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The Iowa Café: 

AAA and Restaurant Partnerships 

Principal Investigator: 

Bambi Press, RD, LD, Healthy Aging Director at Iowa Department of Health and Human Services Division of 

Aging and Disability Services

Authors: 

Bambi Press, RD, LD, Healthy Aging Director at Iowa Department of Health and Human Services Division of 

Aging and Disability Services and Nutrition & Aging Resource Center

Alexandra Bauman, RD, LDN, Nutrition & Wellness Director at Iowa Department of Health and Human 

Services Division of Aging and Disability Services and Director, Nutrition & Aging Resource Center

Danielle Crail, RD, LD, former Healthy Aging Director at Elderbridge Agency on Aging 

Jody Applegate, RD, LD, Healthy Aging Director at Elderbridge Agency on Aging

Janet Buls, Nutrition Director at Northeast Iowa Area Agency on Aging 

Date of Report

October 31, 2023

ACL Disclaimer: “This project was supported, in part by grant number 90INNU0020 from the Administration 

for Community Living, U.S. 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.”
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Table of Contents

Background and Purpose....................................................................................................................................................................................................... 3

Partners and Project Staff.......................................................................................................................................................................................................6

Funding and Sustainability....................................................................................................................................................................................................8

Recruitment.......................................................................................................................................................................................................................................9

Tools ......................................................................................................................................................................................................................................................12

Project Timeline............................................................................................................................................................................................................................13

Frequently Asked Questions ...............................................................................................................................................................................................15

Advice for Replication..............................................................................................................................................................................................................17

Appendix List...................................................................................................................................................................................................................................18
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Background and Purpose

A. Goal: 

The goal of the project is to modernize Iowa’s congregate meal program infrastructure, delivery 

mechanisms, and outreach to increase the number of consumers and meals served.

B. Objectives: 

1) Establishing a restaurant partnership infrastructure in the Elderbridge Area Agency on Aging (AAA)

service region and Northeast Iowa Area Agency on Aging (NEI3A) service region (year 2)

2) Developing flexible approaches to congregate meal service delivery mechanisms to target and 

outreach to two generations of older adults

3) Modernizing a streamlined intake process through technology use

4) Identifying seniors who may be food insecure, socially isolated, and rural and providing nutrition 

education.

C. Overview of Project: 

The Iowa Department of Health and Human Services Division of Aging and Disability Services (HHS 

ADS), formerly known as the Iowa Department on Aging, in partnership with Area Agencies on Aging 

(AAA) developed The Iowa Café to modernize Iowa’s congregate meal program infrastructure. The 

Iowa Café transforms the traditional congregate meal site delivery method to an attractive 

restaurant partnership for older adults to gather and enjoy nutritious meals. This mutually beneficial 

project benefits both Iowa’s food insecure older adults and local communities to generate economic 

stimulus.

D. Project Results:

Iowa Area Agencies on Aging contracted with twenty-two (22) restaurant partners who served 98,107 

meals to 6,221 consumers. The addition of The Iowa Café restaurant partnership model:

• Increased congregate nutrition consumers served by up to 112%, 

• Increased reach among older adults age 60-74 by up to 344%, 

• Increased reach among older adults who identify as Hispanic by up to 123%, 

• Increased reach among other culturally and racially diverse groups by up to 125%, 

• Increased reach among consumers living with food insecurity by up to 38%, and

• Increased reach among consumers living in rural areas by up to 112% compared to 2019.
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Background and Purpose Continued

 

0

2000

4000

6000

SFY2019 SFY2021 SFY2022 SFY2023

Consumers

State Fiscal Year July-June (SFY)

Congregate Nutrition Participation 

Increased in Target Counties

NEI3A

Elderbridge

Figure A. Demonstrates the increase in congregate nutrition participation in counties targeted by the grant 

project (includes meals funded outside the grant)

3%

26%

71%

Limited Outreach to 

Congregate Consumers 

Age 60-74 in SFY2019 

0-59 60-74 75+

3%

55%

42%

Improved Outreach to 

Congregate Consumers 

Age 60-74 in SFY2023 

0-59 60-74 75+

 

Figures B and C. Demonstrate improved outreach to two generations of older adults in the Elderbridge AAA 

service region between SFY2019 and SFY23

3%

64%

33%

Iowa Cafe Model Targets 

Consumers 60-74

0-59 60-74 75+

2%

37%

61%

Traditional Model Targets 

Consumers 75+

0-59 60-74 75+

Figures D and E. Compare outreach to two generations of older adults by the traditional and Iowa Café 

models in the Elderbridge service region in SFY23
5 

2388

1123

212

82

686

298

503

227

880

555

0 500 1000 1500 2000 2500 3000

Rural Iowa Café

Rural Traditional

Food Insecure Iowa Café

Food Insecure Traditional

High Nutrition Risk Iowa Café

High Nutrition Risk Traditional

Feel Lonely Iowa Café

Feel Lonely Traditional

Eat Alone Iowa Café

Eat Alone Traditional

Number of Consumers

Iowa Cafe Model Reached More Targeted Consumers 

(Elderbridge SFY23)

586

176

24

10

165

54

147

34

220

78

0 100 200 300 400 500 600 700

Rural Iowa Café

Rural Traditional

Food Insecure Iowa Café

Food Insecure Traditional

High Nutrition Risk Iowa Café

High Nutrition Risk Traditional

Feel Lonely Iowa Café

Feel Lonely Traditional

Eat Alone Iowa Café

Eat Alone Traditional

Number of Consumers

Iowa Cafe Model Reached More Targeted Consumers 

(NEI3A SFY22)

Figures F and G. Compare outreach by the traditional and Iowa Café models in the targeted counties

0

10000

20000

30000

40000

Mat’s Place

DejaBrew

Dom’s ...

Huntley’s ...

Chuck’s ...

Shortee’s

MaryJo’s ...

Aspen...

10th Hole...

Crazy ...

Blue...

Plymouth...

Bean and...

American...

Menlo...

7 Stars

April’s ...

West Side...

Locals Bar...

Sodes...

Hungry ...

Restoran...

Meals Served

Iowa Cafe

Total Meals Served by Iowa Cafe

Meals 2023

Meals 2022

Meals 2021

Figure H. Illustrates meals provided by Iowa Café partners in each year of the grant project (includes meals 

in addition to those funded through the grant)
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Partners and Project Staff

A. Partners:

Area Agency on Aging (AAA) Partners:

• Elderbridge Agency on Aging: AAA providing services in targeted counties. 

• Northeast Iowa Area Agency on Aging: AAA providing services in targeted counties, 

contracted in year 2 of grant project. 

Restaurant Partners:

• Twenty-two (22) local, “mom and pop” contracted restaurants were selected due to the lack 

of a traditional congregate meal site in the county or higher rates of older adults who were at 

greatest economic and social risk. 

• Contracted restaurant partners often reached higher rates of targeted consumers (older 

adults who were at greatest economic and social risk) compared to traditional sites. 

Additional Key Partners:

• Iowa State University and Iowa Department of Public Health: Supported development of The 

Iowa Café project and provided nutrition education materials. 

• Iowa Restaurant Association, Local Chambers of Commerce and Iowa Economic 

Development Authority (IEDA): Supported development of The Iowa Café project, marketed 

the program at no cost, and provided restaurant details and contacts to the AAAs. 

B. Project Staff Roles: 

a. FTEs: 2.3

• Iowa HHS ADS Project Director 0.2 FTE

• AAA Healthy Aging Director 0.2 FTE (Elderbridge)

• AAA Director of Nutrition Services 0.15 FTE (NEI3A)

• AAA Nutrition Coordinators 1.75 FTE (Elderbridge and NEI3A)

b. Staff titles and general responsibilities

• Grant Project Director (Iowa HHS ADS Healthy Aging Director): 

o Oversight of entire project including: 

 develop and monitor project and contracts, 

 monthly contact with project partners, and

 communicate with ACL. 

• AAA Healthy Aging Director/AAA Director of Nutrition Services: 

o Manage day-to-day grant implementation activities including: 

 execute and manage restaurant contracts, data, technology and training,

 registered dietitian menu approval,

 nutrition education activities in collaboration with partners, and

 assist in development of replication resources and project reporting.
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• AAA Meal Site Coordinators: 

o Support day-to-day grant implementation activities including:

 participant intake and registration,

 assist with nutrition education activities, and

 assist with management of restaurant contracts and monitoring, data, 

technology and training.

• Registered Dietitian (Contracted): Provide menu development and approval support. 
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Funding and Sustainability

A. Initial Funding: 

• 2020 Administration for Community Living Nutrition Innovations Grant 

• In-Kind Match including: 0.2 FTE state-funded project director salary and fringe, 0.2 FTE AAAfunded Healthy Aging Director salary and fringe, 0.15 FTE AAA-funded Director of Nutrition 

Services salary and fringe, 1.75 FTE AAA Meal Site Coordinators staff time, travel to nutrition 

sites, technology and supplies (laptop and software, portion of restaurant voucher cards and 

scan fees)

B. Continued Funding: 

• Federal and state funding for Title III C1 services 

• Consumer voluntary contributions 

• In-kind match from local and community partners, including Dubuque County Board of 

Supervisors, City of Waterloo Community Block Grant

C. Sustainability: 

• Full integration of restaurant partnerships into Title III C1 program operations and budgets

• Continued development of local and community partnerships 

• Continued pursuit of grants 

• Developed wait list and prioritization systems, when necessary
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Recruitment 

A. Participants

a. Requirements

• Participant eligibility matches the Older Americans Act Title IIIC-1 eligibility for congregate 

meals.

b. What recruitment methods were used?

Successful: 

• Modernizing a streamlined intake process through technology use

o Developed an online registration form. This helped simplify registration and data 

requirements for older adults who may have otherwise been deterred by lengthy paper 

intake forms. 

o This process also reduced administrative burden on AAAs. 

• Social media, newspapers, radio and community networking 

o “Word of mouth” rapidly increased awareness of the program among older adults and 

other stakeholders, including food banks/pantries and hunger workgroups, faith based 

organizations, health care partners, senior housing and other community based 

organizations. 

• Client testimonials in marketing pieces

o The testimonials demonstrated the impact the project had on the participant’s life and 

were powerful marketing and recruitment tools. 

Not successful:

• “Proxy” registration

o AAAs found that in some cases another individual registered for services on behalf of an 

eligible participant who did not move forward with attending a meal site. 

B. Restaurants

a. Requirements

• Providers may be any licensed foodservice establishment, including restaurants, cafés, 

grocery stores, convenience stores and food trucks. 

o Providers must adhere to Iowa Food Code.

o Providers are subject to monitoring by the AAA and self-monitoring annually. 

• Requirements for meals provided by restaurants match Older Americans Act Title IIIC and 

Iowa Nutrition Services Guidelines (see Appendix B), including dietitian approval.

o Providers are not required to develop brand new recipes and menu items. Project 

dietitians support foodservice establishments to identify appropriate menu items already 

offered by the restaurant to meet nutrition requirements. Small modifications may be 

required to ensure meals meet the nutrition guidelines. One example the AAA may 
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request is for milk be offered with a meal to help meet the nutrition guidelines. See 

Appendix B for additional examples of how to use the Iowa Guide for Menu planning to 

meet Iowa Nutrition Services Guidelines. 

o Foodservice establishments have menu planning flexibility. Providers may offer a set daily 

menu, or may offer different daily menus (“specials”) to provide choices for participants. 

Once the menu is established, foodservice establishments must offer meals according to 

the approved menu; however, consumers may decline any element of the meal. The 

foodservice establishment is not required to offer substitutions beyond the planned 

menu.

• Foodservice establishments using SeniorDine technology (see “Tools” below) are responsible 

for their own internet access and accurate recording of meals provided. 

b. What recruitment methods were used?

Successful: 

• Potential partners received a welcome packet that included an introduction letter, a onepager describing the program and the partnership guide (see Appendix B). 

• The project was supported by the Governor and State representatives, who marketed 

information on their social channels.

• Social media, newspapers, radio and community networking 

o “Word of mouth” rapidly increased awareness of the program among community 

restaurants, older adults and other stakeholders, including food banks/pantries and 

hunger workgroups, faith based organizations, health care partners, senior housing and 

other community based organizations. 

• Restaurant partner and client testimonials in marketing pieces

o The testimonials demonstrated the impact the project had on the participant’s life and 

were powerful marketing and recruitment tools. 

C. Volunteers 

a. Requirements

AAA volunteers assisted with monthly nutrition education and voluntary contribution mailings. 

Volunteer criteria includes: 

• Must successfully pass criminal background and abuse registry check

• Good telephone skills and oral communication skills.

• Knowledge of personal computers and ability to operate computer software.

• Strong interpersonal skills to relate to diverse cultures, older persons and their

• caregivers.

• Excellent data entry skills.

• Strong attention to detail and accuracy.

• Ability to organize and be flexible.
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b. What recruitment methods were used for volunteers? What was successful or 

not successful? 

Successful: 

• Having a dedicated volunteer coordinator on staff at the AAA

• Volunteer application and position descriptions posted on the AAA website

D. Marketing Tips

Successful:

• Naming of the program: “The Iowa Café” is a fresh, upbeat approach to congregate dining 

that attracts new consumers.

• Social media, newspapers, radio and community networking

o The project was supported by the Governor and State representatives, who marketed 

information on their social channels.

o “Word of mouth” rapidly increased awareness of the program among community 

restaurants, older adults and other stakeholders, including food banks/pantries and 

hunger workgroups, faith based organizations, health care partners, senior housing 

and other community based organizations.

o Sample newspaper press release included in The Iowa Café Guide for Area Agencies 

on Aging (Appendix A) 

• Marketing materials such as table tents (see Appendices A and B), flyers, business cards and 

window decals were made available to partners. Many of these were designed inexpensively 

and made available as a Design Kit in Canva for easy access to project staff. 

• “We miss you” mailings: this encouraged those who had not been to a meal site recently to 

come back. An example marketing letter is included in The Iowa Café Guide for Area 

Agencies on Aging (Appendix A). 

• Direct marketing to senior housing communities and gathering places, community centers, 

other aging and disability resource organizations, parks and recreation proved even more 

effective than newspaper marketing.

• Host a “Grand Opening” or special event to attract consumers to a new site. 
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Tools

A. Technology 

• SeniorDine is a program that tracks consumer meals using a credit card-style card or keychainstyle card that is scanned at the foodservice establishment. This technology can be used to track 

consumers, meal counts and types (e.g., congregate or home delivered, or breakfast, lunch or 

dinner meals), and generate a month-end report to be used as an invoice for the AAA’s 

reimbursement to the restaurant. The software also generates a voluntary contribution letter for 

consumers that lists the number of meals the consumer received. Consumers’ cards can be 

automatically loaded with a preset number of meals per month determined by the AAA. 

Elderbridge initially offered fifteen (15) meals per month and NEI3A offered twelve (12) meals per 

month. AAAs later reduced meals to six (6) per month based on utilization, available funding, 

capacity, and prioritization. Consumers in greatest need were able to access additional meals. 

• An internet-enabled device such as an iPad or iPod with internet access was used to access the 

SeniorDine technology. AAAs provided the devices, if needed, and foodservice establishments 

were responsible for their own internet access.

• Services were tracked in the WellSky Data System and imported into Tableau for data 

visualization and project evaluation. 

• Online participant intake and restaurant interest forms were developed using Google forms and 

appengine.

• This Google map of Iowa Café and traditional nutrition sites was developed to help consumers 

navigate to these locations. 

B. Resources 

• Contracted registered dietitians to support restaurant partner menu development and approval

• The Iowa Café Guide for Area Agencies on Aging (Appendix A): Early product of the grant project 

used for replication throughout the grant period 

• The Iowa Café Guide for Partners (Appendix B): Early product of the grant project used for 

replication throughout the grant period

• Paper folding machine was purchased to streamline monthly mailings.
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Project Timeline

2018

Winter 2018

• Condition of Iowa’s Congregate Meal Program explored reasons for program’s decline in 

recent years

2019

Spring 2019

• Wrote grant proposal for 2020 ACL Innovations in Nutrition Grant

• Obtained Letters of Commitment from project partners 

2020

Fall 2020

• Received ACL Innovations in Nutrition Grant

• Executed contract with Elderbridge Agency on Aging

• Drafted Restaurant Partnership Guide (updated throughout project with best practices and 

additional resources) 

2021

Winter 2021

• Executed contract with SeniorDine

• Opened first Iowa Café site

• Obtained Main Street and Chambers of Commerce contact information in target counties 

from Iowa Economic Development Authority and began outreach 

• Iowa Nutrition Guidelines updated 

• Opened 3 additional Iowa Café sites

• Iowa Restaurant Association shared restaurant contacts in target counties

• Posted online participant intake and restaurant interest forms 

Spring 2021

• Opened 6 Iowa Café sites 

• Began gathering testimonials from consumers and restaurants

Summer 2021

• Opened 1 Iowa Café site

Fall 2021

• Opened 4 Iowa Café sites

• Contracted with NEI3A to further expand during year 2 of grant project. Elderbridge and NEI3A 

executed MOU for sites that border AAA counties to allow both AAAs to work with one Iowa 

Café site
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2022

Winter 2022 

• Opened 1 Iowa Café site

• NEI3A conducted consumer survey

Spring 2022

• Opened 4 Iowa Café sites

• NEI3A developed “Wellness 365” nutrition education branding

• NEI3A launched nutrition education videos and began scheduling monthly “Wellness 365” 

nutrition education sessions to be hosted at Iowa Café sites

Summer 2022

• NEI3A distributed QR codes on table cards at Iowa Café sites to advertise nutrition education 

sessions and videos 

• Opened 2 Iowa Café sites

• NEI3A transitioned to sustaining partnerships through Title III C1 funding

Fall 2022

• Elderbridge began hosting monthly nutrition education sessions at The Blue Heron, their most 

popular site

2023

Winter 2023

• Elderbridge implemented soft reduction of monthly meals (allowing consumers who may be 

living with food insecurity to continue to access additional meals)

Spring 2023

• Elderbridge implemented wait list and consumer prioritization

• Elderbridge transitioned to sustaining partnerships through Title III C1 funding
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Frequently Asked Questions

Q: Does the restaurant need to make a new menu from scratch? 

A. No. The AAA’s Dietitian worked with the restaurant to select a sample of menu items already on the 

restaurant’s menu. Cost and nutrition guidelines were considered when selecting menu items, and 

sometimes small adjustments were made. For example, add a glass of milk, reduce portion size of meat, 

switch white bread to wheat bread, etc. 

Q: Does the dietitian need to receive recipes from the restaurant to run a nutrient analysis? 

A. Not necessarily. The dietitian can use the Iowa Guide for Menu Planning to approve menus used. It is 

important to take note of serving sizes in this case, and make sure the restaurant uses standardized 

recipes.

Q: Can approved meals be from the restaurant menu? 

A: Yes, depending on the meal. For approving menus, it is best to work with the dietitian and agency staff 

for menu planning. It may be easiest to use the existing menu and modify meals to fit nutrition 

requirements.

Q. Can AAAs define relationships and deliverables with restaurants/providers via MOUs instead of formal 

vendor contracts? 

A. No, a contract must be in place for federal funds; a sample contract is attached in Appendix G of the 

Iowa Café Guide for Area Agencies on Aging. 

Q: What is the contracted rate per meal?

A: Iowa Café meal rates reimbursed to restaurant partners typically ranged from $8 to $11 per meal as 

part of the grant project. Reimbursement rates depend on the foodservice provider menu and other 

factors that drive the cost of providing services. 

Q: Can a consumer take food home? 

A. Yes, a consumer can take leftovers home. A best practice would be to date the container and provide 

safe food handling instructions because older adults are at a higher risk for foodborne illness. 

Q. Is carry out allowed? 

A. One of the key purposes of the Iowa Café and other Older Americans Act nutrition service programs is 

providing opportunities for socialization, and carry out/Grab & Go may not provide that benefit. AAAs 

and foodservice establishments may choose to negotiate carry out/Grab & Go availability and terms in 

the contract agreement. If the AAA and foodservice establishment agree to offer carry out/Grab & Go, 

these meals must be recorded accurately. 
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Q: Can a participant come in and eat with family or friends who are not eligible for congregate meals?

A: Yes, a participant can dine in with other non-eligible persons. If they are not eligible, they must pay the 

full price of the meal.

Q: Are there income guidelines for consumers? 

A: No, this is not a means-tested program. Anyone who meets the eligibility requirements, regardless of 

income, is eligible.

Q. What information do we need to collect from new consumers? 

A. Nutrition Intake forms as specified by the Iowa Reporting Manual (State Performance Report). 

Q. What if a participant will not fill out intake form?

A. The intake or registration forms are required for funding purposes. If a participant will not complete an 

intake form, please refer them to the agency.

Q. What if the consumer does not want part of the planned meal, for example, they do not like broccoli? 

A. The consumer is allowed to decide what they want to be served and may decline any part of the 

meal. In this case, the foodservice establishment would be encouraged to offer a similar vegetable 

option on the approved Iowa Café menu; however, the foodservice establishment is not required to 

identify a substitution. Substitution options can be provided by the dietitian on request. The dietitian 

must approve substitutions in advance.
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Advice for Replication

“Don’t be afraid to think outside of the box and try something new. Chances are, your current business 

model is already dated. We need to meet the needs of older adults in 2022, but we also need to continue to 

look ahead to meet the needs of older adults five years, ten years, and 20 years from now. Think about if and 

how you are prepared to do that.

Partnerships are extremely important. We rely on all of our partners for success (AAAs, restaurants, 

chambers of commerce, grocery stores, local newspapers, etc.).

Last, it may take some time for a new approach to catch on. Restaurants were slow opening at first, but 

once one opened, community excitement started to build and they wanted to open quickly! Don’t give up or 

get discouraged if progress feels slow.” 

-Alexandra Bauman, RD LDN | Division Director, Nutrition & Wellness | Iowa Department of Health and Human 

Services Division of Aging and Disability Services (formerly the Iowa Department on Aging)
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Appendix List

A. The Iowa Café Guide for Area Agencies on Aging: This guide provides specific guidance to support AAAs 

in developing and managing the Iowa Café service delivery model; it also contains numerous replication 

materials and resources including:

• Nutrition Guidelines and menus, 

• Marketing design toolkit, press release and other marketing materials, 

• Cost proposal and contracts, 

• Letters to foodservice establishments, consumers, and public officials,

• Consumer and foodservice provider surveys, 

• Frequently asked questions, and 

• Technology resources. 

B. The Iowa Café Guide for Partners: This guide provides basic guidance to support foodservice 

establishments in successfully partnering with a AAA to host an Iowa Café that meets the requirements of 

the Older Americans Act; it also contains numerous replication materials and resources including:

• Hospitality tips for serving older adults,

• Nutrition Guidelines and menus, 

• Marketing materials such as table tents that also explain tipping and voluntary contributions,

• Frequently asked questions, and 

• Technology resources.