NSLP/SBP PY20-21 Sodium, Whole-Grain, and Milk Meal Pattern Notification Form

A federal court ruling earlier this year has reversed several NSLP/SBP meal pattern flexibilities. As a result, the following meal pattern changes are effective immediately:

All grain contribution components must be 100% Whole Grain Rich.
Sodium reduction goals will revert to (original) Sodium Target 2.
All flavored milk must be fat-free/skim.
Texas CEs have one school year to come into compliance. No action is necessary at this time unless the CE prefers to immediately comply with the current meal pattern including the changes listed above. CEs immediately implementing the meal pattern with the above changes must notify TDA.

All CEs are required to comply with these meal pattern changes for SY 21-22.

If you choose to continue serving the 2019-2020 meal pattern, no further action is required. You are not required to submit this form and may continue to serve the 2019-2020 meal pattern through June 30, 2021.

If you plan to use the original 2012 meal pattern, you must submit this form to notify TDA of your intention in following the original meal pattern as follows:

Component	Requirement
Milk	Fat free-flavored and unflavored milk Low fat (1%) unflavored
Whole Grain-Rich	100% weekly grains will be whole grain-rich
Sodium	Target 2

Detailed guidance about the original 2012 meal pattern requirements can be accessed by clicking the following link to the Administrator Reference Manual. Changes for the Meal Pattern for PY 20-21 are shown in green text.

Administrator Reference Manual Changes for the Meal Pattern for PY 20-21

Please check: *

Only CE staff may submit this form. A food service management company (FSMC) staff member cannot submit this form on behalf of the CE or attest to its accuracy.

Please complete the following questions and click at the bottom of the form. TDA will provide email notification that the form has been received.

Contracting Entity (CE) Name: *

Enter name as displayed in the TX-UNPS application.

CE Identification (ID) *

Enter the 5-digit number from the TX-UNPS application and claims.

CE elects to meet the following requirement(s) in PY 2020-2021: *

All grains offered in NSLP/SBP must be 100% whole grain-rich All flavored milk offered in NSLP/SBP must be fat-free/skim milk only Sodium Target level 2 for NSLP/SBP

Sodium Target	Grades K-5	Grades 6-8	Grades 9-12
SBP Target (mg)	T2 ≤ 485 mg	T2 ≤ 535 mg	T2 ≤ 570 mg
NSLP Target (MG)	T2 ≤ 935 mg	T2 ≤ 1035 mg	T2 ≤ 1080 mg

Attestation Statement

Check that each of the following statements is true: *

I am an Authorized Representative (AR) of the Contracting Entity (CE) listed on the “FND-101, CERTIFICATE of AUTHORITY for EXTERNAL USERS” or “FND-135, USER ACCESS MANAGER FORM” that has been approved by TDA prior to this submission of this waiver notification. I certify that the CE has retained documentation related to the information submitted in this request for all meals served and claimed under this waiver. This includes, but is not limited to, food production records. I understand that it is the CE’s RESPONSIBILITY TO IMPLEMENT THIS WAIVER IN COMPLIANCE WITH ALL APPLICABLE REGULATIONS and that NON-COMPLIANCE MAY RESULT IN ADVERSE AND/OR FISCAL ACTION.

Enter name of Authorized Representative *

First Name Last Name

Each party acknowledges and agrees that information in this form is attested to by the name entered in the field above and shall be considered as an original signature for all purposes and shall have the same force and effect as an original signature.

Submissions will be denied if submitted by a non-authorized representative in TX-UNPS.

Contact Name *

First Name Last Name

Contact Position/Role *

Superintendent Child Nutrition Director Administrator Dietitian Manager/Supervisor Authorized Individual

Contact Email: *

example@example.com

Contact Phone:

Area Code Phone Number

Status:

Denied

Reason for denial:

Authorized user not in TX-UNPS. Please resubmit the form with an authorized contact name and email address