The Essex North Shore Agricultural & Technical School will must make reasonable modifications to the meal, including providing special meals at no extra charge, to accommodate disabilities which restrict a child’s diet. Some disabilities may require modifications to the service provided at meal time. For example, a child with diabetes may require help tracking what he or she eats at each meal. We may consider taking steps to design a meal plan within the Program meal pattern to accommodate common disabilities. In many cases, disabilities can be managed within the Program meal pattern requirements when a well-planned variety of nutritious foods is available to children. In other cases, however, the needs of a Program participant with a disability may involve requests for accommodations that result in the service of meals that do not meet the Program meal pattern.
Program regulations require the Food Service Department to provide modifications for children with disabilities on a case-by-case basis. But only when requests are supported by a written statement from a State licensed healthcare professional, such as a physician or nurse practitioner (medical statement). See 7 CFR 210.1O(m), and 220.8(m). In addition, meals that do not meet the Program meal pattern are not eligible for reimbursement unless supported by a medical statement. However, SFAs may choose to accommodate requests related to a disability that are not supported by a medical statement if the requested modifications can be accomplished within the Program meal pattern. The medical statement should include a description of the child’s physical or mental impairment that is sufficient to allow the SFA to understand how it restricts the child’s diet. It should also include an explanation of what must be done to accommodate the disability. In the case of food allergies, this means identifying the food or foods to be omitted
and recommending alternatives. In other cases, more information may be required. For example, if the child would require caloric modifications or the substitution of a liquid nutritive formula to accommodate a disability, this information must be included in the statement. When the ENSAT Food Service Department and School Nurse believe the medical statement is unclear, or lacks sufficient detail, they must obtain appropriate clarification so that a proper and safe meal can be provided. SFAs may consider using the services of a Registered Dietitian, when available, to assist in implementing meal modifications, as appropriate. SFAs may also contact their State administering agency for guidance
The ENSAT Food Service Department may consider expense and efficiency in choosing an appropriate approach to accommodate a child’s disability. ENSAT is not required to provide the specific substitution or other modification requested, but must offer a reasonable modification that effectively accommodates the child’s disability and provides equal opportunity to participate in or benefit from the program (Regional Directors State Directors Page 7)For example, a child with an allergy to a specific ingredient found in a menu item may request that the SFA provide a particular brand name version as a substitute. Generally, the ENSAT is not required to provide the brand name item identified, but must offer to provide a substitute which does not contain the specific allergen that affects the child. When determining what is appropriate, the age and maturity of the child should factor into all decisions. For instance, younger children may need greater assistance with selecting and eating their meals, whereas older children may be able to take a greater level of responsibility for some of their dietary decisions. ENSAT is not required to provide modifications that would fundamentally alter the nature of the program; however, this
should very rarely be the case. Generally, the emphasis should be on working with parents and guardians to develop an approach that works for everyone.
ENSAT must work with the school food service staff to implement procedures for parents or guardians to request modifications to meal service for children with disabilities and to resolve grievances. See 7 CFR lSb.25 and 15b.6(b). Procedures in place to address requests to accommodate students with disabilities in the classroom in compliance with Section 504 or the IDEA may be used to fulfill this requirement. At a minimum, parents and guardians must be notified of the process for requesting meal modifications to accommodate a child’s disability and arrange for an impartial hearing process to resolve grievances related to requests for modifications based on a disability. The hearing process must include the opportunity for the child’s parent or guardian to participate, be represented by counsel, and examine the record. It must also include notice of the final decision, and a procedure for review. See 7 CFR lSb.25 and 15b.6(b). Procedures in place to address requests to accommodate students with disabilities in the classroom in compliance with Section 504 or the IDEA may be used to fulfill this requirement.