USDA regulation 7 CFR Part 15b requires substitutions or modifications in school meals for children whose disabilities/medical needs restrict their diets. This includes students who have been identified as having a disability under Section 504 of the Rehabilitation Act of 1973 or under Part B of the Individuals with Disabilities Education Act (IDEA). This also covers students identified as having a disability/medical need that restricts their diet by their licensed physician (MD or DO), Physician Assistant (PA), or Advanced Practice Nurse (APN) with prescriptive authority (RXN) but not through Section 504 or IDEA.
The district will accommodate the special dietary needs of students identified as having a disability/medical need as noted above. There is a very wide range of conditions considered disabling so that is to be determined by the licensed physician, PA or APN with RXN. Generally, this would include severe food allergies/intolerances, metabolic diseases, renal conditions, heart conditions, and brain injury among others.
A “Medical Statement for Meal Modification” completed by the MD or DO, PA or APN with RXN is required before substitutions can be made. This must identify:
- The child’s disability/medical need and how it restricts the child’ diet
- The major life activity affected by the disability
- The food or foods to be omitted from the child’s diet and the food or foods to be substituted.
Students that have a 504 plan or IEP identifying a medical need for meal modification, including the food or foods to be omitted and foods to be substituted, do not need to provide a “Medical Statement for Meal Modification” form.
Return the completed form to the school nurse. The district’s Registered Dietitian (RD) who will put together a menu/food plan for the student, within 15 days of receiving the form. This will be shared with the foodservice manager at the student’s school with directions for providing the special diet. It will also be on record with the school nurse and Food Services area supervisor. Information for 504 plan students will also be shared with the 504 coordinator.
Substitutions will be made for lactose intolerance when supported by the “Medical Statement for Meal Modification” identifying what the substitution should be. Students are not required to take milk and may bring milk substitutes from home. Water is available in all cafeterias.
Food service staff is trained in food safety and in preventing cross contact and cannot make dietary changes without approval from the RD that created the menu/food plan.
If a completed medical statement is not received by the district RD, the student will receive a regular meal. Medical statements completed by parents or guardians will not be accepted. Good communication between all involved parties is vital to meeting the student’s needs.
The district does not make meal modifications for religious, ethical or cultural reasons that do not rise to the level of a disability/medical need. Vegetarian options are available daily. Menu items containing pork are identified on the menu and serving line and other options are available.
To discontinue any meal modifications, the “Discontinuation Form” must be completed by the parent/guardian or medical professional. All forms are available on the website.
DOCUMENTS & FORMS
CDE Medical Statement Requirements
2018 – 2019 Carb Count List I [revised] | 2018 – 2019 Carb Count List II [revised] | Carb Count Gluten Free
Statement to Request School Meal Modification | Statement to Request School Meal Modification (Spanish)
Discontinuation of School Meal Modification | Discontinuation of School Meal Modification (Spanish)