Nutrition Services Division Management Bulletin
|Purpose: Policy, Beneficial Information|
To: Child and Adult Care Food Program, Adult Care Agencies
Attention: Food Program Director
Date: October 2012
Subject: Adult Day Care Center Eligibility and Licensing/Approval
|Reference: U.S. Department of Agriculture Policy Memo CACFP 21-2012
|Supersedes: Child Care Food Program Adult Day Care Provisions: Operational Memorandum 3, 11, 15, and 16|
This Management Bulletin (MB) updates, clarifies, and condenses previous guidance addressing adult day care center eligibility and licensing/approval for the Child and Adult Care Food Program (CACFP). Please note, there are two additional MBs recently posted regarding adult day care, USDA-CACFP-19-2012 and USDA-CACFP-20-2012, which can be viewed on the CACFP MB Web page at http://www.cde.ca.gov/ls/nu/cc/mb.asp.
The U.S. Department of Agriculture (USDA) recently issued Policy Memo CACFP 21-2012, which supersedes the following USDA memoranda and guidance issued in 1989 as part of the Child Care Food Program Adult Day Care Provisions:
- Operational Memorandum 3—Center Eligibility, March 16, 1989
- Operational Memorandum 11—Medicaid as Approval, September 19, 1989
- Operational Memorandum 15—Title XX as Approval, June 9, 1989
- Operational Memorandum 16—Medicaid, June 9, 1989
The USDA guidance below also supersedes all previous California Department of Education (CDE) policy memoranda regarding adult day care center eligibility and licensing/approval.
Per Title 42, U.S. Code (U.S.C.) Section 1766(o)(1), adult day care centers are considered eligible institutions for reimbursement for meals served to persons sixty years of age or older, or to chronically impaired disabled persons in a nonresidential group setting. For purposes of determining CACFP eligibility, it is sufficient that such a center cares for elderly or functionally impaired adults. It is not necessary that the majority of the clients receiving care in the center be functionally impaired.
The purpose of the adult day care component of CACFP, as stated by the U.S. Congress in the Conference Report (House of Representatives 100–427) on the Older American Act Amendments of 1987, is to “assist its participants to remain in the community, enabling families and other caregivers to continue caring for an impaired individual at home.’’ It is clear that Congress intended CACFP benefits to be available to serve individuals attending adult day care while remaining in the community. Therefore, facilities that provide residential care are not eligible to participate in the CACFP with respect to those residential clients. This would include, but is not limited to, hospitals, nursing homes, residential facilities for the mentally ill or physically handicapped, convalescent homes, apartment complexes designed only for the functionally impaired that provide meals and full-time care, and hospice programs.
Additionally, sheltered workshops, vocational or substance abuse rehabilitation centers, social centers, or other types of centers do not qualify as adult day care centers for purposes of CACFP participation, since they are not operated primarily to provide day care to elderly and disabled adults in order to avoid premature institutionalization.
In order to participate in the CACFP, adult day care centers also must be licensed or approved by federal, state, or local authorities to provide adult day care services [42 U.S.C., 1766(o)(2)(ii)]. The CDE approves adult day care centers that are licensed by the California Department of Health Care Services and the Department of Social Services (Adult Day Care license), or the Department of Aging (Alzheimer’s Day Care Resource Center license).
Tribal authorities are considered local authorities for purposes of licensing or approval. Operation of a center by a tribal or local government is tantamount to “approval.” However, the center must be operated and funded by the state, tribal, or local government. This may be confirmed by a written assurance by a state, tribal, or local official.
Generally, the simple presence of public funding in an adult day care center does not constitute “approval.” Receipt of state or federal funds may constitute “approval” only when standards are established to ensure a safe and healthy environment for participants and funding authorities determine that, in order to receive the funds, these standards must be met. Receipt of Medicaid funds by an adult day care center meets these requirements and constitutes state approval for purposes of CACFP participation.
Those centers receiving public funding are required to implement a financial management system that can show that other public funding is not being used to support CACFP meals. Additionally, adult day care centers purchasing meals from other than clearly commercial vendors must make a determination that the meals they are receiving are not supported by other public funds. We encourage such centers to preserve other public funding for services they administer outside the meal service and not allow such funding to interfere with the integrity of their CACFP claims.
If you have any questions regarding this MB, please contact the CACFP Specialist assigned to your agency listed in the Download Forms section of the Child Nutrition Information and Payment System. You may also contact Robin Kraus, CACFP Unit Secretary, by phone at 916-327-2991 or by e-mail at email@example.com.