Federal law and the regulations for the National School Lunch Program and the School Breakfast Program require schools to make accommodations for children who are unable to eat the school meal as prepared because of a disability. Accommodation generally involves substituting food items, but in some cases schools may need to make more far reaching accommodations to meet the needs of the children. For example, some children may need to have the texture modified.
In order to make substitutions for items in the reimbursable meals, the school must have on file a written statement signed by a licensed physician indicating the child's disability is, what foods must be omitted from the child's diet, and what foods must be substituted.
Schools may, at their option, make substitutions for persons who have special needs that do not meet the definition of disability under Federal las. In these instances, the school must have a written statement signed by a recognized medical authority (e.g., nurse or physician's assistant) indicating what foods should be substituted.
The purpose of requiring a written statement is two-fold. First, it ensures that the nutrition integrity of the school meal will not be compromised by the substitution. More importantly, it ensures that decisions about specific food substitutes are made by persons who are highly qualified to prescribe them. Therefore, this requirement helps to protect both the child and the food service personnel who are working to meet the child's needs.
~Who qualifies as a physician or other recognized medical authority?
A physician is a person licensed by the state to practice medicine. The term includes osteopathic physicians or doctors of osteopathic medicine. These are fully trained physicians who are licensed by the state to prescribe medication or to perform surgery. A recognized medical authority is a licensed physician, physician assistant, nurse practitioner or other health professional specified by the state agency.
Download the written statement here
If you need further information, please contact Leslie Tuimaualuga at 805-389-2100 x1223 or email