Home-Delivered Meals Provider Manual

HDMPM, Section 1000, Introduction

Revision 14-1; Effective September 19, 2014

 

 

The Department of Aging and Disability Services (DADS) contracts for Home-Delivered Meals (HDM) with:

The provisions in this manual apply to provider agencies that receive Title XX and/or Title XIX funding and to the Title XX/Title XIX funded portion of a common provider. This manual does not apply to Title III funded provider agencies or to the Title III funded portion of a common provider. A common provider and a Title III-only provider should consult with its local Area Agency on Aging (AAA) for requirements that apply to the Title III HDM program. However, the manual does include Title III requirements that also apply to provider agencies that receive Title XX and/or Title XIX funding.

 

1100 Home-Delivered Meals Eligibility

Revision 14-1; Effective September 19, 2014

 

A provider agency serves individuals who have been determined eligible by Department of Aging and Disabilities Services (DADS) case managers based on age and functional need criteria described in DADS rules at 40 Texas Administrative Code, Chapter 48, Subchapter H. DADS case managers initiate the Home-Delivered Meals referral process by sending Form 2101, Authorization for Community Care Services, to a provider agency to begin the delivery of eligible meals to eligible individuals. Service authorization is only sent to the provider agency of the individual’s choosing.

 

1200 Purpose, Rule

Revision 13-0; Effective September 3, 2013

 

In this section, as well as other sections of this manual, references to one or more relevant rules are cited when no further explanation of the requirement is necessary.

40 Texas Administrative Code, §55.1.

Additional rules and standards, both federal and state, may apply, as found in food management standards set by the Department of State Health Services and the Monitoring Tool used by Department of Aging and Disability Services contract monitors.

 

1300 Definitions, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.3.

Rural county has the meaning established by the United States Department of Agriculture (USDA), which states that a rural county in Texas contains a population of less than 50,000 individuals.

HDMPM, Section 2000, Contract Requirements

Revision 13-0; Effective September 3, 2013

 

 

2100 Contract Requirements

Revision 13-0; Effective September 3, 2013    

 

 

2110 Contracting Requirements for Provider Agencies, Rules

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.5, Contracting Requirements for Provider Agencies.

40 Texas Administrative Code, Chapter 49, Contracting for Community Services.

 

2111 List of Excluded Individuals and Entities (LEIE)

Revision 13-0; Effective September 3, 2013

 

All provider agencies must comply with requirements to identify individuals and entities excluded from participation in federal and state health care programs.

 

2112 Subcontracting

Revision 13-0; Effective September 3, 2013

 

The provider agency is responsible for the performance of the subcontractor. If the Department of Aging and Disability Services (DADS) determines that the subcontractor is not in compliance with program requirements, DADS will take action against the provider agency, not the subcontractor.

 

2113 Contract Amendment

Revision 13-0; Effective September 3, 2013

 

An amendment is a revision to an existing contract. Either the Department of Aging and Disability Services (DADS) or the provider agency may identify a need and initiate an amendment.

A provider agency must submit an amendment request in writing, using company letterhead, and the request must be signed by the authorized signature authority. DADS will not accept an amendment request that does not meet this requirement. The contract amendment must be completed following the appropriate amendment process. The contracting forms can be found on the HHS Website at https://hhs.texas.gov/laws-regulations/forms. Contact your DADS contract manager in order to process any contract amendment.

 

2120 Nutritional Risk Assessment and National Aging Program Information Systems (NAPIS) Reporting

Revision 13-0; Effective September 3, 2013

 

The Administration on Aging (AoA) requires the Department of Aging and Disability Services (DADS) to report program information in the National Aging Program Information System (NAPIS). A provider agency must collect, compile and report the required NAPIS information identified below to the DADS contract manager.

A provider agency must:

  1. Develop a nutritional risk score for each individual to whom it delivers a meal, with the exception of individuals receiving meals under Title XIX (Community Based Alternatives), if the individual is:
Nutritional Risk Score Nutritional Risk Category
0 - 2 Good Nutritional Health
3 - 5 Moderate Nutritional Risk
6 or More High Nutritional Risk
  1. Complete the Nutritional Risk Assessment form for each individual at least annually.
  2. Keep the completed Nutritional Risk Assessment on file for each individual.
  3. A provider agency must use the Nutritional Risk Assessment form. Revisions to this form are not allowed. The Nutritional Risk Assessment form is available in both English and Spanish.
  4. The Nutritional Risk Assessment is used to develop a nutritional risk score for each individual. Each answer on the Nutritional Risk Assessment form is assigned a certain value. The provider agency adds the values to get the nutritional risk score.
  5. The provider agency must give the Determine Your Nutritional Health Handout to an individual each time the Nutritional Risk Assessment form is completed. The Determine Your Nutritional Health Handout is also available in Spanish.
  6. The provider agency must encourage each individual to take the appropriate action for his nutritional risk category indicated on the Determine Your Nutritional Health Handout.

Form #AIAAA_NRA_ES 2.0: Nutritional Risk Assessment (English and Spanish), PDF format
Form #AIAAA_NRA_ES 2.0: Nutritional Risk Assessment (English and Spanish) MS Word format
Form #AIAAA_NRAHH_ES 1.0: Determine Your Nutritional Health Handout (English and Spanish) PDF format
Form #AIAAA_NRAHH_ES 1.0: Determine Your Nutritional Health Handout (English and Spanish) MS Word format.

 

2121 NAPIS Reporting Requirements

Revision 13-0; Effective September 3, 2013

 

A common provider and a Title III provider must contact its Area Agency on Aging (AAA) for National Aging Program Information System (NAPIS) reporting requirements.

A provider agency that receives Title XX funding must collect and report the number of Nutritional Services Incentive Program (NSIP) eligible individuals and the following demographic information to its Department of Aging and Disability Services (DADS) contract manager quarterly on an Excel spreadsheet, template provided by DADS. See Section 4920, Nutrition Services Incentive Program Policies, Section 4921, Reporting Requirements for NSIP Eligible Meals, Section 4921.2, Common Providers, Section 4921.3, DADS Title XX-Only Provider Agencies, and Section 4922, Other Requirements, for information on NSIP policies and reporting requirements.

The reporting must include the number of:

A provider agency that receives Title XX funding must:

Quarter Months Covered Report Due
1st October, November, December January 16th
2nd January, February, March April 16th
3rd April, May, June July 16th
4th July, August, September October 16th

 

2200 Staff Requirements

Revision 13-0; Effective September 3, 2013

 

 

2210 Staff Requirements, Rule

Revision 13-0; Effective September 3, 2013

 

A common provider must follow the staff requirements according to both 40 TAC Chapter 55 (see link below) and Chapter 85, Implementation of the Older Americans Act. A provider agency should contact its Area Agency on Aging representative for questions related to Title III and Chapter 85.

A provider agency that receives Title XX and/or Title XIX funding must follow the staff requirements according to TAC Title 40 Chapter 55.

40 Texas Administrative Code, §55.7.

 

2300 Training Requirements, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.9.

 

2400 Nutrition Education, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.11.

 

2500 Compliance with Laws and Regulations, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.13.

HMPM, Section 3000, Nutrition and Meals

Revision 13-0; Effective September 3, 2013    

 

 

This section outlines the nutritional and meal requirements as part of menus, diets and packaging of home-delivered meals for all providers that receive funding from Title XX and/or Title XIX.

 

3100 Menus, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.15.

 

3200 Standard Recipes, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.17.

 

3300 Modified Diets, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.19.

 

3400 Frozen, Chilled, or Shelf-Stable Meals, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.21.

 

3500 Meal Packaging, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.23.

HDMPM, Section 4000, Service Delivery

Revision 13-0; Effective September 3, 2013

 

 

4100 Service Initiation, Rule

Revision 13-0; Effective September 3, 2013

40 Texas Administrative Code, §55.25.

 

4110 Service Initiation

Revision 13-0; Effective September 3, 2013

 

The provider agency must initiate services within ten calendar days from the begin date on Form 2101, Authorization for Community Care Services. Form 2101 must be completed and returned to the Department of Aging and Disability Services (DADS) case manager within 21 calendar days from the date of the referral. The DADS case manager will inform the provider agency in the Comment section of Form 2101 of any special circumstances that are relevant to the individual's service provision, such as exceptions to service delivery requirements.

 

4200 Case Manager Community Care for Aged and Disabled Handbook

Revision 13-0; Effective September 3, 2013

 

For information on case manager activities related to enrolling an individual, look in the Case Manager Community Care for Aged and Disabled Handbook.

Section 4500, Meal Services, contains specific information on Home-Delivered Meals program requirements that the Department of Aging and Disability Services case manager completes.

 

4300 Service Requirements, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.27.

An HDM provider or subcontractor performing meal delivery must monitor each meal delivery route annually to verify meals are delivered within the required time frames. Documentation of monitoring must include the route name/number, the date of the monitoring, and the times of the first and last meal deliveries.

A DADS HDM provider is required to document, for each meal delivery site, a record of the hot and cold foods served on the last meal delivery day of the last month of the review period. Documentation is to include the date and time each hot or cold food item was removed from temperature control and the temperature of the item when removed from temperature control. Temperature readings are not required on a test meal at the end of the route. However, all meals must be delivered within four hours of removal from temperature control.

When meals for more than one day of service are delivered and the individual becomes ineligible for the HDM program, meals delivered to be consumed past the date of the individual’s ineligibility are considered invalid and are not reimbursable.

 

4310 Waiver Request

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.5(c)(1).

40 Texas Administrative Code, §55.21.

40 Texas Administrative Code, §55.27.

Provider agencies must submit a waiver request to the Department of Aging and Disability Services (DADS) contract manager during the rate negotiation process if it determines that delivery of frozen or shelf-stable meals is required for certain individuals within its contracted service area. Any waivers granted will be effective for a period not to exceed one fiscal year. The provider agency must not exceed the parameters of the waiver description or implement the waiver of the requirement for delivery of a hot meal five days a week, for delivery of multiple meals fewer than five days per week, or to deliver meals during hours other than the delivery window, prior to the DADS contract manager giving approval of the waiver request.

Effective in each new federal fiscal year (FFY), a provider agency must complete a waiver request during the budget-based rate negotiation process for each service area in which the provider agency has a contract and is planning to implement or continue a waiver. The provider agency submits the completed form to the DADS contract manager with each FFY’s budget-based rate negotiation documents.

DADS will consider for approval a waiver only if the provider agency assures it will:

If approved, DADS incorporates the waiver description for the current FFY into the provider agency contract with the budget amendment for the period. The contract manager will review a provider agency’s compliance with the provisions of the waiver as a component of DADS on-site monitoring of the provider agency’s program. The DADS contract manager considers whether the waiver reduced the provider agency’s HDM operating costs for purposes of the next budget negotiation.

The provider agency may not implement provisions of the proposed waiver description without DADS approval and may not exceed the parameters of the approved waiver description. The provider agency must obtain a new budget waiver to change delivery frequency or meal format after execution of the amendment.

The approval is made during the budget-based rate negotiation process. See Section 5230, Budget-Based Rate Negotiation, for additional information on budget-based rate negotiation.

 

4320 When a Waiver Request is Not Needed

Revision 13-0; Effective September 3, 2013

 

A provider agency does not have to submit a waiver request if the Department of Aging and Disability Services case manager uses Form 2101, Authorization for Community Care Services, to authorize fewer than five hot meals a week for an individual. See Section 4310, Waiver Request, and Section 5230, Budget-Based Rate Negotiation, for information about when a waiver request is needed.

 

4400 Significant Changes, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.29.

 

4500 Provider Agency Quality Control Measures, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.31.

 

4600 Suspension of Services, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.33.

 

4700 Service Plan Changes, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.35.

 

4800 Termination of Services, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.37.

 

4900 Recordkeeping, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.39.

 

4910 Retention of Contract-Related Records, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §69.158.

 

4920 Nutrition Services Incentive Program Policies

Revision 13-0; Effective September 3, 2013

 

The Administration on Aging (AoA) uses Nutritional Services Incentive Program (NSIP) reports to determine the OAA NSIP funds allotted to Texas. These funds are used to purchase additional OAA eligible meals in the following federal fiscal year (FFY).

DADS has elected to receive NSIP cash in lieu of commodities for the state of Texas. All providers who receive either Area Agencies on Aging (AAA) funding or Title XX funding benefit from the NSIP cash DADS receives. Title XX HDM providers are not eligible for NSIP funds if they receive donations from U.S. Department of Agriculture (USDA) commodities and may not solicit funds from meal recipients if food received by the HDM provider include USDA donated food.

NSIP policy requires Title XX HDM providers to ask individuals for voluntary donations towards the cost of the meals. Title XX HDM program rules, 40 Texas Administrative Code §55.41, will be revised to allow for requests for funds from individuals to voluntarily make donations towards the cost of the meal.

Title XIX HDM individuals are not included in the counts for NSIP funds and the HDM provider must not solicit funds from individuals receiving Title XIX funded meals.

 

4921 Reporting Requirements for NSIP Eligible Meals

Revision 13-0; Effective September 3, 2013

 

This section contains instructions for common providers and for provider agencies receiving Title XX funding.

To be eligible for Nutritional Services Incentive Program (NSIP) funds:

  1. Meals must be served to:
    • A person 60 years of age or older.
    • A spouse (regardless of age) of a person 60 years of age or older who is receiving an NSIP eligible meal.
  2. Meals must meet the minimum nutritional requirements:
    • Contain a minimum of 33 1/3% of the dietary reference intakes (DRIs) daily recommended dietary allowances RDA), as stated in Section 339 of the Older Americans Act.
    • Comply with the most recent Dietary Guidelines for Americans, with the most recent DRIs established by the Department of Aging and Disability Services for Texas.
    • Be based on menus that have prior approval by a dietitian licensed by the Texas State Board of Examiners of Dieticians or who has a degree in food and nutrition, dietetics or food service management.
  3. The provider agency must not charge a fee to a meal recipient.
  4. The provider agency may accept contributions in accordance with rule 40 Texas Administrative Code §55.41(b).

 

4921.1Title XX Individual Contributions to Meals

Revision 13-0; Effective September 3, 2013

 

The following procedures are to be used by Title XX HDM providers when requesting donations from Title XX HDM individuals. These same procedures are used by Area Agencies on Aging (AAA) HDM providers.

Title XX HDM providers:

HDM providers are responsible for ensuring individuals receiving Title XX HDM do not feel pressured or harassed to contribute to the cost of meals. Historically, individuals receiving Title XX HDM have lower incomes and decreased ability to contribute to the cost of services.

 

4921.2 Common Providers

Revision 13-0; Effective September 3, 2013

 

Common providers must prepare two separate reports for Nutritional Services Incentive Program (NSIP) eligible meals.

Common providers must report all Title XX meals monthly using the procedures outlined below.

What to Report: The number of Title XX meals provided in the previous month.
Required Form Form 2071, Report of Older Americans Act (OAA) Nutrition Services Incentive Program (NSIP) Eligible Meals.
Report To: DADS contract manager.
Due Date of Report: 10th of each month.
Common Providers must report all Area Agency on Aging (AAA) meals and all other NSIP eligible meals using the procedures outlined below.

What to Report: The number of AAA meals and all other NSIP eligible meals provided in the previous month.
Required Form Use the method established by the AAA.
Report To: Designated AAA contact.
Due Date of Report: Established by the AAA.

 

4921.3 DADS Title XX-Only Provider Agencies

Revision 13-0; Effective September 3, 2013

 

Provider agencies receiving Title XX funds must prepare a single monthly report of Nutritional Services Incentive Program (NSIP) eligible meals. Monthly reporting must include Title XX meals as well as other NSIP eligible meals using the procedures outlined below.

What to Report: The number of NSIP eligible Title XX meals and other NSIP eligible meals provided in the previous month.
Required Form Form 2071, Report of Older Americans Act (OAA) Nutrition Services Incentive Program (NSIP) Eligible Meals.
Report To: DADS contract manager
Due Date of Report: 10th of each month.

DADS collects and aggregates this information in order to comply with OAA reporting requirements.

 

4922 Other Requirements

Revision 13-0; Effective September 3, 2013

 

Required Supporting Documentation

A provider agency participating in the NSIP program must maintain eligibility documentation as outlined in Form 2071, Report of Older Americans Act (OAA) Nutrition Services Incentive Program (NSIP) Eligible Meals, including site rosters and documented eligibility for all meals reported.

Department of Aging and Disability Services (DADS) contract management or Area Agency on Aging (AAA) staff, or both, will conduct on-site reviews to verify provider agencies are maintaining the required information. AAA or DADS contract management staff will each reconcile the information on the site roster and supporting documentation with the number of eligible meals reported. If errors are found, the provider agency may need to take corrective action.

Records Maintenance

A provider agency must maintain a copy of all documentation related to eligible meals reported as NSIP eligible, according to the terms of its contract or until all audits, claims or litigation have been resolved.

HDMPM, Section 5000, Billing and Reimbursement

Revision 13-0; Effective September 3, 2013

 

 

5100 Billing and Claims

Revision 13-0; Effective September 3, 2013

 

5110 Billing and Claims Payment, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.41.

Rule §55.41, regarding reimbursement of two consecutive failed delivery of meals, is applicable unless otherwise stated. See Section 4300, Service Requirements, Rule, for billing exception.

 

5120 Claims and Payment Information

Revision 13-0; Effective September 3, 2013

 

A provider agency may access information about, or request assistance with, claims and payments through the Texas Medicaid and Healthcare Partnership (TMHP) website on the Provider for Long Term Care Web page.

 

5200 Rate Setting

Revision 13-0; Effective September 3, 2013

 

5210 HHSC Rate Analysis

Revision 13-0; Effective September 3, 2013

 

A provider agency may access rate information at the Health and Human Services Commission
(HHSC) Rate Analysis website.

 

5220 Reimbursement Methodology for Home-Delivered Meals, Rule

Revision 13-0; Effective September 3, 2013

 

1 Texas Administrative Code §355.511.

See Appendix III, Cost Determination Process, for information.

 

5230 Budget-Based Rate Negotiation

Revision 13-0; Effective September 3, 2013

 

The Department of Aging and Disability Services (DADS) posts budget-based rate negotiation documents and detailed instructions on the Home-Delivered Meals (HDM) provider page at FFY Budget Negotiation. A provider agency may also access that information at the HDM home page.

A provider agency must use these documents during budget-based rate negotiations with the DADS contract manager to develop a per meal unit rate for the upcoming Federal Fiscal Year (FFY). In addition, a provider agency that is a common provider will be contacted by its Area Agency on Aging (AAA) to negotiate per meal unit rates for those meals. AAAs and DADS continue to jointly negotiate budgets and rates for common providers.

DADS contract managers and provider agencies, as applicable, will review projected expenses for the coming FFY in conjunction with final budget numbers for the most current completed fiscal year and apply cost allocation methodology and cost principles to arrive at the appropriate per meal unit rate for the upcoming FFY. The contract specific rate cannot exceed the unit reimbursement rate established by the Texas Health and Human Services Commission.

For additional information on delivery of fewer than five hot meals per week, see Section 4310, Waiver Request.

HDMPM, Section 6000, Complaints

Revision 13-0; Effective September 3, 2013

 

6100 Complaints, Rule

Revision 13-0; Effective September 3, 2013

 

40 Texas Administrative Code, §55.43

 

6200 Complaints

Revision 13-0; Effective September 3, 2013

 

A complaint is a situation, problem or concern that alleges abuse, neglect or exploitation of an individual, may pose a health or safety threat, may cause harm or that appears to be a violation of state standards, program standards or contract requirements. The complaint may be general or specific, and could involve the provider agency’s staff, beneficiaries, volunteers, physical environment, administration or services.

In accordance with Human Resources Code, Chapter 48, Subchapter B, a person must report to the Texas Department of Family and Protective Services (DFPS) Adult Protective Services (APS) if the person has cause to believe that an elderly or disabled person is in the state of abuse, neglect or exploitation. A provider agency must also report any suspected cases of abuse, neglect or exploitation to DFPS Adult Protective Services.

When the reporter contacts APS to report abuse, neglect or exploitation, the reporter is filing a complaint alleging that harm may be occurring, or may have occurred. If APS determines the harm does not meet its threshold for conducting an investigation, the report is forwarded to the Department of Aging and Disability Services (DADS) Consumer Rights and Services for follow up.

In situations where the provider agency receives a complaint regarding services from the individual or the individual’s designated representative, the provider agency must document and investigate the complaint. Title 40 Texas Administrative Code, §49.17, defines complaint procedures. If the complaint alleges abuse, neglect or exploitation, the provider agency must submit a report to APS, as previously stated.

The provider agency must send the documented complaint and resolution to the assigned DADS contract manager and must send a copy to the DADS staff if the complaint was submitted by a DADS staff member, who may have reported on behalf or in place of the individual, as applicable.

A contract manager monitors for compliance with this requirement. A contract manager looks for possible violations of contract and program requirements when reviewing the complaint log and the provider agency's investigation of the complaint.

 

6210 Notification of Rights and Responsibilities and Complaint Procedure

Revision 13-0; Effective September 3, 2013

 

Notification

A provider agency of Title XIX and Title XX Home-Delivered Meals (HDM) is required by 40 Texas Administrative Code, §49.18, to notify, orally and in writing and annually, each individual or authorized representative of the individual’s rights and responsibilities under Texas Human Resources Code, Chapter 102, Rights of the Elderly; and procedures for filing a complaint, including the name, title and telephone number of the person to whom a verbal complaint may be made.

A provider agency may use DADS “Your Rights in a DADS Community Program” booklet to inform an individual or the individual’s representative of this information.

Also, a provider agency may order copies of the booklet by emailing crscomplaints@dads.state.tx.us. The provider agency must note in the subject line of the email that Consumer Rights booklets are being requested, and include the following in the body of the email:

Documentation

A provider agency must document delivery of the notification in one of two ways:

The provider agency must keep the signed and dated original notification form in the individual’s
record and must give the individual or authorized representative a copy of the signed and dated form.

HDMPM, Section 7000, Monitoring

Revision 13-0; Effective September 3, 2013

 

 

The Department of Aging and Disability Services conducts monitoring reviews of program contracts it administers. Rules that apply to this section are:

 

40 Texas Administrative Code, Chapter 49, Subchapter E.

40 Texas Administrative Code, Chapter 69, Subchapter I.

 

7100 Contract Monitoring Tool

Revision 13-0; Effective September 3, 2013

 

The Department of Aging and Disability Services created a Contract and Fiscal Compliance Monitoring Tool for the Home-Delivered Meals (HDM) Program.

Note: Scroll down the Web page to locate the tool for the HDM program.

A provider agency should direct questions about the tool or requests for additional assistance to its contract manager.

HDMPM, Section 8000, Sanctions, Fraud and Abuse

Revision 13-0; Effective September 3, 2013

 

 

Rule: 40 Texas Administrative Code, Chapter 49, Subchapter F.

The Department of Aging and Disability Services (DADS) identifies and refers cases of suspected fraud or abuse of Medicare, Medicaid or social services program funding or resources to the Texas Health and Human Services Commission, Office of Inspector General (HHSC-OIG).

If directed to do so by the OIG, DADS excludes from program reimbursement any provider agency that defrauds or abuses a Medicare or Medicaid program. DADS suspends, in the event that the U.S. Department of Health and Human Services (HHS) directs the suspension, any recipient of Medicaid reimbursement who has been convicted of a crime related to the delivery of medical care or services under Medicare, Medicaid or social services programs.

 

8100 Report Fraud

Revision 13-0; Effective September 3, 2013
 

A provider agency must report suspected waste, fraud or abuse in health and human services programs to the Texas State Auditor's Office at 1-800-TX-AUDIT (1-800-892-8348), and to the HHSC Office of Inspector General at 1-800-436-6184.

Additional reporting resources are:

All reports are kept confidential except as required by state or federal law. For further information, visit the CRS website.

HDMPM, Appendices

HDMPM, Appendix I, 40 Texas Administrative Code Chapter 49, Contracting for Community Care Services

Revision 13-0; Effective September 3, 2013


 

This appendix is available online only at the following website:
http://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=4&ti=40&pt=1&ch=49&rl=Y

HDMPM, Appendix II, DADS Contract Management

HDMPM, Appendix III, Cost Determination Process

HDMPM, Appendix IV, HIV/AIDS in the Workplace

HDMPM, Appendix V, Mutually Exclusive Services

HDMPM, Appendix VI, Retired Information Letters

Revision 13-1; Effective September 13, 2013

 

The Department of Aging and Disability Services (DADS) deployed the Home-Delivered Meals (HDM) Provider Manual on Sept. 3, 2013. This manual contains all contract guidelines that were formerly found in Information Letters (ILs).

Content in the provider manual supersedes any previous ILs or similar guidance published by DADS. The ILs that were retired are listed below. DADS recommends that providers remove the ILs from their records to ensure they reference the most current information.

Number Title Date
IL 2010-94 HDM Rate Setting Procedures for Federal Fiscal Year (FFY) 2011 (replaces IL 09-83) 6/25/2010
IL 2010-61 FFY 2011 Request for Waiver of Requirement to Deliver Meals Fewer than Five Days a Week (Replaces Information Letter 09-64) 5/3/2010
IL 2009-83 HDM Rate Setting Procedures for Federal Fiscal Year (FFY) 2010 6/17/2009
IL 2009-11 Notifying Individuals of Rights and Responsibilities and of Procedures for Filing Complaints 2/19/2009
IL 2008-142 Hurricane Ike Services: FC and HDM Services Available
to Limited Number of Individuals Temporarily Residing in Shelters,
Hotels, or Home Settings
10/2/2008
IL 2008-116 Request for Waiver of Requirement to Deliver Meals Fewer than Five Days a Week (Replaced by IL 2009-64 and IL 2010-61) 8/25/2008
IL 2008-114 Home Delivered Meals Rate Setting Procedures for Federal Fiscal Year (FFY) 2009 8/4/2008
IL 2007-76 Home Delivered Meals Rate Setting Procedures for FFY 2008 8/16/2007
IL 2006-61 Administration on Aging Nutrition Services Incentive
Program Reporting Requirements and Rate Setting Procedures for Federal
Fiscal Year 2007 (Letter requires Adobe Reader 6 or 7 to access
attachments)
6/20/2006
IL 2005-18 Administration on Aging (AoA) Nutrition Services
Incentive Program (NSIP) Reporting Requirements and Rate Setting
Procedures for Federal Fiscal Year 2006 - This letter requires Adobe
Reader version 6 or newer to view.
7/25/2005
IL 2004-40 Home-Delivered Meals Nutritional Risk Assessment and National Aging Program Information Systems (NAPIS) Reporting 4/1/2005
IL 2004-27 Administration on Aging (AoA) Nutrition Services
Incentive Program (NSIP) Reporting Requirements and Rate Setting
Procedures for Federal Fiscal Year 2005
6/11/2004
IL 2004-10 Repeal of Chapter 48, Subchapter M, Home-Delivered
Meals and Subchapter N, Support Documents, and Adoption of Chapter 55,
Contracting to Provide Home-Delivered Meals, Effective March 1, 2004
3/5/2004
IL 2003-19 FY 2004 Reimbursement Rate Ceiling for Home-Delivered Meals (HDM) 8/28/2003
IL 2003-06 USDA Cash-In-Lieu Reporting Requirements and Rate Setting (FY 2004) 6/13/2003
IL 2002-40 New Home Delivered Meals Rules 12/31/2002
IL 2002-17 USDA Cash-in-Lieu Reporting Requirements and Uniform Rate Setting Procedures (URSP) for FFY '03 7/8/2002
IL 2002-07 Change in CIL Reporting Requirements for Home Delivered Meals 4/12/2002
IL 2001-19 New Billing Code for CBA Meals 10/17/2001
IL 2001-06 United States Department of Agriculture Cash-in-Lieu of Commodities - Home Delivered Meals Providers 7/27/2001
IL 2000-20 Payment Rate Methodology for Home Delivered Meals 8/31/2000
IL 2000-19 United States Department of Agriculture (USDA) Cash-in-Lieu of Commodities Home Delivered Meals 8/22/2000
IL 1999-42 Cash-in-Lieu of Commodities Reimbursement 10/22/1999
IL 1999-15 Payment Rate Methodology for Home Delivered Meals 8/16/1999
IL 1999-25 Uniform Reimbursement Methodology for Home Delivered Meals 6/30/1999
IL 1999-02 Cash-in-Lieu (CIL) of Commodities Reimbursement Rate for Fiscal Year 1999 2/17/1999
IL 1999-01 TDHS Policy Cash-in-Lieu of Commodities Home Delivered Meals Providers 2/17/1999

If there are questions about the revised HDM provider manual or any of the ILs that were retired, send an email to PDO@dads.state.tx.us.

HDMPM, Appendix VII, List of Excluded Individuals Entities (LEIE)

HDMPM, Forms

Form Title
2027 Home-Delivered Meals Waiver Request
2031 Governing Authority Resolution - Business Organization
2031-G Governing Authority Resolution - Governmental Entity
2071 Report of Older Americans Act (OAA) Nutrition Services Incentive Program (NSIP) Eligible Meals
2101 Authorization for Community Care Services
3053 Informacion en espanol Notification of Rights and Responsibilities, Complaint Procedures, and Allegations of Abuse, Neglect or Exploitation
3681 Community Services Contract Application
3691 Service Area Designation

Informacion in espanol = form also available in Spanish.

HDMPM, Revisions

HDMPM, 15-1, January 16, 2015, Mutually Exclusive Services

Revision Notice 15-1; Effective January 16, 2015


 

Section Title Change

Appendix V

Mutually Exclusive Services Removes Community Based Alternatives, Emergency Care,
STAR MRSA and MC Dental. Changes STAR+PLUS to STAR+PLUS Program and
updates the information.

HDMPM, 14-1, September 19, 2014, Section 1100 Change

Revision Notice 14-1; Effective September 19, 2014

 

Section Title Change

1100

Home-Delivered Meals Eligibility

Removes income and resources from the first sentence.

HDMPM, 13-1, September 13, 2013, New Appendix

Revision Notice 13-1; Effective September 13, 2013
 

 

Section Title Change

Appendix VI

Retired Information Letters

Adds an appendix that lists retired information letters.

HDMPM, 13-0, September 3, 2013, New Handbook

Revision Notice 13-0; Effective September 3, 2013

 

The replaces the Contracting to Provide Home-Delivered Meals Handbook.

HDMPM, Contact Us

For questions about the Home-Delivered Meals Provider Manual, email: hdmpolicy@hhsc.state.tx.us

For technical or accessibility issues with this handbook, please email: handbookfeedback@hhsc.state.tx.us