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Tuesday, August 31, 2010

More Back to School Tips for food allergies

Hi again,
If you are new to managing food allergies in schools you may be wondering about the terms "504 plan," "care plan," "individualized health plan," etc. Read on for a very long post about these topics.

Disclaimer: Please keep in mind that I am not a lawyer or a health care provider. I did participate in the development of the Washington State Guidelines for Care of Students with Anaphylaxis and I have managed my child's food allergy in public schools for 6 years. This post is intended to help you with your own research and provide possible topics to discuss with the appropriate licensed professionals when choosing and drafting your child's care plans for school.

Section 504 Plans and the Americans with Disabilities Act (ADA)
Luckily for all of us, there is an excellent explanation of Section 504 of the Rehabilitation Act of 1973 and Title II of the Americans with Disabilities Act for public schools at Wrights Law webstie:
http://www.wrightslaw.com/info/section504.ada.peer.htm

There are also brief descriptions in the Washington State Anaphylaxis Guidelines under the heading State and Federal Laws:
http://www.k12.wa.us/HealthServices/Publications/09-0009.aspx

These laws establish that students with disabilities cannot experience discrimination because of their disability. These students have a right to "free and appropriate education" (FAPE). Public schools are local public institutions that receive federal funds; private schools who accept federal funds would also be required to meet these standards. Students with life-threatening food allergies (those in which the ability to eat, breath, study, etc., would be compromised if an exposure were to happen in the classroom) are protected by the ADA. The plan and process that spells out the accommodations that allow a school to accommodate a child with a disability is called a 504 Plan.

Wrights Law also has a page dedicated to explaining and distinguishing the differences between Section 504 and the Individuals with Disabilities Education Act (IDEA). The bottom line is that the needs of most students with life-threatening food allergies are addressed under Section 504.

While all students at risk for life-threatening anaphylaxis are protected by Section 504 and the ADA, a parent must go to the school district and request that their child be evaluated for the disability designation. Once the school has agreed to engage in the 504 process, there is a well defined set of criteria for creating the 504 plan and for requesting hearings if the plan is not being followed.

Rhonda Riggott Stevens, The Food Allergy Advocate, and the author of the Massachusetts guidelines, has a great website on Section 504 and how to develop a 504 plans for a food allergic student.


Individual Health Plan/Emergency Care Plan

An Individual Health Plan" (IHP) or nursing care plan are two terms used by public school nurses in the State of Washington to describe a health care management plan for a student. In 2002 in response to Nathan Walter's death on a field trip while he was enrolled in Spokane Public Schools, the state passed a law that required all students with life-threatening health conditions to have treatment and medication orders and a nursing care plan in place before the start of school (RCW 28A.210.320). (I provide links to examples of medication orders under Nuts and Bolts below). An emergency care plan (ECP) is a third type of plan, defined in the OSPI guidelines, that describes how to respond in the event of a food allergy emergency. Most parents of food allergic children have developed some sort of emergency care plan or use something like the Food Allergy Action Plan that is available from the Food Allergy and Anaphylaxis Network.

In the OSPI Anaphylaxis Guidelines (p. 11), OSPI offers this clarification:

"Emergency Care Plan and/or an Individualized Health Plan
Any student diagnosed with a life-threatening allergy must have an emergency care
plan (ECP). Most often the ECP is incorporated into a more comprehensive individual
health plan (IHP). An ECP may be separate or a part of the IHP. The ECP/IHP may also
be the 504 plan. In accordance with RCW 28A.210.320, the plans must be completed
prior to the student attending school. Care plans are developed by the school nurse in
collaboration with the family and a team of professionals, addressing the school's
overall responsibilities for the provision of a safe school environment. The ECP/IHP is
distributed to school staff having contact with the student. The school nurse trains and
supervises school staff regarding their responsibilities and care under the guidance of
the written care plan(s)."

The "team of professionals" could refer to anyone the parent or nurse deems to be critically important in the development of the ECP/IHP, which could be nutrition services, non-homeroom teachers, etc.

Similarities and Difference
The major difference between an ECP/IHP and a 504 Plan is in the process and level of compliance; content could theoretically be exactly the same. Your school district has a process in place for evaluating a student's need for a 504 Plan. Your job is to notify the district that you would like to have your child's situation evaluated. The district will also have a 504 Coordinator and your school will have a designated 504 officer who will be on your student's 504 team. Once it is determined that your child needs a 504 Plan, you would follow your districts 504 meeting process. Regarding compliance, the district would have an established mechanism for you to submit a complaint.

It could be argued that, because a 504 process ultimately engages more school staff in the development of a care plan, it is a better choice than an ECP/IHP. The more staff members who know about your child's situation, the better. From the school perspective, it is also a more cumbersome endeavor as it does require direct attention of the 504 Officer, who is often the school principal or other administrator. On the other hand, in a school where the level of food allergy awareness is high, EMP/IHP may be just as effective at achieving a safe environment for your child.

It is my understanding that a school could argue that, even though your child has a medical condition that entitles them to accommodations, the child does not need a 504 plan because the school is already accommodating your child with current policies, such as designating an allergen-free classroom or a peanut-/tree nut-free table. That said, based on my participation in the state anaphylaxis guidelines development, if a parent can show that a school is not providing a safe learning environment for their child or feels that the ECP/IHP process is not resulting in appropriate accommodations, it would be difficult for a district to deny that family's request for a 504 Plan. LIkewise, I think there are many situations for which a 504 is in definitely in order, such as the situation where a student who has multiple life-threatening food allergies or life-threatening allergies and asthma or a school environment exists which poses an increased risk to a food allergic individual, such as schools where lunch is eaten in the classroom.

Any parent of a student who has a life-threatening condition and who feels that their school is not accommodating them can file a complaint through the Office of Civil Rights (OCR), however, for some reason that I don't completely understand but most likely to avoid duplication of efforts, you cannot then file a complaint with the school. Here is the link to the Wright's Law page on this issue: http://www.wrightslaw.com/info/sec504.faqs.ocr.complaints.htm.

The nuts and bolts

In practice, health plans - IHPs and 504 plans in particular - are often hammered out in the week before school, which can make for a stressful time for parents of food allergic students. The thought that you will be leaving your child in the care of adults who may or may not understand all they need to know about food allergies is daunting and extremely stressful. Preparation and good communication can go far to alleviate this stress and improve the likelihood that your child will be safe at school from day one because they will be in the care of staff members who are educated about their food allergy. Here are some tips to help you start the year with confidence.

Be Proactive! It is important to advocate for your child in the short time before summer ends and school starts. Nurses are only funded for a few days (I believe the number is 2 or 3) to prepare health plans. Make sure your school nurse and teacher have an email or voice mail from you requesting a meeting with you at their earliest convenience.
Be Prepared! If you don't have the required forms to give to your child's doctor, get your hands on them and fax or drop off at your doctor's office, the sooner the better. Draft letters that can be modified when you get more details from the teacher about what food allergy issues will need to be managed in your child's new classroom or school. Come up with a list of your concerns or requests so that you will be prepared for the meeting. It might help to share your list with the nurse and teacher before hand. Rhonda Riggott Stevens has a fairly comprehensive list of possible accommodations for food allergic students in school on her website (listed below). Food projects, field trips, snacks, and the teacher's plans on how to handle classroom celebrations, and where to store the epinephrine should definitely be on the list.
Be patient! Nurses are overloaded at this time of year and they work very hard to accommodate all students and you can feel fairly confident that the life-threatening nature of your child's food allergy will bring their plan to the top of the pile in most cases. Teachers are also busy but they will have a vested interest in getting to know you and learn about your child's food allergy.
Be Persistent! If the day before school has arrived and you haven't heard from the school nurse or teacher, then you need to get in there and figure out what is going on. One year, our school nurse got very sick and staff training did not happen when it was supposed to and did not figure this out until much later than the first day of school. If you are like me and really don't enjoy causing others undue hardship, keep in mind that they may not understand what is at stake - a child left in the care of adults who don't know they are at risk for anaphylaxis is a dangerous child. It is vitally important to make sure that information about your child's food allergy gets out to everyone you and the nurse deem worthy if not the entire staff.
Start planning for training! If it seems like your school could benefit from school food allergy training, start the process of scheduling a training session with a school food allergy educator or get your hands on a training module. See links below.

Links/Resources

Wrights Law resources: Section 504 of the Rehabilitation Act of 1973 and Title II of the Americans with Disabilities Act
http://www.wrightslaw.com/info/section504.ada.peer.htm

Washington State 2009: Guidelines for the Care of Students with Anaphylaxis
http://www.k12.wa.us/HealthServices/Publications/09-0009.aspx

The Food Allergy Advocate, Rhonda Riggott Stevents
http://www.foodallergyadvocate.com/504Plan.htm

Difference between IDEA and 504
http://www.wrightslaw.com/advoc/articles/504_IDEA_Rosenfeld.html

Seattle Public Schools 504 student evaluation form:
http://www.seattleschools.org/area/speced/documents/504form2.pdf

Seattle Public Schools Medication Authorization:
http://www.seattleschools.org/area/healthservices/forms/medauth1.pdf

Seattle Public Schools Health Registration Form (asks about life-threatening allergies and asthma):
http://www.seattleschools.org/area/healthservices/forms/healthreg4705.pdf

Seattle Public Schools Mutual Exchange Form:
http://www.seattleschools.org/area/healthservices/forms/exchange.pdf

FAAN's Food Allergy Action Plan
http://www.foodallergy.org/files/FAAP.pdf

OCR Online Compaint Form
http://www2.ed.gov/about/offices/list/ocr/complaintintro.html

School Food Allergy Training - Seattle Children's Food Allergy Community Health Educator - Hilary Stephens, RN - FREE TRAINING! Schedule soon!
http://www.seattlechildrens.org/classes-community/community-programs/food-allergy/

ELL Foundation/Protect Allergic Children Safe at School training - Erin Hayes, Seattle consultant; fee
http://ellfoundation.org/protect-allergic-children/training-services/

FAAN School Food Allergy Program including "Safe At School" Powerpoint - UPDATED!
School Food Allergy Program $75
Comprehensive Guide Only $40
Safe@School Only $40
Available for ordering from FAAN in October.

I hope this is helpful to some of you! And for those of you with law degrees or who have more experience with 504s than I do, please chime in!

Also, I will point out again that this information is not legal advice and I am only sharing my observations and interpretation of the laws and regulations. You should consult your lawyer for legal advice and your health care provider for help assessing the need for and the contents of your child's emergency care plan,individual care plan and/or 504 plan. Washington FEAST listserve disclaimers apply as well.

Kelly Morgan, President Washington FEAST, www.wafeast.org

Thursday, August 26, 2010

Back-to-School Tips for food allergies

As the first day of school approaches, I thought that I'd share some reminders to help all of us prepare for safe and successful classroom experiences!

Today's tip: Draft the letter(s) of introduction.......

Everyone handles this a little bit differently, but if your child will have a new school, a new teacher, or new parents and students in the classroom, it is a good time to think about how to introduce or re-introduce information about your child's food allergy to these audiences.

In your written and verbal communications with a new teacher, it is critical to clearly explain your child's medical condition. It may be, however, that sharing some important developmental milestone or emerging intellectual interest or their enthusiasm for school starting again, will help remind them that our children are beautiful human beings who also happen to have life-threatening food allergies, rather than ticking food allergy time bombs who will soon be left in their care for 7 hours a day! Share as much medical info as you deem appropriate, including short descriptions about past reactions, will help get the teacher up to speed so that those critical and short meetings you'll have the week before school starts can be used for clarifying and hammering out accommodations.

In your letter to other parents, you may want to share accommodations that have been agreed to in your child's 504 or Student Health Plan meeting, especially if you need their cooperation, and in most cases you will. It may be desirable to ask the parents to share part of the letter with their students or ask the teacher to share the letter as part of classroom food allergy education. It may also be desirable to have the letter come from the school nurse or other staff member. Over the years, I have found that it is much easier to accomplish my goals if the letter is from me, but I have successfully hammered out joint letters with other parents of food allergic students.

With the passing of the State Anaphylaxis Law in 2008, hopefully many schools will initiate their own letter to the entire school about food allergies. If this is not the case, however, you can find principal letters online or in the State Anaphylaxis Guidelines, at http://www.k12.wa.us/HealthServices/Publications/09-0009.aspx.

If this is your first year in school or preschool, peruse the internet, the FEAST sites and the guidelines for letters that you can modify or pick and choose what you like from what is out there.

Working on these letters is one way to help formulate what you do want to ask for in your 504 or Individual Health Plan. Look for more on this on the next Back to School Tip!

More to come!
Kelly Morgan, President
Washington FEAST
kelly@wafeast.org

More school links http://www.wafeast.org/School_Information.html

Wednesday, August 25, 2010

Seattle Food Allergy Conference

Support, Education and Prizes!

Food Allergy Conference


“Living well with food allergies at all ages and stages”

Saturday, September 25, 2010
Talaris Conference Center
(4000 NE 41st Street; Seattle, WA 98105)

Join us for an exciting day of presentations by food allergy experts from across the country

Linda Coss is our keynote speaker from Southern California. Ms. Coss is the author of several food allergy books.
Jennifer Kim MD from New York will report on exciting food allergy research. Dr. Kim is an allergist and researcher from the Mount Sinai School of Medicine Jaffe Food Allergy Institute.
David Naimi DO of Northwest Asthma and Allergy Seattle will lead a panel discussion on anaphylaxis.
Hilary Stephens RN will represent Seattle Children’s Hospital Food Allergy Community Health Education Program
Kelly Morgan MS, Nutrition Science and Policy; MPA WA-FEAST President and others will present family, community, school, and restaurant food allergy resources.

Attendees will be eligible for prizes!!
Registration is $50 on or before September 3rd; $60 thereafter.
Registration page: http://www.wafeast.org/Conference_Registration_IUQ.html

In memory - This conference is dedicated to the memory of Daniel Sargent, who died from peanut anaphylaxis at a potluck party at Seattle’s Warren G. Magnuson Park in 2008.

Kelly Morgan, President, Conference co-organizer
Jana Robertson, Vice President, Conference co-organizer
Washington FEAST, http://www.wafeast.org/
Email: leader@wafeast.org
Voice-mail: 425-24FEAST(425-243-3278)
Mailing address:2400 NW 80th St, #315Seattle WA 98117
Thank you to conference sponsors Allerbling, Allergy Monkey, Coconut Bliss, Dey (The makers of Epipen), Microsoft Employee Giving Programs, Spokane Food Allergy Support Network

Please Click for the Seattle Conference Page
Please "click" to visit our registration page.

Saturday, August 14, 2010

Kyle Dine Tween/Teen Event and WAFEAST Family Social

What a BEAUTIFUL day for a Kyle Dine Tween/Teen event and Washington FEAST family social! Good times at Camp Korey in Carnation, WA

Friday, August 6, 2010

Support, Education, Fun and Prizes!

Support, Education, Fun and Prizes!

Saturday, August 14 - Tweens and Teens (and siblings) Event, 1:00-3:00 PM - Door prizes! Win a $50 gift card to Amazon! Join us for an afternoon of fun with Canadian food allergy musician and advocate, Kyle Dine at Camp Korey (Carnation, Washington)! There will be games and discussion followed by pool time at 3PM. Siblings will have a separate discussion session with a FEAST leader. Registration fee is $20 and includes the September 25 Conference. Register at the conference registration link - http://wafeast.org/Seattle_Conference.html

Saturday, August 14 – FEAST Swim and Social at Camp Korey, 3-5 PM – More door prizes! ! Allergy Monkey t-shirt! At 3 PM we’ll open up the pool to all FEAST members. Please join us for conversation, support and a nice cool swim in the pool! Please bring your own watermelon (or other summer fruit) to enjoy! Beverages provided. All participants will be required to sign a pool waiver. Request but do not require RSVP by 8/11, 10PM, Kelly@wafeast.org. Please alert us to any fruit allergies!

Sunday August 15 – FAAN Walk for a Cure, Magnuson Park - Washington FEAST is sponsoring the second annual Kyle Dine concert at the 2010 FAAN Walk. FEAST also has a team participating - consider joining or sponsoring us at http://tinyurl.com/feastteam! Finally, if you plan to come to the walk, stop by the FEAST table to say hello. Registration starts at 9 AM, Walk at 11 AM. Kyle Dine Concert time to be announced soon!

Sunday, September 19 – Microsoft Golf Club Charity Tournament - Washington FEAST will again be the recipient of the Microsoft Golf Club’s Charity Tournament proceeds. Procuring donations that will make fun door prizes for the golfers is our way of thanking the golfers for their support of FEAST. We could not host these wonderful activities listed here without their support! An updated donation procurement letter will be on the website soon!

Saturday, September 25 - Washington FEAST Food Allergy Conference: “Living well with food allergies at all ages and stages” at the Talaris Conference Center in Seattle. Join us for an exciting day of presentations by food allergy experts from across the country including food allergy author and expert Linda Coss and allergist and researcher Jennifer Kim, MD from the Jaffe Food Allergy Institute. Participants will be entered in drawings for door prizes including donated products from local companies (e.g. Allerbling, Allergy Monkey and Namaste, among others). Registration is $50 on or before September 3rd; $60 thereafter. Registration page: http://wafeast.org/Seattle_Conference.html .

In memory - This conference is dedicated to the memory of Daniel Sargent, who died from peanut anaphylaxis at a potluck party at Magnuson Park in 2008. We hope to raise awareness among adults about the risks associated with eating food prepared by others at social events and the importance of having an emergency care plan that includes having epinephrine on hand at all times as well as transport to the nearest emergency room if epinephrine is administered.

Please visit http://www.wafeast.org/ , for more information about Washington FEAST.

Kelly Morgan, President, Conference co-organizer
Jana Robertson, Vice President, Conference co-organizer
Washington FEAST, http://www.wafeast.org/
Email: leader@wafeast.org
Voicemail: 425-24FEAST(425-243-3278)
Mailing address:
2400 NW 80th St, #315
Seattle WA 98117


Thank you to conference sponsors
Allerbling http://allerbling.com/
Microsoft Golf Tournament

Spokane Food Allergy Support Network http://spokanefasn.org/

Monday, August 2, 2010

Seattle Area Summer Food Allergy Events!

Saturday, August 14 – Tweens/Teens (& siblings) Event, 1:00-3:00 PM - Hang out with Canadian food allergy musician and advocate, Kyle Dine at Camp Korey (Carnation, Washington)! Kyle will lead the group through team building exercises and fun games followed by a discussion. Siblings will have a separate discussion session with a FEAST leader. Registration fee - $20; includes Sept. 25 Conference (see below). Register at http://wafeast.org/Seattle_Conference.html.

Saturday, August 14 – FEAST Social at Camp Korey, 3-5 PM - Please join us for conversation, support and a nice cool swim in the pool! Please bring your own watermelon (or other summer fruit) to enjoy! Non-allergenic beverages provided. Questions? Kelly@wafeast.org.

Sunday, August 15 – FAAN Walk for a Cure, Magnuson Park - Washington FEAST is sponsoring the second annual Kyle Dine concert at the 2010 FAAN Walk. FEAST also has a team participating - consider joining or sponsoring us at http://tinyurl.com/feastteam!

Saturday, September 25 - NEW DATE! Washington FEAST Food Allergy Conference: “Living well with food allergies at all ages and stages” at the Talaris Conference Center in Seattle. Join us for an exciting day of presentations by food allergy experts from across the country, including food allergy author and expert Linda Coss and allergist and researcher Jennifer Kim, MD from the Jaffe Food Allergy Institute. Participants entered in drawing to win food allergy products donated from Allerbling, Allergy Monkey and Namaste, among others. Registration is $50 on or before September 3rd; $60 thereafter.

In memory - This conference is dedicated to the memory of Daniel Sargent, who died from peanut anaphylaxis at a potluck party at Magnuson Park in 2008.

Washington FEAST (Food Allergy, Eczema, and Asthma Support Team) is a 501(c)3 organization dedicated to improving the lives of food allergic individuals and their families through education, support and advocacy.
Washington FEAST
www.wafeast.org
Phone: 425-243-3278, email: leader@wafeast.org
Mailing address: 2400 NW 80th St., #315, Seattle WA 98117