Subsection 148-1-III-G - PRICING ORGANIZATIONS1. PURPOSE: To establish guidelines for any organization participating in the Child and Adult Care Food Program as a "Pricing Organization".
2. STANDARDS: 1. An adult day care center, a child day care center, an outside-school-hours center, or an organization operating such, and participating in the C.A.C.F.P. may declare itself to be a "Pricing Organization" and thereby charge a separate and identifiable price for breakfasts, lunches, suppers and supplements served to any adult or child enrolled in its centers whose family size, income and provision of Social Security number information places that person in either the "Reduced-price" or "Paid" reimbursement category. Pricing organizations shall also meet the standards in Section III, Subsection D, or Subsection F as appropriate.2. Child day care homes and their sponsors shall not assess a separate and identifiable charge for any meal or supplement served to a child enrolled in the program.3. Adult day care centers, child day care centers and outside-school-hours care centers receiving Federal and State funds for the provision of day care or head start shall not be eligible to participate as pricing organizations if Federal and/or State restrictions placed on such funds would prohibit that participation.4. Centers shall not charge a separate fee for meals served to enrolled children or adults who meet the eligibility guidelines for meals/supplements in the "Free" category. a. Pricing organizations serving children shall verify the categorical eligibility of a child listed as a member of a food stamp family or an AFDC assistance unit. Verification shall consist of a current "Notice of Eligibility". for Food Stamp benefits, or equivalent documentation for a Food Stamp Household. An AFDC assistance unit may show an AFDC check stub, or a Medicaid card showing the applicant child's name as a member of the AFDC assistance unit. Categorically eligible children shall be enrolled in the "Free" category. A Food Stamp, AFDC, or Medicaid identification card is not acceptable unless it contains an expiration date and is currently valid.b. Verification that an adult day care participant is a member of a Food Stamp household shall consist of a current "Notice of Eligibility" for Food Stamp benefits, or equivalent documentation, issued by a Food Stamp or Welfare Office which shows that the adult applicant is a member of a household currently certified to participate in the Food Stamp Program. A Food Stamp identification card is not acceptable unless it contains an expiration date and is currently valid.c. Verification that an adult day care participant is a SSI or Medicaid recipient shall consist of official documentation issued by an appropriate SSI or Medicaid office which shows that the adult participant currently receives SSI or Medicaid assistance. A SSI or Medicaid identification card is not acceptable as verification unless it contains an expiration date and is currently valid.5. An organization electing to participate in the C.A.C.F.P. as a pricing organization shall be required to report each month and be reimbursed for the actual number of meals served daily to participants from families meeting the family size and income standards for "Free" meals; to participants from families meeting the family size and income standards for "Reduced-price" meals; and to participants from families not meeting either guideline "Paid" meals.6. An organization shall apply to the Bureau for approval to participate in the C.A.C.F.P. as a pricing organization. An organization shall submit a written policy statement, at the time of application,, stating its intention to uniformly charge a separate fee for participants enrolled in the "Reduced-price" and "Paid" categories in all adult day care or child day care centers under its jurisdiction. The policy statement shall include: a. A statement that the organization will determine eligibility for "Free" and "Reduced-price" meals using the family size and income guidelines shown in Appendix 2;b. A description of the method or methods to be used to assure applications are accepted from households on behalf of children who are members of A.F.D.C. assistance units or for Food Stamp households or, for adult day care center participants who are members of a Food Stamp household or who are S.S.I. or Medicaid participants.c. A description of the method or methods to be used to collect payments from those participants paying the full or reduced-price of the meal which will protect the anonymity of the participants receiving "Free" or "Reduced-Price" meals;d. An assurance that there will be no overt identification of "Free" and "Reduced-Price" meal recipients and no discrimination against any person on the basis of race, color, national origins, sex, age or handicap; ande. An assurance that separate charges for a "Reduced-price" lunch or supper will not exceed 40 cents, that the charge for a "Reduced-price" breakfast will not exceed 30 cents, and that the charge for a "Reduced-price" supplement will not exceed 15 cents.7. A Pricing Organization shall establish a hearing procedure for use when benefits are denied or terminated as a result of verification. It shall contain:a. A simple, publicly announced method for an individual or a family to make an oral or written request for a hearing;b. A provision that households which have been approved for benefits and which are subject to a reduction or termination of benefits later in the same year shall receive continued benefits if they appeal the adverse action within 10 days of receipt of the notification;c. An opportunity for the individual or family to be assisted or represented by an attorney or other person, in presenting its appeal;d. An opportunity to examine, prior to and during the hearings the documents and records presented to support the decision under appeal;e. A provision that the hearing shall be held with reasonable promptness and convenience to the individual or family and that adequate notice shall be given to the individual or family as to the time and place of the hearing;f. An opportunity for the individual or family to present oral or documentary evidence and arguments supporting its position;g. An opportunity for the individual or family to question or refute any testimony or other evidence and to confront and cross-examine any adverse witness;h. A provision requiring the organization to notify the appellant, in writing, of the date and time of the hearing and the name of the hearing officer.i. A provision that the determination of the hearing official shall be based on the oral and documentary evidence presented at the hearing and made a part of that hearing record;j. A provision that the individual or family and any designated representatives shall be notified in writing of the decision of the hearing official;k. A provision that a written record shall be prepared with respect to' each hearing, which shall include the decision under appeal, any documentary evidence and a summary of any oral testimony presented at the hearing,, the decision of the hearing official.. including the reasons therefore and a copy of the notification to the individual or family of the decision of the hearing official; andl. A provision that such written record of each hearing shall be preserved for a period of three years and shall be available for examination by the family or its representatives at any reasonable time and place during such period.8. The Fair Hearing officer shall be an independent and impartial official who is not accountable to the decision making authority. C.M.R. 10, 148, ch. 1, 148-1-III, subsec. 148-1-III-G