This website publishes administrative rules on their effective dates, as designated by the adopting state agencies, colleges, and
universities.
| Rule |
Rule 173-4-01 | Older Americans Act nutrition program: introduction and definitions.
Effective:
January 29, 2022
(A) Introduction: This chapter 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 this
chapter: "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. "Dietary Guidelines for Americans"
(2020-2025) means the guidelines published by the United States departments of
agriculture and health and human services on
https://www.dietaryguidelines.gov/. "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 42 U.S.C. 3030d-21 to 3030g-23 (2020). "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.
Last updated January 30, 2022 at 10:00 AM
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Rule 173-4-02 | Older Americans Act nutrition program: meals eligible for payment.
Effective:
January 29, 2022
(A) Congregate dining: Meals provided 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 provided at a congregate dining location located in the
person's building. (B) Home-delivered meals: Meals delivered to a home 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.
Last updated January 30, 2022 at 10:01 AM
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Rule 173-4-03 | Older Americans Act nutrition program: consumer enrollment.
Effective:
January 1, 2023
(A) Congregate dining: (1) Initial verification: 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. (2) Annual verification: The provider may keep a consumer
enrolled in a congregate dining project or congregate dining project based in
restaurants or supermarkets project for more than one year only if, at least
once every calendar year, the provider verifies that the consumer's
congregate 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. (B) Home-delivered meals: (1) Initial verification:
Before enrolling a consumer into a home-delivered meals project, the provider
shall verify that the consumer's 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 may keep a consumer enrolled in a home-delivered meals project for
more than one year only if, at least once every calendar year, the provider
verifies that 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 of age or older. (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 have the highest nutritional risk, as determined by
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.
Last updated January 3, 2023 at 8:38 AM
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Rule 173-4-04 | Older Americans Act nutrition program: procuring for person direction.
Effective:
January 1, 2023
(A) When an AAA procures for congregate
dining project(s) or home-delivered meals project(s), the AAA is subject to
rules 173-3-04, 173-3-05, 173-3-05.1, and 173-3-06 of the Administrative Code
and this rule. (B) When an AAA procures for congregate
dining project(s) or home-delivered meal project(s), the AAA shall procure for
person direction by one of the following competitive procurement
methods: (1) Procurement by the
competitive-proposal method defined in 45 C.F.R. 75.329: (a) 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) Indicate in the request for proposal (RFP) that a
responsive bid is a bid in which the provider explains how it proposes to offer
person direction. (c) Award the AAA-provider agreement(s) to the provider(s)
offering the most-responsive bid(s) that is based on a score on the level of
person direction that each provider's bid offers in the score determining
the responsiveness of a bid. (2) Procurement by the
sealed-bid, small-purchase, and micro-purchase methods defined in 45 C.F.R.
75.329: (a) Determine the level of person direction that providers
in the PSA are capable of offering without basing the AAA's calculations
of this level solely on the willingness of providers who are currently in
AAA-provider agreements with the AAA. (b) Indicate in the RFP that a responsive bid is a bid in
which the provider explains how it proposes to meet or exceed the level of
person direction that the AAA determined providers in the PSA are capable of
offering. (c) Award the AAA-provider agreement(s) to the provider(s)
offering the most-responsive bid(s) that is based on a score on the level of
person direction that each provider's bid offers in the score determining
the responsiveness of a bid. (C) During a state of emergency declared
by the governor or a federal public health emergency, paragraph (B) of this
rule does not apply with regard to dining formats, location, delivery methods,
times, and frequencies. (D) 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 entres at each mealtime; and giving
consumers options between one entre and the sides that accompany it and
at least one other entre and the sides that accompany it (even if
consumers exchange entres 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 entres at each mealtime; and
options between one entre and the sides that accompany it and at least
one other entre and the sides that accompany it (even if consumers
exchange entres 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.
Last updated January 3, 2023 at 8:38 AM
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Rule 173-4-05 | Older Americans Act nutrition program: nutrition projects.
Effective:
December 1, 2023
(A) Requirements, flexibilities, and
recommendations to include in every AAA-provider agreement for a nutrition
project paid, in whole or in part, with Older Americans Act funds: (1) Every AAA-provider
agreement paid, in whole or in part, with Older Americans Act funds is subject
to rule 173-3-06 of the Administrative Code. (2) Project types: (a) An AAA-provider agreement for a congregate dining project, is
subject to rule 173-4-05.1 of the Administrative Code. (b) An AAA-provider agreement for a home-delivered meals project,
is subject to rule 173-4-05.2 of the Administrative Code. (c) An AAA-provider agreement for a congregate dining project
based in restaurants and grocery stores, is subject to rule 173-4-05.3 of the
Administrative Code. (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 AAA shall include a requirement for the provider to
provide nutrition health screening to consumers at least every calendar year
and strongly encourage providers to provide the nutrition health screening in
person. (b) The AAA shall indicate whether the provider is offering
nutrition assessment, nutrition counseling, or nutrition education to
consumers. (c) The AAA shall indicate whether the provider is providing
grocery shopping assistance or grocery ordering and delivery to consumers, and
if so, include the requirements in rules 173-4-10 and 173-4-11 of the
Administrative Code in the AAA-provider agreement. (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 and do so in
person whenever possible. (6) Consumer contributions: The provider
is subject to rule 173-3-07 of the Administrative Code. (7) Person direction: (a) The provider shall implement the person direction the
provider pledged to provide when the provider bid for the AAA-provider
agreement. During a state of emergency declared by the governor or a federal
public health emergency, the provider is only responsible for providing the
person direction that the provider pledged to provide to the extent practicable
during the state of emergency or federal public health emergency. (b) The provider shall offer consumers opportunities to give
feedback on current and future menus. (8) Menus: (a) The provider shall only offer menus approved by a
dietitian. (b) The AAA shall indicate the method by which the provider
offers ingredient information on the meals provided to consumers. (c) The provider shall list the serving size for each food item
on each production menu. (9) Nutritional adequacy: (a) The provider shall offer meals that satisfy at least
one-third of the dietary reference intakes (DRIs) for each mealtime by
targeting nutrient levels 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
https://www.nal.usda.gov/fnic/dietary-reference-intakes. (b) For each mealtime, the provider shall offer meals that follow
the "Dietary Guidelines for Americans." (c) For each meal time, the provider shall offer meals that, to
the maximum extent practicable, are adjusted to meet any special dietary needs
of consumers, including meals adjusted for cultural considerations, and
preferences, and medically-tailored meals. (d) The provider has flexibility in designing meals that are
appealing to consumers. (e) The provider has flexibility to use either nutrient analysis
or menu patterns to determine nutritional adequacy. (f) The AAA shall encourage providers to use, where feasible,
locally-grown foods and identify potential partnerships and contracts with
local producers and providers of locally-grown foods. (10) Diet orders: If the AAA-provider
agreement requires the provider to offer consumers therapeutic diets, then the
provider is subject to the additional requirements in rule 173-4-06 of the
Administrative Code unless it is the consumer's preference to choose a
therapeutic diet. (11) Dietary supplements: The provider
shall not pay for supplements, in whole or in part, with Older Americans Act
funds unless the supplement is part of a meal with a therapeutic
diet. (12) Food safety: (a) 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) The AAA shall state that the AAA 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 in-service training. (i) Orientation: The
provider shall ensure that each employee, including each volunteer, who
participates in meal preparation, handling, storage, or delivery successfully
completes orientation on topics relevant to the employee's job duties
before the employee performs those duties. (ii) In-service training:
The provider shall ensure that each employee, including a volunteer, who
participates in meal preparation, handling, storage, or delivery successfully
completes in-service training every twelve months on topics relevant to the
employee's job duties. (b) During a state of emergency declared by the governor or a
federal public health emergency, the provider is not responsible for complying
with paragraph (A)(13)(a)(i) or (A)(13)(a)(ii) of this rule. (B) Units: (1) Congregate dining
project: A unit is 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 is 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 is one meal provided in
compliance with this rule and rule 173-4-05.3 of the Administrative
Code.
Last updated December 1, 2023 at 9:30 AM
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Rule 173-4-05.1 | Older Americans Act nutrition program: congregate dining projects.
Effective:
January 1, 2023
The following are the requirements for every
AAA-provider agreement for a congregate dining project paid, in whole or in
part, with Older Americans Act funds: (A) The AAA-provider agreement is subject
to rules 173-3-06 and 173-4-05 of the Administrative Code. (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, within a
reasonable distance to older adult target populations. An AAA may obtain
ODA's approval to enter into an AAA-provider agreement that allows fewer
days per week or during a state of emergency declared by the governor or a
federal public health emergency. (2) The provider has
flexibility to offer 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 do not pay, in whole or in part, for regularly-provided
carry-out meals (also known as "grab-and-go 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 or a state of
emergency declared by the governor or a federal public health
emergency. (D) Emergency closings: (1) The provider shall
give those consumers enrolled in its congregate dining project reasonable
notice, to the extent practicable, before a scheduled mealtime when a
congregate dining location will be closed due to weather-related emergencies,
loss of power, kitchen malfunctions, natural disasters, a state of emergency
declared by the governor, or a federal public health emergency by using
broadcast media, its website, telephone, or by any combination of the
three. (2) The provider shall
distribute information to consumers on how to stock an emergency food shelf to
prepare for emergency closings. (E) Quality assurance: 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 by
reviewing the existing project and the changing needs or interests of
consumers, staff, or volunteers. (F) Meal verification: (1) The following are the
mandatory reporting items for each meal provided that a provider retains to
comply with the requirements under paragraph (B)(9) of rule 173-3-06 of the
Administrative Code: (a) Consumer's name. (b) Date of meal provision. (c) Unique identifier of the consumer or the
consumer's caregiver to attest to receiving the meal. (2) During a state of
emergency declared by the governor or a federal public health emergency, the
provider may verify each meal provided without collecting a unique identifier
of the consumer or the consumer's caregiver.
Last updated November 8, 2023 at 8:20 AM
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Rule 173-4-05.2 | Older Americans Act nutrition program: home-delivered meals projects.
Effective:
January 1, 2023
The following are the requirements to include in
every AAA-provider agreement for a home-delivered meals project paid, in whole
or in part, with Older Americans Act funds: (A) The AAA-provider agreement is subject to rules 173-3-06
and 173-4-05 of the Administrative Code. (B) Delivery: (1) Availability: (a) Per-meal delivery: (i) To a consumer who
chooses to receive per-meal deliveries and needs 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 a consumer who
chooses to receive per-meal deliveries, but does not need meals on five or more
days per week, the provider shall deliver at least one meal per day on days
that the consumer needs meals. (b) Periodic delivery: The provider has flexibility to
deliver meals to cover multiple mealtimes in one delivery to consumers who
choose periodic deliveries. (c) State of emergency: During a state of emergency
declared by the governor or a federal public health emergency, the provider has
flexibility to, in one delivery, deliver meals to cover multiple mealtimes for
consumers who received meals before the state of emergency (or federal public
health emergency) by per-meal delivery or periodic delivery. (2) Successful deliveries: The provider
may deliver meals to the consumer's home only when the consumer or the
consumer's caregiver is home, unless otherwise authorized by the
AAA. (C) Emergency closings: The provider shall develop and
implement emergency preparedness plans for emergency closings due to short-term
weather-related emergencies, loss of power, kitchen malfunctions, natural
disasters, a state of emergency declared by the governor (or a federal public
health emergency), etc. that include both of the following: (1) Providing timely notification of
emergency situations to consumers. (2) Distributing either of the
following: (a) Information to consumers on how to stock an emergency
food shelf. (b) Shelf-stable meals to consumers for an emergency food
shelf. (D) Quality assurance: 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 by
reviewing the existing project and the needs or interest of consumers, staff,
or volunteers. (E) Delivery verification: The following
are the mandatory reporting items for each meal delivery that a provider
retains to comply with the requirements under paragraph (B)(9) of rule 173-3-06
of the Administrative Code: (1) Consumer's
name. (2) Delivery
date. (3) Number of meals
delivered. (4) A unique identifier
of the consumer, the consumer's caregiver, or the delivery person to
attest to the delivery.
Last updated November 8, 2023 at 8:20 AM
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Rule 173-4-05.3 | Older Americans Act nutrition program: congregate dining projects based in restaurants or grocery stores.
Effective:
January 1, 2023
The following are the requirements to include 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: (A) The AAA-provider agreement is subject to rules 173-3-06
and 173-4-05 of the Administrative Code. (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 registers
each consumer that it serves and issues the consumer an identification card.
When the consumer visits the restaurant or grocery store, the consumer provides
the identification card to the designated staff person at the restaurant or
grocery store to receive a prepared meal. The provider may use an electronic
verification system to validate the identification card. (2) Voucher method (whether or not
electronically verified): The provider that uses this method registers each
consumer that it serves and issues the consumer a voucher. When the consumer
visits the restaurant or grocery store, the consumer provides a voucher to the
designated staff person at the restaurant or grocery store to receive a
prepared meal. The provider may use an electronic verification system to
validate the voucher. (3) Handwritten verification method:
Before providing a consumer the first meal, the provider that uses this method
collects information required by the AAA and obtains a unique identifier from
the 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) The provider that
uses the consumer identification method in paragraph (B)(1) or (B)(3) of this
rule solicits the consumer to voluntarily contribute to the cost of the meals
when the provider provides the meals. (2) The provider that
uses the method in paragraph (B)(2) of this rule solicits 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
consumer's comments on dining environments, food appearance, type of food,
food temperatures, and staff professionalism. (F) Meal verification: (1) The following are the
mandatory reporting items for each meal provided that a provider retains to
comply with the requirements under paragraph (B)(9) of rule 173-3-06 of the
Administrative Code: (a) Consumer's name. (b) Date of meal provision. (c) Unique identifier of the consumer or the
consumer's caregiver to attest to receiving the meal. (2) During a state of
emergency declared by the governor or a federal public health emergency, the
provider may verify each meal provided without collecting a unique identifier
of the consumer or the consumer's caregiver.
Last updated November 8, 2023 at 8:20 AM
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Rule 173-4-06 | Older Americans Act nutrition program: diet orders.
Effective:
December 1, 2023
(A) Definitions for this
rule: (1) "Diet
order" means an order for a therapeutic diet from a licensed healthcare
professional whose scope of practice includes ordering a therapeutic
diet. (2) "Therapeutic diet" means a
calculated nutritive regimen 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) Requirements for every AAA-provider
agreement for therapeutic diets paid, in whole or in part, with Older Americans
Act funds: (1) The AAA-provider
agreement is subject to the requirements in rule 173-3-06 of the Administrative
Code. (2) Diet orders: (a) The provider may provide a therapeutic diet to a consumer
only if the provider received a diet order for the consumer or if it is the
consumer's preference to choose a therapeutic diet. If a therapeutic diet
is a dysphagia nutritive regimen, the provider may provide the therapeutic diet
only if the diet order indicates whether the consumer requires texture-modified
foods and/or thickened liquids. (b) The provider shall provide a therapeutic dietto the consumer
identified in a 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) The provider shall provide the therapeutic diet according to
any updated diet order if the updated diet order is received before the
expiration of the current diet order. (d) The provider may use either nutrient analysis or a
meal-pattern plan approved by a dietitian to assure that the therapeutic diet
contains nutrients consistent with the diet order. (e) The provider may provide a therapeutic diet only if the
provider (or, if the consumer is in a care-coordination program, the AAA)
retains a copy of the diet order unless it is the consumer's preference to
choose a therapeutic diet. (3) Dietitians: (a) The provider shall determine the need, feasibility, and
cost-effectiveness of offering a therapeutic diet by consulting with a licensed
dietitian. (b) A provider may provide a therapeutic diet only if the
provider relies upon the oversight of a dietitian when providing the
therapeutic diet.
Last updated December 1, 2023 at 9:30 AM
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Rule 173-4-07 | Older Americans Act nutrition program: nutrition counseling.
Effective:
January 1, 2023
(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) Requirements for every AAA-provider agreement for nutrition
counseling paid, in whole or in part, with Older Americans Act
funds: (1) The AAA-provider
agreement is subject to the rule 173-3-06 of the Administrative
Code. (2) Dietitian: Only a
licensed dietitian ("dietitian") working for an agency provider, or a
licensed dietitian working as a self-employed provider may provide counseling
to consumers. (3) Orders and limits: (a) The provider may provide counseling to a consumer only if the
provider obtains an order for the consumer's counseling from a licensed
healthcare professional whose scope of practice includes ordering counseling
before providing the counseling. (b) The provider may only provide counseling up to the amount the
licensed healthcare professional ordered. (c) The provider may provide counseling to a consumer's
caregiver only if the licensed healthcare professional also ordered counseling
for the consumer's caregiver to improve the caregiver's care to the
consumer. (4) Venue: The provider may conduct
sessions by telephone, video conference, or in person in the consumer's
home. (5) Nutritional assessment: (a) 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: The
provider shall perform all of the following activities concerning a nutrition
intervention plan: (a) Base the plan on the initial assessment and subsequent
assessments (if conducted). (b) Include all of the following in the plan: (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. (c) Forward, no more than seven days after the provider
sends the assessment to the licensed healthcare professional who ordered the
counseling, the plan to the same professional and, if the consumer is in a
care-coordination program, to the consumer's case manager. (d) Provide reports on the 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: (a) The following are the mandatory reporting items for
each counseling/assessment session that a provider retains to comply with the
requirements under paragraph (B)(9) of rule 173-3-06 of the Administrative
Code: (i) Date of
session. (ii) Time of day when the
session begins and ends. (iii) Name of the
dietitian providing the session. (iv) Unique identifier of
the dietitian to attest to providing the session. (v) Unique identifier of
the consumer or the consumer's caregiver to attest to receiving the
session. (b) During a state of emergency declared by the governor or a
federal public health emergency, the provider may verify each episode of
service provided without collecting a unique identifier of the consumer or the
consumer's caregiver. (C) Units: (1) A unit of nutrition counseling is
fifteen minutes of counseling. (2) A unit of nutrition
assessment is one nutrition assessment session per consumer.
Last updated January 3, 2023 at 8:40 AM
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Rule 173-4-08 | Older Americans Act nutrition program: nutrition education.
Effective:
January 1, 2023
(A) "Nutrition education" means
an intervention targeting consumers and caregivers that uses information
dissemination, instruction, and training with the intent to support food,
nutrition, and physical activity choices and behaviors (related to nutritional
status) in order to maintain or improve health and address nutrition-related
conditions. (B) Requirements for every AAA-provider agreement for nutrition
education paid, in whole or in part, with Older Americans Act
funds: (1) The AAA-provider
agreement is subject to rule 173-3-06 of the Administrative Code. (2) Approved content: The provider shall
provide education content that meets the following requirements: (a) A licensed dietitian approved it as promoting better
health. (b) It is consistent with the "Dietary Guidelines for
Americans." (c) It is accurate, culturally sensitive, regionally appropriate,
and considerate of personal preferences, including a consumer's needs
interests and abilities (including literacy level). (d) It supports food, nutrition, and physical activity choices
and behaviors in order to maintain or improve health and address
nutrition-related conditions. (3) Education format: The
provider may provide education in person, through remote formats (including
video, audio, or online), or through the distribution of materials. The
provider shall use a format that is culturally sensitive, regionally
appropriate, and considers personal preferences, including a consumer's
needs and abilities. (4) Approved evaluation methodology: 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. (5) Frequency: The AAA-provider agreement
shall obligate the provider to provide nutrition education according to one of
the following three options: (a) The provider offers nutrition education at least 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)(5)(a) and (B)(5)(b) of this
rule. (6) Special requirements for congregate
dining projects: If the AAA-provider agreement obligates the provider to offer
nutrition education through a congregate dining project, the provider shall
comply with the following requirements: (a) Offer nutrition education in group sessions. (b) Report the following mandatory reporting items for each
session to comply with the requirements under paragraph (B)(9) of rule 173-3-06
of the Administrative Code: (i) Each consumer's
name (e.g., in a list). (ii) Session
date. (iii) Duration of
session. (iv) Educational
topic. (v) Instructor's
name. (vi) Unique identifier of
the instructor to attest to providing the session. (7) Special requirements for
home-delivered meal projects and congregate dining projects based in
restaurants and supermarkets: If the AAA-provider agreement obligates the
provider to offer nutrition education through a home-delivered meal project or
congregate dining project based in restaurants or supermarkets, the following
are the mandatory reporting items for the service that a provider retains to
comply with the requirements under paragraph (B)(9) of rule 173-3-06 of the
Administrative Code: (a) Number of consumers who received the approved
content. (b) Service date. (c) Topic of approved content. (d) Unique identifier of the provider to attest to
providing the approved content. (C) Units: A unit of nutrition education
is one nutrition education session per consumer whether provided in person,
through remote formats (including video, audio, or online), or through the
distribution of materials.
Last updated January 3, 2023 at 8:40 AM
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Rule 173-4-09 | Older Americans Act nutrition program: nutrition health screening.
Effective:
January 1, 2023
(A) Definitions for this
rule: "High nutritional risk" means the
status of a consumer whose score on the ODA form labeled "Determine Your
Own Nutritional Health" (ODA0010, rev. May, 2009) is a six or
above. "Nutrition health screening"
("screening") means using the ODA form labeled "Determine Your
Own Nutritional Health" (ODA0010, rev. May, 2009) to screen a consumer for
nutritional risks and, if the screening determines the consumer to be at high
nutritional risk, referring consumer to home and community-based services with
potential for reducing the risk. (B) Requirements for every AAA-provider
agreement for nutrition health screening paid, in whole or in part, with Older
Americans Act funds: (1) The AAA-provider
agreement is subject to rule 173-3-06 of the Administrative Code. (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) Venue: The provider
may screen consumers by telephone, video conference, or in person, but is
strongly encouraged to screen consumers in person. (4) Checklist: The provider shall use an
ODA form labeled "Determine Your Own Nutritional Health" (ODA0010,
rev. May, 2009) to screen consumers for nutritional risks at least once every
calendar year. (5) Referrals: If a screening determines
a consumer to be at high nutritional risk, the provider shall refer the
consumer to home and community-based services with potential for reducing the
risk. (6) Service verification: The following
are the mandatory reporting items for each screening that a provider retains to
comply with the requirements under paragraph (B)(9) of rule 173-3-06 of the
Administrative Code: (a) Consumer's name. (b) Date of screening. (c) Provider's name. (d) 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 a single instance of
screening one consumer. (2) When a provider
provides nutrition health screening as part of another 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 service.
Last updated January 3, 2023 at 8:40 AM
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Rule 173-4-10 | Older Americans Act nutrition program: grocery shopping assistance.
Effective:
January 1, 2023
(A) "Grocery shopping
assistance" means a service that assists consumers with the act of
shopping for groceries. (B) Requirements for every AAA-provider
agreement for grocery shopping assistance paid, in whole or in part, with Older
Americans Act funds: (1) The AAA-provider
agreement is subject to rule 173-3-06 of the Administrative Code. (2) Introductory information: The
provider shall provide a consumer with a packet of introductory information
that explains how grocery shopping assistance works on the consumer's
enrollment into the grocery shopping assistance service. (3) Transferring groceries: The AAA shall
indicate the extent to which it requires the provider to transfer the groceries
that the consumer purchases or receives. (4) Payment: (a) No Older Americans Act funds, other than funds from Title
III-B or III-E of the Older Americans Act, may pay for grocery shopping
assistance. (b) No Older Americans Act funds, other than funds from Title
III-B or III-E of the Older Americans Act, may pay for consumable supplies or
material aid to meet basic needs, such as groceries. Providers may accept other
funds (e.g., private pay, SNAP) for consumable supplies or material aid to meet
basic needs. (5) Service verification: (a) The following are the mandatory reporting items for each
episode of assistance that a provider retains to comply with the requirements
under paragraph (B)(9) of rule 173-3-06 of the Administrative
Code: (i) Consumer's
name. (ii) Service
date. (iii) Pick-up time and
location. (iv) Drop-off time and
location. (v) Service
units. (vi) Unique identifier of
the consumer or the consumer's caregiver to attest to receiving the
service. (b) During a state of emergency declared by the governor or
a federal public health emergency, the provider may verify each episode of
service provided without collecting the unique identifier of the consumer or
the consumer's caregiver. (C) Units: One unit of grocery shopping
assistance is one-way transportation to or from a retail food establishment or
non-profit food establishment.
Last updated January 3, 2023 at 8:40 AM
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Rule 173-4-11 | Older Americans Act nutrition program: grocery ordering and delivery.
Effective:
January 1, 2023
(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) Requirements for every AAA-provider
agreement for grocery ordering and delivery paid, in whole or in part, with
Older Americans Act funds: (1) The AAA-provider
agreement is subject to rule 173-3-06 of the Administrative Code. (2) Procedures: The provider shall
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 or III-E of the Older Americans Act, may pay for grocery ordering and
delivery. (b) No Older Americans Act funds, other than funds from Title
III-B or III-E of the Older Americans Act, may pay for consumable supplies or
material aid to meet basic needs, such as groceries. Providers may accept other
funds (e.g., private pay, SNAP) for consumable supplies or material aid to meet
basic needs. (4) Service verification: (a) The following are the mandatory reporting items for each
episode of service that a provider retains to comply with the requirements
under paragraph (B)(9) of rule 173-3-06 of the Administrative
Code: (i) Consumer's
name. (ii) Service
date. (iii) Unique identifier
of the consumer or the consumer's caregiver to attest to receiving the
service. (b) During a state of emergency declared by the governor or
a federal public health emergency, the provider may verify each episode of
service provided without collecting the unique identifier of the consumer or
the consumer's caregiver. (C) Units: One unit of grocery ordering
and delivery is one episode of grocery ordering and delivery.
Last updated January 3, 2023 at 8:40 AM
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