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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).​​

Meal modification requests can be made due to a disability or a preference. USDA requirements for each type of request are outlined below. Additional details can be found in Section K (Dietary Accommodations)PDF Document of ISBE's School Nutrition Programs Administrative Handbook.​

 Modifications Related to a Disability

Sponsors operating the federal Child Nutrition Programs must ensure children with disabilities have an equal opportunity to participate in the meal programs. The Americans with Disabilities Act (ADA), Section 504, and Departmental Regulations at 7 CFR part 15b define a disability as a physical or mental impairment that substantially limits one or more major life activities of an individual, a record of such an impairment, or being regarded as having such an impairment. According to the ADA, most physical and mental impairments will constitute a disability; a physical or mental impairment does not need to be life-threatening in order to be classified as a disability.

Certain physical or mental impairments require meal modifications that do not follow the required program meal pattern. In a disability situation, meal modifications outside the meal pattern must be supported by a medical statement signed by a State Licensed Healthcare Professional for program operators to receive reimbursement for the meal. When the modification does not meet meal pattern requirements, and therefore a medical statement is required, the medical statement must include: 1) information about the child’s physical or mental impairment that is sufficient to allow the operator to understand how it restricts the child’s diet, 2) an explanation of what must be done to accommodate the child’s disability, and 3) food(s) to be omitted and recommended alternatives (if applicable). A sample medical statement is below.

If a meal modification for a child’s disability can be made within the program meal pattern, a medical statement is not required under USDA regulations. However, local program operators may choose to require a medical statement. In situations where program operators do not obtain a medical statement, record of the child’s meal modification and the actions taken to accommodate it should be kept to safeguard the child.


 Modification Related to a Preference

Menu planners are encouraged to consider children’s cultural, religious, and ethical preferences when planning and preparing meals. Meal program operators have the option to accommodate food preferences for children without disabilities. Preference modifications must meet the program meal pattern; reimbursement is not provided for meals that do not meet the meal pattern requirements. A signed form from a parent/guardian explaining the modification should be provided to assist program operators in making a determination. A sample form is below.

 Fluid Milk Substitutions

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​

Fluid milk substitutions must meet FNS nutrient requirements. Low-fat or fat free lactose-free milk, or reduced-lactose milk, meet the nutrient requirements. Meal program operators will not receive reimbursement for meals that do not meet the fluid milk nutrient requirements unless a milk substitute is specified on a signed medical statement for a child with a disability. For meal modifications related to a disability, program operators will continue to receive reimbursement when following a signed medical statement in situations where the meal does not meet meal pattern requirements.

Child Nutrition Program operators must inform the Illinois State Board of Education of facilities that choose to offer fluid milk substitutions for non-disability reasons.​​

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