Assistive Technology
(10) The term "assistive technology" means technology, engineering methodologies, or scientific principles appropriate to meet the needs of, and address the barriers confronted by, older individuals with functional limitations.

Information and referral
(11) The term "information and referral" includes information relating to assistive technology.

Disease Prevention and Health Promotion Services
(12) The term "disease prevention and health promotion services" means--
(A) health risk assessments;
(B) routine health screening, which may include hypertension, glaucoma, cholesterol, cancer, vision, hearing, diabetes, bone density, and nutrition screening;
(C) nutritional counseling and educational services for individuals and their primary caregivers;
(D) health promotion programs, including but not limited to programs relating to prevention and reduction of effects of chronic disabling conditions (including osteoporosis and cardiovascular disease), alcohol and substance abuse reduction, smoking cessation, weight loss and control, and stress management;
(E) programs regarding physical fitness, group exercise, and music therapy, art therapy, and dance-movement therapy, including programs for multigenerational participation that are provided by--
(i) an institution of higher education;
(ii) a local educational agency, as defined in section 14101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 8801); or
(iii) a community-based organization;
(F) home injury control services, including screening of high-risk home environments and provision of educational programs on injury prevention (including fall and fracture prevention) in the home environment;
(G) screening for the prevention of depression, coordination of community mental health services, provision of educational activities, and referral to psychiatric and psychological services;
(H) educational programs on the availability, benefits, and appropriate use of preventive health services covered under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.);
(I) medication management screening and education to prevent incorrect medication and adverse drug reactions;
(J) information concerning diagnosis, prevention, treatment, and rehabilitation concerning age-related diseases and chronic disabling conditions, including osteoporosis, cardiovascular diseases, diabetes, and Alzheimer's disease and related disorders with neurological and organic brain dysfunction;
(K) gerontological counseling; and
(L) counseling regarding social services and follow-up health services based on any of the services described in subparagraphs (A) through (K).
The term shall not include services for which payment may be made under titles XVIII and XIX of the Social Security Act (42 U.S.C. 1395 et seq., 1396 et seq.).';

Aging network
(14) The term "aging network" means the network of - (A) State agencies, area agencies on aging, title VI grantees, and the Administration; and (B) Organizations that (i) are providers of direct services to older individuals; or (ii) are institutions of higher education; and (iii) receive funding under this Act.

Area agency on aging
(17) The term "area agency on aging" means an area agency on aging designated under section 305(a)(2)(A) or a State agency performing the functions of an area agency on aging under section 305(b)(5).

Case management
(21) The term "case management service"-
(A) means a service provided to an older individual, at the direction of the older individual or family member of the individual-
(i) by an individual who is trained or experienced in the case management skills that are required to deliver the services and coordination described in subparagraph (B); and
(ii) to assess the needs, and to arrange, coordinate, and monitor an optimum package of services to meet the needs, of the older individual; and
(B) includes services and coordination such as-
(i) comprehensive assessment of the older individual (including the physical, psychological, and social needs of the individual);
(ii) development and implementation of a service plan with the older individual to mobilize the formal and informal resources and services identified in the assessment to meet the needs of the older individual, including coordination of the resources and services-
(I) with any other plans that exist for various formal services, such as hospital discharge plans; and
(II) with the information and assistance services provided under this Act;
(iii) coordination and monitoring of formal and informal service delivery, including, coordination and monitoring to ensure that services specified in the plan are being provided;
(iv) periodic reassessment and revision of the status of the older individual with-
(I) the older individual; or
(II) if necessary, a primary caregiver or family member of the older individual; and (v) in accordance with the wishes of the older individual, advocacy on behalf of the older individual for needed services or resources.

Frail
(26) The term "frail" means, with respect to an older individual in a State, that the older individual is determined to be functionally impaired because the individual -
(A) (i) is unable to perform at least two activities of daily living without substantial human assistance, including verbal reminding, physical cueing, or supervision; or (ii) at the option of the State, is unable to perform at least three such activities without such assistance; or
(B) due to a cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual.

Greatest economic need
(27) The term "greatest economic need" means the need resulting from an income level at or below the poverty line.

Greatest social need
(28) The term "greatest social need" means the need caused by non-economic factors, which include -
(A) physical and mental disabilities;
(B) language barriers; and
(C) cultural, social, or geographical isolation, including isolation caused by racial or ethnic status, that-
(i) restricts the ability of an individual to perform normal daily tasks; or
(ii) threatens the capacity of the individual to live independently.

Information and assistance
(29) The term "information and assistance service" means a service for older individuals that-
(A) provides the individual with current information on opportunities and services available to the individuals within their communities, including information relating to assistive technology;
(B) assesses the problems and capacities of the individuals;
(C) links the individuals to the opportunities and services that are available;
(D) to the maximum extent practicable, ensures that the individuals receive the services needed by the individuals, and are aware of the opportunities available to the individuals, by establishing adequate follow-up procedures; and
(E) serves the entire community of older individuals, particularly -
(i) older individuals with greatest social need; and
(ii) older individuals with greatest economic need.

Multipurpose senior center
(33) The term "multipurpose senior center" means a community facility for the organization and provision of a broad spectrum of services, which shall include provision of health (including mental health), social, nutritional, and educational services and the provision of facilities for recreational activities for older individuals.

Older individual
(35) The term "older individual" means an individual who is 60 years of age or older.

Planning and service area
(37) The term "planning and service area" means an area designated by a State agency under section 305(a)(1) (E), including a single planning and service area described in section 305(b)(5)(A).

Administration on Aging (AoA)
The Older Americans Act (OAA) established the AoA under the U.S. Department of Health and Human Services. AoA is the federal focal point and advocacy agency for older persons, as mandated by the OAA, and administers most OAA programs at the federal level. These programs provide assistance to older persons and their caregivers, as well as critical support services, such as nutrition and transportation, for older persons at risk of being prematurely or unnecessarily institutionalized.

State Units on Aging
AoA awards funds for Title III to the 57 State Agencies on Aging which are located in every State and Territory. Program funding is allocated to each State Agency on Aging, based on the number of older persons in the State, to plan, develop, and coordinate systems of supportive in-home and community-based services. Most States are divided into Planning and Service Areas (PSAs) so that programs can be effectively developed and targeted to meet the unique needs of older adults residing in that area. States establish planning and service areas of the State (AAAs) or designate a State to be a single planning and service area .

Area Agencies on Aging
Nationwide some 655 Area Agencies on Aging (AAA) receive funds from their respective State Agencies on Aging to plan, develop, coordinate and arrange for services in each PSA. In rural areas, an AAA may serve the needs of older adults living in a number of counties, while other AAA's serve the elderly living in a single city. AAA's contract with public or private groups to provide services. There are some 27,000 service provider agencies nationwide. In some cases, the AAA may act as the service provider, if no local contractor is available. There are approximately 4000 nutrition service providers in the country.

Adult Day Care/Adult Day Health
Provision of personal care for dependent adults in a supervised, protective, congregate setting during some portion of a twenty-four hour day. Services offered in conjunction of adult day care/adult day health typically include social and recreational activities, training, counseling, meals for adult day care and services such as rehabilitation, medications assistance and home health aide services for adult day health.

Assisted Transportation
Provision of assistance, including escort, to a person who has difficulties (physical or cognitive) using regular vehicular transportation.

Congregate Meals
Provision, to an eligible client or other eligible participant at a nutrition site, senior center or some other congregate setting.

Home Delivered Meals
Provision, to an eligible client or other eligible participant at the client's place of residence.

Native Americans
Grants for Native Americans are provided under Title VI of the Older Americans Act. It is the purpose of this title to promote the delivery of supportive services, including nutrition services to American Indians, Alaskan Natives, and Native Hawaiians that are comparable to services provided under Title III. A tribal organization of an Indian tribe is eligible for assistance if (1) the tribal organization represents at least 50 individuals who are 60 years of age or older; and (2) the tribal organization demonstrates the ability to deliver supportive services, including nutrition services. The terms "Indian Tribe" and "tribal organization" have the same meaning.

Nutrition Counseling
Provision of individualized advice and guidance to individuals, who are at nutritional risk, because of their health or nutritional history, dietary intake, medications use or chronic illnesses, about options and methods for improving their nutritional status, performed by a health professional in accordance with state law and policy.

Nutrition Education
A program to promote better health by providing accurate and culturally sensitive nutrition, physical fitness, or health (as it relates to nutrition) information and instruction to participants or participants and caregivers in a group or individual setting overseen by a dietitian or individual of comparable expertise. [Note: this is the only service of the 14 listed services in the SPR where the unit measure (one session) refers to either an individual or group service. In this case, for example, a group of people attending a session on nutrition issues for the elderly would count as one unit of "Nutrition Education".

The Nutrition Services Incentive Program (NSIP)
NSIP is the new name for the United States Department of Agriculture (USDA) cash or commodity program, known as the Nutrition Program for the Elderly (NPE). The NPE is administered by the Administration on Aging (AoA), but receives commodity foods and financial support from USDA's Food and Nutrition Service (FNS). The program is funded through an appropriation to USDA and administered by the FNS. For additional information, refer to AoA's website, Nutrition Frequently Asked Questions, #36, What is the Nutrition Services Incentive Program?

Registered Dietitian / Diet Technician / Licensed Dietitian

Registered Dietitians (RDs) are food and nutrition experts who have met the following criteria to earn the RD credential:

• Complete a minimum of a bachelor's degree at a US regionally accredited university or college and course work approved by the Commission on Accreditation for Dietetics Education (CADE) of The American Dietetic Association (ADA).
• Complete a CADE-accredited or -approved supervised practice program at a healthcare facility, community agency, or a foodservice corporation, or combined with undergraduate or graduate studies. Typically, a practice program will run six to twelve months in length.
  Pass a national examination administered by the Commission on Dietetic Registration (CDR).
• Complete continuing professional educational requirements to maintain registration.

Some RDs hold additional certifications in specialized areas of practice, such as pediatric or renal nutrition, nutrition support, and diabetes education. These certifications are awarded through CDR, the credentialing agency for ADA, and/or other medical and nutrition organizations and are recognized within the profession, but are not required. In addition to RD credentialing, many states have regulatory laws for dietitians and nutrition practitioners. Frequently these state requirements are met through the same education and training required to become an RD. The ADA provides a number of resources concerning State Professional Regulation.

Registered Dietetic Technicians (DTRs) are trained in food and nutrition and are an integral part of health care and foodservice management teams. DTRs have met the following criteria to earn the DTR credential:

• Complete at least a two-year associate's degree at a US regionally accredited college or university.
• Complete a dietetic technician program approved by the Commission on Accreditation for Dietetics Education (CADE) of the American Dietetic Association (ADA), including 450 hours of supervised practice experience in various community programs, health care, and food-service facilities.
• Pass a national, written examination administered by the Commission on Dietetic Registration (CDR).
• Complete continuing professional educational requirements to maintain registration.
  

Rural
Any area that is not defined as urban. Urban areas comprise (1) urbanized areas (a central place and its adjacent densely settled territories with a combined minimum population of 50,000) and (2) an incorporated place or a census designated place with 20,000 or more inhabitants.

Transportation
Provision of a means of going from one location to another. Does not include any other activity.

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Additional resources concerning the Administration on Aging, U.S. Department of Agriculture, Centers for Medicare and Medicaid, and OAA Aging Network Organizations are available at http://www.fiu.edu/%7Enutreldr/Aging_Network/aging_network.htm

Updated 01/28/03

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