Home-Delivered Meals Provider Manual
1000, Introduction
Revision 14-1; Effective September 19, 2014
The Texas Health and Human Services Commission (HHSC) contracts for Home-Delivered Meals (HDM) with:
- Provider agencies that receive funding only under Title XX (Social Services Block Grant) of the Social Security Act (Title XX-only HDM providers);
- Provider agencies that receive funding under Title III of the Older Americans Act (OAA) of 1965 and Title XX (common providers);
- Provider agencies that receive funding only under Title III of the OAA of 1965 (Title III providers);
- Provider agencies that receive funding only under Title XIX (Medicaid) of the Social Security Act (Title XIX providers);
- Provider agencies that receive funding under Title XIX (Medicaid) of the Social Security Act and Title XX (Social Services Block Grant) of the Social Security Act (uncommon providers); and
- Provider agencies that receive funding under Title III of the Older OAA of 1965, Title XIX (Medicaid) and Title XX (Social Services Block Grant).
The provisions in this manual apply to provider agencies that receive Title XX and/or Title XIX funding and to the Title XX/Title XIX funded portion of a common provider. This manual does not apply to Title III funded provider agencies or to the Title III funded portion of a common provider. A common provider and a Title III-only provider should consult with its local Area Agency on Aging (AAA) for requirements that apply to the Title III HDM program. However, the manual does include Title III requirements that also apply to provider agencies that receive Title XX and/or Title XIX funding.
1100, Home-Delivered Meals Eligibility
Revision 14-1; Effective September 19, 2014
A provider agency serves individuals who have been determined eligible by Texas Health and Human Services Commission (HHSC) case managers based on age and functional need criteria described in HHSC rules at 40 Texas Administrative Code, Chapter 48, Subchapter H. HHSC case managers initiate the Home-Delivered Meals referral process by sending Form 2101, Authorization for Community Care Services, to a provider agency to begin the delivery of eligible meals to eligible individuals. Service authorization is only sent to the provider agency of the individual’s choosing.
1200, Purpose, Rule
Revision 13-0; Effective September 3, 2013
In this section, as well as other sections of this manual, references to one or more relevant rules are cited when no further explanation of the requirement is necessary.
40 Texas Administrative Code, Section 55.1.
Additional rules and standards, both federal and state, may apply, as found in food management standards set by the Department of State Health Services and the Monitoring Tool used by Texas Health and Human Services Commission (HHSC) contract monitors.
1300, Definitions, Rule
Revision 13-0; Effective September 3, 2013
40 Texas Administrative Code, Section 55.3.
Rural county has the meaning established by the United States Department of Agriculture (USDA), which states that a rural county in Texas contains a population of less than 50,000 individuals.
2000, Contract Requirements
2100, Contract Requirements
Revision 13-0; Effective September 3, 2013
2110 Contracting Requirements for Provider Agencies, Rules
Revision 13-0; Effective September 3, 2013
40 Texas Administrative Code, Section 55.5, Contracting Requirements for Provider Agencies.
40 Texas Administrative Code, Chapter 49, Contracting for Community Services.
2111 List of Excluded Individuals and Entities (LEIE)
Revision 13-0; Effective September 3, 2013
All provider agencies must comply with requirements to identify individuals and entities excluded from participation in federal and state health care programs.;
2112 Subcontracting
Revision 13-0; Effective September 3, 2013 The provider agency is responsible for the performance of the subcontractor. If Texas Health and Human Services Commission (HHSC) determines that the subcontractor is not in compliance with program requirements, HHSC will take action against the provider agency, not the subcontractor.
2113 Contract Amendment
Revision 13-0; Effective September 3, 2013
An amendment is a revision to an existing contract. The provider agency may identify a need and initiate an amendment.
A provider agency must submit an amendment request in writing, using company letterhead, and the request must be signed by the authorized signature authority. HHSC will not accept an amendment request that does not meet this requirement. The contract amendment must be completed following the appropriate amendment process. The contracting forms can be found under HHS Forms site. Contact your HHSC contract manager in order to process any contract amendment.
2120 Nutritional Risk Assessment and National Aging Program Information Systems (NAPIS) Reporting
Revision 13-0; Effective September 3, 2013
The Administration on Aging (AoA) requires the Texas Health and Human Services Commission (HHSC) to report program information in the National Aging Program Information System (NAPIS). A provider agency must collect, compile and report the required NAPIS information identified below to the HHSC contract manager.
A provider agency must:
- Develop a nutritional risk score for each individual to whom it delivers a meal, with the exception of individuals receiving meals under Title XIX (Community Based Alternatives), if the individual is:
- 60 years of age or older; or
- the spouse (regardless of age) of an individual 60 years of age or older.
Use the Nutritional Risk Assessment which includes the Determine Your Nutritional Health checklist (see links below). Revisions to this form are not allowed. The Nutritional Risk Assessment form is available in both English and Spanish. Each answer on the Nutritional Risk Assessment form is assigned a certain value. The provider agency adds the values to get the nutritional risk score. The nutritional risk score places an individual in a nutritional risk category as follows:
Nutritional Risk Score Nutritional Risk Category 0 - 2 Good Nutritional Health 3 - 5 Moderate Nutritional Risk 6 or More High Nutritional Risk - Complete the Nutritional Risk Assessment form for each individual at least annually.
- Keep the completed Nutritional Risk Assessment on file for each individual.
- A provider agency must use the Nutritional Risk Assessment form. Revisions to this form are not allowed.
- The Nutritional Risk Assessment form is available in both English and Spanish. The Nutritional Risk Assessment is used to develop a nutritional risk score for each individual. Each answer on the Nutritional Risk Assessment form is assigned a certain value. The provider agency adds the values to get the nutritional risk score.
- The provider agency must give the Determine Your Nutritional Health Handout to an individual each time the Nutritional Risk Assessment form is completed. The Determine Your Nutritional Health Handout is also available in Spanish.
- The provider agency must encourage each individual to take the appropriate action for his nutritional risk category indicated on the Determine Your Nutritional Health Handout.
- Form #AIAAA_NRA_ES 2.0: Nutritional Risk Assessment (English and Spanish PDF)
- Form #AIAAA_NRA_ES 2.0: Nutritional Risk Assessment (English and Spanish Word)
- Form #AIAAA_NRAHH_ES 1.0: Determine Your Nutritional Health Handout (English and Spanish PDF)
- Form #AIAAA_NRAHH_ES 1.0: Determine Your Nutritional Health Handout (English and Spanish Word)
2121 NAPIS Reporting Requirements
Revision 13-0; Effective September 3, 2013
A common provider and a Title III provider must contact its Area Agency on Aging (AAA) for National Aging Program Information System (NAPIS) reporting requirements.
A provider agency that receives Title XX funding must collect and report the number of Nutritional Services Incentive Program (NSIP) eligible individuals and the following demographic information to its Texas Health and Human Services Commission (HHSC) contract manager quarterly on an Excel spreadsheet, template provided by HHSC . See 4920, Nutrition Services Incentive Program Policies, 4921, Reporting Requirements for NSIP Eligible Meals, 4921.2, Common Providers, 4921.3, HHSC Title XX-Only Provider Agencies, and 4922, Other Requirements, for information on NSIP policies and reporting requirements.
The reporting must include the number of:
- males and females, and the number of individuals whose gender information is unavailable;
- individuals who live in a rural county, and the number of individuals whose county information is unavailable;
- individuals living in poverty, and the number of individuals whose poverty (or income) information is unavailable;
- To determine whether an individual is living in poverty, select HHS Poverty Guidelines for 2023. Refer to Frequently Asked Questions for the official definition of poverty as defined by the Office of Budget and Management;
- Using the Poverty Guidelines Chart for the 48 contiguous states and the District of Columbia, compare the individual’s annual income to the poverty guideline for persons in family/household of one;
- For married couples, compare their joint annual income to the poverty guideline for persons in a family/household of two; and
- Starting with the amount shown, divide by 12 months to determine the monthly amount.
- individuals by ethnicity and the number of individuals whose ethnicity information is unavailable. Ethnicity is defined as:
- not Hispanic or Latino; or
- Hispanic or Latino.
- individuals by race or the number of individuals whose race information is unavailable. Race is defined as:
- White (alone with no other races) – Non-Hispanic;
- White (alone with no other races) – Hispanic;
- American Indian or Alaskan Native (alone with no other races);
- Asian (alone with no other races);
- Black/African American (alone with no other races);
- Native Hawaiian or Pacific Islander (alone with no other races); or
- Persons reporting some other race.
A provider agency that receives Title XX funding must:
- Break down this demographic information by the number of activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and then by age;
- Not report an individual more than once per federal fiscal year (October 1 through September 30); and
- Provide the NAPIS report quarterly to its contract manager no later than the due date on the following chart.
Quarter | Months Covered | Report Due |
---|---|---|
1st | October, November, December | January 16th |
2nd | January, February, March | April 16th |
3rd | April, May, June | July 16th |
4th | July, August, September | October 16th |
2200, Staff Requirements
Revision 13-0; Effective September 3, 2013
2210 Staff Requirements, Rule
Revision 13-0; Effective September 3, 2013
A common provider must follow the staff requirements according to both 40 TAC Chapter 55 (see link below) and Chapter 85, Implementation of the Older Americans Act. A provider agency should contact its Area Agency on Aging representative for questions related to Title III and Chapter 85.
A provider agency that receives Title XX and/or Title XIX funding must follow the staff requirements according to TAC Title 40 Chapter 55.
2300, Training Requirements, Rule
Revision 13-0; Effective September 3, 2013
2400, Nutrition Education, Rule
Revision 13-0; Effective September 3, 2013
2500, Compliance with Laws and Regulations, Rule
Revision 13-0; Effective September 3, 2013
3000, Nutrition and Meals
Revision 13-0; Effective September 3, 2013
This section outlines the nutritional and meal requirements as part of menus, diets and packaging of home-delivered meals for all providers that receive funding from Title XX or Title XIX.
Pages in this section:
3100, Menus, Rule
Revision 13-0; Effective September 3, 2013
3200, Standard Recipes, Rule
Revision 13-0; Effective September 3, 2013
3300, Modified Diets, Rule
Revision 13-0; Effective September 3, 2013
3400, Frozen, Chilled, or Shelf-Stable Meals, Rule
Revision 13-0; Effective September 3, 2013
3500, Meal Packaging, Rule
Revision 13-0; Effective September 3, 2013
4000, Service Delivery
4100, Service Initiation, Rule
Revision 13-0; Effective September 3, 2013
40 Texas Administrative Code, Section 55.25.
4110 Service Initiation
Revision 13-0; Effective September 3, 2013
The provider agency must initiate services within ten calendar days from the begin date on Form 2101, Authorization for Community Care Services. Form 2101 must be completed and returned to the Texas Health and Human Services Commission (HHSC) case manager within 21 calendar days from the date of the referral. The HHSC case manager will inform the provider agency in the Comment section of Form 2101 of any special circumstances that are relevant to the individual's service provision, such as exceptions to service delivery requirements.
4200, Case Manager Community Care for Aged and Disabled Handbook
Revision 13-0; Effective September 3, 2013
For information on case manager activities related to enrolling an individual, look in the Case Manager Community Care for Aged and Disabled Handbook.
4500, Meal Services, contains specific information on Home-Delivered Meals program requirements that the Texas Health and Human Services Commission (HHSC) case manager completes.
4300, Service Requirements, Rule
Revision 13-0; Effective September 3, 2013
40 Texas Administrative Code, Section 55.27.
An HDM provider or subcontractor performing meal delivery must monitor each meal delivery route annually to verify meals are delivered within the required time frames. Documentation of monitoring must include the route name/number, the date of the monitoring, and the times of the first and last meal deliveries.
A HHSC HDM provider is required to document, for each meal delivery site, a record of the hot and cold foods served on the last meal delivery day of the last month of the review period. Documentation is to include the date and time each hot or cold food item was removed from temperature control and the temperature of the item when removed from temperature control. Temperature readings are not required on a test meal at the end of the route. However, all meals must be delivered within four hours of removal from temperature control.
When meals for more than one day of service are delivered and the individual becomes ineligible for the HDM program, meals delivered to be consumed past the date of the individual's ineligibility are considered invalid and are not reimbursable.
4310 Waiver Request
Revision 13-0; Effective September 3, 2013
40 Texas Administrative Code, Section 55.5(c)(1).
40 Texas Administrative Code, Section 55.21.
40 Texas Administrative Code, Section 55.27.
Provider agencies must submit a waiver request to the Texas Health and Human Services Commission (HHSC) contract manager during the rate negotiation process if it determines that delivery of frozen or shelf-stable meals is required for certain individuals within its contracted service area. Any waivers granted will be effective for a period not to exceed one fiscal year. The provider agency must not exceed the parameters of the waiver description or implement the waiver of the requirement for delivery of a hot meal five days a week, for delivery of multiple meals fewer than five days per week, or to deliver meals during hours other than the delivery window, prior to the HHSC contract manager giving approval of the waiver request.
Effective in each new federal fiscal year (FFY), a provider agency must complete a waiver request during the budget-based rate negotiation process for each service area in which the provider agency has a contract and is planning to implement or continue a waiver. The provider agency submits the completed form to the HHSC contract manager with each FFY's budget-based rate negotiation documents.
HHSC will consider for approval a waiver only if the provider agency assures it will:
- deliver multiple meals to an individual at least one day per week;
- make contact with the individual at least three days per week, including the day of meal delivery;
- provide continuity of daily hot meal service to an individual who cannot use a frozen or shelf-stable meal;
- notify HHSC of a significant change of condition of an individual, as required by rule;
- handle alternate meals safely (e.g., frozen, chilled or shelf-stable);
- provide safe and sanitary storage, thawing and preparation capacity; and
- comply with rules in Texas Administrative Code Section 55.27 regarding temperature control, marking of meals and time in transit.
If approved, HHSC incorporates the waiver description for the current FFY into the provider agency contract with the budget amendment for the period. The contract manager will review a provider agency's compliance with the provisions of the waiver as a component of HHSC on-site monitoring of the provider agency's program. The HHSC contract manager considers whether the waiver reduced the provider agency's HDM operating costs for purposes of the next budget negotiation.
The provider agency may not implement provisions of the proposed waiver description without HHSC approval and may not exceed the parameters of the approved waiver description. The provider agency must obtain a new budget waiver to change delivery frequency or meal format after execution of the amendment.
The approval is made during the budget-based rate negotiation process. See 5230, Budget-Based Rate Negotiation, for additional information on budget-based rate negotiation.
Form 2101, Authorization for Community Care Services, to authorize fewer than five hot meals a week for an individual. See 4310, Waiver Request, and 5230, Budget-Based Rate Negotiation, for information about when a waiver request is needed.
4400, Significant Changes, Rule
Revision 13-0; Effective September 3, 2013
4500, Provider Agency Quality Control Measures, Rule
Revision 13-0; Effective September 3, 2013
4600, Suspension of Services, Rule
Revision 13-0; Effective September 3, 2013
4700, Service Plan Changes, Rule
Revision 13-0; Effective September 3, 2013
4800, Termination of Services, Rule
Revision 13-0; Effective September 3, 2013
4900, Recordkeeping, Rule
Revision 13-0; Effective September 3, 2013
40 Texas Administrative Code, Section 55.39.
4910 Retention of Contract-Related Records, Rule
Revision 13-0; Effective September 3, 2013
40 Texas Administrative Code, Section 69.158.
4920 Nutrition Services Incentive Program Policies
Revision 13-0; Effective September 3, 2013
The Administration on Aging (AoA) uses Nutritional Services Incentive Program (NSIP) reports to determine the OAA NSIP funds allotted to Texas. These funds are used to purchase additional OAA eligible meals in the following federal fiscal year (FFY).
HHSC has elected to receive NSIP cash in lieu of commodities for the state of Texas. All providers who receive either Area Agencies on Aging (AAA) funding or Title XX funding benefit from the NSIP cash HHSC receives. Title XX HDM providers are not eligible for NSIP funds if they receive donations from U.S. Department of Agriculture (USDA) commodities and may not solicit funds from meal recipients if food received by the HDM provider include USDA donated food.
NSIP policy requires Title XX HDM providers to ask individuals for voluntary donations towards the cost of the meals. Title XX HDM program rules, 40 Texas Administrative Code §55.41, will be revised to allow for requests for funds from individuals to voluntarily make donations towards the cost of the meal.
Title XIX HDM individuals are not included in the counts for NSIP funds and the HDM provider must not solicit funds from individuals receiving Title XIX funded meals.
4921 Reporting Requirements for NSIP Eligible Meals
Revision 13-0; Effective September 3, 2013
This section contains instructions for common providers and for provider agencies receiving Title XX funding.
To be eligible for Nutritional Services Incentive Program (NSIP) funds:
- Meals must be served to:
- A person 60 years of age or older.
- A spouse (regardless of age) of a person 60 years of age or older who is receiving an NSIP eligible meal.
- Meals must meet the minimum nutritional requirements:
- Contain a minimum of 33 1/3% of the dietary reference intakes (DRIs) daily recommended dietary allowances RDA), as stated in Section 339 of the Older Americans Act.
- Comply with the most recent Dietary Guidelines for Americans, with the most recent DRIs established by the Texas Health and Human Services Commission.
- Be based on menus that have prior approval by a dietitian licensed by the Texas State Board of Examiners of Dieticians or who has a degree in food and nutrition, dietetics or food service management.
- The provider agency must not charge a fee to a meal recipient.
- The provider agency may accept contributions in accordance with rule 40 Texas Administrative Code Section 55.41(b).
4921.1 Title XX Individual Contributions to Meals
Revision 13-0; Effective September 3, 2013
The following procedures are to be used by Title XX HDM providers when requesting donations from Title XX HDM individuals. These same procedures are used by Area Agencies on Aging (AAA) HDM providers.
Title XX HDM providers:
- must provide an individual with an opportunity to donate toward the cost of the meal;
- must not require an individual to donate towards the cost of the meal;
- may provide an individual with a donation schedule that only suggests an amount based on the income range of the program population being served, but may not determine an individual's income using an income test;
- must protect the individual's privacy with respect to the individual's donations;
- must establish appropriate procedures to secure and account for all donations made; and
- must use all of the individual's donations to support or expand services for which the individual donated, in accordance to state and federal laws, rules and regulations.
HDM providers are responsible for ensuring individuals receiving Title XX HDM do not feel pressured or harassed to contribute to the cost of meals. Historically, individuals receiving Title XX HDM have lower incomes and decreased ability to contribute to the cost of services.
4921.2 Common Providers
Revision 13-0; Effective September 3, 2013
Common providers must prepare two separate reports for Nutritional Services Incentive Program (NSIP) eligible meals.
Common providers must report all Title XX meals monthly using the procedures outlined below.
What to Report: The number of Title XX meals provided in the previous month.
Required Form: Form 2071, Monthly Report of Nutrition Services Incentive Program (NSIP) Eligible Meals and Title XX Meals.
Report To: HHSC contract manager.
Due Date of Report: 10th of each month.
Common Providers must report all Area Agency on Aging (AAA) meals and all other NSIP eligible meals using the procedures outlined below.
What to Report: The number of AAA meals and all other NSIP eligible meals provided in the previous month.
Required Form: Use the method established by the AAA.
Report To: Designated AAA contact.
Due Date of Report: Established by the AAA.
4921.3 HHSC Title XX-Only Provider Agencies
Revision 13-0; Effective September 3, 2013
Provider agencies receiving Title XX funds must prepare a single monthly report of Nutritional Services Incentive Program (NSIP) eligible meals. Monthly reporting must include Title XX meals as well as other NSIP eligible meals using the procedures outlined below.
What to Report: The number of NSIP eligible Title XX meals and other NSIP eligible meals provided in the previous month.
Required Form: Form 2071, Monthly Report of Nutrition Services Incentive Program (NSIP) Eligible Meals and Title XX Meals.
Report To: HHSC contract manager
Due Date of Report: 10th of each month.
HHSC collects and aggregates this information in order to comply with OAA reporting requirements.
4922 Other Requirements
Revision 13-0; Effective September 3, 2013
Required Supporting Documentation
A provider agency participating in the NSIP program must maintain eligibility documentation as outlined in Form 2071, Monthly Report of Nutrition Services Incentive Program (NSIP) Eligible Meals and Title XX Meals, including site rosters and documented eligibility for all meals reported.
The Texas Health and Human Services Commission (HHSC) contract management or Area Agency on Aging (AAA) staff, or both, will conduct on-site reviews to verify provider agencies are maintaining the required information. AAA or HHSC contract management staff will each reconcile the information on the site roster and supporting documentation with the number of eligible meals reported. If errors are found, the provider agency may need to take corrective action.
Records Maintenance
A provider agency must maintain a copy of all documentation related to eligible meals reported as NSIP eligible, according to the terms of its contract or until all audits, claims or litigation have been resolved.
5000, Billing and Reimbursement
5100, Billing and Claims
Revision 13-0; Effective September 3, 2013
5110 Billing and Claims Payment, Rule
Revision 13-0; Effective September 3, 2013
40 Texas Administrative Code, Section 55.41.
Rule Section 55.41, regarding reimbursement of two consecutive failed delivery of meals, is applicable unless otherwise stated. See 4300, Service Requirements, Rule, for billing exception.
5120 Claims and Payment Information
Revision 13-0; Effective September 3, 2013
A provider agency may access information about, or request assistance with, claims and payments through the Texas Medicaid and Healthcare Partnership (TMHP) website on the Provider for Long Term Care Web page.
5200, Rate Setting
Revision 13-0; Effective September 3, 2013
5210 HHSC Rate Analysis
Revision 13-0; Effective September 3, 2013
A provider agency may access rate information at the Health and Human Services Commission
(HHSC) Rate Analysis website.
5220 Reimbursement Methodology for Home-Delivered Meals, Rule
Revision 13-0; Effective September 3, 2013
1 Texas Administrative Code Section 355.511.
See Appendix III, Cost Determination Process, for information.
5230 Budget-Based Rate Negotiation
Revision 13-0; Effective September 3, 2013
The Texas Health and Human Services Commission (HHSC) posts budget-based rate negotiation documents and detailed instructions on the Home-Delivered Meals (HDM) provider page.
A provider agency must use these documents during budget-based rate negotiations with the HHSC contract manager to develop a per meal unit rate for the upcoming Federal Fiscal Year (FFY). In addition, a provider agency that is a common provider will be contacted by its Area Agency on Aging (AAA) to negotiate per meal unit rates for those meals. AAAs and HHSC continue to jointly negotiate budgets and rates for common providers.
HHSC contract managers and provider agencies, as applicable, will review projected expenses for the coming FFY in conjunction with final budget numbers for the most current completed fiscal year and apply cost allocation methodology and cost principles to arrive at the appropriate per meal unit rate for the upcoming FFY. The contract specific rate cannot exceed the unit reimbursement rate established by the Texas Health and Human Services Commission.
For additional information on delivery of fewer than five hot meals per week, see 4310, Waiver Request.
6000, Complaints
6100, Complaints, Rule
Revision 13-0; Effective September 3, 2013
6200, Complaints
Revision 13-0; Effective September 3, 2013
A complaint is a situation, problem or concern that alleges abuse, neglect or exploitation of an individual, may pose a health or safety threat, may cause harm or that appears to be a violation of state standards, program standards or contract requirements. The complaint may be general or specific, and could involve the provider agency’s staff, beneficiaries, volunteers, physical environment, administration or services.
In accordance with Human Resources Code, Chapter 48, Subchapter B, a person must report to the Texas Department of Family and Protective Services (DFPS) Adult Protective Services (APS) if the person has cause to believe that an elderly or disabled person is in the state of abuse, neglect or exploitation. A provider agency must also report any suspected cases of abuse, neglect or exploitation to DFPS Adult Protective Services.
When the reporter contacts APS to report abuse, neglect or exploitation, the reporter is filing a complaint alleging that harm may be occurring, or may have occurred. If APS determines the harm does not meet its threshold for conducting an investigation, the report is forwarded to the Texas Health and Human Services Commission (HHSC) Consumer Rights and Services for follow up.
In situations where the provider agency receives a complaint regarding services from the individual or the individual’s designated representative, the provider agency must document and investigate the complaint. Title 40 Texas Administrative Code, Section 49.17, defines complaint procedures. If the complaint alleges abuse, neglect or exploitation, the provider agency must submit a report to APS, as previously stated.
The provider agency must send the documented complaint and resolution to the assigned HHSC contract manager and must send a copy to the HHSC staff if the complaint was submitted by a HHSC staff member, who may have reported on behalf or in place of the individual, as applicable.
A contract manager monitors for compliance with this requirement. A contract manager looks for possible violations of contract and program requirements when reviewing the complaint log and the provider agency's investigation of the complaint.
6210 Notification of Rights and Responsibilities and Complaint Procedure
Revision 13-0; Effective September 3, 2013
Notification
A provider agency of Title XIX and Title XX Home-Delivered Meals (HDM) is required by 40 Texas Administrative Code, Section 49.18, to notify, orally and in writing and annually, each individual or authorized representative of the individual’s rights and responsibilities under Texas Human Resources Code, Chapter 102, Rights of the Elderly; and procedures for filing a complaint, including the name, title and telephone number of the person to whom a verbal complaint may be made.
A provider agency may use “Your Rights In a Home and Community-Based Services (HCS) Program (PDF)” booklet to inform an individual or the individual’s representative of this information.
Also, a provider agency may order copies of the booklet by emailing ciicomplaints@hhs.texas.gov. The provider agency must note in the subject line of the email that Consumer Rights booklets are being requested, and include the following in the body of the email:
- Name of the Consumer Rights booklet requested;
- Number of booklets requested; and
- Physical address to which the booklets are to be delivered.
Documentation
A provider agency must document delivery of the notification in one of two ways:
- By developing a form for documenting that it has notified an individual or authorized representative of rights and responsibilities and of procedures for filing a complaint; or
- By using Form 3053, Notification of Rights and Responsibilities, Complaint Procedures, and Allegations of Abuse, Neglect or Exploitation.
The provider agency must keep the signed and dated original notification form in the individual’s
record and must give the individual or authorized representative a copy of the signed and dated form.
7000, Monitoring
Revision 13-0; Effective September 3, 2013
The Texas Health and Human Services Commission (HHSC) conducts monitoring reviews of program contracts it administers. Rules that apply to this section are:
40 Texas Administrative Code, Chapter 49, Subchapter E.
40 Texas Administrative Code, Chapter 69, Subchapter I.
7100, Contract Monitoring Tool
Revision 13-0; Effective September 3, 2013
The Texas Health and Human Services Commission (HHSC) created a Contract and Fiscal Compliance Monitoring Tool for the Home-Delivered Meals (HDM) Program.
Note: Scroll down the Web page to locate the tool for the HDM program.
A provider agency should direct questions about the tool or requests for additional assistance to its contract manager.
8000, Sanctions, Fraud and Abuse
Revision 13-0; Effective September 3, 2013
Rule: 40 Texas Administrative Code, Chapter 49, Subchapter F.
The Texas Health and Human Services Commission (HHSC) identifies and refers cases of suspected fraud or abuse of Medicare, Medicaid or social services program funding or resources to the Texas Health and Human Services Commission, Office of Inspector General (HHSC-OIG).
If directed to do so by the OIG, HHSC excludes from program reimbursement any provider agency that defrauds or abuses a Medicare or Medicaid program. HHSC suspends, in the event that the U.S. Department of Health and Human Services (HHS) directs the suspension, any recipient of Medicaid reimbursement who has been convicted of a crime related to the delivery of medical care or services under Medicare, Medicaid or social services programs.
8100, Report Fraud
Revision 13-0; Effective September 3, 2013
A provider agency must report suspected waste, fraud or abuse in health and human services programs to the Texas State Auditor's Office at 1-800-TX-AUDIT (1-800-892-8348), and to the HHSC Office of Inspector General at 1-800-436-6184.
Additional reporting resources are:
- HHSC Consumer Rights and Services (CRS) Complaint Intake Hotline: 1-800-458-9858;
- HHSC contract manager; or
- HHSC case manager.
All reports are kept confidential except as required by state or federal law. For further information, visit the site at How Do I Report Suspected Fraud or Misuse of State Resources?.
HDMPM Appendices
Appendix I, 40 Texas Administrative Code Chapter 49, Contracting for Community Care Services
Revision 13-0; Effective September 3, 2013
This appendix is available online only at the following website:
http://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=4&ti=40&pt=1&ch=49&rl=Y
Appendix II, HHSC Contract Management
Appendix III, Cost Determination Process
Appendix IV, HIV/AIDS in the Workplace
Appendix V, Mutually Exclusive Services
Appendix VI, Retired Information Letters
Revision 13-1; Effective September 13, 2013
The Texas Health and Human Services Commission (HHSC) deployed the Home-Delivered Meals (HDM) Provider Manual on Sept. 3, 2013. This manual contains all contract guidelines that were formerly found in Information Letters (ILs).
Content in the provider manual supersedes any previous ILs or similar guidance published by HHSC. The ILs that were retired are listed below. HHSC recommends that providers remove the ILs from their records to ensure they reference the most current information.
Number | Title | Date |
---|---|---|
IL 2010-94 | HDM Rate Setting Procedures for Federal Fiscal Year (FFY) 2011 (replaces IL 09-83) | 06/25/2010 |
IL 2010-61 | FFY 2011 Request for Waiver of Requirement to Deliver Meals Fewer than Five Days a Week (Replaces Information Letter 09-64) | 05/03/2010 |
IL 2009-83 | HDM Rate Setting Procedures for Federal Fiscal Year (FFY) 2010 | 06/17/2009 |
IL 2009-11 | Notifying Individuals of Rights and Responsibilities and of Procedures for Filing Complaints | 02/19/2009 |
IL 2008-142 | Hurricane Ike Services: FC and HDM Services Available to Limited Number of Individuals Temporarily Residing in Shelters, Hotels, or Home Settings | 10/02/2008 |
IL 2008-116 | Request for Waiver of Requirement to Deliver Meals Fewer than Five Days a Week (Replaced by IL 2009-64 and IL 2010-61) | 08/25/2008 |
IL 2008-114 | Home Delivered Meals Rate Setting Procedures for Federal Fiscal Year (FFY) 2009 | 08/04/2008 |
IL 2007-76 | Home Delivered Meals Rate Setting Procedures for FFY 2008 | 08/16/2007 |
IL 2006-61 | Administration on Aging Nutrition Services Incentive Program Reporting Requirements and Rate Setting Procedures for Federal Fiscal Year 2007 (Letter requires Adobe Reader 6 or 7 to access attachments) | 06/20/2006 |
IL 2005-18 | Administration on Aging (AoA) Nutrition Services Incentive Program (NSIP) Reporting Requirements and Rate Setting Procedures for Federal Fiscal Year 2006 - This letter requires Adobe Reader version 6 or newer to view. | 07/25/2005 |
IL 2004-40 | Home-Delivered Meals Nutritional Risk Assessment and National Aging Program Information Systems (NAPIS) Reporting | 04/01/2005 |
IL 2004-27 | Administration on Aging (AoA) Nutrition Services Incentive Program (NSIP) Reporting Requirements and Rate Setting Procedures for Federal Fiscal Year 2005 | 06/11/2004 |
IL 2004-10 | Repeal of Chapter 48, Subchapter M, Home-Delivered Meals and Subchapter N, Support Documents, and Adoption of Chapter 55, Contracting to Provide Home-Delivered Meals, Effective March 1, 2004 | 03/05/2004 |
IL 2003-19 | FY 2004 Reimbursement Rate Ceiling for Home-Delivered Meals (HDM) | 08/28/2003 |
IL 2003-06 | USDA Cash-In-Lieu Reporting Requirements and Rate Setting (FY 2004) | 06/13/2003 |
IL 2002-40 | New Home Delivered Meals Rules | 12/31/2002 |
IL 2002-17 | USDA Cash-in-Lieu Reporting Requirements and Uniform Rate Setting Procedures (URSP) for FFY '03 | 07/08/2002 |
IL 2002-07 | Change in CIL Reporting Requirements for Home Delivered Meals | 04/12/2002 |
IL 2001-19 | New Billing Code for CBA Meals | 10/17/2001 |
IL 2001-06 | United States Department of Agriculture Cash-in-Lieu of Commodities - Home Delivered Meals Providers | 07/27/2001 |
IL 2000-20 | Payment Rate Methodology for Home Delivered Meals | 08/31/2000 |
IL 2000-19 | United States Department of Agriculture (USDA) Cash-in-Lieu of Commodities Home Delivered Meals | 08/22/2000 |
IL 1999-42 | Cash-in-Lieu of Commodities Reimbursement | 10/22/1999 |
IL 1999-15 | Payment Rate Methodology for Home Delivered Meals | 08/16/1999 |
IL 1999-25 | Uniform Reimbursement Methodology for Home Delivered Meals | 06/30/1999 |
IL 1999-02 | Cash-in-Lieu (CIL) of Commodities Reimbursement Rate for Fiscal Year 1999 | 02/17/1999 |
IL 1999-01 | TDHS Policy Cash-in-Lieu of Commodities Home Delivered Meals Providers | 02/17/1999 |
If there are questions about the revised HDM provider manual or any of the ILs that were retired, send an email to PDO@hhs.texas.gov.
Appendix VII, List of Excluded Individuals Entities (LEIE)
HDMPM Forms
HDMPM Revisions
15-1, January 16, 2015, Mutually Exclusive Services
Revision Notice 15-1; Effective January 16, 2015
Section | Title | Change |
---|---|---|
Appendix V | Mutually Exclusive Services | Removes Community Based Alternatives, Emergency Care, STAR MRSA and MC Dental. Changes STAR+PLUS to STAR+PLUS Program and updates the information. |
14-1, September 19, 2014, Section 1100 Change
Revision Notice 14-1; Effective September 19, 2014
Section | Title | Change |
---|---|---|
1100 | Home-Delivered Meals Eligibility | Removes income and resources from the first sentence. |
13-1, September 13, 2013, New Appendix
Revision Notice 13-1; Effective September 13, 2013
Section | Title | Change |
---|---|---|
Appendix VI | Retired Information Letters | Adds an appendix that lists retired information letters. |
13-0, September 3, 2013, New Handbook
Revision Notice 13-0; Effective September 3, 2013
The replaces the Contracting to Provide Home-Delivered Meals Handbook.
HDMPM Contact Us
For questions about the Home-Delivered Meals Provider Manual, email: hdmpolicy@hhsc.state.tx.us
For technical or accessibility issues with this handbook, please email: form.handbook.request@hhs.texas.gov