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F-1210 Overview
Revision 21-0; Effective January 15, 2021
Eligible people receive meals delivered to their homes. This section gives information about eligibility, frequency, and flexible meal models for home delivered meals (HDM).
F-1220 Eligibility
Revision 22-1; Effective March 1, 2022
To be eligible for a Title III HDM, a person must be:
- 60 or over;
- frail;
- homebound by reason of illness or incapacitating disability, or otherwise isolated; and
- have a Consumer Needs Evaluation (CNE) form score of at least 20.
Homebound means a person cannot leave their home without the help of another person. People receiving HDMs must be physically, mentally, or medically unable to attend a congregate nutrition program as shown on the CNE form. This includes people at nutritional risk who:
- have physical, emotional, or behavioral conditions that would make their service at a congregate nutrition site inappropriate; or
- are socially or otherwise isolated and unable to attend a congregate nutrition site.
Meals may also be provided to the following, if the provision of the meal supports keeping the person at home and is in the best interest of the eligible older person:
- the spouse of an eligible older person, regardless of the spouse’s age or condition; or
- a person with a disability, regardless of age, who lives at home with an eligible older person.
- Establish procedures to allow meal providers the option to offer HDMs to a person with a disability on the same basis as meals provided to an eligible person who is 60 or older.
The AAA must develop procedures to allow meal providers the option to offer home delivered meals to a person with a disability who lives with an older person. Offering a meal to a person with a disability must be on the same basis as meals provided to an eligible person who is 60 or older.
AAAs and their subrecipients complete the following before service initiation and at least every 12 months, for each person receiving HDMs:
- a DETERMINE Your Nutritional Health checklist; and
- a CNE functional assessment.
Complete a Determination of Type of Meal before service initiation and at least every 12 months, for each person assessed for meals that are consumed at a time other than the day of delivery.
Note: There are no citizenship or residency requirements for OAA services. Do not deny nutrition services based on citizenship or residency criteria.
Related Policy
Consumer Needs Evaluation, D-1040
Nutritional Risk Assessment, D-1060
F-1230 Home Delivered Meals for Caregivers
Revision 21-0; Effective January 15, 2021
A Title III-E eligible caregiver can receive a HDM as a supplemental service according to AAA written policy.
If counted for Nutrition Services Incentive Program (NSIP) cash, a HDM purchased through Title III-E as a supplemental service is a meal to a person 60 and over who is either a care recipient (as well as their spouses of any age) or a caregiver.
Documentation for Home Delivered Meals
Documentation of meals must include the name of the meal provider, date the meal was provided and the name of the person receiving the meal.
Reporting
Report data for people and meals using HHSC’s information management system. Reporting of meals requires unduplicated persons and unit counts.
A unit of service = one meal.
F-1240 Frequency of Service
Revision 21-0; Effective January 15, 2021
Providers must make available at least five meals per week to eligible homebound people and are encouraged to provide seven meals per person if feasible.
A HDM may be a hot, chilled, frozen, fresh, or shelf-stable meal and any supplemental foods the provider choses to deliver.
Providers must make available five meals a week for a total of 250 meals a year whether the meals served are hot, chilled, frozen, or other meals, or a combination of meals. If a meal provider is in a rural area, it can request HHSC permission to provide less than five HDMs each week.
The State Program Report (SPR) defines rural as any area not defined as urban. Urban areas are (1) a central place and its adjacent densely settled territories with a combined minimum population of 50,000 and (2) an incorporated place, or a census designated place, with 20,000 or more inhabitants.
F-1250 Flexible Meal Model for Home Delivered Meals
Revision 21-0; Effective January 15, 2021
The flexible meal model gives people and meal providers an alternative option to the hot meal delivered daily model. Providers may offer the flexible meal model based on:
- meal providers not available in the area served;
- meal providers only available on a limited basis;
- interest lists;
- a person’s ability to access nutrition is limited, e.g. cannot be home for a regularly scheduled delivery due to medical issues such as dialysis or outpatient rehabilitation or lives in a rural area;
- meal providers cannot meet a person’s dietary needs; or
- other situations that call for a flexible meal model.
AAAs may purchase meals from a variety of contractors under case management if a provider cannot provide meals to meet special dietary needs.
A flexible meal model can range from delivering four hot meals and one chilled or frozen meal to delivering a combination of five or more meals once a week.
Meal providers must deliver meals at least one time each week, regardless of the type and number of meals delivered. All meals must meet the nutritional requirements in this policy handbook. A meal provider, including a AAA, must complete an assessment for a person who receives meals to consume on a day other than the day of delivery.