The Child and Adult Care Food Program

1. Serious Deficient (Centers) What does it all mean? The Child and Adult Care Food Program playing a vital and integral role in improving the overall quality of care and daily nutritional health of participants

2. SERIOUS DEFICIENCY • Serious Deficient means the status of an institution that has been determined to be non-compliant in one or more aspects of its Program operation. • It is NOT THE END OF WORLD!! • It is the first step in successfully addressing the non-compliance, ensuring that Program uniformity and Program integrity is being met.

3. The Process…. • Proper implementation of the serious deficiency process includes the development of a Corrective Action Plan (CAP). • Your CAP must demonstrate that the deficiencies will be fully and permanently corrected. • During this process, you will continue to participate in the Program and receive technical assistance. • We both have a responsibility: • You must work hard to achieve compliance • SA will work with you to help achieve compliance

4. How does it begin? • Administrative Reviews/Technical Assistance/Follow-Up Visit • Do you know why we conduct these type of reviews and visits? • Ensure compliance with Program requirements and to provide technical assistance to reach compliance • SA reviews some or all related Program records • What are some of the records we examine? • IES, Meal Counts, Attendance, Receipts, MEL, Menus • How many years are you required to maintain Program records? • 3 years plus the current year

5. Next Steps………. • SA finished conducted its review of “Baby First Child Development Center” • Baby First Child Development Center was deficient in four Program areas • IES errors • Meal pattern • Menus • Lack of records • SA complies findings and sends Notice of Serious Deficient letter to Baby First CDC

6. The SD Notification……. • Must identify certain things: • Name of chairman of board, executive director, director and any additional individuals determined to be responsible • List all serious deficiencies • Action to be taken to correct • Time allotted to correct • SD is not appealable

7. The SD Notification……. • Institution has been assessed fiscal action---owes money to State—this action can be appealed • Failure to fully and permanently correct w/in allotted time will result in Notice of Proposed Termination and Disqualification • Voluntary termination of agreement by organization after receiving notification will result in Notice of Termination, Disqualification and placement on NDL.

8. SA….USDA…..CAP….. • SA must notify USDA--send copy of institution SD notification • Institution must submit CAP detailing internal controls implemented to ensure how you will fully and permanently correct the deficiencies • Timely/Acceptable CAP---SA issues notice of temporarily deferred • Follow-up • Not Timely/Unacceptable/No CAP--SA issues Notice of Proposed to Termination & Disqualification

9. Acceptable CAP…. • Institution submits CAP within the allotted time frame • How long do you think is an acceptable time to submit a CAP and have the SA review and finalize? • No more than 90-calendar days from receipt of notification. • CAP must include supporting documentation and describe the: • What • Who • When • Where • How

10. Acceptable CAP…. • CAP addresses each deficiency ensuring full and permanent correction • SA send institution letter that: • CAP has been submitted timely • CAP fully and permanently detailed how compliances will be met • Institution is in a “temporarily deferred” status • Anytime in future, SA can visit to ensure actions are being taken to correct deficiencies • HOWEVER, if same deficiencies are identified during follow-up, SA can move to immediately Terminate and Disqualify—this action is NOT appealable

11. Unacceptable CAP…. • Not submitting a CAP • Not submitting a timely CAP • Not responding to each deficiency identifying actions to fully and permanently correct • SA must move to send Notice to Propose to Terminate and Disqualify— this action can be appealed

12. Notice of Proposed Termination and Disqualification • SA will send detailed letter informing you that: • CAP was submitted timely but inadequate/ unacceptable • Failed to ensure full and permanent correction of each deficiencies • Right to appeal this action— attached hearing procedures • Written notification must be received by SA within 15-calendar days of receipt of proposed actions--- not later than close of business (5 pm) on the deadline date

13. Suspension Due to False/Fraudulent Claims • Institution knowingly submits false or fraudulent claims • SA: • issues notice to propose to suspend participation and payment • Identify effective date of suspension • Duration of suspension—up to 120 days

14. Suspension Due to False/Fraudulent Claims • Inform institution---action can be appealed • Institution must submit written appeal request within 10 calendar days of receipt of notification • Notify USDA • Will not pay any claims for reimbursement during the suspension

15. Notice of “Final” Termination and Disqualification • Institution didn’t appeal Notice of Proposed Termination and Disqualification OR Suspension • Institution appealed Notice of Proposed Termination and Disqualification OR Suspension • Hearing Official upheld SA’s decision • SA must immediately notify institution of this decision • Effective date of termination and disqualification • If debt is owed to SA, must be repaid • Institution and responsible parties are placed on (NDL) National Disqualifying List

16. National Disqualifying List Question: How long does the organization and the responsible individual remain on this list? • 3 years • 5 years • 7 years Answer: 7 years If institution/RPI owes a debt, remain on list until debt is paid in full (interest in accrued); Less than 7 years, if organization/SA request to re-apply, only after acceptable CAP is submitted; USDA and SA must both concur

17. What happens if Institution’s Appeal is Upheld? • Hearing Official renders decision upholding the institution • SA must immediately notify the institution; the proposed termination and disqualification is “rescinded” • No further action is necessary---you’re in good standings again • Suspension is overturned • SA must notify organization and disburse all suspended reimbursement payments

18. RECAP

19. What Actions Can Be Appealed? • Under the Serious Deficiency Process: • Suspension to participate due to submission of false/fraudulent claims • Suspension of payment due to submission of false/fraudulent claims • Adverse fiscal sanctions resulting from administrative review/technical assistance/follow-up visit • Proposed to Terminate and Disqualify

20. What Actions CANNOT Be Appealed? Under the serious deficiency process: • Declared Serious Deficient • Determination that CAP is unacceptable • Final Termination and Disqualification

21. Main Objective • Stay in Program compliance • When in doubt of Program operations, STAY in contact with your Specialist • we are here to assist and provide technical assistance • If declared SD, submit timely CAP that addresses all deficiencies ensuring internal controls to fully and permanently correct problem areas • It’s Still Not the End of the World? • If you appeal adverse actions—make sure your case is strong-bring any and all documentations

22. Summary • WIN Appeal • Your organization is in good standings, adverse action is rescinded

23. Summary • LOSE Appeal • SA must complete serious deficiency process • Proposed to terminate and disqualify • Final termination and disqualification • Placed on National Disqualifying List

24. Summary • SA: • wants you to remain in good standings • wants you to maintain your records • wants to help you in any way possible to stay in compliance • doesn’t want any organization losing money and to go through the Serious Deficient process