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Guidance for Accommodating Children with Special Dietary Needs in the School Nutrition Programs

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Title: Guidance for Accommodating Children with Special Dietary Needs in the School Nutrition Programs


1
  • Guidance for Accommodating Children with
    Special Dietary Needs in the School Nutrition
    Programs
  • Presented by The NH Department of Education,
    Bureau of Nutrition Programs and Services
  • Judy Gosselin
  • Elaine VanDyke
  • School Food Service Directors
  • Meagan Bizzarro, RD, LD
  • FSD Joyce Liebl, RD,LD FSD Pat
    Laska, RD
  • FSD Cheri White, MS
  • Child Health Services
  • Nutrition Feeding and Swallowing Program
  • Honey Weiss, MS,RD,LD
  • Judith Mikami, CCC,SLP

2
Rehabilitation Act of 1973
  • Prohibits discrimination against qualified
    persons with disabilities in the programs or
    activities of any agency of the federal
    governments executive branch or any organization
    receiving federal financial assistance.

3
Federal Laws that Guide the Child Nutrition
Programs
  • IDEA-Requires a free and appropriate public
    education be provided for children with
    disabilities aged 3-21.
  • IDEAIndividuals with Disabilities
    Education Act
  • ADA- Broadens and extends Civil Rights
    protections for approximately 50 million
    Americans with disabilities.
    ADAAmericans with Disabilities Act

4
USDA Law 7-CFR 15b 210 USDA Non-discrimination
and National School Lunch/Breakfast regulations
  • Clearly defines that substitutions to the regular
    meal MUST be made for children who are unable to
    eat school meals because of their disabilities,
    when that need is certified by a physician.
  • The information is documented by a licensed
    physician using the Special Meals Prescription
    Form.

5
Tools to Use for Implementing the Laws
  • The written document that contains the program of
    special education and related services to be
    provided to a child with a disability covered
    under IDEA.
  • IEP- Individualized Education Program/Plan
  • This is the correct tool for required nutrition
    services when the child also has an educational
    disability.
  • The written document that contains the services
    to be provided to a child with a disability.
  • Section 504 Plan- a format for non-educational
    disabilities
  • This is the correct tool for required nutrition
    services when there is a disability but no
    educational disability.
  • School officials must ensure that school food
    service staff are involved at the incept of the
    nutrition services requirements

6
Special Meals Prescription Form
  • The Statement must identify
  • The childs disability and an explanation of why
    the disability restricts the childs diet.
  • The major life activity affected by the
    disability.
  • The food or foods to be omitted from the childs
    diet.
  • The food or choice of foods that must be
    substituted.

7
Food Allergies vs Disabilities
  • Children with food allergies or intolerances
    generally do not have a disability.
  • However, when a physicians prescription
    indicates food allergies MAY RESULT in severe,
    life-threatening (anaphylactic) reactions, the
    condition is adisability and the substitutions
    prescribed by the physician must be made.

8
School Food AuthorityResponsibility
  • The SFA is responsible for ensuring that the
    benefits of the National School Lunch Program are
    made available to all children including children
    with disabilities.
  • A. What are the school food service
    responsibilities?
  • B. Where and how can funds be found and accessed?
  • C. Who can provide more information and technical
    assistance?

9
A. School Food Service Responsibilities
  • Staff must make food substitutions or
    accommodations for students with disabilities.
  • Substitutions for students with disabilities must
    be documented by the physician on the Special
    Meals Prescription Form.
  • Encouraged but not required to provide food
    substitutions or accommodations on a case by case
    basis for other children with medically certified
    special dietary needs.
  • Under no circumstances are school food service
    staff to revise or change a special Meals
    Prescription Form or medical order.

10
Providing Special Meals to Children with
Disabilities
  • The SFA is required to offer special meals at no
    additional cost to children with defined
    disabilities.
  • A nutrition component in the IEP requires the
    involvement of the appropriate food service
    staff.
  • The school food service is not required to
    provide meal services to children with
    disabilities when the meal service is not
    normally available to the general student body,
    unless the food service is require under the IEP.
  • (Such as when no meals are served to
    Kindergarten students because they are not in the
    school during meal service, then Special Dietary
    Meals are not required if school is closed for
    any reason and the general student body is not in
    attendance then no meals will be provided).

11
Menu Modifications
  • Children with disabilities who require changes to
    the basic meal are required to provide a Special
    Meals Prescription Form completed by a licensed
    physician.
  • Special Meals should be reflected on the
    production record.
  • School food service staff must follow the
    instructions that have been prescribed.

12
Serving Special Dietary Needs of Children without
Disabilities
  • Children who have special health needs that
    require dietary modifications may request that a
    school food service meet their needs.
  • Case by case consideration.
  • A licensed physician must document the Diet
    orders.
  • Schools are not required by law to make meal
    modifications due to personal opinions regarding
    healthy diets.

13
B. Funding Sources
  • Price of Meals
  • Meals must be served free or at a reduced price
    to all qualified children.
  • Schools may not charge children with disabilities
    or with certified special dietary needs who
    require food substitutions or modifications more
    than they charge other children for program meals
    or snacks.

14
Additional Fund Resources
  • Most expenses should be able to be absorbed by
    Food Service for the cost of making meal
    modifications.
  • However, the cost may be so high that alternative
    sources of funding should be sought. These other
    funds may be
  • General Fund
  • IDEA Funds
  • Medicaid- Title XIX Medicare
  • Social Security Income
  • Maternal and Child Health Services Block Grants
    Title V

15
Local State Contacts
  • STATE CONTACTS
  • Department of Education
  • ? Bureau of Nutrition Programs and
  • Services 603-271-3646
  • Catastrophic Illness Program
  • ? 603-271-4518
  • NH Dietetic Association
  • ? http//www.eatrightnh.org
  • State DHHS Title V Director
  • ? Maternal and Child Health
  • ? Children with Special Health Care Needs
  • Child and Family Service
  • ? Child Health Services
  • Nutrition, Feeding and Swallowing Program
  • 603-606-5456
  • LOCAL CONTACTS
  • The local school ADA coordinator
  • The school nurse
  • Occupational and physical therapists
  • Local registered dietitian

16
Legal Concerns and Liability
  • What you may care to discuss!
  • The School Food Authoritys responsibility for
    providing program accommodations for children
    with disabilities.
  • 2. Personal responsibility in cases of
    negligence.

17
Legal Citations
  • Individuals with Disabilities Education Act
    (IDEA).
  • Title II- equal and accessibility in state and
    local government programs and services.
  • Title III- extends accommodation requirements to
    privately owned facilities.
  • Title V- Section 504- Rehabilitation Act of 1973.
  • 7 CFR- 15(b)3 7 CFR 210.
  • FCS Instruction 783-2 Revision 2- Meal
    Substitutions for Medical or Other Special
    Dietary Reasons.

18
Personal Responsibility in cases of Negligence
  • School Food Authorities must ensure that both
    facilities and personnel are adequate to provide
    necessary services
  • It may be advisable for specially trained
    personnel to provide guidance to the school
    nutrition staff.
  • It may be necessary to have a nurse or health
    aide feed or assist the child.
  • Who will feed the child is a local decision
  • Food Service is responsible for providing the
    necessary foods however, it is not the specific
    responsibility of the food service staff to
    physically feed the child.
  • Schools should note that they could be held
    liable if persons without sufficient training are
    performing tasks or activities prescribed by a
    licensed physician.

19
Questions and Resources
  • Resource List
  • http//www.education.nh.gov/program/nutrition/inde
    x.htm
  • http//www.foodallergy.org
  • Questions
  • Bureau of Nutrition Programs and Services
  • 603-271-3646
  • Child Health Services-
  • 603-606-5456
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