+ 504 Quick Start for School Nurses Presented at OASN Conference Spring 2012 Sara Reith, Ed.S. NCSP

+ Session Objectives for the hour The Law Present Federal law relating to 504 Student candidates Difference between 504 and IEP The Toolkit Cheat sheets 504 forms Process timeline The Examples Timeline example of start up 504 committee Case study example of a 504 student Difference between initial and reevaluations The Questions

+ THE LAW: Present Federal Law 504 is a federal mandate to schools requiring the elimination of discrimination based upon disability. Section 504 of the Rehabilitation Act of 1973 states: “No otherwise qualified individual with a disability shall solely by reason of his/her disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.” Section 504 is a civil rights statute and not a special education statute. (Taken from Neola’s 2010 interpretation of 504 Procedural Rights).

+ THE LAW: Student Candidates Any student with a defined disability is eligible as a candidate for service under 504 “A student qualifies for 504 protection of s/he is determined to have a physical or mental impairment that substantially limits one or more major life activities. Major Life Activities include, but are not limited to: Caring for one’s self: performing manual tasks, walking, seeing, hearing, speaking, breathing, working, eating, sleeping, standing, lifting, bending, reading, concentrating, thinking, communicating, learning, The operation of major bodily functions: immune system, normal cell growth, digestive, bladder, bowel, neurological, brain, respiratory, circulatory, endocrine, and reproductive functions

+ THE LAW: Student Candidates THE PROBLEM: No specific limitations to how we define a disability THE CHALLENGE: Establish a standardized method of defining and evaluating disability in your school ONE INTERPRETATION: Use of the Response to Intervention system and present School Health Care plans to establish strong candidates for service. Find a place to start by looking hierarchically at your “at risk” populations.

+ THE LAW: Difference between 504 and IEP 504IEP (Other Health Impairment) Students with a medical diagnosis who require accommodation in the classroom in order to successfully access the school curriculum Students who evidence a discrepancy between ability and achievement requiring interventions as well as accommodations in order to successfully access the school curriculum AccommodationIntervention Instructional supports afforded in the classroom to adjust educational materials or environments Direct instruction promoting the development of specific skills in a given academic or behavioral area. Example: Calculator and extended time given to a student with ADHD Example: Touch math instruction given to a student who demonstrates a deficit in math related to poor stamina defined by ADHD

+ THE TOOLKIT: Forms and Cheat Sheets Start up 504 in your building by creating a Handbook referencing forms and procedures specific to your district Consult your school’s commissioned law firm to verify their recommendations regarding 504 forms and procedures. See accompanying handout Word copies of all forms are available at

+ THE TOOLKIT: Process Timeline Child is Suspected of having a physical or mental impairment which limits a major life function Obtain a copy of Physician- signed medical diagnosis dated within one year (Use Form 1 to gain parent permission for Record Release) 504 Initial Referral form (Form 2) Completed by parent or school employee & Submit form to 504 Coordinator 504 Coordinator will send d Prior Written Notice to Parents (Form 3) 504 Coordinator will Have parent sign Parent Permission for Initial Evaluation and receipt of Procedural Information (Form 4) Parent consent granted Team completes Learning Evaluation Worksheet (Form 10), and 504 Evaluation (Form 7) Send parent invitation for Evaluation Review / 504 Plan Review (Form 5) Within 60 days of referral, review 504 Evaluation Report (Form 7) at Team Meeting and make team determination about Eligibility Student Eligible Create 504 Plan (Form 8) and furnish copies to: Central Office, Main Office, Nurse, and Parent Review 504 Plan Annually Reevaluation completed at least every 3 years or whenever there is a question of continued eligibility (Form 9) Student not Eligible Serve Student with RTI plan Parent consent not granted Parent refusal documented, Student served through RTI process 504 Coordinator will review procedural safegards with parent (Form 6) Form 1 Release of Records: 1 Sent by 504 Coordinator to parent to obtain permission to secure a copy of student’s medical diagnosis from his/her primary care physician Form 2 (Suspected Disability Referral Form): Completed by teacher, school employee, or parent initiating the 504 process. Form 3 Prior Written Notice: Completed and sent by 504 Coordinator explaining why child is a candidate for 504 planning Form 4 Consent for Evaluation: 4 Sent by 504 Coordinator to parents to obtain permission to move forward in the ADA process Form 5 Notice of 504 Conference: Completed and sent by 504 Coordinator inviting parent to participate in 504 meeting Form 6 Procedural Information: Sent by 504 Coordinator to educate parents about 504 Form 7 Summary Evaluation Report: Completed by 504 Coordinator using RTI documentation and optional forms such as Form 10 (Learning Evaluation Worksheet) Form 8 Section 504 Plan: Completed Prior to (as a draft) or at 504 Meeting, reviewed annually Form 9 Section 504 Plan Review: Completed annually in the event that accommodation need has not substantially changed. If student need changes, complete F10 and F 13.

+ THE EXAMPLES: Timeline Start up Steps Develop a Handbook Establish a Committee in each Building ( 504 Coordinator, Teachers, School Nurse, School Psychologist, Principal) Review your “frequent flyers” on safety plans, initiate one 504 evaluation at a time Use the RTI or IAT system for academic disability referrals Develop a roster referencing all 504 plans, accommodations, and due dates Ensure that teachers all get a copy of the final 504 plan Annually, review each student’s plan

+ THE EXAMPLES: A Student identified through RTI Adam maintains a diagnosis of ADHD. He is struggling with work completion and organization in the classroom Through RTI screening, Adam evidences average test performance but below average homework grades in math and writing Given his poor work completion, the team suspects that Adam requires organizational accommodations to be successful in the classroom Adam’s writing and math teachers arrange a peer model to promote organization, provide agenda support, and establish a home to school communication system to support homework. They accommodate in the classroom with pre-teaching and chunking strategies. Adam’s work performance improves.

+ THE EXAMPLES: A Student identified through RTI Considering his significantly improved performance (15% improvement in work completion), the team feels that Adam’s symptoms associated with ADHD limits his life functions of learning and concentrating The 504 Coordinator contacts Adam’s mom to share Adam’s accommodation success and explain the 504 process. If the parent verbally indicates interest in a 504, a recent MD diagnosis is requested A record release is sent home to the parent and a copy of Adam’s current ADHD diagnosis is requested (either by the parent or school) Once a copy of the diagnosis is secured, a 504 referral is made

+ THE EXAMPLES: A Student identified through a Health Plan Beth maintains a diagnosis of Diabetes. She requires monitoring support three times daily during school hours. Her support is managed through a health plan developed by her school nurse. In association with the health plan, a copy of her MD’s diagnosis is on file A 504 referral is made and the 504 Coordinator contacts Beth’s mom to explain the 504 process. The following forms are sent to the parent: Form 3 Prior written Notice Form 4: Permission for Evaluation Form 6: Procedural Safegards If a parent gives permission, an evaluation is initiated. If permission is refused, the refusal is documented and Beth’s health plan is maintained.

+ THE EXAMPLES: Initials vs. Reevaluations Initials: (Complete forms 1-8) Reevaluations: (Complete forms 3, 5, 6, and 9)

+ THE QUESTIONS