Transition to Community-Based Adult Services

Nutrition Services Division Management Bulletin
Purpose: Beneficial Information
To: Child and Adult Care Food Program Adult Day Health Care Sponsors	Number: NSD-CACFP-02-2012
Attention: Authorized Representatives and Program Directors	Date: February 2012
Subject: Information for Adult Day Health Care Centers Regarding the Transition to the Community-Based Adult Services Program
Reference: Title 7, Code of Federal Regulations parts 226.10(c) and 226.19a; Waiver 11-W-00193/9, “California Bridge to Reform Demonstration” Amendment

This Management Bulletin (MB) provides information to sponsors of Adult Day Health Care (ADHC) centers participating in the Child and Adult Care Food Program (CACFP) regarding the elimination of the ADHC benefit and the creation of the Community-Based Adult Services (CBAS) program.

Background

As part of the cost-cutting measures in the Fiscal Year 2011–12 California state budget, the state legislature approved reductions to Medi-Cal provider payments including payments for services provided by ADHC facilities. The California Department of Health Care Services (DHCS) has reached a settlement in the class action lawsuit that challenged elimination of the ADHC benefit. The settlement provides an option for continued delivery of essential health care services to individuals who had previously participated in ADHC programs. Under the settlement, the new CBAS program will replace ADHC services beginning March 1, 2012.

Currently, agencies operating ADHC centers may also participate in the CACFP and receive reimbursement for participants served at these centers. The elimination of the ADHC services as a Medi-Cal benefit and the creation of the CBAS program may create changes in these centers’ eligibility to participate in the CACFP. The Nutrition Services Division (NSD) anticipates that most agencies will continue their participation in the CACFP as a means to reduce the costs of serving nutritious meals.

Closing Agencies

Any agency that ceases operations is required to notify the NSD of their intent to cancel participation in the CACFP. Agencies should download and submit the Self-Cancellation Form (Form ID CACFP 42) from the Child Nutrition Information and Payment System (CNIPS), or send an e-mail or letter with the date of cancellation to the specialist assigned to their agency.

Non-profit ADHCs

Non-profit ADHCs that choose to become CBAS providers should experience little change in CACFP eligibility. If a non-profit ADHC chooses not to become a CBAS provider, but to continue operation as a private pay center, the agency will need to ensure that they have appropriate eligibility documentation for each enrolled participant. Because not all private pay participants will be automatically eligible for the free meal reimbursement rate, centers will likely see a decrease in the number of free participants and an increase in the number of participants who qualify at the reduced-price or base rate.

For-profit ADHCs

In order to claim CACFP reimbursement for meals served, Title 7, Code of Federal Regulations Part 226.10(c) requires that for-profit ADHCs participating in the CACFP must document each month that at least 25 percent of their enrolled eligible participants at each participating center are beneficiaries under Title XIX or Title XX. With the elimination of the ADHC services as a Medi-Cal benefit, for-profit agencies must ensure they continue to meet this monthly requirement for each of their participating centers.

Questions