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Physician assistants and nurse practitioners both work under the direction of a licensed physician.

This will safeguard program integrity while allowing appropriate flexibility for those families that do not have access to a licensed physician.

An Individualized Education Program (IEP) is a plan or program developed in accordance with the Individuals with Disabilities Education Act to ensure that a child who has a disability receives specialized instruction and related services.

When specialized nutrition services are required, a written medical statement or completed Medical Statement form that is signed by a recognized medical authority must support the child’s IEP.

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For the purpose of this MB, these entities will be collectively referred to as Agencies. Department of Agriculture (USDA) regulations under Title 7, Code of Federal Regulations (7 CFR), sections 15.3(b) and 210.10(m), require substitutions or modifications in the National School Lunch Program and School Breakfast Program for children whose disabilities restrict their diets.Either medical statement must clearly identify the child’s: The Agency is required to make dietary accommodations, including texture modifications (such as preparing chopped, ground, or pureed foods), when a recognized medical authority provides a medical statement to the Agency for children whose disability restricts their diet.As defined in 7 Section 210.10(m), an individual who does not have a disability, but is unable to consume a particular food because of a medical or other special dietary condition, is considered to have a special dietary need. This MB provides clarification to child nutrition program (CNP) sponsors on the process, requirements, options, and resources for accommodating children, with and without disabilities, who have special dietary needs. Department of Agriculture Policy Memoranda SP 36-2013, CACFP 10-2013, SFSP 12-2013: Guidance Related to the Americans With Disabilities Act Amendments Act, and SP 32-2015, SFSP 15-2015, CACFP 13-2015: Statements Supporting Accommodations for Children with Disabilities in the Child Nutrition Programs Subject: Guidelines for Accommodating Children with Special Dietary Needs in Child Nutrition Programs This Management Bulletin (MB) supersedes California Department of Education (CDE) MB CNP-07-2014: Guidelines for Accommodating Children with Special Dietary Needs in Child Nutrition Programs, issued in June 2014.An IEP does not supersede the recognized medical authority’s written medical statement.