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STATE
OF NEVADA
DIVISION FOR AGING SERVICES
SERVICE
SPECIFICATIONS
NUTRITION SERVICE
(Revised
7/08)
Any
exceptions to these Service Specifications must be requested in advance in
writing and approved by the Administrator.
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 client or
other eligible participant, 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 client
or other eligible participant, 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) Special meals are modified
both in texture/consistency (chopped or pureed) or modified based on related
disease. One unit equals one
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.
SPECIFICATIONS:
1.
Nutrition Services
1.1
Meals provided to seniors in either a congregate setting or delivered to
those individuals who are homebound due to physical or mental health
conditions.
1.2
Special meals, provided by nutrition programs to
clients that have specific dietary needs arising from health conditions,
religious requirements or ethnic backgrounds.
1.3
A diabetic diet is not provided unless there is an order written by a
physician and designed by a registered dietitian.
1.4
Frozen meals, sack lunches, cold meals, and/or shelf stable meals may be
used to provide supplemental meal service to clients.
1.5
During each program year, all certified home delivered meal recipients
must receive a two (2) day supply of shelf stable meals.
1.6
Meals will be provided for five (5) or more days a week, except in situations
where such frequency is not feasible and a lesser frequency is approved by the
State agency.
1.7
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. 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 receiving
the information.
2.
Nutrition Service Standards:
2.1
Programs must maintain the food safety standards listed in the Food
Safety Checklist.
2.2
The program’s Food Service Establishment 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
Prior to providing services, programs are
required to complete a background check on all home-delivered meal
drivers and document the results.
2.5
Drivers cannot accept tips, gifts, loans or fees from home-delivered meal
participants. Drivers 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
Grantees are required to establish a waiting list policy for
home-delivered meals that will be activated in the event the demand for service
exceeds the program’s capabilities. A waiting list is to be established only
after all other measures for improving the efficiency of the service delivery
system have been examined and, when feasible, implemented. Clients with the
greatest needs are to receive priority consideration. The program must establish
a procedure for updating the continued service needs of clients placed on the
waiting list.
2.9
The program shall establish a method to determine consumer satisfaction,
including meal preferences, which will be used to provide continuous quality
improvement, develop acceptable menus and address identified concerns.
2.10
Training shall be provided for all paid and volunteer personnel to
assure the safe preparation and delivery of senior meals. Directors and head
cooks must complete ServSafe (or equivalent) training.
Certification is achieved by passing the nationally recognized
examination in food safety.
Recognized
providers of the food safety examination and certifications are:
National Restaurant Association
1200 17th St, NW
Washington, DC 20036
202-331-5900
www.restaurant.org |
Nevada Restaurant Association
1500 E. Tropicana, Suite 114-A
Las Vegas, NV 89119
702-878-2313
www.nvrestaurant.com |
Sysco
Intermountain Food Services, Inc.
9494 S. Prosperity Road
West Jordan, Utah 84088
801-563-6300
www.sysco-slc.com
Or any
other ServSafe certified trainer.
The
Director is responsible for making sure that they and their head cook complete
the ServSafe Examination within three (3) months of employment.
All other paid/volunteer
foodservice related staff must have 4 hours of training on topics related to
their job duties. All staff must complete the training requirement within 3
months of hiring/volunteering. The
Director is responsible for ensuring that all other paid/volunteer kitchen staff
is properly trained in food safety.
2.11
All long-term recipients of home-delivered meals will be certified as to
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 should include:
2.11.1
The date service was started.
2.11.2
The physical and/or mental health condition that prevents the individual
from attending a congregate meal site, and any documentation concerning their
condition.
2.11.3
A notation whether the client has a working refrigerator, freezer,
microwave or stove.
2.11.4
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
should include a determination of when the next reassessment should take place.
2.11.5
Documentation regarding the need for weekend or second meals, if provided
by the program. The program is responsible for the costs to provide a second
meal unless the Division’s assigned Resource Development Specialist has
approved, in writing, the need to supply additional meals to a client due to
extenuating circumstances.
2.11.6
The date of certification and signature of certifying staff member.
2.12
Grantees are required to establish a written home delivered meal service
termination policy, which includes at a minimum:
2.12.1
The client’s decision to stop receiving services, or;
2.12.2
Reassessment, which determines a client to be ineligible;
2.12.3
Improvements in the client’s condition so that they no longer are in
need of home delivered meals;
2.12.4
An increase in the availability of support from friends and/or family;
2.12.5
Institutionalization of client (in either acute care or long term care
facility);
2.12.6
Death of client;
2.12.7
Written documentation of acknowledgement of request to end service or
notification of the client termination must include the date service will end or
be terminated and any referrals to another provider if appropriate.
2.13
A "recommended donation" meal summary statement can be sent to all
home delivered meal recipients. The statement must stress that "it is
not a bill and service will not be denied because of an inability to donate”.
2.14
Clients determined to be in need of other services shall be assisted with appropriate
referrals. Incorporating services that promote client independence in
the community should be part of the
home-delivered meal client assessment and
certification.
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 representative, are required to attend
any and all DAS-sponsored nutrition conferences and/or trainings.