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STATE OF NEVADA
Aging and Disability Services Division
SERVICE SPECIFICATIONS
NUTRITION SERVICE
(Revised 4/11)
Any exceptions to these
Service Specifications must be requested in advance, in writing, and approved by
the Deputy Administrator.
PURPOSE:
To promote quality of service, the Aging and Disability Services Division (ADSD)
has established service specifications that contain general guidelines. ADSD
will use these service specifications as the basis for assessing program
performance. The service specifications that each grantee must follow consist of
GENERAL REQUIREMENTS, according to the funding source, and SERVICE-SPECIFIC
REQUIREMENTS established for each funded service.
SERVICE DEFINITION:
Nutrition services provide meals
to congregate and/or home-delivered meal participants.
AoA SERVICE CATEGORIES AND UNIT
MEASURES:
Congregate Meals (1 Meal)
- Provision, to an eligible individual,
at a nutrition site, senior center or some other congregate setting, a meal
which meets the standards established by the Older Americans Act, and complies
with the Dietary Guidelines for Americans published by the Secretaries of the
Department of Health and Human Services and the United States Department of
Agriculture.
Home-Delivered Meals (1
Meal) -
Provision, to an eligible individual, at the client’s
place of residence, a meal which meets the standards established by the Older
Americans Act, and complies with the Dietary Guidelines for Americans published
by the Secretaries of the Department of Health and Human Services and the United
States Department of Agriculture.
Special Meals (1 Meal)
- Provision, to an eligible individual, a modified meal, which meets the
standards established by the Older Americans Act, and complies with the Dietary
Guidelines for Americans published by the Secretaries of the Department of
Health and Human Service and the United States Department of Agriculture.
Special meals are modified both in texture/consistency (chopped or pureed) or
modified based on related disease.
SPECIFICATIONS:
1.
Nutrition Services:
1.1 Meals provided to
eligible individuals in a congregate setting or delivered to individuals who are
homebound due to physical or mental health conditions that prohibit them from
eating in a congregate setting.
1.2 Special meals may
be provided, according to the nutrition program’s ability, to eligible
individuals who have specific dietary needs arising from health conditions,
religious requirements or ethnic backgrounds.
1.2.1 A diabetic diet is
provided in accordance with the nutrition program’s ability and an order
written by a physician. The diet is then designed by a registered dietitian.
1.3 Frozen meals, sack
lunches, cold meals, and/or shelf-stable meals may be used to provide
supplemental meal service to clients who receive home-delivered meals.
1.4 During each
program year, all certified home-delivered meal recipients must receive two
shelf-stable meals.
1.4.1 Clients are to be
advised to save the meals for an occasion on which the program cannot deliver a
regularly-scheduled meal (e.g. severe weather, emergencies, etc.).
1.4.2 Additional
information about shelf-stable meals can be found at
http://www.nvaging.net/grants/IIIC/shelf_stable_meals.htm.
1.5 Five congregate
meals, or five-to-seven home-delivered meals, are to be provided each week,
except in situations where such frequency is not feasible and a lesser frequency
is approved by the Division.
1.6 Nutrition
education services are to be provided, no less than semi-annually, to congregate
and home-delivered meal participants. The goal of nutrition education is to
provide older persons with information that will promote improved food
selection, eating habits and health-related practices.
1.6.1 Nutrition education
documentation shall include: date of presentation or distribution of materials,
name and title of presenter, a copy of materials distributed to clients or topic
discussed (if applicable), and number of persons in attendance. If materials are
delivered to homebound participants, documentation shall include date of
distribution, copy of distributed material, and number of participants that
received the information.
2.
Nutrition Service Standards:
2.1 Programs must
maintain the food safety standards listed in the Food Safety Checklist, which is
available at
www.nvaging.net/grants/IIIC/forms.htm.
2.2 The program’s Food
Service Establishment Inspection Report must be sent to the Division on an
annual basis, or as new inspections occur.
2.3 A quarterly food
safety self-assessment, using the Food Safety Checklist and cover sheet, is to
be completed by the program director or a member of the board. The program must
retain a copy of the completed cover sheet for review.
2.4 Programs are
required to complete a background check on all home-delivered meal drivers and
document the results, before drivers provide services.
2.5 Although drivers
cannot accept tips, gifts, loans or fees from home-delivered meal participants,
they may collect program donations.
2.6 Programs are
prohibited from providing eligible congregate clients with “take-out” meals as
an alternative to participating in the congregate meal program, which requires
meals to be consumed in a group setting. These meals will not be eligible for
reimbursement from USDA or Title III-C funding under any circumstances.
2.7 Programs are
required to establish written alternative procedures for the availability of
home-delivered meal service during inclement weather.
2.8 Training shall be
provided for all paid and volunteer personnel to assure the safe preparation and
delivery of meals. The director is responsible for ensuring that all
foodservice-related personnel are properly trained.
2.8.1 Upon employment,
and before working in the kitchen, the director and head cook must have taken
and passed the Division’s online food safety tutorial, which is available at
http://www.nvaging.net/grants/IIIC/
food_safety_training.htm. Additionally, the director and head cook
must successfully complete ServSafe (or a Division-approved equivalent) training
within six (6) months of employment. Certification is achieved by passing this
training’s nationally-recognized examination in food safety.
Recognized providers of the ServSafe food safety examination and certifications
are:
Or any other
ServSafe-certified trainer.
2.8.2 All other paid and/or volunteer
foodservice-related staff must have four (4) hours of training on topics related
to their job duties. All staff must complete the training requirement within
three (3) months of hiring/volunteering. Successful completion of the Division’s
online food safety tutorial will meet this requirement.
2.9 All recipients of
home-delivered meals will be visited at their homes by program staff to be
certified regarding the need for service. The continued need for service should
be periodically reviewed and documented by staff to assure program resources are
being appropriately allocated. Documentation must include:
2.9.1 The date service
was started;
2.9.2 The physical and/or
mental health condition(s) that prevents the individual from attending a
congregate meal site, and any documentation concerning the noted condition(s);
2.9.3 A notation whether
the client has a working refrigerator, freezer, microwave and stove;
2.9.4 The estimated
length of time the individual is expected to receive home-delivered meals. The
length of certification must be based on the client’s health condition and
cannot exceed 12 months. Each assessment and reassessment must include a
determination of when the next reassessment should take place;
2.9.5 Documentation
regarding the need for weekend or second meals, if provided by the program. The
program is responsible for the costs associated with providing a second meal in
any one day, unless the Division’s assigned Resource Development Specialist has
approved, in advance, in writing, the need to supply additional meals to a
client due to extenuating circumstances; and
2.9.6 The date of
certification and signature of certifying staff member.
2.10 Incorporating
services that promote client independence in the community should be part of the
home-delivered meal client assessment and certification.
2.11 Grantees are
required to establish a written, home-delivered meal service termination policy,
which includes at a minimum:
2.11.1 The client’s
decision to stop receiving services;
2.11.2 Reassessment, which
determines the client to be ineligible;
2.11.3 Improvement in the
client’s condition, which eliminates the need for home-delivered meals;
2.11.4 An increase in the
availability of support from friends and/or family;
2.11.5
Institutionalization of the client (in either an acute care or long-term care
facility);
2.11.6 Death of the
client; or
2.11.7 Written
documentation of acknowledgement of request to end service. Notification of
client termination must include the date service will end or be terminated and
any referrals that were made to another provider, if appropriate.
2.12 A “monthly participant letter” can only be
sent to home-delivered meal recipients who self-report an income above 185% of
the current Federal Poverty Level. The letter must stress that "it is not a
bill and service will not be denied because of an inability to donate.” The
participant letter is to only include the number of meals provided to the client
for one month and the recommended donation amount.
2.13 The program is to ask
each congregate and home-delivered meal client to fill out the Nutrition Risk
Form as part of the annual registration process. The resulting nutritional risk
score is to be used to determine if the client is at High Nutritional Risk, per
the directions on the form. The resulting determination is to be entered into
the NAPIS section of the client’s file in the Social Assistance Management
System (SAMS).
2.14 Clients determined
to be in need of other services shall be assisted with appropriate referrals.
2.15 Each nutrition
program must maintain a perpetual food inventory and conduct a physical
verification of the inventory on a monthly basis. (PIN-23)
2.16 Program directors, or a nutrition program
representative, are required to attend any and all ADSD-sponsored nutrition
conferences and/or trainings.
