The Connecticut State Department of Education's (CSDE) Guide to Meal Modifications in School Nutrition Programs provides information and guidance for the U.S. Department of Agriculture's (USDA) school nutrition programs on providing meal modifications for children with special dietary needs, based on the federal nondiscrimination laws and USDA regulations. School nutrition programs include the National School Lunch Program (NSLP), School Breakfast Program (SBP) , Afterschool Snack Program (ASP) of the NSLP, Seamless Summer Option (SSO) of the NSLP, Fresh Fruit and Vegetable Program (FFVP), Special Milk Program (SMP), and Child and Adult Care Food Program (CACFP) At-risk Supper Program implemented in schools.
Children with a Disability
The USDA requires reasonable meal modifications on a case-by-case basis for children whose disability restricts their diet, based on a medical statement signed by a recognized medical authority. “Case-by-case basis” means that the meal modifications are specific to the individual medical condition and dietary needs of each child. The Connecticut State Department of Public Health defines a recognized medical authority as a state-licensed health care professional who is authorized to write medical prescriptions under state law. This includes physicians (MD), physician assistants (PA) and certified physician assistants (PAC), doctors of osteopathy (DO), and advanced practice registered nurses (APRN).
Children without a Disability
The USDA allows optional modifications within the meal patterns for grades K-12 and the meal patterns for preschoolers on a case-by-case basis for children whose dietary restrictions are not related to a disability. A medical statement is required if these optional modifications are outside the school meal patterns. Examples of optional modifications include requests related to religious or moral convictions, general health concerns, and personal food preferences, such as parents who prefer that their children eat a gluten-free diet or organic foods because they believe it is healthier.
Guidance and Resources
- Implementation Guidance
- CSDE Guide: Guide to Meal Modifications in School Nutrition Programs
- Milk Substitutes (Documents/Forms section)
- Self-assessment of Local Practices for Meal Modifications in School Nutrition Programs (CSDE)
- Summary Chart: Summary of Requirements for Meal Modifications in School Nutrition Programs (CSDE)
- Resource List for Special Diets in Child Nutrition Programs (CSDE)
- USDA Guide: Accommodating Children with Disabilities in the School Meal Programs
- Medical Conditions
- Information about celiac disease and intolerance, diabetes, food allergies, inborn errors of metabolism, and lactose intolerance: Go to Documents/Forms in the left navigation bar.
- Medical Statements
- Medical Statements (Documents/Forms section)
- Procedural Safeguards
- Policy Memos (CSDE and USDA)
- CSDE Operational Memo No. 13-17: Requirements for Meal Modifications in the School Nutrition Programs
- CSDE Operational Memo No. 22-15: Statements Supporting Accommodations for Children with Disabilities in the Child Nutrition Programs
- USDA Memo SP 59-2016: Policy Memorandum on Modifications to Accommodate Disabilities in the School Meal Programs
- USDA Memo SP 26-2017: Accommodating Disabilities in the School Meal Programs: Guidance and Q&As
- USDA Memo SP 40-2017: 2017 Edition: Accommodating Children with Disabilities in the School Meal Programs
- Training for Meal Modifications
- CSDE Presentation: Managing Food Allergies in the Cafeteria: The Role of School Food Service Managers and Staff
- CSDE Presentation: Requirements for Meal Modifications in School Nutrition Programs
- Food Allergies (Documents/Forms section)
- Training for Child Nutrition Programs (CSDE webpage)
Developing Policy and Standard Operating Procedures (SOPs) for Meal Modifications
The CSDE recommends that schools and institutions develop a written policy and SOPs for meal modifications in school nutrition programs. For information on developing policies and SOPs, go to What's Next in the left navigation bar.
Nondiscrimination Statements (USDA and CSDE)