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The U.S. Department of Agriculture's (USDA's) nondiscrimination regulation (7 CFR 15​b) applies to any site participating in a federally-funded meal program, including the National School Lunch Program (NSLP), School Breakfast Program (SBP), Special Milk Program (SMP), Child and Adult Care Food Program (CACFP), and Summer Food Service Program (SFSP).

If a requested substitution meets the meal pattern requirements under any child nutrition program, the substitution can be made, but is not required.​

 For a child with a disability

​Substitutions must be made to the regular meal, including milk for any child with disabilities (i.e. a life-threatening reaction when exposed to the food and/or beverage) when the following two requirements are met:

  • A licensed physician's statement is required. Pursuant to Section 27-8.1 of the School Code, the licensed physician that may perform student health examinations is a physician licensed to practice medicine in all of its branches. Child Nutrition Program Sponsors can provide the form below to families for a physician to complete 
  • The Statement must include the child's disability, explanation as to how the disability restricts the child's diet, the major life activity affected by a disability, and food(s)/beverage(s) to be omitted and foods/beverages to be substituted

For children with disabilities only requiring modifications in food texture (such as chopped, ground, or pureed), a licensed physician's written instructions indicating the appropriate texture is recommended, but not required.


 For a child without a disability

​​Requests may be made for a preference with the understanding, a Child Nutrition Program Sponsor may not be able to accommodate requests based on preference. Sponsors do not receive federal reimbursement for meals that do not meet USDA meal pattern requirements. To assist sponsors in making a determination please provide:
  • A signed statement from a parent/legal guardian or "medical authority" is required. A medical authority would include licensed physicians, chiropractic physician assistants, and nurse practitioners. Child Nutrition Program Sponsors can provide the sample form to families ot medical authority to complete.
  • The statement must include the food(s)/beverage(s) to be omitted from the student’s meal based on preference and food(s)/beverage(s) to be substituted. If a non-dairy milk substitute (i.e; soy milk) is served, it must meet the nutritional standards of milk as outlined below.

 For a child without a disability who is requesting JUST a fluid milk substitution from the meal pattern requirement


Any fluid milk substitution that meets these requirements may be made by the SFA for non-disabled students when the following requirements are met:

  • A signed statement from a medical authority, parent or guardian which includes the medical or other special dietary reason for the need for substitution. Any reasonable request could be accepted (e.g. milk allergy, vegan diet, and religious, cultural or ethical reasons). 
  • The Child Nutrition Program Sponsor may choose the nondairy beverage to be provided, as long as the substituted beverage includes the following nutrients:
    Nutrient Per Cup
    Calcium 276 mg
    Protein 8 g
    Vitamin A 500 IU
    Vitamin D 100 IU
    Magnesium 24 mg
    Phosphorus 222 mg
    Potassium 349 mg
    Riboflavin 0.44 mg
    Vitamin B-12 1.1 mcg

    Because the Nutrition Facts Label in food products does not list all the required nutrients listed above, the food service operation must request documentation from the product manufacturer to confirm the presence of all required nutrients at the proper level. NOTE: Lactose-free milk provides the same nutrients found in regular cow's milk; therefore, it can be served as part of the reimbursable meal without documentation/written statement.
  • Expenses that exceed program reimbursements must be paid by the Child Nutrition Program Sponsor for fluid milk substitutions
  • The Child Nutrition Program Sponsor must inform the State agency of school that choose to offer fluid milk substitutions for non-disabled students or child care center/home.
  • The substitution request must remain in effect until the request is revoked or the school changes its fluid milk substitution policy for non-disabled students.

Child Nutrition Program Sponsor​s can receive reimbursement for meals without milk if they operate Offer versus Serve (OVS), under which milk or other meal component(s) could be declined by a student. If a Child Nutrition Program Sponsor​ does not however operate OVS, a non-disabled child with a medical or special dietary need must take the regular fluid milk or an acceptable milk substitute provided by the school or child care/home in order for the meal to be claimed for reimbursement.​

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