473 Neb. Admin. Code, ch. 4, § 003

Current through September 17, 2024

Section 473-4-003 - HOME-DELIVERED AND CONGREGATE MEALS SERVICE

This section contains material which governs:

(A) The authorization and provision of home delivered and congregate meals; and

(B) The evaluation and approval of meal providers.

003.01 MEALS SERVICE NEED. Meals service is not provided based on the demand of the recipient. Any individual receiving meals service must have a defined need for the service in order to meet eligibility requirements. Need for a service implies that the provision of that service will assist the recipient in achieving program goals.

003.02MEALS SERVICE DEFINITIONS. The following definitions apply:

003.02(A)CONGREGATE MEALS. Meals prepared and served at a dining facility outside of the recipient's residence.

003.02(B)HOME-DELIVERED MEALS. Meals that are prepared outside of the recipient's residence and delivered to their residence. The residence must be an independent living arrangement.

003.02(C)MEAL. A variety of properly prepared foods containing one-third of the minimum daily nutritional requirements for adults.

003.03RECIPIENTS SERVED. Home-delivered or congregate meals service may be authorized for those individuals age 19 or older who are:

(A) Current Supplemental Security Income State Supplemental recipients; or

(B) Low income aged or disabled persons.

003.04NEED FOR SERVICE. Eligible recipients must meet at least one of the following criteria:

(A) Be unable to prepare adequate meals within their own residences. This inability may be due to:

(i) Physical or mental impairment or disabilities;

(ii) Chronic illness;

(iii) Inability to obtain food products because of distance to the source;

(iv) Lack of cooking facilities; or

(v) Lack of motivation. Lack of motivation is characterized by emotional or physical deterioration which seriously endangers the recipient's ability to remain in an individual living situation;

(B) Have no other person living in their homes who are able and willing to obtain, prepare, and serve adequate meals in the home; or

(C) Not living in a congregate facility where meal service is the responsibility of the facility and the cost of meals is included in the payment rate.

003.05LIMITS FOR ADULT PROTECTIVE SERVICES WITHOUT REGARD TO INCOME RECIPIENTS. Recipients eligible without regard to income may be eligible for a maximum of 31 days in situations of abuse or neglect for an individual age 18 or older.

003.06 MAXIMUM RATES AND ALLOWABLE UNITS. The following guidelines of rate and allowable units are applicable to meal services:

003.06(A)RATES. The statewide rate is established utilizing the total federal funding appropriation to the State of Nebraska for meals services and the total state funding for meals services divided by the projected total of the congregate and delivered meals to be produced on an annual basis. The projected number of meals to be produced is derived from data provided by the state Area Agency on Aging organizations. Periodic increases or decreases may be made to the meal service rate in a percentage amount corresponding with legislative appropriations or budget directives from the Nebraska Legislature which result in general Medicaid service provider increases or decreases.

003.06(B) FREQUENCY. The frequency of service is per occurrence.

003.06(C)MAXIMUM ALLOWABLE UNITS. One congregate or home-delivered meal per day can be authorized.

003.07MEAL SERVICE EXCEPTIONS. The following criteria are considered when agreements are entered into with meals service providers:

(A) Actual service cost in the provision of meal service is not a basis for granting a rate increase;

(B) Special rates will not be granted to providers who prepare meals catering to the various dietary requirements of their recipients. Providers are required to prepare meals for special diets; and

(C) No exceptions will be approved for Area Agencies on Aging as their rates are standardized.

003.08HEALTH AND SAFETY STANDARDS. Food preparation and serving facilities and areas are required to conform to all established local, state, or federal fire prevention, sanitation, zoning, and facility maintenance standards. Food preparation and serving personnel must meet the following criteria:

(1) Be in good health and free from contagious disease;

(2) Skilled and instructed in sanitary food handling, preparation, and serving practices;

(3) Courteous, understanding, and helpful when seating or serving aged or mentally impaired or disabled recipients;

(4) Knowledgeable of basic first aid; and

(5) Aware of available resources for medical emergencies and for transportation.

003.08(A)HOME-DELIVERED MEAL STANDARDS. Home-delivered meal providers must:

(i) Deliver meals to recipients on an established schedule;

(ii) Be knowledgeable of basic first aid; and

(iii) Transport and deliver meals using utensils and equipment which are sanitary and maintain proper food temperatures. Thermos type containers and disposable or sterilizable serving dishes must be used.

003.08(B)CONGREGATE MEAL STANDARDS. Providers serving meals in a congregate setting must ensure the facility is:

(i) Accessible to adult recipients and free from architectural barriers to aged or handicapped individuals; and

(ii) Maintained at a comfortable temperature, properly ventilated, and have sufficient space.

003.09MENU AND MEAL REQUIREMENTS. The meals and menu must:

(A) Reflect the general dietary needs of aged or disabled people as well as the specific dietary needs of the recipients served;

(B) Be prepared one week in advance on a weekly menu plan form and kept available for inspection by service unit staff at any time; and

(C) Contain one third of the minimum daily nutrition requirement for adults using a variety of foods from day to day.

473 Neb. Admin. Code, ch. 4, § 003

Adopted effective 7/11/2021