1. Presenter: Barbara J. Smith Senior Program Analyst April 3, 2014 USDA, FNS, Child Nutrition Programs Program Monitoring Branch

2. The serious deficiency process of the Child and Adult Care Food Program (CACFP) was established to ensure compliance with U.S. Department of Agriculture (USDA) Food and Nutrition Service (FNS) regulations and guidance.

3. Seriously Deficient Defined 7 CFR 226.2 “…the status of an institution or a day care home that has been determined to be non- compliant in one or more aspects of its operation of the Program…”

4. Intent of the Process Positive outcomes Allows for correction Ensures integrity Allows for due process

5. Trends from TMEs Reports failed to note repeated findings Serious review findings not identified Incomplete CAPs were accepted Missing Date of Birth

6. SD Process Step 1 Identify the SD Step 2 Prepare the SD notice Step 3 Assess CA

7. SD Process (cont.) Step 4 Prepare the notice of intent to terminate and disqualify Step 5 Hold the appeal Step 6 Terminate the agreement and place institution and RP/RI’s on the NDL

8. CACFP Suspension Process Protect children in care and protect Program funds Declare seriously deficient at the same time as proposed suspension or suspension

9. CACFP Suspension Process TME Trend: Suspension Process not implemented as per regulations

10. Health and Safety Violations “Imminent threat to health or safety of participants” “Activities that threaten the public health or safety of participants” [CACFP 13-2013 dated July 26, 2013 and HB - Part 4. B. 1, page 42]

11. Health and Safety Violations What to do if the licensing agency has identified a “serious health or safety violation”? How to most efficiently use the process when license revocation does not actually occur?

12. Suspension- False Claim Should the State agency use the term “fraud”? Should the State agency use suspension option or the serious deficiency process?

13. False Claim Unintentional SD Process CA Addresses System Errors Intentional (Can you prove it?) NoYes Suspension Process (Propose Suspension) CA Addresses Offending Individual Suspension Process False Claim Flow Chart

14. Removal from the NDL SAs must establish procedures Consideration of requests a lower priority Burden on institution to show correction of problems

15. Removal from the NDL (cont.) Institution must show what’s different from last request No deadline for SA decision No appeal of SA decision

16. SD or Not? Scenario 1 You be the judge… Scenario 2

17. QUESTION During its management evaluations, what criteria will FNS use to assess the State’s performance in using the serious deficiency process for institutions?

18. QUESTION How willing is FNS to support a State in declaring seriously deficient those institutions that have significant political clout within the State, such as schools, Head Start Programs, Indian Tribal Councils and military installations?

19. QUESTION If an institution simply stops submitting claims after receiving a notice of serious deficiency, and never notifies the State that it was “voluntarily terminating” the agreement, what should be done ?

20. QUESTION A new institution was declared seriously deficient because it submitted false information on its application, regarding recent criminal convictions. The new institution withdrew its application. Should the SD process be implemented?

21. QUESTION If the disqualification period usually runs seven years, should records relating to the serious deficiency process for that institution be retained indefinitely?

22. QUESTION Will an institution, RPIs, FDH provider, etc., be notified when it “falls off” the NDL after 7 years?

23. QUESTION When is FNS going to have the National Disqualified List available to State agencies and sponsoring organizations?

24. What if the State agency decides on its own to withdraw the serious deficiency notice while the appeal is pending? QUESTION

25. What is full and permanent correction for the institution when key individuals in the institution have changed over time?

26. QUESTION If the same serious deficiency recurs ten years after it was first found and corrected, should the State immediately propose to terminate and disqualify the institution, based on the institution’s failure to permanently correct the deficiency?