Innovations and 

Lessons Learned 

from COVID-19:

A Tip 

Sheet for 

the Aging 

Nutrition 

Network

Background

Beginning the spring of 2020, older adults were 

vulnerable to the COVID-19 virus and social 

distancing forced congregate meal sites to close 

across the country. At the same time, demand 

for Older Americans Act meals increased. In 

2021, the Administration for Community Living 

commissioned an exploratory study that used 

interviews with staff from State Units on Aging 

(SUAs), Area Agencies on Aging (AAAs), and local 

service providers (LSPs) from nine states to learn 

about their experiences providing services during 

the pandemic. This also included experiences in 

collecting and reporting data, changes in financial 

conditions, and staffing challenges. The goal 

was to gain a better understanding of the impact 

of the COVID-19 pandemic on aging nutrition 

programs and identify what programming 

practices are likely to continue into the future.
Innovations

Aging Nutrition Programs in both urban and rural 

communities quickly adapted to meet the increased 

demand for services. Rural programs tended to need a 

little more time to scale up innovations, but they also 

updated their services. Three themes occurred among 

these innovations: 

• increased flexibility for participants

• changing service delivery methods due to staff, 

volunteer, and supply chain shortages 

• rethinking emergency planning

The following innovations appeared to be successful and are 

likely to continue: 

Grab-and-Go, CarryOut, and DriveThrough Meals

Congregate nutrition sites 

closed and reopened in 

response to local COVID-19 

transmission rates. In some 

cases, sites closed and 

opened repeatedly or never 

reopened. Providers offered 

participants the option to 

pick up multiple meals at a 

time or pick up meals daily 

from a congregate meal site 

to eat at home. See Title III 

C1 and C2 Service Delivery 

Decision Tree.

More Meal Choices

The use of frozen and shelf-stable 

meals increased, and providers 

used funds to offer more culturallyspecific meals. This provided greater 

flexibility and choice for participants 

and better access to services.

Reduced Frequency of Meals

Reducing the frequency of meal pickup and delivery helped 

providers with staffing and volunteer challenges. Some providers 

were able to offer volunteers more flexible schedules to better 

manage workforce shortages. Many then conducted more 

safety and wellness checks by phone. Home delivered nutrition 

programs delivered more meals at one time using less frequent 

delivery schedules (often once or twice weekly).

Senior Centers without Walls

Many AAAs planned to transition to “Senior Center 

Without Walls” models. This included either graband-go meals with virtual congregating options 

or partnerships with restaurants. “Senior Centers 

without Walls” provide more virtual health, 

wellness, and educational programming. It was 

found that younger older adults age 60-69 are 

less interested in congregate nutrition services 

offered at senior centers and other “typical” 

locations. This new group of participants want 

more community-inclusive environments (i.e., 

restaurants), more meal options and activities 

reflective of better health. The state of Georgia

provides examples of this work. 

Restaurant Voucher Models

Restaurant partnerships also offer program 

benefits: they help diversify the food 

source supply chain, offer meals in less 

stigmatizing settings, are more resilient 

than traditional congregate settings 

because participants have other options 

if a site has to close, and support local 

economies. Review Guide to Working with 

Restaurants and Grocery Stores for Meals

for more information about partnering with 

foodservice establishments.
Virtual Programming

Social distancing led the Aging Nutrition network to 

innovate delivery of programming that would have 

normally been offered in-person at congregate 

nutrition sites. Virtual programming helped provide 

opportunities for socialization, nutrition education 

and evidence-based programming. Expanded 

virtual programming in the Aging Nutrition network 

provides increased flexibility for participants and 

increased opportunity to mitigate workforce and 

volunteer shortages. The network also identified 

the need to increase technology literacy offerings 

to improve participants’ access and to support 

participants in taking full advantage of virtual 

programming. Review Tele or Virtual Nutrition 

Education for Older Adults for more information. 

Review this Title III C1 and C2 Service Delivery 

Decision Tree to learn more about how virtual 

programming and other innovative service delivery 

models fit into congregate nutrition service delivery 

and funding. 

New Partnerships

Study participants reported increasing 

food insecurity and socialization needs 

nationally. In response, the Aging 

Nutrition network developed or expanded 

partnerships with other food insecurity 

stakeholders, such as food banks, food 

pantries and other state and community 

agencies. Review Partnerships with Food 

Banks and Other USDA Programs for more 

information. 

Lessons Learned

How to manage increased cost and supply chain challenges

The aging nutrition network reported a dramatic increase in the cost of and reduced access to food 

and supplies due to supply chain shortages and shipping delays. There were major challenges in 

sourcing proteins, prepared and frozen meals, and packaging and distribution supplies. Providers 

reported costs that exceeded negotiated reimbursement rates and cited long lag times (often two 

years) between agreement and reimbursement. 

It appeared that larger organizations and groups who negotiated with vendors collectively were more 

successful in leveraging their purchasing power to reduce cost and availability pressures. States, AAAs 

and LSPs may find that collective negotiation (e.g., contracting, joining group purchasing organizations) 

is a mutually beneficial approach to help manage costs and source necessary products. Review 

Contracting Tips for Purchasing Meals for more information.

How to rethink emergency plans for a long-term crisis

The pandemic led the aging nutrition network to rethink emergency planning for longer service 

disruptions and ongoing supply chain disruptions. Existing emergency plans at the beginning of 

the pandemic were found to be primarily designed for short-term or isolated disruptions and were 

expanded or adjusted to manage a longer crisis. Many participants were used to more socialization 

prior to the pandemic compared to older adults who were homebound. This increase in isolation 

caused an increase in support needs for participants and more complex cases. Lessons learned 

included: 

1. Acquire and reserve meals for distribution during a crisis (often frozen or shelf-stable food);

2. Plan for additional storage and distribution supplies (to-go boxes, cutlery, equipment and 

packaging to maintain holding temperatures) to adapt to changing delivery systems and 

manage longer emergencies; 

3. Develop lists of “high risk” participants who may need additional support; and

4. Add emergency planning requirements to LSP requests for proposals (RFP).

Review FAQ Managing Senior Nutrition Programs During Emergencies for more information.
How to gather data in an emergency

AAAs and LSPs shifted to gathering data questions by phone. This shift is 

likely to continue past the pandemic. Well-checks were conducted over 

the phone to accommodate social distancing and increase safety for 

participants, staff, and volunteers. Some SUAs provided more assistance 

to their AAAs and LSPs by developing data collection guidance, adjusting 

the frequency of programmatic monitoring, and increasing the 

frequency of data collection monitoring. SUAs that were able to take a 

flexible approach and maintain alignment with ACL guidance may have 

been able to better support services changing at the local level. Review 

Funding Flexibilities for Senior Nutrition Programs for more information.

Some providers expressed concern about potential dissatisfaction 

among participants when prioritization becomes necessary. Several 

SUAs reported that they anticipated finding missing Activities of Daily 

Living and instrumental Activities of Daily Living (ADL/iADL) data as older 

adults who would typically participate in congregate nutrition services 

utilized more grab-and-go and home delivered nutrition services. See 

ACL OAA Performance System (OAAPS) Title III State Performance Report 

Technical Resources for more information related to collecting and 

reporting data.

In planning for future emergencies, it may be helpful for the network to 

consider gathering more ADL/iADL data at intake and update points. 

Depending on state, AAA and LSP policies, this approach may help 

providers leverage virtual programming and other innovative service 

delivery models into congregate nutrition services delivery as shown in 

this Title III C1 and C2 Service Delivery Decision Tree. Investing in gathering 

data upfront may also create more flexibility to assign different service 

delivery methods depending on a participant’s immediate needs (e.g., 

congregate or grab-and-go). Gathering additional data may support 

improved targeting of services to evaluate how effective services are 

reaching those in greatest need. This approach is similar to the suggestion 

of implementing prioritization systems to meet the needs of participants 

at highest risk first. While the administrative burden may be higher 

upfront, it may save administrative time during future emergencies. 

Review SNP Guide to Prioritizing Clients for more information.

Disclaimer: During an emergency, senior nutrition programs will need to 

adapt their services, activities, and events to continue safely supporting 

their communities. This tip sheet provides information to help programs 

plan for, and adapt to, some of the most common emergencies 

that they may face. The strategies and suggestions in this guide are 

not exhaustive and should be adapted and modified to meet your 

situation. In addition, a prudent program administrator will develop 

emergency plans, policies, and procedures well in advance and review 

the plans annually. Review FAQ Managing SNPs During Emergencies for 

more information.

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.