Special Dietary Needs

When nutrition services are required by a child’s IEP/MP, school officials need to make sure that school food services staff are involved early in the decision-making process regarding special meals.

Physician’s Statement for Children with Disabilities

United States Department of Agriculture (USDA) regulations 7 CFR Part 15b require substitutions or modifications in school meals for children whose disabilities restrict their diets. A child with a disability must be provided food substitutions when a statement signed by a licensed physician supports this need. The form, “School Food Services Program, Medical Statement for Disabled Child Special Needs” (see page F-19) must be completely filled out by the physician. The physician’s statement must identify the following:

• the child’s diagnosis,
• an explanation of why the disability restricts the child’s diet,
• the major life activity affected by the disability, and
• the food or foods to be omitted from the child’s diet, and the food or choice of foods that must be substituted.

The term child with a “disability” under Chapter 56 means a child evaluated in accordance with IDEIA as having one or more of the recognized fourteen disability categories and who, by reason thereof, needs special education and related services (see page 5).

Under Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act (ADA) of 1990, a “person with disability” means any person who has a physical or mental impairment which substantially limits one or more major life activities, has a record of such an impairment, or is regarded as having such an impairment (see page 5).

The term “physical or mental impairment” includes various diseases and conditions, a few of which may be:

• orthopedic, visual, speech, and hearing impairments,
• cerebral palsy,
• epilepsy,
• muscular dystrophy,
• multiple sclerosis,
• cancer,
• heart disease,
• metabolic diseases, such as diabetes or phenylketonuria (PKU),
• food anaphylaxis (severe food allergy),
• mental retardation,
• emotional illness,
• drug addiction and alcoholism,
• specific learning disabilities,
• HIV disease, and
• tuberculosis.

The term child with a “disability” under Chapter 56 means a child evaluated in accordance with IDEIA as having one or more of the recognized thirteen disability categories and who, by reason thereof, needs special education and related services.

Cases of Food Allergy

Generally, children with food allergies or intolerances do not have a disability as defined under either Section 504 of the Rehabilitation Act or Part B of the IDEIA, and the school food services section may, but is not required to, make food substitutions for these children.

However, when the licensed physician’s assessment indicates that food allergies may result in severe, life-threatening (anaphylactic) reactions, the child’s condition would meet the definition of “disability,” and the substitutions prescribed by the licensed physician must be made.

DOE does not provide meal substitutions for food allergies or intolerance unless it is life threatening or the condition meets the USDA National School Lunch Special Dietary Needs definition of “disability.”

Other Special Dietary Needs

The school food services section may make food substitutions, at their discretion, for individual children who do not have a disability, but who are medically certified as having a special medical or dietary need. Please contact School Food Services Branch as soon as possible regarding special meals at (808) 733-8400.

Medical Statement for Children with Special Dietary Needs

Each special dietary request must be supported by a statement, which explains the food substitution that is requested. DOE requires a licensed physician to complete and sign the “Medical Statement for Disabled Child Special Needs” form (see page F-19).

The medical statement must include the following:

• an identification of the medical or other special dietary condition which restricts the child’s diet,
• the food or foods to be omitted from the child’s diet, and
• the food or choice of foods to be substituted.

Food Preparation

Classroom staff should collaborate with the cafeteria manager for food preparation (i.e., chopping food, pureeing food, thickening liquids, etc.).