F-1300 Nutrition Screening, Nutrition Education and Nutrition Counseling

F-1310 Overview

Revision 21-0; Effective January 15, 2021

AAAs and their subrecipients must provide nutrition screening and nutrition education to all people receiving congregate and HDMs.  If appropriate, people may also receive nutrition counseling.

F-1320 Nutrition Screening

Revision 22-1; Effective March 1, 2022

Every person receiving congregate, HDMs or nutrition counseling must be screened for the risk of poor nutritional health and malnutrition. Use the DETERMINE Your Nutritional Health checklist (D-1060) to complete the assessment.

Complete the DETERMINE Your Nutritional Health checklist at intake and then annually within 30 days of the anniversary of the person’s initial risk assessment date. The content of the form is required and may not be altered.


Documentation of the nutrition screening must include the:

  • name of the meal provider;
  • date the screening was performed; and
  • name of the person receiving the screening.


Report the nutrition screening results using HHSC's information management system.

Related Policy

Intake, D-1020
Caregiver Intake, D-1030
Nutritional Risk Assessment, D-1060

F-1330 Nutrition Education

Revision 21-0; Effective January 15, 2021

Nutrition education helps to promote nutritional well-being and to delay the onset of adverse health conditions from poor nutritional health or sedentary behavior by providing accurate and culturally sensitive information and instruction on nutrition, physical fitness, or health (as it relates to nutrition).

Design material to provide participants with the understanding, skills, and motivation necessary to make informed food, activity, and behavioral choices that can improve their health and prevent chronic disease.

A qualified dietitian or a person with equivalent education and training in nutrition science must develop and approve the material. After the qualified dietitian or other qualified person provides training and guidance on using the materials, a nurse, social worker, therapist, congregate meal site director, wellness coordinator or other person may provide the nutrition education session.

While educational or informational flyers or handouts are good reinforcements of nutrition education, the distribution of flyers or handouts alone is not nutrition education.

Provide nutrition education to all recipients of nutrition services at least once every 12 months. Participants must receive at least 15 minutes of nutrition education annually.

Provide nutrition education to recipients of congregate meals in group settings or one-on-one.

Provide nutrition education to recipients of HDMs:

  • in person;
  • by phone; or
  • through other electronic means such as webcasts, if such electronic means can give each person an opportunity to ask questions.


Document that nutrition education was provided and include the following:

  • name of the meal provider;
  • date of the session;
  • name of the person providing the education;
  • lesson plan or curriculum approved by the qualified dietitian; and
  • name of each person receiving the service.


Report the total units of service and the estimated number of eligible people who received nutrition education using the HHSC information management system.

A unit of service = one session per participant. Count a session for every eligible person attending a nutrition education session.

F-1340 Nutrition Counseling

Revision 21-1; Effective December 1, 2021

Nutrition counseling:

  • provides one-on-one individualized advice and guidance to people or the caregivers of people who are at nutritional risk because of their health or nutrition history, dietary intake, chronic illness or medication use;
  • provides information on the options and methods for improving nutrition status with a measurable goal;
  • differs from nutrition education as nutrition counseling is specific to the person receiving the help; and
  • must be provided by a registered dietitian.

Nutrition counseling is an optional service to support the best health possible for people who receive other nutrition services.


Document the following in the eligible person’s case file:

  • name of the dietitian providing the counseling;
  • date of each counseling session;
  • name of person receiving counseling;
  • why the person is receiving nutrition counseling;
  • name of physician referring person for nutrition counseling;
  • measurable goals set up for the person receiving the service; and
  • their progress in meeting the specific goals.


Report unduplicated persons and units of service using HHSC’s information management system.

Unit of service is hour(s). Partial hours may be reported in two decimal places, e.g. 0.25 hours.