The nutrition program service provider must provide information for partici­pants to take advantage of benefits available to them under the Basic Food Program. The Basic Food Program helps low-income individuals and families obtain a more nutritious diet by supplementing their income with Basic Food benefits to purchase food. Basic Food Assistance can be applied for at local Community Services Offices or online using the Online Application for Services. 

Providers must coordinate their activities with local agencies that conduct outreach for the Basic Food Program to facilitate participation of eligible older persons in the program.

Good nutrition prolongs independence by maintaining physical strength, mobility, endurance, hearing, vision, and cognitive abilities. Eighty-seven percent of older Americans have one or more chronic diseases that can be improved by nutrition therapy, including cancer, chronic lung disease, heart disease, dementia, diabetes mellitus, high blood cholesterol, high blood pressure, osteoporosis, obesity and overweight, and failure to thrive (Draft Nutrition Screening Initiative Policy Statement: Nutrition: Proven Effective in Managing Chronic Disease in Older Americans.)
Nutrition education can be defined as any set of learning experiences designed to facilitate the voluntary adoption of eating and other nutrition-related behaviors conducive to health and well-being. It is an integral part of providing nutrition services to older persons. 
Nutrition services providers must conduct nutrition education activities, consistent with the goals and content described below, at a minimum of two times per calendar year at each site. Providers are encouraged to use existing nutrition education resources from the Basic Food Nutrition Education Program, Washington State University Cooperative Extension, Senior Farmers Market Nutrition Program, or Department of Health’s 5-a-Day Program. 
Nutrition education should include information on physical activity in addition to nutrition. In recognition of the importance of physical activity on health and the prevention of disease, the Dietary Guidelines for Americans recommend being physically active each day. Regular physical activity sustains the ability of older adults to live independently, and benefits individuals with arthritis and those with depression and anxiety. It may reduce the risk of cognitive decline in older adults, and is effective in helping to manage many chronic diseases.

1. Nutrition Education Goals
   1. To create positive attitudes toward good nutrition and physical activity and provide motivation for improved nutrition and lifestyle practices conducive to promoting and maintaining the best attainable level of wellness for an individual.
   2. To provide adequate knowledge and skills necessary for critical thinking regarding diet and health so the individual can make healthy food choices from an increasingly complex food supply.
   3. To assist the individual to identify resources for continuing access to sound food and nutrition information.
2. Nutrition Education Content 
   The Dietary Guidelines, which include maintenance of a healthy weight, daily physical activity, food safety, and moderation of alcohol intake should serve as the framework for all nutrition education activities. The Dietary Guidelines can be found here.
   A nutrition education program makes available information and guidance pertaining to:
   1. Food, including the kinds and amounts of food that are required to meet one's daily nutritional needs.
   2. Nutrition, including the combination of processes by which the body receives substances necessary for maintenance of its functions and for growth and renewal of its components, i.e., ingestion, digestion, absorption, metabolism, and elimination.
   3. Behavioral practices, including the factors which influence one's eating and food preparation habits.
   4. Consumer issues, including the management of food purchasing­ power to obtain maximum food value for the money spent.
   5. Information on physical activity.
   6. Information on the roles of nutrition and physical activity in maintaining health and independence, and preventing or managing chronic diseases such as diabetes, heart disease, high blood pressure, osteoporosis, and arthritis.
3. Nutrition Education Activities 
   Nutrition education consists of activities which provide visual and verbal information and instruction to participants or participants and caregivers in a group or individual setting. The presentations or activities may be led by an RD or ICE, or someone else overseen by an RD or individual with comparable expertise (ICE; see definition under Section VIIB Staffing). The minimum length of one nutrition education presentation is five minutes. 
   Examples of nutrition education activities include: presentations, cooking classes, food preparation demonstrations, field trips, plays, panel discussions, planning and/or evaluating menus, food tasting sessions, question and answer sessions, gardening, physical fitness programs, videos, etc. For home-delivered participants, activities can include the distribution of educational materials.

   When nutrition education is being provided by the nutrition program service provider, all costs associated with the delivery of nutrition education services must be budgeted and charged appropriately to that service.

Nutrition outreach is an activity designed to seek out and identify, on an ongoing basis, the hard-to-reach, isolated, and vulnerable target group of eligible individuals throughout the program area. Nutrition outreach should be provided as necessary to reach the target population. It may be provided by the AAA, nutrition services provider, or by another contracted provider on behalf of one or more nutrition services providers. 

When nutrition outreach is being provided by the nutrition program service provider, all costs associated with the delivery of nutrition outreach services must be budgeted and charged appropriately to that service.

Nutrition screening is a first step in identifying individuals at nutritional risk or with malnutrition. The OAA requires nutrition programs to provide nutrition risk screening. At a minimum, nutrition program service providers must administer the 10 questions from the Nutrition Screening Initiative Checklist (NSI Checklist, Appendix I, https://www.aafp.org/home.html ) to participants and determine their nutrition risk scores. HDNS providers may administer the NSI checklist alone or incorporate the questions into the participant assessments. The number of participants determined to be at high risk must be included in the data submitted to the AAA for the State Performance Report to the Administration on Aging. 

For participants whose screening indicates nutritional risk, service providers should suggest they bring the checklist to their doctor, dietitian or other qualified health or social service professional and ask for help to improve their nutritional health.

Nutrition therapy includes assessment of nutritional status, evaluation of nutritional needs, and interventions or counseling to achieve optimal outcomes. Nutrition counseling, as a component of nutrition therapy, is the 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, working with the individual's physician as appropriate. 
If provided by the nutrition program, nutrition therapy or counseling must be provided by an RD or ICE (see Section VIIB. Staffing). The service includes:

1. Assessing present food habits, eating practices and related factors.
2. Developing a written plan for appropriate nutrition intervention.
3. Assisting the individual to implement the written plan.
4. Planning follow-up care and evaluating achievement of objectives.

Nutritious meals are served to the eligible population in congregate settings, enabling participants to socialize and participate in other activities that may be provided, and delivered to the homes of eligible participants who have difficulty leaving their homes unassisted. Meals must contain at least one-third of the current Recommended Dietary Allowances (see Section VIIE Menus and Menu Planning for detailed nutrient requirements).

Subject to participant consent, all participants who appear to have need for other services should be referred to the Information and Assistance Program.