Section 213.203 - Nutrition Services(a) Purpose. This section establishes the requirements for nutrition services, a service provided under Older Americans Act and funded, in whole or in part, by HHSC.(b) Policy. Nutrition services must be provided in compliance with all HHSC policies established by authority of Older Americans Act §305(a)(1)(C) ( 42 U.S.C. § 3025(a)(1)(C)) , relating to organization and responsibilities of the State.(c) Eligibility and assessment. A AAA must ensure that a person who receives a nutrition service is: (1) 60 years of age or older; or(2) eligible in accordance with Older Americans Act §339(2)(H) ( 42 U.S.C. § 3030g-21(2)(H) ) and §339(2)(I) ( 42 U.S.C. § 3030g-21(2)(I) ) and assessed for eligibility as required by Older Americans Act §339(2)(J) ( 42 U.S.C. § 3030g-21(2)(J) ) and the AAA Policies and Procedures Manual.(d) Nutrition screening. A AAA must conduct or ensure a meal provider conducts nutrition screening for a person receiving a nutrition service as required by Older Americans Act §339(2)(J) ( 42 U.S.C. § 3030g-21(2)(J) ).(e) Meal requirements. A AAA must ensure that a meal provider serves meals that comply with Older Americans Act §339(2)(A) ( 42 U.S.C. § 3030g-21(2)(A) ), relating to Dietary Guidelines for Americans, dietary reference intakes, and adjustments to meet special dietary needs of persons receiving nutrition services, and with the AAA Policies and Procedures Manual policies related to menus, standard recipes, and approval of menus.(f) Service days. A AAA must ensure that meals are provided in accordance with Older Americans Act §331 ( 42 U.S.C. § 3030e) and §336 ( 42 U.S.C. §3030f) , and with the AAA Policies and Procedures Manual policies, related to serving fewer than five meals a week.(g) Delivery of multiple meals. A AAA must complete or ensure that a meal provider completes a Determination of Type of Meal assessment in compliance with the AAA Policies and Procedures Manual for each person who receives other than hot meals or receives multiple meals at one time to determine the person can safely handle the type of meals to be delivered.(h) Facilities and food service. A AAA must ensure that a meal provider: (1) complies with 25 TAC Chapter 228 (relating to Retail Food) and 25 TAC Chapter 229 (relating to Food and Drug) in training staff, and the preparation, handling, and delivery of food; and(2) provides a copy of all facility inspection results required by state law or rule to the AAA.(i) Nutrition Services Incentive Program. A AAA must ensure that a meal provider: (1) complies with the Older Americans Act §311 ( 42 U.S.C. § 3030a) , relating to the Nutrition Services Incentive Program; and(2) includes eligible meals in reports to HHSC through which Nutrition Services Incentive Program cash is calculated as earned for distribution to AAAs.(j) Voluntary contributions. A AAA must ensure that a meal provider complies with Older Americans Act §315(b) ( 42 U.S.C. § 3030c-2(b)) , § 213.151(l) of this chapter (relating to AAA Administrative Responsibilities), and the AAA Policies and Procedures Manual policies relating to voluntary contributions.(k) Meal cost recovery. A AAA must ensure that a meal provider: (1) posts the cost of a meal for purposes of cost recovery as described in paragraph (2) of this subsection;(2) recovers, at a minimum, the cost of a meal that is served to a person who is not eligible for a meal funded by the Older Americans Act; and(3) keeps payments for a meal served to an ineligible person separate from voluntary contributions from an eligible person.(l) Holding time. A AAA must ensure that a meal provider complies with state and local laws for the safe and sanitary handling of food. (1) A AAA must ensure that a congregate meal provider does not allow more than four hours to expire from the time the provider: (A) removes hot food from temperature control and the time the provider serves the hot food; or(B) removes cold food from temperature control and the time the provider serves the cold food.(2) A AAA must ensure that a home delivered meal provider limits the amount of time meals are in transit and does not allow more than four hours to expire from the time the provider: (A) removes hot food from temperature control and the time the provider delivers the hot food; or(B) removes cold food from temperature control and the time the provider delivers the cold food.(m) Nutrition outreach. A AAA must ensure that a meal provider develops and maintains a written outreach plan giving priority to people described in the Older Americans Act §306(a)(1) (42 U.S.C. § 3026(a)(1) ).(n) Nutrition education. In accordance with the Older Americans Act §339(2)(J) ( 42 U.S.C. § 3030g-21(2)(J) ), a AAA must ensure that an eligible person is provided with nutrition education annually and, if appropriate, nutrition counseling.(o) Political activity. A AAA must ensure that a meal provider does not: (1) use a congregate meal site for political campaigning except in those instances where a representative from each political party running in the campaign is given an equal opportunity to participate; or(2) distribute political materials at a congregate meal site.(p) Religious activities and prayer. A AAA must ensure that a meal provider does not: (1) allow a prayer or other religious activity to be officially sponsored, led, or organized by a staff person of a congregate meal site; or(2) prohibit a person from praying silently or audibly at a congregate meal site if the person so chooses.(q) Monitoring. (1) A AAA must monitor meal providers in compliance with 40 TAC §83.19(f), § 213.151(e) of this chapter, and the AAA Policies and Procedures Manual.(2) A AAA must ensure that the Department of State Health Services or the local health authority, as applicable, monitors a food preparation site, at least annually.(3) A AAA must ensure that the meal provider submits the written report of the food preparation site monitoring to the AAA.(r) Emergencies and disasters. A AAA must ensure that a meal provider develops a plan and written procedures for emergencies and disasters to keep food, facilities, and equipment available to the extent possible, for people participating in the nutrition services program, in accordance with the AAA Policies and Procedures Manual policies giving priority to people 60 years of age or older.(s) Subcontracting by a meal provider. A AAA must require a meal provider to obtain written approval from the AAA before the meal provider contracts with any entity for meal preparation or service delivery.(t) Adoption by reference. HHSC adopts by reference as requirements for nutrition services the following:(1) OAA §§306(a)(1) ( 42 U.S.C. § 3026(a)(1)) , 311( 42 U.S.C. § 3030a) , 315(b) ( 42 U.S.C. § 3030c-2(b)) , 331( 42 U.S.C. § 3030e) , 336( 42 U.S.C. § 3030f, and 339(2) ( 42 U.S.C. § 3030g-21(2)) , as amended through Public Law 116-131, enacted March 25, 2020; and(2) the AAA Policies and Procedures Manual, adopted effective January 15, 2021.26 Tex. Admin. Code § 213.203
The provisions of this §213.203 adopted to be effective September 1, 2008, 33 TexReg 7293; amended to be effective November 24, 2014, 39 TexReg 9264; transferred effective November 15, 2020, as published in the Texas Register October 30, 2020, 45 TexReg 7721; amended by Texas Register, Volume 46, Number 22, May 28, 2021, TexReg 3415, eff. 6/3/2021