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Authors: Donna Decosta

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Safe@School™ was the nonprofit whose sole mission was to educate people at schools, camps and daycares how to confidently care for kids with food allergies. One of the main reasons I believe this curriculum has proven so effective is that I approached the problem not just from a parent's perspective, but from a school's perspective as well. How unsettling it must be to have to deal with a medical condition that is often unfamiliar, while at the same time educating the hundreds of other kids in your care. I wanted the curriculum to be practical, efficient and doable for schools.

Q: As the CEO of FAAN, what guided your work on behalf of children and adults with food allergies?

A: I was guided by two main mission points: to continue our quest for a medical treatment for food allergies, and to provide the lifesaving education that our families rely on in the meantime.

Q: FAAN emphasized a four-point mission statement including advocacy, research, education and awareness. Please elaborate on some of the programs the organization developed to address these points.

A: 1. Advocacy: At the federal level, FAAN's efforts led to the passage of FALCPA in 2004, the Food Allergen Labeling Consumer Protection Act. This legislation was monumental in increasing the food choices and safety of food-
allergic consumers. Today, we are fighting hard for the national passage of the School Access to Emergency Epinephrine Act. No child should lose his or her life to an anaphylactic reaction because the school doesn't have access to an epinephrine auto-injector. The story of Amarria Johnson, a first grader in Virginia who succumbed to fatal anaphylaxis in January 2012 while at school, perfectly illustrates why we need this law.

2. Research: FAAN and FAI continue to fund research to bring an effective food allergy treatment to patients across the country. Several promising treatments, primarily oral immunotherapy, offer much hope to our patients.

3. Education: From food allergy conferences across the country to a resource store packed with books, pamphlets and recipes, FAAN's sweet spot has always been usable, practical education for all our stakeholders: families, schools, restaurants, airlines and more.

4. Awareness : FAAN was the driving force behind Food Allergy Awareness Week, held in May every year. Our walk program is expanding to over 60 cities in 2013. We've also been fortunate to be able to air public service announcements with Dr. Oz and Trace Adkins on food allergy safety.

Q: FAAN has achieved remarkable strides on behalf of those affected by food allergies. The Food Allergy and Anaphylaxis Network (FAAN) and the Food Allergy Initiative (FAI) successfully merged in November 2012 to become a new organization called FARE. What is the mission of this organization?

A:
What made the merger of FAAN and FAI so logical is that our missions are completely aligned. FARE will continue to support world class research for a cure for food allergies while supporting families with education and advocacy that help them lead safer, fuller lives.

Q: What specific information is important for parents of food-allergic children to communicate to caregivers, school personnel and other family members about a child with food allergies?

A:
This is such an important question. I've thought a lot about what the most important things are to communicate, especially when you feel like you have a limited amount of time/attention span. First and foremost, you must
communicate the need for strict avoidance of the allergenic food and the reality that an anaphylactic reaction can be fatal. In addition, you must communicate the need to administer epinephrine immediately when the symptoms of anaphylaxis are recognized. Epinephrine is safe and is the unanimous first-line treatment for anaphylaxis. It's essential that epinephrine be on hand at all times for the allergic child. No exceptions, period, on this rule.

Q: Regarding the protection of food-allergic children in a school setting, please explain 504 and individualized health plans. Where can parents find more information regarding how to implement such a plan on behalf of their food-allergic children?

A:
There are three types of written documents that help schools keep kids with food allergies safe: 504 plans, individualized health care plans (IHP), and food allergy action plans (FAAP). 504s are really a set apart because they are the only plans that are legally binding upon the school, having their origins in Section 504 of the Rehabilitation Act of 1973 (a federal law that establishes a policy of nondiscrimination against individuals with disabilities). We could write a book on 504s or IHPs themselves! The website "Kids with Food Allergies" (
www.kidswithfoodallergies.org
) has a wonderful document that I co-authored with the founder and president, Lynda Mitchell. It compares these three written plans.

A FAAP is the minimum documentation that every food-allergic child should have. It is a two-sided, one-page document that lists the allergies, recommended treatment and emergency contact information. It also usually includes a photograph of the child.

IHPs are more involved and record more information. They are completed with the help of the school health personnel and discuss different accommodations the school may be making to ensure the safety of the child.

A 504 has similar information to an IHP but comes with legal enforcement mechanisms and due process rights. Parents should seek out their school's 504 officer to discuss how to initiate this process. A lot of wonderful information can also be found on the website of the U.S. Department of Education's Office for Civil Rights, which has jurisdiction over Section 504. That information is located at
www.ed.gov/about/offices/list/ocr/504faq.html
.

Q: What resources are available from FARE to assist schools and daycare facilities with food allergy training of staff and students?

A:
The Safe@School™ curriculum is wonderful. It comes with a ready-made presentation for staff along with talking points for each and every slide. It covers everything an educator should know about caring for kids with food allergies in an easy-to-understand, practical way. FARE also has more comprehensive tools such as the school food allergy binder and the daycare binder that covers all the topics from A to Z that need to be thought through and acted upon.

23

JOEL SCHAEFER

Title: President, Allergy Chefs, Inc.

Previous position: Manager of Product Development and Special Diets, Walt Disney
®
World Resort

Author of
Serving People with Food Allergies: Kitchen Management and Menu Creation

Website:
www.AllergyChefs.com

Question: Because of its excellence in food safety and risk management strategies, Walt Disney World
®
Resort is recognized as a role model for food establishments worldwide. As the former Manager of Product Development and Special Diets at Walt Disney World
®
Resort, please explain how you acquired that position and how you created and implemented a food safety program.

Answer:
My first role at Disney was a chef at the Polynesian Resort. While there, it was my first opportunity to cook for people with food allergies and special diets. After a few years, I transferred to the Yacht and Beach Club Resort in catering and worked there for two years. During that time, we noticed an increase
in food allergy requests. Disney was proactive and in 2004 created a brand-new position called Culinary Development and Special Dietary Needs Manager to address the increase in special dietary requests. The company didn't have anybody to head up this position, so I applied. Having a background in culinary education and a milk allergy myself, I was perfect for the position.

My first task was to bring a team together from all departments and begin brainstorming about what would be the best way to develop one standard that everybody could live by. With the work of the Special Dietary Committee and feedback from the restaurant managers and chefs, we came up with one standard program that worked for all types of food service operations -- quick service restaurants, table service restaurants, buffets and catering.

Q: Please elaborate on the food safety program you implemented.

A:
The Special Dietary Request Program is based on the four R's (Refer, Review, Remember, Respond) developed by FAAN, now known as FARE. "Refer" is when a guest alerts a front-of-the-house cast member (employee) that the guest has a special dietary request, and he is then referred to a manager or chef. "Review" is when the manager reviews the special dietary request with the guest to determine the best food option. "Remember" is for the chef or manager to remember to check all ingredient labels and cooking procedures to check for hidden ingredients and cross-contact issues. "Respond" is when the manager or chef responds back to the guest on their findings and how they can accommodate the guest.

Q: How has that experience contributed to the development of your own company, Allergy Chefs?

A:
After working at Walt Disney World
®
Resort for many years, I decided it would be great to take what I learned and help educate other restaurants on how to do what Disney has accomplished. It really inspired me to write a book so I could share this knowledge and help other chefs and managers develop their own program using these steps. So I wrote
Serving People with Food Allergies: Kitchen Management and Menu Creation.
It was specifically written for chefs and managers in food service terms so they could understand how to apply it to their operation. The book was a great calling card so I started my own business and started working with restaurants and culinary programs that were interested in learning about food allergies.

Q: Regarding food establishments, do you think it is the responsibility of the food service industry to accommodate the dietary restrictions, including food allergy and intolerance, of their patrons?

A:
I think there are two pieces to that. I think they are responsible for knowing what they can and cannot do. You have to know the difference when to say yes or no. Many establishments are not capable of serving people with food allergies because they're not educated about food allergies. So I would rather have them understand the difference when to say yes or no. This will save a guest from being sick or possibly dying and keeps the restaurant from a possible lawsuit or other issues that can come along from not handling the situation correctly.

Q: How should they best communicate to patrons they're able to do that? Just by asking or talking to them?

A:
They should use the four R's as their process. If a guest tells you they have a food allergy, the person that's talking to the guest refers them to a manager or chef, someone that can give them a reasonable answer to their question. Don't leave it up to the servers or hostess because that's not their responsibility.

Q: What advantages does a restaurant stand to gain by implementing a special dietary needs program?

A:
The advantage is an increase in business and a better standing in the community. It could be only one person with the food allergy, but once they find a restaurant where they feel safe to eat, they're going to go back. They're going to bring more people because "Hey, I can eat at this restaurant! Come on, let's go have a party!" They've probably been invited many times to places where they thought, "I can't go there because they can't cook for me."

Q: What resources are available to assist those professionals who want to implement such a program?

A:
Definitely my book is one. There's a variety of companies that offer online training. It's really important to find the correct training because there are some training programs that are so vague it doesn't really give you what you need. I offer online training on my website at Allergy Chefs which is only $15 per session. There's also another version of my training on My Culinary
Campus.com
. And then there's of course FAAN, Food Allergy and Anaphylaxis Network,
which is now FARE. They merged with FAI, Food Allergy Initiative. There are some gluten-free associations that offer training. Great Kitchens is another one.

Q: Please explain your unique training program called "T.E.A.C.H. Food Allergen Safety" for the food service industry.

A:
What "T.E.A.C.H. Food Allergen Safety" offers is more detail about what you should do when dealing with people with food allergies. It's coming from the perspective of a chef. I have key points in there that I focus on that chefs should remember. The biggest one is you can't destroy or kill a protein by heat. That's the biggest misunderstanding that chefs have in the kitchen, "Oh, I can just cook it out." They're thinking of bacteria or viruses versus protein. I also offer training tools that can be purchased that are great and can be used in house for their own training.

Q: What do you think are the responsibilities of the server, chef and manager in accommodating food allergy and special dietary requests of their patrons?

A:
The server should know that they need to notify a manager or chef once someone says they have a food allergy or special dietary request. That's the most important piece because they need to get management involved.

If a manager gets involved, they need to make sure they discuss in detail what the guest's food allergies are and not make any promises. Find out what the allergies are and what the guest can eat. This goes for the chef as well.

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