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AGING AND DISABILITY SERVICES ADMINISTRATION

SENIOR NUTRITION PROGRAM STANDARDS

PROGRAM ADMINISTRATION

  1. Organizational Structure
    CNS and HDNS services may be provided independently or by the same provider. They may be provided under the auspices of a parent agency including, but not limited to, a Community Action Agency, Council on Aging, senior center, public or private school, hospital, housing authority, county health department, parks and recreation department, city or county government, Indian Tribal Council, or by an agency that is independent and not part of a larger organization.
    HDNS providers may also contract to provide Medicaid waiver (COPES) home-delivered meals but must account for program revenue and expenditures separately.
    The service provider should develop a written agreement, or contract if necessary, with each agency or organization where a congregate nutrition site or home-delivered food preparation site is located. Each agreement or contract should specifically address the following issues between the nutrition program and the agency or organiza­tion allowing the nutrition program to use its facilities:
    1. Responsibilities and obligations of each party, including compliance with these standards;
    2. Staffing interrelationships;
    3. Costs or payments, if any, to be paid or incurred by either party;
    4. Days and hours the congregate nutrition site will operate and provide services in the agency's or organization's facility, or for HDNS, days meals will be delivered.
    5. Other matters as necessary to operate the nutrition program according to these standards.
  2. Staffing
    The service provider should employ an adequate number of qualified personnel to assure satisfactory conduct of the program. Preference should be given to persons age 60 or over in the hiring for all positions when other qualifications are equal.
    The staffing pattern should include:
    1. Nutrition Program Director : The program director should be empowered with the necessary authority to conduct the day-to-day management and administrative functions of the program. The director may be hired on a part-time or full-time basis, at the discretion of the AAA, as long as the staff time allocated is adequate to fulfill the responsibilities of the position.
      Program directors should have management or supervisory experience and a background in food, nutrition, or food service management, which can be ful­fil­led by education or experience in the food service industry.
    2. Registered Dietitian or Individual with Comparable Expertise (ICE): The Older Americans Act requires CNS and HDNS to be carried out with the advice of “a dietitian or individual with comparable expertise.” For the purpose of these standards, a dietitian shall be defined as a dietitian registered by the Commission on Dietetic Registration (Registered Dietitian or RD). An individual with comparable expertise (ICE) is defined as a nutritionist according to RCW 18.138, which requires a master's or doctorate degree in one of the following areas: human nutrition, nutrition education, foods and nutrition, public health nutrition, or nutrition sciences. It is recommended that the RD or nutritionist be certified by the State of Washington in accordance with RCW 18.138.
      An RD or ICE must be available to the service provider for the planning and provision of nutrition services, either on staff, under contract, or in a volunteer capacity.
      The required responsibilities of the RD or ICE are:
      1. assist in the development of menus;
      2. certify that all meals meet the nutrient requirements as defined in the section on menu planning;
      3. provide consultation on food quality, safety, and service;
      4. plan meals prepared to meet special dietary or therapeutic needs, if provided by the program;
      5. assist with the development of program objectives related to nutrition education;
      6. provide directly or oversee the provision of nutrition education;
      7. assist with the development of program objectives related to nutrition therapy services, and provide nutrition therapy, where the nutrition program has allocated the resources to provide the service.
      Additional responsibilities may include staff training and other activities based upon the needs and priorities established for the program. These needs and priorities should be jointly estab­lish­ed by the AAA and the service provider.
    3. Other Personnel : The method used to provide meals, nutrition education, and nutrition outreach will determine the number and type of permanent, consultant, or volunteer personnel required to manage the nutrition program and provide fiscal, administrative and clerical support.
  3. Training and Other Staff and Volunteer Requirements
    1. Safe Food Handling Practices
      All staff involved in the handling of food must have training on safe food handling practices prior to beginning food handling duties if the worker does not hold a valid food worker card. These staff must receive the required food worker training and obtain a food worker card, according to local health department requirements and WAC 246-217 (Appendix II), within fourteen calendar days of beginning paid or volunteer work. The provider must document the health department requirements relevant to each site and develop its policies in response.
    2. Orientation and In-Service Training
      All staff, both paid and volunteer, should receive orientation before providing nutrition program services.
      The service provider should provide in-service training on a regular basis for all staff, paid or volunteer, engaged in implementing the program. Such training should be designed to enhance each staff member's performance of his/her specific job responsibilities, take into account requests for training from staff, and be designed to resolve problems identified during the AAA assessment of program performance.
      Each service provider should have a written training plan describing the content of orientation and the subject matter expected to be covered during in-service training. The dates and content of training actually provided should be documented.
      As allowed by the funding source (refer to chart in Section II. Funding), nutrition program funds may be used to pay for costs to local, statewide or out-of-state training in accordance with AAA policies.
    3. Emergency Procedures
      A written plan which describes procedures to be followed in case a CNS or HDNS participant becomes ill or is injured should be thoroughly explained to staff, volunteers and participants, and should also be posted in at least one visible location in each congregate nutrition site. Staff should also be trained in emergency and evacuation procedures.
    4. Criminal Background Checks
      HDNS providers must conduct criminal history background checks, as allowed by RCW 43.43.830-43.43.834 , for all employees or volunteers who will have unsupervised access to participants. Unsupervised is defined at RCW 43.43.830 as not in the presence of:
      1. Another employee or volunteer from the same business or organization as the applicant; or
      2. Any relative or guardian of any of the children or developmentally disabled persons or vulnerable adults to which the applicant has access during the course of his or her employment or involvement with the business or organization.
  4. Physical Facilities and Equipment for Congregate Nutrition Services
    Each congregate nutrition site must meet the following requirements related to physical facility and equipment:
    1. Be in compliance with federal, state and local fire and building codes. Programs must have the local or state fire marshal conduct a fire and life safety inspection of each site prior to opening and annually thereafter. The most recent inspection report or a copy shall be on file at the nutrition site. At sites where a timely inspection can not be obtained, documentation of efforts to obtain an inspection and the alternative actions taken to address building safety issues must be kept on file.
      In areas where there is difficulty obtaining an annual inspection, the AAA shall work with the provider to obtain an inspection or provide for alternative ways to address building safety issues.
    2. Be in compliance with the Americans with Disabilities Act. At a minimum:
      1. Be free of architectural barriers that limit the participation of people with disabilities.
      2. Make special provisions as necessary for the service of meals to persons with disabilities.
      3. Have available for use upon request adaptive food containers and utensils for individuals with disabilities.
      It is recommended that a self-assessment for ADA compliance be conducted at each site annually or after remodeling, and for new facilities, prior to opening. Sample assessments are provided in Appendix III.
    3. Provide for a permanent or temporary separation between the dining area and the food preparation area when food is prepared and served in the same facility.
    4. Be located in a facility where all participants will feel free and comfortable to visit. Selection must take into consideration the type and location of the facility so as not to offend the cultural and ethnic preferences of eligible persons in the program area.
    5. Have equipment, including tables and chairs, that is sturdy and appropriate for older persons. Tables should be arranged to ensure a pleasant atmosphere for dining and encourage maximum socialization among participants. Adequate aisle space should be provided between tables to allow persons with canes, walkers or crutches to walk with ease and to accommodate wheelchairs.
    6. Provide tableware and flatware, including plates, glasses, cups, forks, spoons, and knives, which is appropriate for older persons. The service provider may not ask or require partici­pants to bring their own tableware and flatware for use at the congregate nutrition site.
Menu Pattern
Food Group Servings per meal/portion size Dietary Guidelines
Bread or Bread Alternate 2 servings (1 serving equals 1 slice bread; 1/2 cup cooked pasta, rice or cereal; 1 cup cold cereal). A bread alternate may include vegetables or fruits high in complex carbohydrates (starch), e.g., potatoes, yams, plantains, starchy squashes, etc. (these can not be counted as a bread and a vegetable). 6-11 servings daily. Eat a variety of grain products, including several servings of whole grain (high fiber) foods.
Vegetable 2 servings (1 serving equals ½ cup; 1 cup leafy; 3/4 cup 100% vegetable juice). An additional vegetable may be served in place of a fruit 3-5 servings daily. Eat a variety of types and colors of vegetables, including dark-green leafy, orange vegetables, cooked dry peas and beans.
Fruit 1 serving (1 serving equals one medium whole fruit; ½ cup chopped, cooked, or canned; 3/4 cup 100% fruit juice). An additional fruit may be served in place of a vegetable 2-3 servings daily. Eat a variety of fruits, including deeply colored such as orange fruits.
Milk or Milk Alternate 1 serving (1 serving equals 1 cup fluid milk or calcium enriched soy milk or juice; 1 cup yogurt; 1 cup tofu processed with calcium salt; 1 1/2 oz. natural cheese) 3 servings daily. Select low fat products. Watch “alternative” milks as they may lack calcium and Vitamins A and D.
Meat or Meat Alternate 1 serving (1 serving equals 2.5-3 oz meat, fish poultry; 3 eggs;3 oz cheese; 1 1/2 cups cooked dried beans, peas, or lentils; 7 oz soyburger; 6 tbsp peanut butter or 1 cup nuts; 3/4 cup cottage cheese; 1 1/2 cups tofu) 2 servings daily, total of 6 ounces. Choose fish, shellfish, lean poultry or other lean meats, beans or nuts daily. Trim fat from meat and take skin off poultry. Limit intake of high-fat processed meats like bacon, sausage, cold cuts.
Fats 1 serving (1 serving equals 1 teaspoon or equivalent measure) Select foods low in fat, saturated fat, trans fats, and cholesterol. Choose vegetable oils rather than solid fats (meat and dairy fats, shortening). Limit total fat to 30% and saturated fat 10% of calories.
Dessert Serving size varies; dessert is optional Select foods high in whole grains, low in fat and sugars

Whether meals are analyzed using analysis software or a meal pattern is used, menus must be certified by signature of a Registered Dietitian or ICE that each meal or the week’s meals meets the nutrient requirements. AAAs may require providers to submit documentation regularly or review documentation at annual monitoring visits, or some other method to ensure compliance.

    1. Food Substitutions
      Each meal certified as meeting the nutrient requirements should be served as written. If the meal cannot be served or is not acceptable to the participants, this should be brought to the attention of the program director and Registered Dietitian or ICE involved in planning menus.
      Food substitutions should be of similar nutritional value and may not reduce or significantly alter the nutritional content of the meal. Food substitutions should be approved by the program director, Registered Dietitian, ICE, or the person responsible for the food service. Any deviation from the certified Menu Pattern or Nutrient Analysis must be documented and initialed on the service provider's official file copy of the Menu Pattern or Nutrient Analysis form. Food substitutions at the time of food preparation and serving should be infrequent.
    2. Special Menus and Therapeutic Diets
      The service provider must provide meals that, to the extent practicable, are adjusted to meet any special dietary needs or cultural preferences of program participants. In determining practicability, the provider should consider:
      1. whether there are a sufficient number of persons who need a special menu to make the provision practical; and
      2. whether the food and skills necessary to prepare the special menus are available to the program.
      Making special menus available will help encourage certain target­ed groups of older persons to participate in the nutrition program when the lack of special menus would deny their participation. The service provider may not ask or require participants to absorb the added costs (if any) of having special menus.
      Therapeutic diets (modified diets) represent one classification of special menus a service provider may offer to its partici­pants. A therapeutic diet is a treatment diet based on the normal diet and designed to meet the requirements of a given situation. Therapeutic diets may be modified in individual nutrients, caloric values, consistency, flavor, techniques of food preparation, content of specific foods, or combinations of the preceding.
      A current therapeutic diet prescription (no older than six months) should be signed by the participant's physician, RD, or ICE and filed in the service provider's official files.
      Programs choosing to provide therapeutic diets should ensure the diets are planned, prepared and served under the supervision and/or consultation of a Registered Dietitian or ICE. Training and monthly supervision of food service personnel responsible for the preparation of therapeutic diets should be provided by a Registered Dietitian or ICE.
      Vitamins, minerals and/or food supplements, with the exception of liquid meals that meet the criteria described below, may not be provided with nutrition program funds.
      The provision of liquid meals is generally discouraged. They may be used only when:
      1. they are provided to a participant who has been determined to be at nutritional risk through the nutrition risk screening or by a medical professional, Registered Dietitian, or ICE, and they are in addition to a standard meal which meets the requirements in these standards; OR
      2. as a replacement for a standard meal only when approved by a medical professional, Registered Dietitian, or ICE as part of a participant’s nutritional plan.
  1. Food Service Sanitation and Safety
    Compliance with federal, state, and local fire, health, sanitation, safety and building codes, regulations, licensure requirements, and other provisions relating to the public health, safety, and welfare applicable to each congregate nutrition site, food preparation site, and food service vendor/caterer used in the nutrition program is required in all stages of food service operations.
    Specifically regarding food, food service, and the food worker, the service provider must comply with Washington Administrative Code (WAC) 246-215, Food Service; WAC 246-217 Food Worker Cards; Revised Code of Washington (RCW) 69.06 Food and Beverage Establishment Workers’ Permits. (Appendix II)
    1. Inspection Reports
      Service providers must have in their official files a copy of all current Food Service Inspection Reports (or their equiva­lents) completed by state or local health department staff, or a Registered Sanitarian, for each congregate nutrition site, food preparation site, and food service vendor/caterer used in the nutrition program. For the purposes of these standards, a food service vendor/caterer is defined as an entity contracted by the service provider to prepare meals for HDNS or CNS.
      To be current, the date on the report must not exceed one year elapsed. If for any reason a congregate nutrition site, food preparation site, or food service vendor/caterer does not have a current Food Service Inspection Report, the AAA and the provider must take immediate action and work together to achieve compliance. This may entail hiring a private Registered Sanitarian, or working with the local health department to expedite an inspection.
    2. Food and Beverage Service Handlers Permits
      All food service workers, either paid or working in a volunteer capacity, are required to earn their Food and Beverage Service Worker’s Permit. Persons working in a paid or voluntary capacity have 14 days from commencement of their work to earn their permits. Service providers may pay the permit fees for their volunteers and paid staff.
      The Food and Beverage Service Workers’ Permits earned by all food service workers must be maintained in the service provider's official files.
    Foods should be prepared, displayed, served and transported with the least possible manual contact, with suitable equipment and utensils, and on surfaces that, prior to use, have been cleaned, rinsed, and sanitized to prevent cross contamination.
    Effective procedures for dish sanitizing, cleaning equipment, and work areas should be written, posted, and followed consistently.
    On a daily basis, temperature checks should be taken with a food thermometer at the time all food leaves the production area (including the food service vendor/caterer's kitchen) and at the time of serving. Records of these temperature checks must be maintained in the nutrition program service provider's official files. Depending upon procedures involved in food preparation and delivery (e.g., transportation, receiving, storing and serving), additional temperature checks may be required.
    Additional Food Safety Requirements for HDNS
    Food and meals being transported to the home for use of the homebound participant should be protected from potential contamination, including dust, insects, rodents, unclean equipment and utensils, and unnecessary handling.
    The holding time, with appropriate temperature control, between food preparation and the consumption of the meal should be minimal to reduce opportunities for contamination and to maintain nutritional quality, food acceptability, and food safety. Providers are encouraged to enter into contracts that limit the amount of time meals must spend in transit before being consumed.
    The transport equipment, packaging materials and procedures used by the service provider to deliver meals to the home for immediate consumption should be able to maintain hot food temperatures at or above 140 ° F and cold food temperatures at or below 45 ° F (41 ° F effective May 2, 2005) from the time of packing to the time of delivery to the home of the participant.
    Frozen foods or meals used in a home-delivered meals program should be based upon the ability of the service provider and homebound participant to provide safe conditions for the storage, thawing, and reheating of the frozen foods. Frozen food should be kept frozen until such time as it is to be thawed for use. Frozen food storage should be maintained at 0 F.
    Food should only be supplied to the homebound participant for later consumption when adequate storage, refrigeration, reconstitution or heating equipment is available and can be used safely and properly by or for the participant.
    On a daily basis, temperature checks should be taken with a food thermometer at the time all food leaves the production area (including the food service vendor/caterer's kitchen). On each delivery route, temperature checks of each food (with the exception of frozen, freeze dried, dehydrated or canned foods) should be taken with a food thermometer at the time of delivery of the last home-delivered meal. These temperature checks shall be done at least monthly, or more frequently to ensure required temperatures are maintained. The frequency shall be determined based upon the procedures involved in food preparation and delivery, e.g., transportation, receiving, storing, packaging and delivering. Records of these temperature checks must be maintained in the home-delivered nutrition program service provider's official files.
  2. Food Quality
    All foods used in the nutrition program must meet standards of quality, sanitation and safety applying to foods that are processed commercially and purchased by the program.
    All foods used in the nutrition program must be:
    1. from approved sources;
    2. be in compliance with applicable state and local laws, ordinances and regulations;
    3. and be clean, wholesome, free from spoilage, free from adulteration and mislabeling, and safe for human consumption.
    Hermetically sealed food which has been processed in an approved commercial food processing establish­ment may be used. Home-canned foods may not be used.
    All foods contributed to the nutrition program must meet the same standards of quality, sanitation and safety that apply to foods processed commercially and purchased by the nutrition program.
    Fresh or frozen meat and poultry used in the meals provided by the service provider must be USDA inspected. Wild game cannot be used in the nutrition program because it is not inspected by USDA and is considered "adulterated" and would not be approved for use according to the Washington State Health Code.
    Dried meat or dried fish may be used in meals only if it has been commercially processed at a government (including tribal) approved processing plant.
    The service provider assumes the responsibility for determining the condition, quality and safety of fresh or frozen fish used in its food service since federal or state inspection of fresh or frozen fish is not required.
    The service provider assumes responsibility for determining the condition, quality and safety of fresh produce used in its food service.
    Purchasing procedures should assure availability of food, supplies and equipment in the quantity and quality consistent with established stan­dards and at the most favorable prices consistent with set standards.
    Service providers are encouraged to use locally produced foods whenever possible, and collaborate with local food producers and other food assistance programs to maximize access to and use of high quality, nutritious, affordable foods.
  3. Food Service Standards
    All staff working in the preparation of food must be under the supervision of a person who will ensure the application of hygienic techniques and practices in food handling, preparation and service. This supervisory person should consult with the Registered Dietitian or ICE for advice as necessary.
    The service provider should prepare and serve the meal in such a manner as to ensure that each food item identified on the menu is readily available and easily accessible to each participant to maximize the likelihood that each participant will receive the full nutritional benefits of the meal.
    Food should be prepared using production and presentation methods that enhance the palatability, hence acceptability, of the food served. Acceptability of the food served will depend upon appearance (color, consistency, shape or form, arrangement, size portion) and flavor (seasoning, texture, odor, temperature, degree of doneness).
    In purchasing food and preparing and delivering meals, service providers should follow appropriate procedures to preserve nutritional value and food safety.
    Foods used in the nutrition program should be selected, stored, prepared, and served in a manner to assure maximum nutrient content or food value.
    Additional requirements for CNS
    Meal service should be available for a period of time adequate for all participants to eat a leisurely meal.
    Menus should be posted in a conspicuous location in each congregate nutrition site.
    Service providers are not required to post signs at the congregate meal site about the use of sulfating agents, nuts, or other common food allergens, however, they should be prepared to identify all ingredients in the meals served in the event a participant asks for this information.
  4. Standardization of Recipes and Portion Control
    Recipes used by the nutrition program service provider should be adapted and standardized for use by carefully testing each recipe in its own kitchens with its particular equipment, available ingredients, and skills and abilities of its personnel. The recipes should then be adjusted for yield (number of servings) based on the number of people to be served and the portion size necessary to comply with nutrient requirements.
    Except when food comes from a food service vendor/caterer, a file of standardized recipes which are acceptable to program participants should be kept and used for the purposes of:
    1. Production Control: To save time and money by eliminating the guesswork and waste due to poor estimating of quantities and failures in cooking and reduce supervision time of inexperienced or new personnel.
    2. Portion Control: To prevent leftovers and eliminate waste, or not having enough food at serving time or for the number of home-delivered meals required; assure that participants at congregate sites feel fairly treated when each person is served the same quantity or amount of food; predict food costs and stay within the budget; and provide examples of sensible portion sizes to help participants achieve or maintain healthy weights.
    3. Quality Control: To achieve an acceptable finished product each time it is prepared because the weights and measures and food ingredients are the same each time; allow more time to develop pleasing items for a better accepted food program; accurately calculate the nutrient content of the meal by using the listed amounts of ingredients in each recipe in order to certify that the total meal will meet one-third of the Recom­mended Dietary Allowances when proper portion sizes are served.
    4. Cost Control: To simplify purchasing because it helps establish what and how much food is needed; control food costs by using only exact quantities of food ingredients.
    All food service workers should be familiar with, understand the need and purposes of, and be given the necessary equipment and utensils to use standardized portions. A visual standard of reference for portion size should be provided.
    The nutrition program service provider should develop procedures for determining how many people will eat at each congregate nutrition site on each serving day, or how many home-delivered meals must be prepared in order for the food production staff to adjust their standardized recipes to yield the proper number of portions.
    The service provider should develop, and have approved by the AAA, a written policy describing the procedures the nutrition provider will follow regarding the use and handling of excess food not needed to serve CNS participants or prepare home-delivered meals. In developing these procedures, particular attention should be accorded to the sanitation and safety of the foods and the economic consequences that leftovers have on the service provider's food costs and budget. Use of leftovers is strongly discouraged in the preparation of home-delivered meals.
    Leftovers may be offered to CNS participants as second helpings at those congregate settings that do not have on-site cooking facilities or methods to preserve leftover food to meet the nutritional standards for later consumption. Only if these meals meet 1/3 RDA may they be counted as a meal for reporting purposes. Staff who are not members of the eligible population may not take leftovers home.
    If leftover meals are provided at a congregate site, a set of written instructions should be included with each meal. The instructions should include the date the meal was prepared, the discard date (two days following), refrigeration instructions, a statement about proper hand washing, instructions to reheat to 165 degrees, and a disclaimer that states: For your safety: food removed from this site must be kept hot or refrigerated promptly. We are not responsible for illness or problems caused by improperly handled food.
  5. Nutrition Program Costs
    The service provider must account for the program costs identified in this section. From these costs, the provider must determine an average per meal complete cost (including all costs from all categories) for both a home delivered and a congregate meal at least annually. The complete per meal cost is the amount that must be charged to non-eligible individuals and outside fund sources, such as COPES or an adult day services provider. Revenue and expenditures for home-delivered, congregate, and non-OAA funded meals must be accounted for separately. The per meal cost for Medicaid-funded (COPES) meals must not be more than the cost charged to other funds sources (CFR 42 Section 447.325).
    The cost categories include:
    1. Salaries and wages: labor costs for food prepa­ration, cooking, and serving; cleaning of the dining facility, meal preparation areas, and food service equipment; transporting meals to nutrition sites or participants’ homes; direct food service supervision.
    2. Personnel benefits: costs for health insurance, pension, unemployment, OASI, workers’ compensation, etc.
    3. Supplies: costs of food raw food and food purchased with NSIP funds; all non-capital supplies and equipment such as serving supplies, disposables, cleaning materials, computers.
    4. Other Services and Charges: space rental/leases; professional services; communications such as phone, Internet, postage; travel; advertising; insurance; utilities; repairs and maintenance; miscellaneous.
    5. Capital Outlays: costs of capital items such as land and buildings, capital improvements, and equipment such as stoves, dishwashers, trucks and vans, steam tables, freezers, etc.
    Nutrition education and outreach costs should be accounted for as required by the AAA.
  6. Surplus Property
    Nutrition program service providers are eligible to receive property which is declared surplus by the federal government in accordance with laws applicable to surplus property. See the General Administration website at http://www.ga.wa.gov/customer/cust-surplus.htm
  7. Sales and Use Tax
    The service provider is exempt from paying sales or use tax for:
    1. Food or meals purchased at the wholesale or retail level and utilized by the nutrition program.
    2. Donations for meals received from individuals participating in the nutrition program.
    The service provider will not violate its tax-exempt status if it develops printed material suggesting a donation amount as a guide for participants to use when they make their donation.
  8. Nutrition Services Incentive Program
    AAAs and their nutrition program service providers are eligible to participate in the Nutrition Services Incentive Program (NSIP). The purpose of the NSIP is to provide incentives to encourage and reward effective performance in the efficient delivery of nutritious meals to older individuals. The NSIP provides an allotment of cash or commodities to states and Indian Tribal Organizations (ITO) for their nutrition programs based on the number of meals served in the previous year in proportion to the total number of Title IIIC meals served by all states and ITOs that year, as reported in the State Program Reports (NAPIS).
    Washington State has elected to receive cash in lieu of commodities. NSIP cash is allocated to AAAs based on the number of NSIP-eligible meals served in the previous year in proportion to the total number of NSIP-eligible meals served by all AAAs as reported through NAPIS. NSIP cash may only be used for meals served to individuals eligible for CNS or HDNS according to these standards. Food purchased with NSIP cash must be United States (U.S.) agricultural commodities or other foods of U.S. origin.
    Meals counted for purposes of NSIP reporting are those served to individuals listed in Section III, Target Population and Eligibility. Meals that cannot be included in counts used to determine NSIP funding are:
    1. Any meal that is served to a participant who is required to meet income eligibility criteria to receive the service through which the meal is served. This includes:
      1. COPES home-delivered meals
      2. COPES adult day care meals
      3. Medicaid Adult day health meals
      4. Adult day care or health meals for which Child and Adult Care Food Program (7CFR Part 226) funds have been claimed
      5. SCSA- or Respite-funded adult day care or health meals;
    2. Meals funded by Title IIIE served to caregivers under age 60;
    3. Meals served to individuals under 60 who pay the full cost of the meal.
    Meals served at adult day care or health services that can be included in counts used to determine NSIP funding are those that meet the following criteria:
    1. the adult day care or health service is a contracted congregate nutrition site, in compliance with the SNP Standards, and
    2. the individual served the meal is aged 60 or over, and
      1. attending the adult day care or health service for the purpose of receiving congregate nutrition services rather than adult day care or health services, or
      2. the cost of the adult day services for the individual is covered by a source other than COPES, Medicaid, SCSA or Respite or any other means-tested program, and OAA funds are allocated specifically for meals for these individuals; and
    3. the individual is given the opportunity to donate toward the cost of the meal.
    Service providers must maintain separate records to document that NSIP cash was used to purchase:
    1. United States Agriculture commodities and other foods used in their food service;
    2. Food in the meals furnished to them under contractual arrangements with food service management companies, caterers, restaurants or institutions, provided that each such meal contains United States produced commodities or other foods at least equal in value to the NSIP funding.
    NSIP cash may be carried over into the next consecutive contract year at the AAA’s discretion. NSIP cash which is carried over into the next contract period must be included in the service provider's budget for the next contract period and must be considered as a resource when projecting the total number of meals to be served in the next contract year.
  9. Participant Information
    Service providers must maintain in their official files information which identifies individual participants in the program and the date or dates on which they ate a meal during the program year. This information can be filed in a number of different ways; e.g., a daily meal attendance record, participant sign-in sheet, monthly attendance record, an electronic reporting system, etc.
    The CNS service provider must collect the following information about each participant no later than his/her fifth meal at the congregate nutrition site:
    1. Name, home address, and phone number of participant;
    2. Name and phone number of participant's physician and/or person to contact in case of an emergency;
    3. Special diet requirements, restrictions, or nutritional problems and concerns expressed by the participant.
    The nutrition services program provider must also collect other reporting data required by the AAA and ADSA including nutrition risk screening data. With the exception of HDNS applicants who refuse to allow an in-home assessment to determine eligibility for home-delivered meals, participants may not be denied service if they refuse to provide the required information. This in no way relieves the provider of the responsibility to make reasonable attempts to get the information from the participant and to explain the reasoning behind the request.
  10. Participant Donations
    Nutrition program service providers must provide each person served a meal funded by Title III or SCSA with the opportunity to make a voluntary and confidential donation to the cost of the meal. The AAA shall consult with the service providers and older individuals to determine the best method for accepting voluntary contributions and to ensure that any method used is not coercive.
    1. Privacy and Confidentiality
      The service provider must protect the privacy of each older person with respect to his/her donation or lack of contribution.
      The service provider must arrange for methods of receiving donations from individuals in such a manner as not to publicly differentiate among individual donations. The service provider should periodically assess the nutrition program's methods of receiving donations to ensure that the confidenti­ality of each individual donation is not compromised.
    2. Collection of Donations
      Each service provider may develop a suggested donation schedule for services received. In developing a donation schedule, the provider should consider the income ranges of older persons in the community and the provider's other sources of income. Suggested donation schedules must in no case be used as a means test to determine the eligibility of individuals to participate in the nutrition program.
      The amount of donation, if any, should be determined by each participant according to his/her ability to donate. Providers must clearly inform participants that there is no obligation to contribute and that the contribution is purely voluntary.
      The service provider may not deny any older person a meal because the older person will not or can not contribute to the cost of the meal.
    3. Use and Handling of Donations
      Donations made by older persons are considered program income. Nutrition services donations must be used to increase the number of meals served by a program, to facilitate access to such meals, and to provide other supportive services directly related to nutrition services. The service provider should develop, and the AAA should approve and monitor, specific written guidelines and procedures for the collection of donations for meals served at nutrition sites.
      The service provider should develop, and the AAA should approve and monitor, specific procedures for collecting, handling, counting, and depositing cash donations or their equivalents. These procedures must follow generally accepted accounting principles (refer to Aging and Disability Services Administration’s AAA Policies and Procedures Manual – Chapter 9, Fiscal Procedures).
    4. Donations Using Basic Food Program Benefits
      Basic Food Benefits, in the form of the Quest Card, may be accepted from participants as contributions toward the cost of the meal. Because benefits are available only through the Quest Card, an electronic benefits transfer (EBT) system, the service provider must inform participants that these donations can not be completely confidential.
      In order to accept contributions through the Quest Card, the provider must be certified by the USDA Food and Nutrition Service (FNS) and have a contract with the State’s EBT vendor, the financial institution that administers the EBT system. If the provider receives over $100/month in basic food contributions, a point of sale (POS) machine will be provided by the Basic Food Program. If the provider receives less than $100/month per meal site or delivery route, manual vouchers will be provided by the Basic Food Program. To contribute with vouchers, a participant would have to request a voucher(s) from a staff person and sign it. The staff person must call a toll-free number to verify that the participant has the contribution amount in his account. The provider must then redeem the voucher through the State’s EBT vendor within 30 days.
      The service provider must assure that all provisions relating to the use and handling of basic food benefits as prescribed by federal, state and local agencies responsible for administering the Basic Food Program are met.
      Providers must contact the Food and Nutrition Service at (206)553-7410 to become a Basic Food vendor.
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