|
|
|---|
| TO: | Area Directors Area Chief Medical Officers Headquarters Office Directors Service Unit Directors Chief Executive Officers of IHS Federally Operated Facilities |
|---|---|
| FROM: | Chief of Staff (Delegated Authority of the IHS Director) |
| SUBJECT: | Implementation of the Dietary Guidelines for Americans, 2025-2030, and Increased Use of Traditional Foods |
The purpose of this Special General Memorandum (SGM) No. 26-01 is to direct all Indian Health Service (IHS) federally operated facilities to align food and nutrition services with the Dietary Guidelines for Americans, 2025–2030 1 (DGA) and to increase the use of traditional foods, when feasible and appropriate.
Facilities must incorporate traditional foods into meals and programs, establish safe procedures to accept and serve them, and comply with applicable food safety and legal requirements.
Facilities should engage local Tribes, patients, clinicians, dietitians, and, as appropriate, elders, culture bearers, and food sovereignty partners to identify appropriate traditional foods and culturally grounded approaches.
BACKGROUND
Federal guidance issued in March 2026 2 requires hospitals to follow current nutrition standards. The DGA emphasizes whole, nutrient-dense foods, and limits highly processed foods and added sugars. This aligns with IHS policy supporting culturally appropriate nutrition and traditional foods.
APPLICABILITY
This memorandum applies to all IHS Federally operated facilities, including hospitals, clinics, and Youth Regional Treatment Centers that provide food and nutrition services, as well as to Headquarters and Area Offices supporting nutrition or food services. It does not impose requirements on Tribes or Urban Indian Organizations.
POLICY
Effective immediately, facilities must update menus and nutrition materials; prioritize whole, minimally processed foods; and reduce highly processed foods and added sugars. Facilities must follow clinician orders, meet patient needs, and ensure oversight by qualified nutrition professionals. Facilities must implement changes as quickly as practicable.
HEADQUARTERS AND AREA RESPONSIBILITIES
Headquarters and Area Offices must review existing food and nutrition policies for update or withdrawal, provide technical assistance on compliance, and ensure IHS-funded events serve food consistent with this memorandum.
REPORTING
Within 60 days of the date of the SGM, each IHS facility must submit a brief status report to its Area Office. Area Offices must review and consolidate facility reports and submit one Area report to the Office of Clinical and Preventive Services (OCPS). Reports must describe actions taken to implement this memorandum, current status, barriers and challenges, and any technical assistance needs. The OCPS will review submissions, provide technical assistance as needed, and brief the IHS Executive Leadership Team on overall progress.
This memorandum does not override clinical judgment, patient needs, or legal requirements. Staff must follow all applicable laws and safety standards.
EFFECT ON EXISTING AUTHORITIES AND CLINICAL JUDGMENT
Nothing in this memorandum supersedes individualized clinical judgment, therapeutic diet orders, patient-specific medical needs, emergency feeding requirements, or applicable procurement and appropriations law. This memorandum shall be implemented in a manner consistent with patient safety, applicable accreditation and regulatory standards, and all other applicable laws.
EFFECTIVE DATE
This SGM is effective immediately upon signature and remains in effect until superseded or incorporated into the Indian Health Manual.
/Clayton W. Fulton/
Clayton W. Fulton
Chief of Staff
(Delegated Authority of the IHS Director)
Indian Health Service
1 HHS and USDA, Dietary Guidelines for Americans, 2025-2030 (Jan. 2026), https://cdn.realfood.gov/DGA.pdf
2 CMS, QSSAM-26-03-Hospital/CAH, Hospital Nutrition Service Obligations in Light of Updated Federal Nutrition Guidelines (Mar. 30, 2026), https://www.cms.gov/files/document/qssam-26-03-hospital-cah-original-release-2026-03-30.pdf
