CACFP Policy Memo Number 94-3

DOH-CACFP: Number 94-3

TO: Adult Day Care Participation in CACFP

FROM: Jeanne Colegrove, State Director, Child and Adult Care Food Program

SUBJECT: CACFP Sponsoring Organizations of Adult Day Care Centers

This policy memorandum provides clarification of previous United State Department of Agriculture (USDA) guidelines and rulings related to participation in the adult component of CACFP. These requirements are in effect.

Eligible Centers

Adult day care centers may participate in the Child and Adult Care Food Program (CACFP) under criteria outlined in the federal regulations 7 CFR Part 226 applicable to all sponsoring organizations and individual centers. More specifically, 7 CFR Part 226.19a(1) requires that to be eligible adult day care centers must provide a community-based group program designed to meet the needs of functionally impaired adults through an individual plan of care.

Eligible Participants

I. Living Situations

The intent of the adult component of CACFP is to assist centers in providing respite to family and friends. The variety of living situations of participants in adult day care in New York State demands careful analysis by sponsoring organizations. Following are guidelines to help determine whether individuals living in these situations would be eligible for CACFP.

  1. Functionally impaired adults living in a household, either their own, with relatives, or in foster care settings (including family day care homes), are eligible for CACFP.
  2. Functionally impaired adults living in group homes, community residences and some apartment programs may also be eligible to have their meals reimbursed by CACFP. Eligible adults must have no paid personal caregiver and be generally responsible for themselves. Eligible adults likely qualify if the following questions can be answered with a yes: 1) Is the participant able to perform the functions of daily living without close 24-hour supervision or care by staff members? and 2) Is the participant able to come and go freely with little oversight but little or no monitoring from the staff?
  3. Institutionalized adults are not eligible to receive CACFP benefits. For the purposes of CACFP, "institutionalized" individuals are defined as persons in residences providing 24-hour care by staff or professional caregivers, hired to provide that care. Residents of intermediate care facilities (ICF's) and nursing homes are examples of adults in the institutionalized category, and therefore would not be eligible for meal reimbursement. Not included as institutions are houses in the community which may be subsidized by federal, state or local funds and house an individual or group of individuals who are primarily responsible for their own care but who may receive on-site monitoring.

II. Enrollment in Adult Day Care

Participants must be enrolled in order to receive CACFP benefits. An "enrolled eligible participant" is an individual registered with a center to receive day care. The attendance status (full-time, part-time, permanent, temporary, regular or sporadic) of the individual is irrelevant. Enrollment and an individual plan of care are separate but related requirements. "Drop-in" adults who eat meals at the center but are not registered to receive care at the center are not "enrolled", and thus, do not meet CACFP eligibility requirements.

Loss of Participant Eligibility

Eligible participants are not eligible for CACFP benefits if their meals are specifically reimbursed or paid for from another source or if the adult receives pay for any work performed at the adult day care center.

Income Eligibility Determination

The eligibility standards stated above - which determine whether an individual is entitled to participate in CACFP - must be distinguished from the income eligibility determination, which affects the rate of reimbursement from CACFP for eligible participants. All participants eligible for CACFP benefits must be included in the enrollment figures and meal count information submitted on monthly CACFP claims for reimbursement. Each center shall collect and maintain the documentation necessary to classify only eligible participants in one of the three reimbursement categories: free, reduced or paid.

Any adults not eligible to participate in CACFP, as defined above, should not be included in either the enrollment figures or meal count submitted for CACFP reimbursement.

Pricing and Non-Pricing Program

A pricing program, as defined in the federal regulations 7 CFR Part 226, is a program under which a CACFP sponsor or center has a separate identifiable charge for meals served to participants. A non-pricing program is one under which no separate identifiable charge is made for meals provided to participants.

The regulations do not permit a pricing program to charge for meals served to CACFP eligible participants who meet the income guidelines for the free category. A pricing program may charge for meals served to eligible participants who meet the income guidelines for the reduced category, but not more than the difference between the free and reduced rate of reimbursement for any meal (i.e., for federal FY 94, the charge for a reduced-price lunch or supper charge may not exceed 40 cents, the charge for a reduced price breakfast may not exceed 30 cents, and the charge for a reduced-price supplement may not exceed 14 cents). A pricing program may charge for meals served to eligible participants who meet the income guidelines for the paid category; the price of that meal is not regulated. Pricing programs must collect payments for reduced- or full-price meals in a manner that preserves the anonymity of the participants receiving free or reduced-price meals.

Non-pricing programs may not charge separately for any meal served to any eligible participant regardless of their income determination category: free, reduced or paid.

As stated above, meal count information and enrollment figures submitted on monthly CACFP claims for reimbursement must include meals served to all individuals entitled to participate in CACFP, whether free, reduced or paid.