Home-Delivered Nutrition Services

1. Homebound; the definition of homebound is normally unable to leave home unassisted, and for whom leaving home takes considerable and taxing effort. A person may leave home for medical treatment or short, infrequent absences for non-medical reasons, such as a trip to the barber or to attend religious services. 
   AND
2. Unable to prepare meals for themselves because of:
   1. A disabling condition, such as limited physical mobility, cognitive or psychological impairment, sight impairment, or 
      Lack of knowledge or skills to select and prepare nourishing and well balanced meals, or
   2. Lack of means to obtain or prepare nourishing meals, or
   3. Lack of incentive to prepare and eat a meal alone.

   AND

3. Meet the vulnerability criteria. A person is considered vulnerable if s/he:
   1. Is unable to perform one or more of the activities of daily living (ADL’s) or instrumental activities of daily living (IADL’s) listed below without assistance due to physical, cognitive, emotional, psychological or social impairment.
      Activities of daily living are eating, dressing, bathing, toileting, transferring in and out of bed/chair, walking.
      Instrumental activities of daily living are preparing meals, shopping, medication management, managing money, using the telephone, doing housework, transportation; or 
      Has behavioral or mental health problems that could result in premature institutionalization; or is unable to perform the activities of daily living listed in #1, or is unable to provide for his/her own health and safety, primarily due to cognitive, behavioral, psychological/emotional conditions which inhibit decision-making and threaten the ability to remain independent. 
      AND
   2. Lacks an informal support system: Has no family, friends, neighbors or others who are both willing and able to perform the service(s) needed, or the informal support system needs to be temporarily or permanently supplemented.

Other individuals who are eligible for a home-delivered meal, if resources are available, are:

1. The spouse, regardless of age, of a participant receiving home-delivered meals funded through OAA or the Medicaid Waiver home-delivered meal service (COPES);
2. Individuals with disabilities who are not older individuals but who reside in the same home with other individuals eligible for the service;
3. Individuals, regardless of age, providing volunteer services in the home-delivered meals program.
4. An eligible participant’s unpaid caregiver aged 18-59 whose meal is paid for through Title IIIE Family Caregiver Support Program or other funds.

To the degree feasible, the provider shall ensure that preference is given to low-income and minority individuals and to those with the greatest economic and social need. 
Waiting list policies shall be developed by the AAA and HDNS provider in consultation with eligible participants. 
In accordance with the AAA or service provider policy, the following individuals may be served a home-delivered meal once the needs of the eligible population have been met:

1. Staff of the nutrition program;
2. Anyone who pays the full cost of the meal.