Two bills introduced in the Massachusetts legislature last week aim to address long-standing gaps in the diagnosis of celiac disease and the ability for children with this chronic autoimmune condition to safely receive gluten-free meals as part of the state’s Universal School Meals Program.
Filed by Representative Michelle Badger in the House and Senator Joan Lovely in the Senate, HD.5511/ SD.3545, known as the CAPE Act (Celiac Awareness and Pediatric Evaluation Act), establishes a pilot program to evaluate routine screening for celiac disease in children. HD.5510/ SD.3544, known as the SNACCK Act (Safe Nutrition, Allergen, and Celiac Communication for Kids), focuses on improving transparency and communication around medically necessary diets in schools to support safe participation in the Universal School Meals Program.
“Early identification and safe access to food are foundational to a child’s health and ability to succeed in school,” said Rep. Badger. “These bills reflect a thoughtful, evidence-based approach to supporting children with celiac disease and ensuring our public systems work for families who rely on them.”
Both bills were informed by extensive research, clinical collaboration, and stakeholder engagement led by the Celiac Disease Foundation’s education and policy teams, working closely with pediatric clinicians at Boston Children’s Hospital and Mass General Hospital for Children, researchers, school nutrition professionals, and families across the Commonwealth.
“Every child deserves to be diagnosed early and supported at school in a way that allows them to be healthy, included, and successful,” said Sen. Lovely. “These bills are about using data from research, listening to families, and ensuring our policies reflect what children with celiac disease actually need.”
HD.5511/SD.3545, An Act to establish a celiac disease screening pilot program, would create a three-year pilot to evaluate routine screening for celiac disease among 12-year-old children when cholesterol and lipid screenings are already performed. The proposal reflects growing concern among clinicians that celiac disease remains significantly underdiagnosed in children, particularly when symptoms are non-classical or easily attributed to other conditions. The pilot would allow health care providers within the Commonwealth to participate with little or no additional cost, while collecting data on feasibility, outcomes, and potential long-term health and economic impacts.
“Celiac disease remains significantly underdiagnosed in children, often because symptoms are subtle, atypical, or not immediately recognized,” said Dr. Maureen Leonard, Director of the Center for Celiac Research and Treatment at Massachusetts General Hospital for Children, Associate Professor of Pediatrics at Harvard Medical School, and President-Elect of the Society for the Study of Celiac Disease. “By integrating celiac disease screening into an existing, routine health screening at age 12, this pilot program creates a critical opportunity to identify children earlier, prevent years of avoidable health consequences, and ensure families are connected to evidence-based care and support at the moment it matters most.”
Under the bill, the Department of Public Health would oversee the pilot and issue annual reports evaluating screening effectiveness, cost considerations, and recommendations for future action.
HD.5510/ SD.3544, An Act relative to students accessing food and nutritional information, addresses barriers that prevent students with celiac disease and other medically restricted diets from safely participating in school meal programs. Massachusetts is one of a small number of states that provides universal school meals, which include a requirement for schools to accommodate medically necessary diets, including gluten-free meals for students with celiac disease.
The bill would require public, private, and charter schools (Pre-K through grade 12), as well as institutions of higher education, to maintain a centralized, easily accessible section of their website with clear information on:
- Policies and procedures for safe gluten-free and allergen-free food handling
- Monthly gluten-free and allergen-free menus with nutritional information
- Instructions for enrollment and access to meals
- Contact information for food service staff and disability and accessibility services
At a recent statewide summit hosted by the John C. Stalker Institute of Food and Nutrition, researchers from Boston Children’s Hospital presented data underscoring these challenges. Findings showed that 50% of families who screened positive for food insecurity were not participating in free school meals despite eligibility, and 1 in 6 students with celiac disease did not have a 504 Plan in place. Families cited concerns about gluten cross-contact, limited menu options, and lack of clear communication as primary reasons for avoiding school meals. These are the exact issues HD.5510 is designed to address.
“Families have been telling us for years that diagnosis comes too late and that school systems are not consistently equipped to meet their children’s celiac-related needs,” said Marilyn Geller, Chief Executive Officer of the Celiac Disease Foundation. “These bills reflect what happens when research, education, and lived experience are brought together to inform policy. Massachusetts has the opportunity to lead with solutions that meaningfully improve health and quality of life for children with celiac disease.”
Together, HD.5511/ SD.3545 and HD.5510/SD.3544, reflect a growing recognition that celiac disease requires coordinated public health, education, and policy responses. If enacted, the bills could help identify children earlier, reduce preventable health complications, and improve access to safe, inclusive school meals across Massachusetts.
Massachusetts residents can help move these bills forward. The Celiac Disease Foundation encourages individuals across the Commonwealth to contact their state representative and state senator and ask them to sign on as co-sponsors of the CAPE Act (HD.5511/SD.3545) and the SNACCK Act (HD.5510/SD.3544).
Hearing directly from constituents, especially patients, parents, clinicians, and educators, plays a critical role in advancing evidence-based legislation that supports early diagnosis of celiac disease and safe, inclusive access to gluten-free school meals. Personal stories about delayed diagnosis, challenges navigating school meals, or the importance of clear communication can be especially impactful.
To contact your state representative and senator, please use the following link: https://celiac.org/masslegislation
In addition, the Celiac Disease Foundation will host a legislative briefing at the Massachusetts State House on Wednesday, May 13, 2026, to educate lawmakers and staff about the CAPE Act and the SNACCK Act and to highlight the real-world impact of delayed diagnosis and unsafe access to school meals. Families, clinicians, educators, and advocates are invited to attend in person and share their experiences living with or supporting children with celiac disease. Space is limited, and advance registration is required. Sign up to attend using the following sign-up form: https://celiac.org/massbriefingregistration