Policy Memo 197

DOH-CACFP: Number 197 (01/18),Supersedes Number 94-3 (2/08)

TO: CACFP Sponsoring Organizations of Day Care Centers

FROM: Dwight LaDu, Director, Child and Adult Care Food Program

SUBJECT: Adult Day Care Eligibility in CACFP

Purpose and Scope

The intent of the adult component of CACFP is to assist participants with remaining in the community and to avoid premature institutionalization by providing respite to family and other caregivers. This memo provides clarification of the eligibility of adults and adult day care centers' participation in CACFP.

Center Eligibility

Adult day care centers must provide a community-based, non-residential program designed to meet the needs of functionally-impaired adults or persons 60 years of age or older through an individual plan of care. These plans demonstrate a center's ability to provide a variety of health, social and supportive services for its enrolled participants. Eligible centers must also have State or local approval to provide adult day services.

The following centers are not eligible to participate in CACFP: sheltered workshops, vocational or substance abuse rehabilitation centers and senior citizen's centers. These centers are not operated primarily to provide day care to elderly and disabled adults to avoid premature institutionalization. The same is true for facilities which provide residential care such as nursing homes, intermediate care facilities and psychiatric facilities. Also, apartment complexes that provide meals and full-time care only for functionally-impaired individuals would not be considered eligible for CACFP.

Participant Eligibility

CACFP regulations define an adult participant as a person enrolled in an adult day care center who is functionally impaired or 60 years of age or older. Functionally-impaired adults are those who have chronic physical or mental impairment that markedly limits their capacity for independence and their ability to carry out activities of daily living. Activities of daily living may include activities such as cleaning, shopping, cooking, taking public transportation, maintaining a residence or caring appropriately for one's grooming or hygiene.

Eligible individuals may reside in their own home or in the home of a family member, guardian or other caregiver. Participants who reside in a residential facility, even on a temporary basis for respite care, crisis intervention or other reasons, are not eligible for CACFP benefits until they have returned to their residence in the community.

Enrollment in Day Care

Participants must be enrolled in care to be eligible for CACFP. It does not matter if the status of the participants attendance is full-time, part-time, permanent, temporary, regular or sporadic. "Drop-in" adults who eat meals at the center but are not registered to receive care at the center are not considered to be "enrolled", and thus, do not meet CACFP eligibility requirements.

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 determine whether an individual is entitled to participate in CACFP. This is different from the income-eligibility determination, which affects the rate of reimbursement from CACFP. Participants eligible for CACFP benefits must complete an income eligibility form each year. Participants are classified by the center into one of three reimbursement categories: free, reduced or paid. These classifications only affect the center's reimbursement and are not meant to indicate that adults should be charged for meals.

The income eligibility is reported on the monthly CACFP claim for reimbursement. Enrollment figures submitted on the monthly CACFP claim for reimbursement must include all individuals entitled to participate in CACFP, whether free, reduced or paid. Any adults not eligible to participate in CACFP, as defined above, should not be included in the enrollment section on the CACFP claim for reimbursement.

Meal Requirements

An adult day care program may be approved to serve and claim up to two meals and one snack or two snacks and one meal per day for each eligible adult, depending on the length of time in care. The attached table shows the required food components for each meal type and the minimum required serving sizes for adults. All the required food components identified in this table must be offered with each meal opportunity.

Special diets for medical or dietary needs, that do not conform to the regulatory meal pattern must have a signed medical statement on file.


1258 Adult Meal Pattern