END OF PUBLIC HEALTH 

EMERGENCY EXPIRATION 

CONSIDERATIONS FOR TITLE 

III C SENIOR NUTRITION 

PROGRAMS

March 23, 2023

The Public Health Emergency (PHE) for COVID-19 

expires May 11, 2023. With the ending of the PHE, the 

two flexibilities related to the PHE also end:

• Dietary Guidelines for Americans (DGAs) and 

Dietary Reference Intakes (DRIs) nutrition 

requirements waived; and

• Transfer of 100% of funds between Title III-C1 

(congregate nutrition) and Title III-C2 (home 

delivered nutrition).

Therefore, no later than May 11, 2023, all Title 

III-C meals must meet DRIs and DGAs and funds 

transfers between Title III C-1 and Title III C-2 will 

return to standard OAA limits.

What is expected?

The OAA says the following about nutrition 

guidelines and funding transfers: 

• Nutrition Guidelines: An OAA-funded 

eligible congregate or home delivered 

meal must meet 1/3 of the DRIs and 

comply with the DGAs.

• Transfer Authority: State Units on Aging 

(SUAs) may transfer up to 40% of OAA Title 

III C funds between Title III-C1 and Title 

III-C2. SUAs may request a waiver from the 

Assistant Secretary for Aging to transfer 

an additional 10% of funds between Title 

III-C1 and Title III-C2.

It is recommended that State Units on Aging 

(SUAs) start planning for the return to prePHE flexibilities now and communicate to 

Area Agencies on Aging and local service 

providers. If meals do not meet the DGA/DRI 

requirements by May 11, 2023, they:

• May not be counted towards NSIP 

reporting (see Other Considerations 

below);

• Would be reported in the SPR 

“consumable supplies;” and/or 

• Would need to use funding other than Title 

III C-1 or Title III C-2.
Other Considerations

SUAs should keep in mind:

• If your state has a Major Disaster Declaration (MDD) under the Stafford 

Act in effect, “bucketing” of OAA funds can be continued during a limited 

unwinding period. ACL strongly encourages SUAs to unwind all MDD 

flexibilities by September 30, 2023. Please refer to COVID-19 Response (acl.

gov) 

• Meals reported under the Nutrition Supplemental Incentive Program (NSIP) 

are required to meet the DGAs/DRIs. FFY2023 NSIP meal counts will be used 

by ACL to establish FFY2024 NSIP funding allotments. 

• New service delivery (eg, Grab and Go, etc), assessment (eg, virtual 

assessment) and eligibility models are determined by your SUA and/or 

AAA, and are not necessarily impacted by the ending of the PHE and MDD. 

See Inherent OAA Flexibility section below.

• Find a Registered Dietitian to help you. Use the Academy of Nutrition and 

Dietetics’ Find a Nutrition Expert tool to get started.

• Identify substitutions allowed within your state nutrition policies, and 

consult with a Registered Dietitian as needed, if food supplies vary.

• Try adding a missing meal component to meet the DGA/DRIs. For example, 

a glass of milk to reach calcium and protein requirements, switching to a 

lower sodium product to reduce sodium content, or switching from white 

bread to wheat bread to meet fiber requirements. This Menu Creation 

Toolkit provides more examples.

• Request donations of food items from local grocery stores, convenience 

stores, or pantries to help meet the missing meal component.

For meals that do not currently meet the DGA/DRI requirements, senior nutrition programs can 

consider the following ways to help meet the requirements: · 

Inherent OAA Flexibility and Program Resources

As a reminder, SUAs, AAAs, and local service providers have always had considerable flexibility 

around how they meet the intent and requirements of the OAA Title III C. SUAs are responsible 

for developing policies, procedures, guidance, and technical assistance to carry out nutrition 

services. SUAs may delegate some of this responsibility to AAAs or local service providers who 

may have additional policies and procedures. 

ACL and the Nutrition and Aging Resource Center encourages the aging network to employ 

creative and adaptive approaches to meet the nutrition, socialization, and wellness needs of 

seniors when establishing specific policies and procedures. Example resources that highlight 

flexibilities include:

• Eligibility requirements1 (e.g., whether a Title III-C2 recipient must be 

homebound, prioritization requirements, assessment procedures); 

• Menu policies (e.g., state nutrition standards, menu approval process);

• Programmatic policies and procedures (e.g., restaurant programs, graband-go meals, groceries); and

• Target populations2 (e.g., data reporting to show effective targeting, added 

groups to achieve equity).

1 Individual served must be 60+ or the spouse of an older adult. A meal 

may be supplied to people who volunteer during meal hours and people with 

disabilities who either live with an eligible older adult or live in a senior housing 

facility that offers congregate services.

2 OAA programs should target older adults with greatest economic need 

and older adults with greatest social need (with particular attention to low-income older individuals, including low-income minority older individuals, older 

individuals with limited English proficiency, older individuals residing in rural 

areas, and older individuals at risk for institutional placement).
The Nutrition and Aging Resource Center website has many resources that are helpful for OAA 

Title III-C program planning and innovation.

Nutrition Guidelines:

• Nutrition Requirements of the Older Americans Act — Quick guide of the basics for Title III C

• DGA Policy and Practice Implications for Senior Nutrition Programs — Guide to help senior 

nutrition programs develop policies that meet the OAA requirements to align with the 2020-

2025 DGAs

• Menu Creation Toolkit — Examples and resources to create menus

• DGA and DRI Overview (YouTube)— Recording of presentation about what they are, 

flexibility, how states and AAAs use them

◊ PowerPoint

• State Unit on Aging and Provider Best Practices (YouTube)— Recording of presentation of 

state experiences with DGA, DRI

◊ Takeaway Sheet

Inherent OAA Flexibilities and Title III-C reporting: 

• Title III-C1 and -C2 Service Delivery Decision Tree Tool – classifies various service delivery 

methods including grab and go and food truck meals

• Understanding Title III-C Flexibilities — FAQ on flexibilities around DGA, DRIs, grab-and-go, 

groceries, and more 

NSIP meals:

• NSIP Guidance: FY2022 Title III Program, Reporting, and Fiscal Updates – clarifies that FFY2023 

NSIP meals must be reported and will count towards FFY2024 funding allocations.

• Nutrition Services Incentive Program (NSIP) — Definition of foods that can be purchased with 

NSIP allocations and resources to help ensure OAA alignment.

Advice for moving forward

The Nutrition and Aging Resource Center 

website is an excellent place to find the 

latest information about innovative service 

planning. Resources are regularly updated, 

so we encourage you to check the website 

frequently, subscribe to our newsletter and 

follow us on social media.

State Units on Aging are encouraged to seek 

your own legal counsel in regard to contract 

and sub-grant questions and concerns, 

work closely across programmatic and fiscal 

offices to balance service delivery needs 

and fund transfer decisions, and reach out 

to your Administration for Community Living 

(ACL) Regional Administrator (RA) if you need 

further advice or clarification about federal 

requirements. 

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.