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United States Value:
Dollars per adult age 60 and older of Older Americans Act funding spent on support services for older adults and caregivers, including congregate meals, home-delivered meals and senior centers
Number of adults age 60 and older served a home-delivered meal per 100 adults age 60 and older with independent living difficulty
37.5 - 16.1
16.0 - 12.1
12.0 - 8.5
8.4 - 6.2
6.1 - 3.6
US Value: $62
Top State(s): Massachusetts: $272
Bottom State(s): South Carolina: $17
Definition: Dollars per adult age 60 and older of Older Americans Act funding spent on support services for older adults and caregivers, including congregate meals, home-delivered meals and senior centers
Data Source and Years(s): U.S. Department of Health and Human Services, Administration for Community Living, State Program Reports, 2021
Suggested Citation: America's Health Rankings analysis of U.S. Department of Health and Human Services, Administration for Community Living, State Program Reports, United Health Foundation, AmericasHealthRankings.org, accessed 2026.
Most older adults value living in their own home safely and independently. Several federal and state programs offer support to older adults in remaining independent at home, which ultimately saves money for both older adults and the federal programs that help fund nursing home care.
Since the Older Americans Act (OAA) was passed in 1965, the Administration on Aging has funded states for community, social and nutritional services that assist older adults and their caregivers. These funds are targeted toward adults age 60 and older with an emphasis on those with the greatest social and economic need, such as low-income older adults, racial and ethnic minorities, older adults living in rural communities and those at risk of institutional care. Services funded by the OAA include accessible transportation, personal care, adult day care, homemaker assistance, case management, home-delivered meals, congregate meals, physical fitness and nutrition education. In 2018, the Administration on Aging provided services to 1 in 7 older adults in the United States.
While the community support measure in this report is limited to OAA dollars, other state and federal funding exists to support older adults. In fiscal year 2022, $129.4 billion in Medicaid long-term services and support spending went toward home- and community-based services such as home health aides, adult day care, meal programs, in-home modifications and assistive equipment, a 12.5% increase from 2021.
Of the 10.8 million individuals served by OAA support programs in 2018:
OAA programs also serve a disproportionate amount of older individuals who live alone, which is a risk factor for nursing home admission and social isolation.
Investment in social services for older adults may help them maintain function and independence. A 2013 study found that increases in home- and community-based services for older adults, such as home-delivered meals, congregate meals or community centers, were associated with a decrease in the proportion of low-care residents in nursing homes. Further research published in 2017 found that Medicaid waivers for home- and community-based services lower the risk of long-term nursing home admissions, enabling older adults to continue engaging in their communities and living in their homes.
Results from the 2023 National Survey of OAA Participants spoke to the effectiveness of community support services — 75% of congregate meals clients and 91% of home-delivered meals clients reported that these services helped them continue to live independently at home.
To learn about the programs and services funded in your community, visit the Administration on Aging’s Eldercare Locator.
AARP. “2024 Home & Community Preferences Among Adults Age 18 and Older.” AARP Research, December 2024. https://www.aarp.org/content/dam/aarp/research/topics/livable-communities/housing/2024-home-community-preferences-report.doi.10.26419-2fres.00831.001.pdf.
Administration on Aging, and Administration for Community Living. “FY 2018 Older Americans Act Report to Congress.” U.S. Department of Health and Human Services, June 2021. https://acl.gov/sites/default/files/about-acl/2021-06/ACL_FY2018%20OAA%20Report%20to%20Congress.pdf.
Klinenberg, Eric. “Social Isolation, Loneliness, and Living Alone: Identifying the Risks for Public Health.” American Journal of Public Health 106, no. 5 (May 2016): 786–87. https://doi.org/10.2105/AJPH.2016.303166.
Segelman, Micah, Orna Intrator, Yue Li, Dana Mukamel, Peter Veazie, and Helena Temkin-Greener. “HCBS Spending and Nursing Home Admissions for 1915(c) Waiver Enrollees.” Journal of Aging & Social Policy 29, no. 5 (October 20, 2017): 395–412. https://doi.org/10.1080/08959420.2017.1319714.
Stepanczuk, Cara, Alexandra Carpenter, Caitlin Murray, and Andrea Wysocki. “Medicaid Long-Term Services and Supports Users and Expenditures by Service Category, 2022.” Chicago, IL: Mathematica, August 29, 2024. https://www.medicaid.gov/medicaid/long-term-services-supports/downloads/ltss-users-expenditures-category-brief-2022.pdf.
Thomas, Kali S., and Vincent Mor. “The Relationship between Older Americans Act Title III State Expenditures and Prevalence of Low-Care Nursing Home Residents.” Health Services Research 48, no. 3 (June 2013): 1215–26. https://doi.org/10.1111/1475-6773.12015.
Ujvari, Kathleen, Wendy Fox-Grage, and Ari Houser. “Spotlight: Older Americans Act.” AARP Public Policy Institute, February 2019. https://www.aarp.org/content/dam/aarp/ppi/2019/02/older-americans-act.pdf.
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