the following services below:

• SUPPORTIVE SERVICES

Case Management, Community Services,

In-Home Services, Transportation,

Information and Referral, Legal Assistance

• NUTRITION PROGRAMS

Congregate Meals and

Home-Delivered Meals

• FAMILY CAREGIVER

SUPPORT

• HEALTH PROMOTION

AND DISEASE

PREVENTION SERVICES

Source: Overview of Older Americans Act Title III Programs: 2018 Summary of Highlights 

and Accomplishments
History of Title 

III of the Older 

Americans Act

1950s

• President Truman initiated the first National Conference on 

Aging, sponsored by the Federal Security Agency (1950).

• Federal funds were first appropriated for social service

programs for older persons under the Social Security

Act (1952).

• Special Staff on Aging was established within the Office

of the Secretary of Health, Education, and Welfare to

coordinate responsibilities for aging (1956).

1960s

• First White House Conference on Aging was held in

Washington, D.C. (1961).

• Older Americans Act was signed into law on July 14 (1965).

• It established the Administration on Aging within the

Department of Health, Education, and Welfare and called

for the creation of State Units on Aging (1965).

• Older Americans Act Amendments provided grants for

model demonstration projects, Foster Grandparents

Program, and Retired Senior Volunteer Program (1969).

1970s

• Second White House Conference on Aging was held in

Washington, D.C. (1971).

• A new Title VII was created under the Older Americans

Act, authorizing funds for a national nutrition program for

older adults (1972).

• Older Americans Act Comprehensive Services Amendments

established Area Agencies on Aging. The amendments

1970s (continued)

added a new Title V, which authorized grants to local 

community agencies for multipurpose senior centers 

and created the Community Services Employment grant 

program for low-income persons age 55 and older, 

administered by the Department of Labor (1973).

• Older Americans Act Amendments authorized grants

under Title III to Indian tribal organizations. Transportation,

home care, legal services, and home renovation/repair

were mandated as priority services (1975).

• Older Americans Act Amendments required changes

in Title VII nutrition program, primarily related to

the availability of surplus commodities through the

Department of Agriculture (1977).

1980s

• Third White House Conference on Aging was held in

Washington, D.C. (1981).

• Older Americans Act was reauthorized; it emphasized

supportive services to help older persons remain

independent in the community (1981).

• The reauthorization of the Older Americans Act authorized

appropriations for six additional services; in-home 

services for older adults; long-term care ombudsman; 

assistance for special needs; health education and

promotion; prevention of elder abuse, neglect, and

exploitation; and outreach activities for persons who

may be eligible for benefits under supplemental security 

income, Medicaid, and food stamps. Additional emphasis

was given to those in the greatest economic and social

need, including low-income minorities (1987).

Source: Overview of Older Americans Act Title III Programs: 2018 Summary of Highlights and Accomplishments
History of Title III of the Older 

Americans Act — Continued

1990s

• Reauthorization of the Older Americans Act placed

increased focus on caregivers, intergenerational

programs, protection of elder rights, and calls for a 1995

White House Conference on Aging (1992).

• White House Conference on Aging was held in

Washington, D.C. (1995).

• Older Americans Act, Medicare, Medicaid, and the Foster

Grandparent Program observed 30th anniversaries (1995).

2000s

• HHS Secretary Tommy G. Thompson released $113 million

for First National Family Caregiver Support Programs

grants to states on February 15 (2001).

• Kickoff of 30th Anniversary of the Older Americans Act

Nutrition Program took place in March (2002).

• The fifth White House Conference on Aging was held in

Washington, D.C. (2005).

• Older Americans Act Amendments of 2006 was signed

into law (P.L. 109-365) reaffirming the principles of

consumer information for long-term care planning,

evidence-based prevention programs, and self-directed

community-based services to older individuals at risk of

institutionalization (2006).

2010s

• The Affordable Care Act was enacted (2010).

• The Administration for Community Living was established

on April 18, bringing together the Administration on

Aging, the Office of Disability, and the Administration on

Developmental Disabilities (2012).

2010s (continued)

• On April 19, President Obama signed the Older Americans

Act Reauthorization Act of 2016 into law to further

improve access and quality of comprehensive services

to older adults in our country. The 2016 Older Americans

Act reauthorized programs for Fiscal Year 2017 through

Fiscal Year 2019. It included provisions to protect

vulnerable elders by strengthening the Long-Term

Care Ombudsman program and elder abuse screening

and prevention efforts. It also promoted the delivery of

evidence-based programs such as falls prevention and

chronic disease self-management programs (2016).

2020s

• On March 25, President Trump signed H.R. 4334, the

Supporting Older Americans Act (SOAA) into law. The

SOAA reauthorizes the Older Americans Act for five

years and includes a seven percent increase in funding

in the initial year and a six percent increase annually

for the remainder through Fiscal Year 2024. Along with

these increases, the SOAA establishes a new Research,

Demonstration, and Evaluation Center for the Aging

Network within the Administration on Aging, requires

additional research into the impact of social isolation on

senior health, and affirms the importance of local control

and flexibility in the administration of Older Americans

Act programs (2020).

• Kickoff of 50th Anniversary of the Older Americans Act

Nutrition Program took place in March (2022).

Source: Overview of Older Americans Act Title III Programs: 2018 Summary of Highlights and Accomplishments
Older Americans Act :

Title III Network

The Older Americans Act established a national network of federal, state, and local agencies 

to provide services that maximize the independence and well-being of older adults in their 

homes and communities.

Federal

U.S. Department of Health and Human Services: HHS has designated 

ACL to carry out the provisions of the OAA and to administer the OAA 

programs. HHS also provides funding for the OAA programs. 

Administration for Community Living: ACL is the primary federal 

agency responsible for administering the OAA programs and authorizes 

grants to SUAs and AAAs to act as advocates on behalf of older persons 

and to coordinate programs and services for older persons. 

State

State Units on Aging: SUAs are designated state-level agencies that 

are responsible for the planning and policy development as well as the 

administration of OAA activities. SUAs also coordinate with AAAs to collect 

and report state performance data to ACL on Title III program performance.

It is the responsibility of the SUA to develop regulations, policies, procedures, 

guidance, and technical assistance to address program accountability. The 

OAA requires that SUA/AAA consult with local service providers to develop 

the best method of program administration. 

Area Agencies on Aging

AAAs are overseen and work closely with their State Unit on Aging while 

providing services to their local area. AAAs serve as local entities that, 

either directly or through contract with local service providers, oversee 

a comprehensive and coordinated service system for the delivery of 

home- and community-based services.

Local

Local Service Providers or contractors deliver aging services, such as 

meals, transportation, and in-home services. 

Consumers

Individuals receive the Older Americans Act services within their 

states and communities.

Source: Overview of Older Americans Act Title III Programs: 2018 Summary of 

Highlights and Accomplishments

Department of Health and Human Services

The Administration for Community Living: 

Regional Administrators 

State Units on Aging

Service Providers / Direct Services

Federal

State

Local

Consumers

Area Agencies on Aging 
Older Americans Act :

Title III Distribution 

of Funding

The majority of funding for OAA Title III programs flows from the federal to the state level and 

from there to the local level. Funding for Title III programs is also provided by other sources. 

Since OAA funding is neither available nor intended to serve every eligible person, programs 

also secure funding from sources such as Medicare and Medicaid, state and local sources, 

private donations, and voluntary contributions from those receiving services. 

Source: Overview of Older Americans Act Title III Programs: 2018 Summary of 

Highlights and Accomplishments

Federal

Funding is distributed to each state (as well as the District of 

Columbia, Puerto Rico, and the U.S. territories) and its aging 

network according to a formula based on the state’s share of 

the U.S. population age 60 or older. The formula considers the 

geographic distribution of older individuals with the greatest 

economic and social need.

State

The states and territories award funds to the regional 

programs known as Area Agencies on Aging (AAAs).

Local 

AAAs contract with local service providers to deliver aging 

services, or in some cases, deliver services directly. 

State Units on Aging

Area Agencies on Aging 

Service Providers / Direct Services

Department of Health and Human Services

The Administration for Community Living: 

Regional Administrators 

Federal

State

Local
Older Americans Act :

Title III Services

TITLE III - B

Supportive services and programs are designed to 

ensure that communities can meet the individual needs 

of older adults and caregivers and to help older adults 

remain independent.

TITLE III - C

NUTRITION SERVICES AIM:

1. To reduce hunger, food insecurity, and malnutrition;

2. To promote socialization of older individuals; and

3. To promote the health and well-being of older

individuals by assisting such individuals to gain access

to nutrition and other disease prevention and health

promotion services to delay the onset of adverse health

conditions resulting from poor nutritional health or

sedentary behavior.

TITLE III - D

Provides grants to states and territories for programs that 

support healthy lifestyles and promote healthy behaviors; 

to improve the health and well-being of older adults and 

reduce disease and injury through the implementation of 

evidence-based programs.

TITLE III - E

Provides family caregivers with a flexible base of services 

and supports to assist them in keeping their loved ones in 

the settings of their choice for as long as possible.

Source: Overview of Older Americans Act Title III Programs: 2018 Summary of Highlights

and Accomplishments
Older Americans

Act: Title III – B

ADULT DAY CARE

Personal care for dependent older adults in a 

supervised, protective, and congregate setting 

during a portion of a day.

ASSISTED TRANSPORTATION

Assistance and transportation for a person who has 

difficulties using regular transportation.

CASE MANAGEMENT

Assistance with access or care coordination for 

an older person who has diminished functioning 

capacities, personal conditions, or other characteristics 

and so needs to receive services.

CHORE SERVICES

Assistance with activities such as heavy housework, 

yard work, or sidewalk maintenance.

HEALTH PROMOTION AND 

DISEASE PREVENTION

Services that include health screenings and assessments; 

organized fitness activities; evidence-based health 

promotion programs; medication management; home 

injury control services; and/or information, education, 

and prevention strategies for chronic disease and 

other health conditions.

HOMEMAKER

Assisting a consumer with routine tasks to achieve 

and maintain a clean, safe, and healthy environment.

INFORMATION AND 

ASSISTANCE

A service providing individuals with information on 

services available within communities; links individuals 

to services and opportunities available; and, as much as 

possible, establishes adequate follow-up procedures.

LEGAL ASSISTANCE

Legal advice, counseling, and representation by an 

attorney or other person acting under the supervision of 

an attorney.

OUTREACH

Intervention with individuals initiated by an agency or 

organization for the purpose of identifying potential 

clients and encouraging them to use existing services 

and benefits.

PERSONAL CARE

Service that helps a consumer to achieve optimal 

functioning with Activities of Daily Living (ADL) and 

Instrumental Activities of Daily Living (IADL).

SELF-DIRECTED CARE

An approach to providing services (including programs, 

benefits, supports, and technology) under this act intended 

to assist an individual with activities of daily living in 

which services are provided under the direction and 

control of the person served.

OTHER SERVICES

A service provided using Older Americans Act funds 

that does not fall into the listed service categories. Source: Overview of Older Americans Act Title III Programs: 2018 Summary of 

Highlights and Accomplishments
Older Americans Act :

Title III – C

HOME-DELIVERED MEALS

A meal provided by a qualified nutrition project provider to an 

eligible individual and is consumed in their place of residence. 

Meals may be provided via home delivery, pickup, carryout, or 

drive through.

CONGREGATE MEALS

Meals provided to an eligible individual in a group setting 

(e.g., senior center, senior housing sites, restaurant programs, 

faith-based locations) and/or virtual interaction arranged by the 

nutrition provider.

NUTRITION COUNSELING

A standardized service as defined by the Academy of Nutrition and 

Dietetics that provides individualized guidance to individuals who 

are at nutritional risk because of their health 

or nutrition history, dietary intake, chronic illness, or medication use, 

or to caregivers. Counseling is provided one-on-one by a 

registered dietitian and addresses the options and methods for 

improving nutrition status with a measurable goal.

NUTRITION EDUCATION

An intervention targeting Older Americans Act participants and 

caregivers that uses information dissemination, instruction, or 

training with the intent to support food, 

nutrition, and physical activity choices and behaviors in order to 

maintain or improve health and address nutrition-related 

conditions. Content is consistent with the Dietary Guidelines for 

Americans; is accurate, culturally sensitive, regionally 

appropriate, and considers personal preferences; and is 

overseen by a registered dietitian or individual of comparable 

expertise as defined in the OAA.

Source: Overview of Older Americans Act Title III Programs: 2018 Summary of Highlights 

and Accomplishments
Older Americans Act: 

Title III – D

Funds are provided for evidence-based disease 

prevention and health promotion services including 

programs related to physical fitness, medication 

management, chronic disease self-management 

education, psychosocial behavioral health 

intervention, HIV, arthritis, brain health, diabetes, 

falls prevention, depression, mental health supports, 

chronic pain, etc.

Evidence-Based Disease 

Prevention and Health 

Promotion Services

• Physical Fitness

• Medication

Management

• Chronic Disease

Self-Management

Education

• HIV

• Arthritis

• Brain Health

• Diabetes

• Psychosocial

Behavioral Health

Intervention

• Falls Prevention

• Depression

• Mental Health

Supports

• Chronic Pain

For more information, visit acl.gov.

Source: Overview of Older Americans Act Title III Programs: 2018 Summary of Highlights and Accomplishments
Older 

Americans

Act: Title III – E

INFORMATION FOR 

CAREGIVERS ABOUT 

AVAILABLE SERVICES

A service for caregivers that provides them with 

information on resources and services available 

within their communities.

ASSISTANCE TO CAREGIVERS 

IN GAINING ACCESS TO 

SERVICES

A service for caregivers that assists in obtaining access 

to the services and resources available to them within 

their communities. Ensures that the individuals receive 

the services needed by establishing adequate followup procedures.

CAREGIVER TRAINING AND 

EDUCATION, INDIVIDUAL 

COUNSELING, SUPPORT

GROUPS

Counseling to caregivers to assist them in making 

decisions and solving problems related to their 

caregiver roles. This includes counseling to individuals, 

support groups, and caregiver training (of individual 

caregivers and families). These services help caregivers 

better manage their responsibilities and cope with the 

stress of caregiving.

RESPITE CARE

Services that offer temporary, substitute supports or 

living arrangements for care recipients in order to 

provide a brief period of relief or rest for caregivers. 

Respite care includes:

• In-home respite (personal care, homemaker, and

other in-home respite)

• Respite provided as the care recipient attends a senior

center or other nonresidential program

• Institutional respite provided by placing the care

recipient in an institutional setting such as a nursing

home for a short period of time as a respite service to

the caregiver.

• For grandparents caring for children, summer camps

SUPPLEMENTAL SERVICES

Services provided on a limited basis to complement 

the care provided by caregivers (e.g., transportation, 

home modifications, medical equipment, assistive 

technologies, and emergency response systems).

For more information, visit acl.gov.

Source: Overview of Older Americans Act Title III Programs: 2018 Summary of Highlights and Accomplishments
Older Americans Act : 

Title III Data

OAA Title III Program 

data and information 

are key for monitoring 

progress toward 

achieving strategic 

goals, objectives, and 

priorities. The data can 

also help answer key 

questions about OAA 

Title III programs such as: 

• How much funding

is allocated to the

individual service

types?

• How do expenditures

differ by service type?

• What are the

characteristics of Title

III service recipients?

• How many individuals

receive Title III services?

• What is the health

status of service

recipients?

• How helpful are the

services?

Title III Data Collection and Access: ACL collects information and reports on the 

performance of Title III programs through two primary data collection systems.

State Performance Report (SPR)

• Includes demographic and descriptive data, performance data on

programs and services, and data on the infrastructure of home- and

community-based services.

• Older Americans Act Performance System: A reporting tool the

Administration for Community Living (ACL)/Administration on Aging (AOA)

uses to monitor performance and collect information on Older Americans

Act (OAA) Title III, VI, and VII programs.

• Aging, Independence, and Disability: Features links to Administration

on Disabilities (AOD) programs, as well as new data products from the

Administration on Aging’s (AOA) programs and reporting systems. AGID

is an online query system that enables data users to access and analyze

data in a centralized location.

National Survey of Older Americans Act Participants (NSOAAP)

• National survey to assess the effectiveness of the Title III programs,

maintain accountability, and demonstrate the program’s success in

achieving legislative goals.

• Comprised of six annual surveys that focus on the consumers’ assessment

of service quality and outcomes as well as measure client characteristics

such as demographics and physical and social functioning.

• Data include information for the six Title III service areas.

- Caregiver, Homemaker, Transportation, Home-Delivered Meals,

Congregate Meals, and Case Management.

• Data from the 2021 National Survey of OAA Participants help to illustrate

how the Congregate Nutrition Programs and Home-Delivered Nutrition

Services are effectively targeting their services.

• Eldercare locator: A public service of the U.S. Administration on Aging

connecting you to services for older adults and their families.

Source: Overview of Older Americans Act Title III Programs: 2018 Summary of Highlights and Accomplishments