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July 5th, 2024
By Katie Chatfield, MPH, RDN, LD, CCNP, Nutrition Manager

In April 2024, the United States Department of Agriculture (USDA) released its final rule updating nutrition requirements in the Child and Adult Care Food Program (CACFP) to better align with recommendations from the Dietary Guidelines for Americans. In addition to this final rule updating sugar limits from total sugar to added sugar for breakfast cereals and yogurt, it now allows registered dietitians to sign medical statements requesting meal modifications for children with food allergies, medical conditions or other disabilities.

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Special Diet Statements are needed when children require modifications to the CACFP meal patterns (for example, a child with a cow's milk allergy needs milk alternative that does not meet meal pattern requirements). With a Special Diet Statement on file, a child care provider is able to meet the child's need for a meal modification while still being able to claim a reimbursable meal or snack.

For a Special Diet Statement to be approved, they must meet three criteria:

Explain how the child is affected by exposure to the food in question
List the food(s) to be omitted and food(s) to be substituted (if applicable)
Be signed by a state licensed healthcare professional

Under the new rule, registered dietitians will be able to write and sign Special Diet Statements along with other licensed healthcare providers such as physicians, physician's assistants and nurse practitioners licensed in Minnesota. This change will go into effect October 1, 2025.

This update benefits providers and families in several ways, including making it simpler to access a provider who can sign a medical statement requesting a meal modification. Instead of waiting to get an appointment with a child's primary care provider or nurse, families can request meal modifications from a registered dietitian who is familiar with the child's medical and nutrition needs (for example, a registered dietitian already working with a child at a WIC clinic). Providers Choice is pleased that USDA has streamlined the process of supporting and accommodating children with special dietary needs.

Questions about this change? Reach out! We love working with providers and families and are dedicated to supporting you.