Final Rule:

2024 Update to ACL’s 

Older Americans Act Regulations

An overview for ACL’s networks

On February 6, 2024, ACL released a final rule to update the regulations implementing its Older 

Americans Act (OAA) programs. The new regulations will take effect on March 15, 2024, but 

regulated entities have until October 1, 2025 to comply. ACL looks forward to working with partners 

in the aging network to implement the final rule, and will provide robust technical assistance and 

other resources to support states, tribes and tribal organizations, area agencies on aging, and others 

in the aging network in meeting its requirements.

Summary

The first substantial update to most OAA program 

regulations since 1988, the 2024 Older Americans 

Act final rule aligns regulations to the current statute, 

addresses issues that have emerged since the last 

update and clarifies a number of requirements. It aims 

to better support the national aging network that delivers 

OAA services and improve program implementation, with 

the ultimate goal of ensuring that the nation’s growing 

population of older adults can continue to receive the 

services and supports they need to live – and thrive – in 

their own homes and communities. 

The updated regulations reinforce and clarify policies and 

expectations, provide guidance for programs authorized 

since the last update, promote appropriate stewardship of 

OAA resources, and incorporate lessons learned during 

the COVID-19 pandemic. For example, the final rule:

• Clarifies requirements for state and area plans on

aging and details requirements for coordination

among tribal, state and local programs.

• Improves consistency of definitions and operations

between state and tribal OAA programs.

• Clarifies and strengthens provisions for meeting OAA

requirements for prioritizing people with the greatest

social and economic needs.

• Specifies the broad range of people who can receive

services, how funds can be used, fiscal requirements,

and other requirements that apply across programs.

• Clarifies required state and local agency policies and

procedures. For example, the final rule establishes

expectations regarding conflicts of interest.

• Requires state agencies to establish flexible and

streamlined processes for area agencies to receive

approval for contracts and commercial relationships.

• Includes guidance for the National Family Caregiver

Support Program and the Native American Caregiver

Support Program, which were authorized since the

last update.

• Addresses emergency preparedness and response,

incorporating lessons from the COVID-19 pandemic.

• Establishes expectations for legal assistance and

activities to prevent elder abuse.

• Clarifies the role of the aging network in defending

against the imposition of guardianship and in

promoting alternatives.

• Updates definitions, modernizes requirements,

and clarifies flexibilities within the OAA nutrition

programs. For example, the rule allows for

continuation of innovations developed during the

pandemic, such as providing carry-out meals through

the congregate meals program, in certain

circumstances.

Last Updated: 2/2024

The Administration for Community Living is an operating division of 

the U.S. Department of Health and Human Services. Visit ACL.gov.
The release of the final rule is the culmination of many

years of engagement with the national aging network.

It also reflects input received through a request for

information (RFI); a series of listening sessions,

including consultations with tribes and other engagement

with Native American grantees; and more than 750 

comments received in response to the June 2023 Notice

of Proposed Rule Making (NPRM), from a wide range

of stakeholders including states, area agencies on

aging, and national aging organizations. The thoughtful

comments validated the overall direction of the proposed

rule and provided information that ACL incorporated to

further refine and strengthen the final rule.

Background on the Older

Americans Act:

First passed in 1965 and last reauthorized on March 25,

2020, the OAA authorizes a wide range of programs and

services that help older adults age in place. Through the 

aging services network, the OAA helps older adults 

remain active and engaged in their communities to the

great benefit of all. Because of the OAA, communities

across the country are able to continue to draw upon the

wealth of knowledge that comes only with life experience.

The services authorized by the OAA include:

• Home-delivered and congregate meals, support

for family caregivers, preventive health services,

personal and home care services, transportation,

legal assistance, elder abuse prevention, and more

(authorized under Title III – Grants for state and

community programs on aging).

• Home and community-based services for Native

American elders and caregivers (authorized under

Title VI – Grants to Indian tribes and Native Hawaiian

grantees for supportive, nutrition, and caregiver

services).

• Ombudsman services for people who live in longterm care facilities, funding for prevention of elder

abuse, and other elder rights programs (authorized

under Title VII – Allotments for vulnerable elder rights

protection activities).

ACL administers these provisions through its 

Administration on Aging. (The Department of Labor 

administers Title V of the OAA, the Senior Community 

Services Employment Program. It is not covered by ACL’s 

final rule.)

Key Provisions of the Final Rule

Following is a brief overview of some of the key 

provisions of the final rule. Please note that this was 

written with a goal of providing a plainer-language 

description that is easier to understand for people who 

may not have an in-depth understanding of the technical 

provisions of the OAA. In addition, this overview includes 

only some of the highlights of the final rule; it does not 

include all of the provisions or complete details of the 

summarized provisions. Please use this document as 

a tool to help navigate the final rule; it should NOT be 

considered a substitute.

Roles and Responsibilities of State 

Agencies and Area Agencies on Aging:

The OAA authorizes grants to state agencies, which in 

turn provide funding to area agencies on aging (AAAs) to 

coordinate programs and advocate for older adults and 

family caregivers. State agencies and AAAs have both 

emphasized a need for additional guidance on a number 

of issues, including fiscal requirements, service delivery 

and avoiding conflicts of interest. To address those 

issues (and others), the final rule: 

• Clarifies requirements for state and area plans on

aging. For example, the final rule makes clear that

plans must describe:

» How state agencies and AAAs will use OAA

funding, how “greatest economic need” and

“greatest social need” are determined and

addressed, and how requirements for public

participation are met (§ 1321.27 and § 1321.65).

» How state agencies and AAAs will ensure

coordination between programs that serve all older

adults, including tribal elders, (authorized under

Title III) and those that specifically focus on tribal

elders (authorized under Title VI) (§ 1321.53, §

1321.69, and § 1321.95).

• Lists requirements for designation of planning

and service areas and area agencies on aging

(§ 1321.13, § 1321.15, § 1321.17, § 1321.19, §

1321.21, and § 1321.23).

• Clarifies the state agency’s responsibility to establish

and maintain policies and procedures to monitor the

programmatic and fiscal performance of programs

and activities carried out under Title III of the OAA

and to ensure that its own – and its AAAs’ – policies

and procedures are aligned with ACL’s data collection

and reporting requirements (§ 1321.9(a) and (b)).
• Clarifies policies and procedures that AAAs and

service providers must follow, including setting

requirements for client eligibility, assessment, and

person-centered planning and detailing limitations on

the frequency, amount, or type of service provided (§

1321.9(c)(1)).

• Lists and clarifies the policies and procedures that

state agencies must establish and maintain regarding

fiscal requirements, including distribution of Title

III funds; non-federal share (match) requirements;

permitted transfers; reallotment of funds; use of

program income; private pay programs; contracts

and commercial relationships; buildings, alterations

or renovations, maintenance, and equipment; and

advance funding (§ 1321.9(c)(2)).

• Requires state agencies to establish flexible and

streamlined processes for AAAs to receive approval

for contracts and commercial relationships. This

provision is included in the final rule in response to

numerous questions about the appropriate roles,

responsibilities, and oversight of such activities,

feedback received in response to the RFI and NPRM,

and based on our observations of program activities.

The provision is intended to promote and expand the

ability of the aging network to engage in business

activities while ensuring that the unique roles of OAA

grantees are preserved (§ 1321.9(c)(2)(xiv)).

• Defines “conflicts of interest” and establishes

several requirements to prevent them. The scope of

activities of entities that receive OAA funding has

changed significantly since the last update to the

OAA regulations, and the potential for conflicts of

interest has increased. These provisions are intended

to ensure the integrity of – and trust in – the activities

carried out under the OAA. (§ 1321.3, § 1321.47, §

1321.67, and § 1321.73).

Serving Older Adults, Tribal Elders, and 

Family Caregivers with the Greatest 

Economic and Greatest Social Need:

Prioritizing people who have the greatest economic 

and social needs is one of the basic tenets of the OAA 

(OAA Section 305 (a)(2)(E)). The final rule clarifies 

requirements for state agencies’ definitions of both 

needs, as well as expectations for serving those who 

meet them. It also clarifies expectations for ensuring 

that the perspectives of older people with the greatest 

economic and social needs are incorporated into 

planning efforts. For example, the final rule:

• Establishes standard expectations for what state

agencies and AAAs must include in their definitions

of greatest economic and greatest social need,

while allowing state agencies and/or AAAs flexibility

to include additional populations based upon local

considerations (§ 1321.27 and § 1321.65).

• Requires state and area plans to include how they

will reach populations they have defined as having

the greatest economic and/or social need. State

agencies and AAAs must also seek and consider

the views of people with the greatest economic

and greatest social need when developing and

administering their plans (§ 1321.27, § 1321.29, §

1321.49, § 1321.51, and § 1321.65).

• Requires at least half of AAA advisory council

members to be 60 years or older. These must include

people from minority populations, and AAAs must

make efforts to include people identified as having

the greatest economic and greatest social need.

Councils also must include family caregivers, and,

when available, representatives of tribes, pueblos,

and tribal aging programs (§ 1321.63).

• Requires service providers to specify how they will

satisfy the service needs of those identified as in the

greatest economic need and greatest social need (§

1321.79).

Family Caregivers:

Family caregivers make it possible for millions of older 

adults to remain in their homes in the community. 

The sections of the OAA that authorize ACL’s primary 

caregiver support programs – the National Family 

Caregiver Support Program and the Native American 

Caregiver Support Program, which together provide 

crucial services to nearly 800,000 caregivers – were 

authorized after the last substantial update to the 

OAA regulations. Consequently, regulations for these 

programs did not exist.

The final rule provides key definitions, implements statutory 

mandates, and clarifies requirements for family caregiver 

support services, allowable uses of funds, and the method 

of funds distribution. For example, the final rule:

• Codifies the definitions of “family caregiver” and

“older relative caregiver” that have been used since

the programs were established in 2000. Specifically:

» The term “family caregiver” includes unmarried

partners, friends, or neighbors who are caring for an

older adult or a person of any age with Alzheimer’s

disease or a related disorder with neurological and

organic brain dysfunction (§ 1321.3).
» The term “older relative caregiver” means a person

who is at least 55 years old who lives with a child

or a person with a disability for whom they are

the primary caregiver and to whom they provide

informal care. The final rule further delineates

the specific relationships and circumstances that

qualify and clarifies that when the person receiving

care is an adult with a disability, the caregiver may

be that person’s parent (§ 1321.3).

» Includes family caregivers as a service population

for state agencies and AAAs (§ 1321.1, § 1321.5,

and § 1321.55).

» Clarifies allowable uses of funds for communitybased family caregiver support services, as well

as eligibility requirements for receiving services (§

1321.91 & § 1322.29).

Emergency Preparedness 

and Response:

Emergencies and disasters have distinct and 

disproportionate impacts on older adults and family 

caregivers, and often create unique challenges for the 

aging services network. They also can trigger specific 

flexibilities in OAA programs. However, the previous OAA 

regulations included limited guidance addressing these 

situations. The final rule includes several provisions for 

emergency preparedness and response, which reflect 

lessons learned from the COVID-19 pandemic and 

address feedback received during the pandemic and 

through the RFI and NPRM. For example, the final rule:

• Creates a new subpart (Part 1321 Subpart E —

Emergency and Disaster Requirements), which

supports older adults and family caregivers, including

those in tribal communities, during emergencies and

disasters with provisions such as:

» Requiring state agencies and AAAs to establish

emergency plans. They also are required to

have policies and procedures in place for

communicating and coordinating with state, tribal,

and local emergency management, as well as Title

VI programs within their jurisdictions (§ 1321.97

and § 1321.103).

» Allowing state agencies to set aside funding to

exercise flexibilities related to a major disaster

declaration (and specifying requirements for

exercising such flexibilities). For example, the

final rule allows a state agency to procure items

on a statewide level, subject to certain terms and

conditions (§ 1321.99 and § 1321.101).

• Creates a new subpart (Part 1322 Subpart D —

Emergency and Disaster Requirements), which

supports services specifically for Native American

elders and family caregivers during emergencies and

disasters with provisions such as:

» Requiring tribal organizations and Hawaiian Native

grantees to establish emergency plans. They also

are required to have policies and procedures in

place for communicating and coordinating with

tribal, state, and local emergency management,

as well as with the state agency and any AAA

providing Title III- and VII-funded services within

the grantee’s approved service area (§ 1322.33

and § 1322.37).

» Enabling tribal organizations and Hawaiian Native

grantees to exercise flexibilities related to a major

disaster declaration and specifying requirements

for exercising such flexibilities (§ 1322.35).

• Enabling the Assistant Secretary for Aging to modify

emergency and disaster-related provisions set forth

in the regulation when a major disaster or public

health emergency is declared (§ 1321.105 and §

1322.39).

Nutrition Flexibilities and 

Modernization:

The congregate and home-delivered meals provided by 

the OAA Senior Nutrition programs help to reduce hunger 

and food insecurity; provide an opportunity for older 

adults to engage with other people, which is critical to 

maintaining health and independence; and provide an 

opportunity to screen older adults for other needs before 

they become crises. The programs help more than two 

million older adults continue to live in the community 

each year.

The COVID-19 pandemic brought to light limitations in 

the previous nutrition regulations and highlighted the 

need for guidance to support innovation and response 

to emerging needs. The final rule modernizes nutrition 

rules, reflecting the evolving needs of both grantees and 

OAA participants, and alleviates uncertainty caused by 

relying on sub-regulatory guidance. The final rule also 

clarifies requirements for transfers of funds between 

programs. For example, the nutrition services-related 

provisions of the final rule:
• Clarify that home-delivered meals may be provided

via home delivery, pick-up, carry-out, or drivethrough; that eligibility for home-delivered meals

is not limited to people who are “homebound;” that

eligibility criteria may depend upon many factors;

and that home-delivered meal participants may also

be encouraged to participate in congregate meals

programs (§ 1321.87 and § 1322.27).

• Allow for a limited number of “carry-out” and similar

meals to be provided through the congregate meals

program, in some circumstances (§ 1321.87).

• Specify that nutrition education, nutrition counseling,

and other nutrition services may be provided as part

of both the congregate meals program and the homedelivered meals program (§ 1321.87 and § 1322.27).

• Clarify that Nutrition Services Incentive Program funds

may only be used to purchase domestically produced

foods used in a meal (§ 1321.87 and § 1322.27).

Services for Native Americans Elders

and Caregivers:

American Indians, Alaskan Natives, and Native

Hawaiians (AI/AN/NH) have long experienced

disproportionate poverty, barriers in accessing health

care and related services, unequal education and

employment opportunities, and cultural differences

that have resulted in health disparities and lower life

expectancy. Title VI of the OAA authorizes grants that 

provide nutrition, supportive, and caregiver services to 

AI/AN/NH elders and family caregivers to help them to

live full, engaged lives in their communities.

The final rule clarifies what qualifies as a Title VI service;

requirements for collaboration and coordination between

programs for all older adults (authorized under Title III)

and those specifically focused on tribal populations (Title

VI programs); and allowable caregiver support services.

It also addresses needs for technical assistance. For

example, the final rule:

• Combines parts 1322 and 1323 and incorporates

requirements specific to Title VI part B, to reduce

confusion and improve consistency in service

provision to AI/AN/NH elders and family caregivers

(part 1322).

• Establishes expectations that tribal organizations

and Native Hawaiian grantees coordinate with

state agencies and AAAs regarding provision of

services. The final rule also explicitly incorporates

requirements for coordination between Title III

grantees and Title VI grantees into each applicable

section of the regulations (parts 1321 & 1322).

• Specifies that applications for Title VI funds must

include program objectives; a map and/or description

of the geographic boundaries of the service area,

which may include Bureau of Indian Affairs service

area maps; documentation of supportive and

nutrition services capabilities; completion of a needs

assessment and other assurances; and a tribal

resolution, among other requirements (§ 1322.5).

• Specifies program and fiscal requirements for which

grantees should have established policies and

procedures. For example, the rule requires Title

VI grantees to have policies and procedures for

ensuring that their data collection and reporting align

with ACL requirements, voluntary contributions, and

buildings and equipment (§ 1322.13).

Elder Abuse Prevention, Legal 

Assistance, Guardianship, and LongTerm Care Ombudsman Programs:

An estimated one in ten adults over the age of 60 has 

experienced some form of elder abuse, which may 

reduce their quality of life and limit their independence. 

Title VII of the OAA authorizes activities that uphold the 

rights of older adults and prevent, detect, and respond 

to elder abuse, neglect, and exploitation. These play a 

critical role in promoting elder justice, ensuring that older 

adults can live safely in the community or in long-term 

care settings, and upholding their right to participate in 

decisions about their lives. For example, the elder rightsrelated provisions of the final rule:

• Define “defense of guardianship” as advice to, and

representation of, people to help them:

» Oppose appointment of a guardian; and/or

» Seek limitation and/or revocation of guardianship.

• Specify that defense of guardianship also includes

assistance that diverts people from guardianship

to less restrictive, more person-directed forms of

decisional support whenever possible (§ 1321.93).

• Clarify the role of legal assistance providers

as promoters of self-determination and persondirectedness. The final rule also requires that legal

assistance providers meet complex and evolving

legal needs involving a range of private, public and

governmental entities, programs and activities that

may impact an older adult’s independence, choices,

or financial security (§ 1321.93).
• Provide standards for selecting legal assistance

providers funded under the OAA. For example, the

rule requires that legal assistance providers have

demonstrated capacity to represent older adults

at both administrative and judicial proceedings (§

1321.93).

• Clarify that the state agency’s obligations to develop

policies and procedures extend to elder abuse

prevention and legal assistance development

programs, and that such programs must be

addressed in state plans on aging (§ 1321.9(a) and §

1321.27).

• Provide clarity on the requirements that state

agencies must meet with respect to the development

and enhancement of programs to address elder

abuse, neglect, and exploitation (§ 1324.201).

• Specify the purpose, role, and responsibilities of the

legal assistance developer, and prohibit related

conflicts of interests, including those related to

guardianship (§ 1324.303).

• Add language to require policies and procedures

to provide direction for the Long-Term Care

Ombudsman and representatives of the Office for

how to address situations where a resident is unable

to communicate consent (§ 1324.11(e)(2) and

§ 1324.11(e)(3)(iv)).

• Require ombudsman programs to enter into memoranda

of understanding with OAA legal assistance programs and

licensure and certification entities for facilities and longterm care providers to ensure coordination between these

entities. The final rule maintains the other potential

partners recommended in the 2015 rule, which include

organizations in ACL’s aging and disability networks.

(1324.13(h)).

• Clarify prohibitions that preclude state government

agencies from interfering with the functions of

the Office of the Long-Term Care Ombudsman

(§ 1324.11(e)(8)).

Effective Date and Compliance 

Information

The final rule will take effect on March 15, 2024 (30 

days after it is officially published), and regulated 

entities have until October 1, 2025 to comply. In the 

coming months, ACL will share resources and provide 

robust technical assistance to support states, tribes and 

tribal organizations, area agencies on aging, and others 

in the aging network in meeting the requirements of the 

new regulations. ACL also will work with regulated 

entities in a supportive corrective action process if 

more time is needed to fully comply with specific 

provisions.

Learn More

Save the dates for these upcoming webinars:

• Informational Webinar: Join ACL for an overview

of the updated regulations on Thursday, Feb. 8

from 2-3 p.m. (Eastern).

• "Back to Basics" technical assistance webinar:

On Thursday, Feb. 15 from 2-3:30 p.m. (Eastern),

ACL will host the first in a series of webinars to

support the network in implementing the updated

regulations.

More information, including registration information for 

these webinars, a link to the final rule, and links to 

resources and technical assistance can be found at 

ACL.gov/OAArule.

The final rule was posted “on display” in the Federal

Register on Feb. 6, 2024 and will be published 

officially on Feb. 14, 2024.