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, as indicated in this Register of Ohio document.
Effective:
September 1, 2016
(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.
Last updated August 26, 2021 at 5:01 PM
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Rule 173-4-02 | Older Americans Act nutrition program: meals eligible for payment, as indicated in this Register of Ohio document.
Effective:
September 1, 2016
(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.
Last updated August 26, 2021 at 5:01 PM
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Rule 173-4-03 | Older Americans Act nutrition program: consumer enrollment.
Effective:
December 31, 2020
(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, in person, 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. During a state of
emergency declared by the governor, the provider may verify eligibility by
telephone, video conference, or in person. (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, in person, 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. During a state of
emergency declared by the governor, the provider may verify eligibility by
telephone, video conference, or in person. (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.
Last updated August 26, 2021 at 5:01 PM
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Rule 173-4-04 | Older Americans Act nutrition program: procuring for person direction.
Effective:
December 31, 2020
(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) During a state of emergency declared
by the governor, 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 August 26, 2021 at 5:01 PM
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Rule 173-4-05 | Older Americans Act nutrition program: nutrition projects.
Effective:
October 29, 2020
(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 in-person nutrition health screening
to consumers at least annually. In a state of emergency declared by the
governor, the provider may offer the nutrition health screening by telephone,
video conference, or in person. (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 in person before
paying for their meals, in whole or in part, with Older Americans Act funds.
During a state of emergency declared by the governor, the provider may verify
eligibility by telephone, video conference, or in person. (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. During a state of emergency
declared by the governor, the provider is only required to provide the person
direction the provider pledged to provide to the extent practicable during the
state of emergency. (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
https://www.nal.usda.gov/fnic/dietary-reference-intakes. (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
https://health.gov/our-work/food-nutrition. (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, preferences, and medically-tailored meals. (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 in-service training. (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) In-service training:
The provider shall assure that each employee, including a volunteer, who
participates in meal preparation, handling, or delivery completes in-service
training 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 in-service training. The record
shall include the topics covered during the orientation and in-service
training. (c) During a state of emergency declared by the governor,
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 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.
Last updated August 26, 2021 at 5:01 PM
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Rule 173-4-05.1 | Older Americans Act nutrition program: congregate dining projects.
Effective:
December 31, 2020
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, within a
reasonable distance to older adult target populations, unless the AAA obtains
ODA's approval to enter into an AAA-provider agreement or during a state
of emergency declared by the governor 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 or a state of emergency declared by the governor. (D) Emergency closings: (1) The provider shall
give those consumers enrolled in its congregate dining project, to the extent
practicable, 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, a state of emergency declared
by the governor, 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 a unique identifier of the consumer or the
consumer's caregiver. (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 a unique identifier of the
consumer or the consumer's caregiver. (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. (3) During a state of
emergency declared by the governor, the provider may verify each meal provided
without collecting a unique identifier of the consumer or the consumer's
caregiver.
Last updated August 26, 2021 at 5:01 PM
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Rule 173-4-05.2 | Older Americans Act nutrition program: home-delivered meals projects.
Effective:
December 31, 2020
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. (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. (c) State of emergency: During a state of emergency
declared by the governor, the provider may, in one delivery, deliver meals to
cover multiple mealtimes for consumers who received meals before the state of
emergency by per-meal delivery or periodic delivery. (2) Successful deliveries: The provider
shall only deliver meals to the consumer's home 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
written contingency procedures 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, 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) The provider shall
verify each meal delivery for which it bills the AAA using either an electronic
or manual system. Regardless of the system used, the provider shall collect all
the following information: (a) Consumer's name. (b) Delivery date. (c) Number of meals delivered. (d) A unique identifier of the consumer, the consumer's
caregiver, or the delivery person. (2) In the AAA-provider agreement, the
AAA shall not require the provider to use a particular system. Use of either
system is acceptable. (3) During a state of emergency declared by the governor,
the provider may verify each meal provided without collecting a unique
identifier of the consumer or the consumer's caregiver.
Last updated August 26, 2021 at 5:01 PM
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Rule 173-4-05.3 | Older Americans Act nutrition program: congregate dining projects based in restaurants or grocery stores.
Effective:
December 31, 2020
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 paragraph (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 a unique identifier of the consumer or the
consumer's caregiver. (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 a unique identifier
of the consumer or the consumer's caregiver. (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. (3) During a state of emergency declared by the governor,
the provider may verify each meal provided without collecting a unique
identifier of the consumer or the consumer's caregiver.
Last updated August 26, 2021 at 5:01 PM
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Rule 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 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) 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 indicates whether the consumer requires thickening agents in his or her drinks, soups, etc. and indicates whether the consumer requires a level-one (pured) 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.
Last updated August 26, 2021 at 5:01 PM
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Rule 173-4-07 | Older Americans Act nutrition program: nutrition counseling.
Effective:
December 31, 2020
(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. (4) Venue: (a) The provider shall conduct the initial counseling session in
person in the consumer's home. During a state of emergency declared by the
governor, the provider may conduct the initial counseling session by telephone,
video conference, or in person in the consumer's home. (b) The provider may conduct subsequent sessions by telephone,
video conference, or in person in the consumer's home. (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: (a) By one of the following two methods, the provider shall
verify that each consultation for which it bills was provided: (i) The provider may use an electronic system if the system
does all of the following: (a) 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. (b) Retains the information it collects. (c) Produces reports, upon request, that the AAA can
monitor for compliance. (ii) 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 signature of the licensed dietitian providing the consultation
and a unique identifier of the consumer. (b) During a state of emergency declared by the governor,
the provider may verify each episode of service provided without collecting a
unique identifier of the consumer. (C) Unit: A unit of nutrition counseling
equals fifteen minutes of counseling.
Last updated August 26, 2021 at 5:01 PM
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Rule 173-4-08 | Older Americans Act nutrition program: nutrition education.
Effective:
September 1, 2016
(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.
Last updated August 26, 2021 at 5:01 PM
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Rule 173-4-09 | Older Americans Act nutrition program: nutrition health screening.
Effective:
December 31, 2020
(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 in person as a stand-alone service or as part
of a nutrition project or nutrition counseling. During a state of emergency
declared by the governor, the provider may screen consumers by telephone, video
conference, or in person. (3) Checklist: The provider shall use
form ODA0010 to screen consumers for nutritional risks in person. During a
state of emergency declared by the governor, the provider may screen consumers
by telephone, video conference, or in person. (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.
Last updated August 26, 2021 at 5:01 PM
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Rule 173-4-10 | Older Americans Act nutrition program: grocery shopping assistance.
Effective:
October 29, 2020
(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 or III-E of the Older Americans Act, shall 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, shall 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) 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 a unique identifier of the consumer. (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) During a state of
emergency declared by the governor, the provider may verify each episode of
service provided without collecting the unique identifier of the
consumer. (C) Units: One unit of grocery shopping
assistance equals one-way transportation to or from a grocery
store.
Last updated August 26, 2021 at 5:01 PM
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Rule 173-4-11 | Older Americans Act nutrition program: grocery ordering and delivery.
Effective:
October 29, 2020
(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 or III-E of the Older Americans Act, shall 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, shall 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) For each episode of service, the provider to retain a record
of the consumer's name; service date; provider's signature; and
unique identifier of the consumer. (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) During a state of
emergency declared by the governor, the provider may verify each episode of
service provided without collecting the unique identifier of the
consumer. (C) Units: One unit of grocery ordering
and delivery equals one episode of grocery ordering and delivery.
Last updated August 26, 2021 at 5:01 PM
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