HomeMy WebLinkAboutG.A. Food Service Inc
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DOCUMENT NAME: C;. A. ~ 3er \J t' c.e. 1-:l.0 L.
DOCUMENT TYPE: Con~
YEAR: OJ.-i
BOX NUMBER: Z ~
FILE NUMBER: \136t \
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NUMBER OF PAGES: l"'7l
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FOOD SERTICE CONTRACT
FOR THE
NUTRITION SITE PROGRAM
(Preparation and Delivery of Congregate and Homebound Meals)
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JUL Y 1,2004 TO JUNE 30, 2005
State of Georgia.
County of
The Contract, made this 1 st day of July 2004 between the, Augusta/Richmond County
R:@Qreatmn aHa P;;u-k51 Ikpt. ~ s!Af)" JJ -
(hereinafter referred to as "Purchaser" and G.A. Food Service, Incorporated, having
its principal place of business ,at 12200 32nd Court North. 8t. Petersburg. Florida
33716
(hereinafter referred to as "Seller").
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WITNESSETH
WHEREAS, Purchaser is desirous of -purchasing meals for consumption by eligible
individuals under the provisions of the Older Americans Act of 1965, As Amended (Title
III Cl and C2); and
WHEREAS, Purchaser has been provided an allocation from the Central Savannah River
Area Regional Development Center's Area Agency on Aging for the purchase of such
-----------meals-through_the_TitleJlLCJ_and_C2_program;_and _______....__._____..,._
WHEREA~the Central Savannah River Area Regional Development Center has qualified a
nutrition program food vendor through a competitive bid process; and
WHEREAS, Seller is recognized by the Central Savannah River Area Regional
Development Center as the region's qualified nutrition program food vendor; and
WHEREAS, Seller has the technical knowledge and capacity required to supply such
meals.
NOW, THEREFORE, the parties hereto, intending to be legally bound hereby, agree as
follows:
1. Purchaser agrees to purchase meals and Seller agrees to sell meals as specified in item 8
of this contract.
2. Seller shall provide meals as specified and according to the number and type of diets
being served each meal service day.
3. Seller shall comply with all Georgia Department of Human Resources, Division of
Aging Services Standards and with all Food Service Vendor Qualification
DRAFT NUTRITION CONTRACT
REVISION 2 - May 14,2004
PAGE 1 OF lQ+
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specifitations as outlined in EXHIBIT A which is attached hereto apd made a part of
this Contract. j ·
4. Seller shall develop four-week cycle menus which will change quarterly. Menus, along
with the Nutritional Analysis of each menu served, are due at least eight (8) weeks prior
to implementation of menus in order to allow for adequate review of the menus. The
menus are to include the following: (1) a four-week cycle menu for Hot Congregate
Meals and Hot Home-Delivered Meals (regular), (2) a four-week cycle menu for Hot
Congregate Meals and Hot Home-Delivered Meals (no concentrated sweets), (3) a
menu for five Picnic Meals (regular), (4) a menu for five Picnic Meals (no concentrated
sweets), (5) a menu for five Shelf Stable Meals (regular), and (6) a menu for five Shelf
Stable Meals (no concentrated sweets), (7) a four-week cycle menu for Frozen Meals
(regular), and (8) a four-week cycle menu for Frozen Meals (no concentrated
sweets).To ensure food production is managed, standardized recipes adjusted to the
number of servings must be utilized.
The menus must be prepared by a Registered Dietitian. The signature of the qualified
Dietitian is required on all menus. The Georgia Department of Human Resources,
Division of Aging Services defines the term "qualified Dietitian" as a person who is
licensed as a Dietitian by the State of Georgia. In order to be licensed, a person must
be a Registered Dietitian, which means that he or she holds certification by the
American Dietetics Association (ADA).
5. Seller covenants and warrants that each meal provided under the terms of this Contract
shall comply with all applicable regulations of the United States Department of Health
and Human Services, Administration on Aging, respecting meals to be served pursuant
to the Older Americans Act oLI~6S,_as_Amended_(Iitle_IILCLancLC2);_the-Senior_u
Center program, and as outlined in EXHIBIT A which is attached hereto and made a
part of this Contract. Purchaser shall be represented in this Contract by its designated
employee(s) or authorized representative(s), including the Senior Center Program
Director, who shall at all times during the term of this Contract have the right and
authority to:
a. Inspect all food and meals furnished or supplied by Seller to determine whether
same comply with applicable specifications and to reject any food or meals not
meeting such specifications;
b. Have access to Seller's purchase records bearing upon all food purchased for the
purposes of this Contract and to review and audit said records as deemed necessary
and advisable;
c. Seller's dietitian must attend all menu meetings and approve all menus and recipes
for meals and food to be delivered pursuant to this Contract so as to insure
compliance with United States Department of Health and Human Services
requirements; to inspect the meals served to determine compliance with United
States Department of Health and Human Services meal-type requirements, and, to
withhold payment for meals and food not meeting prescribed requirements;
DRAFT NUTRITION CONTRACT
REVISION 2 - May 14,2004
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d. Inspect at' any time all Seller's food'preparation, 'packing, and.storage areas and
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food containers and automotive vehiCles used in transporting prepared meals and
other food and determine the adequacy of Seller's cleaning, sanitation, and
maintenance practices and to impose reasonable requirements to assure sanitation
and quality;
e. Determine the adequacy of Seller's storage and record-keeping practices so as to
insure the safekeeping of all food; and, in connection therewith to have ready access
to the related food inventory control records of Seller at any time Purchaser deems
advisable; and
f. Record food temperatures while food is on steam table and before food is packaged.
6. Seller shall comply with all applicable local, state, and federal laws and regulations
governing the preparation, handling, and transporting of food; shall procure and keep in
effect all necessary licenses, permits, and food handler's cards, as are required by law; and
shall post such licenses, permits and cards in a prominent place within meal preparation
areas, as required by Purchaser. Seller shall comply with all local, state, and federal laws
and regulations pertaining to wages and hours of employment. Seller, as an Equal
Opportunity Employer, further agrees to comply with Executive Order 11375, and as
supplemented in Department of Labor regulations (41 CFR Part 60). In addition, Seller
shall comply with all Specifications as outlined in EXHIBIT A which is attached hereto
and made a part of this Contract.
7. Seller shall supply automotive vehicles and insulated containers for hot and cold food for
the transportation of meals and other food to the Senior Center, and maintain proper food
temperature.s..fQrJheJlO.Land_cold.food.as_specified.in_EXHIBLLA.
8. The purchase price for meals ordered under this Contract shall be $4.45 per meal (Hot
Meals) $4.45 per meal (Picnic Meals), $4.45 per meal (Shelf Stable Meals) and $4.45 per
meal (Frozen Meals). Purchaser or its designee 'shall not be liable or responsible for any
cost or expense whatsoever other than the designated said price per meal. Seller will bill
Purchaser monthly at the itemized per meal rate of $4.45 (Hot Meals), $4.45 (Shelf Stable
Meals), $4.45 (Frozen Meals) and $4.45 (Picnic Meals). Meals shall be delivered directly
to the Senior Center by Seller. Delivery of these will be mutually determined. Purchaser
will pay such billings within forty-five (45) calendar days from the date on which the
billings are received by Purchaser.
9. Purchaser or its designee shall notify Seller of its daily meal requirements not less than 24
working hours prior to the time said meals are to be delivered. Notification shall be written
notification on the prior working day's invoice for the number of meals specified. In the
event of a chapge in the number of meals, a telephone call to Seller prior to 5 AM on the-
day of delivery will be honored by Seller.
10. Seller shall indemnify purchaser against any loss or damage (including attorney's fees and
other costs of litigation) caused by Seller's negligent acts or .omissions, theft by Seller's
employees, or the negligent acts or omissions of Seller's agents or employees. Seller shall
defend any suit against Purchaser alleging personal injury or property damage arising out
of the transportation of meals or other food to the Senior Center and any claim alleging
DRAFT NUTRITION CONTRACT
REVISION 2 - May 14, 2004
PAGE 3 OF lQ+
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personal injury, sickness or disease arising out to the consumption of meals or food caused
by the storage, preparation, and del-ivery of meals or food to the Senior Center. '
11. Purchaser shall promptly notify Seller in writing, of any claims against Seller or Purchaser,
and in the event of a suit being filed, shall promptly forward to Seller all papers in
connection therewith. Purchaser shall not incur any expense or make any settlement for
which Seller would be liable without Seller's consent. However, if Seller refuses or
neglects to defend any such suit, Purchaser may defend, adjust, or settle such claim, and the
costs of such defense, adjustment, or settlement, including reasonable attorney's fees, shall
be charged to Seller.
12. Seller shall maintain books, records, documents and other evidence of accounting
procedures and practices which sufficiently and properly reflect all costs expended in the
performance of this Agreement and paid for by the Purchaser. These records shall be
subject at all reasonable times to review, inspection, copy, and audit by any persons duly
authorized by the Seller, or at the request of the Central Savannah River Area Regional
Development Center or a State or Federal agency or department. These records must be
maintained by the Seller for a period of six (6) years after the end of the Federal Fiscal
Year to which they pertain or any other period which the Administration on Aging or State
reimbursement agency may from time to time designate.
13. The parties further agree as follows:
A. Upon delivery of meals to the Senior Center, an authorized on-site representative of
Purchaser shall sign a receipt in triplicate, supplied by Seller, evidencing receipt of
such food of which one copy will be retained by Seller, and one copy will be
retained by- theJieniQLCenteLdirectQrs_ancLone_cop~dof-the-CSRA
B. Seller shall keep complete and accurate sales records in connection with the sales
covered by this Contract. All such records shall be kept on file for six (6) years
after the end of the Federal Fiscal Year to which they pertain or any other period
which the Administration on Aging or State reimbursement agency may from time
to time designate.
C. Seller warrants that the meals delivered by it under this Contract will be
wholesome, suitable for human consumption, and will satisfy the nutritional
requirements of existing regulations pursuant to the Older Americans Act of 1965,
as Amended (Title III, C 1 and C2).
D. Seller agrees to furnish Purchaser with a certificate of insurance in a form
acceptable to Purchaser certifying that Seller carries the following insurances and
amounts:
~ Worker's Compensation, as prescribed by the State of Georgia.
~ Comprehensive Bodily Injury and Property Damage Liability; $1,000,000 for
one person and $2,000,000 for anyone accident; and $1,000,000 Property
Damage.
~ Fidelity Bond. A Fidelity Bond covers the Food Service Vendor for Financial
Responsibility._Amount of the Fidelity Bond is 12% of the projected total
DRAFT NUTRITION CONTRACT
REVISION 2 - May 14,2004
PAGE 4 OF ,LQ-I-
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contractual amount for the Contract Period of July 1, 2004 through June 30,
2005. The time period of the bond must coincide with the Contract Period. If
a Food Service Vendor has a very large bond covering its entire operations, it
can assign, through an endorsement or rider, the required portion of the bond.
However, it is sometimes simpler to purchase an individual bond for the
specific contract. The bond may be a blanket bond covering all of Food
Service Vendor employees, or it may be a position bond, listing specific
positions. If a position bond is used, the positions bonded must be those
persons handling funds. Positions frequently bonded are board chairperson,
director; treasurer, and bookkeeper, varying with individual circumstances. If
a position bond is used, each position schedule must be for the minimum
amount required. (Example: If a contract requires $75,000.00 bonding, each
scheduled position must be bonded for that amount (not scheduling three
positions for $25,000.00 each.
~ Proof of Personal Guarantee must be submitted by Seller prior to execution of
the Contract to cover the time it will take to requalify and renegotiate another
Contract should Seller terminate the Contract during the Contract Period.
E. Seller is a wholesaler and the sale of meals contracted for herein are sales to a non-
consuming purchaser and not retail sales. Meals purchased by a local government
are not subject to sales tax. Sales tax required to be collected on sales to any entity
not a local government are included in the price. In the event that the sale of any
food items contracted for herein is subject to any local or state sales tax, the amount
of such sales tax shall be included in the purchase price of each meal type as
specified in number 8 above.
F. It is mutually agreed that neither party shall be held responsible to the other for any
losses resulting from its delay or failure to perform to the extent that performance is
delayed or prevented by local, state, or federal action, war, fire, flood, Act of God,
or without limiting the foregoing, by any other cause not within the control of the
party whose performance is interfered with, and which by the exercise of reasonable
diligence, the party is unable to prevent.
G. Seller shall develop an emergency procedure for delivery of food in the case of
emergencies, including weather-related emergencies, vehicle breakdowns,
equipment breakdowns, power outages, gas outages, water outages, fire( or
destruction of the premises by any cause whatsoever), food delivered outside of
specified temperature standards, food contamination or spoilage, and lack of staff
(due to vacation, sick leave, etc). In the event that Seller fails to prepare and deliver
any meal or meals or other food to the Senior Centers as agreed upon, Purchaser
may procure a replacement meal or meals or other food elsewhere and charge to
Seller the cost of $6.00.to replace the meal. Reimbursement of said meals shall be
within thirty (30) days of the request.
14. Meal Shortages: In the event Seller fails to deliver meals or portions of meals, or Seller
delivers food that is unwholesome, fails to meet specifications, or has been substituted
without prior approval, Purchaser's designated employee(s) or its authorized
DRAFT NUTRITION CONTRACT
REVISION 2 - May 14,2004
PAGE 5 OF 1.Q+
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representaiive(s) 'shall note all discrepancies on the delivery receipt, ~d the following
procedures shall apply: '- ·
A. Alternate Vendor Procedures: Purchaser's designated employee(s) or its
authorized representative(s) shall procure the necessary items from an
alternate vendor. Seller will be responsible for establishing an appropriate
alternate vendor in the local counties. All meals or portions of meals
procured from alternate vendors must contain at least thirty-three and one-
third (33 1/3) percent ofthe RDAlDRI.
B. Seller. will be responsible for alternate vendor bills. Supporting
documentation must be submitted to Seller for all such payments.
C. Alternate vendor payments, and/or credits, will be deducted from
Purchaser's invoice.
D. Purchaser will not be responsible for the payment of the meal if a
substitution was not approved at least two (2) working days prior to the meal
delivery or if the meal did not meet at least 33 1/3 percent of the RDAlDRI
or if the approved menu was not followed.
15. In the event of any breach or default by Purchaser or Seller in performing the terms and
conditions of this Contract, the party not in default shall give written notice to the party in
default, specifying the acts or omissions constituting the alleged default or breach; if within
thirty (30) calendar days after issuance of such notice the party in default shall have failed
to cure such default, THEN IN THAT EVENT, the party not in default may terminate this
Contract and exercise such other rights as are Qrovided herein and by law fur.-br.eaclLof
contract, PROVIDED, HOWEVER, that if the alleged default can be cured by the
performance or work or repairs or by some act, the performance of which requires a
reasonable period of time, such default shall be determined to have been cured if, within
thirty (30) calendar days, the party allegedly in default shall have commenced the curing of
such default and shall thereafter diligently and continuously cause the same to be
prosecuted to completion.
16. Purchaser or Seller may, from time to time, request changes in the Contract to be
performed hereunder. Such changes, including any increase or decrease in the amount of
Seller's compensation and/or time limitations, which are mutually agreed upon by and
between Purchaser and Seller, shall be incorporated in written amendments to this
Contract. Changes in compensation during the Contract Period are subject to the approval
of the Georgia Department of Human Resources, Division of Aging Services and the
CSRA Regional Development Center.
17. Seller's Assurances:
A. Seller's representative shall be provided on a regular basis to visit the
individual Senior Centers Programs to promote public relations and to
prevent food service problems.
DRAFT NUTRITION CONTRACT
REVISION 2 - May 14,2004
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B. Seller's employee shall be located on the Kitchen Facility premises on a daily
basis to ensure an orderly flow of meal orders and to ensure accountability on a
timely basis.
C. Seller shall distribute a Menu Preference Survey quarterly to the Senior Center
participants in order to assure the quality, appearance, and variety and portion
sizes of the meals.
D. Seller shall permit Purchaser and/or Purchaser's agents or employees, to enter
into the premises at all reasonable times for the purpose of inspecting the same
or for the purpose of maintaining or making repairs, alterations or additions to
any portion of the premises.
18. Seller's representative shall be available to visit the individual nutrition sites to promote public
relations and to prevent food service problems.
19. Seller shall distribute a Menu Preference Survey quarterly to the nutrition site participants in
order to assure the quality, appearance, variety, and portion sizes of the meals and a copy of
that survey and all survey results must be submitted to each nutrition site and to the Central
Savannah River Area Regional Development Center.
20. Seller shall permit Purchaser and/or. Purchaser's agents, employees, or authorized
representative(s), to enter the food preparation site at any reasonable time for the purpose of
inspecting the same.
21. Seller shall not assign this Contract, or any interest therein.
22. This Contract constitutes the entire agreement between Seller and Purchaser with respect of
the subject matter hereof and there are no other or further written or oral understandings or
agreements with respect hereto. No variation or modification of the Contract, and no waiver
of its provisions shall be valid unless in writing and signed by the duly authorized officers of
Purchaser and Seller.
23. Seller and Purchaser hereby acknowledge that a lawsuit has been filed by The Senior Citizens
Council of Greater Augusta and the CSRA, Georgia, Inc., et aI. vs. CSRA Regional
Development Center, et aI., in the Superior Court of Richmond County (Civil Action No.
2004-RCCV -530) st1eking to enjoin the award of the bid to G.A. Foods.. A hearing on this
matter was held on Monday, June 14, 2004. Should the Court rule adversely to the Regional
Development Center and G.A. Foods and void the bid award to G.A. Foods as the meal
vendor, this contract will stand voided, terminated, amended or otherwise conformed to. such
final Order as may be entered in said case, including any final order after appeal In addition
Purchaser specifically reserves its right to terminate this contract for its convenience as
provided in Paragraph 27 herein. Except as herein provided, should any provision or portion of
any provisions of the Contract be held invalid by a Court of competent jurisdiction, the
remainder of this Contract or the remainder of such provision shall not be affected thereby.
24. All notices required under the terms of this Contract to be furnished to Seller shall be properly
given if mailed in the United States mail with sufficient postage affixed thereto to Seller at the
following address, to wit:
Contact Name: John Hale, COO
Company Name: G.A. Food Service, Incorporated
DRAFT NUTRITION CONTRACT
REVISION 2 - May 14,2004
PAGE 7 OF 10
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Mailing'Address: 12200 32\1(1 Cotirt- N~rth .. .
Cty, State, Zip: St. Petersburg"florida 33716
Telephone: 727-573-2211
Fax: 727-572-8209
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25. All notices under the terms of this Contract to be furnished to Purchaser shall be properly
given if mailed in the United States mail with sufficient postage affixed thereto to
Purchaser at the following address, to wit:
Contact Name:&t:tl &- ~ w:s.1 r ~ A-; (M.:,^- J*;fr/t.;v
Mailing Add:ess: S3 c) (;;D~.!..~ R.Jo"- I/i)~
Cty, State, ZIp:
Telephone: tJ c)
Fax: 0
26. All notices under tlie terms of this ontract to be furnished to the Central Savannah River
Area Regional Development Center shall be properly given if mailed in the United States
mail with sufficient postage affixed thereto to. Central Savannah River Area Regional
Development Center at the following address, to wit:
Attn: Andy Crosson, Executive Director
Central Savannah River Area Regional Development Center
3023 River Watch Parkway, Suite A
Augusta, GA 30907
Telephone: (706) 210-2000 (extension 107)
Fax: (706) 210-2006
27. This Contract shall become effective July 1, 2004 and shall remain in effect through and
including June 30, 2005. Either party may terminate this Contract by giving thirty (30)
calendar days written notice of intention to terminate. Until so terminated, this Contract
shall remain in full force and effect.
28. In the event that local, state, and/or federal funding is terminated or otherwise unavailable
for the purpose of financing the Senior Centers Programs, then and in that event, this
Contract shall immediately become null and void and Purchaser shall be released
immediately from all obligations hereunder. In the event that this Contract is terminated
for any reason, Purchaser shall pay Seller for all services actually performed to date of
termination and under this Contract.
29. Seller shall provide the following products at the Senior Centers: sturdy table flatware
(individually wrapped packages of a fork, a knife, and a spoon); disposable plates (with at
least five (5) compartments for Hot Congregate Meals, medium weight); cups (4 oz. cups
for dessert and 6 oz. and 8 oz. cups for water, tea, coffee and juice); lids (for 4 oz cups);
napkins (12" x 12" - 2 ply); sandwich bags; lunch bags; disposable polyethylene gloves;
haimets or hair restraints; disposable plastic aprons; coffee stirrers (wood); individually
wrapped straws; and appropriate condiments.
Note: Aluminum foil plates with three (3) partitions and single lids [or equivalent Cpet or
Chinet Tray with Film Seals] must be used for Hot Home-Delivered Meals. Cold and hot
food items must be packaged and transported in separate containers. Seller must provide
ice for coolers which are used for transporting milk and desserts.
DRAFT NUTRITION CONTRACT
REVISION 2 - May 14,2004
PAGE 8 OF LQ+
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Typewritten package labeling for frozen m~als~ustbe legible, showing package date [Best
Vsed By Date], list of food items in the package, Storage, preparation, and safe thawing and
reheating instructions.
Federal regulations require Seller to use appropriate food containers and utensils for blind
and disabled participants. Food preparers must wear disposable polyethylene gloves,
haimets or hair restraints, and disposable plastic aprons while preparing food for packaging
and serving.
In addition to disposable products listed above, Seller must agree to provide the Senior
Centers: food and refrigerator thermometers, coffee maker and tea dispenser.
30. Seller agrees to notify Purchaser or its designee of change(s) in designated menu two (2)
working days prior to the change(s) and to obtain a written notice from Purchaser or its
designee so that copies of the change(s) can be delivered with the meals in the event of
approval of the change(s).
IN WITNESS WHEREOF, the parties hereto have caused this Contract to be signed by
their duly authorized representatives the day and the year above written.
FOR PURCHASER:
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DRAFT NUTRITION CONTRACT
REVISION 2 - May 14, 2004
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NOTARY BLIr .'
Notary Public. Columbia County, Georgia
My Commission Expires Aug. 1,2006
PAGE 9 OF 10
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MY COMMISSION EXPIRES:
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A TT A GMlfllJlll\l~KJ::j TO:
EXHIBIT A - FOOD SERVICE VENDOR QUALIFICA nON SPECIFICA nONS
EXHIBIT B - SCOPE OF SERVICES
(AFFIX AND IMPRESS NOTARY
PUBLIC SEAL HERE)
DRAFT NUTRITION CONTRACT
REVISION 2 - May 14,2004
PAGE 10 OF 1Q+
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EXHIBIT A
FOOD SERVICE VENDOR QUALIFICA nON SPECIFICA nONS
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EXHIBIT A
Georgia Department of Human Resources
Division of Aging Services
Requirements for Non-Medicaid
Home and Community Based Services
and
Operations Manual
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Georgia Department of Human Resources Division of Aging Services
Requirements for Non-Medicaid Home and Community Based Services
Section 300.
Individual Service Requirements
~304 Nutrition Service Program Guidelines and Requirements
January 2002
revised 6/2003
~304.1 Purpose
This section establishes requirements for Area Agencies on
Aging and their subcontractors in the administration and
provision of a comprehensive program of nutrition services to the
elderly.
~304.2 Scope.
These requirements apply to all congregate and/or home
delivered nutrition services contracted and provided through the
Area Agency on Aging, supported by any and all non-Medicaid
sources of funding,
~304.3 Congregate Nutrition
Program Description and
Performance Requirements
(a)
Service obiective. To promote better physical and
mental health for older people through the provision of
nutritious meals and opportunities for social contact.
Congregate nutrition services shall be a part of a system
of services which promotes independent living for the
elderly.
(b) Service outcomes. At a minimum to identify persons at
nutritional risk through nutrition screening, to reduce
nutritional risk among consumers through the provision
of nutritious meals, education and counseling and to
reduce isolation/increase the sense of well being of
consumers through socialization.
(c) Service activities. Service activities include:
(1) the provision of meals and nutrition education in
a group setting at a nutrition site, senior center,
or multipurpose senior center, and ongoing
outreach to the community.
(2) access by participants to nutrition screening,
nutrition education and counseling on an
individual basis, when appropriate; access to
the site through transportation services;
shopping assistance; health, fitness, and other
educational programs; and recreational
activities,
(d) Eliqibilitv. Client eligibility is established by
provisions of the Older Americans Act at
~307(a)(13)(A) and (I) for nutrition services provided
through all non-Medicaid fund sources. Eligible persons
are:
. persons aged 60 and over;
. their spouses, regardless of age;
. handicapped/disabled1 residents of housing
facilities occupied primarily by the elderly at
which congregate nutrition services are
provided;
Reference Section 200, S204 "Definitions," Medical certification of disability is not required,
) \
Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 2 of 41
. handicapped/disabled individuals who live in a
non-institutional household with and accompany
an eligible person to the congregate nutrition
program.
. conditional upon AM policies, volunteers, staff
and guests age 60 and above. (Also see
9304.7)
(e) Schedule of meal service. Each provider agency shall
serve meals in accordance with provisions stated in the
Older Americans Act at 9 331, Subpart 1, concerning
Program Authorization.
(1) Providers of congregate nutrition services shall
use an advance reservation system to determine
the number of meals necessary for each day's
service and inform participants of procedures for
reserving meals.
(2) Providers shall serve eligible drop-in seniors and
other unscheduled guests only after participants
who have made advance reservations are
served a meal which provides all of the
Recommended Dietary Allowances.
(f) Participant records. The service provider agency shall
maintain files in a form and format approved/accepted by
DAS, including information which, at a minimum,
identifies regular participants; documents individuals'
eligibility for the program; and contains instructions for
emergency contacts and care preferences, All providers
shall maintain any other additional individual participant
information as specified by DAS service program
policies and procedures. Files of participants served
through the DAS contract are confidential and are the
property of the Department of Human Resources. All
participant files are subject to review and monitoring by
the AM, the Division, the Department, and the federal
granting agencies,
(g) Meal service requirements, Nutrition service providers
shall use procedures which provide for the safety,
sanitation, accessibility and convenience needs of
participants, and efficiency of service, and shall include
the following:
(1) using correct portion sizes and utensils as
specified on approved menus;
(2) adherence of staff and volunteers to food
sanitation requirements, as prescribed by
applicable Federal, State and local rules and
regulations; 2
2 County health departments have the right of amendment to add requirements to State rules and regulations, The higher of the
two sets of standards shall apply.
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~304 Nutrition Program Guidelines and ReqLiirements
January 2002
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(3) taking and recording food temperatures daily to
document that safe temperatures are
maintained; and
(4) to prevent cross-contamination, kitchenware and
food-contact surfaces of equi~ment shall be
washed, rinsed and sanitized after each use
and following any interruption of operations
during which contamination may have occurred;
(5) if cafeteria-style service is used, assisting those
participants who have physical difficulties with
trays.
(6) food shall be available to participants for at least
30 minutes after serving begins.
(7) providers shall establish policies and procedures
which assure that participants do not take
potentially hazardous foods from the site.
(8) providers shall make available to visually-
impaired, blind or otherwise handicapped
persons, food containers and utensils
appropriate to their needs.
(9) after offering additional servings to program
participants if appropriate, providers may donate
unconsumed food products to other charitable
community social service or public service
organizations. Providers wishing to make such
donations shall obtain a "hold harmless"
agreement from the receiving organization,
which protects the provider from any liability.
(10) providers shall not arrange for or provide
covered dish meals at nutrition sites or other
locations, using any funds which are
administered through the contract with the Area
Agency on Aging to support the cost of such
activities.
(h) Food storaQe safetv.4 Potentially hazardous foods shall
be stored at safe temperatures as stated at
~ 290-5-14-.03 of the Administrative Rules and
Regulations of The State of Georgia, "Food Care.
Amended," which state in part that, "The temperature of
potentially hazardous food shall be (maintained at) either
41 degrees Fahrenheit or below or at 140 degrees
Fahrenheit or above at all times." Frozen food shall be
stored at a temperature of 32 degrees Fahrenheit or
below, All rules found at ~ 290-5-14.03 shall apply.
3 Refer to Appendix 304-A of this section for instructions on preparing and using a sanitizing solution,
4 Reference htto:llwww,nal.usda,gov/fnic/foodborne/wais,shtml . maintained by the USDA Food and Nutrition Service for
information and resources on food safety,
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~304 Nutrition Program Guidelines and Requirements
. . ., ...,. '~. >,~..... .....,.~.i - .,,~,
January 2002
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(i) Holdina time. Providers shall assure that holding times
for hot foods do not exceed four hours from the final
stage of food preparation until the meal is served to
the participant, including delivery to the homes
of home delivered meals participants.
U) Nutrition outreach. Providers shall conduct outreach
activities with emphasis on identifying potential program
participants who are among those in greatest social and
economic need. Providers shall refer potential
participants to the Area Agency for intake and screening,
including administration of the NSI-D checklist,
according to procedures developed by the AAA. See
9304.7(b)(1). AAAs may fund outreach activities through
Older Americans Act Title 111-8, Title III-C1 and C2 and
state funds.
(k) Nutrition education, Providers shall conduct nutrition
education activities at each congregate nutrition site, as
follows:
(1 )
Sessions shall be provided at least once
monthly consisting of a session of not less than
15 minutes in length.
(2)
Each provider shall develop a written plan of
nutrition education programming, including a
calendar, which documents subject matter,
presenters, and materials to be used, in
accordance with requirements below. If
AAAs/providers employ or contract with
Registered Dieticians, the RDs may develop a
single educational curriculum, which may be
used by multiple sites or review or approve
curricula developed by the providers,
(3)
Providers shall assure that nutrition education
content and materials5,6 are developed to be
consistent with the nutritional needs, literacy
levels, and vision and hearing capacities, as well
as the multi-cultural composition of participating
seniors. At a minimum, providers shall
incorporate into the curriculum the content
provided in the "Take Charge of Your Health
Train-the- Trainer" manual materials.
(4)
A qualified dietician, home economist, or other
qualified source shall develop or review and
approve nutrition education contenVmaterials.
5 Websites which may assist in the development of nutrition education materials include htto://nutrition4liyil)g,org .
maintained by Benedictine University, Lisle IL; htto://trc.ucdayis,edu/gerinutr/Resources/Educational%2OMaterials,htm
maintained by the Gerontological Nutritionists, a practice group of the American Dietetic Association; and
htto://nirc,cas,osu.edu/links,cfm?area=275 maintained by the Penn State College of Agriculture Nutrition Information and
Resource Center,
6 Reference: The Nutrition Interventions Manual for Professionals Caring for Older Georgians, Nutrition Intervention and
Patient Outcomes. A Self-Study Manual. and Managing Nutrition Care in Health Plans, Contact the Nutrition Screening
Initiative, 10lOl Wisconsin Avenue, NW, Washington, D,C. 20007 for further information or additional copies,
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(I)
(5) Each nutrition service provider shall maintain
written documentation of programs presented to
verify that the requirements are met.
Nutrition screenina7 - Nutrition screening begins at the
AAA with the administration of the Nutrition Screening
Initiative DETERMINE (NSI-D) Checklist as part of the
intake and screening process. The AAA may allow
congregate meal sites with no waiting lists to perform
initial applicant intake and screening directly.
Congregate meal providers shall complete the checklist
six months after services begin and, at a minimum,
annually thereafter, or at anytime that a change in the
participant's condition or circumstances warrants. The
AAA and provider(s) jointly shall develop protocols to
assure that applicantslrecipients whose NSI-D score is 6
or greater (at high nutrition risk) receive or are referred
to an appropriately trained social service or health care
professional for a Level One Screening (or higher);
receive individual nutrition counseling, if indicated; are
referred to their primary health care providers for follow-
up; and/or are referred for any other assistance or
services needed. 8
(m) Nutrition counselina. The AAA or provider shall develop
protocols to determine those participants with special
needs who would benefit from individual counseling and
assure that such counseling is made available by
qualified professionals, Please note that individual
counseling may not be indicated, regardless of the level
of nutritional risk. See note 6, page 4, for resources,
(n) Alternative meals,
(1) Picnic, holiday and weekend meals must meet
the ~ RDA requirements for adults aged 55 and
over for nutritional value; temperature
requirements for hot and cold foods; and must
be prepared in a commercial food service or on-
site kitchen.
(2) Shelf-stable, chilled and frozen meals must meet
the ~ RDA requirements for nutritional value
and applicable temperature standards. Package
labeling must be legible and show the packaging
date, list of food items in the pack, storage
instructions, and instructions for preparation or
safe thawing and re-heating.
(0) Facilitv access and safety. All nutrition sites shall
comply with the Americans with Disabilities Act
requirements, relating to access, with any
other relevant DAS standards or program requirements.9
7 Reference note 6 and also see http://www,aafp,org , the website of the American Academy of Family Physicians.
8 If the AAA contracts for or provides case management services for recipients of non-Medicaid services, the case management
provider is responsible for comprehensive client assessment and reassessment, including the administration of the NSI-D
Checklist. The case management provider is responsible for arranging for and/or coordinating nutrition services, including
obtaining additional nutrition screening, with the nutrition service provider.
9 Facility requirements for senior centers which house congregate meal programs are found in Section 200, g206,
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Georgia DHR Division of Aging Services .
~304 Nutrition Program Guidelines and RequirementS
~304.4 Home Delivered Meal
Program Description and
Performance Requirements
revised 8/2002
(a)
Service obiective. To promote better health for frail,
older people, and eligible members of their households,
through the provision of nutritious meals; nutrition
screening, education and counseling services, if
indicated, and collateral opportunities for social contact.
Home delivered nutrition services shall be a part of a
system of services which promotes independent living
for the elderly.
(b) Service outcomes. At a minimum to measure the
degree of nutritional risk of program participants; to
delay decline in health/nutritional status through nutrition
screening; to reduce identified nutritional risk among
consumers through the provision of nutritious meals,
education and counseling; and to reduce isolation /
increase the sense of well being of consumers through
collateral contacts with program staff /volunteers.
(c) Service activities, Service activities include the
provision of meals, and nutrition screening,
education and counseling to clients and their
caregivers in the home and appropriate referral
to other services/resources.
(d)
Eliqibility and priority for services. Eligible persons are
those aged 60 and over, whose functional impairments 10
prevent them from participating in a congregate meals
program, or who provide care to a dependent, disabled
person in the home, to the extent that they cannot leave
the person to attend a congregate site, AAAs shall give
priority to those in those in greatest social and economic
need, in conjunction with nutrition risk status, as
indicated by the NSI-DETERMINE Checklist Score and
high functional impairment levels, as documented on the
DON-R instrument. Persons with NSI-D Checklist.
Scores of 6 or higher are considered to be at high
nutritional risk and are to be given priority for services,
relative to comparative scores of other applicants.
Providers may offer a meal to the spouse/caregivers of a
homebound eligible person if the provision of the
collateral meal supports maintaining the person at home.
Providers also may offer meals to the non-elderly,
disabled individuals, who reside in the households of
elderly (age 60+) persons and are dependent on them
for care,
(e) Schedule of meal service, The service provider shall
provide home delivered meals, at a minimum, in
accordance with the Older Americans Act, ~ 336,
Subpart 2, concerning Program Authorization. Providers
shall make meals available at least once a day, five days
or more a week, with arrangements for the provision of
10 Functional impairment status and need for assistance are determined by the AAA at the time of intake and screening through
the use of the Determination of Need-Revised (DON-R) instrument, and subsequently at the time of initial assessment and annual
reassessment. Impairments in the eating and meal preparation items of the DON-R are particular indicators that a person may be
at nutritional risk, However, staff shall consider the complete DON-R assessment and NSI-D Checklist in determining
nutritional risk.
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meals to participants during weather-related or other
states of emergency.
(f) Participant records. The service provider agency shall
maintain files in a form and format approved/accepted by
DAS, including information which, at a minimum,
identifies regular participants and documents individuals'
eligibility for the program, All providers shall maintain
any other additional individual participant information as
specified by DAS service program policies and
procedures. Files of participants served through the
DAS contract are confidential and are the property of the
Department of the Human Resources. Files are subject
to review and monitoring by the AAA, DAS, the
Department and federal funding agencies.
(g) Conditions for referral to other services. When
appropriate, service providers shall work with the Area
Agency (or case management agency, if available11) to
refer participants to other service resources which may
be appropriate to assist them with remaining
independent and safe in their home, and/or to assist
care givers with maintaining their own health and well-
being.
(h) Meal deliverv. Providers shall develop and implement
. procedures for assuring safe meal delivery in
accordance with applicable DHR Food Service and
Food Safety rules and DAS requirements for holding
times.
(i) Meal oackaaina. Providers shall use supplies and
carriers which allow for packaging and transporting hot
foods separately from cold foods.
(1) Providers shall use meal carriers of appropriate
design, construction and materials to transport
trays or containers of potentially hazardous food,
and other hot or cold foods. Carriers shall be
enclosed to protect food from contamination,
crushing or spillage, and be equipped with
insulation and/or supplemental sources of heat
and/or cooling as is necessary to maintain safe
temperatures.
(2) Providers shall clean and sanitize meal carriers
daily or use carriers with inner liners which can
be sanitized.
(3) Meal packaging, condiments and utensils must
meet the following criteria:
(A) be sealed to prevent moisture loss or
spillage to the outside of the container;
II See note 7. Case management agencies, when available, oversee the coordination and provision of all services for non-
Medicaid service participants,
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Georgia DHR Division of Aging Services
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January 2002
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(8)
be designed with compartments to
separate food items for maximum visual
appeal and minimize spillage between
compartments;
(C)
be easy for the participant to open or
use. Providers must make every effort
to provide assistive devices or modified
utensils to persons who needed them, to
assure maximum consumption and
benefit from the meals.
U) Frozen, chilled or shelf-stable meals. These meals shall
be prepared and served in accordance with DAS
requirements and may be used only if the following
criteria can be met: 12
(1) The provider and the participant or caregiver can
assure sanitary and safe conditions for storage,
thawing (if applicable), and reheating.
(2) The participant can safely handle the meal, or
when the participant is frail, cognitively impaired
otherwise disabled, s/he has someone available
to assist with food preparation, meal handling,
and eating, if necessary.
(k) Monitorina bv service orovider. Each provider shall
monitor meal and document daily that temperatures of
hot meals received from vendors are within acceptable
ranges upon delivery to the site. Providers will monitor
no less than twice per month and document the
temperature of the last meal delivered on a given
delivery route to assure that holding times, safe
temperatures and quality of meals are maintained.
Providers shall select routes randomly for monitoring.
(I) Nutrition outreach. Providers shall conduct outreach
activities with emphasis on identifying potential program
participants who are among those in greatest social and
economic need, Providers shall refer potential
participants to the Area Agency for intake and screening,
when appropriate, according to procedures developed
by the AM.
(m) Nutrition education. Each provider shall provide nutrition
education services to recipients of home delivered meals
and/or their caregivers at least once per month,
(1) Providers shall develop nutrition education program
plans outlining activities to be performed; identifying
materials to be sent to the homes of program
participants and/or their caregivers. If the
AAAlprovider employs or contracts with a Registered
Dietician, individual
12 If the AAA contracts for or provides case management services to HeBS participants, the case management provider is
responsible for assessing the ability of the home delivered meal recipient to store and prepare alternative meal types, as well as to
determine whether the available meal is appropriate to meet the participant's health and dietary needs, See Appendix 304-0 for
documentation content.
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~304 Nutrition Program Guidelines and Requirements
revised 6/2003
v~
January 2002
Page 9 of 41
sites may use a single education curriculum
developed or approved by the staff RD.
(2) Nutrition education content shall address the
nutritional needs of home-bound elderly and be
developed, approved or distributed by a qualified
dietician, county extension agent, home
economist, or other qualified source.
(3) Providers shall make available print materials
which are in sufficiently large (14 point or
larger), clear and commonly used type faces, .
such as Arial or Times New Roman to
be easily read, and in language which is
appropriate for the educational levels and
cultural backgrounds of the participants.
(4) Each nutrition service provider shall maintain
written documentation of educational materials
provided, monthly distribution lists to verify that
the requirements are met. Providers also shall
document telephone and/or home visit contacts.
(n)
Nutrition screeninq. Nutrition screening begins
at the AAA with the administration of the NSI-D
checklist as part of the intake and screening
process. The home delivered meals frovider
shall administer the NSI-D checklist 1 , at six
months following the beginning of services and
annually thereafter, or more frequently if
indicated by a change in the participant's
condition or situation. The AAA and provider(s)
jointly shall develop protocols to assure that
applicants/recipients whose NSI-D score is 6 or
greater (at high nutrition risk) receive or are
referred to an appropriately trained social
service or health care professional for a Level
One Screening (or higher); receive individual
nutrition counseling, if indicated; are referred to
their primary health care providers for follow-up;
and/or are referred for any other assistance or
services needed (Also see note 6, page 4,for
NSI interventions reference materials.)
(0) Nutrition counselinq. The AAA and home delivered
meals provider(s) jointly shall develop protocols to
determine which program participants would benefit from
individual counseling and assure that such counseling is
made available by qualified professionals, (Also see
note 6, page 4, for NSI interventions resources.)
13 See notes 8,10, and II regarding the provision of case management services. Cease management staff may administer the
NSI-D checklist and make necessary and appropriate referrals for additional nutrition interventions, coordinating such activities
with the provider,
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~304 Nutrition Program Guidelines and Requirements
January 2002
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~304.5 Requirements
for Meals.
(a)
Each meal shall comply with provisions in the Older
Americans Act, Title III, Subpart 3 ~ 339, concerning
compliance with Dietary Guidelines for Americans.
(b) Nutrient content. Providers shall assure that individual
meals contain no more than 1200 milligrams of sodium
and no more than 30 percent of total calories from fat. 14
(c)
Menu approval. A qualified dietician shall certify menus
in each cycle as meeting the dietary guidelines and
providing recommended dietary allowances. The AM
shall submit copies of certified menus to the Division of
I Aging Services on a quarterly basis.
rev. 12/02 .
(1) The provider shall request and document
approvals by the AM to substitutions or other
menu revisions,
(2) The AM shall assure that the services of
registered dietician are available for menu
review and certification. This dietician shall not
be employed by the commercial food vendor
which provides meals for the planning and
service area, if the provider subcontracts meal
preparation,
(2) The certified menus are subject to the audit
process and are to be retained for a minimum of
five years, according to state record retention
requirements, 15
(d) Nutrient analvsis. The provider shall obtain and
maintain documentation of nutrient analysis for each
meal per menu cycle. If the AM allows the use of
altemative protein sources, the procurement documents
must clearly state how frequently alternative protein may
be used on a monthly basis and to what degree,
14 The American Heart Association recommends that total fat content of each meal be no more than 10% saturated fat, 10%
unsaturated fat, and 10% polyunsaturated fat. The Registered Dietician responsible for menu planning and analysis may approve
exceptions in view of the overall nutritional analysis for meals planned for a given week,
15 The AAA may elect to maintain certified menus at that level for a lesser period of time, as long as the nutrition service
provider complies with record retention requirements,
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Georgia DHR Division of Aging Services .
~304 Nutrition Program Guidelines and Requirements
January 2002
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(e) Meal patterns. Providers shall plan menus using the
meal pattern(s) established by DAS.
Tab
Ie 304-1 Meal Pattern Requirements - Basic Meal Components
Food GroUD Amounts to Serve
Meats/Protein 3 ounces, edible portion, of cooked, lean meat,
poultrv, fish, eoos or meat alternate
Two servings, Y:z cup each, of vegetables
VeaetableslFruits and/or fruits
1 serving of enriched or whole grain bread or its
equivalent; whole grain products twice a week
Breads/Grains at a minimum
8 ounces of milk or its equivalent, low fat or
Milk/Milk Products skim preferred
1 teaspoon of buller or fortified margarine with
each meal (excluding oils/fats used in meal
Fats and Oils preparation)
Dessert Y:z cup of a nutritious dessert
Optional Beverages: Water. coffee, 8 ounces, minimum, according to seasonal
tea, decaffeinated beverages, fruit preferences,
iuices.
(1) Providers/vendors shall use standardized
recipes which yield all requirements of the meal
pattern.
(2) Food items chosen for each meal must vary
daily, and must vary within the category of food.
(f) Menu cycles, Providers shall develop twenty to twenty-
eight day menu cycles, which can be repeated
quarterly. Menus for therapeutic/modified meals may
prepared on a six-month cycle (three or four-month cycle
optional), in accordance with the Georgia Dietetic
Association Manual.
(g) Modified diets, Modified and/or therapeutic medical
diets may be provided and may deviate from the
standard menu pattern as required by the participant's
special needs and medical condition, providing
(1) The nutrition service provider obtains a
physician's prescription for each participant
needing a special meal and maintains
documentation of specific guidance on meal
modification, and
(2) Appropriate foods and staff with the skills
necessary to prepare modified/therapeutic
meals are available in the planning and
service area.
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(h) Menu monitorinq, Each nutrition service provider shall
retain on file each menu with meals as served, for
monitoring purposes. If providing services at multiple
sites, each site must have a copy of the menus with
meals as served.
~304.6 Administrative
Responsibilities of
Nutrition Service Providers
(a)
Compliance with the Older Americans Act. All
providers shall comply with all provisions for nutrition
services contained in the Older Americans Act, as
amended.16
(b) Nutrition outreach, Each provider of nutrition services
shall conduct outreach activities and document outreach
strategies and contacts,
(c) Compliance with other laws and requlations. Each
provider agency shall use procedures that comply with
all applicable state and local fire, health, sanitation, and
safety laws and regulations. All food preparation,
handling and serving activities shall comply with
applicable requirements as found at ~ 290-5-14 of the
Administrative Rules and Regulations of the
State of Georgia, 17
(d) Food production. Nutrition service providers shall
assure that food production is planned and managed
using standardized recipes adjusted to yield the desired
number of servings, and to provide for
consistency in quality and documented nutrient content
of food prepared.
(e) Food borne illness complaints. The provider shall
promptly initiate investigation by local health authorities
of complaints involving two or more persons with
symptoms of food borne illness within a similar time
frame after consuming food supplied through the
nutrition service program. Providers shall report such
complaints to the contracting Area Agency on Aging,
within two business days of the occurrence of and/or
receipt of a complaint regarding a food borne illness.
(f) Weather-related emerqencies, fires. and other
disasters.
(1) The provider agency shall make facilities,
equipment, and services available to
the fullest extent possible in emergencies and
disasters, according to the AM regional
emergency/disaster plan.
16 Pending final compilation of the 2000 reauthorization of and March 2001 amendments to the Act, the following references are
provided provisionally: Title Ill, Part A, Section 307(a)(8), (a)( 16); Part A, Section 311; Part A. Section 315; Part C,
Subpart 1, Section 331, Subpart 2, Sections 336 and 337; Subpart 3, Section 339,
17 Complete State Food Service Rules and Regulations may be found at
http://www.ph.dhr.state.ga.us/publications/foodservice/iii.shtml or may be obtained from county health departments,
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
January 2002
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(2) The provider agency shall develop and
implement written procedures to provide for the
availability of food to participants in anticipation
of and during emergencies and disasters,
including contingency planning for delivery
vehicle breakdowns, inclement weather
shortages in deliveries, food contamination,
spoilage, etc.
(g) Manaqement and oversiqht of the nutrition oroqram.
The service provider agency shall identify an individual
who is responsible for the overall management of
nutrition services and compliance with performance
requirements, standards and procedures. This person,
and any other employee(s) responsible for food service
management, shall complete appropriate coursework in
food protection, hazard avoidance and contamination
control procedures,18 and maintain any related
certification according to the certifying entity's schedule,
through continuing education or other professional
development.
(h) Staff orientation and traininq 19. The service provider
shall assure that orientation and ongoing training for
administrative and direct service staff and volunteers
shall be adequate to provide for safe, appropriate, and
efficient services to the elderly, and compliance with all
applicable requirements and procedures.
Providers shall document and maintain records of all
content and dates of orientation and training for
monitoring purposes.
(i) Health insoections. It is the responsibility of the
nutrition service provider to obtain required health
inspections and certificates from the appropriate local
health authorities, and post the annual certificates in
each site.
U) Recordkeeoinq and reoortinq. Nutrition service
providers shall comply with all record keeping and
reporting and retention requirements as prescribed by
the Division. Documentation requirements specific to
food service include, but are not limited to, maintenance
of:
(1) Daily records documenting persons who receive
meals, for both congregate and home delivered
meals program, if applicable;
(2) Meal counts or reports, including meals eligible
and ineligible for the Nutrition Service Incentive
Program (NSIP);
(3) Perpetual and physical inventory records for all
foods, if meals are prepared on site.
18 AAAs and providers are referred to the ServSafe @training program offered by the County Cooperative Exstention Service,
or to area technical schools and adult education programs for similar training courses in food safety and related topics.
19 See Appendix 304-8 for basic topics required for training. Providers may offer additional topics.
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Georgia DHR Division of Aging Services
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(4) Food cost records, if applicable.
(5) Documentation of daily temperature checks for
congregate meals and bi-weekly checks for
home delivered meals.
(6) Documentation of daily meal reports.
(7) Documentation of participant feedback, and the
method used to obtain feedback on a routine
basis and the feedback obtained.
(k) Contributions. Nutrition service providers shall comply
with the Older Americans Act, as reauthorized, related to
providing participants the opportunity to make voluntary
contributions in support of the program, in a manner
which protects their confidentiality.
(1) Providers shall assure that contributions shall
be used only to support or expand the nutrition
program, including:
(A) provision of additional outreach
activities:
(B) provision of additional nutrition
screening, education and counseling
services;
(C) purchase of transportation services that
will increase or enhance attendance at
nutrition sites; or
(D) expansion of meal services or
improvements in meal quality.
(2) The service provider may accept
Electronic Benefits Transfers(EBT) if available,
from eligible participants as a form of voluntary
contribution.
(3) Providers shall assure that no participant is
denied service due to an inability or
unwillingness to make a voluntary contribution
(4) Providers shall assure that solicitations of
voluntary contributions are non-coercive in
nature.
(I) Other oroqram income and fees.
(1) The provider agency shall recover, at a
minimum, the full meal cost as determined by
the uniform cost methodology for those
meals served to staff and guests under age 60.
The provider shall account for payment for
these meals on separate receipts from
contributions and handle funds in the
same manner as program income. The meal
cost for purposes of cost recovery from staff
'ol.':.')."
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirenu!iits
January 2002
Page 15 of 41
and guests under age 60 shall be posted in a
prominent location and updated on an annual
basis. For the purpose of determining the
amount to be recovered, the meal cost will be
calculated only for central kitchen or food
vendor costs. The total costs, including
overhead/operating costs shall be posted as
well.
(2) Providers shall not apply a cost share to meals
paid for with Older Americans Act funds. The
AAAs at the time of intake and screening, (or the
provider agency if applicable) shall inform each
applicant of the potential for the payment of part
or all of the cost of the meal as provided by DAS
policies for State Community Based Services
funds, and assess each applicant's potential fee
using DAS guide
(m) Nutrition Services Incentive Proqram (NSIP)
The cash allotment made available by the United States
Department of Agriculture (USDA) shall be used in
accordance with the Older Americans Act and United
States Department of Agriculture policy and procedures.
Meals provided through the NSIP must meet all
requirements of the former USDA cash reimbursement
program and must be served to eligible participants.
Meals eligible for NSIP funding are those which:
(1)
meet one-third of the Recommended Dietary
Allowances (RDA);20
(2)
are served to eligible individuals {see
9304.3(d)and 9304.4(d);}
(3)
are served by a nutrition service provider who is
under the jurisdiction, control, management and
audit authority of the State Unit on Aging, or the
Area Agency on Aging.
~304. 7 Area Agency on Aging
Responsibilities for the
Nutrition Services Program
(a) Policies and orocedures. The AAA shall develop and
implement any necessary additional policies and
procedures for the following:
(1 ) compliance with the Older Americans Act, as
reauthorized, with regard to the elderly nutrition
program.
20 Exception: Meals which are modified in nutrient content for medical reasons and which are prescribed by a
physician.
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~304 Nutrition Program Guidelines and Requirements
January 2002
Page 16 of 41
(2) program evaluation activities, including
conducting periodic evaluations of assessment,
reassessment and nutrition risk information for
congregate and home delivered meals
participants to assure that those persons in
greatest need are being served and desired
. outcomes are achieved;
(3) verification that all providers comply with the
Older Americans Act, as reauthorized,
concerning use of NSIP funding; that only
eligible meals are funded through NSIP;
and that cash will be used to purchase only
meals prepared from food grown or commodities
produced in the United States.
(4) the election to allow providers to provide meals
to volunteers, guests and staff.
(A)
Nutrition services staff guests and
volunteers age 60 and over are
considered to be eligible older persons
for purposes of receiving meals and
shall be given the same opportunity to
make voluntary contributions as any
other participant.
(B)
Staff, guests, and volunteers under age
60 (except for spouses of eligible
participants) may consume a meal only
when it will not deprive an eligible older
person of the opportunity to receive a
meal.
These individuals shall pay the full cost
of any meals received.
(b) Comoliance reauirements. AAAs are responsible for:
(1) assuring that all meals served meet
requirements as specified in 9304.5;
(2) establishing procedures for consistent AAA
management of waiting lists and
communications with nutrition providers
regarding referrals to and openings in the
program.
(3) assuring that service provider staff have made
appropriate arrangements for providing meals
in emergency situations or natural disasters,
with emphasis on plans for providing services
during periods of inclement weather, particularly
to people residing in geographically remote
areas.
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 17 of 41
(c) Staffinq for nutrition oroqram contract manaqement
duties. The AAA shall designate one or more staff to
manage the nutrition service contracts or obtain the
services of consultants to coordinate with staff for the
management of nutrition services contracts. The
minimum qualification for staff or consultants shall be:
(1) satisfactory completion of a DAS-approved
course in food safety, food proteGtion, or
equivalent (see note 17, page 12); and/or
(2) Licensure through the state of Georgia as a
registered dietician.
(d) Comoliance MonitorinQ.
(1) The AAA shall monitor each nutrition service
provider and in'dividual provider site at least
once annually within the first six months of the
contract year, placing additional emphasis on
monitoring more often those sites which
continue to demonstrate substantial non-
compliance for the previous year, or new
provider( s )/site( s).
(2) The AAA shall monitor each commercial food
vendor kitchen or commissary on-site at least
once annually. Follow-up during the contract
period shall be made as desired or indicated.
(e) Neqotiation of contracts.
(1) Using the uniform cost methodology and
principles of performance based contracting to
procure Congregate and Home Delivered Meals,
AAAs shall assure that potential subcontractors
establish a base meal cost. AAAs shall
base reimbursement rates on actual cash costs,
excluding estimates of volunteer time, and the
value of contributed goods and services. The
base meal cost shall be the basis for negotiation
between the AAA and any respondents to
requests for proposals.
(2) Costs of services other than the base
meal rate must be accounted for in other
service categories.
(3) The AAA has the authority to renegotiate
reimbursement rates during the contract period,
based on documentation from the provider
which identifies additional costs and the
rationale for including any additional costs as
necessary and reasonable to the provision of
meals.
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~304 Nutrition Program Guidelines. and Re.ql,llr~rn~~t$~:~\~:,.:.,;;<:~,1\'.;,<,:"; n_' .
January 2002
Page 18 of 41
(f) Proqram Planninq and Evaluation. The AAA shall use
NSI-D Checklist data at a minimum, and any other
relevant data, to identify and target nutrition services to
the at-risk population. On an annual basis, the AAA
shall analyze client and cost data, in addition to
compliance monitoring results to identify necessary
program improvements. The AAA shall involve the
provider(s) in the evaluation process and provide written
feedback regarding required corrective actions or
program improvement initiatives.
~304.8 Registered Dieticians
(a) The AAA is responsible for assuring compliance with the
Older Americans Act, as reauthorized, which provides
that the nutrition program be administered with the
advice of dieticians or individuals with comparable
expertise. The AAA may employ directly the dietician(s)
or contract for consultation services. Nutrition service
providers may also employ or contract for dietician
services in fulfillment of this requirement.
(b) Duties of the dietician include, but are not limited to,
(1) Menu olanninq - the development (or oversight
of the development of) regular four week cycle
menus ( four or six-month cycle for special diets)
which will change quarterly with consideration of
input from program participants and staff. The
dietician shall convene quarterly menu planning
meetings with senior center managers, and on-
site kitchen staff or commercial food vendor
staff.
The dietician shall assure that the menus
conform to the Division of Aging Services' meal
patterns and nutrient content.
(2) Develooment of standardized redoes and
nutritional analvsis - The dietician shall develop,
select, and/or approve standardized recipes as
needed/appropriate and provide/obtain full
nutritional analysis for all proposed menus.
(3) Traininq - The dietician shall provide quarterly
(or more frequently as needed) in-service
training to on-site kitchen staff and
senior center staff on such topics as food
sanitation and safety; portion control; quality
control; cost control; special nutritional needs of
the elderly; planning low-cost nutritious meals
for one or two people and other nutrition and
health related topics.
(4) Nutrition Education - The dietician shall develop
and/or disseminate approved nutrition education
materials to food service personnel (for use with
kitchen staff) and to senior center managers (for
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Georgia DHR Division of Aging Services. . >,.'....
~304 Nutrition Program Guidelines and Requitemerits
January 2002
Page 19 of 41
use with congregate and home delivered meals
program participants).
(5) Technical Assistance - The Dietician shall
provide technical assistance in the areas of
food service management and nutrition
program management to Area Agency staff,
nutrition project personnel and food service
personnel.
(6) Nutrition Screeninq and Intervention - The
dietician shall assist the Area Agency staff and
nutrition service providers in the implementation
of the Nutrition Screening Initiative in the
pi
anning and service area, including assisting
with developing protocols and mechanisms to
provide access to Levell Screening (or higher)
or referrals to appropriate health care providers
for individuals identified as being at high n
nutritional risk.
(7) Nutrition Counselinq - The dietician shall
provide, oversee and/or develop resources for
the provision of individualized nutrition
counseling for persons identified as being at
high nutrition risk, including developing protocols
for targeting client groups and priorities for using
available resources. The counseling shall
include referral to other needed services and
assistance and follow-up. The dietician shall
coordinate service referrals with case managers,
if present.
(8) Proqram Monitorinq. Planninq and Evaluation -
!he dietician shall oversee or assist with program
monitoring and evaluation; the analysis of
programmatic data; oversee or assist in the
development of bid specifications; and oversee
or assist in developing the Area Plan with regard
to meal service and nutrition program initiatives.
~304.9 Transfers of Program
Funding
AAAs may transfer up to 40% of the funding between the
congregate and home delivered meals program, and an
additional 30% between the nutrition services program and
supportive services, with approval from the Division, to assure
that the Division does not exceed the transfer percentages in the
aggregate. AAAs shall provide in the Area Plan/Update a
description of the amounts to be transferred, the purpose, the
need, and the impact on the provision of services from which
funding will be transferred. AAAs may request waivers to
transfer a larger percentage, with justification, and DAS may
approve excess transfers, conditional on not exceeding the
maximum percentage statewide.
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Georgia DHR Division of Aging Services .
~304 Nutrition Program Guidelines and Requirement~ .:,
January 2002
Page 20 of 41
~304.10 Provider Quality Assurance
and Program Evaluation (a)
AAAs shall assure that each nutrition program provider
organization develops and implements an annual plan to
evaluate and improve the effectiveness of program
operations and services to ensure continuous
improvement in service delivery
(b) The evaluation process shall include:
(1) a review of the existing program.
(2) satisfaction survey results from consumers,
staff, and program volunteers.
(3) program modifications made that responded to
changing needs or interests of consumers, staff
or volunteers.
(4) proposed program and administrative
improvements.
. (c)
Each provider with an individual contract shall prepare
and submit to the AAA annually a written report which
summarizes the evaluation findings, improvement goals,
and implementation plan for each site. The provider
shall submit the report no later than the end of the first
quarter of the new fiscal year (September 30.)
revised 8/2002
(d) Providers which also operate senior centers shall
incorporate the evaluation of the nutrition program into
the annual senior center program evaluation.
~304.11 Fiscal Management
Contractors providing nutrition services shall practice sound and
effective fiscal planning and management, financial and
administrative record keeping and reporting. Contractors will use
the Division's Uniform Cost Methodology on an annual basis to
analyze, evaluate and manage the costs of the program.
~304.12 Laws and Codes
Each nutrition service program site shall be operated in
compliance with all federal ,state, and local laws and codes that
govem facility operations, specifically related to fire safety;
sanitation; insurance coverage; and wage and hour
requirements.
Effective Date: Upon issuance.
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~304 Nutrition Program Guidelines anCt Requirements
January 2002
Page 21 of 41
Appendix 304-A
Making a Sanitizing Solution
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 22 of 41
SANITATION OF FOOD PREPARATION WORK AREAS AND EQUIPMENT
A number of factors influence the effectiveness of any chemical sanitizer. They are:
Contact
In order to lower the number of microorganisms to an acceptable level, the sanitizing solution
must make contact with the surface or the utensil for the amount of time required by the state or
local regulatory authority.
Selectivity
All sanitizers may not reduce the number of certain microoganisms to an acceptable level.
Concentration
The concentration of the sanitizing solution is a critical factor. In the case of chlorine bleach, the
1997 FDA Model Food Code recommends a concentration of 25-100 ppm (parts per million)
depending on the job to be done, the temperature of the water and the pH of the solution.
Concentrations higher than necessary can create a safety hazard, cause taste and odor
problems, corrode metals and other materials and leave residues. The effectiveness of a chlorine
bleach sanitizing solution diminishes with use. Therefore it is necessary to test the sanitizing
solution using test strips. These are readily available from foodservice supply houses.
Temperature
Chlorine sanitizing solutions should be at a minimum temperature of 750F. They are less effective
at lower temperatures. At temperatures higher than 1200F chlorine may evaporate from the
solution and corrode certain metals. In general all sanitizers work best at temperatures between
750 and 1200F.
To Sanitize Work surfaces
· After each use, especially after working with raw meat, fish or poultry, thoroughly wash
with hot water and soap/detergent and rinse with warm water.
· Use a sanitizing solution of 1 teaspoon of liquid chlorine bleach to one gallon of warm
water (at least 750F) (200 ppm solution) with clean wiping cloth. (Note: solution should be
changed often). Wiping cloths should be kept in the sanitizing solution. (Also, see note
below)
. Air dry.
To Sanitize Dishes, Glassware, Utensils, Pots and Pans
· Wash thoroughly in warm water and soap/detergent.
. Rinse thoroughly in warm water.
· Soap/detergent residue and organic matter (food/soil) even in small amounts reduces the
effectiveness of the sanitizing solution.
· Immerse in a solution of one teaspoon of liquid chlorine bleach to one gallon of water for
at least one minute (60 seconds).
. Air dry.
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 23 of 41
To Sanitize Dishtowels, Dishcloths and Wiping Towels
In the sink
· Fill sink with warm water and appropriate amount of laundry detergent.
· Add one teaspoon of liquid chlorine bleach for each gallon of water.
. Swish around.
. Rinse in warm water
. Air dry.
/n the washing machine
· Wash in washing machine with laundry detergent/soap and one cup of
liquid chlorine bleach.
· Always thoroughly mix with water as directed before using.
· Do not allow undiluted liquid chlorine bleach to come in contact with any fabric (If it does,
rinse out immediately with clear, cold water)
· Do not use on steel, aluminum, silver or chipped enamel.
In addition to cleaning and sanitizing work surfaces, equipment and utensils, also note the areas of the
facility that may have been overlooked for cleaning, e.g., walls, ceiling, light fixtures, floors, floor drains
and shelves.
Note: Solution proportions are based on the concentration of chlorine in bleach-
· 2%: Use 2 teaspoons of bleach to I quart of water or
Use 2 tablespoons of bleach to I gallon of water
.
4%
Use I teaspoon of bleach to I quart of water, or
Use I tablespoon of bleach to I gallon of water
.
6%
Use 1/2 teaspoon ofbteach to I quart of water, or
Use 2 teaspoons of bleach to I gallon of water
Sources: The University of Georgia Cooperative Extension Service, University of Rhode Island Cooperative
Extension Service and FoodServiceSearch.Com, hlto://www.foodservicesearch.com/food safety
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January 2002
Page 24 of 41
Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
Appendix 304-B
Basic Training Topics for Nutrition Program Staff
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~304 Nutrition Program Guidelines and Requirements
January 2002
Page 25 of 41
Training Topics
The following topics at a minimum are to be covered in initial training and orientation for all program staff
and volunteers involved in the serving of meals, prior to their assuming their job responsibilities:
. Agency orientation
. Food safety and sanitation
. DAS meal temperature standards
. Policies on voluntary contributions and fees for service
. Portion control
. Emergency management procedures
. Handling client emergencies (health/medical)
. Policies on client confidentiality
. Policies on non-discrimination and Americans with Disabilities Act requirements
. Meal packaging ( for home delivered meals only)
Additional training content to be covered during the first quarter of employment includes, but is not limited
to:
. Basic nutrition for older adults
. Food service management (for congregate meals staff )
. Training participants on food safety, good nutrition and health conditions
. Coordination with the Area Agency on Information, Referral and Assistance services
. Reporting and record maintenance
. Food service evaluation and procedures for communicating with food vendors
. Participant Assessment (if applicable)
. Coordination with AAA on waiting list administration
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~304 Nutrition Program Guidelines and Requirements
January 2002
Page 26 of 41
Appendix 304-C
Sources of Meal Pattern Foods
and
Portion Control Guides
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 27 of 41
Meats and Meat Alternates
As a group, meat and meat alternates provide protein, iron, B vitamins (thiamine, riboflavin, and
niacin) among other nutrients.
For each meal, a 3-ounce edible portion of lean meat, poultry, fish, eggs, or meat alternate (dried
beans, peas or other legumes; nuts and nut butters; or cheese) must be served.
Nuts and seeds may be used to meet no more than one-half of the meaUmeat alternate
requirement, and must be appropriately combined with other meats/meat alternates to fulfill the
requirement.
~
Cooked dried beans, peas or legumes intended as the meat alternative for any meal may
not also count toward the fruiUvegetable requirement for the same meal.
~
Meats or alternate foods may be served alone or combined with other foods in
casseroles, loaves, patties, soups, salads and sandwiches.
~
Cured meat products, such as ham, sausages, luncheon meats, and hot dogs are very
high in sodium and the use of these type products must be limited to no more than three
or four times during the menu cycle. Bacon is not considered a meat alternate, since it
provides primarily fat and sodium, and few other nutrients.
~
Vegetable protein products or textured vegetable protein (VPP or TVP) are low cost
alternatives and are effective in increasing the fluid intake of program participants. The
recommended ratio of protein product to meat is 20 : 80.
Portion Control Guide - Meats and Meat Alternates
Food Item
Required Portion Size = 3 ounces = 1 M/MA
Cottage Cheese
2 ounces by weight = y.. cup = 1 M/MA
6 ounces by weight = % cup
Chicken
1 drumstick and 1 thigh or Y, breast to equal 3 ounces
Chili, soups
Must serve at least 1 Y, cups containing 3 ounces of meat or meat
alternate to provide one meal's protein requirement
Dried beans and peas, cooked
1 Y, cups
Eggs
One egg = 1 ounce
3 eggs
Lasagna, Macaroni and Cheese, Beef or
other Meat Stew, Meat Casseroles
1 Y, cups
Meat Loaf 1 slice 2"x4"x2" = 4 ounces
4 ounces (yield from a 20"x12"x2" pan = 33 servings)
Pizza
3y.." x 7" = 3 ounces M/MA
10 servings per 18"x26" pan
5+ servings from 12"x20" pan
Roast Meats
Sandwiches
Sliced meats/cheese
Salad type fillings
3 ounces
3 ounces
3 ounces = % cup filling
Spaghetti sauces with ground beef
1 cup
Tofu
4 ounces
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 28 of 41
Meat/Meat Alternates, continued
Prepared Fish Products
Fish Product Serving or Portion Size
Fish sticks, Frozen Fried Breaded Six 1 ounce sticks = 3 ounces cooked fish
60 per cent fish
Fish sticks, Frozen Raw Breaded Six 1 ounce sticks = 3 ounces cooked fish
72 per cent fish
Fish portions, Frozen. Fried Battered
There is no standard portion for this product. 9 ounce portion = 3 ounces cooked fish
Specify 45 per cent fish and require a
certificate of inspection from the processor
Fish portions, Frozen, Fried. Breaded 6 ounce portion = 3 ounces cooked fish
Fish portions Frozen, Raw Breaded 6 ounce portion = 3 ounces cooked fish
75 per cent fish
Fish portions Frozen, Unbreaded 4 ounce portion = 3 ounces cooked fish
Additional Information on Specific Products
Canned Soups
Most canned soups do not contain enough meat to make a substantial contribution to the meat
requirement.
For example: Bean soup or Pea Soup
A 1 cup serving of soup contains ~ cup beans or peas. This is equivalent to 1 ounce of M/MA. It
would take 3 cups to provide the required 3 ounces of M/MA.
An 8 ounce serving (1 cup) would provide 1 cup M/MA. The remaining 2 ounces required for a
meal could be provided in a sandwich or other entree item.
Hot Dogs/Frankfurters
Red meat (beef, pork, etc.) and poultry (turkey, chicken) hotdogs that do not contain meat by-
products, cereals, binders, or extenders:
1 ounce of product provides 1 ounce of cooked lean meat
Look for products labeled "All Meat," "All Beef," "All Pork." etc.
If a single hotdog equals 2 ounces, it will take one and a half hot dogs to equal a 3-ounce portion
Hotdogs containing meat by products, cereals, binders, or extenders are not acceptable on an
ounce-for-ounce basis. Product labeling will indicate the presence of any such ingredients.
If using hotdogs containing extenders or binders, only the cooked or lean meat portion of the
product can be used toward the M/MA requirement. Obtain product information from the manufacturer if
necessary.
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 29 of 41
Luncheon Meat
Luncheon meat is a smoked, cooked sausage. Those that do not contain meat by-products,
cereals, binders or extenders are exchangeable on an ounce-per-ounce basis (1 ounce of product
provides 1 ounce of cooked lean meat.)
Look for products labeled "All Meat."
Read the label to determine portion size; often servings are less than 3 ounces
The contribution of lunch meats that do contain meat by-products, cereals, binders, or extenders
cannot always be determined on the basis of the label information. Unless you can get a signed written
statement from the manufacturer certifying the amount of cooked, lean meat in the finished product, it is
wiser not to use the products at all.
Note: Federal law requires that binders, extenders, etc. be listed on product labels in
descending order of the percentage of content (from highest to lowest.)
Cheese Foods and Cheese Spreads
Cheese foods and spreads such as Velveeta™ and Cheese Whiz™ may be served as meat
alternates, but twice as much is required because these products contain less protein and more moisture
than natural and processed cheeses.
A 2 ounce serving of cheese food or spread is equivalent to only 1 ounce of M/MA. Six ounces of
cheese food/spread is required to equal a 3 ounce portion.
Note: All of these food products contain significant amounts of sodium and fat and their use should be
limited.
Georgia DHR Division of Aging Services .
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 30 of 41
Fruits and Vegetables
Fruits and vegetables are the primary sources of vitamins A, C and folacin in the diet.
They also are good sources of such minerals as iron, zinc, magnesium, and are good sources of fiber. They
are low in fat and should be included in the diet as often as possible. The nutrition program should encourage
participants to "Take Five a Day," meaning to eat five servings in total of fruits and vegetables daily. Individually,
three to five servings of vegetable and two to four servings of fruit are recommended according to the Food Guide
Pyramid. Meals served through the nutrition program should be planned to help people to the greatest extent possible
achieve that goal. To meet program requirements, each meal served must contain two or more different vegetables
and/or fruits. Plan to serve foods rich in Vitamin A at least three times per week, and foods rich in Vitamin C daily.
Fruits and vegetables may be served cooked, or raw, if properly washed, and may be served alone or in
combinations. A serving is Yo cup or a single piece. If serving raw vegetables as a relish tray, each serving must be
at least Y. cup, and additional food items must be provided to fulfill the entire 1 cup requirement.
One-fourth cup, drained weight, minimum of fruits or vegetables must be provided per serving in any soup,
stew, casserole, gelatin or other combination dish, if it is identified as a "FruiWegetable" serving. The total meal
must provide 1 cup in total of fruiUvegetables from at least two sources.
When juices are served they must be 100 percent fruit or vegetable juice. Fruit drinks, nectars, or cocktails
containing less than 50 percent juice may not count toward this requirement.
Juices may be served daily. However, due to a generally low fiber content, they may not be considered a
part of the fruiUvegetable requirement more than once a week.
When purchasing frozen and canned fruits, choose those without added sugar or syrup, preferably canned
in fruit juice or water.
Macaroni, rice, noodles, and spaghetti are not vegetables and do not contribute toward the vegetable
component. (See bread/grain requirement.)
Salad bars may be provided as one of the two servings of fruits and/or vegetables for any meal. Foods rich
in Vitamins A and C must be offered in salad bars, when offered.
Pasta and Macaroni salads rarely contain sufficient vegetables to meet the requirement of a Yo cup serving.
When serving these salads, include sufficient fruits and/or vegetables in the meal to provide a total of 1 cup. The
macaroni may be considered the bread for the meal if Yo cup of the salad is served. (The total salad serving would be
larger than Yo cup.)
Main dish salads, such as Chef of Taco salad, can meet the full requirement providing that it provides a 3-
ounce portion of meaUmeat alternate, and at least one cup of vegetables, with more than two types of vegetable
included. For example, a salad composed only of Iceberg lettuce would not meet program standards, but one
containing cabbage, romaine, spinach and Iceberg, plus other vegetables (tomato, green pepper, onion, cucumber,
etc.), as well as the meaUmeat alternative would.
Fruits and Veaetables Portion - Total 1 CUD minimum from two or more items
Canned or frozen fruits or vegetables % cup = #16 scoop
% cup = #8 scoop
Fresh fru it % cup = 1 medium piece
Juice, full strength % cup (4 ounces) served in a 5 or 6 ounce cup
Soups - canned, vegetable types 1 cup reconstituted or ready-to-serve = % cup serving of vegetable
pea soup 1 cup = Y:z cup vegetable
Tomato, Sauce % cup = % cup vegetable
Paste 2 Tablespoons = % cup vegetable
Puree 4 Tablespoons = % cup vegetable
Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
Fruits and Vegetables, continued
January 2002
Page 31 of 41
Sources of Vitamin A: A Y2 cup serving of the following will provide:
500+ microarams > 1 /~ RDA
Carrots
Chard, Swiss (cooked)
Collards (cooked)
Pumpkin
Spinach (cooked)
Squashes, Winter varieties
Sweet potato
Mixed vegetables
RDA for Vitamin A-
Women - 800 micrograms
Men - 1,000 micrograms
200 -500 mlcroarams = 1/'J. RDA
Mango
Cantaloupe
Papaya (half)
Beet Greens
Bok Choy (cooked)
Kale
Mustard Greens
Parsley
Peas and Carrots
Peppers, Sweet, red
Spinach (fresh)
Turnip Greens
100 - 200 microarams < 1/3 RDA
Apricots. dried, canned
Cranberries
Nectarines
Peaches
Persimmons
Asparagus
Broccoli
Bok Choy (fresh)
. Chard, Swiss (fresh)
Mustard Greens (fresh)
Tomatoes
Vegetable Juice Cocktail
50 ma. +
Sources of Vitamin C: A Y2 cup serving of the following foods will provide e/3 RDA = 20 miligrams)
15 - 30 ma
Broccoli
Brussels Sprouts
Chili Peppers, red and green
Grapefruit
Guava
Oranges, orange juice
Papayas
Parsley
Kiwi fruit
RDA for Vitamin C-
60 mglday for men and women
30 - 50 ma.
Cauliflower
Collards
Cranberries
Grapefruit juice
Kale
Mangoes
Mustard Greens
Raspberries
Strawberries
Asparagus
Cabbage
Cantaloupe
Honeydew melon
Mandarin Orange
Okra
Pineapple juice
Potatoes
Tangerines. juice
Rutabagas
Sauerkraut
Spinach
Sweet Potatoes
Tangelos
Tomatoes, juice. paste, puree
Turnip roots and greens
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 32 of 41
Breads, Cereals, Rice and Pasta Group
Whole Grain/Enriched Bread Requirement
Enriched or whole grain bread and cereals are sources of B vitamins, minerals (especially iron), protein and calories.
Whole grain products supply additional vitamins and minerals, as well as dietary fiber and a variety of tastes and
textures.
Breads or alternates must be whole grain or enriched or made from whole grain or enriched meals and/or flours, as
the primary ingredient(s) by weight, as specified by labeling or recipe.
The bread or bread alternate must serve the customary function of bread in a meal. This means that for lunch the
bread/product must be served as an accompaniment to, or a recognizable part of the main dish, not merely as an
ingredient.
One serving of whole grains or enriched bread or an alternate is required. One serving is one slice of bread, or one
biscuit, muffin, roll, or square of cornbread.
· Bread alternatives include enriched or whole grain cereals such as spaghetti, macaroni, dumplings,
pancakes and waffles. Rice, crackers and tortillas also are included.
· Breads containing fruits and vegetables, such as banana and pumpkin, are considered desserts
due to their calorie and nutrient composition.
· To provide additional variety, certain vegetables and fruits high in complex carbohydrates may
occasionally be served as bread alternates. A four-ounce serving of the following may be used: white potatoes,
sweet potatoes, yams, plantains, corn, pumpkin, squash, dried beans, peas or lentils (4 ounces = Y:. to Yo cup.) When
used as the bread alternates, these foods may not be considered as part of the fruit and vegetable requirement.
· When serving breakfast meals, include muffins made from low fat recipes, bagels or English
muffins instead of sweet rolls, coffee cakes or doughnuts (which are higher in fat and calories,) whenever possible.
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Georgia DHR Division of Aging Services . . .
~304 Nutrition Program Guidelines arid Requirements
Include:
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January 2002
Page 33 of 41
Bread and Bread Products
Whole grain or enriched breads
Whole grain or enriched cereals
Chow Mein Noodles
Com tortillas and corn products made with whole grain or enriched corn meal
Egg roll or Won Ton wrappers
Graham crackers
Grains, such as bulgur, oats, wheat, farina, corn meal, millet, rice, etc.
Grits - enriched corn grits or hominy grits
Macaroni and macaroni products - enriched lasagna, elbow macaroni, and spaghetti
Noodles and noodle products (enriched)
Popovers
Pretzels - soft only
Rice cakes
Stuffings/dressings (made with enriched breads)
Taco shells
The following may be used on an limited basis due to fat content:
· Coffee cakes
· Doughnuts
· Granola cereal
· Pie crust for main dishes
· Puff pastry for main dishes
· Sweet rolls and buns
The following may not be used to meet the bread requirement
.
Commercial bread stuffing made from unenriched bread products
Cakes
Chips (taco, potato, corn, etc.)
Unenriched corn meal or grits
Cupcakes
Gingerbread
Ice Cream cones
Dessert pie crusts
Popcorn
Tapioca
Wheat germ (may be used in bread products)
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 34 of 41
Bread Equivalents
Item Serving Size ADDroximate Weiaht per Unit
Grams Ounces
Bagel 1 bagel 57 2.0
Bread Stick 4 sticks 20 0.7
Buns, all tVDes 1 bun 28 1.0
Chow Mein Noodles '12 cup 22 0.8
Cornbread (2-inch square) 1 square 38 1.3
Enalish Muffin 1 muffin 57 2.0
Graham Cracker
(2 '12" square) 3 crackers 21 0.7
Muffin, low fat 1 muffin 38 1.3
Pancakes 1 pancake 50 1.8
Pizza Crust 1 slice crust 30 1.1
PODover 1 popover 50 1.8
Pretzel,soft 2 pretzels 32 1.2
Rye wafers (whole grain) 4 wafers 25 0.9
Roll, dinner 1 roll 30 1.1
Saltine crackers 8 crackers 20 0.8
Stuffing/dressing 1/3 cup 46 1.6
Taco shells 2 shells 30 0.8
Tortillas 16-inch diameter) 1 tortilla 30 1.1
Waffles 1 waffle 30 1.1
Cooked portions of cereal products such as pasta (Macaroni, noodles, spaghetti), rice, bulgur, or other
cereal grains may count toward meeting the bread requirement as follows:
Bulgur.. ........................... .............. ..... ...... ........ .... .... .................................. .... ...... .... '12 cup
Fortified Dry Cereal.................... ....... .... ............... .......... ...... ..... ....... ........... ............. % cup
Cream of Wheat.............. ... ...... ...... ...... .... ... ...... ...... ......... ...................... ............ ...... '12 cup
Pasta products....... ........... .......... ...... ........... ...... ..................... ......... ............ ....... ...... '12 cup
Rice. .................................... .......... ...... ...... .... ..... .......... ................ ...... .... .... ............... '12 cup
Rolled Oats.......................... ...... ........ ........ ....... ............ ....... ........... ....... ...... ........... ... '12 cup
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Georgia DHR Division of Aging Services .
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 35 of 41
Milk and Dairy Products
Milk or Equivalent Products
Milk products are good sources of calcium, protein, and riboflavin. Fortified products also provide vitamins A and D.
Eight ounces of fortified milk (preferably low fat or skim), buttermilk, or a calcium equivalent must be served daily.
The use of skim or low fat milk and milk products is encouraged to help reduce the total fat in the meal.
In August 1997, the RDA for calcium for Adults was increased from
800 mg. to 1200 mg, a 33% increase.
For individuals who do not tolerate milk products well, dietary modifications may include:
· Products such as canned sardines and salmon, including the bones; dark green leafy vegetables;
cooked dried peans and beans.
.
Yogurt. Many people who are lactose intolerant can eat yogurt (especially with live cultures).
Custards, puddings, and ice milk also may be used to meet some of the calcium requirements. Because of the large
portions which would be required, however, these foods should be considered as a supplement, rather than
replacement for other dairy products. This recommendation is made to keep fat, sugar and total calories within the
U.S. Dietary Guidelines.
One 8 ounce serving of low fat milk will provide approximate 300 mg. of calcium. This amount must be supplied
through other foods if milk is not consumed.
Lactose-reduced milk is a fluid milk product modified by the addition of lactose enzymes. The lactose (milk sugar) in
this milk has been broken down into simple sugars. People who have difficulty digesting or cannot digest the lactose
in milk may benefit from a lactose-reduced or lactose free lowfat milk product.
Milk and Milk Alternatives
8 ounces flavored or unflavored:
Whole milk
Low fat milk (1%, 2%)
Skim milk (non-fat)
Buttermilk
.
Hot Chocolate or Cocoa made with non-fat milk
Lactose-reduced or lactose-free milk
Yogurt
Other portion sizes required to meet calcium needs:
Cheeses:
.
Ricotta, part skim - Yo cup
Cottage, 1 % fat - 1 1f4 cup
Cheddar, Monterey, Provolone, Swiss, Colby, Mozzarella, American - 1 Y2 ounces.
Tofu, preserved in calcium sulfate -- Y2 cup
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'Note: use of "hard" cheeses should be limited due to the higher fat content.
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 36 of 41
Rich Sources of Calcium
200 - 300+ Mg Per Serving
Mg Calcium Calories Mg Calcium Calories
Dairy Products MeaUMeat Alternatives
Buttermilk, 1 cup 285 99 Seafood
Milk, Skim, 1 cup 302 86 Mackeral, canned Jack, 3 oz 202 131
Milk, 1%, 1 cup 300 102 Salmon, canned w/bones, 3 oz.
Milk, 2%m I cup 297 121 Chum 212 120
Milk, whole, 1 cup 291 150 Sockeye 203 130
Milk, chocolate 2%, 1 cup 284 179 Sardines, canned, drained/bones
Milk, nonfat dry, 1/3 cup 280 81 Atlantic, 3 oz. 351 192
Buttermilk, dry, y.. cup 355 118 Pacific, 3.5 oz. 351 176
Milk, canned:
skim, evaporated, Y:. cup 369 100 FrultsNegetables
whole, evaporated, Y:. cup 329 170 Collard Greens, raw,
3.5oz 203 40
Cheeses
Cheddar, 1 oz. 204 114 Desserts
Monterey, 1 oz. 212 106 Custard pie, 6 oz. slice 297 305
Provolone, 1 oz. 214 100 Ice cream, soft serve, I c. 236 377
Ricotta, part skim, Y:. cup 337 170 Ice Milk, soft serve, I cup 274 223
Swiss, 1 oz. 272 107 Pumpkin pie, 7 oz. slice 212 367
Tofu, firm, Y:. cup 258 183 Yogurt. frozen, 1 cup 240 220
Yogurt, plain 10wfat, 1 cup 452 127
Yogurt, vanilla lowfat, I cup 389 193
Yogurt, fruit, lowfat, 1 cup 231 231
100 - 200 Mg Per Serving
Mg Calcium Calories Mg Calcium Calories
Dairy Products MeaUMeat Alternates
Cheeses Beans, Baked, Homemade, lcup 155 382
American , 1 oz. 174 106 Bean, canned, plainlvegetarian, 1 c. 126 235
Blue, 1 oz. 150 100 Beans, w/ pork, sweet sauce, 1 cup 155 282
Colby, 1 oz. 194 112 Beans w/ pork, tomato sauce, 1 cup 141 247
Cottage, 1 %, Yo c. 138 164 Beans. Navy, (dry) cooked, 1 cup 128 259
Mozzarella, part skim
1 cup 183 80 Beans, refried, canned, 1 cup 118 270
Yogurt cheese, y.. c. 179 56 Beans, White (dried) cooked, 1 cup 131 253
Beans, Soy (dried) cooked, 1 cup 175 298
Breads, Grains, Cereals Seafood
English muffin, sourdough Clams, canned, Y:. cup 118 74
2 oz. 112 129 Salmon, canned w/ bones. 3 oz. (Pink) 182 130
Oatmeal, instant, fortified,
plain, 0/. cup 163 104
FrultsNegetables Desserts
Collard Greens, cooked Fudgesicle, one 129 91
Y:. cup 152 29 Ice Cream, regular vanilla, 1 cup 176 269
Kale, 3 Y:. oz. raw 179 38 Ice Milk, Hard, vanilla,l cup 176 184
Kale, cooked, 0/. cup 134 28 Puddings,
Rhubarb, frozen Chocolate, (instant or cooked) Y:. cup 138 152
cooked, 1 cup 174 139 Coconut (instant) Y:. cup 148 184
Swiss chard, cooked Lemon (instant) Y:. cup 147 178
Leaves, stems, 1 c. 106 26 Rice (mix) Y:. cup 133 155
Leaves only, 1 c. 128 32 Tapioca (mix) Y:. cup 131 145
Tumips, greens Vanilla, Y:. cup 130 148
cooked, 2/3 cup 184 20
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
50 - 100 Ma Per Servin a
Rich Sources of Calcium, continued
January 2002
Page 37 of 41
Mg Calcium Calories
Cheeses
Cottage, creamed, Y:. cup 63 225
Cottage, 2%, Y:. cup 77 205
Parmesan, 1 Tbsp. 70 22
Breads, Grains, Cereals
Combread, 2 inch square 94 200
FrultsNegetables
Beans, wax, Y:. cup 50
Broccoli, Yo cup 66
Romaine lettuce, 3 Y:. oz. 66
Okra, frozen, cut, Y:. cup 72
Rhubarb, cooked, 3 Y:. oz. 86
Spinach, raw, 3 Y:. oz. 93
Spinach, cooked, Y:. cup 83
Sweet potatoes, canned, solid or vacuum packed
Mashed, 1 cup 64
Pieces, 1 cup 50
22
25
18
26
15
26
21
Mg Calcium
Meat/Meat Alternates
Almonds. Y. cup (36 g.) 83
Beans, kidney,
(dried) cooked. 1 c. 50
Beans, kidney
canned, 1 c. 69
Beans, Garbanzo,
canned, cooked, 1c. 80
Brazil nuts, Y. cup 65
Filberts, Y. cup 71
Seafood
Clams, breaded, fried
30z (10 clams) 59
Clams, steamed
3 oz. (20 clams) 83
Halibut, baked, 3 oz. 51
Oysters, breaded/fried,
3 oz. (6 oysters) 54
Desserts
Pudding pops, various flavors 76
Pudding pops, chocolate/fudge 67
Calories
210
225
208
269
230
213
190
133
119
173
94
99
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
Appendix 304-0
Evaluation of Home Delivered Meals Participants
for Chilled, Frozen, and/or Shelf Stable Meals
January 2002
Page 38 of 41
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements,
January 2002
Page 39 of 41
Use of Alternative Meal Types
When considering providing alternate meal types to homebound individual, as either a routine method of
meeting part of their nutritional needs or in planning for continuity of services in emergencies, Area
Agencies and/or provider staff are responsible for assessing the appropriateness of alternate meal types
for each person who will need them. These types include frozen meals, chilled meals, or shelf stable
meals.
Such meal types may not be appropriate if:
. the client's home lacks proper appliances for food storage and preparation, and adequate
space for proper storage of multiple meals, if a supply for an extended period of time is
planned, or
. the client has physical or cognitive impairments which limit his/hert ability to prepare or
safely reheat the meals, and/or eat without assistance.
The Determination of Need-Revised (DON-R) screening at the time of intake provides information about
the person's functional abilities, specifically in the area of eating and food preparation. It also provides
indicators of possible cognitive impairment which may affect the person's functional capacity. The ability
to eat is an Activity of Daily Living (ADL) which often is more affected by physical impairment than
cognitive impairment. Meal preparation is an Instrumental ACtivity of Daily Living, which represents a
more complex series of tasks. Persons with dementia may be unable to prepare meals, but able to eat
with minimal assistance or cueing.
The assessor will use this information, as well as additional information on the physical conditions of the
home, to determine the appropriateness of the alternate meal type. The assessor will make a home visit
to visually inspect the cooking facilities and availability and condition of equipment and utensils.
The assessor will document the evaluation findings in the client's file, using the following form, or
otherwise capturing the required data. Staff responsible for periodic client reassessment will re-verify and
document the client's status and continuing appropriateness for alternate meals, if such meals are part of
the ongoing care plan.
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Georgia DHR Division of Aging Services
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 40 of 41
Client/Home Evaluation for Alternate Meal Types
Client Name:
Evaluation Date:
Address:
Agency Name:
Evaluation Completed By
Title
DON-R Scores and Comments:
Eatina:
Is the client able to feed himself/herself? Assess the client's ability to feed him/herself using routine or adapted
table utensils and without frequent spills. Address the client's ability to chew, swallow, cut food into manageable size
pieces, and to chew and swallow hot and cold foods/beverages.
Score 0-
The client can eat, with or without an assistive device.
1 -- The client can eat, with or without an assistive device, but requires some verbal or
physical assistance in some or all components of the activity.
2 - The client cannot eat, even with an assistive device, and/or requires a great deal of
verbal and/or physical assistance.
3 - The client cannot eat unassisted.
A vailabilitv of assistance with eatina. If the client scores at least (1) in impairment level, determine whether
someone is available to assist and/or motivate the client in eating.
Need for assistance with eatina
Score 0 --
The client's need for assistance is met to the extent that there is no risk to health or
safety if current level of assistance is maintained or no other assistance is added.
1-- The client's need for assistance is met most of the time, or there is minimal risk to the
client's health or safety is additional assistance is not acquired
2-- The client's need for assistance is not met most of the time; or there is moderate risk to
the client's health/safety if additional assistance is not acquired;
3- The client's need for assistance is seldom or never met; or there is severe risk to the
health and safety of the client.
Who, if anyone, is available to provide assistance?
Preparina Meals
Is the client able to prepare hot and or cold meals. includina re-heatina frozen or chilled meals? Assess the ability to
open containers, to use kitchen appliances, and to clean up after the meal, including washing, drying and storing any
utensils used in preparing or eating the meal.
Score 0 -
The client can prepare the meal type, with or without an assistive device.
1 -- The client can prepare the meal type, with or without an assistive device, but requires
some verbal or physical assistance in some or all components of the activity.
2 -- The client cannot prepare the proposed meal type, even with an assistive device, and/or
requires a great deal of verbal or physical assistance.
3 -- The client cannot prepare the proposed meal type without assistance.
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Georgia DHR Division of Aging Services . .
~304 Nutrition Program Guidelines and Requirements
January 2002
Page 41 of 41
Need for assistance with meal preparation
If the client scores at least (1) in this area, evaluate the appropriateness of the meal type being proposed.
Score 0 -
The client's need for assistance is met to the extent that there is no risk to health or
safety if current level of assistance is maintained or no other assistance is added.
1-- The client's need for assistance is met most of the time, or there is minimal risk to the
client's health or safety is additional assistance is not acquired
2-- The client's need for assistance is not met most of the time; or there is moderate risk to
the client's health/safety if additional assistance is not acquired;
3-- The client's need for assistance is seldom or never met; or there is severe risk to the
health and safety of the client.
Who, if anyone, is available to provide assistance?
EQuioment for Meal Preoaration and StoraQe and Utensils
The client has in proper working condition:
Yes
No
Not Needed for Meal Tvoe
Refrigerator
Freezer or freezer compartment
Oven
Microwave
Toaster Oven
The client has an adequate supply of:
Appropriate utensils for serving and eating
Towels/Hot pads or mits
for handling hot food items
The client has an adequate amount
of refrigerator/freezer space to store
multiple meals if needed.
Type of meal recommended:
Hot_
Shelf stable
Frozen
Chilled
Other
Specify
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EXHIBIT B
MEAL ALlLOCATIONS FOR FISCAL YEAR 2005
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EXHIBIT B
SECTION I
AREA AGENCY ON AGING
NUTRITION PROGRAM
FISCAL YEAR 2005
ROC AAA Qualified Nutrition Program Food Vendor:
Fiscal Year 2005 Unit Cost for All Meal Types:
Number of Days Meals Served in Year:
GA Food Service, Incorporated
$4.45
250
The following table outlines the meals that have been approved
for your jurisdiction for the FY2005 year.
Meal Types
Title III C-1
Title III C-2
NSI C-1
NSI C-2
Site C-1
Site C-2
Congregate Meals (requires a 10 percent match)
Home-Delivered Meals (requires a 10 percent match)
Congregate Meals (no match required)
Home-Delivered Meals (no match required)
Locally Purchased Congregate Meals (voluntary)
Locally Purchased Home-Delivered Meals (voluntary)
Jurisdiction
Richmond
Title III C1
26,109
Annual Number of Meals Alloted By Category
Title III C2 NSI C1 NSI C2 Site C1
26,548 7,195 17,343 13,750
Site C2
7,750
Tota
98,695
Daily Meal Allotments
Jurisdiction Title III C1 Title III C2 NSI C1 NSIC2 Site C1 Site C2 Tota
Richmond 104 106 29 69 55 31 395
Dollar Value of Meals By Category
Funding Title III C1 Title III C2 NSI C1 NSIC2 Site C1 Site C2 Tota
ROC Funds: $104,566.55 $ 106,324.74 $ 32,017.75 $ 77,176.35 $ $ $320,085.39
Local Match: $ 11,618.51 $ 11,813.86 $ $ $61,187.50 $ 34,487.50 $119,107.37
Total Cost: $116,185.05 $118,138.60 $32,017.75 $77,176.35 $61,187.50 $34,487.50 $439,192.75
Note that this contract includes the preliminary planning allocation for meals from the CSRA ROC and that
final allocation numbers are subject to change based on final state allocations. All Site meals are purchased
voluntarily by the local jurisdiction. Paragraph 1 of the attached contract duly notes the right to alter
final numbers based on funding availability.
"Note: Title III C1 and C2 meals will be reimbursed by the ROC at ninety (90) percent of their value
(Le. $4.45 x 0.9 equals $4.01). Site C1 and Site C2 meals are voluntarily provided by the community
and are not reimbursed by the ROC.
Periodic adjustments may be made during the course of the year to allocate unused meals in the region
to other areas of need or based on reductions in state funds.