504 PLAN HOW TO GUIDE
FOR THE FOOD ALLERGIC STUDENT
FACTS:
The U.S. Department of Education’s Office for Civil Rights lists allergy is an example of a hidden disability for the
purpose of Section 504.
To be eligible for a 504 plan, a child must be determined to have a disability by satisfying 3 criteria: (1) have a
physical or mental impairment that substantially limits one or more major life activities; or (2) have a record
of such an impairment; or (3) be regarded as having such an impairment. According to the Americans with
Disabilities Act Amendment Act of 2008 a child with a food allergy is determined disabled because the impairment may substantially limit the major life activities of eating, breathing, caring for one self (among others). If a child has an emergency epinephrine auto injector prescribed, then there is a risk for anaphylaxis.
According to the ADAAA, if the impairment is episodic (the food allergic child is not always reacting, just as a
child with seizures is not always seizing), it does NOT dismiss eligibility if the imaprement (anaphylaxis) limits
a major life activity WHEN ACTIVE. In this case, the major life activity that is substantially limited during anaphylaxis is breathing." See ADA Sec. 12102, 4, D.
The Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA), afford these food allergic children
the right to a 504 plan. This plan can follow the child through college.
A 504 Plan, is a written management plan outlining how the school will address the individual needs of the child,
and allow that child to participate safely and equally alongside peers during all normal facets of the school
day. Once signed, it starts immediately, and is required by law to be adhered to.
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BASIC STEPS TO IMPLEMENTING A 504 PLAN:
Obtain a written letter from your child’s physician or board certified allergist as mentioned
above.
Choose to hire a paid advocate, or contact a local agency to support you at no cost.
(Contact AFAA, [email protected], for local resources).
Request in writing a 504 Plan assessment to include: Request the school to complete a 504
Plan assessment, and include a copy of the physicians letter. A sample letter is as follows
on the next page. Bring 3 copies t of the request letter and physicians letter, to give to the
school: 504 Coordinator, Principal, and School Psychologist.
Follow-up on the schools completion of the requested 504 Plan assessment at 5 days from
date letter was received by school administration.
Once 504 Plan assessment is complete, schedule a meeting with the school to create the
504 Plan.
Create the 504 Plan with the school team, and your advocate or support team in attendance with you.
The 504 Plan will then be completed and signed. Once signed, the 504 Plan goes into effect
the following day.
If you have difficulty with your school concerning a 504 Plan contact AFAA,
[email protected], or The U.S. Department of Education’s Office for Civil Rights,
[email protected] or 800-421-3481.
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SAMPLE 504 ASSESSMENT REQUEST LETTER #1
(Date)
(Insert name of 504 Coordinator)
(Insert name of county) County
(Insert address of school)
(Insert your name)
(Insert your address)
RE: Request for accommodations under section 504 of the Rehabilitation Act
Dear Mr./Ms. (Insert 504 Coordinator’s last name),
I am the parent of (Insert your child’s full name), a (Insert your child’s grade) grade student
at (Insert your child’s school’s name).
This letter is to serve as a request for accommodations under section 504 of the Rehabilitation Act. (Insert your child’s first name) has been diagnosed with (Insert your child’s diagnosis).
Given this diagnosis, (he/she) should be eligible for a 504 plan as per 34 CFR 104.33. Please arrange for the necessary assessments and/or evaluations and notify me of completion of assessment and scheduled meeting date by (Insert a deadline for completion—typically 5 business days
out). Enclosed are evaluations from (Insert name of who the evaluation are from i.e. the physician and/or allergists who wrote the letters).
If this request should be denied, please respond in writing with the basis for the denial.
Otherwise, please call me at (Insert your phone number) with any questions you may have. I
look forward to a response within five (5) days of receipt of this letter.
A copy of this letter is to be included in (Insert child’s first name)’s educational record.
Sincerely,
(Sign your name)
(Type your name)
Cc: Principal and School Psychologist
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SAMPLE 504 ASSESSMENT REQUEST LETTER #2
July 26, 2012
[Parent Name/Contact Information]
[Principal of _____________School]
[504 COORDINATOR}
Dear _________________:
I am the parent of _____________________, age ______who is having some difficulty with his
academics and therefore we are requesting the school ___________________to conduct an evaluation
for Section 504 of the Rehabilitation Act of 1973 so he can progress.
I am writing to request that __________________________________school schedule a 504 team
meeting in order to review accommodations that can be implemented. I am also requesting that all his
teachers be in attendance since these accommodations are to affect each of his major classes and his
learning process.
[List dates and times that you are available, or specify dates/times when you are not available to attend
a meeting]
If you have any questions, the best way to reach me is ____________________(list phone and/or email, provide specific number and /or address) .
Thank you.
*This letter sample is from Raising Special Kids, www.raisingspecialkids.org, RSK 2012*
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SAMPLE OUTLINE OF 504 PLAN
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Student Information
504 Team Information
Background Information
Overview of Childs Condition as it Pertains to Section 504
Goals of the 504 Plan
Food Allergy Education, Awareness and Reaction Prevention
Individualized Health Care Plan (IHP)
Classroom Management
Instructional Aids
Substitute Teachers and Nurses
Bus Transportation
Signature Page
Copy of Section 504 of the Rehabilitation Act of 1973 & Copy of Statement of Parental Rights
under Section 504
Cover Letter
Additional Resources
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SAMPLE 504 PLAN
The Team believes that the following accommodations or related aids and services are necessary for the student to access and benefit from his or her educational program:
The Student’s placement into ___ grade will be carefully considered with regard to the classroom environment, and
placement with other students whose families have been supportive and receptive in their understanding of allergy
risks.
The school will: (state action and person responsible)
a. provide the entire staff with information re: Student, offending allergens, symptoms of allergic reactions and emergency procedures, and the [school district] [Food Allergy] policy (Nurse, prior to the start of school)
b. Provide classroom teachers, duty staff, bus drivers and teaching specialists with additional training in the use of the
Epi-Pen and recognizing the signs of anaphylaxis, with IHP (Nurse, prior to Sept. 3rd) and a refresher as/if needed during school year.
c. Maintain copies of IHP in the Nurse’s Office and in Students' medical pack (Nurse)
d. Communicate regularly with home through notes, e-mails, phone calls (classroom teacher, nursing staff, parents)
e. Remind all parents and staff of [school district] Food Allergy policy through staff meetings and written notices home
(Administration, prior to the start of school).
f. Send home information about the presence of a student with life threatening allergies and ask that the offending allergens not be brought to school. Send home a list of “safe foods” to all families in Student’s classroom. (classroom
teacher, first newsletter home prior to start of school)
g. Ensure medical pack (with Student’s picture on it) is with him/her at all times throughout the school day. (teaching
and duty staff)
h. Educate classmates re: food allergies at the start of the school year (Nurse)
i. Offer the opportunity for classroom parents to meet to learn more about food allergies if requested (Nurse)
j. Not include offending allergens in lesson plans. The school will make sure all teachers/specialists are aware of certain
materials which could pose risk. These include any shared items such as musical instruments with mouth pieces, sharing the water fountain (Student will use his/her own water bottle), computer and iPads (children should wash hands
with soap and water before use), the use of food containers (i.e. milk cartons, egg crates) for crafts or activities.
k. Have students wash hands prior to using any shared items such as computers, iPads; clean shared items with Clorox
wipes, or equivalent safe procedure.
l. Recess monitor will carry Emergency Medicine Pack when Student is outside, and have means to contact nurse/office
via walkie-talkie/cell phone/ etc. in case of emergency.
m. Be aware of any food “bullying” incidents, and notify guidance and parents (classroom teacher, guidance counselor,
parent) as soon as occurs, or is reported.
n. Student will not participate in fundraising, bake sales, or other projects involving food, and those items will not be
present in classroom for storage or distribution. (Classroom teacher)
o. Within in classroom, a folder with Student’s picture on it will be visible and readily available. This folder will include: medical information, 504 plan, and interventions for any substitute or adult volunteers in the classroom.
(Classroom teacher)
p. Substitute teachers will check folder and if unfamiliar with the plan, or if they need further instruction/training, will
go to health professional to learn prior to start of school day. ( classroom teacher, nurse)
q. Notify parents immediately in event of a reaction at scholar. The Emergency Medical Pack will be kept between 59
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and 86 degrees at all times [to prevent Epi-Pen failure]. (all staff)
SAFE SNACKS/BIRTHDAYS/PARTIES
a. Ensure that Student only consumes food considered safe for him/her including snacks and lunches.
b. Students will share a safe, community snack in the classroom. Teacher will double-check packaging as companies
sometimes change processing, to ensure safety of snack. (classroom teacher)
c. Place individually packaged safety snacks in the teacher’s closet to avoid cross-contamination (classroom teacher)
d. Have students clean their desks after handling food using appropriate cleansers and gloves (classroom teacher).
e. Encourage birthdays, holidays, and celebrations to be non-food events (classroom teacher).
f. Notify parents at least 24 hours in advance of any upcoming birthdays, celebrations, other events when other parents
might bring food/treats to school (classroom teacher)
LESSON PLANS/ ACTIVITIES/ CLASSROOM GUESTS/ FIELD TRIPS:
a. Inform all visitors, volunteers and presenters of [school district‘s] policy addressing [school district ] policy and include a statement about the presence of students in our school with life threatening food allergies (Nurse, 504 Coordinator, Office Staff, Administrator)
b. Ensure that student and nursing staff will bring medical packs on fire drills and field trips.
c. Review the IHP with all teachers and adults on the field trip prior to leaving. Identify the nearest hospital prior to
departure and the quickest route to it (nurse, teacher, bus driver, Director of Transportation)
d. Perform an “allergen risk assessment”[see appendix] with parent well in advance of the field trip (teacher and parent).
e. Offer parent the opportunity to be part of the field trip, and be responsible for only Student.
f. An Epi-Pen will be available by the classroom phone, with instructions.
g. Any after school activities (i.e. scouts, clubs, etc) will be scheduled to meet in rooms OTHER than Student’s classroom to prevent any allergens being introduced into the classroom. (Administrator)
h. During assemblies in the cafeteria/gym, Student will not sit next to any trash barrels, staff will watch for crumbs on
floor, and Student will be within sight of teacher. (teacher)
i. Teacher/adult/chaperon will have cell phone for use in case of emergency [to call 911].
j. On field trips, a designated person will be responsible for carrying and administering medications in an emergency
situation.
CAFETERIA ACCOMMODATIONS:
a. Maintain a peanut-free table that will be washed only by an adult.
b. Sit Student in well-ventilated area, at the end of the table.
c. Allow student to purchase food or drinks from the cafeteria only with parental permission.
d. Designate “go to” adults in both the lunchroom and recess area.
e. Student will either put his/her trash back in his/her lunch box, or have a “trash buddy” than can empty his/her trash in
the cafeteria.
f. Student will not put his/her lunch box in the “bin” with all the other lunch boxes, but will have a special spot to leave
the his/her lunch box after lunch. (duty and lunch staff)
g. Allergen safe table or where Student is to eat, will be cleaned prior to sitting with spray bottle of soapy water, then
disinfectant cleaner, and paper towels; [as wash cloth in a bucket can just re-contaminate surface].
h. All cafeteria monitors will be informed of Student’s allergies.
BUS ACCOMMODATIONS:
a. Medical pack will be handed to the bus driver, and the bus driver will hold it in a safe
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and secure space, and hand it to parent/adult/student as he/she leaves the bus.
b. Student will sit in an assigned seat at front of bus, in view of bus driver.
c. In an emergency, bus driver will pull over, have the bus driver assess the medical situation, administer the medication,
call 911, radio transportation, then contact the school who will contact parents.
d. Enforce the no food policy on the bus.
e. Have the school nursing staff explain the IHP to any substitute drivers.
f. The seats on the bus will be wiped down prior to Student riding the bus. (bus driver, Nurse,
transportation staff, school office staff)
EMERGENCY PLAN:
a. Emergency action plan will be followed in event of emergency. A copy will be stored with Benadryl and Epi-pen in
emergency medical pack kept with Student throughout the day, secondary medications kept in nurses office.
b. Student will not be expected to self administer medication in event of emergency.
c. A trained adult staff member will remain with student until the emergency is resolved, including hospital transport if
needed.
d. Student will not report to office or nurse without a chaperon during a reaction.
e. School will provide support to student as needed in the event of a serious reaction, upon reentry into school.
The parent(s) will:
a. Provide a medical bag with Student’s picture, if they choose
b. Help create a “safe snack” list for the classroom teacher to send home to families of children in Student’s classroom.
c. Communicate frequently with school.
d. Provide school with current and updated medical information.
e. Check with the allergist regarding Student’s readiness for self-care.
f. Provide a water bottle.
g. Provide safe snacks and lunches contained in a secure lunch bag to avoid cross-contamination.
h. Attend field trips, if available, and be only responsible for Student.
i. Inform the school of any after school activity changes, in case a different bus driver needs to be informed of Student’s
medical plan.
j. Provide written notice to the school regarding any changes in bus seating, purchasing of food, etc.
k. Provide current medication, and replace them in the event of them being used, or expiring.
l. Provide non-perishable food in case of an emergency [forgotten lunch/spilled contents/etc]
The student will:
a. Use his/her own water bottle.
b. Know to only eat food brought from home.
c. Know not to trade food with classmates or adults.
d. Understand how a safe food may become cross contaminated.
e. Increase his/her self-awareness and recognition of symptoms of a reaction.
f. Self-advocate: understand there are specific adults and friends (playground, lunch, bus, etc) that he/she can go to when
he/she has symptoms or concerns.
g. Wash his/her hands well with approved soap and water prior to eating.
h. Wear a Medic Alert bracelet at all times.
i. Promptly inform adult as soon as accidental exposure or symptoms appear.
Appendix:
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Allergen Risk Assessment: an allergen risk assessment is one part of preparing for field trips, which means asking some
questions in order for teachers, student and the locale to think about the risk of exposure to allergens and preparedness
for potential emergencies.
The assessment questions are:
1. Are allergens displayed on the site? i.e. the eight most common allergens in the US are: milk, egg, peanut, tree nut,
fish, shellfish, wheat, and soy. Students may be allergic to one or more allergens on this list, or to any other foods not
listed here as well.
2. Are allergens used in any demonstrations or as feed for any animals?
3. Are there any hands-on activity areas that allergens have been used? [i.e. places where birdseed or peanut butter was
used, milking a cow, bubble creation/water play areas, or where “slime” was used] Make sure to consider whether there
could be contaminated equipment or exposure to an area where food was previously prepared.
4. Are the ingredients and substances that students touch free from allergens? [i.e. paints, glue, animal eggs, animal feed,
animals]
5. Will the staff or guests at the field trip be handing anything out to the students? [food, animal eggs, animal feed, animals, etc.]
6. Will the class eat at the facility? If so, will the teacher be able to clean and designate an area for an allergic child to
eat? Will there be hand washing facilities available?
7. How quickly can an ambulance reach the location, and then reach a student with in the facility?
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SAMPLE FOOD ALLERGY ACTION PLAN (FAAP) TO BE INCLUDED
IN INDIVIDUAL HEALTH PLAN (IHP),
AND COMPLETED BY CHILD’S PHYSICIAN OR ALLERGIST
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