What is a 504 Plan anyway?
Section 504 of the Rehabilitation Act of 1973 is a federal law that ensures that those with disabilities, including diabetes, are not discriminated against. The law applies to public schools, as well as private schools that receive federal funding. The law states that children with disabilities need to be given accommodations so that they receive an education comparable to that of other children who do not have disabilities.
What should the 504 include?
I always encourage parents to create a 504 Plan. The plan does several things, including specifying which school staff will be trained, where care will take place, what accommodations will be given to your child, and when you should be notified by the school. Your child may have a separate medical care plan that details the specifics of daily care, including testing blood sugar, and treatment for hypo– and hyperglycemia.
Leighann Calentine (LC): What are the top issues that need to be addressed in a 504 Plan for a child living with diabetes?
Crystal Jackson (CJ): 1) Identification of school staff members, in addition to the school nurse, who have been trained to provide care. 2) Making sure trained personnel are available on-site to provide needed care at all times during school-sponsored activities, including extracurricular activities and before- and after-school activities. 3) Students who have the ability and maturity to self-manage should be permitted to do so anytime, anywhere.
LC: What do you feel parents tend to overlook or not think about when forming the plan?
CJ: Many parents assume the school is well equipped to provide care. Parents should make sure a school nurse, as well as a small group of school staff members, have been trained to provide needed care and that at least one person is available at all times, including field trips and extracurricular activities.
It is very important that parents make sure a plan is in place for those times a school nurse is not on-site. Even in those schools lucky enough to have a full-time school nurse, the school nurse cannot be in all places at all times.
Also, parents should make sure to include provisions to allow their child to take academic tests at an alternate time if blood glucose levels are out of target range.
LC: Some private schools are resistant to implementing a 504. Why are most private schools (and all public schools) required to allow a 504 for a child living with diabetes?
CJ: Public schools and private schools receiving federal funding cannot discriminate against students with disabilities and, therefore, must provide aides and related service under Section 504.
LC: What should parents do if they don’t feel the 504 Plan is being followed?
CJ: Parents should contact the school’s 504 coordinator, who should address the issue and reconvene the 504 team to resolve.
LC: In closing, what is your best advice for parents?
CJ: Parents should take a proactive approach and work with the school’s 504 team to develop a 504 Plan, even if things are going well. School administrators, school nurses, and teachers are subject to change, so document how your child’s needs should be met with a 504 Plan while things are going well.
Where to start?
As a D-Mom and author, I’ve written frequently about 504 Plans and the many details and points you should consider. I think this list can act as a good starting point for many parents:
- Identification of Trained Diabetes Personnel (TDP) who: 1) know how to test blood sugar levels and interpret the results; 2) know how to measure and administer insulin; 3) know how to respond to hypoglycemic events, including the use of the glucagon kit
- Training of staff
- Appropriate locations for blood sugar testing and administration of insulin
- Access to the bathroom, water, office, and glucose sources
- Hallway transportation when hypo- or hyperglycemic or not feeling well
- Accommodations for important tests
- Recognition of hypoglycemic conditions (Learn more about the causes and symptoms of hypoglycemia here.)
- Field trips
- Parental notifications
- Notifying substitute teachers
- Emergency supplies to accompany the child during fire drills, field trips, etc.
- Lockdown situations
- Attendance and absences for diabetes-related appointments
More 504 Plan resources
- American Diabetes Association Safe at School
- JDRF School Advisory Toolkit
- Children With Diabetes
- My Care Connect
- Kids First, Diabetes Second
- If you are looking for more information, you can get a back-to-school checklist here.
Leighann Calentine is the author of the book Kids First, Diabetes Second and the website D-Mom Blog. She is married with two children – including a daughter with type 1 diabetes – has a graduate degree, and works for a major university doing research. Calentine is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.
© 2013 The DX: The Diabetes Experience