Subsection 148-1-III-F - ADULT DAY CARE CENTER RESPONSIBILITY1. PURPOSE: To establish requirements for adult day care center participation in the Child and Adult Care Food Program.
2. STANDARDS: 1. Adult day care centers may participate In the C.A.C.F.P. either as independent centers or under the auspices of a sponsoring organization; provided, however, that public and private non-profit centers may not participate in the C.A.C.F.P. under the auspices of a for-profit sponsoring organization. Independent centers shall comply with the same provisions as sponsoring organizations.2. Adult day care centers shall be licensed or approved by the State of Maine to provide day care services to functionally impaired adults, (as defined in 7 CFR § 226.2 ) or to individuals 60 years of age or older, in a group setting outside their home on less than a 24 hour basis. An adult day care center which is complying with the state licensing rules and which is in the process of license renewal may, if the Department is reasonably sure the license will be renewed, participate or continue to participate in the C.A.C.F.P.3. Adult day care centers shall not enroll individuals in the C.A.C.F.P. who reside in an Institutional setting, such as a nursing home, a boarding homes, etc., or individuals whose placements are supplemented by Title XIX of the Social Security Act.4. Meals served in adult day care centers which are reimbursed all or in part by Title III, Subsection C. of the Older Americans Act of 1965 shall not be claimed for reimbursement under the C.A.C.F.P.5. Adult day care centers shall maintain annually completed "Dear Household Member" enrollment applications provided by the Department for determining eligibility for "Free" or "Reduced-price" meals. a. When a household applies for "Free" meal eligibility on behalf of an adult who is a member of a food stamp household or who is a SSI or Medicaid participant such information shall consist of the Food Stamp case number or SSI or Medicaid identification number of the adult for whom application is being made, plus the applicant's name, age, racial/ethnic identification, the signature of a responsible individual and the date of the signature.b. Applicants who are not eligible for "Free" meals based on membership in a food stamp household or due to receipt of SSI or Medicaid benefits shall complete the entire enrollment application.6. The adult day care center shall maintain annual documentation of enrollment of participants not eligible for "Free" or "Reduced-price" meals because of family size and income or refusal to provide information on family size, income, or social security numbers.7. Adult day care centers shall maintain records on the age of each enrolled person. In addition,, the adult day care center shall maintain records which demonstrate that each enrolled person under the age of 60 meets the functional impairment eligibility requirement established under 7 CFR, Part 226, § 226.2 which states: "Functionally impaired adult means chronically impaired disabled persons 18 years of age or older, Including victims of Alzheimer's disease and related disorders with neurological and organic brain dysfunction, who are physically or mentally impaired to the extent that their capacity for independence and their ability to carry out activities of daily living is markedly limited. Activities of daily living include, but are not limited to.. adaptive activities such as cleaning, shopping, cooking, taking public transportation, maintaining a residence caring appropriately for one's grooming or hygiene., using telephones and directories, or using a post office. Marked limitations refer to the severity of impairment, and not the number of limited activities, and occur when the degree of limitation is such as to seriously Interfere with the ability to function independently."
8. The adult day care center shall ensure that each adult participant has an Individual Plan of Care that includes an assessment of the individual's strengths and needs and a plan of service. See definitions, Section l, Subsection D.9. Adult day care centers shall keep daily meal count and attendance records of all eligible enrolled adults. The attendance record may cover a period of one day, one week, or one month. The report shall be completed at the time of each meal/supplement service for each center, and include: a. The day, month and year of the report;b. The name of the center;c. The name and age of each eligible adult enrolled in the C.A.C.F.P.;d. Each eligible enrolled adult's presence or absence in the program for each day the center operated; ande. The meals and/or supplements claimed for reimbursement for each eligible adult in attendance each day.10. Adult day care centers shall maintain daily menus, food production reports, and records of the number of meals, by type, prepared for service to eligible enrolled adults and to staff performing labor necessary to the food service. a. A Menu shall: 1 Be completed for each meal/supplement provided to adults enrolled in the program;2 Contain the date and day of the week for which the meal/supplement is planned;3 list each component of the meal/supplement separately; and4 Be conspicuously displayed for participant or Supervisory review.b. A Food Production Report shall: 1 Be completed for each meal/supplement prepared at the adult day care center;2 Contain a listing of each prepared food item;3 Specify the total quantity prepared of each listed food item;4 Show the number of participants the meal was prepared to serve; and5 The number of staff the meal was prepared to serve.11. Adult day care centers shall ensure that meals are planned on the basis of one meal per participant expected to be in attendance, plus staff persons expected to be served.12. Adult day care centers may utilize existing school food service facilities or other vendor service to obtain meals. The responsibilities and requirements of each party shall be embodied in a written contract between the adult day care center and the vendor. The center shall maintain responsibility for all financial and program requirements set forth in this manual. A copy of each vendor contract shall be submitted to the Bureau for Inclusion as part of the Bureau's Child and Adult Care Food Program agreement with the organization.13. Adult day care centers shall ensure that each meal/supplement served is supervised by an adequate number of staff.14. An organization may contract with a Food Service Management Company for meal service In adult day care centers provided that all provisions of 7 CFR Part 226, § 226.21 are complied with in their entirety.15. Adult day care centers participating in the C.A.C.F.P. shall serve one or more of the following meal types: Breakfast, A.M. Supplement, Lunch, P.M. Supplement, Supper, Evening Supplement. A participating center: a. Shall not claim for reimbursement more than two meals and one supplement or one meal and two supplements, provided daily to each eligible enrolled adult in attendance;b. Shall only claim the meal types specified in its approved agreement and served in compliance with meal pattern requirements of Section IV of this manual; andc. Shall plan for meals and supplements so that at least 2 hours elapse between the beginning of each meal and/or supplement service. C.M.R. 10, 148, ch. 1, 148-1-III, subsec. 148-1-III-F