Area Agencies on Aging (AAAs) and meal providers must complete a Determination of Type of Meal (DTM) form to ensure a person can manage a specific type of meal. The form documents the steps taken by a AAA or meal provider to resolve identified barriers.
When to Prepare Area Agencies on Aging (AAAs) and meal providers must complete a Determination of Type of Meal (DTM) form to ensure a person can manage a specific type of meal. The form documents the steps taken by a AAA or meal provider to resolve identified barriers.
AAAs and meal providers complete the DTM by phone or face-to-face with the person who will receive the meals or their caregiver before chilled, frozen or shelf-stable meals which are to be consumed on a different day than they are delivered (flexible meals) are approved. A new DTM form is completed annually.
Do not use the DTM form for a meal delivered for consumption the same day, even if the meal has all chilled foods. Do not use the DTM form for meals served in emergency conditions, inclement weather, disasters or on holidays.
Do not complete the DTM if the AAA or provider has a process in place and decides flexible meals would not be proper for a person.
Number of Copies
The AAA or provider completes a copy for its records and the person who will receive the meals or their caregiver.
Enter the results of the DTM in the State Unit on Aging Programs Uniform Reporting System (SPURS). Answer all questions, unless otherwise shown in these instructions.
Conducting an Interview
To help decide if a person can safely handle and store the type of meals considered, explain the following:
- Estimated size and weight of a box of meals;
- Size of each individual meal packet;
- Method used to seal (packing tape, glue, etc.) the box and tools needed to open the container;
- Disposal of shipping or transportation materials;
- Where instructions to prepare the meals are in each delivery; and
- Where the expiration date of a meal is located on each meal packet.
Discuss or observe the environment of the home to identify any barriers to delivering or managing the meals that may not be covered in the DTM form.
Explain that the AAA or the meal provider will make regular contacts.
Explain that meals left unattended outside the person’s home is not allowable. The person who is eligible or the person’s designated caregiver must directly accept the delivery of the meals.
Completing the Determination of Type of Meal
Part I – Client Information
Name of Meal Provider — Enter the name of the AAA or meal provider.
Date of Assessment — Enter the date of the assessment.
Name of Person Conducting Assessment — Enter the name of the person conducting the assessment.
Client’s First Name — Enter the person’s first name.
Client’s Last Name — Enter the person’s last name.
Primary Local Client Identifier — Enter the client identification number from SPURS if known.
Client’s Primary Language — Select the client’s most comprehensive language.
Type of Meals Requested? — Select the types of meals the person will receive including standard or hot, frozen, chilled, or shelf-stable. If the person will receive a combination of meal types, select all that apply.
If entering the information directly into SPURS, the first name, last name, and Primary Local Client Identifier (Client ID) populate automatically. If known, enter the Client ID on an electronic fillable or paper form.
Part II – Meal Questionnaire
- Do you have a working refrigerator or freezer for the meals? — The options are: Yes (refrigerator), Yes (freezer), or No. If the person has both a working refrigerator and freezer mark “Yes” to both. Mark “No” and add a note to contact other resources to buy the appliance needed to store the requested meal type. Skip this question if the person will receive only shelf-stable meals.
- Do you have enough storage in your freezer or refrigerator for the number of meals in each delivery? — The options are: Yes or No. Tell the person how many meals will come in each delivery and the approximate size of the meals. Ask if there is enough room in the refrigerator or freezer to store the requested meal type. If there is not enough space to store the requested meal types mark “No” and add a note to contact other resources to buy the appliance needed to give more room for the meals.
- Will you be able to prepare the meals by yourself? — The options are: Yes, No, or No (Someone else helps prepare every meal). Explain how the meals are opened and prepared. Ask the person if they can prepare the meals by themselves. A sealed, removeable film and other packaging may cover the meal, and you should be sure the person can remove the packaging according to the cooking directions.
- Do you have a working device you can use to heat up the type of meals you will be receiving? — The options are: Yes (Stove), Yes (Oven), Yes (Microwave), Yes (Toaster Oven), and No. Explain the type of heating device needed to heat up the requested meal type. Ask if the person has a heating device to prepare the type of meals selected and mark the proper heating device. If the person has the heating device necessary, mark “Yes.” If the person does not have the proper heating device mark “No.”
- Are you able to purchase a working device? — The options are: Yes or No. If the person does not have the resources to buy the proper heating device, add a note to contact other resources to purchase the appliance needed to heat up the meals.
- Do you have any problems reading or understanding instructions? — The options are: Yes (Someone else helps me understand), Yes (Need instructions verbally), Yes (Need instructions in primary language), or No. Ask the person if they have any difficulty reading or understanding instructions. Emphasize the importance of preparing the meals correctly and throwing away meals that have expired. Take note of these needs to determine how these needs can be accommodated, including locating a caregiver. If no accommodation is available, assess the person for other meal services including hot meals.
- Do you have any dietary problems? — Ask the person if they have difficulty eating specific foods. Select all that apply.
- Identify any other dietary problems or preferences not identified above. — If the person has difficulty eating specific foods, shelf-stable meals may not be proper. Note other concerns that may be identified.
- Will you know when someone is at the door? — Ask the person if they know when there is someone at the door. A AAA or meal provider may never leave meals unattended anywhere outside the person’s home or at a location other than where the person lives.
- Are you able to go to the front door to receive your meals and carry them to where you will store the meals? — Describe the approximate size and weight of the package and ask if they will be able to receive the box and carry it to where they store the meals. Observe the home or ask if there is a clear pathway from the door to the storage area. Emphasize the importance of storing chilled and frozen meals right away to be sure they are safe.
- Will you be able to open the box of meals, unpack them and store them in your refrigerator or freezer right away? — Ask the person if they can open the box of meals, unpack the meals and store them in the refrigerator, freezer, or pantry. Scissors or other tools are needed to open some boxes and you should be sure the person has those tools available and can use them. Let the person know they should store meals in the refrigerator or freezer right away.
- Are you able to be home for your meal deliveries on a regular basis? — Inform the person of the approximate timeframe and day of the meal deliveries. Ask the person if they will be there on a regular basis to receive the meals. If they are unable to be there, ask if there is someone who can be there on their behalf. Inform the person how they can cancel a delivery if they are unable to be home to receive a shipment and how far in advance they will need to contact the provider to cancel a delivery. Let them know how often the AAA or meal provider delivers meals each week.
- Can we communicate with you on a regular basis? — Explain to the person that someone will be contacting them on a regular basis. Ask if they can take part in these contacts regularly, or if there is someone else you can contact on their behalf. If a person does not wish to receive socialization contacts, record this in the person’s record and communicate this to the meal provider. A person does not have to take part in socialization contacts.
- What is your preferred method of communication with the provider? — Ask the person what their preferred method of contact is for socialization contacts and enter the proper information if they do not opt out.
- Enter preferred contact method’s information (phone number, email address, etc.) — Enter the contact details for the preferred person.
Part III – Caregiver Information
If a person said they will have someone to help them for any of the questions, complete Part III to identify the primary person who will be helping with these tasks.
Caregiver’s Name — Enter the first and last name of the primary person helping with tasks.
Area Code and Phone No. — Enter the best contact phone number for the primary person helping with tasks.
Email Address — Enter the email address of the primary person helping with tasks, if available.
What is the caregiver’s relationship to the care recipient? — Select the most applicable choice.
Resources to Overcome Barriers
The intent of flexible meals is to serve people based on their needs and, when possible, to expand services to new areas. It should not reduce services to people who are frail or isolated.
In some cases, certain barriers may exist that prohibit a person from safely storing or preparing flexible meals.
Report any resources accessed to address those barriers that allow the person to successfully store and prepare flexible meals. Select all that apply.
- Income support — The AAA provided income support (pay utilities, set up utilities, buy a refrigerator, freezer or microwave as appropriate), so the person can receive the type of meal being considered.
- Caregiver assistance — The AAA was able to find an informal caregiver (family member, friend, neighbor) to help the person manage the type of meal being considered.
- Residential repair — The AAA provided home repairs (electrical, plumbing, gas), so the person could manage the type of meal being considered.
It is possible flexible meals will not be proper for some people assessed using the Determination of Type of Meal.
Report how other resources will meet a person’s nutritional needs if it is decided flexible meals are not proper for the person. Select all that apply.
- Homemaker — Title III – The person received homemaker services for meal preparation through Older Americans Act funds, instead of a home delivered meal.
- Homemaker — Medicaid Waiver – The person received homemaker services for meal preparation through a Medicaid Waiver program, instead of a home delivered meal.
- Homemaker — Other – The person received homemaker services for meal preparation through another source, instead of a home delivered meal.
- Hot meals — No solution to identified barriers was available for the type of meal being considered so the provider continues to deliver hot meals to this person.