Section 504 of the Rehabilitation Act of 1973 prohibits discrimination on the basis of disability.
Students in regular or special education are entitled to the related services and program and policy modifications that enable them to attend school and benefit from their instruction.
"Disability" is defined as "any physical or mental impairment which affects one or more body systems or substantially limits one or more major life activities...for example, breathing.
US Department of Education regulations implementing S. 504 require schools to follow procedures to safeguard parents' rights, to ensure that decisions about a child's needs and how they will be met are fair and appropriate, and to ensure that schools and parents act as equal partners in planning an decision-making.
(Reference: The Civil Rights of Students with Hidden Disabilities under Sec. 504, U.S. Department of Education Office for Civil Rights, www.ed.gov/OCR)
What are the Risks? air quality animals art field trips fire drills infection exposure lunchroom meals/parties overcrowding physical education playground plays/dress up recess renovation schedule changes science siblings special events sports substitute teasing testing transitions transportation visitors other
Legal Issues in School Health Services: A Resource for School Administrators, Attorneys and Nurses, (Schwab & Gelfman, Eds., 2001, North Branch MN: Sunrise River Press.
Managing Life Threatening Food Allergies In Schools, Massachusetts Department of Education
The School Nurse's Source Book of Individualized Healthcare Plans, 1993. Marykay B. Haas, et al.
Food Allergies: Building the Coordinated Care Plan
A coordinated care plan ensures that care is safe, reliable, continuous and effective.
Your child's IHP and 504 Plan provide the information, guidelines and standards that promote both your child's health and educational goals while avoiding unnecessary risk, restriction, stigma, illness and absences. It establishes a basis for ongoing teamwork, communication and evaluation.
An Individualized Health Plan (IHP) is your child's health security plan.
A licensed school nurse develops the IHP in collaboration with the student's parents in accordance with applicable laws and standards of practice for nursing in the school setting. (See the National Association of School Nurses www.nasn.org.)
An IHP is based on the student's physician's documentation of the student's diagnosis and recommendations for the student's health and safety in all locations and during all activities during the school day.
The school nurse ensures that the plan for comprehensive health management, safety and emergency response is safe, reliable, continuous and effective in all school settings and activities.
In addition, a 504 plan defines and coordinates roles, responsibilities, guidelines, policies and practices for all school staff to enable your child to access and benefit from all elements of his/her educational program.
The IHP and the 504 plan provides school personnel with the necessary information and authorizations to make appropriate decisions, the family's and staff's concerns are addressed,roles and responsibilities are clear. (What if......?)
How do school routines, policies, staff roles and responsibilities fit student's needs? What adjustments or changes are necessary?
What is the teacher/administrator's/ school nurse's relationship with student's physician(s)? Who is the parent's school contact?
How will medication/treatment be administered? health monitored?
When should the teacher/school nurse call the parent or physician(s) with a question or a concern?
What special emergency provisions are necessary? What planning should be done with local rescue team? nearest emergency treatment center?
What places, materials, supplies, events or situations require special caution or guidelines to ensure preventive measures are implemented and that staff have appropriate knowledge of child's needs?
The Emergency Plan
identify first responders, back ups, chain of command
develop sequential action lists
require full participation in drills
post steps in every classroom.
conduct drills at intervals throughout the year
document the drills (who, what, where, when)
Medication - Epinephrine is available at all times.
The school nurse will train all personnel to recognize the signs of an allergic reaction, to act promptly, and to summon emergency help.
All personnel must know where an EpiPen is at all times, and how to use it.
The school nurse documents training dates, topics, names of instructors, outlines or texts of presentations, tests or other means of verifying attendees understanding of the material, copies of all handouts, and signed attendance sheets. (Training is required for any change in staffing or school routine, and after each incident.)
Incident Documentation, Reports and Analysis
name, date, time, place
name of teacher present
names of witnesses
type of incident
description of incident
steps taken, treatment administered
Learn from Experience. Revise guidelines. Replace old copies!
Evaluation and Communication. (parent/school, school/child, child/parent, student/student).
Teachers: Precautions and Practical Issues/ Best Practices
Recognize students' limited self-report skills.
Develop and rehearse cues, signals, key words to ensure child can communicate needs.
Develop Food Safety plan. Include monitoring of food products, guidelines for storage, hygiene, handwashing protocols
Reminders for children and staff.
Provide substitute snacks, emphasize healthy choices.
Always give preference to the universal option.
Food handling - develop, post and enforce guidelines to prevent cross contamination.
Emphasize importance of personal hygiene (frequent hand washing) and environmental hygiene.
Clarify expectations for supervision. Report conditions when appropriate vigilance by staff is compromised by overcrowding, activity demands, etc.
Communicate expectations and win cooperation by educating peers, peers' parents, and auxiliary staff.
Communicate confidentiality guidelines to staff and families.
Know what to do in case of an emergency.
Restrictions are also opportunities for altruism, building peer support (students and parents), teaching peer refusal skills
Orientation: emphasize optimism
Ingredient substitutions presented as challenges, problem solving, categories, math sets