F-1500 Administration of Nutrition Programs

F-1510 Overview

Revision 21-0; Effective January 15, 2021

Selecting, administering, and evaluating a network of meal providers responsible for the provision of nutrition services to older people is a critical function of AAAs.

Coordinate local community resources to increase capacity for an effective and comprehensive local system for nutrition and supportive services. Local resources include:

  • agencies that administer home and community care programs;
  • tribal organizations;
  • providers (including voluntary organizations or other private sector organizations) of supportive services, nutrition services and multipurpose senior centers;
  • organizations representing or employing older persons; and
  • organizations that have experience in training, placing and providing stipends for volunteers.

 

F-1520 Planning Nutrition Services

Revision 21-0; Effective January 15, 2021

Determine the extent of need for congregate and HDMs and find resources within the PSA to support the provision of nutrition services to meet the identified need. Evaluate the effectiveness of the use of all resources in meeting the needs of people within the PSA.

Nutrition services funds may be awarded to subrecipients that provide congregate and HDMs. HDMs may also be purchased from contractors to serve people on a case-by-case basis through case management.

In setting up a system of providers, ensure:

  • eligible people receive congregate or HDMs;
  • service design is based on regional needs;
  • facilities and meals meet all requirements for safety and nutritional standards;
  • services coordinate with nutrition-related supportive services including nutrition screening and education; and
  • nutrition assessment and counseling are available, if appropriate.

Maintain written policy and procedures for procuring services to be provided with OAA funds. Approval and oversight of the service provider application process is the responsibility of the AAA’s governing body.

All procurement transactions must comply with applicable laws and regulations, including the CFR, and in compliance with established policy.

Subrecipients must request written approval from the AAA before contracting with another entity for meal preparation or delivery of meals.

 

F-1530 Outreach

Revision 21-0; Effective January 15, 2021

Ensure nutrition subrecipients develop and maintain a written outreach plan that gives priority to older people:

  • who live in rural areas;
  • with the greatest economic or social need (particularly low-income older people, low-income minority older people, older people with limited English skill, and older people who live in rural areas);
  • with severe disabilities;
  • with limited English skill;
  • with Alzheimer’s disease and related disorders with neurological and organic brain dysfunction (and the caretakers of such people);
  • at risk for institutional placement, specifically including survivors of the Holocaust; and
  • who are Native Americans, if there is a significant population of older people who are Native Americans in the AAA’s region.

Outreach to Native American populations and their caregivers must include information about the help available to them through the nutrition program.

 

F-1540 Budgeting and Monitoring Performance

Revision 21-0; Effective January 15, 2021

Establish and maintain procedures and processes to monitor progress in achieving benchmarks and performance to effectively manage resources.

Consider the following when setting up a system to monitor progress:

  • federal funds;
  • matching funds;
  • program income;
  • local cash;
  • number of meals served;
  • cost per meal;
  • number of unduplicated persons served; and
  • targeting.

 

F-1550 Cost Controls for Meals

Revision 21-0; Effective January 15, 2021

Planning is essential for meals to stay within budgeted costs, be appealing to the consumer, and comply with the nutrition program guidelines. To control meal cost, consider the following:

  • use of raw foods vs. frozen, canned or other prepared food items;
  • food availability or seasonal foods;
  • purchasing practices that provide the correct quantity and the best quality at the right price;
  • food storage procedures and equipment to minimize loss or waste;
  • labor, skill and number of employees to maximize efficiency; and
  • packaging and food containers to support food safety and temperature control.

A key to cost control in menu planning is the use of cycle menus and standardized recipes.

The cycle menu allows the food manager to become accustomed to the foods and amounts of food needed for specific menus. This lets the food manager analyze quality of raw food against cost variances based on upcoming menu cycles and find the best sources of food. The purchase history sets up patterns and practices for staff to follow.

A cycle menu sets a different menu every day that repeats itself after a set number of weeks. A cycle menu for the nutrition program is usually four to six weeks in length with four cycles per year (spring, summer, fall and winter).

Consider the following when developing a cycle menu:

  • available storage for food;
  • purchasing and delivery schedule of food suppliers;
  • production limitations based on labor, equipment, or number of meals;
  • seasonal foods availability; and
  • regional or traditional foods of the people served.

The advantages of using cycle menus include:

  • reduction in menu planning time;
  • streamlined buying procedures;
  • standardized food production;
  • simplified staff training; and
  • ability to better evaluate food service quality, efficiency and costs.

A standardized recipe is one that is tested for consistency, quality, correct serving size and yield. Use of the same procedures, serving utensil, and ingredients to produce the same serving size produces the same product each time. The history of labor, production time and amount of food needed to produce a menu item using a standardized recipe supports efficient planning for future increases or reductions in the number of meals.  The advantages of using standardized recipes include:

  • customer satisfaction due to a high-quality product;
  • consistent nutrient content because the recipes use the same ingredients and amounts;
  • food cost control due to reduced food waste in storage and preparation;
  • efficient purchasing by knowing exact amounts of food to buy;
  • labor control through efficient use of staff skills; and
  • portion control based on information about the serving size, serving utensil and yield.

 

F-1560 Calculating and Posting the Full Cost of a Meal

Revision 21-0; Effective January 15, 2021

Calculation of the full cost of a meal is an essential food service management practice. The meal cost is the basis to find a suggested donation per meal and to inform ineligible participants of the full cost of the meal.

Calculate the costs of each meal according to the following categories:

  • Personnel
    • food service operations should include all expenditures for salaries and wages, for personnel involved in food preparation, cooking, delivery, serving and cleaning of meal sites, equipment and kitchens, including the valuation of volunteer hours; and
    • project management should include all expenditures for salaries and wages for personnel involved in project management.
  • Professional Development should include all costs for conference fees, dues and materials.
  • Meals or Raw Food should include all costs of buying foodstuff or purchased, pre-prepared meals to be used in the program.
  • Equipment should include all expenditures for items with a useful life of more than one year and an acquisition cost of less than $5,000.
  • Occupancy should include all expenditures for rent, gas, electricity, water, sewer, waste disposal, etc.
  • Transportation or travel should include all costs for mileage, fuel, vehicle insurance or repairs, etc.
  • Administrative or general should include expenditures for all other items that do not belong in any of the above categories (e.g. supplies, printing, communications, etc.).

Do not include capital expenditures in the calculation of a unit rate. Capital expenditures are expenses to buy capital assets (land, buildings, equipment and intellectual property) used in the meal program that have a useful life of more than one year, are capitalized according to with generally accepted accounting principles, and cost $5,000 or more. Capital expenditures can also include expenses which increase the value or useful life of capital assets and exclude routine repairs or maintenance.

Congregate meal sites must post the full cost of a meal.  Establish written policy and procedures to ensure:

  • all congregate nutrition sites post the full cost of a meal;
  • ineligible people pay the full cost of a Title III meal;
  • providers develop suggested voluntary contributions per meal;
  • providers separate payments for meals served to ineligible people from voluntary contributions made by people eligible for a meal; and
  • funds for nutrition services are not spent on meals provided to ineligible people.

 

F-1570 Reimbursement for Meals

Revision 21-0; Effective January 15, 2021

Establish and maintain written policies and procedures to ensure reimbursement is made to providers only for meals served to eligible recipients in compliance with the requirements for those meals.

Do not reimbursement providers for meals not delivered or meals delivered but damaged in transit and not edible because of the damage, with the following exception:

  • Reimburse an HDM provider for a maximum of two attempted, but unsuccessful meal deliveries per eligible person per month.

 

F-1580 Serving Fewer than Five Meals a Week

Revision 21-0; Effective January 15, 2021

The provision of congregate or HDMs is based on providing at least five meals a week and allowing 10 days a year for observing holidays.

All meal providers must make at least five meals a week available and congregate meal sites must be open to make meals available at least 250 days a year.

If a provider covers a rural area and it is not possible to meet that minimum requirement, request HHSC approval for the provider to serve fewer than five meals a week.  A meal provider can serve less than five meals a week in different parts of their total service area. HHSC approval to serve fewer than five meals a week for those individual sites is not needed if the congregate provider has multiple sites that, in total, make available 250 meals each year.

For provider requests to serve fewer than five meals per week, review the request and:

  • verify the information to ensure it is not possible for the provider to make five meals available each week;
  • submit the request to HHSC for approval;
  • ensure the provider does not implement a reduction in serving days or provide fewer than five meals a week until HHSC approves the request; and
  • notify the provider of HHSC’s approval or disapproval of the request.

Note: AAAs and meal providers must comply with their disaster plan when an emergency or inclement weather prohibits the provision of regularly scheduled meals.

Related Policy

Emergency Conditions, Inclement Weather, Disasters and Holidays, C-1211
Congregate Meal Site Closure, C-1212

 

F-1590 Suspension and Termination of Meals

Revision 21-0; Effective January 15, 2021

Establish and maintain written policy for the suspension and termination of meals.

A meal provider may suspend or stop meal service for the following reasons.

The eligible person:

  • dies;
  • is admitted to a long-term care facility;
  • requests the service be stopped;
  • threatens the health or safety of a person at the congregate site;
  • threatens, or another person living in the home threatens, the health or safety of a person delivering meals;
  • racially discriminates against a person at the congregate site;
  • racially discriminates against, or another person living in the home racially discriminates against, a person delivering meals;
  • sexually harasses a person at the congregate site; or
  • sexually harasses, or another person living in the home sexually harasses, a person delivering meals.

A meal provider may also suspend HDMs if the eligible person is not home to accept delivery of a meal for:

  • two consecutive service days in a calendar month; or
  • three non-consecutive service days in a calendar month.

Meal providers who serve meals under AAA case management must notify the AAA case manager and request permission before suspending the delivery of meals to an eligible person. The meal provider must specify the reason for the request to suspend or stop meal service. The AAA case manager must notify the participant in writing that meals are being suspended and for all documentation of the suspension or termination of service.

Documentation

Document the following in the eligible person’s record when the provision of meals is suspended or stopped:

  • reason for the suspension or termination;
  • date and method the case manager notified the meal provider of the action leading to suspension or termination of service;
  • how the action leading to suspension or termination was confirmed;
  • if the delivery of meals to the eligible person should be reinstated or stopped; and
  • date of reinstatement or termination.

Notify an eligible person in writing when their service is suspended or stopped. Documentation of the notification must be kept in the person’s file.