The Child and Adult Care Food Program

1. The Child and Adult Care Food Program FFY 2013 Adult Care Eligibility & Participation Requirements

2. ~ The Big Picture ~ Funded by the Federal Government TheUnited States Department of Agriculture Food and Nutrition Services Regional Office (Chicago)

3. ~ The Big Picture ~ Administered by State government Wisconsin Department of Public Instruction Community Nutrition programs School Nutrition Programs Child and Adult Care Food Program Summer Food Service Program Special Milk Program Adult Care Component Child Care Component At Risk After School Care Emergency Shelters

4. ~ Its History ~ • Authorized by the 1987 amendments made to the Older Americans Act (P.L. 100-175) • Incorporated into section 17 of the Richard B. Russell National School Lunch Act, as a component of the Child Care Food Program, which was then amended to be the Child and Adult Care Food Program (CACFP) in 1989.

5. ~ Its Essence~ The CACFP provides financial assistance to eligible adult day care agencies for providing nutritious meals to their clients. Eligible agencies may receive reimbursement for two meals and one snack or two snacks and one meal per eligible client per day.

6. ~ Potentially Eligible Agencies ~ Are… • Public • Private Nonprofit ~ have tax exempt status under the Internal Revenue Code of 1986; your agency must have its IRS “501(c)(3)” document on file as part of its CACFP contract. Or • For Profit ~ 25% of enrolled and “eligible” clients must be beneficiaries of Title XIX (Medicaid) or Title XX of the Social Security Act starting the month preceding the first month of CACFP Participation.

7. ~ Potentially Eligible Agencies ~ Are… licensed by Federal, State, or local authorities to provide nonresidential adult day care services to functionally impaired adults and persons 60 years or older in a group setting outside of their homes on a less than 24-hour basis.

8. ~ Potentially Eligible Agencies ~ Do not… • solely provide residential care, employment, vocational training, and/or rehabilitation • claim meals funded by part C of Title III of the Older Americans Act of 1965 which requires a contract with Department of Health Services for the Elderly Nutrition Program.

9. ~ Potentially Eligible Agencies ~ Provide… • structured, comprehensive programs that are guided by the Individual Plans of Care (per DHFS) for each enrolled client. • meals and snacks to the attending clients.

10. ~ Participating Agencies ~ Have… • one site and are “Independent Agencies” Or • two or more sites and are “Sponsoring Organizations”

11. ~ Participating Agencies~ Provide care to clients who reside in… • their own homes • the homes of family or friends • a group living arrangement, which may be a group home or Residential Care Apartment Complex (RCAC) • Adult Family Homes (ADH) - Licensed and Certified (including Foster Homes) • Community Based Living Facilities (CBRF) • Nursing Homes

12. ~ Eligible Clients ~ Reside in… • Their own homes • The homes of family or friends • Group living arrangements as “residential communities” which may or may not be subsidized by federal, state or local funds, but which are private residences housing an individual or a group of individuals who are primarily responsible for their own care and who maintain a presence in the community, but who may receive on-site monitoring. (USDA Definition)

13. ~ Eligible Clients ~ Do not reside in… • Community Based Residential Facilities (CBRFs) • Nursing Homes • Adult Family Homes (AFH) ~ both certified and licensed

14. ~ Ineligible Clients ~ Reside in ADHs, CBRFs, and Nursing Homes… which USDA defines as “institutions”: Why? The clients are no longer primarily responsible for their own care; the designated service coordinators of the clients’ residential facilities are primarily responsible for their care. ~ Maintain Individualized Service Plans (ISP) for clients ~ They must provide meals and snacks ~ They must provide service 24/7

15. ~ Participating Agencies ~ Responsibilities… “Each adult day care center shall maintain records which document qualified adult care participants reside in their own homes (whether alone or with spouses, children, or guardians) or in group living arrangements as defined in USDA Federal Regulation part 226.2”. USDA Federal Regulation: 7 Code of Regulations, Chapter II, part 226.19a (b)(10)

16. ~ Participating Agencies ~ Responsibilities… • Documentation of their residential information must clearly indicate if the client’s residence is a AFH, CBRF, or nursing home.

17. ~ Participating Agencies ~ Responsibilities… • Documentation of their residential information must clearly indicate if the client’s residence is a AFH, CBRF, or nursing home. • Must identify and exclude clients who reside in AFHs, CBRFs, and nursing homes from CACFP participation(enrollment data, meal counts, and average daily attendance).

18. ~ The CACFP Composition~ Financial Documentation (GM 11) Reimbursement Claim (GM 1A, 2, 3A, 6A, 9A, 12A) Civil Rights Compliance (GM 8A) The Wisconsin State Agency Guidance Memorandums http://fns.dpi.wi.gov/fns_adultmemos

19. ~Reimbursement Claim~The Pieces to the Puzzle Meal Pattern Compliance Average Daily Attendance Meal and Snack Counts Enrollment Data

20. ~ Meal Pattern Compliance Pieces ~ Menus – Required Components Offer Vs serve Production Records – Quantity Requirements Meal Service Method

21. ~ Meal & Snack Count Records~ Client’s Residential Status Meal & Snack Count Records GM 9A & 12A Fully Compliant Meal Accurate Calculations Record at Time-of-Service

22. ~ Enrollment Data Pieces ~ Client’s Residential Status Household Size-Income Statements Enrollment Policy Daily Sign In/Out Records GM 1A and 6A

23. ~Average Daily Attendance Pieces ~ Daily Sign in/out Records # of days of service Client’s residential status

24. Delegate, train, and monitor staff… Site reviews GM 5A Pre-operational visits

25. Read… http://fns.dpi.wi.gov/fns_adultmemos Permanent Agreement (PI-1486-AP)

26. Refresh… http://fns.dpi.wi.gov/fns_adcwebcasts

27. Use Resources… nutrition.gov http://www.fns.usda.gov/cnd/care/AdultCare.htm

28. Keep… • Retain all CACFP records by Federal Fiscal Year, three years back and the current year. • As of October 1, 2012, you must retain all records back to October 1, 2009 • Approved copy of Online CACFP Application (Contract) • The Permanent Agreement (signed in FFY 2007); You must retain this document indefinitely. Make sure to pull ahead to retain in current year’s files! • State Agency Guidance Memorandums; you can download the most current guidance memorandums on our website

29. Organize… Have Different Binders/Folders for… • The annually required documentation • HSIS and HSIR • Monthly Claim documentation • Financial documents

30. Putting the pieces together… • Submitted monthly reimbursement claims • Dated menus, showing all foods served for each claimed meal and snack including substitutes. • Daily dated production records • Original tally records (do not toss) and meal count summary records • Participant eligibility documentation, HSIS, HSIR • Attendance records • Civil rights compliance documentation • Training documentation, including meeting minutes. • Monitoring documentation, i.e. pre-operational visit forms & review forms • Submitted annual (Independents) or quarterly (SOs) Nonprofit Food Service Financial Reports, with all support documentation. • Procurement doc – cost/service comparison, i.e. for vended meals. GM 9A

31. ~In Summary ~ Listing of Required CACFP Documentation for Adult Care Centers Go to: http://fns.dpi.wi.gov/files/fns/pdf/gm_9_checklist_adc.pdf Under Guidance memo 9A We know how hard it is to stay organized with all the requirements of the CACFP. When are forms due? How often do you have to update them? When should forms be completed? This checklist will help you keep track of all of the paperwork. You may want to print it out and hang it on a clipboard in your office or use it to add reminders to your calendar, and refer to it throughout the year to make sure you're on track.

32. Questions? • Contact DPI at 608-267-9129 OR • Contact your assigned Consultant • Region map: http://fns.dpi.wi.gov/fns_cacfpmap • Directory : http://fns.dpi.wi.gov/fns_directory

33. Thank you for your time in viewing this webcast. In accordance with Federal Law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability. To file a complaint of discrimination, write USDA, Director, Office of Adjudication, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call toll free (866) 632-9992 (Voice).  Individuals who are hearing impaired or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339; or (800) 845-6136 (Spanish).   USDA is an equal opportunity provider and employer.