CACFP Administrative Manual Section 3.3CACFP Administrative Manual Section 3.3: Adult Day Care Centers Reimbursement Determination.
Section 3: Centers Reimbursement Determination
Section 3.3: Adult Day Care Centers Reimbursement Determination
An ADC center can have enrolled adults that are either eligible or not eligible to participate in the CACFP, depending on the age and residency of the adult. The ADC center must determine which enrolled adults are eligible for the CACFP and distribute Meal Benefit Forms (MBFs) to them.
The MBF allows ADC centers to determine the meal reimbursement category of adult participants. The number of adult participants by reimbursement category (free, reduced-price, and base), in conjunction with the claimed meals, serve as the basis for the monthly reimbursement claims.
ADC centers must maintain a current, complete, and certified MBF for each adult participant claimed in the free or reduced-price eligibility category. When distributing MBFs to families, center staff must also distribute the Letter to Households to inform the adult or adult household member of the procedures regarding eligibility for free and reduced-price meals. A copy of the adult MBF and Letter to Households can be found in the Download Forms section of the CNIPS.
An ADC center may determine a participant to be eligible for free or reduced-price meals according to one of two methods: categorical eligibility or income eligibility.
Categorical Eligibility for Free Meal Reimbursement
An adult participant is categorically eligible for free meal benefits if he or she receives any one of the following:
- CalFresh benefits
- Food Distribution Program on Indian Reservations (FDPIR) benefits
- Supplemental Security Income (SSI)
The adult MBF for a categorically eligible adult must contain the following information:
- Name of the participant
- Case number for CalFresh, FDPIR, SSI, or Medicaid/Medi-Cal
- Signature of the participant/adult household member
Household income and the last four digits of the participant’s social security number (SSN) are not required. Center officials must certify the adult as eligible for free meals by signing and dating the application. If any of the required information is missing from the MBF, or if the MBF is not returned, the center must claim the participant at the base rate.
The CDE no longer accepts alternative documentation for categorical determinations. All participants claimed at the free or reduced-price rate must have a valid MBF on file. For further information, please see MB CACFP-02-2016: Participant Eligibility Record for Adult Day Care located on the CDE CACFP MB web page.
A participant is income-eligible for meals reimbursed at the free or reduced-price rate if the individual’s family or household size and income, as stated on the MBF, are within the USDA Income Eligibility Guidelines. The current USDA Income Eligibility Guidelines can be found in the Download Forms section of the CNIPS.
A complete adult participant MBF must contain the following household information:
- The participant’s name and source/frequency of income, if applicable.
- The names of the other household members and their source/frequency of income, if applicable. An ADC household is defined as the adult participant, the spouse and any dependents that reside with the adult participant. Functionally impaired adults living with their parents are considered a family separate from their parents for the purpose of determining family size and income.
- The last four digits of the SSN of the adult household member completing the MBF, or, if applicable, the box Check here if no SSN should be checked.
- Signature of the participant/adult household member.
The MBF also must contain the center’s certification, which consists of the following:
- Certification that the participant is 60 years of age or older, or that the participant meets the functional impairment eligibility requirements
- The participant’s type of residence
- Total household income
- Certification of eligibility status: free, reduced-price, or base
- Signature of the eligibility official
- Certification date for eligibility
If any of the required information is missing from the MBF, or if the household does not submit a MBF, the participant must be claimed at the base rate.
Participant Eligibility Determinations and Duration
For ADC centers, the eligibility effective date may either be:
- the date the participant or adult household member signs the MBF; or
- the date the MBF was certified by an agency official.
If an ADC center uses the participant or adult household member signature date, this date must be within the month of certification or the immediately preceding month, otherwise the effective date must be the date of certification. For example, if a participant signs an MBF on February 1, and the agency completes certification on April 1, the effective date must be April 1.
MBFs are valid until the last day of the calendar month in which they were originally dated one year earlier. For example, an MBF that was certified by an agency official on October 10, 2016, is valid from October 1, 2016, to October 31, 2017. A household is not required to report an increase in income or a decrease in household size, or ineligibility for benefits, during the calendar year.
Participants that Decline the Child and Adult Care Food Program
If eligibly enrolled adults do not wish to participate in the CACFP, it is only a best practice for the ADC center to obtain a Decline Participation in the CACFP form which is located in the Download Forms section of the CNIPS. These eligibly enrolled adults must still be included on the eligibility roster and, if using the fixed percentage claiming method, in the fixed percentage calculation. In the calculation, the declining participants would be in the base reimbursement category unless they have valid MBFs that qualify them for free or reduced price meals.
Adult Day Care Center Eligibility Roster
After an ADC center has determined the enrolled adults that can participate in the CACFP, and the reimbursement eligibility for each, the center’s staff must create a roster. The roster must list all the enrolled adults in their care, both CACFP eligible and noneligible.
For the eligible adults, or adult participants, the ADC must identify each participant’s reimbursement meal category.
The eligibility roster must include:
- the month and year the roster was created;
- each enrolled adult’s name, eligible and not eligible;
- If the enrolled adult is eligible to participate, the certified reimbursement category (free, reduced-price, or base) and categorical determination, if applicable.
- the total number of adult participants in each category; and
- the total number of enrolled adults at the site.
A sample adult eligibility roster can be found in the Download Forms section of the CNIPS.
Centers using the fixed percentage claiming method must develop a roster each October and for any other months in which the enrollment, eligibility, or both must be updated on the claim for reimbursement. Centers using the actual count claiming method must develop a roster each month. All for-profit agencies, regardless of claiming method, must develop a roster for each site for every month they submit a claim. More information regarding claim for reimbursement submission can be found in Section 5.1 of this manual.
Eligibly Enrolled Adult: An adult enrolled in an ADC that is 60 years of age or older. If under the age of 60, the participant must be functionally impaired with a plan of care. This definition includes adults who are eligible, but do not wish to participate in the CACFP.
Noneligibly Enrolled Adult: An adult enrolled in an ADC that is under the age of 60 without a functional impairment and plan of care.
References: 7 CFR, sections 226.2, 226.15(e)(2), 226.19a(b)(8), 226.23(e), and 226.23(f); MB CACFP-02-2016 Participant Eligibility Record for Adult Day Care, MB CACFP-01-2015 Guidance on Income Eligibility Determinations and Duration, and MB 00-210 Establishing Eligibility for Free Meals; USDA Adult Day Care Handbook