1. Accommodating Children with Special Dietary Needs in the School Nutrition Programs

2. Laws and Regulations… Section 504 of the Rehabilitation Act of 1973 The Americans with Disabilities Act The National School Lunch Act of 1946 Child Nutrition Act of 1966, as amended

3. Some common disabilities requiring accommodation by the School Food Service:  Diabetes  Food anaphylaxis  Cerebral palsy  Epilepsy  Muscular dystrophy  Multiple sclerosis

4. What documentation do I need? Medical certification by a physician to include:  The disability of the student and affect on diet  The major life activity affected by the disability  The food(s) to be omitted and those that may be substituted  Recommend yearly update of medical certification to ensure any changes in student’s diet prescription is reflected.

5. Exceptions to the NSLP & SBP Meals served which accommodate the exceptions & variations are reimbursable. Exceptions are restricted to: 1.Medical or Dietary Needs substitutions shall be made on a case-by-case basis only when supported by a statement of need signed by a recognized medical authority

6. Exceptions continued… 2.Ethnic, religious or economic variations 3.Foreign meal patterns 4.Natural disasters 5.Insufficient milk supply

7. Food Allergies If a physician’s assessment indicates a possible severe life threatening (anaphylactic) reaction --- the child’s conditions would meet the definition of a disability, and … substitutions prescribed by the physician MUST BE MADE.

8. What is a Food Allergy? -reaction of the body’s immune system to something in a food or an ingredient in a food – usually a protein.

9. Most Common Food Allergens FishSoy ShellfishWheat MilkPeanuts EggTree nuts

10. Generally, children with food allergies or intolerances do not have a disability as defined under USDA’s nondiscrimination regulations – and school food authorities MAY BUT ARE NOT REQUIRED to make substitutions for them.

11. Issues to consider… There is no provision for additional federal reimbursement--- It is a legitimate program cost Can be paid out of CNP funds A modified school meal must be provided at no extra cost to the student Meals must be claimed according to the child’s approved eligibility status Alternate funding sources may be available