Requirement to Accept Medical Statements from Registered Dietitians for Schools and Child and Adult Care Institutions and Facilities

On April 25, 2024, the U.S. Department of Agriculture’s (USDA) Food and Nutrition Service (FNS) published the final rule, Child Nutrition Programs: Meal Patterns Consistent With the 2020-2025 Dietary Guidelines for Americans (89 FR 31962). The rule finalized practical, science-based, long-term school nutrition requirements consistent with the goals of the Dietary Guidelines for Americans, 2020-2025 (Dietary Guidelines), extensive partner input, and lessons learned from prior rulemakings. The final rule also included minor updates to the Child and Adult Care Food Program (CACFP) and Summer Food Service Program (SFSP) to better align child nutrition program (CNP) requirements. These updates represent continued progress toward supporting the nutritional quality of school meals, strengthening the CNPs, and advancing USDA’s commitment to nutrition security.

This memorandum and the attached Questions and Answers (Q&A) clarify the updated regulatory requirement for program operators to accept medical statements from registered dietitians. This requirement applies to program operators of the National School Lunch Program and School Breakfast Program (collectively, the school meal programs) (7 CFR 210.10(m)(1)(i), 220.8(m)) and the CACFP (7 CFR 226.20(g)(1)(i)). The change requiring program operators to accept medical statements from registered dietitians must be implemented by July 1, 2025, for school meal programs and Oct. 1, 2025, for CACFP.

Program operators have the option, but are not required, to implement this change prior to the implementation dates.

With the final rule, USDA is balancing the importance of improving participant access to meals that meet their individual needs with the importance of ensuring that program operators have the information necessary to keep participants safe.

State agencies are reminded to distribute this information to program operators immediately. Program operators should direct any questions regarding this memorandum to the appropriate state agency. State agencies should direct questions to the appropriate FNS regional office.

Attachment

• Questions & Answers