Presentation on theme: "2 HOME DELIVERED MEALS Waiver Workshop Presented by: Regional and Local Services (RLS) Access and Intake /Area Agency on Aging (A&I/AAA) May 27-28, 2009."— Presentation transcript:
13 Form 2027 – Section 1 Describe the area(s) or delivery route(s) that will be affected by this proposed waiver. A.City and county or portion thereof: B.Distance from the meal preparation site to distribution point(s): C.Other geographical identifying information that supports the need for the proposed waiver, e.g., road conditions;
14 Form 2027 – Section 2 Describe the circumstances necessitating this request for a waiver.
15 Form 2027 – Section 3 Describe the pattern and type of meal delivery under this proposed waiver by including, at a minimum, the following information: A.How frequently will a hot meal be delivered to each individual at the individuals home?
16 Form 2027 – Section 3 (contd) B.For days when a hot meal will not be provided, what type of alternate meal (frozen, chilled, shelf-stable) will be delivered? C.How many alternate meals will be provided to the individual each time a home delivery is made? D.Other relevant information:
17 Form 2027 – Section 4 If one or more individuals are unable to safely store and prepare a frozen or shelf-stable meal in the area covered by this proposed waiver, describe the projects plan to continue service to those individuals.
18 Form 2027 – Section 5 Notification to each individual in the area affected by this proposed waiver must occur at least 30 calendar days before initiation of the modified meal delivery schedule, unless otherwise requested by the provider and approved by DADS. How will the provider notify each individual of the change in the pattern and type of meals to be served?
19 Form 2027 – Section 6 A.What method will the provider use for regularly scheduled contact? If delivery of a meal will occur less frequently than every other day, describe the providers method(s) for regularly scheduled contact with individuals receiving alternative meals.
20 Form 2027 – Section 6 (contd) B.How will the provider investigate and report significant changes in participants physical or mental condition and environment?
21 Form 2027 – Section 6 (contd) C.How will the provider implement appropriate action within one business day following identification of the change?