HomeMy WebLinkAboutNutrition Advisory Council - Agenda - 8/21/2024
(715) 373-6144 Phone/TDD • (715) 373-6130 FAX • www.bayfieldcounty.org • baycodhs@bayfieldcounty.org
Department of Human Services
117 East Fifth Street
P.O. Box 100
Washburn, WI 54891-0100
FROM: Carolyn Novack, Aging Services Coordinator
DATE: 08/21/24
RE: Meeting Notice
The Bayfield County Department of Human Services Nutrition Advisory Council will meet at
11:00 on Wednesday August 21, 2024, at the Port Wing Congregate Meal Site, First Lutheran
Church, 83105 Washington Ave, Port Wing, WI, 54865.
Participation via remote access is available by phone by calling +1 715-318-2087 at the start of
the meeting and entering participant code, 453 687 237 followed by the # sign. Committee
members will receive an invitation via Microsoft Teams.
Notice is hereby given, in the event the standing committee does not have a quorum, the
County Board Chair or Vice Chair may act as an ex officio member (County ordinance, Chapter
3, section 2-3-1(c)).
Any person wishing to attend who, because of a disability, requires special accommodation should contact the
Department of Human Services at 715-373-6144, at least 24 hours before the scheduled meeting time so
appropriate arrangements can be made.
The agenda includes: Call to Order and Introductions; Discussion and Possible Action-
Review of the May 16, 2024, Meeting Minutes; Preliminary Discussion about Nutrition Goals
for the 2005-2007 Aging Unit Plan; Dining Site Hospitality Reviews – report back from
Council members; Program Reports: Congregate Meals, Home Delivered Meals; Other
(Informational Items); Future Meeting Dates, Motion to Adjourn.
cc: Post (bulletin board and website)
E-Mailed:
Dennis Pocernich, County Board Chair
Mark Abeles-Allison, County Administrator
Lynn Divine, County Clerk
Human Services Board
Elizabeth Skulan, BCDHS Director
Management Staff
Anne Marie Coy, Health Dept. Director
Greater Wisconsin Agency on Aging Resources, Inc. (GWAAR)
DCS, Rhinelander
Red Cliff-Tribal Chair
Daily Press
K:\Agends and Minutes\A&D Nutrition Advisory Council \Notices\NAC Meeting Notice-8/21/24
(715) 373-6144 Phone/TDD • (715) 373-6130 FAX • www.bayfieldcounty.org • baycodhs@bayfieldcounty.org
Department of Human Services
117 East Fifth Street
P.O. Box 100
Washburn, WI 54891-0100
BAYFIELD COUNTY DEPARTMENT OF HUMAN SERVICES
NUTRITION ADVISORY COUNCIL
Frances Renn-Malcheski (Chairperson) Sue Aiken (Vice-Chairperson) Fred Strand
RE: August 21, 2024, Nutrition Advisory Council Meeting
Dear Council Members:
The Bayfield County Department of Human Services Nutrition Advisory Council will meet at
11:00 on Wednesday August 21, 2024, at the Port Wing Congregate Meal Site, First Lutheran
Church, 83105 Washington Ave, Port Wing, WI, 54865.
Participation via remote access is available by phone by calling +1 715-318-2087 at the start of
the meeting and entering participant code, 453 687 237 followed by the # sign. Committee
members will receive an invitation via Microsoft Teams.
Notice is hereby given, in the event the standing committee does not have a quorum, the
County Board Chair or Vice Chair may act as an ex officio member (County ordinance, Chapter
3, section 2-3-1 (c)).
Any person planning to attend who, because of a disability, requires special accommodation,
should contact the Department of Human Services at 715-373-6144, at least 24 hours before
the scheduled meeting time, so appropriate arrangements can be made.
Microsoft Teams
Join the meeting now
Meeting ID: 296 931 250 086
Passcode: 7UCHDo
Dial in by phone
+1 715-318-2087, United States, Eau Claire
Phone conference ID: 453 687 237#
Department of Human Services
117 East Fifth Street
P.O. Box 100
Washburn, WI 54891-0100
The agenda for the meeting is as follows:
AGENDA
1. Call to Order and Introductions
2. Discussion and Possible Action-Review of the May 16, 2024, Meeting Minutes
3. Preliminary Discussion about Nutrition Goals for the 2005-2007 Aging Unit Plan
4. Dining Site Hospitality Reviews – report back from Council members
5. Program Reports:
Congregate Meals
Home Delivered Meals
6. Other (Informational Items)
7. Future Meetings:
October 21, 10:45 at the Cable Meal Site
8. Motion to Adjourn
Join us for the Senior Lunch afterward at 12:00 p.m.
Carolyn Novak, Elder Nutrition Program Supervisor
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BAYFIELD COUNTY DEPARTMENT OF HUMAN SERVICES
THE NUTRITION ADVISORY COUNCIL
Barnes Meal Site, Barnes Town Hall
May 16, 2024, at 11:00 a.m.
Committee Members Present: Karen Anderson, Frances Renn-Malcheski, Sue Aiken, Lynette
Benzschawel, Fred Strand
Others Present: Carolyn Novak, Jim Crandall
Call to Order and Introductions
Benzschawel called the meeting to order at 11:05 a.m.
Discussion and Possible Action-Review of the February 27, 2024, NAC Meeting Minutes
Motion by Renn-Malcheski, seconded by Aiken to approve the corrected meeting minutes of February 27,
2024. Motion passed.
Membership Updates:
County Board Supervisor, Madelaine Rekemeyer, has resigned from the NAC due to other obligations. She is
being replaced by Supervisor Fred Strand. Both Karen Anderson and Chairperson Lynette Benzschawel, are
going off the NAC because their 2nd terms have expired. This leaves 2 openings for community members. New
members will be recruited from outlying areas of the county to provide representation from underserved
communities.
Carolyn Novak and Carrie Linder will start the recruiting process ASAP.
Discussion and Possible Action-Election of Chairperson
Benzschawel needs to be replaced as NAC Chairperson because she is leaving the Council. Nominations for the
new chair were limited to Renn-Malcheski. She accepted the nomination and was voted in unanimously.
Motion by Anderson, seconded by Benzschawel to approve Renn-Malcheski as Chairperson. Motion passed.
Discussion and Possible Action-Election of Vice Chairperson
Since Renn-Malcheski moved up from Vice Chair to Chair, the Vice Chair position was left vacant. Nominations
for the new Vice Chair included Aiken. Aiken was voted in unanimously.
Motion by Benzschawel, seconded by Anderson to approve Aiken as Vice Chairperson. Motion passed.
ENP goal development for the 2025-2027 Aging Plan
A new 3-year aging plan is being developed for approval later this summer. Assessment surveys have been
collected and listening sessions are being held around the county. Survey results are currently being tallied.
The plan requires at least one goal developed for the nutrition program. Goal ideas will be discussed at the
next NAC meeting.
Dining Site Hospitality Review Orientation
New dining site hospitality review forms were introduced to NAC members. As discussed in previous meetings,
it was determined that all NAC members would do at least 1 hospitality review at one of the congregate meal
K:\Agendas and Minutes\A&D Nutrition Advisory Council\NAC minutes\2024-05-16-NAC Meeting-CN.doc 2
sites. The review includes how people are welcomed, site features (easy parking, accessible bathrooms),
rating of the food and volunteers/site managers. NAC members were asked to choose a site other than one
they might go to regularly and to have the review completed by the end of summer. Anderson and
Benzschawel volunteered to complete an assessment even though this is their last council meeting.
Some NAC members signed up for sites, others are checking their availability and will let Novak know their
preferences.
Cornucopia – Fran Renn-Malcheski
Iron River – Sue Aiken
Port Wing – Lynette Benzschawel
Time Out – Karen Anderson
Program Reports:
Congregate Meals – Chartwells, the main food vendor for Bayfield County and Ashland County Senior
Meals, is in negotiations with Northland College administrators about the future of Chartwells at
Northland. Chartwells is supposed to provide a 60-day written notice if they are ending their contract
with Bayfield County, however, it seems unlikely they will do so. As a backup plan, Bayfield County can
move all current Chartwells meal production to the Bayfield County Jail kitchen. Discussions are
underway on what that may look like.
The new Cable site is open and running well with an average participation number of 40-45 people per
meal. Barnes is also doing well – going from 2-3 people last year to about 20 participants per meal. Iron
River changed food vendors and will continue to be monitored for participant satisfaction. Time Out,
St. Louis and Cornucopia numbers are increasing as people return from winter vacations. Port Wing has
increased and is holding steady.
Home Delivered Meals –Bob Marx, meal route driver, recently retired. His position will be re-evaluated
before posting. Marx does have a long-term substitute taking his place. Another driver will be taking a
summer sabbatical, but his route will be covered by a long-term substitute. Ads have been posted for
substitute drivers.
Other (Informational Items)
Renn-Malcheski will be trained to implement the “Mind over Matter” bladder and bowel curriculum
for older women. The training will be done online. Renn-Malcheski will work with the office to set up
classes in Bayfield County.
A&D will have an outreach booth at the South Shore EMS Expo on Saturday, May 18 at the Community
Center in Port Wing. Both congregate and home delivered meal information will be promoted at the
event, along with other department services.
WEAAD (World Elder Abuse Awareness Day) occurs annually on June 15th. This year, A&D staff will host
a Senior Empowerment Day at the Iron River Community Center on Friday, June 14 from 8:30 a.m.-
12:30 p.m. Speakers will be addressing a variety of topics, including financial frauds and scams. Door
prizes and lunch will be offered. The event is free!
Future Meetings:
August 21, 11:00 at the Port Wing Meal Site
October 21, 10:45 at the Cable Meal Site
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Benzschawel adjourned the meeting at 12:00 noon.
Minutes respectfully submitted by Carolyn Novak
GWAAR Nutrition Team 7-23-24 FINAL
Technical Assistance Document: GWAAR Service Area Meal
Prioritization/Waitlist Local Considerations & Actions Needed
Local programs shall utilize the Right Meal & Services for You Form & Process and the supporting
materials provided by GWAAR if implementing a Meal Prioritization and/or Waitlist. This process has
been reviewed and approved by BADR and aligns with the requirements in the Nutrition Services Aging
Operations Manual. This guide will assist you in adopting this process, as some local decisions need to be
made when implementing this process. You can access the required score form, editable templates,
training materials, and supporting documents on the GWAAR Partner Resources-External Site in the
Nutrition Library- Meal Prioritization Folder. Reference for this document: Nutrition Services Aging
Operations Manual P-03062-38 (04/2024) WI Dept of Health Services (pages 8, 19, 25-27, 54). (See
Appendix A for full text). If you have any questions, please contact your regional GWAAR Nutrition Team
Representative, they will be happy to assist you. The GWAAR Nutrition Team
Reasons for adopting this process:
If demand appears to, or does exceed capacity, or if you want to avoid a waitlist, or pivot to offering
person-centered tailored nutrition options that meet people where they are, i.e. the Right Meal for You.
1. First, Local agencies will ensure that everyone on their HDM program meets the eligibility
criteria by completing initial assessments or annual reassessments before a waiting list/meal
prioritization process is considered.
2. If it is found that the demand for program resources exceeds funding, staff, volunteers, or other
capacity issues a local waiting list or meal prioritization process will be implemented.
3. If you want to begin or continue offering Carryout or Grab-N-Go meals, using this process fulfills
the requirements of the Nutrition Services Operations Manual.
If you are going to adopt & implement this process locally, you must notify your GWAAR Nutrition Team
Representative by completing the Notification Form
Local Implementation:
Local programs have the flexibility to decide who will complete the Right Meal & Services for You Form
(Meal Prioritization/waitlist) and determine what interventions you can offer. Programs can adapt or
combine any of the following methods of implementation:
1. Support Staff-Complete HDM Inquiry Form over the phone.
o After completing the form over the phone, if they are eligible for Carry Out or HDMs, the
support staff can offer to fill out the appropriate registration form with them while on
the call. OR ask if they would like to schedule a follow-up call with them or the HDM
Assessor to complete the registration form. AND/OR
Older Americans Act program area (Select a program area if applicable.)
☐Title III-B Suppor ve Services
☒Title III-C1 and/or III-C2 Nutri on Program
☐Title III-D Evidence-Based Health Promo on
☐Title III-E Caregiver Supports
Aging Network value (Select a value if applicable.)
☒Person centeredness
☒Equity
☐Advocacy
Goal statement:
1. Why are we choosing this thing to focus our efforts on?
2. Why do we believe this par cular effort will make things be er?
3. How do we think this leads to people being be er off?
4. How will we know when we’re done with this effort?
5. How will we know whether anyone is be er off because of this effort?
Bayfield County has a Meal Priori za on policy and a Wai ng List policy. Both need to be
updated to reflect new informa on and resources available. Staff reorienta on and
orienta on regarding both processes is also necessary. By u lizing the GWAAR Person-
Centered Meal Priori za on Process, we can implement a standardized process to assess
individual needs and offer resources to best meet personal goals.
Plan or strategy:
By 10/01/2025 staff will implement the GWAAR Person-Centered Meal Priori za on Process
to op mize the delivery of meals and related services within the OAA Nutri on Program. This
will ensure that individuals with the highest nutri onal needs are being served within the
means of program resources while also offering person-centered services to those with
moderate to low needs that meet the individual where they are to op mize their nutri on
status and enhance their quality of life.
Nutri on resource op ons will be tailored to meet individual needs, providing appropriate
nutri on and suppor ve services that are grounded in person-centered prac ces and
equitable to all by ensuring transporta on needs and financial burdens are met.
DRAFT
Preliminary ideas about documen ng efforts and tools:
The Meal Priori za on policy and Wai ng List policy will be updated between
October and December of 2024.
Nutri on resources will be developed between by March 1, 2025
Staff and commi ee members will be informed and trained on the updated processes
by April 1, 2025.
The new process will be implemented for all new par cipants beginning May 1, 2025.
The new process will be implemented for reassessments when they begin in June
2025.
How well it has been done:
Data will be recorded as directed by GWAAR and BADR and analyzed quarterly for
service delivery trends by need category, scope of u liza on, and overrides.
o Assess # par cipants who are short term (less than 3 months), High, Moderate
and Low need to be er understand the demand.
o Addi onal services and referrals will be offered to 50% of par cipants to
demonstrate person-centered planning.
Assessing whether anyone is be er off:
Processes will be established and implemented to ensure par cipants at each level of need
are being monitored and reassessed to prevent decline. In addi on, surveys to par cipants
and staff will measure their level of sa sfac on with the new process.
Within 4 to 12 weeks follow up with the par cipant will occur to see how their plan
is working and if referrals have been completed and addi onal programs/services
started.
Provide a Sa sfac on Survey to the par cipant. The intent is to see if anyone is
be er off and to iden fy strengths and opportuni es for improvement. (This should
be provided within 4-12 weeks of ini al contact). Survey results will be entered via
this link The goal is to have 80% return rate.
Bayfield County will provide input about the new process via this link
Staff will provide input by comple ng the Right Meal & Services for You process
Sa sfac on Survey via Staff Sa sfac on Survey Link
Time Added to the assessment process: Goal 80% of staff will note no or negligible
me addi on.
GWAAR Nutrition Team 7-23-24 FINAL
2. Assessor-Completed Prioritization and Notification
o The HDM Assessor completes the HDM registration form. If the participant is eligible for
HDMs, the Assessor also completes the Right Meal & Services for You Form and informs
the participant of the number of meals and other interventions they qualify for. We have
sample scripts and conversation tips for HDM assessors available. AND/OR
3. Assessor-Completed Prioritization and Deferred Notification
o The HDM Assessor completes the registration form and, if the participant is eligible for
HDMs, completes Steps 1 and 2 of the Right Meal & Services for You form. The
participant is informed that they will be notified within a specified number of days about
the number and type of meals and other interventions they qualify for. The Assessor
then discusses the case with the local director or designee, who decides on the number
of meals and interventions to offer. A process must be in place for communicating this
decision to participants (sample letters are available in the Meal Prioritization folder on
the Nutrition – EXT SharePoint site). AND/OR
4. Director-Completed Prioritization and Notification
o The HDM Assessor completes the registration form and informs the participant that
they will be notified within a specified number of days about the meals and other
interventions they qualify for. The Assessor then discusses the registration form with the
local nutrition director or designee, who completes the Right Meal & Services for You
form and determines the number and type of meals and other interventions to offer. A
process must be in place for communicating this decision to participants.
By implementing these methods, local programs can ensure an efficient and clear process for prioritizing
meal services and communicating eligibility and interventions to participants.
INTERVENTIONS
a. You can use Version 1, or Version 2 of the Right Meal & Services for You Form, the difference is on
how the Intervention section is laid out.
b. Customize this section of the form to reflect the innovations, programs, services, and referrals you
offer. Define the interventions for each need level or adopt a person-centered approach and decide
on a case-by-case basis. Consider the following when determining interventions.
• Meal Allocation Strategy:
o Will you assign a specific number of meals to each need category, or will you adopt a
person-centered approach and base it on individual needs or a hybrid of both?
• Implementation Scope:
o Will you keep all current participants on the program and inform them about the new
process during reassessment, or will this new process only apply to new participants?
GWAAR Nutrition Team 7-23-24 FINAL
Intervene
Keep in mind, that we are trying to determine what type of meal service, or combination of meal service
and supportive services can best support the nutrition security, socialization, and wellness of the
individual to align with the intent of the OAA. In collaboration with the participant, offer interventions
that align with their level of need and situation.
Refer to the Right Meal & Serviced for You Decision Tree and the If this, then that guide HDM Assessor
Conversation Guide to help train HDM Assessors. Both of these documents can be placed on their
clipboard as a quick reference. In alignment with the purpose of the OAA, all individuals requesting
nutrition services should be provided with additional resources and referrals to other organizations
and/or services within your agency that might assist in meeting their needs. Aging units and providers
should develop relationships with key stakeholders and partners in their communities to meet the
growing and ever-changing needs of older adults.
Will You Provide Additional Meals and if so what type?
If yes, include them on Step 3-Interventions on the Right Meal and Services for You form.
1. Programs may provide two or three meals per day, seven days per week, to those who need
them and/or have no other assistance with their nutritional needs. (High Need Category).
2. When resources permit, additional HDMs may be offered on a voluntary contribution basis.
3. Approval from the program nutritionist is required for providing additional meals.
HDM Verbal Consent to Share Information Form
If you are going to make referrals outside of your agency, we strongly suggest you obtain verbal consent
from the participant to share information. We have a template available however, be sure to discuss with
your local corp. counsel and follow their advice and your local policies and procedures. The HDM
Assessor would check the Verbal Consent box on the form if verbal consent were given. If no consent is
given, inform the participant that only the interventions noted that are offered by your agency will be
made since we need their consent to share with entities outside of our office. (I.e., VA officer, Center for
Independent Living, etc.).
Referrals and Person-Centered Plan
• Follow through with the intervention plan. We have a sample 1-page Services and Referral
Summary form for consideration. Record in the state database notes as directed by GWAAR.
• Review and Update the Right Meal & Services for You Nutrition Plan Tri-fold brochure to
include the interventions you can offer locally. Then be sure each person receives a copy of the
brochure as it summarizes their nutrition plan. Leave the brochure with the participant for their
records.
GWAAR Nutrition Team 7-23-24 FINAL
• Provide other information as appropriate based on the assessment. I.e., Nutrition,
Socialization, Wellness brochure, Emergency Preparedness information and handouts, Social
Connectedness, Falls Prevention resources, etc. Supporting materials can be found in our
GWAAR Partner Resources-External Site in the Nutrition Library- Meal Prioritization Folder ub
the Forms and Supporting Documents and Options Supporting Materials Folders.
Holding or Discontinuing Service
Define Situations when applicants may remain active on home-delivered meals, while not receiving
meals: (for example)
• The individual is temporarily a resident of a hospital or nursing home (Less than 2 weeks), OR
• The individual has a temporary caregiver who is assisting with meals (less than 2 weeks).
Discontinued Service:
• An individual shall be discontinued from the HDM program when they no longer meet the
eligibility criteria. They will be provided with appropriate referrals and options as noted above.
• The date HDMs were discontinued, and the reason shall be documented in the state database.
• Senior Dining and/or Carryout meals will be offered as appropriate and available.
Data:
If you are using the Right Meal for You Tool, please record at this link as well as in the required
statewide database. More details forthcoming.
• Data will be analyzed quarterly for service delivery trends, client outcomes, scope of utilization,
etc.
Follow-up & Evaluation
• Within 4 to 12 weeks contact participant to see how their plan is working and if referrals have
been completed and additional programs/services started.
• Provide a Satisfaction Survey to the participant. We have developed a half-page cover sheet
with a QR code embedded that can be provided with the 1-page Satisfaction Survey. The intent
is to see if anyone is better off and to identify strengths and opportunities for improvement.
(This should be provided within 4-12 weeks of the process). Please enter the survey results at
this link.
• Local programs can provide continuous input about the process at this link.
• Staff Satisfaction Survey: We encourage you to have whoever is completing the Right Meal &
Services for You process complete this survey so we can obtain valuable input. Staff Satisfaction
Survey Link
GWAAR Nutrition Team 7-23-24 FINAL
• If a participant or family member is dissatisfied with the process and services offered.
o Follow your local Appeal/Grievance Process/Complaint policies and procedures.
o Provide them with the Advocacy letter template.
o See sample letter for inquiries related to the new process.
o Templates for the letters noted above are available on GWAAR Partner Resources-
External Site in the Nutrition Library- Meal Prioritization Folder in the Forms and
Supporting Documents Folder.
Caregiver Meals
Be familiar with the guidelines related to Caregiver Meals: Receiving a meal for the caregiver as part of
their caregiver plan through AFCSP or NFCSP. There is a learning module in the Meal Prioritization
Folder and in the Optional Supporting Materials folder on our Nutrition SharePoint location.
o Note: NFCSP can only be used for meals to a caregiver who does not already qualify
under the C1 or C2 contracts otherwise their meals must be applied to C1 and C2 and
not the caregiver program. This also applies to using NFCSP money for nutrition
counseling or nutrition education.
o 2019 AFCSP Policy Elder Nutrition Services memo
Fee For Service/Private Pay Full-Cost Meals: (Full cost should be recovered for meals, do not use OAA
funds)
From Section 212 of OAA: Agreements may not "result in the displacement of services otherwise
available to an older individual with greatest social need, an older individual with greatest economic
need, or an older individual who is at risk for institutional placement; or (4) in any other way
compromise, undermine, or be inconsistent with the objective of serving the needs of older individuals, as
determined by the Assistant Secretary."
❑ Willing to pay full cost for the meal while on the waitlist. OR
❑ If the person is enrolled in Family Care, IRIS, or the Insurance Plan includes HDMs. Since these are a
source of revenue and additional support offered through these programs, meals may be provided at
the discretion of the local program. Local programs are not required to provide meals for Family
Care, IRIS, or other entities. If a person was receiving meals through the MCO and there was a
change and the meals are no longer authorized and included in their plan but the participant still
wants to receive meals, here is the process to follow:
❑ Refer to their MCO case manager to authorize or understand more about why HDMs at full
cost are no longer being offered.
❑ Provide ombudsman contact information as appropriate to the participant.
GWAAR Nutrition Team 7-23-24 FINAL
❑ Refer participant/legal guardian to Care Manager for eligibility and authorization.
❑ If you have concerns or issues with MCO meals, please email Sara Koenig DHS
SaraS.Koenig@dhs.wisconsin.gov, and cc: your GWAAR Nutrition Team representative.
Please include the name of the MCO and any specific instances (individual-related), thank
you!
❑ Refer to the insurance company to authorize meals, as applicable.
❑ Keep in mind that OAA is the payer of last resort and should not be funding these services.
❑ According to federal Medicaid guidance, “Medicaid is generally the ‘payer of last resort,’
meaning that Medicaid only pays claims for covered items and services if there are no
other liable third party payers for the same items and services.” However, “Medicaid will
pay for a service if there is another party that may—but is not legally obligated to—pay
for the service. […] Under the OAA, there is a source of funding to cover some services
that are also covered by Medicaid. Individuals, however, are not legally entitled to
receive services through the OAA, and thus the OAA program has no legal obligation to
cover those services. Since the OAA program is not legally liable for the service, the OAA
does not fall within the definition of ‘third party.’ Accordingly, Medicaid will pay for a
service even if the OAA program would also pay for the service.”
Waiting List
If the program is operating at capacity (due to financial and/or route availability & capacity) and there is
currently a waiting list for Title III-C nutrition services, nutrition programs will offer placement on a
waiting list to eligible individuals. The decision to place eligible recipients of a meal on a waiting list, and
their position on such a list, is based on the greatest social and economic need. Local programs will
utilize the “Right Meal & Services for You” Form to determine the level of need.
Process: Adding/Removing an individual to/from the Waitlist.
• Assessment:
o Advise new individuals a Meal Prioritization and/or Waitlist process is in effect.
o First, complete the HDM Registration form for all new individuals requesting home-
delivered to determine if they are eligible for HDMs. Note: This can be done over the
phone initially to determine if they qualify so meals can begin.
o If they are eligible to receive meals, then set up a call to complete the “Right Meal &
Services for You” form to determine their Priority Level Nutrition Plan utilizing the
tools created by GWAAR.
o Document the individual's determined priority level (High, Moderate, or Low) at this
link as well as in the required statewide database. (More details forthcoming) and
offer appropriate meal options.
GWAAR Nutrition Team 7-23-24 FINAL
o Complete in-home assessment within 12 weeks to better assess the individual's
situation. Adjust priority level and/or services offered as appropriate.
• Notification:
o Inform individuals if they are eligible for meals or of their placement on the waiting
list and their position based on prioritization criteria.
o Provide an estimated time limit that they will be on the waitlist.
o Provide information on available private-pay options.
• Waitlist Management:
o Define the process for how often you will check in with individuals on the waitlist
and what services you will provide to them. At a minimum, you are required to
provide:
▪ Senior Dining Site locations
▪ Participants placed on a waitlist must be provided with Senior Dining
locations along with other food/meal options. Here are two Templates for
local communities to use. Food Related Resources Template & Additional
Meal and Food Support Template
o The waitlist will be reviewed at least quarterly to re-evaluate the individual's status.
This can be done by trained staff or volunteers via phone or in person to determine
if the person’s status or situation has changed.
• Removable from the Waitlist.
o Eligible persons will be removed from the HDM waitlist and receive meals as there is
availability of funding, route space, or route availability. People will be removed
from the waitlist based on the established need categories defined earlier, high need
served first, followed by moderate need, then low need. If someone is enrolled in
Family Care of IRIS, they will receive the lowest priority for services.
o A person can request a rescreen of their Priority level placement at any time if there
has been a significant change in condition.
Compliance: This policy and procedure document ensures that services are prioritized effectively,
waiting lists are managed fairly, and private-pay systems are implemented transparently while adhering
to the guidelines of the Older Americans Act.
GWAAR Nutrition Team 7-23-24 FINAL
Appendix A: Reference: Nutrition Services Aging Operations Manual P-03062-38
(04/2024) WI Dept of Health Services ((pages 8, 19, 25-27, 54).
Prioritization of services
When nutrition program resources are fully committed and the program is unable to provide meals to all
eligible individuals on a contribution basis, it may become necessary to determine priorities of service or
to create waiting lists for services.
As long as the intent of the OAA remains intact, the OAA allows states, AAAs, and/or service providers to
create prioritization systems, create waiting lists if necessary, and seek payment for meals by establishing
contracts and/or offering private-pay meals for eligible individuals who might otherwise be placed on
waiting lists.
AAAs may develop prioritization systems for their service area if systems are reviewed by BADR before
implementation. Any prioritization systems developed by aging units or providers must be submitted to
the AAA for review and approval before implementation. Tools used in prioritization must be user
friendly, fair, and reliable and target services to eligible individuals who are in greatest social and
economic need, as required by the OAA, with particular attention to older adults who are:
• Individuals with low incomes.
• People of color.
• Residents of rural communities.
• Individuals with limited English proficiency.
• Individuals at risk of institutional care.
In addition to the targeting requirements above, nutrition programs should use factors obtained through
screening processes as criteria for prioritization, such as:
• Food security and/or geographic access to food.
• Malnutrition risk.
• Nutrition risk score.
• Functional status (limitations in Activities of Daily Living and Instrumental Activities of Daily Living).
• Transportation access.
• Living situation (whether an individual lives alone or faces housing insecurity).
• Availability of other supports and services.
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Waiting lists
If the program is operating at capacity and there is currently a waiting list for Title III-C nutrition services,
nutrition programs will offer placement on a waiting list to eligible individuals. The decision to place
eligible recipients of a meal on a waiting list, and their position on such a list, is based on greatest social
and economic need in accordance with the OAA and the prioritization and waiting list procedure
established by the nutrition program in consultation with the AAA. Each waiting list procedure
established by the nutrition program must be submitted to the AAA for review and approval before
implementation so that AAAs can review service resource usage and efficiency, offering technical
assistance if necessary. AAAs will communicate status of their aging units’ and/or providers’ waiting lists
to BADR at least quarterly.
Fee-for-service, private-pay systems
Private-pay systems, for which the older adult or their payor agrees to pay to receive services, are
separate from programs funded under the OAA. Nutrition programs may develop private-pay systems,
but funds provided under the OAA may not be used to support private-pay programs or any other
services for which fees are required. Meals served to clients participating in a fee-for-service, private-pay
option may not be reported as NSIP meals in the National Aging Program Information System (NAPIS)
state program report.
Private-pay programs offered by agencies cannot compromise core responsibilities under the OAA. All
individuals eligible for OAA services must be offered the opportunity to receive OAA services on a
contribution basis. If an OAA nutrition program is at capacity, the nutrition program must give eligible
individuals the opportunity to be placed on a waiting list to receive OAA services. After the eligible
individual is either placed on the waiting list or declines placement on the waiting list, the individual can
be offered available private-pay options. Agencies will ensure that no eligible individual is pushed into a
fee-for-service, private-pay option or denied service due to the inability to contribute toward the cost of a
meal.
Additional meals
When sufficient funding and resources are available, programs may offer additional HDMs to
participants on a voluntary contribution basis. Provision of such meals requires approval from the
program nutritionist.
Carryout meals
Individuals for which carryout meals might be particularly appropriate include those who meet the
eligibility criteria above but who might not require a meal delivered to their residence. Examples include
individuals who:
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• Are unable to consume meals at a congregate dining location due to personal health reasons or other
reasons that make dining in a congregate setting inappropriate.
• Have access to transportation to pick up meals.
• Have supports in place to pick up meals on their behalf.
a. Carryout meal screening and assessment
Section 339 of the OAA requires nutrition programs to conduct nutrition screening and assessment for
services.
Carryout meal participants may be screened via phone, virtually, or in person to determine the
individual's need for nutrition and other services. Because carryout meal participants may be receiving
meals intermittently or continuously for personal or programmatic reasons, a home visit is not required.
Home visits are recommended for carryout meal participants who are not receiving other nutrition
services so that agencies may better assess the level of support a participant needs based on their
individual situation and connect participants with education and other resources that will best meet their
nutritional and health needs in alignment with the purposes outlined in section 330 of the OAA.
b. Determination of continued carryout meal eligibility
A reassessment of available nutrition program resources and a participant’s continued need for carryout
meals will be done at least annually, depending on the extent of other resources available to the
individual.
Carryout meals (p. 19-20)
Carryout meals are complete meals offered to participants who choose not to dine in a congregate
setting and instead take the entire meal from the point of service to be eaten at home or another
location. Examples of carryout meals include grab-and-go, pick-up, or drive-through meals. Carryout
meals are handled differently than congregate meal leftovers, in which the meal is consumed in a
congregate setting and the participant chooses to take home an uneaten portion of it.
Because carryout meals are not provided to participants in a congregate setting, they are classified and
reported as HDMs. Title III-C2 funds are used to fund carryout meal service. Nutrition programs may also
utilize local funds (beyond what is required for match) to fund carryout meals.
In alignment with the OAA requirements that services are targeted to older adults who have the greatest
economic or social need—paying particular attention to low-income, minority, and rural individuals—
nutrition programs should consider their overall capacity and whether providing carryout meals will
contribute to a waiting list for HDMs delivered to an individual’s residence.
Agencies offering carryout meals will establish a local procedure, reviewed by the AAA, which describes:
• When carryout meals will be offered, (for example, on a regular, ongoing basis versus only at times of
emergency or staff and/or volunteer shortage).
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• How older adults receiving carryout meals will be served if resources are limited.
Carryout meals are subject to the same requirements as congregate and HDMs regarding nutrition
education, collection of voluntary contributions, and food safety, unless otherwise specified in this
chapter.
Nutrition programs offering carryout meals should continuously evaluate utilization of the carryout and
congregate dining models to ensure that those most in socioeconomic need are being provided sufficient
access to, and adequately served by, both service models.
Caregiver support programs
Caregivers who do not otherwise meet eligibility criteria for Title III-C nutrition services may be eligible to
receive meals, nutrition counseling, or nutrition education as a supplemental service of the National
Family Caregiver Support Program (NFCSP) or Alzheimer’s Family Caregiver Support Program (AFCSP).
Caregiver support program coordinators will complete a caregiver needs assessment to determine need
for nutrition services in coordination with the nutrition program. Per AFCSP policy, completion of DHS
form F-02425 is required to purchase home-delivered or congregate meals. The caregiver’s signature
ensures that they are aware they are choosing to use their limited AFCSP funds to pay for the full cost of
the meal. It is also best practice to use form F-02425 with caregivers enrolled in NFCSP as a way to
coordinate among the two programs and the caregiver. For those enrolled in NFCSP, an opportunity to
voluntarily contribute towards the meal will be provided in accordance with OAA Title III-E requirements,
and program income will be used to expand Title III-E services.