Sample forms and resources are provided for example purposes only. They should be updated and modified according to your local laws and your organization’s needs.

Supplemental Nutrition Assistance Program Rates: Fiscal Years 2010 and 2011

April 16, 2015

The Supplemental Nutrition Assistance Program (SNAP) helps low-income individuals purchase food so that they can obtain a nutritious diet. SNAP is the largest of the domestic food and nutrition assistance programs administered by the Department of Agriculture’s Food and Nutrition Service. The participation rates presented in this report estimate the percentage of individuals eligible under… Read more »

Million Hearts

April 16, 2015

Million Hearts® is a web-based resource center developed by the Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Services to unite communities, health systems, nonprofit organizations, federal agencies, and private-sector agencies from across the country as partners in the fight against heart disease and stroke. This website provides background information on… Read more »

Toolkit: POMP To Go Part 1

August 17, 2017

Resource Topic Guide The POMP website contains all the information and tools necessary to conduct performance-related surveys of Older Americans Act service recipients on the state and local level. These tools may also be useful to other social service and support programs. POMP Tutorial for the POMP Toolkit (WMV, 7 minutes) to familiarize you with… Read more »

POMP To Go Part 1: How to Start Measuring Your Performance?

September 15, 2015

What is Pomp to Go? POMP stands for Performance Measurement Outcomes Project. Why is performance measurement important for you? Performance measurement data is useful for: Monitoring and improving the quality of services; Examining the effect of services on recipients; and Providing empirical evidence on which to base program improvements and funding decisions. But where do… Read more »

Enjoy Your Meals: Eating Well As You Get Older

April 15, 2015

Eating is one of life’s pleasures, but some people lose interest in eating and cooking as they get older. They may find that food no longer tastes good. They may find it harder to shop for food or cook, or they don’t enjoy meals because they often eat alone. Making small changes can often help… Read more »

Sample Consumer Needs Evaluation

April 16, 2015

A sample consumer needs evaluation form. Meals On Wheels, Inc. of Tarrant County (MOWI) has been utilizing basic evidence based screening tools but has very recently expanded its screening process to include other evidence based screening tool to better assess clients’ need and health risks. This template is provided for reference purposes only, to assist… Read more »

Sample Client Intake Form

April 16, 2015

A sample client intake from from Meals On Wheels, Inc. of Tarrant County (MOWI).  MOWI has been utilizing basic evidence based screening tools but has very recently expanded its screening process to include other evidence based screening tool to better assess clients’ need and health risks. This template is provided for reference purposes only, to… Read more »

Sample Home-Delivered Meal Driver Sign-Out Log

April 16, 2015

A sample log sheet for each home-delivered meal route driver to sign-out meals. This template is provided for reference purposes only, to assist those interested in developing forms and documents which fit the needs of their program. This is not a substitute for advice from a qualified legal, policy, regulatory or other subject matter expert…. Read more »

Sample Home-Delivered Meal Packing Slip

April 16, 2015

Sample form for delivering meals food items to a home-delivered meal distribution site. This template is provided for reference purposes only, to assist those interested in developing forms and documents which fit the needs of their program. This is not a substitute for advice from a qualified legal, policy, regulatory or other subject matter expert…. Read more »

Sample Contract Addendum – Short Form

April 15, 2015

Contract addendum for a senior nutrition program, to ensure home-delivered meal services are accessible to all clients, regardless of disability. This template includes sample provider requirements language. This template is provided for reference purposes only, to assist those interested in developing policies and procedures which describe the unique circumstances and operations of their program. This… Read more »

Sample Contract Addendum – Long Form

April 16, 2015

Contract addendum for a senior nutrition program, to ensure home-delivered meal services are accessible to all clients, regardless of disability.  This template includes sample provider and food service requirements language. This template is provided for reference purposes only, to assist those interested in developing policies and procedures which describe the unique circumstances and operations of… Read more »

Sample Civil Rights Compliance Paragraph

April 16, 2015

Sample text for a civil rights compliance section of a vendor contract. This template is provided for reference purposes only, to assist those interested in developing policies and procedures which describe the unique circumstances and operations of their program. This is not a substitute for advice from a qualified legal, policy, regulatory or other subject… Read more »

Sample Congregate Program Packing Slip

April 16, 2015

A sample packing slip for delivery of food items to a congregate meal site. This template is provided for reference purposes only, to assist those interested in developing forms and documents which fit the needs of their program. This is not a substitute for advice from a qualified legal, policy, regulatory or other subject matter… Read more »

2012 Older Americans : Key Indicators of Well-Being

April 16, 2015

Older Americans 2012: Key Indicators of Well- Being (Older Americans 2012) provides a comprehensive, easy-to-understand picture of our older population’s health, finances, and well-being, drawn from the most reliable official statistics. The indicators are categorized into five broad groups: population, economics, health status, health risks and behaviors, and health care. In addition, the report contains… Read more »