C.M.R. 10, 149, ch. 6, 149-6-5, subsec. 149-6-5.05

Current through 2024-25, June 19, 2024

Subsection 149-6-5.05 - PROVIDER REQUIREMENTS

Providers of nutrition services authorized under this rule shall comply with the following:

1.General and Specific Requirements

A. AAAs must obtain a waiver from OADS to directly provide nutrition services as outlined in 10-149 C.M.R. ch. 5, Section 30, § 30.09.

B. If a AAA provides any nutrition services through or with the assistance of another person or entity, the AAA must have a written contract with such subcontractor(s) in conformance with this subsection.

C. Each Provider shall:

(1) Maximize the number of eligible individuals who are provided an opportunity to receive nutrition services;

(2) Provide outreach, intake, and information and assistance referral services to recipients of nutrition services pursuant to 10-149 C.M.R. ch. 5, Section 67.

(3) Comply with 10-149 C.M.R. ch. 5, Section 40;

(4) Meet the requirements of the State of Maine Food Code, 10-144 C.M.R. ch. 200;

(5) Immediately report any incidence of food borne illness to the Department, Centers for Disease Control and Prevention (CDC) with a follow-up report provided to OADS within ten (10) business days;

(6) Provide special meals to the greatest extent possible to meet dietary needs arising from health, religious requirements, or other cultural considerations affecting participating individuals;

(7) Conduct periodic surveys, at least once a year, to obtain recipients opinions about meals and meal sites;

(8) Participate, where feasible, in group purchasing efforts to maximize cost-effective purchasing; and

(9) Report any suspicion of abuse, neglect, or exploitation in conformance with 22 M.R.S. § 3477.

2.Subcontracts

A. AAAs shall include, in all contracts for nutrition services with subcontractors, the following requirements for subcontractors, without limitation:

(1) Meet Federal and State rules and regulations for Nutrition Services Programs;

(2) Meet the requirements of 10-149 C.M.R. ch. 5, Section 40.

(3) Provide OADS staff with access to recipients' records when requested; and

(4) Provide financial records and reports to the AAAs as requested.

B. The AAAs shall visit each subcontracted entity at least annually, to ensure compliance with the parties' contract.

(1) During site visits, the AAAs shall:

(a) Complete an OADS-approved site review form, including any corrective measures required of the subcontractor.

(b) Provide a copy of the completed site review form to the subcontractor, including a list of any corrective measures required;

(c) Submit completed site review forms and identified deficiencies to OADS within ten (10) business days of the site visit;

(d) Ensure all deficiencies noted on the completed, OADS-approved site review form are corrected by the subcontractor within 30 days of the site visit; and

(e) Submit to OADS a report documenting the outcome of corrective measures within 45 days of the completion of corrective measures.

C. The AAAs shall retain and make available to OADS for inspection all site review forms and documentation of corrections of deficiencies on file for at least seven (7) years.

D. The AAAs shall identify deficiencies and require corrective action plans from the subcontracted entity.

3.AAA Staff Requirements

A. The AAAs shall designate a full-time Nutrition Director. The requirement for a full-time Nutrition Director may be waived by OADS if the AAA:

(1) Assigns the administration of all the AAA's nutrition services to a subcontractor; or

(2) Can demonstrate in writing that it is adequately managing its nutrition services without a full-time qualified Nutrition Director.

B. The Nutrition Director will provide program management for the Congregate Nutrition and Home Delivered Nutrition services, including:

(1) Monitoring and providing technical assistance to subcontractors;

(2) Supervising nutrition services AAA staff;

(3) Overseeing general program operations including the safeguarding of cash donations, food handling and storage; and

(4) Providing training on a quarterly basis, regarding, at a minimum, aspects of the Nutrition Services Program such as food safety, business with Older Individuals, and other relevant issues.

C. The AAAs shall hire, contract with, or secure the volunteer assistance of a Registered Dietitian, whose duties shall include, without limitation:

(1) Reviewing and approving menus to ensure nutrition requirements of this rule are met;

(2) Providing dietary education to and supporting Nutrition Services staff with meeting special dietary needs of recipients of services;

(3) Reviewing available modified menus with the physician of each individual with unique dietary needs, when needed, to determine whether physician-ordered dietary requirements can be met by the Provider. In the event the Provider concludes it is unable to serve an individual with unique dietary needs, the Provider shall inform the individual, in writing, in conformance with 10-149 C.M.R. ch. 5, Section 40; and

(4) Providing Nutrition Counseling to nutrition services recipients, as appropriate, in accordance with the OAA.

4.Nutrition Manual

A. In consultation with the Registered Dietitian, each AAA must create and distribute a nutrition manual, addressing, at minimum, procedures relating to:

(1) Sanitation;

(2) Reporting food borne illness;

(3) The handling and storage of leftover foods; and

(4) Medical and other emergencies.

B. This manual shall be reviewed and updated annually, and available anytime to:

(1) Subcontractors;

(2) Employees;

(3) Volunteers;

(4) OADS; and

(5) Any others working with the Nutrition Services Program.

5.Menu Planning

A. All menus must comply with the most recent version of the U.S. Department of Agriculture and U.S. Department of Health and Human Services' Dietary Guidelines for Americans available at dietaryguidelines.gov, and provide:

(1) To each eligible individual a minimum of 33.33% of the dietary reference intakes established by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences, if the program provides one meal per day;

(2) To each eligible individual a minimum of 66.66% of the dietary reference intakes if the program provides two meals per day; or

(3) 100% of the dietary reference intakes if the program provides three meals per day.

B. Menus must be planned for a minimum of four weeks and must be approved and signed by a Registered Dietitian prior to use and retained for inspection by OADS.

C. Menus must be retained for seven (7) years.

(1) Menus must be prepared with no added salt, a minimum of fat, and must include a variety of low fat, low sodium, low cholesterol and low sugar foods while striving to maintain overall menu appeal and acceptability to recipients.

6.Recipients of Services Surveys

A. Providers shall provide and ask recipients of services to complete, voluntarily, satisfaction surveys no less than annually.

B. The surveys shall address, at a minimum:

(1) Food preparation;

(2) Size of portions;

(3) Frequency with which meals are served;

(4) Varieties of foods offered, including culturally appropriate offerings;

(5) Delivery and service times; and

(6) The temperature of the meals when received.

C. Individuals with limited English proficiency shall be provided an opportunity meaningfully to participate in the survey.

D. Responses from individuals and a summary of results must be made available on request and retained electronically for inspection by OADS for seven (7) years.

7.Voluntary Contribution System

A. Each AAA shall develop and maintain a confidential voluntary contribution collection system policy which is submitted to OADS for approval on at least an annual basis.

B. The AAAs must:

(1) Explain the voluntary contribution collection system to recipients both orally and in writing;

(2) Accept Supplemental Nutrition Assistance Program as payment of voluntary contributions; and

(3) Retain records of collections by nutrition service, not individual contributions.

C. Each AAA shall prepare quarterly reports, aggregated by nutrition service, and ensure reports are available to OADS upon request. Each AAA shall retain its quarterly reports for at least seven (7) years.

8.Records and Reports

A. Each AAA shall keep records and submit reports to the Department as specified in the contract between the Department and the AAA. This includes, but is not limited to, reporting in the OADS Data System. OADS must provide advanced notice to the AAAs if reporting requirements change.

B. The AAA will also report, by the fifteenth (15th) day of each month, the number of meals provided in the preceding month as required by the OADS Data System. The AAA will specify the funding source for each meal in the OADS Data System.

C. Providers shall enter and maintain individual information and service information in the OADS Data System pursuant to the State Performance Report for State Units on Aging, Appendix A: Data Element Definitions, Version 2.0 (OMB Control Number 0985-0072). OADS may require Providers to enter additional data beyond the provisions the State Performance Report for State Units on Aging, as specified in the contract between the Department and the AAA. OADS must provide advanced notice to the AAAs if reporting requirements change

C.M.R. 10, 149, ch. 6, 149-6-5, subsec. 149-6-5.05