Transcript Standardized Recipes & Nutrition Facts Labels

Meeting the Nutritional
Needs of Children with
Special Dietary Requests
by
Linda Fischer, RD, LDN
Educational Specialist
Tel. #781-338-6456
E-mail: [email protected]
Agenda
• Child Nutrition Program Regulations
• American with Disabilities Act
Amendments Act (ADAAA)
• Types of Dietary Medical Issues
• Massachusetts Allergen Awareness
Regulation
• Resources
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Child Nutrition Program Regulations
Section 9(a) of the Richard B. Russell
National School Lunch Act, 42 USC
1758(a), states those schools,
institutions, facilities, sites, and
sponsors participating in the Child
Nutrition Programs must make dietary
accommodations for children with
disabilities.
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What Qualifies as a Disability?
Americans with Disabilities Act
Amendments Act (ADAAA) of 2008
The ADAAA (P.L. 110-325) amended
the Federal definition of disability,
broadening it to cover additional
individuals.
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What Does the Amendment Mean for
Child Nutrition Program Operators?
Because of the broader definition of
disability, it is reasonable that Child
Nutrition Program operators may see
more children identified by their
licensed physician as having a food
related disability than were identified
previously.
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The ADAAA Broadened Definition
There are now two categories (instead
of one) to consider when identifying
individuals with disabilities.
These include:
1) Major Life Activities (was part of the
original Americans with Disabilities
Act)
2) Major Bodily Functions (new)
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Major Life Activities Include:
• Caring for
oneself
• Walking
• Reading
• Standing
• Concentrating
• Lifting
• Thinking
• Seeing
• Bending
• Communicating
• Hearing
• Speaking
• Working
• Eating
• Breathing
• Sleeping
• Learning
• Performing
manual tasks
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Major Bodily Functions Include:
• Functions of
the immune
system
• Normal cell
growth
• Digestive
• Bowel
• Neurological
• Bladder
• Cardiovascular
• Brain
• Endocrine
• Respiratory
• Reproductive
functions
• Circulatory
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The ADAAA Broadened Definition
It’s Important to Note…
• Individuals who take mitigating
measures to improve or control any of
the conditions recognized as a disability,
are still considered to have a disability
and require an accommodation.
• However, the process for identifying
children with disabilities requiring an
accommodation has not changed.
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Familiar Disabilities Impacting
Child Nutrition Programs
• Food anaphylaxis (severe food allergy)
• Metabolic diseases, such as diabetes or
phenylketonuria (PKU)
• Celiac disease
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Milk
Shellfish
Fish
Eggs
Eight Major
Food
Allergens
Soybeans
Peanuts
Tree Nuts
Wheat
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Food Allergy vs. Food Intolerance
Food Allergy
• An overreaction of the immune system to
certain proteins in foods. Some food
allergies can be life threatening.
Food Intolerance
• Does not involve the immune system. Food
intolerances can cause great discomfort but
are not life threatening. Lactose intolerance
is one of the most common.
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Types of Dietary Medical Issues
1) Severe
Includes children with:
- A life-threatening food allergy (i.e. food
anaphylaxis)
2) Non-Severe
Includes children with:
- Non life-threatening food allergies
- Special dietary needs
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Severe Food Allergy Considerations
YES
YES
YES
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Non-Severe Food Allergy Considerations
NO
NO
YES
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Reimbursable Meal Considerations
1) In order for a meal to be claimed for
reimbursement it must contain all
required components.
2) Refer to individual medical statements
for children who require food
substitutions.
3) If substitutions are not provided as
documented in the medical statement
then the meal CAN NOT be claimed for
reimbursement.
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Massachusetts Food Allergen
Awareness Regulation
Section 105 CMR 590.009 established Food
Allergy Awareness Requirements
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Exemptions
Exemptions for public and private schools,
educational institutions, summer camps,
childcare facilities, and other child care
programs approved to participate in USDA
Child nutrition Programs are exempt from
105 CMR 590.009(H), with the exception of
105 CMR 590.009(H)(3)(b)2,
Provided that they have…
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Exemptions
1) Written policies and procedures
(effective October 1, 2010) for
identifying, documenting, and
accommodating students with food
allergies, and
2) Documentation verifying participation in
food allergen training recognized by the
MA Department of Elementary and
Secondary Education (ESE) and the
Department of Public Health (DPH).
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What Will Satisfy the
Food Allergen Training Requirement?
1) Food Allergen training provided by the
John C. Stalker Institute (JSI) of Food and
Nutrition.
2) Food allergy awareness certification from a
MA Department of Public Health (MDPH)
approved vendor.
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Enforcement
• The Act gives the authority for
enforcement of the regulations to local
boards of health.
• Health inspectors may question the
Person in Charge (PIC) to ensure
knowledge of allergens and symptoms
of an allergic reaction.
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Enforcement
What Happens if Compliance With the
Regulations are Not Met?
1) Failure to comply will result in a critical
item on the inspection report requiring
corrective action within 10 days.
2) Local boards of health may use fines
and other enforcement actions available
under 105 CMR 590.000 and state law
to achieve compliance.
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Resources for Districts/Schools
Accommodating Children with Special
Dietary Need in the
School Nutrition Programs
Guidance for School
Food Service Staff
United States Department of Agriculture
Food and Nutrition Service
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Resources
Accommodating Children with Special Dietary Needs in
the School Nutrition Programs
http://www.fns.usda.gov/cnd/guidance/special_dietary_n
eeds.pdf
Asthma and Allergy Foundation of America
http://www.aafa.org/display.cfm?id=9&sub=30#over
John C. Stalker Institute of Food and Nutrition
http://www.johnstalkerinstitute.org/
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Resources
MA Food Protection Program
http://www.mass.gov/eohhs/gov/departments/dph/progr
ams/environmental-health/food-safety/retailfood/policies/special-operations.html
Managing Life Threatening Food Allergies in Schools
http://www.doe.mass.edu/cnp/allergy.pdf
USDA Guidance Related to the ADA Amendments Act
(Policy Memo SP 36-2013)
http://www.fns.usda.gov/cnd/governance/PolicyMemos/2013/SP36-2013os.pdf
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Questions??
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