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4510 Description
Revision 25-4; Effective Sept. 1, 2025
Home-Delivered Meals (HDM) provides nutritious meals typically served in the person's home. Meals may be delivered to alternate locations if the location is within the provider's standard service delivery area.
Example: A person receives dialysis treatments on Mondays, Wednesdays and Fridays. Because the treatment center is within the provider's standard service delivery area, HDMs can be delivered to that location on the days the person receives treatments.
When the person must regularly receive meals in an alternate location outside the service area, shelf-stable or frozen meals may be delivered to the person's home for use in the other location. The caseworker must check with the contract manager to make sure the provider's contract allows delivery of shelf-stable or frozen meals.
Meals delivered by contracted providers are approved by a dietitian consultant who is either a registered dietitian licensed by the Texas State Board of Examiners of Dietitians or has a bachelor’s degree with major studies in food and nutrition, dietetics or food service management.
Related Policy
26 Texas Administrative Code (TAC) Section 2881.15, Menus
26 TAC Section 281.19, Modified Diets
26 TAC Section 281.11, Nutrition Education
4520 Eligibility
Revision 25-5; Effective Dec. 1, 2025
People who apply for or receive Title XX meals are not subject to an income and resource eligibility determination.
A person must score at least 20 on Form 2060, Needs Assessment Questionnaire, Task and Hour Guide, to be functionally eligible for Home-Delivered Meals.
Related Policy
26 Texas Administrative Code Section 271.71
4521 Home-Delivered Meals Interest List Procedures
Revision 26-2; Effective June 1, 2026
If Title XX Home-Delivered Meals (HDM) funds are unavailable when a person requests that service, add the person's name to the HDM Interest List(s) by entering the information in the Community Services Interest List (CSIL) system. People who request placement on an interest list must be Texas residents. Names are released from the interest list on a first-come, first-served basis. Eligibility determinations are conducted as funds become available. Review 2230, Interest List Procedures.
If the person is receiving meals through another service, the caseworker must find out if the meals are through a temporary service. Several community organizations offer temporary delivery of meals until another source is available. Meals received through the Area Agency on Aging (AAA) via Title III are limited and only meant to provide temporary assistance to people. Meals provided through other local organizations may also be temporary.
If a person requests HDM through Title XX and currently receives meals, the intake person records the current meal source. The person must not be screened out because they receive meals from another source. The intake person completes the intake and either refers to a caseworker for assessment, if the region has open enrollment, or places the person's name on the interest list. The same policy applies when a person receiving other CCSE services requests Title XX HDM. The applicant or person may continue to receive temporary meals while on the interest list for Title XX HDM.
When the caseworker receives the request for services or a person's name is released from the interest list, the caseworker must find out if the current meal source is ongoing or temporary. If the applicant or person states the meals are ongoing, the caseworker must verify with the source and document that the meals are ongoing. The applicant or person can choose between Title XX HDM and the other source. The caseworker must document the applicant's or person's decision and follow procedures for approving or denying the service request.
If the source is a temporary service, the applicant must be authorized for Title XX meals if all other eligibility requirements are met. Service initiation through Title XX meals must be coordinated with the termination of the temporary service and documented in the case record.
4530 Casework Procedures
Revision 17-1; Effective March 15, 2017
4531 Service Initiation
Revision 25-4; Effective Sept. 1, 2025
To refer people to providers for Home-Delivered Meals (HDM), complete Form 2101, Authorization for Community Care Services, and send the referral packet to the selected provider. Review Appendix XIII, Content of Referral Packets. The provider must initiate services within 10 calendar days from the date of referral and return Form 2101 to the caseworker within 21 calendar days.
Inform the provider of any special circumstances relevant to the person's service provision. Specify on Form 2101 that the provider must deliver meals prepared without added salt as seasoning or flavoring, when necessary for the person's health. Ensure that the person understands when the home-delivered meals will be delivered, their responsibility for receiving the meals and that they are not responsible for contributing or paying for them.
Reassess the persons eligibility for services annually, within 12 months of the previous functional assessment.
Note: Coordinate services with the local Area Agency on Aging to ensure there is no service duplication of home-delivered meals
Related Policy
26 Texas Administrative Code Section 281.25, Service Initiation.
4532 Person's Health and Safety
Revision 25-3; Effective June 1, 2025
A provider agency must have written procedures in place to ensure it investigates and reports to the appropriate persons or entities any significant changes in the person’s physical or mental condition or environment. These procedures must require the following:
- The provider agency notifies a person’s caseworker, verbally or by fax, within one business day after becoming aware of significant changes in the person’s physical or mental condition or environment.
- If the provider agency notifies the caseworker verbally, the provider agency must send written notification to the case worker within five business days of the initial verbal notification.
A provider agency must inform the person about safety, health, or fire hazards identified in the person’s home when the provider agency discovers these hazards. The provider agency must keep documentation of such communications in its files, per the terms of the contract.
A provider agency must notify the Texas Health and Human Services Commission (HHSC) personnel, verbally or by fax, within one business day after an incident that may prevent the provider agency from delivering meals to one or more people.
A reportable incident includes:
- weather-related emergency;
- fire; or
- other natural disasters.
The provider agency must report an incident to:
- the contract manager;
- the person’s caseworker or supervisor.
If the provider agency notifies the caseworker verbally, the provider agency must send written notification to the contract manager or caseworker or both, within five business days of the initial notification.
If the person delivering the meal reports to the provider any individual illnesses, potential threats to safety or observable changes in the person's condition, the provider must notify the caseworker about the report within 24 hours. The provider must also notify the caseworker within 24 hours whenever the meal is found uneaten or untouched.
4532.1 Waivers for Alternate Meal Delivery Methods
Revision 24-4; Effective Sept. 1, 2024
Home Delivered Meals (HDM) providers generally deliver five hot meals a week to each person. Occasional exceptions to this rule, such as the use of frozen, chilled or shelf-stable meals for emergency or inclement weather situations, and situations approved by the contract manager on a case-by-case basis, may be granted. HDM providers must submit a waiver request to the Texas Health and Human Services Commission (HHSC) contract manager if they determine that delivery of frozen or shelf-stable meals is required for certain people within the provider's contracted service area. Any waivers granted will be effective for a period not to exceed one fiscal year. The provider must not implement the waiver of the requirement for delivery of a hot meal five days a week before HHSC approves the waiver request.
Caseworkers play a vital role in the waiver process. They are expected to work closely enough with the contract manager to be aware of the delivery provisions of each HDM provider. Any inquiries by providers about the waiver must be referred to the contract manager.
4532.2 Service Plan Changes
Revision 25-4; Effective Sept. 1, 2025
The caseworker must revise the service plan within 14 calendar days of learning that the person needs an increase or decrease in units, or document why no changes are needed.
For an increase in units the begin date on Form 2101, Authorization for Community Care Services must be seven calendar days from the Form 2101 date unless an earlier date is negotiated.
For a decrease in units allow 12-day adverse action, review 2811, Effective Dates, Appendix IX, Notification Effective Date of Decision and Appendix XVIII, Time Calculation.
The caseworker sends Form 2065-A, Notification of Community Care Services notifying the person of the change. If the caseworker decides the change is not necessary, send Form 2065-A. Document the reason and related handbook reference.
4533 Suspension of Services
Revision 25-4; Effective Sept. 1, 2025
Refer to 26 Texas Administrative Code Section 281.33, Suspension of Services.
The provider must notify the caseworker on the day Home-Delivered Meals is suspended without the caseworker's authorization. The provider must suspend services in any of the following situations when the:
- person moves out of the geographical area served by the provider;
- person enters an institution;
- person requests that services be suspended or terminated;
- person dies; or
- caseworker directs the provider to suspend services.
Unless the interruption is the result of one of the above situations, the provider must obtain the caseworker's approval for service interruptions of more than two consecutive days.
When the person requests that services be suspended and specifies a date for services to resume, the provider is not required to notify the caseworker.
4533.1 Provider Changes
Revision 25-3; Effective June 1, 2025
Allow the person the freedom to choose and change providers without restriction in areas where there is more than one provider for Home Delivered Meals.
Within 14 calendar days of person’s request to transfer providers, coordinate with both providers the date the current provider will stop providing services and the date the new provider will begin services. Review 2723, Freedom of Choice.
4534 Termination of Services
Revision 24-4; Effective Sept. 1, 2024
The caseworker must send the provider authorization for community care services for Title XX services, indicating the date services are to be terminated.
Send a copy of Form 2065-A, Notification of Community Care Services, to the provider as notification of the termination and of the date the service will end. Review 2800, Procedures for Denying or Reducing Services for detailed information about service termination.