1. 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 SERIOUS DEFICIENT (CENTERS) What does it all mean?

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.  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 How does it begin?

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