C-1110 Overview

Revision 21-0; Effective January 15, 2021

AAAs must monitor providers on a regular and systematic basis through desk reviews, on-site reviews, and quality assurance reviews. All phases of monitoring must occur in compliance with the AAA’s written policy and HHSC rules and policies.

C-1120 Subrecipient Monitoring

Revision 21-0; Effective January 15, 2021

AAAs must monitor all subrecipient providers on-site annually. Complete follow-up visits as needed for corrective action or quality improvements, unless the AAA conducts an annual risk assessment. The AAA may monitor subrecipient providers less often based on the results of the risk assessment. If a provider has an agreement with another organization for a portion of its program, it is the responsibility of the AAA to ensure that the provider monitors those organizations.

AAAs must issue a written corrective action plan to the provider for any high priority or significant findings resulting from subrecipient monitoring. The AAA must continue to issue written reports to the provider until they remedy all identified issues.

C-1121 Subrecipient Monitoring for Nutrition Services

Revision 21-0; Effective January 15, 2021

AAA staff who conduct monitoring for nutrition services must have demonstrated knowledge of sanitation, food handling, food preparation, and food storage principles. AAA staff conducting monitoring should be a Certified Food Protection Manager.

Monitoring of the nutrition service provider must ensure compliance with DSHS food safety and food sanitation requirements, and the service standards in this handbook.

Meal provider monitoring may include, but is not limited to:

• review of all local and state level health department inspections;
• meal and menu-related invoices;
• client intakes and assessments;
• food staff certifications;
• staff training documentation;
• use of standardized recipes to monitor for nutrient compliance;
• approval of recipes and menus by dietitian; and
• observation of kitchen personnel during meal preparation and serving.

AAAs must ensure DSHS or the local health authority, as applicable, monitors a food preparation site for food safety and sanitation compliance at least once every 12 months. The meal provider must send a written report of such monitoring to the AAA.

Related Policy

Intake, D-1020
Caregiver Intake, D-1030

C-1130 Contractor Monitoring

Revision 21-0; Effective January 15, 2021

The AAA must monitor the quality of services through follow-up activities with the person receiving the service. They may use monthly reports from contractors to decide whether the service criteria established in its contract with the AAA are met.

Through a reassessment, customer satisfaction survey, or other follow-up activities with people receiving services, the AAA must conduct a quality assurance review to confirm the satisfaction with the services provided by contractors.

The AAA may:

• develop a standard risk assessment process to decide how often services a person received from each contractor are reviewed for quality assurance;
• use a standardized sampling method of all active contractors each month; or
• include all people from all contractors each month in the quality assurance review.

AAAs must conduct an annual satisfaction survey of people receiving OAA services.

C-1131 Contractor Monitoring for Nutrition Services

Revision 21-0; Effective January 15, 2021

The criteria for monitoring nutrition services for quality assurance include the:

• contractor provides the type and frequency of meals as authorized for the eligible person by the AAA;
• contractor has a valid permit, license, or certificate issued by the appropriate regulatory authority, including requirements for certified food protection managers and food handlers;
• contractor follows all federal, state, and local laws, ordinances, and codes for establishments that are preparing, handling, and serving food as evidenced through current sanitation inspection reports submitted timely to the AAA;
• eligible person receiving meals indicates the services are satisfactory; and
• meals meet or exceed the Texas nutrient requirements.

An annual random sampling of menus as served must show compliance with Texas nutrient requirements as evidenced by computer nutrient analysis or the Texas Model for Menu Planning and approval by a dietitian.

AAAs must keep documentation and menu approval by a dietitian for compliance with Texas nutrient requirements for all meals authorized by a AAA case manager for direct delivery to an eligible person.

Related Policy

Target Nutrient Requirements Computer Analysis of Nutrients, Appendix III
Texas Model for Menu Planning, Appendix IV