D1 Department of Aging and Adult Services Santa Clara County Social Services Agency CONTENTS Message from the Program Senior Nutrition Program Congregate Meals Program Meals on Wheels Program Friends from Meals on Wheels Mobility Management Program Costs Partnerships Harvey Rose Audit Review Future Challenges and Opportunities DEFEATING MALNUTRITION THROUGH PARTNERSHIPS, INNOVATION, AND BEST PRACTICES The Senior Nutrition Program aims to improve access to food for older adults in Santa Clara County. We look to national trends and best practices to ensure that our actions are backed by evidence?based research. The National Association of Nutrition and Aging Services Program has set the stage for local nutrition providers and, as partners in this national effort, we are focusing on malnutrition prevention, leveraging partnerships, and data?driven decision making to improve our services. Last year was a year of learning and improving. A congregate meal Request for Proposal was released this year, encouraging partners to submit new, innovative models. Through the support of these partnerships, we will offer a weekend evening meal at a low-income older adult housing complex, explore partnerships to offer restaurant meals, and we increased weekend meal programs. We are thankful for the opportunity to provide services in the community, with the constant support of Community Based Organizations. These organizations provide meals and support services despite the increasing cost of personnel, food, and cost of living. We want to acknowledge these groups and thank them for their unwavering support of older adults in Santa Clara County. In the future, we will foster and support data driven decision making, increase access to food across the County, and learn about new ways to increase sustainability across all of our work. We are building outcome measures that can track health improvement over time and releasing the home-delivered meal program Request for Proposal. This will offer organizations the data to support the submission of progressive proposals that will offer much needed updates to the program. We are looking forward to working in true partnership in the year to come. Sincerely, Vanessa Merlano Jennifer Kelly Duane Gott Trisha Lam Belay Tessema Stella Lu Vandana Puri Lilia Roxas Elizabeth Tae Aiysha Ahmed Marilyn Picard Lindsey Tsai Dieuly Nguyen SENIOR NUTRITION PROGRAM The Senior Nutrition Program (SN P) has provided meals to eligible adults 60 years of age and older in Santa Clara County since 1974. The goals of the program are to reduce hunger and food insecurity, increase socialization, and promote the health and well-being of older adults by improving access to nutritious meals and other health and wellness services. A variety of programs offered through the SNP help support older adults aging where they want to age. They include the Congregate Meals Program, Meals on Wheels, Friends from Meals on Wheels, and the Mobility Management program. AT-A-G LANCE 38 unique congregate sites 630,474 congregate meals served 688,022 home-delivered meals served 1,318,496 combined meals served 14,476 combined total unduplicated participants Mobility Management 1,445 16,475 7,286 Shared Rides Gas Cards One-way Rides Bus Passes WELCOMING NEW STAFF Three new staff members joined SNP this year. Our new Accountant Belay Tessema, comes to us from the City and County of San Francisco where he worked as a Principal Accountant. He handles accounts payable, accounts receivable and purchasing. Jennifer Kelly joined us from another Social Services Agency program as a Senior Management Analyst and works on contract development and monitoring legislative files, budgets, data reporting, and site administrative support. Aiysha Ahmed joined us as a Managing Dietitian and comes to us from the Health and Hospital system. PROGRAM HIGHLIGHTS Congregate Meal Program Meals on Wheels Program Each meal provides 1/3 of the Dietary Meets 2/3 of the daily Dietary Reference Reference Intakes for older adults Intakes for older adults Ethnically diverse menus 14 meals per week include: seven Available seven days a week breakfasts, five frozen lunches/dinners, a Provides social opportunities as well as fresh salad and a sandwich/wrap access to exercise programs, classes, Yu-Ai Kai's Neighborhood Meals on legal and financial services and more Wheels prepares and delivers daily hot Transportation assistance available to meals to the Japantown and Berryessa eligible participants neighborhoods Senior Nutrition Program 5 TARGET POPULATION The Older Americans Act of 1965 (0AA) mandates the Senior Nutrition Program to provide nutrition services to all persons age 60 or older. In FY 2017-2018, the Senior Nutrition Program exceeded the targets in all areas. Living Age 75+ Alone 3 69.81% . 0AA Minimum Requirement FY 2017-2018 50.06% Minority Below FPL CONGREGATE MEALS The Congregate Meals Program offers nutritious and healthy lunches at 38 different nutrition sites throughout the County of Santa Clara. These lunches are either cooked on site or are catered by local restaurants or local food vendors and provide a third of the Recommended Dietary Allowance for an older adult. Most congregate meal programs are administered by C805 and smaller groups run by cities. These meal sites allow older adults the opportunity to socialize with one another and access exercise programs, classes, and other activities at the site. The Congregate Meals Program is open to all older adults age 60 or over. Registration In order to receive state and federal reimbursement, all eligible artici ants must re ister. '?du5ive QueStim?s . .p . for Older Adults Pa l'thl Practical Guide to Collecting Data on Sexual Orientation complete a registration form that is . fe'?'z'dem available in several languages (English, Chinese, Spanish, Vietnamese, Korean, Portuguese, Japanese). The forms were updated this year to reflect diversity in sexual orientation and gender identity for older adults. Site Managers were introduced to multiple ways in which to ask inclusive intake questions that take the various experiences around sexual orientation and gender identity into account. CONGREGATE MEALS PARTICIPANT LETTER I am writing to tell you how very much I appreciate the staff of the Roosevelt Nutrition Program. The meals are excellent because the staff works to serve nutritious, delicious and attractive food. They each feel a responsibility to the seniors to make the best lunch possible. The menus are as diverse as are the participants. Although the cook, Nhat Le, successfully has included many items of Asian cuisine because most participants are from Asian countries, he has also supplied American and Mexican entr?es. Good food is popular, no matter where one starts out in life. Nhat makes his own sauces and gravies and other items, or adds ingredients to those purchased, to get the freshest possible taste. I want Nhat to cook at Roosevelt until I can no longer be here. The team is led by Bev Lukac. She is a hard worker with an easy-going style that fits well with her staff and volunteers. I am aware that Bev has many responsibilities but I think that her quick sense of humor speeds her day along. I appreciate a laugh with Bev, or even a smile. I am allergic to broccoli and, bless her heart, she remembers to substitute almost every time. She is my hero for saving me from broccoli and fish. Stephanie Valencia, kitchen aide, under the instructions of Nhat, provides the alternative meals. I am familiar with the good quality of the alternative meals because I do not eat fish. Usually once a week, on fish day, I am given a choice of three entr?es to choose as a substitute for fish. Each item I select, I feel confident that it will be attractive, delicious and nutritious because that's the care that Stephanie puts into the alternative meals. I am aware that everyone does not fill out food surveys, but the comments to my sister and me as we come in to volunteer at the dances after lunch are very positive. These people don't have to say anything about food to us but they do because they truly enjoyed the lunch. Thank you for providing a skilled, caring and professional staff at Roosevelt Community Center Nutrition. It will be my pleasure to continue to avail myself of their services. Sincerely, Marolyn O'Neill CONGREGATE MEALS PARTICIPANT HIGHLIGHTS of participants live 50.4% at or below Federal Poverty Level nutrition education 138 presentations for participants Congregate Meals 8 CONGREGATE MEALS AND OLDER ADULTS SERVED In FY 2017-2018, a total of 630,474 congregate meals were served to 12,815 unduplicated and eligible participants across 38 different nutrition sites in Santa Clara County. CBO Sites City Sites AACI 6,855 Billy DeFrank 1,186 Cubberley 2,202 Eastside 34,256 Gilroy 23,789 ICC 8,242 John 38,227 KACS 10,816 La Comida/Stevenson Los Gatos Villa Vasona 9,311 LOADS 1,472 Morgan Hill 19,021 Mountain View 32,591 Northside 19,652 POSSO 27,372 Salvation Army 28,754 1,996 Self-Help 14,924 Sunnyvale 31,584 Yu-Ai Kai 18,443 Campbell 13,715 Milpitas 17,099 Santa Clara 14,912 Su btotal 45,726 City of San Jose Sites Alma 1 1,008 Almaden 14,496 Alviso 907 Berryessa 31,002 Camden 10,891 Cypress 15,289 Evergreen 23,790 Gardner 8,088 Mayfair 20,793 Roosevelt 30,344 Seven Trees 13,943 Southside 23,420 Willow Glen 16,158 Subtotal 364,619 Subtotal 220.129 FY 2017-2018 Total Meals Served Total 630,474 PROGRAM TRENDS There was a decrease of 14,392 congregate meals served to older adults in FY 2017-2018 (2.23% Decrease). 660,000 7 640,000 7 620,000 600,000 - 580,000 560,000 - 540,000 Congregafe Meals Served 5 Year Trend 648,824 644,866 530,474 62 3,778 588,129 Unduplicaied Clients Served 5 Year Trend 15,000 15,000 14,555 14,000 12,990 13,000 12,000 11.566 11,000 7 1 0,000 7 9,000 1 1 1 3,837 FYl3-l4 FYl7?l8 12,81 5 There was a decrease of 1,022 unduplicated older adults served in FY 2017-2018. (7.39% Decrease). FYl3?l4 FYl6?l7 Congregate Meals 10 PARTICIPANT DEMOGRAPHICS Congregate Meals Participants by Age Range 0.48% 0.70% Age Range Participants 733% Approximately 54.48% of 90 participants in the Congregate I 292734 Meals Program are 75 years of age I 2?568 and older. This represents a 1.53% I 2,529 increase from FY 2016-2017. I 3,453 939 61 Congregate Meals Participants by Race 3.00% 1.65% 0.52% 4.94% 1.37% Race Participants Asuan particupants (54.02%) were the Asian Pacific Islander 6,923 I hi White/Non?Hispanic 4,421 a ges 0g ap Hispanic/Latino 176 group that utilized the Declined to State 633 program. This represents Other/Multiple Race 384 a 1.79% increase in Asian African Ancestry 211 participants from FY American Indian or Alaskan Native 67 2016-2017, Congregate Meals Participants (Asian) Asian Sub-group Participants Chinese 3,510 Filipino 426 Japanese 509 Korean 305 Other Asian 616 Other Pacific Islander 475 Vietnamese 1,082 Participants of Chinese descent were the largest sub-group, making up 50.70% of the Asian demographic. This is unchanged from FY 2016-2017. Congregate Meals 11 PARTICIPANT DEMOGRAPHICS Congregate Meals Participants by Gender 4.59% Gender I Declined to State I Male I Female Approximately 50.43% of Congregate Meals Program Participants live at or below the Federal Poverty Level (FPL). FPL Status I Above 100% FPL I At or below 100household of one 1) I person was $12,060 annually or $1,005.00 Declined To State Congregate Meals Participants by Living Status Living Status Alone Not Alone Declined To State Participants Of the 12,815 older adults participating in the Congregate 588 Meals Program in FY 4931 2017-2018, 56.93% were 7,296 female and 38.48% were male. Congregate Meals Participants by FPL Participants 4,813 6,462 1,540 Participants 3,879 7,776 1,160 Approximately 30.27% of Congregate Meals Participants live alone. CONGREGATE MEALS PARTICIPANT SATISFACTION SURVEY In FY 2017-2018, with the assistance of the Office of Research and Evaluation, SNP redesigned Participant Surveys in order to measure participant outcomes. The results of this survey will be utilized to create baseline measures and engagement strategies to optimize the program's services in subsequent years. There were over 2000 surveys collected. 68.4% of Congregate Meals participants indicate that the reason they enjoy going to nutrition sites is to see friends and socialize. 62.4% of participants indicate that they enjoy going to nutrition sites for food. Senior Nutrition Program helps me to stay healthy. Strongly Agree Agree 90.9% of participants agree or Neutral strongly agree that SNP helps them to stay healthy. Disagree Strongly Disag ree 0% 0% 20% 30% 40% 50% 60% Socialization at the meal site helps me to maintain my overall health. Strongly Agree 90.2% of participants agree or Agree strongly agree that socializing at Neutral 7 congregate meal sites helps them to Disagree maintain their overall health. Strongly Disagree 0% 0% 20% 30% 40% 50% 60% Overall, I am satisfied with the meals provided by the Senior Nutrition Program. 7 Strongly Agree Agree 89.6% of participants agree or Neutral strongly agree that they are satisfied with meals provided by SN P. Disagree Strongly Disagree 0% 0% 20% 30% 40% 50% 60% MEALS ON WHEELS The Home-Delivered Meals Program (Meals on Wheels) delivers meals to homebound, isolated older adults throughout the County of Santa Clara. These individuals are homebound, age 60 or older, have difficulty obtaining food for themselves, and are either frail, disabled, or recovering from an illness. 58% of the participants we serve are women. The Senior Nutrition Program offers two home-delivered meals options: Santa Clara County Meals on Wheels Through a contract with Bateman Community Living, the Meals on Wheels Program provides qualifying older adults with a weekly delivery of 14 meals (five frozen lunch/dinner entr?es, a salad entr?e, a sandwich or wrap, and seven breakfasts) supplemented with milk, bread,juice, and other grocery items. Yu-Ai Kai's Neighborhood Meals on Wheels Yu-Ai Kai's Neighborhood Meals on Wheels program provides eligible older adults in the Japantown and Berryessa areas with a daily hot meal. The Meals on Wheels (MOW) Program is a valued safety-net program for many older adults in our community; it allows homebound older adults to maintain their independence and increases their ability to remain in their homes. Meal Breakdown Born in Indiana, Bob moved to Southern California after high school. He has always been a music lover and enjoys singing songs from the 205 to 70s. He In FY 2017-2018, a total of 688,022 Home-Delivered Meals were served to 1,661 unduplicated older adults. Home-Delivered Option Meals Served Clients is especially inspired by Nat King Cole, Tony Bennett, and Santa Clara County Meals on 674,302 1,596 Frank Sinatra. Bob every Wheels day and competes in singing . ., . competitions in Las Vegas 5 Neighborhood 8,720 65 when he is able to. According Meals on Wheels to Bob, he recently competed Total 688,022 1,661 With one of the top 10 American Idol contestants. He says, can sing better than threefourths of the meme MOW PARTICIPANT HIGHLIGHTS that were there.? Eight years 380? 30b Started of participants are Iosmg his Sight and IS now 48% over 80 years legally blind. Since then, it has been a challenge to cook. He says, often burn myself.? As such, Bob is grateful for MOW since food is delivered directly to his home. Besides the food, Bob appreciates the service from MOW driver Cindy. She is friendly and courteous, asking about his health when she delivers his meals. Once, when Cindy was unable to locate Bob in his home, she called the police. He felt good knowing that people care. ofage of participants 79.2% live at or Federal Poverty Level 57.6% of participants live alone emergency meals 2,850 distributed to participants PROGRAM TRENDS Meals on Wheels Served 5 Year Trend There was an increase of 2,789 meals served to older adults in FY 2017-2018. (0.41% Increase) Unduplicaled Clienls Served 5 Year Trend 20,000 30,000 682,988 687,815 685,233 688,022 30,000 50,000 40,000 20,000 599,243 30,000 30,000 . . . FYl3-l4 FY15-16 1,900 1,800 There was a decrease of 96 1,700 unduplicated older adults served in FY 2017-2018. (5.46% Decrease) ?600 1,500 1,400 PARTICIPANT DEMOGRAPHICS 1,300 Meals on Wheels Participants by Age 07% 0.3% ,757 FYl2-l3 Age Range Participants 116 215 275 236 526 277 11 FYl?-l7 FYl7-l8 The largest age group participating in the Meals on Wheels Program is in the 80 89 Age Group with 526 participants (approximately Meals on Wheels 16 PARTICIPANT DEMOGRAPHICS Meal on Wheels Participants by Race 0.2% 0.5% Race Participants The Meals on Wheels I White/Non-Hispanic 958 . I Asian 272 program prowdes meals . I Hlspanlc/Latlno 266 to a dlverse grOUp Of I African Ancestry 117 homebound older adults. I Other/Multiple Race 35 I Declined to State 4 I American Indian or Alaskan Native 9 Meals on Wheels Participants by Gender . Of the 1,756 older adults Gender Partlc'pants participating in the Meals on I Declined to State 3 Wheels Program in FY 2017-2018, 57.92% were female and 39.18% were male. Meals on Wheels Participants by FPL 1.1% About 79.2% of Meals on Wheels Participants live at or Status participants below the Federal Poverty Level I Above 100% FPL 326 (FPL). This represents a 43% I At or below 100% FPL 1,316 increase from FY 2016-2017. I Declined To State household of one 1) person was $12,060.00 annually or $1005.00 PARTICIPANT DEMOGRAPHICS Meals on Wheels Participants by Living Status Living Status Participants 516% Of Meals on Alone 956 Wheels Participants live Not Alone 691 alone. This represents a 5.3% Dec'ined To State 14 increase from FY 2016-2017. MOW PARTICIPANT SATISFACTION SURVEY The meals provided by the MOW Program help me to maintain my overall health. 89.9% of MOW Strongly Agree participants agree Agree or strongly agree that meals provided Neutral by MOW help them Disagree maintain their Strongly Disagree overall health. 0% 10% 20% 30% 40% 50% The MOW Program has assisted me in maintaining my independence. 89.9% of MOW strongly Agree participants agree or strongly agree that the MOW Neutral program helps them maintain their independence. Strongly Disagree Agree Disagree 0% 10% 20% 30% 40% 50% FRIENDS FROM MEALS ON WHEELS The Friends from Meals on Wheels Program (FMOW) was implemented on April 1, 2016. The goal of FMOW is to increase socialization for the County of Santa Clara?s isolated and homebound older adults. The Senior Nutrition Program, in collaboration with The Health Trust, is working to ensure the frailest and eldest adults in Santa Clara County are receiving services that increase their physical and mental health, happiness, and quality of life. The Health Trust is adopting a new social isolation tool that will help it track its participant?s outcomes more effectively. Additionally, it is expanding the evidence-based programs used for its exercise visits to better meet client needs. Activities provided to FMOW participants include: - initial home-visit assessments, - exercise home-visits or telephone calls, - subsequent home?visits, - pet food deliveries, and - telephone calls, - birthday card and gift deliveries. PARTICIPANT DEMOGRAPHICS 61% of participants 123 live alone unduplicated older adults served MOBILITY MANAGEMENT PROGRAM SNP Administration provides coordination, verification, and distribution of mobility options (gas cards and bus passes) to eligible SNP participants and provides paratransit rides through a partnership with the Santa Clara Valley Transportation Authority (VTA) so that SNP participants with transportation barriers can attend nutrition sites. Senior Nutrition Transportation Services SNP Administration distributed a total of 8,731 benefits (gas cards and bus passes) and reimbursed VTA for providing a total of 16,475 paratransit rides to nutrition program participants in FY 2017-2018. 16, 475 paratransit rides 8731 gas cards and gbus passes Eligibility Service Trends In order to receive transportation benefits, a participant must submit a Mobility Management Program Registration Form and attend lunch at the home site at least 8 times per month2017-2018 Senior Nutrition Transportation Service Trend Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr Bus Puss Gas Card Paratrunsit Rides Jun PROGRAM COSTS SENIOR NUTRITION PROGRAM EXPENDITURES In FY 2017-2018, the Senior Nutrition Program expended $9,137,782. Of the $9,137,7823 expended by the Senior Nutrition Program, $359,587 was utilized for transportation services through the Mobility Management Program (exclusively funded from the County General fund), $154,500 went towards funding the Friends from Meals on Wheels Program, and $7,229,849 funded nutrition services through the Congregate Meals Program and Meals on Wheels Program. An inventory item fund was awarded by the Board of Supervisors to pilot a meal site at Viet Tu Te. $10,279 was spent towards the purchase of kitchen equipment for this site. Expenditures Funding Sources Congregate Meals $5,039,570 NSIP $999,014 Administrative $1,383,567 Title (Federal) $1,455,581 Mobility Management $359,587 Title (State) $325,169 Meals on Wheels $2,190,279 Contributions $748,193 Friends from Meals on Wheels $154,500 County General Fund $5,599,546 Inventory Item (Viet Tu Te) $10,279 Total Funds $9,127,503 Total Expenditures $9,137,782 Federal and State Funding SNP receives funding from the Older Americans Act of 1965 (OAA) Title Funds and Nutrition Services Incentive Program (NSIP) Funds. Each year, the California Department on Aging allocates OAA and NSIP funds across the 33 Area Agencies on Aging within California. The then disburse the funds within their local jurisdiction toward a variety of older adult services including older adult work programs, supportive services, nutrition services, etc. Sourcewise is the designated for the County of Santa Clara. In addition to federal and state funding, the County General Fund is appropriated to the SNP to allow a greater number of participants the ability to attend lunches at nutrition sites or to receive MOW. We thank the Board of Supervisors for their unrelenting support of our program. PARTNERSHIPS Volunteers Volunteers are an indispensable part of every congregate meal program. They are a tremendous resource that builds service capacity at congregate meal sites. The Senior Nutrition Program is grateful for the dedication of volunteers. San Jose State University (SJSU) Work Study Program The Federal Work Study Program from SJSU provides the Senior Nutrition Program with student assistants to assist with office projects. Students gain workplace A Guide for Food Options and Other Resources County experience while continuing their education at SJSU. Guide for Food Options" was created by a work study student and approved for distribution by the staff of SN P. San Jose State University Dietetic Internship Program In Fall 2017, the SNP accepted and trained its first Food Service Management intern, Nancy Liu, from the San Jose State Dietetic Internship Program. Nancy had the opportunity to work alongside SNP registered dietitians and site managers located at the Congregate Meals sites. She was educated on the roles and responsibilities of a registered dietitian. She completed all required Food Service competencies and provided more than 20 PowerPoint presentations on Nutrition and Food Safety to older adults. One project she completed was the creation of the program?s ?Guidelines for New Senior Nutrition Sites.? This guideline will be used for evaluating new programs. A poster version of the guideline was presented at SJSU. It is a privilege for SNP to train future dietitians. Second Harvest Food Bank (SHFB) SNP partners with Second Harvest Food Bank to provide free access to bulk food to reduce raw food costs. Congregate sites picked up 84,549 pounds of food produce at SHFB, saving an estimated $125,391.35. (84,549 SHFB designated value of $1.68/lb) SNP staff gives back to the community On November 20th, 2017, the staff of SNP volunteered time at the SHFB. Volunteers sorted bread into boxes to be distributed on Thanksgiving day. On December 15, 2017, the staff of SNP served lunch to the older adults at Gilroy Senior Caf?. This holiday luncheon was well-attended and the staff had a chance to interact and dine with the older adults at the center. Department of Employment and Benefit Services SNP partnered with CalFresh to enroll more older adults through the Elderly Simplified Application Process. Education was provided to our partners to increase awareness regarding the revised annual recertification process. Rebuilding Together SNP collaborated with Rebuilding Together to repair the homes and rebuild the lives of participants in our Meals on Wheels program. Projects included bathroom and roof repairs at no cost to the eligible older adult. Public Health Department SNP partnered with PHD to increase awareness about the Market Match Program and farmers market vouchers. Training was provided to site managers and vouchers were distributed at various meal sites. The dietitians at SNP collaborated with the Nutrition Education and Obesity Prevention program to spread unified messages on Health and Disease prevention including, but not limited to, Diabetes Prevention. HARVEY ROSE AUDIT REVIEW On February 25, 2015, the Management Audit Division of the Board of Supervisors (Harvey Rose) presented the Management Audit of the Senior Nutrition Program to the Finance and Government Operations Committee. The Senior Nutrition Program has successfully implemented several of the Harvey Rose recommendations since the release of the Management Audit Report. Progress on the remaining recommendations are as follows: Section 5. Distribution of Meal Sites Relative to Distribution of Low-Income Seniors Harvey Rose Recommendation Agency Update 5.1 5.2 5.3 Examine options for providing at least lunchtime service of salads and sandwiches in the George Shirakawa Community Center or other appropriate site within ZIP Code 95122 to reach this area's many low-income seniors. (Priority 1) Examine options for providing congregate meal services in ZIP codes 95 127, 95 121, 95 133, 95118, 95131, 95051, and 95136, with the goal of expanding the reach of daily congregate meals to the neighborhoods of 80 percent of the County's low-income seniors. (Priority 1) Establish a goal to provide congregate meals within the ZIP codes of the County's low-income seniors' residences. Opened a new site (Viet Tu Te) in ZIP code 95122 to provide meals to the older adults in that community. In Progress. In Progress. FUTURE CHALLENGES AND OPPORTUNITIES Meal Reimbursement Rates reimbursement rates have remained relatively flat since 2012, increasing anywhere from 5-12% for all food access programs. According to the Administration on Community Living Older Americans Act Nutrition Program Evaluation: Meal Cost Analysis report released September 2015, the average, weighted cost by the program was $10.69 for a congregate meal and $11.06 for a home-delivered meal. When you look at figures by geographic region, the disparity in reimbursement is exacerbated. For the Western region, the average weighted cost for congregate and home-delivered meals was $12.13 and $14.32, respectively. Our current reimbursement rates for congregate and home?delivered meals are $8.43 and $9.57, respectively. The current reimbursement rate model is not sustainable for our non-profit providers and may, ultimately, lead to organizations opting out of participation in the SN P. Recommendation: Per meal reimbursement rates for congregate meals are low. Our providers are shouldering a large portion of the program costs and this may not be sustainable. Cook-on-site meal rates should be brought up to a rate at least equal to the catered meal rate of $9.57. Innovative Programs to Close the Food Access Gaps SNP has been providing food access through two programs: the congregate and home-delivered meals programs. The face of our County?s older adult population, along with their needs, are changing. In September 2016, Change Helpers, a consultant hired by SNP, published a Review and Recommendations Report for the congregate meals RFP released in November 2017. It identified a number of innovate programs it called ?Best ideas" that did not exist in the County, but which could be adopted, including a restaurant meals voucher program. Along this vein, the County will be partnering with The Health Trust to implement a restaurant voucher pilot program with the ultimate goal of closing food access gaps in areas considered food deserts and attracting clients that do not access traditional congregate meal programs. This last year, SNP experienced a 7.39% drop in congregate meal participation, yet poverty in the older adult population is increasing. Recommendation: Design and develop a restaurant voucher meal program business plan for the County of Santa Clara. Reliable, Consistent, and Cost Effective Data Collection The SNP has been using data collection software that is managed by a third party through an off-site platform. Management, reliability, and need for real time data have been recurring issues with this platform. In addition, the program is looking to collect outcomes focused data that remains difficult with the current platform's inconsistencies and inability to produce live data. Recommendation: Create and implement a user-friendly database that would replace the labor intensive system that is currently in place. This system would better meet the needs of our program in capturing big data and the needs of community based organization service providers.