Section 504 Plans
A child with diabetes will have specific needs that should be attended to throughout the school day. The Section 504 Plan is developed to address those needs.
School Administration Details
- Provide written assurance to parents of nondiscrimination.
- Provide notice of nondiscrimination in admission or access to its programs or activities. Notice must be included in a student/parent handbook.
- Designate an employee to coordinate compliance.
- Cooperate in providing authorized accommodations.
- Provide grievance procedures to resolve complaints.
- Provide training to all adults who provide education/care for the student on the symptoms and treatment of hypoglycemia and hyperglycemia and other emergency procedures. This would include as teachers, coaches, and bus drivers.
- Provide training for an adult and back-up adult(s) who can: perform finger stick blood glucose monitoring and record the results; administer insulin if necessary; test the urine or blood for ketones, when necessary, and respond to the results of this test. NOTE: The delegation of healthcare tasks at school to unlicensed personnel may be governed by the state’s nurse practice act.
- Maintain sufficient trained staff to check blood glucose levels and administer insulin and glucagon.
- Allow the child to test their blood sugar level and administer insulin, or have a snack. If the child is not yet able to do so, provisions will be made for a staff member to perform this task.
- Setting aside an area where blood sugar levels will be tested and insulin administered. The school does have the right to not allow blood glucose testing in the classroom. However, if you can demonstrate that this procedure will not endanger others and medical waste will be disposed of at home and not at school, the school may allow the child to check in a secure area in the classroom. In classroom checks allow a child to miss less class time when dealing with routine care.
- Permission for the student to see school medical personnel upon request.
- Insure the child may fully participate in all sports, extracurricular activities, and field trips, with the necessary assistance and/or supervision provided.
- Allow the child to eat whenever and wherever necessary, including providing lunch at an appropriate time with enough time to finish eating.
- Allow the child to take extra trips to the bathroom or water fountain.
- Permit extra absences for medical appointments and sick days when necessary.
- Making academic adjustments for classroom time missed for medical appointments, testing, or because of periods of high or low blood sugar.
- Provide for alternate learning activities, assignment schedules, or instruction if an influenza outbreak or other health threat requires that the student should not attend school.
- Outline blood glucose monitoring procedures including the frequency and circumstances requiring testing. (For example before eating or exercise).
- Specify medication procedures and dosages including doses/injection times prescribed for specific blood glucose values and the storage of insulin. Be sure to note if your child is capable of deciding what amount to be administer. If they are too young or don’t fully understand self management, provide a chart to determine amount to be given or request a phone call.
- Symptoms and procedures for treatment of hyper and hypoglycemia including the administration of glucagon if recommended by the student’s treating physician.
- When to test for ketones and what actions to take for abnormal ketone levels, if requested by the student’s health care provider.
- Precautions to be taken before physical activity.
- Guidelines for meals, snack, special treats, and parties including food content, amounts, and timing. The parent should work with the school to coordinate this schedule with that of the other students as closely as possible. Timing of meals and snacks at school may pose problems with lunch periods that span 3 hours, as is the case, in larger schools. Insulin and snack regimens can usually be modified to accommodate early or late lunch periods, though rotating lunch schedules are especially difficult for children with diabetes to manage. Long delays in lunch lines, especially if the student has just been treated for hypoglycemia or has had pre-meal insulin, may cause low blood glucose. Younger children may also need school staff to help with serving sizes, monitoring actual food intake at meals, and/or supervision to prevent inappropriate food exchange with classmates.
- Contact information for medical assistance (as needed) and parents.
There is sometimes confusion regarding the differences between a 504 and Individualized Education Plan. Simply, a 504 plan is plan designed to deal with medical issues, such as diabetes, and would contain instructions, for blood glucose monitoring.
An IEP is designed to address educational challenges or special needs not related to a medical treatment plan. An IEP, for example, would include instructions for additional reading education, should it be needed. Children with diabetes may not need an IEP, unless they have special academic needs.