{
    "sop_number": "409.04.09",
    "old_code": "IVL01-0008",
    "title": "Modified Diets/Special Feeding",
    "division": "Executive Division (Georgia Correctional Industries - Food and Farm Services)",
    "topic_area": "409 Policy-GCI Food Service",
    "effective_date": "2022-06-07",
    "summary": "This policy establishes procedures for GDC facilities to provide modified and therapeutic diets to incarcerated individuals with special medical or dietary needs. It covers how medical staff order therapeutic diets, how food service prepares and delivers modified meals, how to document diet refusals, and how to handle physician-ordered between-meal feedings. The policy applies to all state prisons and centers that operate their own kitchens and includes procedures for tracking diet compliance and managing offenders who refuse prescribed diets.",
    "key_topics": [
        "modified diets",
        "therapeutic diets",
        "special feeding",
        "calorie-restricted diets",
        "diabetic diets",
        "master diet roster",
        "diet orders",
        "medical dietary needs",
        "diet refusal",
        "diet compliance",
        "meal delivery",
        "food service operations",
        "dietary restrictions",
        "between-meal feedings",
        "noncompliance procedures"
    ],
    "cross_references": [],
    "content": "|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|\n|---|---|---|\n|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|\n|**Policy Number:**409.04.09|**Effective Date:**6/7/2022|**Page Number:** 1 of 10|\n|**Authority:**<br>Commissioner<br>|**Originating Division:** <br>Executive Division (Georgia<br>Correctional Industries - Food<br>and Farm Services)|**Access Listing:**<br>Level II: Required Offender<br>Access|\n\n\n\n**I.** **Introduction and Summary:**\n\nA. It is the policy of the Food and Farm Service\u2019s Subdivision to provide Georgia\n\nDepartment of Corrections (GDC) State Prisons and Centers, which operate\nkitchens for preparation of the GDC Master Menu, with procedures for providing\nModified Diets and accommodating offenders with special feeding needs. This\npolicy shall establish and outline standard procedures for the following:\n\n\n1. Ordering of Therapeutic Diets by GDC Health Services;\n\n2. Recording the refusal of Therapeutic Diets;\n\n3. Preparation and delivery of Therapeutic Diets;\n\n4. Delivery and receipt of late meals; and\n\n5. Providing a system for the delivery of physician-ordered between meal\n\nfeedings.\n\nB. Exceptions may be made for contracted food service operations.\n\n**II.** **Authority:**\n\nA. O.C.G.A \u00a742-2-11;\n\nB. GDC Standard Operating Procedure (SOP): 507.04.29 Therapeutic Diets; and\n\nC. ACA Standards: 2-CO-4C-01, 5-ACI-5C-05, 5-ACI-5C-06, and 5-ACI-5C-08.\n\n**III.** **Definitions:**\n\nA. **Modified Diets**    - A diet that includes a meal plan differing from the regular GDC\n\nMaster Menu.\n\n\n|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|\n|---|---|---|\n|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|\n|**Policy Number:**409.04.09|**Effective Date:**6/7/2022|**Page Number:** 2 of 10|\n|**Authority:**<br>Commissioner<br>|**Originating Division:** <br>Executive Division (Georgia<br>Correctional Industries - Food<br>and Farm Services)|**Access Listing:**<br>Level II: Required Offender<br>Access|\n\n\n\nB. **Master Diet Roster**    - A list of all offenders who must receive medically\n\nprescribed meals and snacks. This list is created electronically and printed at each\nfacility.\n\nC. **Calorie Restricted Diets**    - A modified diet that provides a specific caloric value\n\nand automatically includes an HS snack and third meal on weekends and\nholidays. This includes Diabetic, Hypoglycemic, and Weight Reduction diets.\n\nD. **Therapeutic Diets**     - A diet based on the dietary restrictions incurred as a result\n\nof a medical need (i.e., diabetes) per SOP 507.04.29, Therapeutic Diets.\n\n**IV.** **Statement of Policy and Applicable Procedures:**\n\nA. Master Diet Roster:\n\n\n1. All diets and snacks prescribed by medical shall be entered into an offender\n\nmanagement system approved for medical use by GDC. The length of time\nthe offender is to remain on the diet must be included by Medical Services.\n\n2. A Master Diet Roster will be printed by the Food Service Director or\n\ndesignee daily and shall include the following information (Refer to\nAttachment 2, Master Diet Roster):\n\n\na. Last and first name of the offender with their corresponding ID number;\n\nb. The current diet and expiration date of the diet order; and\n\nc. Date in which the roster is in effect.\n\n3. The medical department will manage diet orders at all facilities and will input\n\nany new diets into SCRIBE on a daily basis.\n\n\n|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|\n|---|---|---|\n|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|\n|**Policy Number:**409.04.09|**Effective Date:**6/7/2022|**Page Number:** 3 of 10|\n|**Authority:**<br>Commissioner<br>|**Originating Division:** <br>Executive Division (Georgia<br>Correctional Industries - Food<br>and Farm Services)|**Access Listing:**<br>Level II: Required Offender<br>Access|\n\n\n\n4. The Food Service Department will be notified when Modified Diets are\n\nnecessary according to the following schedule:\n\n\na. By 5 p.m. the previous day in which the Breakfast Meal shall be served;\n\nb. By 10 a.m. the same day in which the Lunch Meal shall be served; and\n\nc. By 3 p.m. the same day in which the Dinner Meal shall be served.\n\n5. Diet revisions made by telephone must be entered into SCRIBE within\n\ntwenty-four (24) hours.\n\n6. The Master Diet Roster will be used to verify the delivery, receipt and/or\n\nrefusal of diet trays for all offenders. The Diet Roster should be initialed at\neach meal by the Food Services Director or designee when a modified diet\ntray is received by an offender. Refusal of a diet tray or failure of an offender\nto pick up his/her tray must also be documented on the Master Diet Roster.\n\n\na. The initialed Diet Roster is used to put non-compliance data into the\n\napproved operating system. The Food Service Director or designee is\nresponsible for entering information pertaining to non-compliance. A\nweekly non-compliance report is printed by Food Service and sent to the\nMedical Department for review.\n\nB. Guidelines for Recording Refusal of Therapeutic Diets:\n\n\n1. When an offender refuses to adhere to a Therapeutic Diet prescribed by\n\nMedical Services, the offender will be required to sign Attachment 2,\nModified Diet Waiver Form.\n\n\n|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|\n|---|---|---|\n|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|\n|**Policy Number:**409.04.09|**Effective Date:**6/7/2022|**Page Number:** 4 of 10|\n|**Authority:**<br>Commissioner<br>|**Originating Division:** <br>Executive Division (Georgia<br>Correctional Industries - Food<br>and Farm Services)|**Access Listing:**<br>Level II: Required Offender<br>Access|\n\n\n\n2. The Modified Diet Form will be filed in the offender's Medical Chart. If the\n\noffender refuses to sign the form, documentation of refusal will be written on\nthe Modified Diet Form or in the Medical Chart.\n\n3. The Master Diet Roster will be used to verify refusal of diet trays for all\n\noffenders receiving a Therapeutic Diet.\n\n\na. Each week, two (2) copies of the noncompliance report from the previous\n\nweek will be generated using the approved computer system. One copy\nwill be sent to Medical Services for review.\n\nb. Offenders who fail to pick up a prescribed diet six (6) times in one week\n\nor fifteen (15) times or more in a month will be counseled by Medical\nServices regarding their dietary noncompliance and the importance of\ntheir diets. Offenders who continue to be non-compliant will have their\nnames submitted for review to the Medical Director requesting\npermission to continue or discontinue the diet.\n\nc. Consideration of medical condition, therapeutic benefit of the diet, and\n\ndegree of noncompliance will be involved in the decision to continue or\ndiscontinue all diets.\n\nd. All discontinued Modified Diets must be updated by medical services in\n\nthe approved offender management system\n\ne. Any offender who is removed from the Master Diet Roster due to\n\nnon-compliance may not be placed back on a modified diet for sixty (60)\ndays.\n\n\nC. Preparation and Delivery of Modified Diets:\n\n\n1. All Modified Diets will conform as closely as possible to the regular menu,\n\n\n|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|\n|---|---|---|\n|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|\n|**Policy Number:**409.04.09|**Effective Date:**6/7/2022|**Page Number:** 5 of 10|\n|**Authority:**<br>Commissioner<br>|**Originating Division:** <br>Executive Division (Georgia<br>Correctional Industries - Food<br>and Farm Services)|**Access Listing:**<br>Level II: Required Offender<br>Access|\n\n\n\nhowever, variations in portion size and substitutions from the regular menu\nmay be made for special diets. Additional information on substitutions is\navailable by contacting the Food and Farm Central Office Registered\nDietitian.\n\n2. Each facility preparing Modified Diets is required to follow the GDC\n\nTherapeutic Plating Guide distributed by Food and Farm Services Central\nOffice Registered Dietitian. The Therapeutic Plating Guide will be available\non the serving line of the diet preparation area and followed when plating diet\ntrays.\n\n3. The Food and Farm Central Office Registered Dietitian must be contacted for\n\nrecommendations if medical services request a diet not listed on the\nTherapeutic Plating Guide. Recommendations shall be provided in writing.\n\n\nD. Late Meals:\n\n\n1. Late meals will be provided for the following offenders:\n\n\na. Offenders returning from medical appointments at ASMP or a local\n\nhospital;\n\nb. Offenders attending the clinic in their institution;\n\nc. Offenders requiring laboratory tests or workups; and\n\nd. New offender transfers to the medical facility at ASMP.\n\n2. Medical Services will order any late meals required from the Food Service\n\nDepartment by telephone. The offender's name, I.D. number, and type of diet\nwill be provided by Medical Services. The meal will be prepared and\ndelivered to the appropriate nursing unit by a Food Service employee.\n\n\n|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|\n|---|---|---|\n|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|\n|**Policy Number:**409.04.09|**Effective Date:**6/7/2022|**Page Number:** 6 of 10|\n|**Authority:**<br>Commissioner<br>|**Originating Division:** <br>Executive Division (Georgia<br>Correctional Industries - Food<br>and Farm Services)|**Access Listing:**<br>Level II: Required Offender<br>Access|\n\n\n\n3. The facility will order any late meals required from the Food Service\n\nDepartment by telephone for an offender in the general population. The\noffender's name, I.D. number, and type of diet will be provided by Security.\n\n4. Documentation of modified diet and regular late meals will be recorded on\n\nthe Late Meal Record form by Food Service. Receipt of late meals in the\nMedical Section will be recorded in the offender's medical record and receipt\nof these meals in the general population will be recorded by Security on\nAttachment 1, Late Tray Record Receipt.\n\n5. Late meals requested after meal service will consist of foods that may be held\n\nunder refrigeration. Food and Farm Services Central Office Registered\nDietitian shall provide contents of late meals for offenders on a modified\n(special) diet. For regular diets, these meals consist of:\n\n\na. 2 sandwiches (4 slices of bread with 2 oz. of luncheon meat and 2 slice of\n\ncheese or 4 slices of bread with 2 oz. peanut butter);\n\nb. \u00bd cup canned fruit or 1 piece of fresh fruit; and\n\nc. 1 carton of milk.\n\nE. Between Meal Feedings:\n\n\n1. Between meal feedings will be provided to offenders when ordered by an\n\nadvanced clinical provider and/or dentist. All between meal feedings shall be\nentered into the offender management system.\n\n2. Expiration dates shall be entered with each diet snack order and shall not\n\nexceed ninety (90) days.\n\n\n|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|\n|---|---|---|\n|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|\n|**Policy Number:**409.04.09|**Effective Date:**6/7/2022|**Page Number:** 7 of 10|\n|**Authority:**<br>Commissioner<br>|**Originating Division:** <br>Executive Division (Georgia<br>Correctional Industries - Food<br>and Farm Services)|**Access Listing:**<br>Level II: Required Offender<br>Access|\n\n\n\n3. The desired time for between meal feedings will be specified, such as A.M.\n\n(8:30 a.m.), P.M. (2:00 p.m.), HS (hour before sleep), etc.\n\n\n4. In-between meal feedings and HS snacks must be ordered as part of the diet\n\npattern and do not automatically apply unless a Calorie Restricted Diet has\nbeen ordered. HS snacks and 3 meals x 7 days will be automatically provided\nfor Calorie Restricted Diets. 3 meals x 7 days will also be provided\nautomatically to offenders who receive the Low Protein diet. Offenders on\nany other diet will not receive 3 meals on weekends unless specifically\nordered by a physician. Renal diet orders are only available at certain\nfacilities. Refer to SOP 507.04.29, Therapeutic Diets.\n\n\na. Regular Snacks: \u00bd sandwich will consist of 1 slice of bread with one 1\n\noz. of luncheon meat and 1 slice of cheese or 1 slice of bread with \u00bd oz.\nof peanut butter. 1 sandwich will consist of 2 slices of bread with 1 oz. of\nmeat and 1 slice of cheese or 1 oz. of peanut butter.\n\n\n1) A.M. Snack: \u00bd sandwich and 1 cup low-fat milk;\n\n2) P.M. Snack: \u00bd sandwich and 1 cup low-fat milk;\n\n3) HS Snack: 1 cup Cereal and 1 cup low-fat milk; and\n\n4) 3 meals x 7 days: 1 sandwich, 1 fruit, and 1 cup low-fat milk.\n\n\nb. Calorie Restricted Diet Snacks conform to diet pattern and is included to\n\nprovide the total calories allotted for the day. If additional between meal\nfeedings other than 3 meals x 7 days or HS snack is desired by the\nphysician, it must be ordered separately.\n\n\nc. Other Snacks - Diets such as liquid, low fat, pureed, etc., may require an\n\nin between feeding or snack. The type of snack required must be ordered\n\n\n|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|\n|---|---|---|\n|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|\n|**Policy Number:**409.04.09|**Effective Date:**6/7/2022|**Page Number:** 8 of 10|\n|**Authority:**<br>Commissioner<br>|**Originating Division:** <br>Executive Division (Georgia<br>Correctional Industries - Food<br>and Farm Services)|**Access Listing:**<br>Level II: Required Offender<br>Access|\n\n\n\nin addition to these types of diets and shall include an expiration date of\nno greater than ninety (90) days.\n\nd. All between meal feedings shall be counted as pack-outs on the daily\n\nmeal count to account for food issues.\n\n5. Delivery of these feedings will vary according to local procedure. These\n\nfeedings contain perishable foods and are to be delivered or picked up within\n30 minutes of the requested feeding times. Space for documentation is\nprovided on the Master Diet Roster.\n\nF. Food Allergies:\n\n\n1. Practitioners should not order a food allergy diet from Food Service unless a\n\nverifiable and documented food allergy exists and is an available diet option.\n\n2. Food Service will only honor documented food allergies to main entrees for\n\noffenders on regular diets.\n\n3. Offenders with undocumented food allergies and allergies that effect menu\n\nitems other than main entrees should be counseled by Medical on avoiding\nthose food items.\n\n4. Substitutions for menu items other than main entrees may be needed for\n\noffenders on Modified Diets or with particular allergies. Food Service should\ncontact the Food and Farm Services Central Office Registered Dietitian for\nany substitutions.\n\n\nG. Ordering of Nourishments (Breakfast Beverages):\n\n\n1. Beverages and nourishments will only be ordered by Medical Services when\n\nnecessary, such as when providing medications or meeting other medically\n\n\n|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|\n|---|---|---|\n|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|\n|**Policy Number:**409.04.09|**Effective Date:**6/7/2022|**Page Number:** 9 of 10|\n|**Authority:**<br>Commissioner<br>|**Originating Division:** <br>Executive Division (Georgia<br>Correctional Industries - Food<br>and Farm Services)|**Access Listing:**<br>Level II: Required Offender<br>Access|\n\n\n\nrequired needs. These will be ordered by the physician and provided by the\nFood Service Department.\n\n2. All requests for beverages and nourishments must be in writing from Medical\n\nServices. Medical personnel must sign that they received the items ordered.\nThe signed request should be filed in the Food Service Department for\naccounting purposes.\n\n3. Special diet requests are to be submitted to the Food Service Department on\n\neach Tuesday and Friday by 10:00 a.m. The Food Service Department will\ndeliver the order on the same day by 3:00 p.m.\n\n4. Special diet requests will be signed by appropriate personnel upon receipt of\n\nthe beverage order. The signed request will be returned to the Food Service\nDepartment for accounting purposes.\n\nH. For cases in which an offender has used food service trays or utensils in a manner\n\nthat is hazardous to themselves, staff or other offenders, staff may provide\nalternative ways of serving food to the offender upon the Warden\u2019s approval.\n\n1. Alternative serving methods include disposable plates, cups, utensils, etc.\n\n2. If alternative procedures are needed for more than seven (7) days, Food and\n\nFarm Services Central Office State Food Service Administrator must be\nnotified so that appropriate supply items can be procured.\n\n**V.** **Attachments:**\n\nAttachment 1: Late Tray Receipt Record\nAttachment 2: Master Diet Roster\nAttachment 3: Modified Diet Waiver Form\n\n\n|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|\n|---|---|---|\n|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|**Policy Name:** Modified Diets/Special Feeding|\n|**Policy Number:**409.04.09|**Effective Date:**6/7/2022|**Page Number:** 10 of 10|\n|**Authority:**<br>Commissioner<br>|**Originating Division:** <br>Executive Division (Georgia<br>Correctional Industries - Food<br>and Farm Services)|**Access Listing:**<br>Level II: Required Offender<br>Access|\n\n\n\n**VI.** **Record Retention of Forms Relevant to this Policy:**\n\nUpon completion, Attachments 1, 2, and 3 shall be kept locally for one (1) year in\nthe Food Service Office, then stored locally for five (5) years in an inactive file and\ndestroyed.",
    "word_count": 2555,
    "powerdms_url": "https://public.powerdms.com/GADOC/documents/105506",
    "url": "https://gps.press/sop-data/409.04.09/",
    "attachments": [
        {
            "number": 1,
            "title": "Late Tray Receipt Record",
            "word_count": 54,
            "url": "https://gps.press/sop-data/409.04.09-att-1/"
        },
        {
            "number": 2,
            "title": "Master Diet Roster (Attachment 2)",
            "word_count": 398,
            "url": "https://gps.press/sop-data/409.04.09-att-2/"
        },
        {
            "number": 3,
            "title": "Modified Diet Waiver Form",
            "word_count": 1058,
            "url": "https://gps.press/sop-data/409.04.09-att-3/"
        }
    ]
}