Special Needs-Meal Modification Info

USDA Child Nutrition Programs support access to healthy meals to all children, including children with disabilities who have special dietary needs. Under the law, a disability is any impairment which limits a major life activity, which can include allergies and digestive conditions but does not include personal diet preferences.

NV Health Staff will guide the initial process of collecting required information and health forms. Food & Nutrition Services will work closely with each building nurse to support your child's dietary needs and provide accommodation as needed.

Please note: an Emergency Care Plan is required for students with life threatening health conditions, such as severe allergies to food(s).  For all students requesting school meal modification, a NV Food Prescription form will need to be signed and on file.

NV SCHOOLS HEALTH STAFF:

SCHOOL MEALS DIETARY MODIFICATIONS

Requirements:

•   NVSD will make reasonable modifications to meal(s) on a case-by-case basis to accommodate disabilities which restrict a child’s diet:
  •   Meals will be provided at no extra charge
  •  Accommodations must be made on a case-by-case basis
  • NVSD is not required to offer specific brands or fundamentally alter the program

• Requests for meal modification must be signed by a State-recognized medical authority, a licensed health care professional authorized to write medical prescriptions in Washington State:
  • Medical Doctor (MD)
  •  Doctor of Osteopathy (DO)
  • Physician’s Assistant (PA) with prescriptive authority
  • Naturopathic Physician
  • Advanced Registered Nurse Practitioner (ARNP)
  • Registered Dietitian ( RD or RDN)

•  A completed NVSD Food Modification Prescription Form must be on file and include the following:
  • Food(s) to be omitted/avoided from the child’s diet
  •  How the ingestion of the food impacts the child
  • How the reaction is triggered

• A MILK SUBSTITUTION REQUEST can be requested by parent with out a signed Food Modification form.
  • USDA's Nutrient levels must still be ulhelp for all milk substites  USDA milk Substitutions Requirement

 If you need this information in another language, please call 360-988-4754

 Spanish Si necesita esta información en otro idioma, llame al 360-988-4754

 Punjabi ਜੇ ਤੁਹਾਨੰ ੂ ਹੋਰ ਭਾਸ਼ਾ ਿ ਵੱ ਚ ਇਹ ਜਾਣਕਾਰੀ ਚਾਹੀਦੀ ਹੈ , ਤ� ਿਕਰਪਾ ਕਰਕੇ  ]'ਤੇ ਕਾਲ ਕਰ।  360-988-4754

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Civil Rights Complaint Form

USDA Nondiscrimination Statement

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: U.S. Department of Agriculture USDA Program Discrimination Complaint Form, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:

1. mail:
   U.S. Department of Agriculture
   Office of the Assistant Secretary for Civil Rights
   1400 Independence Avenue, SW
   Washington, D.C. 20250-9410; or
2. fax:
   (833) 256-1665 or (202) 690-7442; or
3. email:
   program.intake@usda.gov

This institution is an equal opportunity provider.