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:

  • deliver multiple meals to an individual at least one day per week;
  • make contact with the individual at least three days per week, including the day of meal delivery;
  • provide continuity of daily hot meal service to an individual who cannot use a frozen or shelf-stable meal;
  • notify DADS of a significant change of condition of an individual, as required by rule;
  • handle alternate meals safely (e.g., frozen, chilled or shelf-stable);
  • provide safe and sanitary storage, thawing and preparation capacity; and
  • comply with rules in Texas Administrative Code §55.27 regarding temperature control, marking of meals and time in transit.

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:

  • must provide an individual with an opportunity to donate toward the cost of the meal;
  • must not require an individual to donate towards the cost of the meal;
  • may provide an individual with a donation schedule that only suggests an amount based on the income range of the program population being served, but may not determine an individual’s income using an income test;
  • must protect the individual’s privacy with respect to the individual’s donations;
  • must establish appropriate procedures to secure and account for all donations made; and
  • must use all of the individual’s donations to support or expand services for which the individual donated, in accordance to state and federal laws, rules and regulations.

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.