Food Allergies School Guidelines and Education Presented by: Christanne Harrison and Karen McGrail

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1 Food Allergies School Guidelines and Education Presented by: Christanne Harrison and Karen McGrail

2 Disclosures Christanne Harrison, MPH, RD Consultant The John C. Stalker Institute for Food and Nutrition The Institute of Child Nutrition Karen McGrail, MEd, RDN, LDN None

3 USDA Non-Discrimination Statement In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) Additionally, program information may be made available in languages other than English. To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) Submit your completed form or letter 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 ; (2) Fax: (202) ; or (3) This institution is an equal opportunity provider.

4 Learning Outcomes Participants will recognize key areas of focus for revising state allergy guidelines. Participants will identify key methods to create and deliver consistent training to school staff. Participants will identify three ways to apply information to their own work with food allergies in schools.

5 Background Parents Department of Education led Advisory Group Managing Life Threatening Food Allergies in Schools

6 Poll How many states provide Life-Threatening Food Allergy Guidance for Schools? Most recent editions ranged from

7 Reasons to Update Guidance

8 Food Allergen Labeling and Consumer Protection Act of 2004 First phase became effective January 1, Requires all products to declare the presence of major food allergens, Milk, Soy, Egg, Tree Nuts, Peanuts, Wheat, Fish and Shellfish, in plain language on the label: Using the word Contains followed by the name of the major food allergen (milk, wheat, or eggs for example); or Using a parenthetical statement in the list of ingredients, e.g., albumin (egg) Major food allergens will be declared in flavorings, colorings and spice blends

9 Technology POS School websites Communication

10 CDC Guidance Inclusion of Early Education Care Education for Staff Terminology (i.e. Allergy Management and Prevention Plan)

11 Laws and Regulations Massachusetts Allergy Awareness Act Massachusetts Department of Health, School Health Services Regulations USDA Related Guidance Medical professional Disability

12 MA School Nursing Data Number of epinephrine administrations reported in schools increased from 133 in 2004 to 225 in percent of epinephrine administrations involved individuals who did not have a previously recognized or reported allergy

13 Guidelines Across the United States Inclusions of EEC Inclusions of Labeling/Food Handling 7% 21% 93% 79% Yes No Yes No

14 Key Updates for Guidelines

15 Revision Committee Department of Elementary and Secondary Education Department of Public Health The John C. Stalker Institute of Food and Nutrition School Nutrition Programs Early Education and Care Pediatric Allergist

16 Life-Threatening Allergic Triggers Food Latex Insect venom Medication Exercise Cold

17 Previously Undiagnosed Be ready to respond to severe allergic reactions in children with no history of anaphylaxis School doctor or nurse should stock their emergency medical kits with epinephrine auto-injectors

18 Education and Training Needs School All staff, including in-depth for staff with frequent contact Contracted employees Parents and students Volunteers and substitutes After-School Summer Feeding

19 Early Education and Care Programs Challenges Less nurse availability Fewer opportunities for training State regulations undergoing revisions High variation in programs and staff education

20 Label Reading and Cross-Contact

21 Terminology Consistent terminology for plans Allergy management and prevention plan Medical emergency response plan Individual health care plan Anaphylaxis emergency care plan Cross-contamination vs cross-contact

22

23 Practice Applications Strengthen connection between the school nurse and school nutrition program Create Allergy Management and Prevention Plans for school nutrition Provide much needed training and education to school staff, parents, and school community

24 School Nutrition Staff: Food Allergy Knowledge Strengths Seriousness of food allergies Symptoms of food allergies Foods are labeled for allergens Identifying students with food allergies Avoiding cross-contact Sharing information about allergens

25 School Nutrition Staff: Food Allergy Knowledge Weaknesses Difference between allergies and intolerance Practices on consistent label reading/keeping labels Specific details about how foods are labeled School Allergy and Prevention Plan/Emergency plan

26 The John C. Stalker Institute of Food and Nutrition (JSI) is a partnership between the Office for Food and Nutrition Programs at the Massachusetts Department of Elementary and Secondary Education and Framingham State University

27

28 Updated January 2016 to align with Massachusetts Managing Life-Threatening Allergies in Schools Guidelines

29 Food Allergy Training Totals FY16 # WTG/ # Participants FY15 # WTG/ # Participants FY14 # WTG/ # Participants Food Allergies Workshop-To-Go (WTG) 15 / 339 (16% total workshops) 16 / 425 (22% total workshops) 14 / 311 (23% total workshops) Food Allergies Online 10 / / 98 9 / 125 Total 25 / / / 436

30 Development Interactive 2-hour workshop Face-to-face and online Adult learning theory Professional presentation of content Q & A, scenarios and learning activities Content aligns with Massachusetts Managing Life-Threatening Allergies in Schools Guidelines Evaluation Learning Objectives Instructional Qualities

31 Learning Objectives

32 Mode of Delivery Workshop-To-Go Face-to-face K-12 schools

33 Mode of Delivery Online 2-hour course available 24/7 over 2 week sessions Certificate 4-week online course for school professionals 15 hours Continuing Education Units for SN and RDNs 22.5 PDPs for Teachers

34

35

36

37

38

39

40 Instructors Cadre of instructors JSI contractors Experts in school nutrition, special diets and workshop presentation RDNs with Masters degree or SNS credential

41 Participant Evaluation

42 Resources Center for Disease Control and Prevention, Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs _a_food_allergy_web_508.pdf Massachusetts Department of Secondary and Elementary Education, Managing Life-Threatening Allergies in Schools The John Stalker Institute of Food and Nutrition

43 Questions Thank you!

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