A sponsor receives a request for a special dietary accommodation for a participant who has a recognized disability. The request must be submitted on the form titled Special Diet Statement for a Participant With a Disability that prescribes the special diet that must be followed. The form must be signed by a licensed physician, physician assistant, or advanced practice registered nurse such as a certified nurse practitioner.
Since the sponsor is receiving federal funds because of its participation in the Child and Adult Care Food Program (CACFP) it must fully accommodate the special diet order written by the physician. The sponsor or their vendor of meals (caterer) must provide all prescribed food substitutions, special foods, beverages or formulas as outlined by the physician at no extra cost to the participant. In some rare cases, when a parent is concerned about the safe and proper administration of a special diet, the physician may prescribe specific foods or beverages that will be supplied by the parent, in addition to other foods that will be provided by the sponsor. When the above conditions are met the sponsor can claim all meals and snacks served to the participant for reimbursement.
1. A sponsor receives a request for a special dietary accommodation on the form titled Special Diet Statement for a Participant Without a Disability which is signed by a recognized medical authority. The request asks the sponsor to provide a non-dairy, non-creditable beverage such as Almond Dream, Soy Dream, Rice Dream or Almond Breeze. Even though the parent/caregiver/guardian has submitted the proper paperwork the sponsor cannot honor the request for these non-dairy, non-creditable beverages as they are not nutritionally equivalent to cow’s milk. When faced with this type of request a sponsor could:
a. Offer to serve the participant one of the approved fluid milk substitutes listed below in number 2. However, be advised that the current list of approved fluid milk substitutes are all soy-based and cannot be offered/given to a participant who is allergic to soy. If the participant cannot consume cow’s milk or a soy-based beverage as the result of a more disabling medical condition a Special Diet Statement for a Participant With a Disability could be completed and signed by a Minnesota licensed physician, physician assistant, or advanced practice registered nurse such as a certified nurse practitioner that names another beverage that would be well tolerated by the participant.
b. Allow the parent/caregiver/guardian to provide/supply a beverage of their choice, for example, Almond Dream, Soy Dream, Rice Dream, Almond Breeze, etc. Since these beverages are not currently approved as fluid milk substitutes the sponsor would NOT be able to claim for reimbursement any meal or snack in which the parent provided non-dairy, non-creditable beverage was served as a replacement for the required food component of cow’s milk.
2. A parent/caregiver/guardian or medical authority submits a written request to the sponsor asking them to provide a fluid milk substitute (a non-dairy beverage that is nutritionally equivalent to cow’s milk). The written request must identify the medical or other special dietary need that is the reason for the request. Currently, there are only seven manufacturers (that we are aware of) that produce a fluid milk substitute that meets these nutrient standards:
Pacific – Ultra Soy Original OR Ultra Soy Vanilla
Kirkland - Signature Organic Soymilk Plain
Walmart Great Value - Original Soymilk
8th Continent - Original Soymilk OR Light Chocolate Soymilk OR Vanilla Soymilk
Silk – only Silk Original Soymilk
SunOpta - Sunrich Naturals Original Soymilk OR Sunrich Naturals Vanilla Soymilk OR Sunrich Naturals Organic Vanilla Soymilk
Kikkoman - Pearl Organic Soymilk Smart Original OR Pearl Organic Soymilk Smart Creamy Vanilla OR Pearl Organic Soymilk Smart Chocolate
a. Sponsor decides to accommodate the request and purchases and serves one of the approved fluid milk substitutes listed above to the participant. Since the sponsor is purchasing and serving the participant the approved fluid milk substitute, the sponsor can claim all meals and snacks served to the participant for reimbursement to the U.S. Department of Agriculture (USDA).
b. Sponsor does not accommodate the request and does not purchase one of the approved fluid milk substitutes listed above for the participant. As a result the parent/caregiver/guardian decides to purchase and supply the product themselves. If the parent/caregiver/guardian provides one of the approved fluid milk substitutes listed above the sponsor can claim for reimbursement all meals and snacks in which the parent provided beverage is served to the participant.
Lactose Free or Lactose Reduced Milk: Parents may request Lactose Free/Reduced Milk for a participant. A Special Diet Statement is not required to request Lactose Free/Reduced Milk as both products are cow’s milk in which an enzyme (Lactase) has been added to break down the milk sugar (Lactose) into a digestible product. The sponsor is not required to provide this product. However, if they choose to provide it, they may claim all meals and snacks served to the participant for reimbursement. If the parent supplies the product, the sponsor cannot claim reimbursement for any meal or snack in which the parent provided product is served as a replacement for the required food component of cow’s milk. Note: If the sponsor decides to supply the product then they must purchase one percent or fat-free (skim) lactose free/ reduced milk to serve to participants over the age of 24 months.