504 Plan for Food Allergies: Crafting Your Food Allergy Worries Into a Plan

Turning Your Food Allergy Worries Into a Helpful Plan

Disclaimer: I am not a legal professional, this is intended to be informational only, and not as legal advice. Any information given is solely intended for informational purposes, and is based only on my experiences in obtaining a 504 plan for my child.  Please seek legal council for advice if needed. 

Preparing for a highly allergic child to start school is similar in many ways to preparing for a non food allergic child allergic to begin their schooling. You want the best for them in every way. You hope that they have a great teacher, and maybe worry that the teacher's style will be too strict, or too lenient. You may worry about them making friends, and hope that they are accepted and liked by their peers. Will they have friends to eat lunch with in the massive ocean of noise that is the cafeteria? Will they have a buddy at recess to share laughter, and play with?  Will they pay attention in class, and thrive academically? 

On top of the usual worries, a parent of a food allergic child may also worry about a few more things:

Bus: 
Can my child ride the school bus?
Will the bus driver allow food to be eaten on the bus?
Has he/she been trained to recognize signs of anaphylaxis and administer the Auvi-Q or Epipen if needed?
Is my child allowed to have their Epipen on the school bus?  
Do they need to ride a special bus, or have an aide ride with them?
Breakfast/Before School Care: 
Do they serve breakfast at school? If so, do they serve my child's allergen?
Do they wash hands after breakfast?
Who supervises the early morning crowd?
Is there a nurse available in case of an allergic reaction?

Classroom:
Will my child be included in all of the classroom lessons, games, incentives, birthday parties, and treats? 

Will the class holiday party be safe and inclusive?
Will my child remember not to eat any treats that are not from her safe treat box?
Will the teacher help remind her, and at the same time help her to feel included?
Will her classmates ridicule her for her differences, or be accepting of them? What books can be read, or materials used to teach classmates about food allergies?
Is my child ready to self carry her Epipen, or Auvi-Q and inhaler?

Will an Epipen or Auvi-Q be kept in the classroom as well as the nurses office?

Are food free birthday treats an option? 
Lunch: 
Can my child eat the school lunch?
Will my child have a safe place to eat?  

Can she sit at the regular lunch table?
Should they sit at an allergen free table? A cleaned dedicated spot at the regular table?
Who will make sure that the dairy, fish, peanut, tree-nut, etc. residue is cleaned off of their eating area before they sit? Will a dedicated bucket, or disposable wipes be used? 
If my child needs accommodations, will they want to sit with my child at the allergen free table, or next to them at their dedicated cleaned spot at the regular table?
If needed, will a friend be willing or able to forgo the dairy/peanut/fish/etc. to be able to sit with my child?
Will her classmates be able to wash their hands after lunch?
After School Care and School Sponsored Activities:
Will my child be able to participate?
How will they navigate the issues surrounding sports, clubs and games?

Fieldtrips:

Will there be food eaten on the bus? 

Will hand washing be available? 

Who will provide the lunch? 

In the event that my child has a reaction, who will be trained to use the Epipen, or Auvi-Q and inhaler, and call 911?
Are parents allowed to chaperon?

Overall:

How allergy aware is the school? What materials/programs can the school use to become educated about food allergies, and anaphylaxis? 

All of these worries can stack up quickly. What can a parent do?

You have a couple of options: An Individualized Health Care Plan (IHCP), or a 504 Plan. We chose to put a 504 Plan in place as we felt the most comfortable with this option, and felt that it was needed.  An Emergency Action Plan is included in both the Health Care Plan, and the 504 Plan. 

While an Individualized Health Care Plan may work well for many children, because of the severity of my daughter's food allergies, I felt that the 504 plan was the best option in our situation. The 504 plan has created a firm network of support for our daughter. I am glad that we did as it brought a team together to make sure that everyone knew what was needed to keep our daughter safe at school, and to literally, and figuratively get us all on the same page. All of our questions were answered, and we were able to make a necessary list of accommodations. As a part of the 504 Plan, we were also able to have the school district educate it's employees on food allergies and anaphylaxis. 

As a former teacher, I have found that without clear guidelines, and accommodations in place, the lines of communication between the school and parents can get crossed, rumors can run wild, and emotions high. 

 

What is a 504 Plan?

In a school setting, it is a list of accommodations, and services that your child needs to allow them to fully participate, and be included in school.  The 504 Plan's name comes from Section 504 of the Rehabilitation Act. A 504 plan protects the rights of people with disabilities

You may be thinking "Wait! My child is not disabled!". Well, while you may not want to think of your child as having a disability, it is important to know that a life threatening food allergy is considered a disability. While this may get some getting used to, it is really important to understand as it means that your child is protected under the Americans with Disabilities Act (ADA), and section 504 of the Rehabilitation Act.

What if my child goes to a private school?  According to the Food Allergy Research, and Education (FARE) organization, the Americans with Disabilities Act (ADA) extends these protections provided by 504 to private schools and private child care centers even if they do not receive money from the federal government.  Here is a great link explaining the 504 and how it relates to your food allergic child from FARE at  http://www.foodallergy.org/advocacy/disability 

Our 504 Team: 

We met with the school's 

principal 

nurse 

counselor 

classroom teachers (Art, Music, PE signed it as well) 

cafeteria monitor 

food service director 

 

Be prepared: 

You may need: 

A copy of your child's food allergy medical records

A  signed Emergency Action Plan from the Allergist 

A written history of past reactions. 

A physician's assessment that the food allergies may result in severe, life threatening (anaphylactic) reactions

A physicians note that meal substitutions are necessary (if you can't, or do not want to pack a lunch daily) 

I printed off an example of a food allergy 504 plan that I found online that I filled out based on my daughter's medical history/needs. But the school may already have a preferred 504 template. 

What the meeting was like: 

I was nervous, but it went very well. We went through it point by point, and discussed each accommodation at length. It was the first 504 plan that the School District had ever had for food allergies. 

Everyone now knows what is needed to keep my child safe, and have a written plan of what is expected of them, and what is expected of my daughter to keep herself safe. This plan will stay with your child from school to school, and will remain in place even with a change of classroom teacher, principal, nurse etc.

 

Plan early, it may take a while to get the plan rolling, but also know it is never too late:

It took months to get an initial 504 meeting as I had to push for it being the first of its kind in the school district. Thankfully we were able to sit down with the team before the start of the school year. If we had wanted to see how it went with a just an Emergency Action Plan, or Health Plan, we could have added the 504 Plan later. It is never to late in the year to request a 504 plan. If you feel it is right for your child, send an email, or call your principal, and your 504 coordinator (sometimes a principal) or "equity coordinator" for your school district, to get the ball rolling. 

I am very happy that we went with a 504 Plan! The school found it helpful as well, and they are now offered to all food allergic children at registration! 

We were able to discuss my daughter's health history, the accommodations needed to keep her included and safe in the classroom, bus, field trips, cafeteria, and birthday, and holiday celebrations, etc. I feel that it is great to have it all written out and discussed in a 504 plan as it helps to prevent misunderstandings. I also feel that it alleviates anxiety for both the school, and the parents. In caring for kids with food allergies emotions can rise, and misunderstandings can easily occur as food is such an integral part of our social gatherings. Class parties, birthday parties, food incentives for reading etc. are a major focal point in school, and having a plan to navigate these events is essential. 

If you hear as I did, "Oh we don't do those 504's here.". Or if your school refuses to put a 504 plan in place, you are entitled to an impartial hearing officer, and you may then review their decision according to the school's impartial hearing procedure. You also have the right, if needed, to file a complaint with the United States Department of Education's Office for Civil Rights (OCR)

 My favorite resources and articles in writing a 504 plan, or Health Plan: 

For a 504 Plan: AllergicChild.com:

http://home.allergicchild.com/why-your-child-with-food-allergies-needs-a-504-plan-at-school/

For a 504 Plan: FARE:
http://blog.foodallergy.org/2013/08/19/what-every-parent-needs-to-know-about-section-504-plans/
and
http://www.foodallergy.org/advocacy/section-504-plans/

For an Individualized Health Care Plan:  ProtectAllergicKids.org: 
http://www.protectallergickids.org/DrWood.html

For both a 504 Plan, and Individualized Health Care Plan: KidsWithFoodAllergies.org:
http://www.kidswithfoodallergies.org/resourcespre.php?id=137

For a 504 Plan:  OneSpot Allergy Blog:
http://blog.onespotallergy.com/2012/09/sample-504-plan-free-to-click-and-print/

About filing an OCR complaint:
http://blog.onespotallergy.com/2012/08/filing-an-ocr-complaint-exercise-your-rights-or-lose-them/

For a 504 Plan: Here is a link to the US Department of Education's Office of Civil Rights (OCR ) explanation of how it pertains to daycare:
http://www2.ed.gov/about/offices/list/ocr/docs/hq5269.html
 Excerpt: "A recipient that operates a preschool education or day care program, or an adult education program may not exclude qualified handicapped persons and must take into account their needs of qualified handicapped persons in determining the aid, benefits, or services to be provided under those programs and activities."

For both a 504 Plan, and an Individualized Health Care Plan:
A great 504 Plan and IHCP: With example plans! From Kidswithfoodallergies.org: http://community.kidswithfoodallergies.org/blog/school-health-care-plans-for-your-child-with-food-allergies

For both a 504 Plan, and an Individualized Health Care Plan:
Asthma Allergies Children: A Parent's (web) Guide found at
http://www.asthmaallergieschildren.com/ 
A great article from the website written by a former elementary school nurse for keeping your food allergic child safe at school: 

food-allergies-elementary-school-tips-for-parents-from-a-couple-of-veterans
They also have a fantastic book "Allergies Asthma Children: a parent's guide" by Dr. Paul Ehrlich, Dr. Larry Chiaramonte, and Henry Ehrlich.

For an Individualized Health Plan: From the  National Association of School Nurses
http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNPositionStatementsFullView/tabid/462/ArticleId/32/Individualized-Healthcare-Plans-The-Role-of-the-School-Nurse-Revised-June-2013
 
For a 504 Plan Q&A Great info!  A Parent & Educator Guide to Free Appropriate Public Education (under Section 504 of the Rehabilitation Act of 1973)
  

My Favorite Resources for educating your School, about Food Allergies:

For my school district, there was a lack of awareness, and training for food allergy safety. I do have it in our 504 plan that all teachers and would be trained on anaphylaxis and food allergies. You can also request this as part of a Health Plan. The school took it even further and trained the bus drivers (they do not use an outside bus company), custodians, principals, nurses etc.! They had a training/awareness seminar given by a school nurse for the district.

At the seminar, they were all given a book called "The Food Allergy Book: What School Employees Need to Know"

It can be found at the NEA Health Information Network http://www.neahin.org/educator-resources/foodallergybook.html . The counselor said that the teachers love this book, and often say, "Well the purple book says..."

Also they used a great anaphylaxis training module. Here is a commonly used one from the National Association of School Nurses:   https://etraining.allergy.org.au/  found at: http://www.nasn.org/ToolsResources/FoodAllergyandAnaphylaxis 
Another great online e-training is: http://www.epipentraining.com/ .

The National Association of School Nurses website has a great list of resources, handouts for school staff, nurses, checklists, Epipen training tools etc. Check them out!

Another of my favorite resources is KidswithFoodAllergies.org it can be found at:
http://kidswithfoodallergies.org/  It has many great articles and webinars on what schools need to know to prepare for a food allergic student, and what we need to know as parents of kids with food allergies. A great one is: http://community.kidswithfoodallergies.org/clip/partnering-with-your-school-nurse-for-a-safe-school-year 

From the National School Board Association: "Safe at School, and Ready to Learn"
http://www.nsba.org/foodallergyguide.pdf

From the Massachusetts Department of Education came the best school allergy action plan that the new IL state guidelines are based off of, and many others as well, titled: "Managing Life Threatening Food Allergies in School":
http://www.doe.mass.edu/cnp/allergy.pdf

From our experience:
It was a tough sell, but after some convincing, our school district came around, and now we have great, district wide, food allergy guidelines, and training. We even have decals stating that the district is "Food Allergy Aware"!

Just a side note: During the training, a nurse from a different school in the district said that many of the school staff  members balked at having to give a shot of epinephrine using an Epipen. When they saw the Auvi-Q, hands down, it was the preferred one because it talked them through it. They said "Oh, well that seems doable, much less scary!" Makes me want to make the switch from our Epipens to Auvi-Q.