Meal modifications must be related to the disability or limitations caused by the disability and require a

medical statement from a state-licensed healthcare professional who is authorized to write medical

prescriptions under state law. According to 225 ILCS 85/3, prescriptions must be issued by one of the

following in the state of Illinois:  physician licensed to practice medicine in all branches, physician’s assistant

(in accordance with subsection (f) of Section 4), or an advanced practice registered nurse (APRNs) (in

accordance with subsection (g) of section 4.

For schools participating in a federally-funded student nutrition program, USDA regulations 7 CFR Part 15b

require substitutions or modifications in school meals for students whose disabilities restrict their diet.  A

student with a disability must be provided substitutions in foods when that need is supported by a statement

signed by a licensed health care provider.  The physician's statement must identify:

• the student's disability;

• an explanation of why the disability restricts the student's diet;

• the major life-activity affected by the disability;

• the food or foods to omit from the student's diet; and

• the food or foods that may be substituted.