CACFP Administrative Manual Section 5.1

• Table of Contents
• Terms, Definitions, and Acronyms

5.1 Claims for Reimbursement

All claims are submitted electronically through the Child Nutrition Information and Payment System (CNIPS). Agencies must submit a claim for reimbursement no later than 60 calendar days after the month being claimed. For example, a claim for June would need to be submitted by August 29, 60 days after the month of June, in order to be accepted. Please make note of the monthly Claim Submission Deadlines. For April and May reimbursement, claims should be submitted no later than June 5th in order to avoid significant delays in receiving the reimbursements due to the year-end close-out process. Until a claim’s status in CNIPS changes to processed, the claim may be modified and resubmitted by the agency at any time.

• If changes resulting in a downward adjustment (reducing the payment amount) need to be made to a claim after it has been processed, the agency may submit a revised claim at any time, even after the 60 day deadline has passed.
• Changes to a processed claim resulting in an upward adjustment (increasing the payment amount) are only allowable up to 60 days after the claim month. Upward adjustments will not be accepted in CNIPS after the 60-day deadline has passed.

Although this section identifies key information required to successfully submit a CACFP claim, it is not a step by step guide. The Child and Adult Care Food Program (CACFP) web page contains the following resources to assist agencies with the claims submission process:

• The CACFP Reimbursement Instruction Booklet
• Claims submission deadlines
• Late claims policies and procedures
• A list of claims specialists by county

Application Submissions in the CNIPS

Application revisions will only be approved prior to or in the month in which an approvable revision is submitted. This means that for an agency to make a change to its application(s) effective February 1, 2023, they must submit a revision and all required documentation through the CNIPS in February 2023 (or earlier). If they do not submit the revision until March 2023, the revision can only be made effective March 1, 2023, at the earliest.

Because the CDSS cannot backdate approval for CNIPS revisions, it remains essential that agencies regularly review their CNIPS applications. Centers must ensure that staffing information, types of meals served, months of service, times of service, and all other information is correct and current. Day Care Home (DCH) sponsors must ensure that all provider applications are complete, correct, and approved for the correct claiming month. Inaccurate or outdated application information could prevent the claim from being submitted and may even result in Findings or require Corrective Action during an Administrative Review.

Average Daily Participation (ADP)

As part of the claims submission process, centers must calculate the average daily participation (ADP) for their site(s). To perform this calculation, an agency should:

• Review the daily meal count records for all approved sites to identify the highest number of participants who received a meal or snack each day at each site. Then, the agency should add together these daily participant counts for the entire month; and
• Divide that total by the greatest number of days that food was served.

For example, in December, a child care agency serves meals at one site for 10 operating days. The highest participation at meal service for each day falls between 20 and 30 participants. To calculate the ADP for December, the agency determines the sum total of participants for the claim month and divides that total by the highest number of days that meals were served.

The attendance records are as follows:

Day 1: 23 participants

Day 2: 27 participants

Day 3: 24 participants

Day 4: 28 participants

Day 5: 22 participants

Day 6: 25 participants

Day 7: 30 participants

Day 8: 26 participants

Day 9: 21 participants

Day 10: 29 participants

To calculate the ADP:

1. 23 + 27 + 24 + 28 + 22 + 25 + 30 + 26 + 21 + 29 = 255 total participants served in December
2. 255 participants ÷ 10 days of meal service = 25.5 participants
3. ADP = 26

Note: If the ADP calculation results in any number including decimals, always round up to the nearest whole number, regardless of the decimal amount.

Centers Only Claiming Instructions

Wraparound Programs—Child Care Centers (CCC) Only

When a CCC claims meals for children enrolled in wraparound programs (see Sections 1.4 and 3.1 for more information), the center must report meal count and eligibility data for the Early Head Start, Head Start, or Even Start program portion of the day separate from the State Preschool or preschool portion of the day. Eligibility rosters must also be separate for both programs.

Incorporated School-age Licenses—CCC Only

When a CC center serves school age (SA) children under a preschool license, the center must report meal counts and eligibility data for SA children separate from the preschool children. Eligibility rosters and meal counts must be maintained separately. Please see Sections 1.4 and 3.1 for more information.

Title III Funds—Adult Day Care Centers (ADCC) Only

Under Title III of the Older American’s Act of 1965, the Department of Health and Human Services provides meal service funds to some ADC centers. A meal that is supported by Title III funds may not be claimed for reimbursement under the CACFP.

Medi-Cal Funds—ADCC Only

If an ADC center receives Medi-Cal reimbursement for providing a meal, that same meal may not be claimed under the CACFP. For more information on Medi-Cal reimbursement, contact the California Department of Health Care Services.

Claiming Methodologies

Agencies should select the claiming method that is most advantageous to their food service operation. There are two methods to choose from: fixed percentage and actual count. Agencies that operate a pricing program are required to use the actual count method.

Fixed Percentage

The intent of the fixed percentage method is to reduce paperwork. With this method, an agency conducts one eligibility study to determine the number of participants enrolled under the free, reduced-price, and base (also known as paid) reimbursement rates. This study is based on the enrollment and valid Meal Benefit Forms (and/or automatic documentation for CCCs; see Section 3.1 for more information) for the first month within the Program Year (October through September) that the center will claim. For continuing agencies, this eligibility study is completed each October. For new centers, the eligibility study is completed the first month of operation. Fixed percentages must include all eligibly enrolled participants, even those that decline the program. For more information, CCCs can refer to Section 3.1 and ADCCs can refer to Section 3.3.

For example, a center with an enrollment of 100 may have the following eligibility breakdown: 75 free, 15 reduced-price, and 10 base (paid). Once the eligibility totals are reported, the CDSS will then convert the figures into fixed percentages—in this example, 75 percent free, 15 percent reduced-price, and 10 percent base (paid)—and apply the percentages to the total meals claimed by the center to calculate the center’s monthly reimbursements throughout the program year.

Using the above percentages, if the center reports that it served a total of 1,000 lunches during June, the CDSS will reimburse the center in the following manner: 750 free lunches, 150 reduced-price lunches, and 100 base lunches.

After the claiming percentages are established, centers are required to report new enrollment and eligibility data during a program year only when:

• Adding an approved site;
• The ADP exceeds previously reported enrollment; or
• A reporting error has been identified.

A center may update its enrollment and/or eligibility data on the claim if it is financially beneficial to the center (for instance, if the number of participants eligible for free or reduced-price meals increases). Failing to report required enrollment changes in a timely manner could result in Findings or Corrective Action during an Administrative Review, so make every effort to submit and maintain accurate enrollment records in CNIPS at all times.

ADCCs and Fixed Percentages for ADCCs

Since not all enrolled adults in an ADC are eligible to participate in the CACFP, the fixed percentages are only calculated using the eligibly enrolled adults. The reimbursement determinations for eligibly enrolled adults that decline participationmust also be used when calculating the fixed percentage.

Actual Count for CCCs and ADCCs

As with the fixed percentage method, a center using the actual count method must determine the numbers of free, reduced-price, and base (paid) participants within its enrollment. However, centers using the actual count method must conduct the enrollment and eligibility study for each month they wish to claim. Centers using the actual count method are also required to use a roster system to take meal counts by eligibility category (free, reduced-price, and base) at the time of service for each meal type claimed.

In other words, when taking a meal count for breakfast, a center must count the number of free breakfasts served, the number of reduced-price breakfasts served, and the number of base (paid) breakfasts served. Centers must then consolidate total meals served by eligibility category to report each month. For instance, if a center serves a total of 1,000 lunches during June, it must report the number of lunches in each category (i.e., 800 free lunches, 150 reduced-price lunches, and 50 base lunches) and receive meal reimbursements accordingly.

Day Care Home (DCH) Only Claiming Instructions

To receive CACFP reimbursement, the DCH sponsor must submit a monthly claim for reimbursement in the CNIPS that provides sufficient data to justify the reimbursement claimed.

Sponsors must report and maintain accurate records which include the following data:

• The number of providers by tiering category approved to participate in the CACFP and that served at least one meal during the claim month
• The total number of children by tiering category that received at least one meal during the claim month
• The highest number of days that CACFP meals were served by providers
• The ADP for all providers being claimed
• The total number of each meal type by tiering category served during the claim month
• Actual administrative expenses incurred and income received during the claim month

All claims submitted must be certified in the CNIPS by the authorized individual to be considered a valid claim.

References: 7 CFR, sections 226.7(k), 226.9(b), 226.10(c), and 226.11(b)(1); MB CNP-07-2017 Reimbursement Claim One-time Exception Submission Deadline Policy Clarification, Financial Management – Child and Adult Care Food Program 796-2 Rev. 4, and USDA Adult Day Care Handbook.

Questions: A list of program specialists that can assist is found on the CACFP Contact List.

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Esta institución es un proveedor que ofrece igualdad de oportunidades.