Thursday, October 7, 2010
Monday, October 4, 2010
Seattle Conference Photos
A beautiful fall Seattle day. Lots of information shared at "Living well with food allergies at all ages and stages" dedicated to the memory of Daniel Sargent.
Photos include pictures of our keynote speaker Linda Coss, Author, Food Allergy Expert.
Food Allergy Initiative Northwest Update
Sally Porter, Food Allergy Initiative Northwest and
Children's Food Allergy Community Nurse Educator Program Hilary Stephens, RN.
Kelly Morgan, MPA, MS. President WA-FEAST presenting food allergy resources.
Deli Lunch
• Buffet set up in lobby
• Sponsor/Info tables open
Jennifer Kim, MD, Mt. Sinai Medical School, Jaffe Food Allergy Institute Research update
and later Dr. Kim and Dr. David Naimi, DO, Northwest Asthma and Allergy
Anaphylaxis & Epinephrine Q & A panel discussion.
Spot Check, Inc. - Food Allergy Training and Certification Program
Lynn Bolgen, President
Alison Leary, PhD, Anxiety and Stress Reduction Center of Seattle .
Coping challenges and success secrets for anxiety management and food allergies
Jana
VP Washington FEAST
Washington Food Allergy Support
Thank you to Conference Sponsors Spokane FASN, Allerbling, Allergy Monkey, Coconut Bliss, Dey the makers of EpiPen, Bastyr Center, Medic Alert, Navan Foods, Allergic Living Magazine, and Microsoft Employee Giving Programs!!
Monday, September 27, 2010
Thank you to our Conference Sponsors!
The Seattle Conference "Living well with food allergies at all ages and stages" was made possible thanks to our sponsors. Registration fee covered some but not all of the day. We also wanted to offer scholarships for those who couldn’t manage the fee at this time so I wanted to extend a VERY special thanks to our wonderful sponsors that we were able to do that!! If you happen to do business with any of them and if you are so inclined, please mention to them you are grateful for their support to the WA-FEAST conference.
Allerbling™
Until there’s a cure, there’s Allerbling™ —raising awareness of children’s food allergies, one wrist at a time.
http://www.allerbling.com/
Allergy Monkey
Products and resources to help keep kids safe
www.allergymonkey.com/
Bastyr Center for Natural Health
The teaching clinic of Bastyr University
http://www.bastyrcenter.org/
Luna and Larry’s Coconut Bliss
Made from coconut milk and
free of dairy, soy and gluten.
Remember bliss is just a lick away!
http://www.coconutbliss.com/
Dey
In a life-threatening allergic reaction, every second counts. EpiPen® helps stop allergic reactions fast—giving you time to get the emergency medical help you need.
http://www.epipen.com/
Medic Alert Foundation
Always There For You
http://www.medicalert.org/
Microsoft Employee Giving Programs
At Microsoft, our mission and values are to help people and businesses throughout the world realize their full potential.
http://www.microsoft.com/
Navan Foods
The allergy free food shop
http://www.navanfoods.com/
Spokane Food Allergy Support Network
Stop • Think • Allergies™
http://www.spokanefasn.org/
Allerbling™
Until there’s a cure, there’s Allerbling™ —raising awareness of children’s food allergies, one wrist at a time.
http://www.allerbling.com/
Allergy Monkey
Products and resources to help keep kids safe
www.allergymonkey.com/
Bastyr Center for Natural Health
The teaching clinic of Bastyr University
http://www.bastyrcenter.org/
Luna and Larry’s Coconut Bliss
Made from coconut milk and
free of dairy, soy and gluten.
Remember bliss is just a lick away!
http://www.coconutbliss.com/
Dey
In a life-threatening allergic reaction, every second counts. EpiPen® helps stop allergic reactions fast—giving you time to get the emergency medical help you need.
http://www.epipen.com/
Medic Alert Foundation
Always There For You
http://www.medicalert.org/
Microsoft Employee Giving Programs
At Microsoft, our mission and values are to help people and businesses throughout the world realize their full potential.
http://www.microsoft.com/
Navan Foods
The allergy free food shop
http://www.navanfoods.com/
Spokane Food Allergy Support Network
Stop • Think • Allergies™
http://www.spokanefasn.org/
Friday, September 24, 2010
Conference Dedicated to Daniel Sargent
The Washington FEAST food allergy conference "Living well with food allergies at all ages and stages" is dedicated to the memory of Daniel Sargent, a sports writer who worked for the Everett Herald and who died in July of 2008 from anaphylaxis caused by an accidental peanut exposure.
His fatal reaction occurred one Sunday afternoon while Daniel was celebrating a friend’s 30th birthday at Magnuson Park in Seattle. Witnesses say that ninety seconds after he took a bite from a chocolate chip cookie, he collapsed. Epinephrine was not on hand, but a nurse, medic, and pulmonologist who happened to be attending the party administered CPR until emergency help arrived.
Daniel was rushed to Harborview Medical Center, where doctors tried for two days to save him from complications wrought by the severe reaction, which had blocked his breathing and deprived his brain of oxygen. Daniel died at the age of 30 from the peanut allergy his family learned about when he was 3 months old.
An article published by the Everett Herald on July 4, 2008 (“Man’s death a stark reminder of food allergy risks” by Sharon Salver), reported that the family had kept an EpiPen, a device for self-injecting epinephrine to provide temporary relief from the symptoms of a severe allergic reaction, at their home. But as an adult, Daniel had decided not to carry an EpiPen at all times. Instead, Daniel tried to be vigilant about what he ate and kept an over-the-counter allergy medicine close at hand. As his father is quoted in the Herald article, “This time, [the allergic reaction] just came too fast, to quick, and too deadly.”
Daniel grew up near Everett and graduated from Snohomish High School in 1996. He worked as a sports writer for the Everett Herald and as a medical assistant for Skagit Valley Medical Center in Mount Vernon. His life-long love of soccer lead to volunteering with Snohomish County Youth Soccer for over a decade. He also coached, played , and refer¬eed indoor soccer.
His driver’s license indicated that he wished to be an organ donor, and his sister reported in the Herald article that his heart had been used in a transplant surgery at the University of Washington and that his liver, kidneys, and corneas would also be donated.
Lacey Boek, a lifelong friend of Daniel’s, wrote the following in July 3, 2008; she posted it on a memorial blog for Daniel at http://rememberingdansargent.blogspot.com/.
Daniel Sargent is . . . a loyal friend who would do anything for those around him. He has a huge heart that has touched the lives of many. It is in his death that he will continue to help people and give back. Daniel is an organ donor with very healthy organs to donate. . . . We will remember him with fond memories forever. It is my hope that we can all take something away from this tragic story.
His fatal reaction occurred one Sunday afternoon while Daniel was celebrating a friend’s 30th birthday at Magnuson Park in Seattle. Witnesses say that ninety seconds after he took a bite from a chocolate chip cookie, he collapsed. Epinephrine was not on hand, but a nurse, medic, and pulmonologist who happened to be attending the party administered CPR until emergency help arrived.
Daniel was rushed to Harborview Medical Center, where doctors tried for two days to save him from complications wrought by the severe reaction, which had blocked his breathing and deprived his brain of oxygen. Daniel died at the age of 30 from the peanut allergy his family learned about when he was 3 months old.
An article published by the Everett Herald on July 4, 2008 (“Man’s death a stark reminder of food allergy risks” by Sharon Salver), reported that the family had kept an EpiPen, a device for self-injecting epinephrine to provide temporary relief from the symptoms of a severe allergic reaction, at their home. But as an adult, Daniel had decided not to carry an EpiPen at all times. Instead, Daniel tried to be vigilant about what he ate and kept an over-the-counter allergy medicine close at hand. As his father is quoted in the Herald article, “This time, [the allergic reaction] just came too fast, to quick, and too deadly.”
Daniel grew up near Everett and graduated from Snohomish High School in 1996. He worked as a sports writer for the Everett Herald and as a medical assistant for Skagit Valley Medical Center in Mount Vernon. His life-long love of soccer lead to volunteering with Snohomish County Youth Soccer for over a decade. He also coached, played , and refer¬eed indoor soccer.
His driver’s license indicated that he wished to be an organ donor, and his sister reported in the Herald article that his heart had been used in a transplant surgery at the University of Washington and that his liver, kidneys, and corneas would also be donated.
Lacey Boek, a lifelong friend of Daniel’s, wrote the following in July 3, 2008; she posted it on a memorial blog for Daniel at http://rememberingdansargent.blogspot.com/.
Daniel Sargent is . . . a loyal friend who would do anything for those around him. He has a huge heart that has touched the lives of many. It is in his death that he will continue to help people and give back. Daniel is an organ donor with very healthy organs to donate. . . . We will remember him with fond memories forever. It is my hope that we can all take something away from this tragic story.
Wednesday, September 22, 2010
2010 Washington FEAST Food Allergy Conference Agenda
Talaris Conference Center; Seattle, WA
Cedar Room
Saturday September 25, 2010
Check in begins at 8:30 AM
9:00-10:30 Keynote: “Managing your child’s food allergy”
Linda Coss, Author, Food Allergy Expert
10:30-10:45 BREAK –
• Sponsor/Info tables open
• Beverages and fruit available
10:45-11:30 AM FAI Food Allergy Northwest Update
Sally Porter, Food Allergy Initiative Northwest
Children's Food Allergy Community Nurse Educator Program
Hilary Stephens, RN
11AM-Noon
Food Allergy Management for Nutritionists/Dietitians
Linda Coss
11:30--12PM School Food Allergy Resources
Kelly Morgan, MPA, MS. Grandparent/Caregiver Breakout session-Tentative
Noon- 1 PM Deli Lunch
• Buffet set up in lobby
• Sponsor/Info tables open
1-2:00 PM
Q & A Research Update
Jennifer Kim MD, Mount Sinai School of Medicine
2:00-3:00 PM Anaphylaxis & Epinephrine Q & A:
-Dr. David Naimi, DO, Northwest Asthma and Allergy
-Jennifer Kim, MD, Mt. Sinai Medical School, Jaffe Food Allergy Institute
3-3:15 BREAK
• Beverages and cookies available
• Sponsor/Info tables open
3:15-4 PM Spot Check, Inc. - Food Allergy Training and Certification Program
Lynn Bolgen, President
4-5 PM
Anxiety Management
Alison Leary, PhD, Anxiety and Stress Reduction Center of Seattle . Teen Breakout - Tentative
Coping challenges and success secrets
5-5:15 PM Closing Remarks
See you then!
Jana
VP Washington FEAST
Washington Food Allergy Support
Thank you to Conference Sponsors Spokane FASN, Allerbling, Allergy Monkey, Coconut Bliss, Dey the makers of EpiPen, Bastyr Center, Medic Alert, Navan Foods, Allergic Living Magazine, and Microsoft Employee Giving Programs!!
Cedar Room
Saturday September 25, 2010
Check in begins at 8:30 AM
9:00-10:30 Keynote: “Managing your child’s food allergy”
Linda Coss, Author, Food Allergy Expert
10:30-10:45 BREAK –
• Sponsor/Info tables open
• Beverages and fruit available
10:45-11:30 AM FAI Food Allergy Northwest Update
Sally Porter, Food Allergy Initiative Northwest
Children's Food Allergy Community Nurse Educator Program
Hilary Stephens, RN
11AM-Noon
Food Allergy Management for Nutritionists/Dietitians
Linda Coss
11:30--12PM School Food Allergy Resources
Kelly Morgan, MPA, MS. Grandparent/Caregiver Breakout session-Tentative
Noon- 1 PM Deli Lunch
• Buffet set up in lobby
• Sponsor/Info tables open
1-2:00 PM
Q & A Research Update
Jennifer Kim MD, Mount Sinai School of Medicine
2:00-3:00 PM Anaphylaxis & Epinephrine Q & A:
-Dr. David Naimi, DO, Northwest Asthma and Allergy
-Jennifer Kim, MD, Mt. Sinai Medical School, Jaffe Food Allergy Institute
3-3:15 BREAK
• Beverages and cookies available
• Sponsor/Info tables open
3:15-4 PM Spot Check, Inc. - Food Allergy Training and Certification Program
Lynn Bolgen, President
4-5 PM
Anxiety Management
Alison Leary, PhD, Anxiety and Stress Reduction Center of Seattle . Teen Breakout - Tentative
Coping challenges and success secrets
5-5:15 PM Closing Remarks
See you then!
Jana
VP Washington FEAST
Washington Food Allergy Support
Thank you to Conference Sponsors Spokane FASN, Allerbling, Allergy Monkey, Coconut Bliss, Dey the makers of EpiPen, Bastyr Center, Medic Alert, Navan Foods, Allergic Living Magazine, and Microsoft Employee Giving Programs!!
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
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
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