University of Massachusetts Amherst

It's MORE Than A Meal


Nutrition & Adult Day Health Programs

facts about the child and adult care food program (CACFP)

What is CACFP?

CACFP is the Child and Adult Care Food Program. This federal program provides healthy meals and snacks to children in day care centers and adults in day health programs. It plays a vital role in improving the quality of care and making it more affordable to families.

CACFP reimburses participating programs for their meal costs. There are three tiers of administration for the CACFP program: federal, state and local. At the federal level, CACFP is managed by the Food and Nutrition Service (FNS), an agency of the U.S. Department of Agriculture. In most states, the state education department or health department administers CACFP. At the local level, independent centers and sponsoring organizations enter into agreements with their state agencies to operate the program. The website address for CACFP is

What types of facilities participate in CACFP?

Many facilities choose to participate in CACFP. These may include childcare centers, family day care homes, after-school care programs, adult day health programs, and homeless shelters. This manual will focus on issues and needs relative to adult day health programs.

Adult day health programs are public, private, nonprofit, and some for-profit adult day health facilities that provide structured, comprehensive services to functionally impaired, non-resident adults. To qualify for CACFP meals and snacks, adult participants must be functionally impaired or age 60 and older. They may receive up to 2 meals and 1 snack each day at the adult day health programs that participate in CACFP.

How are the meals paid for?

Some adult day health participants are charged the full price for their meals. Others qualify for free or reduced-price meals. Those from families with annual gross incomes at or below 130% of the federal poverty level may qualify for free meals; those from families with income between 130% and 185% of the federal poverty level may qualify for reduced-price meals; and those from families with income above 185% of the federal poverty level pay full price.

How much federal reimbursement is available?

Most programs include meals as part of their fees. Programs receive payments based on the type of meal served and adults’ eligibility for free, reduced-price, or paid meals. As of July 1, 2005,* programs in most states also receive an average of 17.5 cents in commodities (or cash in lieu of commodities) for each lunch or supper served, in addition to these rates:

Meal Type Free Reduced-price Paid
Breakfast $1.27 $0.97 $0.23
Lunch or Supper $2.32 $1.92 $0.22
Snack $0.63 $0.31 $0.05

* Rates change annually on July 1.

How do programs receive credit for providing meals?

Programs must serve meals and snacks that meet federal guidelines. Information on crediting meals and snacks is in the Crediting Foods section of this manual. The USDA has prepared documents that describe the full set of regulations.

Who prepares the meals for these programs?

Adult day health programs make different arrangements for meals. Some programs prepare their own meals. Some are located in a nursing home that prepares meals for residents as well as day health program participants. Some contract out to a vendor for meals. There are a variety of vendors. Examples are local restaurants, school food service programs, or community food service agencies that also operate Meals on Wheels programs.

Who controls the content of the meals?

Due to the variety of meal arrangements and vendors, the degree to which your program can influence the content of meals will vary. In all cases, meals and snacks that qualify for reimbursement in the CACFP must meet standardized specifications (see the CACFP Meal Pattern for Adults in the Crediting Foods section in this manual). These specifications meet nutrient needs using a variety of food groups, in specific quantities of foods, with specific kinds of ingredients (such as whole grain or enriched flour). However, the meals may vary in terms of the source of these foods. Some vendors may use USDA commodity foods as ingredients for some of their meals. Other vendors may purchase packaged foods from other sources, or buy fresh foods from a local supplier.

Some vendors must comply with regulations different than, or in addition to, those set by CACFP. For example, a school food service vendor may also be subject to regulations set by its local school district. A vendor that also provides meals for congregate meals in a community center or home-delivered meals (such as Meals on Wheels) must also comply with standards of the U.S. Administration on Aging’s Elderly Nutrition Program (Elder Affairs Menu Policies and Nutrition Standards) which specify that meals provide a certain amount of calories while staying within specific guidelines for fat and sodium.

Many adult day health programs do not use the CACFP program for snacks. They may have more options for purchasing food, and for types of foods to serve.

In implementing the recommendations of this manual, your program will need to evaluate the degree of direct control that you have over the content of meals and snacks. You can then decide how many changes you can implement to improve the content and appeal of meals and snacks, and to address the diversity of older adults served by your program.

Where can your program get more information?

  • To learn more about the CACFP in Massachusetts, contact the Massachusetts Department of Education, Nutrition Health and Safety Unit, 350 Main Street, Malden, Massachusetts 02148, phone–781-338-6498.
  • To learn about CACFP in other states, refer to the list of state agencies in the Resources section of this manual. This list was current as of June 2005. You can find the most recent list of state agencies at the website
  • To learn about USDA’s nutrition assistance programs, check the Food and Nutrition Service website ( You can contact the FNS public information staff by phone at 703-305-2286, or by mail at 3101 Park Center Drive, Room 914, Alexandria, Virginia 22302. If you have further questions that state or local agencies cannot answer, contact the Food and Nutrition Service headquarters by email at

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Developed for the Massachusetts Department of Education Child and Adult Care Food Program by the University of Massachusetts Extension Nutrition Education Program. Permission is hereby granted by the Massachusetts Department of Education to copy any or all parts of this document for non-commercial educational purposes. The Massachusetts Department of Education, an Affirmative Action employer, is committed to ensuring that all of its programs and facilities are accessible to all members of the public. We do not discriminate on the basis of age, color, disability, national origin, race, religion, sex, or sexual orientation.