F-1700 Menus

F-1710 Overview

Revision 21-0; Effective January 15, 2021

AAAs and subrecipients must plan and offer approved menus that meet dietary requirements of the Older Americans Act and HHSC.

 

F-1720 Menus and Menu Approval

Revision 22-1; Effective March 1, 2022

Meal providers must get written approval from a dietitian for each meal on the menu and allowable substitutions before serving the meal. Written approval must show that the meal meets:

  • one-third of the Recommended Dietary Allowances (RDA) referenced in the Dietary Reference Intakes (DRIs), for a person 60 years or older; and 
  • the current Dietary Guidelines for Americans (DGA).

The dietitian must:

  • be licensed by the state of Texas in accordance with Texas Occupations Code, Chapter 701;
  • be registered with the Commission on Dietetic Registration (CDR), Academy of Nutrition and Dietetics; or
  • have a baccalaureate degree with major studies in food and nutrition, dietetics or food service management.

Texas Department of Licensing and Regulation licenses and regulates dietitians in Texas. A license is required to use the titles "licensed dietitian" and "provisionally licensed dietitian." A license is not required to use the titles "dietitian" or "nutritionist."

Meal providers must get service recipient input when planning menus through menu committees, food preference surveys, focus group, or other methods. Culturally or ethnically appropriate, high quality, and tasty meals can be an effective outreach to the target population.

 

F-1730 Menu Documentation

Revision 21-0; Effective January 15, 2021

Keep documentation of menu review and approval on file and include:

  • approved menus and service dates for menus;
  • signature of dietitian with Texas license or CDR registration number;
  • date of menu approval by the dietitian;
  • Computer Nutrient Analysis or compliance with the Texas Model for Menu Planning, as applicable; and
  • approved allowable substitutions.

Related Policy

Texas Model for Menu Planning, Appendix IV

 

F-1740 Menu Substitutions

Revision 21-0; Effective January 15, 2021

Any substitutions on an approved menu must be comparable in nutrient content to the original menu. Document and record all menu substitutions with the menu as served. A dietitian must approve the substitution prior to meal service. A provider can also select from a dietitian-approved list of food substitutes for each food group.

 

F-1750 Menu Choice

Revision 21-0; Effective January 15, 2021

To increase satisfaction of participants in the nutrition program, the meal provider may offer the choice of entrée, choice of food items within the meal or choice of two or more distinct and complete menus. All menu choices must comply with the meal requirements provided in this policy. If more than one menu item is offered, the food item with the lowest nutrient value is counted toward meeting the meal requirement.

 

F-1760 Menu Evaluation

Revision 21-1; Effective December 1, 2021

An evaluation of the menu and meal service can include:

  • compliance with program requirements using the Menu Monitoring for Compliance Tool;
  • analysis of the actual cost per meal against budget costs;
  • customer satisfaction surveys; and
  • survey of plate waste (congregate setting).

Related Policy 

Menu Monitoring for DRI and DGA Compliance, Appendix V
 

 

F-1770 Menus and Special Dietary Needs

Revision 21-0; Effective January 15, 2021

Whenever possible, meal providers must meet any special dietary needs of participants including adjusting meals for cultural considerations and preferences and medical needs.

  • Culturally or ethnic meals and menus are adjusted for the cultural, religious, or ethnic preference of the population served, when possible and appropriate.
  • The meal provider decides the extent to which it can provide therapeutic medical diets.
  • Modified meals alter the regular menu but must meet the menu planning guidelines as provided in this policy.
  • The types and amounts of all food items must conform to the regular menu pattern. Modifications may include consistency or texture, reduced sodium, fat, cholesterol, carbohydrate or calories.
  • The eligible person, along with their physician, decides whether the regular or modified menu would meet and not jeopardize their health needs.
  • Therapeutic meals change the meal pattern significantly by either limiting or eliminating one or more menu items, or by limiting the types of foods allowed, often resulting in a meal that does not meet the meal requirements of this policy. Provide therapeutic meals only under the direction and supervision of a dietitian with a written diet order from a participant’s physician.  Keep the written diet order in the participant’s file.
  • Medical Nutritional Supplements are foods for special dietary uses that appropriately address a person’s individual nutrition needs. Nutritional supplements (e.g., canned formulas, powdered mixes, food bars or puddings) may be available to service participants based on a documented, assessed need and funding sources available. Medical Nutritional Supplements are products defined as health maintenance and are funded through Title III-B.

 

F-1780 Menus and Methods of Compliance

Revision 21-1; Effective December 1, 2021

Show and document compliance with the DGA and DRI requirements for Texas using one of the following methods:

  • Target Nutrient Requirements Computer Analysis of Nutrients; or
  • Texas Model for Menu Planning.

Plan menus and check meals for meeting nutritional requirements using either of these two methods. Use of a computerized nutrient analysis rather than the Texas Model for Menu Planning helps to ensure nutritional adequacy of meals and increases menu planning flexibility.

Plan menus to provide variety in flavor, consistency, texture and temperature. Plan meals to provide a variety of food and preparation methods, including color combinations, texture, size, shape, taste, and appearance.

Adjust menus to yield the number of servings needed. Provide consistency in quality of the food prepared, and maintain documented nutrient content of the food prepared.

Related Policy

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

F-1781 Computer Analysis of Nutrients

Revision 21-0; Effective January 15, 2021

Computer Analysis of Nutrients evaluates a menu through analyzing the nutrient content of all foods offered. This ensures that meals meet the specific standards as specified in the Target Nutrient Requirements Computer Analysis of Nutrients chart.

The Target Nutrient Requirements Computer Analysis of Nutrients chart shows key nutrients to track for maintenance and improvement of long-term health among older people served by the nutrition program. The chart gives the Compliance Range per meal based on one-third of the DRI. Meals are planned to reach these values, but the provider should also consider other nutrients essential for good health. Track the nutrients in the Target Nutrient Requirements Computer Analysis of Nutrients chart for compliance purposes. Calories and protein values must be attained on a daily average. Vitamin A, vitamin C, calcium, sodium, potassium, and fiber must be averaged over the number of serving days per week by each nutrition site.

If serving meals less than five days per week, average the vitamin A, vitamin C, calcium, sodium, potassium and fiber over the number of serving days per week by each nutrition site. For example, if a meal provider or a nutrition site serves meals three days during a week, average the required target nutrients over the three days of meal service. For two-day meal service, average the required target nutrients over the two days of service.

The Compliance Range column in the chart supports approval and monitoring of the nutritional adequacy of menus. The range is one meal for one day. When two meals a day are served, the Target Values and Compliance Ranges are doubled for a combined total; when three meals are served the Target Values and Compliance Ranges are tripled for a combined total. The computer nutrient analysis software program used to document nutritional adequacy should include the U.S. Department of Agriculture (USDA) National Nutrient Database for Standard Reference, standardized recipes, and correct nutrition data from food suppliers and manufacturers.

Related Policy

Target Nutrient Requirements Computer Analysis of Nutrients, Appendix III

 

F-1782 Texas Model for Menu Planning

Revision 21-0; Effective January 15, 2021

The Texas Model for Menu Planning chart must be used to identify the types and amounts of foods recommended to meet specific nutritional requirements when Computer Analysis of Nutrients software is not used.

All planned meals using the Texas Model for Menu Planning must also incorporate the instructions provided within the chart.

Do not classify foods twice when using the Texas Model for Menu Planning. For example, a food item included in one or more food group type is used only once in the meal to meet a requirement under the Texas Model for Menu Planning.

Limit foods high in sodium and include foods high in potassium, vitamin C, and fiber daily.

Provide foods high in vitamin A three times per week if the meal provider or nutrition site serves five or more days per week. Provide foods high in vitamin A two times per week for meal providers or nutrition sites serving fewer than five days per week.

Related Policy

Texas Model for Menu Planning, Appendix IV