Chapter 173-4 Nutrition Programs and Nutrition-Related Services

173-4-01 Older Americans Act nutrition program: introduction and definitions.

(A) Introduction: Chapter 173-4 of the Administrative Code governs nutrition projects paid, in whole or in part, with Older Americans Act funds.

(B) Definitions: The definitions in rule 173-3-01 of the Administrative Code and the following definitions apply to Chapter 173-4 of the Administrative Code:

"Congregate dining project" means a nutrition project that complies with rule 173-4-05.1 of the Administrative Code.

"Congregate dining project based in restaurants and supermarkets" means a nutrition project that complies with rule 173-4-05.3 of the Administrative Code.

"Dietitian" and "licensed dietitian" mean a person with a current, valid license to practice dietetics under section 4759.06 of the Revised Code.

"Groceries" mean foods for a household to eat, such as breads and cereals; fruits and vegetables; meats, fish, and poultry; and dairy products.

"Grocery store" has the same meaning as "retail food establishment" in rule 3717-1-01 of the Administrative Code.

"Home-delivered meals project" means a nutrition project that complies with rule 173-4-05.2 of the Administrative Code.

"Nutrition project" means a congregate dining project, home-delivered meals project, or a congregate dining project based in restaurants and supermarkets.

"Older Americans Act nutrition program" means the program created under Title III, part C of the Older Americans Act of 1965, 79 Stat. 219, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.

"Restaurant" has the same meaning as "food service operation" in rule 3717-1-01 of the Administrative Code.

"Shelf-stable meal" means a meal that is non-perishable, ready-to-eat, stored at room temperature, and eaten without heating.

Replaces: 173-4-01

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Sections 214, 331, 336, and 339 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.
Prior Effective Dates: 03/05/2009

173-4-02 Older Americans Act nutrition program: meals eligible for payment.

(A) Congregate dining: Meals offered at a congregate dining location are eligible for payment with Older Americans Act funds if they meet the requirements for meals in this chapter and if the recipient is one of the following:

(1) A consumer who is sixty years of age or older.

(2) The spouse of the consumer in paragraph (A)(1) of this rule, if the spouse accompanies that consumer to the congregate dining location.

(3) A volunteer who provides volunteer services to the consumer in paragraph (A)(1) of this rule, if the volunteer services are provided to the consumer at the congregate dining location during the mealtime.

(4) A person with disabilities who resides in the home of the consumer in paragraph (A)(1) of this rule, if the person with disabilities accompanies that consumer to the congregate dining location.

(5) A person with disabilities who resides in a non-institutional residential building, but only if the building's residents are primarily sixty years of age or older and the meal is offered through a congregate dining location located in the person's building.

(B) Home-delivered meals: Meals delivered to a residence are eligible for payment with Older Americans Act funds if they meet the requirements for meals in this chapter and if the recipient is one of the following:

(1) A consumer who is sixty years of age or older and meets the following requirements: unable to prepare his or her own meals, unable to consume meals at a congregate dining location due to physical or emotional difficulties, and lacking another meal support service in the home or community.

(2) The spouse of the consumer in paragraph (B)(1) of this rule.

(3) A volunteer who provides volunteer services to the consumer in paragraph (B)(1) of this rule.

(4) A person with disabilities who resides in the home of the consumer in paragraph (B)(1) of this rule.

Replaces: 173-4-02

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 70 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Sections 331, 336, and 339 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.
Prior Effective Dates: 03/05/2009, 04/22/2010.

173-4-03 Older Americans Act nutrition program: consumer enrollment.

(A) Congregate dining: Before enrolling the consumer into a congregate dining project or congregate dining project based in restaurants or supermarkets, the provider shall verify that a consumer's congregate meals are eligible for payment, in whole or in part, with Older Americans Act funds according to rule 173-4-02 of the Administrative Code.

(B) Home-delivered meals:

(1) Initial verification: Before enrolling a consumer into a home-delivered meals project, the provider shall verify that his or her home-delivered meals are eligible for payment, in whole or in part, with Older Americans Act funds according to rule 173-4-02 of the Administrative Code.

(2) Annual verification: The provider shall not keep a consumer enrolled in a home-delivered meals project for more than one year unless, at least once annually, the provider verifies the consumer's home-delivered meals continue to be eligible for payment, in whole or in part, with Older Americans Act funds according to rule 173-4-02 of the Administrative Code.

(3) Temporary verification: A provider may deem a discharge order to be adequate verification to authorize temporary payment for home-delivered meals, in whole or in part, with Older Americans Act funds until the provider conducts its own verification of eligibility, but only if the following conditions are met:

(a) The consumer requires meals before the provider can verify that the consumer's home-delivered meals are eligible for payment, in whole or in part, with Older Americans Act funds.

(b) The consumer is sixty years or more old.

(c) The discharge order indicates the consumer is unable to prepare his or her own meals, unable to consume meals at a congregate dining location due to physical or emotional difficulties, and lacking another meal support service in the home or community.

(d) The provider begins providing home-delivered meals no later than seven days after the discharge.

(e) The provider conducts the initial verification no later than thirty consecutive days after the discharge.

(C) Waiting lists: If a waiting list exists for enrolling into a congregate dining project, congregate dining project based in restaurants or supermarkets, or a home-delivered meals project, the provider or the AAA shall develop a prioritization system that distributes meals equitably by prioritizing consumers who are determined to have the highest nutritional risk. The provider shall base the consumer's nutritional risk status upon the following:

(1) The result of a nutritional health screening of the consumer conducted according to rule 173-4-09 of the Administrative Code.

(2) The nutritional risk status of the spouse (if any), if the spouse is determined to have a higher nutritional risk than the consumer.

Replaces: 173-4-03

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 70 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Sections 331 and 336 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.69 (October, 2015 edition).
Prior Effective Dates: 03/05/2009

173-4-04 Older Americans Act nutrition program: procuring for person direction.

(A) When an AAA procures for congregate dining project(s) or home-delivered meals project(s), the AAA shall comply with rules 173-3-04, 173-3-05, 173-3-05.1, and 173-3-06 of the Administrative Code and also require the project(s) to include person direction.

(B) Each AAA shall procure for person direction by one of the following two methods:

(1) Competitive-proposal method:

(a) The AAA shall allow the highest level(s) of person direction that providers offer in bid(s) to determine what are responsive level(s) of person direction for its PSA.

(b) The AAA shall indicate in the RFP that, in all responsible bids, the provider shall explain how it shall offer person direction.

(c) The AAA shall award AAA-provider agreement(s) to the provider(s) offering the most-responsive bid(s). The AAA shall include a score on the level of person direction each provider's bid offers in the score determining the lowest responsive bid.

(2) Method other than competitive-proposal method:

(a) The AAA shall determine the level of person direction providers in the PSA are capable of offering. The AAA shall not base its calculations of this level solely upon the willingness of providers who are currently in AAA-provider agreements with the AAA.

(b) The AAA shall indicate in the RFP that, in all responsible bids, the provider shall explain how it shall meet or exceed the level of person direction the AAA determined providers in the PSA are capable of offering.

(c) The AAA shall award AAA-provider agreement(s) to the provider(s) offering the most-responsive bid(s). The AAA shall include a score on the level of person direction each provider's bid offers in the score determining the lowest responsible bid.

(C) Definition for this rule: "Person direction" means a subset of person-centered methodology. While person-centered methodology requires providers to work with consumers to determine what is best for the consumers, person direction allows consumers to decide what is best for themselves from a range of viable options. Person direction over congregate and home-delivered meals allows consumers to control the direction of their meals.

Giving consumers options between dining formats, locations, and times; allowing consumers to enjoy multi-generational dining; giving consumers options between entrées at each mealtime; and giving consumers options between one entrée and the sides that accompany it and at least one other entrée and the sides that accompany it (even if consumers exchange entrées or sides between two or more complete meal options) are examples of possible ways to offer person direction to consumers through congregate nutrition projects.

Giving consumers options between delivery formats (e.g., warm, frozen, chilled), options between delivery times (e.g., morning, afternoon), and options between delivery frequencies (e.g., per-meal delivery, periodic delivery); options between entrées at each mealtime; and options between one entrée and the sides that accompany it and at least one other entrée and the sides that accompany it (even if consumers exchange entrées or sides between two or more complete meal options) are examples of possible ways to offer person direction to consumers through home-delivered meals programs.

Replaces: 173-4-05, 173-4- 05.3.

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 70 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Sections 331 and 336 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.
Prior Effective Dates: 03/23/2009, 08/23/2012.

173-4-04.1 [Rescinded] Home-delivered nutrition program.

Effective: 9/1/2016
Five Year Review (FYR) Dates: 04/18/2016
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, Section 305 (a)(1)(C) of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended in 2006; 45 C.F.R. 1321.11(2015)
Rule Amplifies: 173.392, Section 336 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended in 2006.
Prior Effective Dates: 03/3/2009

173-4-04.2 [Rescinded] Restaurant and grocery meal service.

Effective: 9/1/2016
Five Year Review (FYR) Dates: 04/18/2016
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, Section 305 (a)(1)(C) of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended in 2006; 45 C.F.R. 1321.11(2015)
Rule Amplifies: 173.392, Section 331 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended in 2006.
Prior Effective Dates: 03/05/2009, 02/14/2010

173-4-05 Older Americans Act nutrition program: nutrition projects.

(A) In every AAA-provider agreement for a nutrition project paid, in whole or in part, with Older Americans Act funds, the AAA shall include the following requirements:

(1) General requirements: In the AAA-provider agreement, the AAA shall include the requirements in rule 173-3-06 of the Administrative Code for every AAA-provider agreement paid, in whole or in part, with Older Americans Act funds.

(2) Project types:

(a) If the AAA-provider agreement is for a congregate dining project, the AAA shall include the requirements in rule 173-4-05.1 of the Administrative Code in the AAA-provider agreement.

(b) If the AAA-provider agreement is for a home-delivered meals project, the AAA shall include the requirements in rule 173-4-05.2 of the Administrative Code in the AAA-provider agreement.

(c) If the AAA-provider agreement is for a congregate dining project based in restaurants and grocery stores, the AAA shall include the requirements in 173-4- 05.3 in the AAA-provider agreement.

(3) Separate project components: If the AAA procured for components of a nutrition project separately, the AAA shall identify in each provider's AAA-provider agreement, which requirements in Chapters 173-3 and 173-4 of the Administrative Code each provider is required to provide.

(4) Nutrition services in addition to providing meals:

(a) The provider shall offer nutrition health screening to consumers at least annually.

(b) In the AAA-provider agreement, the AAA shall indicate if the provider shall offer nutrition counseling or nutrition education to consumers.

(c) In the AAA-provider agreement, the AAA shall indicate if the provider shall offer grocery shopping assistance or grocery ordering and delivery to consumers.

(5) Eligibility verification: The provider shall determine the eligibility of each consumer before paying for their meals, in whole or in part, with Older Americans Act funds.

(6) Consumer contributions: The provider shall comply with rule 173-3-07 of the Administrative Code.

(7) Person direction:

(a) In the AAA-provider agreement, the AAA shall require the provider to implement the person direction the provider pledged to provide when the provider bid for the AAA-provider agreement.

(b) The provider shall offer consumers opportunities to give feedback on current and future menus.

(8) Menus:

(a) Dietitians: The provider shall only offer menus approved by a dietitian.

(b) Ingredients: In the AAA-provider agreement, the AAA shall indicate the method by which the provider shall offer ingredient information on the meals provided to consumers.

(c) Serving sizes: The provider shall list the serving size for each food item on each production menu.

(9) Nutritional adequacy:

(a) For each mealtime, the provider shall offer meals that satisfy at least one-third of the dietary reference intakes (DRIs). The provider shall target nutrient levels based on the predominant population and health characteristics of the consumers in the PSA. The federal government makes the DRIs available to the general public free of charge on http://fnic.nal.usda.gov/.

(b) For each mealtime, the provider shall offer meals that follow the "2015-2020 Dietary Guidelines for Americans." The federal government publishes the guidelines for the general public free of charge on http://www.health.gov/dietaryguidelines.

(c) In the AAA-provider agreement, the AAA shall not prohibit the provider from adjusting the nutritional-adequacy requirements for meals in paragraphs (A)(9)(a) and (A)(9)(b) of this rule, to the maximum extent practicable, to meet any special dietary needs of consumers.

(d) In the AAA-provider agreement, the AAA shall not limit the provider's flexibility in designing meals that are appealing to consumers.

(e) In the AAA-provider agreement, the AAA shall not prohibit the provider from using either nutrient analysis or menu patterns to determine nutritional adequacy.

(10) Diet orders: If the AAA-provider agreement requires the provider to offer consumers therapeutic diets, medical food, or food for special dietary use, the provider shall comply with the additional requirements in rule 173-4-06 of the Administrative Code.

(11) Dietary supplements: The provider shall not pay for multi-vitamins or mineral supplements, in whole or in part, with Older Americans Act funds.

(12) Food safety:

(a) In the AAA-provider agreement, the AAA shall indicate whether the United States department of agriculture, Ohio department of agriculture, another state's department of agriculture, or a local health district has jurisdiction to monitor the provider's compliance with food-safety laws, including sanitation, food temperatures, thermometers, food-borne illnesses, packaging, and dating meals.

(b) In the AAA-provider agreement, the AAA shall indicate that it is responsible for reporting any reasonable cause to believe a provider is out of compliance with food-safety laws to the government authority identified in the AAA-provider agreement to comply with paragraph (A)(12)(a) of this rule.

(13) Training:

(a) The provider shall develop a training plan that includes orientation and annual continuing education.

(i) Orientation: The provider shall assure that each employee, including each volunteer, who participates in meal preparation, handling, or delivery receives orientation on topics relevant to the employee's job duties before the employee performs those duties.

(ii) Continuing education: The provider shall assure that each employee, including a volunteer, who participates in meal preparation, handling, or delivery completes continuing education each year on topics relevant to the employee's job duties.

(b) The provider shall make, and retain, a written record of each employee's completion of orientation and continuing education. The record shall include the topics covered during the orientation and continuing education.

(B) Units:

(1) Congregate dining project: A unit equals one meal provided in compliance with this rule and rule 173-4-05.1 of the Administrative Code.

(2) Home-delivered meals project: A unit equals one meal provided in compliance with this rule and rule 173-4-05.2 of the Administrative Code.

(3) Congregate dining project based in restaurants or grocery stores: A unit equals one meal provided in compliance with this rule and rule 173-4-05.3 of the Administrative Code.

Replaces: 173-4-05, 173-4- 05.1.

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 70 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Sections 331, 336, and 339 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.
Prior Effective Dates: 03/23/2009, 08/23/2012.

173-4-05.1 Older Americans Act nutrition program: congregate dining projects.

In every AAA-provider agreement for a congregate dining project paid, in whole or in part, with Older Americans Act funds, the AAA shall include the following requirements:

(A) General requirements:

(1) In the AAA-provider agreement, the AAA shall include the requirements in rule 173-3-06 of the Administrative Code for every AAA-provider agreement paid, in whole or in part, with Older Americans Act funds.

(2) In the AAA-provider agreement, the AAA shall include the requirements in rule 173-4-05 of the Administrative Code for every AAA-provider agreement for a nutrition project.

(B) Availability:

(1) The provider shall keep at least one congregate dining location in its nutrition project open for business to provide meals for at least one mealtime (i.e., a breakfast, lunch, or dinner) per day to consumers on five or more days per week unless the AAA obtains ODA's approval to enter into an AAA-provider agreement that allows fewer days per week.

(2) In the AAA-provider agreement, the AAA shall not prohibit the provider from offering meals in different congregate dining locations on different days rather than have every congregate dining location open for at least five days per week.

(C) Carry-out meals: Older Americans Act Title III-C1 funds shall not pay, in whole or in part, for regularly-provided carry-out meals provided at congregate dining locations, but may pay for occasional carry-out meals, including meals sent home with consumers to prepare for an anticipated closing of congregate dining locations for weather-related emergencies.

(D) Emergency closings:

(1) The provider shall give those consumers enrolled in its congregate dining project reasonable notice before a scheduled mealtime when a congregate dining location will be closed due to weather-related emergencies, loss of power, kitchen malfunctions, natural disasters, etc. Providers shall notify consumers by using broadcast media, by using its website, by telephone, or by any combination of the three.

(2) To prepare for emergency closings, the provider shall distribute information to consumers on how to stock an emergency food shelf.

(E) Quality assurance:

(1) Each year, the provider shall implement a plan to evaluate and improve the effectiveness of the project's operations and services to ensure continuous improvement. In the plan, the provider shall include a review of the existing project; modifications the provider made to respond to changing needs or interest of consumers, staff, or volunteers; and proposed improvements.

(2) In the AAA-provider agreement, the AAA shall not prohibit a provider from using an electronic system to collect and retain the records showing compliance with the continuous-improvement requirements in this rule.

(F) Meal verification:

(1) By one of the following two methods, the provider shall verify that each meal for which it bills was provided:

(a) The provider may use an electronic system if the system does all of the following:

(i) Collects the consumer's name, date, and an identifier (e.g., electronic signature, fingerprint, password, swipe card, bar code) unique to the consumer.

(ii) Retains the information it collects.

(iii) Produces reports, upon request, that the AAA can monitor for compliance.

(b) The provider may use a manual system if the provider documents the consumer's name, date, and handwritten signature of the consumer. If the consumer is unable to produce a handwritten signature, the consumer's handwritten initials, stamp, or mark are acceptable if the AAA authorizes such an alternative.

(2) In the AAA-provider agreement, the AAA shall not prohibit a provider from using an electronic system to collect and retain the records this rule requires.

Replaces: 173-4-04

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 70 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Section 331 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.
Prior Effective Dates: 03/05/2009

173-4-05.2 Older Americans Act nutrition program: home-delivered meals projects.

In every AAA-provider agreement for a home-delivered meals project paid, in whole or in part, with Older Americans Act funds, the AAA shall include the following requirements:

(A) General requirements:

(1) In the AAA-provider agreement, the AAA shall include the requirements in rule 173-3-06 of the Administrative Code for every AAA-provider agreement paid, in whole or in part, with Older Americans Act funds.

(2) In the AAA-provider agreement, the AAA shall include the requirements in rule 173-4-05 of the Administrative Code for every AAA-provider agreement for a nutrition project.

(B) Delivery:

(1) Availability:

(a) Per-meal delivery:

(i) To consumers who choose to receive per-meal deliveries and require meals on five or more days per week, the provider shall deliver at least one meal per day for five or more days per week.

(ii) To consumers who choose to receive per-meal deliveries, but do not require meals on five or more days per week, the provider shall deliver at least one meal per day on days that the consumer requires meals.

(iii) To consumers who choose to regularly receive per-meal deliveries, but anticipate that they will not be home during an upcoming regular delivery, and who make arrangements with the provider to deliver an additional meal during a regular delivery for consumption at an upcoming time.

(b) Periodic delivery: To consumers who choose periodic deliveries, in the AAA-provider agreement, the AAA shall not prohibit the provider from, in one delivery, delivering meals to cover multiple mealtimes.

(2) Successful deliveries: The provider shall only deliver meals to the consumer's home when the consumer, or the consumer's caregiver, is home.

(3) Electronic systems: In the AAA-provider agreement, the AAA shall not prohibit the provider from using an electronic system to schedule meal deliveries and to optimize delivery routes.

(C) Emergency closings: The provider shall develop and implement written contingency procedures for emergency closings due to short-term weather-related emergencies, loss of power, kitchen malfunctions, natural disasters, etc. In the procedures, the provider shall include the following:

(1) Providing timely notification of emergency situations to consumers; and,

(2) Either the distribution of:

(a) Information to consumers on how to stock an emergency food shelf; or,

(b) Shelf-stable meals to consumers for an emergency food shelf.

(D) Quality assurance:

(1) Each year, the provider shall implement a plan to evaluate and improve the effectiveness of the project's operations and services to ensure continuous improvement. In the plan, the provider shall include a review of the existing project; modifications the provider made to respond to changing needs or interest of consumers, staff, or volunteers; and proposed improvements.

(2) In the AAA-provider agreement, the AAA shall not prohibit a provider from using an electronic system to collect and retain the records showing compliance with the continuous-improvement requirements in this rule.

(E) Delivery verification:

(1) At the time of each delivery, the provider shall verify that each meal for which it bills was delivered by one of the following two methods:

(a) The provider may use an electronic system if the system does all of the following:

(i) Collects the consumer's name, date, time, number of meals in the delivery, whether the delivery successfully reaches the consumer, and an identifier (e.g., electronic signature, fingerprint, password, swipe card, bar code) unique to the consumer.

(ii) Retains the information it collects.

(iii) Produces reports, upon request, that the AAA can monitor for compliance.

(b) The provider may use a manual system if the provider documents the consumer's name, date, time, number of meals in the delivery, and whether the delivery successfully reaches the consumer, and collects the handwritten signatures of the driver and the consumer. If the consumer is unable to produce a handwritten signature, the consumer's handwritten initials, stamp, or mark are acceptable if the AAA authorizes such an alternative.

(2) In the AAA-provider agreement, the AAA shall not require the provider to obtain multiple verifications for multi-meal deliveries, because the verification under paragraph (E) of this rule is conducted per-delivery and the verification includes documenting the number of meals in the delivery.

(3) In the AAA-provider agreement, the AAA shall not prohibit a provider from using an electronic system to collect and retain the records this rule requires.

Replaces: 173-4- 04.1

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 70 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Section 336 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.
Prior Effective Dates: 03/23/2009

173-4-05.3 Older Americans Act nutrition program: congregate dining projects based in restaurants or grocery stores.

In every AAA-provider agreement for a congregate dining project based in restaurants or grocery stores paid, in whole or in part, with Older Americans Act funds, the AAA shall include the following requirements:

(A) General requirements:

(1) In the AAA-provider agreement, the AAA shall include the requirements in rule 173-3-06 of the Administrative Code for every AAA-provider agreement paid, in whole or in part, with Older Americans Act funds.

(2) In the AAA-provider agreement, the AAA shall include the requirements in rule 173-4-05 of the Administrative Code for every AAA-provider agreement for a nutrition project.

(B) Eligibility verification: The provider shall use one of the following three methods to verify consumers' eligibility when complying with the eligibility-verification requirements in rule 173-4-03 of the Administrative Code:

(1) Identification card method (whether or not electronically verified): The provider that uses this method shall register each consumer that it serves and issue the consumer an identification card. When the consumer visits the restaurant or grocery store, the consumer shall show the identification card to the designated staff person at the restaurant or grocery store to receive a prepared meal or to select a prepared meal from a menu of meals that comply with rule 173-4-05 of the Administrative Code. The provider may use an electronic verification system to validate the identification card and to verify the provision of the meal.

(2) Voucher method (whether or not electronically verified): The provider that uses this method shall register each consumer that it serves and issue the consumer a voucher. At the time the vouchers are received, the provider or AAA shall provide the consumer with the opportunity to voluntarily contribute to the cost of the meal. When the consumer visits the restaurant or grocery store, the consumer shall provide a voucher to the designated staff person at the restaurant or grocery store to receive a prepared meal or to select a prepared meal from a menu of meals that meet the meal requirements established in rule 173-4-05 of the Administrative Code. The provider may use an electronic verification system to validate the voucher and to verify the provision of the meal.

(3) Handwritten verification method: Before providing a consumer his or her first meal, the provider that uses this method shall verify that the consumer is at least sixty years of age, have the consumer sign in, provide information that the AAA will need for reporting, and to obtain a disclosure signature from the consumer. The provider shall provide the AAA with this information. The provider shall also regularly provide the AAA with records that identify each consumer the provider has served and the number of meals that the provider has served to each consumer.

(C) Consumer contributions: The provider shall use one of the following two methods for soliciting consumer contributions when complying with the consumer-contribution requirements in rule 173-3-07 of the Administrative Code:

(1) If the provider uses the consumer identification method in paragraphs (B)(1) or (B)(3) of this rule, the provider shall solicit the consumer to voluntarily contribute to the cost of the meals when the provider provides the meals.

(2) If the provider uses the method in paragraph (B)(2) of this rule, the provider shall solicit the consumer to voluntarily contribute to the cost of the meals when the provider provides the vouchers.

(D) Emergency closings: The provider shall distribute information to consumers on how to stock an emergency food shelf.

(E) Quality assurance: The provider shall elicit comments from consumers on dining environments, food appearance, type of food, food temperatures, and staff professionalism.

(F) Meal verification:

(1) The provider shall verify that each meal for which it bills was delivered by one of the following two methods:

(a) The provider may use an electronic system if the system does all of the following:

(i) Collects the consumer's name, date, and an identifier (e.g., electronic signature, fingerprint, password, swipe card, bar code on voucher, barcode on identification card) unique to the consumer.

(ii) Retains the information it collects.

(iii) Produces reports, upon request, that the AAA can monitor for compliance.

(b) The provider may use a manual system if the provider documents the consumer's name and date, and collects the handwritten signature of the consumer. If the consumer is unable to produce a handwritten signature, the consumer's handwritten initials, stamp, or mark are acceptable if the AAA authorizes such an alternative.

(2) In the AAA-provider agreement, the AAA shall not prohibit a provider from using an electronic system to collect and retain the records this rule requires.

Replaces: 173-4- 04.2

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 70 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Section 331 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.
Prior Effective Dates: 03/05/2009, 07/31/2013.

173-4-05.4 [Rescinded] Medical food and food for special dietary use.

Effective: 9/1/2016
Five Year Review (FYR) Dates: 04/18/2016
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, Section 305 (a)(1)(C) of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended in 2006; 45 C.F.R. 1321.11(2015)
Rule Amplifies: 173.392, Sections 331, 336, and 339 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended in 2006.
Prior Effective Dates: 173-4-05: 03/23/2009; 173-4- 05.4: 08/23/2012

173-4-06 Older Americans Act nutrition program: diet orders.

(A) Definitions for this rule:

(1) "Diet order" means a written order for a therapeutic diet, medical food, or food for special dietary use from a licensed healthcare professional whose scope of practice includes ordering these diets.

(2) "Food for special dietary use" has the same meaning as in 21 C.F.R. 105.3(a)(1) (April, 2015 edition).

(3) "Medical food" has the same meaning as in 21 U.S.C. 360ee(b)(3) (as accessed on December 9, 2015).

(4) "Therapeutic diet" means a calculated nutritive regime including, the following regimens:

(a) Diabetic and other nutritive regimens requiring a daily specific calorie level.

(b) Renal nutritive regimens.

(c) Dysphagia nutritive regimens, excluding simple textural modifications.

(d) Any other nutritive regimen requiring a daily minimum or maximum level of one or more specific nutrients or a specific distribution of one or more nutrients.

(B) In every AAA-provider agreement for therapeutic diets, medical meals, or food for a special dietary use paid, in whole or in part, with Older Americans Act funds, the AAA shall include the following requirements:

(1) General requirements: In the AAA-provider agreement, the AAA shall include the requirements in rule 173-3-06 of the Administrative Code for every AAA-provider agreement paid, in whole or in part, with Older Americans Act funds.

(2) Diet orders:

(a) The provider shall only provide a therapeutic diet, medical food, or food for special dietary use to a consumer if the provider received a diet order for the consumer. If the therapeutic diet is a dysphagia nutritive regimen, the provider shall only provide the therapeutic diet if the diet order requires the meals to have thickening agents and indicates whether the consumer requires a level-one (puréed) or level-two (chopped or ground) dysphagia therapeutic diet

(b) The provider shall provide a therapeutic diet, medical food, or food for special dietary use to the consumer identified in the diet order for the shorter of the following two durations:

(i) The length of time authorized by the diet order.

(ii) One year from the date the diet order indicates the diet should begin.

(c) If the provider receives an updated diet order before the expiration of a current diet order, the provider shall provide the therapeutic diet, medical food, or food for special dietary use according to the updated diet order.

(d) The provider shall assure the therapeutic diet contains nutrients consistent with the diet order by either utilizing nutrient analysis or by using a meal-pattern plan approved by a dietitian.

(e) The provider shall only provide a therapeutic diet, medical food, or food for special dietary use if the provider (or, if the consumer is in a care-coordination program, the AAA), retains a copy of the diet order.

(3) Dietitians:

(a) The provider shall determine the need, feasibility, and cost-effectiveness of offering a therapeutic diet, medical food, or food for special dietary use by consulting with a licensed dietitian.

(b) A provider shall only provide medical food and food for a special dietary use if the provider relies upon the oversight of a dietitian when providing medical food or food for a special dietary use.

(C) Nutrition services incentive program (NSIP) funding for medical food and food for special dietary use:

(1) Stand-alone meals: If the medical food or food for a special dietary use is offered to a consumer as meals, the meals are eligible for payment with Older Americans Act funds as medical food or food for a special dietary purpose, but are not eligible for payment with Older Americans Act funds as congregate or home-delivered meals. Thus, if the medical food or food for a special dietary use is offered to consumers as meals, they would not qualify for NSIP incentive payments.

(2) Supplements to meals: If the medical food or food for a special dietary purpose is offered to consumers as supplements to meals, the supplements are included in the cost of the meals. Meals with the supplement are eligible for payment with Older Americans Act funds as a congregate or home-delivered meals, both of which qualify for NSIP incentive payments.

Replaces: 173-4- 05.2, 173-4- 05.4.

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 70 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Section 339 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.
Prior Effective Dates: 03/23/2009, 08/23/2012.

173-4-07 Older Americans Act nutrition program: nutrition counseling.

(A) Definitions for this rule:

"Nutrition counseling" ("counseling") has the same meaning as "medical nutrition therapy" in rule 4759-2-01 of the Administrative Code.

"Nutritional assessment" ("assessment") has the same meaning as in rule 4759-2-01 of the Administrative Code.

(B) In every AAA-provider agreement for nutrition counseling paid, in whole or in part, with Older Americans Act funds, the AAA shall include the following requirements:

(1) General requirements: In the AAA-provider agreement, the AAA shall include the requirements in rule 173-3-06 of the Administrative Code for every AAA-provider agreement paid, in whole or in part, with Older Americans Act funds.

(2) Dietitian: Only a licensed dietitian ("dietitian") working for an agency provider, or a licensed dietitian working as a self-employed provider shall provide counseling to consumers.

(3) Orders and limits:

(a) Before the provider counsels a consumer, the provider obtains an order for the consumer's counseling from a licensed healthcare professional whose scope of practice includes ordering counseling.

(b) The provider shall not provide counseling in excess of the amount the licensed healthcare professional ordered.

(c) The provider shall not provide counseling to a consumer's caregiver unless the licensed healthcare professional also ordered counseling for the consumer's caregiver to improve the caregiver's care to the consumer.

(d) The provider shall not provide counseling in excess of any limits the AAA establishes.

(4) Face-to-face vs. telecommunications:

(a) The provider shall conduct the initial counseling session as a face-to-face session.

(b) The provider shall conduct subsequent sessions on a face-to-face basis or by a telecommunication system. As used in this paragraph, "telecommunication" has the same meaning as in 2913.01 of the Revised Code.

(5) Nutritional assessment ("assessment"):

(a) During the initial counseling session, the provider shall conduct an assessment of the consumer's nutritional intake, anthropometic measurements, biochemical values, physical and metabolic parameters, socio-economic factors, current medical diagnosis and medications, pathophysiological processes, and access to food and food-assistance programs.

(b) No later than seven days after the initial assessment, the dietitian forwards the results of the initial assessment to the licensed healthcare professional who ordered the counseling and, if the consumer is in a care-coordination program, to the consumer's case manager.

(6) Nutrition intervention plan:

(a) The provider shall develop a nutrition intervention plan based upon the initial assessment and, if the provider conducts subsequent assessments, the subsequent assessments. The plan shall include all the following:

(i) Clinical and behavioral goals and a care plan.

(ii) Intervention planning, including nutrients required, feeding modality, and method of nutrition education and counseling, with expected measurable outcomes.

(iii) Consideration for input from the consumer, licensed healthcare professional who ordered the counseling, case manager (if any), consumer's caregiver (if any), and relevant service provider (if any).

(iv) The scheduling of any follow-up counseling sessions.

(b) No more than seven days after the provider sends the assessment to the licensed healthcare professional who ordered the counseling, the provider shall forward the nutrition intervention plan to the same professional and, if the consumer is in a care-coordination program, to the consumer's case manager.

(c) The provider shall provide reports on the intervention plan's implementation and the consumer's outcomes to the licensed healthcare professional who ordered the counseling and, if the consumer is in a care-coordination program, to the consumer's case manager.

(7) Service verification: By one of the following two methods, the provider shall verify that each consultation for which it bills was provided:

(a) The provider may use an electronic system if the system does all of the following:

(i) Collects the consumer's name, date of consultation, time of day each consultation begins and ends, name of licensed dietitian providing consultation, and an identifier (e.g., electronic signature, fingerprint, password, swipe card, bar code) unique to the consumer.

(ii) Retains the information it collects.

(iii) Produces reports, upon request, that the AAA can monitor for compliance.

(b) The provider may use a manual system if the provider documents the date of service, time of day that each consultation begins and ends, name of the licensed dietitian providing the consultation, and collects the handwritten signatures of the licensed dietitian providing the consultation and the consumer. If the consumer is unable to produce a handwritten signature, the consumer's handwritten initials, stamp, or mark are acceptable if the AAA authorizes such an alternative.

(C) Unit: A unit of nutrition counseling equals fifteen minutes of counseling.

Replaces: 173-4-06

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 70 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Sections 331, 336, and 339 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.
Prior Effective Dates: 03/05/2009

173-4-08 Older Americans Act nutrition program: nutrition education.

(A) "Nutrition education" means a service that promotes better health by providing consumers or caregivers with accurate and culturally-sensitive information and instruction on nutrition, physical activity, food safety, or disease prevention.

(B) In every AAA-provider agreement for nutrition education paid, in whole or in part, with Older Americans Act funds, the AAA shall include the following requirements:

(1) General requirements: In the AAA-provider agreement, the AAA shall include the requirements in rule 173-3-06 of the Administrative Code for every AAA-provider agreement paid, in whole or in part, with Older Americans Act funds.

(2) Approved education materials: The provider shall distribute education materials that the AAA's licensed dietitian has approved as promoting better health by providing consumers or caregivers with accurate and culturally-sensitive information and instruction on nutrition, physical activity, food safety, or disease prevention and as being tailored to consumer's needs, interests, and abilities (including literacy levels).

(3) Approved evaluation methodology:

(a) The provider shall implement a methodology for evaluating the effectiveness of its nutrition education that has the AAA's approval before the provider implements it.

(b) The provider shall retain records of all evaluations that it completes using the methodology in paragraph (B)(3)(a) of this rule.

(4) Frequency: In the AAA-provider agreement, the AAA shall require the provider to provide nutrition education according to one of the following three options:

(a) The provider offers nutrition education two times per year.

(b) The provider offers nutrition counseling according to rule 173-4-07 of the Administrative Code instead of nutrition education within a particular county.

(c) A combination of paragraphs (B)(4)(a) and (B)(4)(b) of this rule.

(5) Special requirements for congregate dining projects: If the AAA-provider agreement requires the provider to offer nutrition education through a congregate dining project, the provider shall comply with the following:

(a) The provider shall offer nutrition education in group sessions.

(b) For each unit of service, the provider shall record each consumer's name (e.g., in a list); the service date and duration of service; the educational topic; the service units; the instructor's name; and the instructor's signature attesting to the accuracy of the record.

(6) Special requirements for home-delivered meal projects and congregate dining projects based in restaurants and supermarkets: If the AAA-provider agreement requires the provider to offer nutrition education through a home-delivered meal project or congregate dining project based in restaurants or supermarkets, the provider shall retain a record to show the number of consumers who received the educational materials, the service date, the topic of the educational materials, and the provider's signature.

(C) Units: A unit of nutrition education is one nutrition education session per consumer.

Replaces: 173-4-07

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 70 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Sections 214, 331, 336, and 339 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.
Prior Effective Dates: 03/05/2009, 07/12/2012.

173-4-09 Older Americans Act nutrition program: nutrition health screening.

(A) Definitions for this rule:

"Form ODA0010" means the "'Determine Your Own Nutritional Health' checklist (Rev. May 28, 2009)." ODA publishes the form on www.aging.ohio.gov. It is available to the general public at no cost.

"High nutritional risk" means the status of a consumer whose score on form ODA0010 is six or above.

"Nutrition health screening" ("screening") means using form ODA0010 to screen a consumer for nutritional risks and, if the screening determines the consumer to be at high nutritional risk, referring consumer to providers of home and community-based goods and services with potential for reducing the risk.

(B) In every AAA-provider agreement for nutrition health screening paid, in whole or in part, with Older Americans Act funds, the AAA shall include the following requirements;

(1) General requirements: In the AAA-provider agreement, the AAA shall include the requirements in rule 173-3-06 of the Administrative Code for every AAA-provider agreement paid, in whole or in part, with Older Americans Act funds.

(2) Stand-alone or part: The provider may screen consumers as a stand-alone service or as part of a nutrition project or nutrition counseling.

(3) Checklist: The provider shall use form ODA0010 to screen consumers for nutritional risks.

(4) Referrals: If a screening determines a consumer to be at high nutritional risk, the provider shall refer the consumer to providers of home and community-based good and services with potential for reducing the risk. The AAA-provider agreement shall not require the provider to document the identity of providers to whom it made referrals.

(5) Service verification: For each screening, the provider shall retain records to verify the date of the screening, the consumer's name, the provider's name, and an indication of whether the consumer is at high nutritional risk.

(C) Units:

(1) One unit of nutrition health screening provided as a stand-alone service is equal to a single instance of screening one consumer.

(2) When a provider provides nutrition health screening as part of another good or service paid, in whole or in part, with Older Americans Act funds, the screening is part of the cost of providing a unit of a meal through the other good or service.

Replaces: 173-4-08

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 70 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Sections 331, 336, and 339 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.
Prior Effective Dates: 03/05/2009, 07/05/2012.

173-4-10 Older Americans Act nutrition program: grocery shopping assistance.

(A) "Grocery shopping assistance" means a service that assists consumers with the act of grocery shopping.

(B) In every AAA-provider agreement for grocery shopping assistance paid, in whole or in part, with Older Americans Act funds, the AAA shall include the following requirements:

(1) General requirements: In the AAA-provider agreement, the AAA shall include the requirements in rule 173-3-06 of the Administrative Code for every AAA-provider agreement paid, in whole or in part, with Older Americans Act funds.

(2) Introductory information: The provider to provide a consumer with a packet of introductory information that explains how grocery shopping assistance works upon the consumer's enrollment into a grocery shopping assistance service.

(3) Transferring groceries: In the AAA-provider agreement, the AAA shall indicate the extent to which the provider shall transfer the groceries the consumer purchases, whether from the grocery store to the vehicle, from the shopping cart to the vehicle, from the vehicle to the consumer's home, or a combination of the three.

(4) Payment:

(a) No Older Americans Act funds, other than funds from Title III-B of the Older Americans Act, shall pay for grocery ordering and delivery.

(b) No Older Americans Act funds shall pay for groceries.

(5) Service verification:

(a) For each episode of assistance, the provider shall retain a record of the consumer's name; service date; pick-up time and location; drop-off time and location; service units; provider's signature; and consumer's signature.

(b) In the AAA-provider agreement, the AAA shall not prohibit the provider from using an electronic system to collect and retain the items in paragraph (B)(5)(a) of this rule.

(C) Units: One unit of grocery shopping assistance equals one-way transportation to or from a grocery store.

Replaces: 173-4-09

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 70 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Sections 331, 336, 339 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.
Prior Effective Dates: 03/05/2009

173-4-11 Older Americans Act nutrition program: grocery ordering and delivery.

(A) "Grocery ordering and delivery" means a service for a consumer who needs assistance shopping for groceries that allows consumers to order groceries, then delivers the ordered groceries to the consumer's home or vehicle (e.g., at a drive-thru pick-up window).

(B) In every AAA-provider agreement for grocery ordering and delivery paid, in whole or in part, with Older Americans Act funds, the AAA shall include the following requirements:

(1) General requirements: In the AAA-provider agreement, the AAA shall include the requirements in rule 173-3-06 of the Administrative Code for every AAA-provider agreement paid, in whole or in part, with Older Americans Act funds.

(2) Procedures: The provider to develop and implement procedures for the safe delivery of groceries.

(3) Payment:

(a) No Older Americans Act funds, other than funds from Title III-B of the Older Americans Act, shall pay for grocery ordering and delivery.

(b) No Older Americans Act funds shall pay for groceries. Providers may accept other funds for groceries (e.g., private pay, SNAP).

(4) Service verification:

(a) For each episode of service, the provider to retain a record of the consumer's name; service date; provider's signature; and consumer's signature.

(b) In the AAA-provider agreement, the AAA shall not prohibit the provider from using a technology-based system to collect and retain the items in paragraph (B)(4)(a) of this rule.

(C) Units: One unit of grocery ordering and delivery equals one episode of grocery ordering and delivery.

Replaces: 173-4-09

Effective: 9/1/2016
Five Year Review (FYR) Dates: 09/01/2021
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.392 ; Section 305(a)(1)(C) of the Older Americans Act of 1965, 70 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016; 45 C.F.R. 1321.11 (July 1, 2016).
Rule Amplifies: 173.392 ; Sections 331, 336, 339 of the Older
Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001, as amended by the Older Americans Act Reauthorization Act of 2016.
Prior Effective Dates: 03/05/2009