It Takes a Village: The 504 Plan It Takes a Village: The 504 Plan Maureen M. Kelly, RN, MS, CPNP Department of Pediatrics, Division of Gastroenterology School of Nursing UNC-Chapel Hill, Chapel Hill, NC December 14, 2013

Objectives Define 504 plan and differentiate from IEP Discuss how to get the 504 process started Identify the kind of accommodations needed for students with IBD Discuss pertinent resources for school accommodations I have no disclosures to report

IBD from the Child’s Perspective “Young people with Crohn’s disease or ulcerative colitis say their single most difficult problem in school is their need to use the toilet frequently and without warning due to sudden attacks of diarrhea” Crohn’s Disease & Ulcerative Colitis: A guide for teachers and other school personnel, CCFA

Case Study 14 year old female freshman in HS with ulcerative colitis having several bloody diarrhea stools daily Had 504 plan in middle school with no problems Mother tried to get plan renewed summer prior to high school, but guidance counselor didn’t sign off She needed to use bathroom during class. When she came back to class after 10 minutes, the teacher said, “What could you have possibly been doing in the bathroom for 10 minutes?

Background In 1973, Congress passed the Rehabilitation Act that prohibits discrimination based on disability Any organization or agency (including public schools) receiving federal funds must comply; schools are required to provide reasonable accommodations for children with disabilities To be qualified under Section 504, the student must be between years of age, and must have a disability

Difference Between IEP and 504 Plan? IEP: Plan or program to ensure child who has disability identified under law and attending elementary or secondary educational institution receives specialized instruction and related services 504 Plan: Plan to ensure child who has disability identified under the law attending elementary or secondary educational institution receives accommodations that will ensure their academic success and access to the learning environment. No specialized instruction needed

When to Initiate a 504 When child likely to miss out on his/her education because of IBD End of 8 th grade if not before due to limited bathroom breaks, frequent standardized testing in high school If extended time needed on standardized tests, may be given with a letter from the school. Less likely if no accommodations during high school

How to Start the Process? Exact rules vary by school district Teachers or parents may make a referral Parents should start with “My child has a medical condition that is affecting their ability to get an education. I would like a meeting to discuss setting up a 504 plan for my child.” School is then required to set up an initial meeting and assemble team to review possible accommodations

Requesting a 504 Plan Make the request in writing Include supporting medical documentation All parties should develop a workable plan

Help the School Help the Student… Initial Diagnosis Contact List: School nurse Guidance counselor School social worker Teachers Administrators Student File Letter Definition of IBD Associated symptoms Cyclical nature Home tutoring option Gym considerations

4 Types of Accommodations Changes in testing Changes to environment Changes in context of teaching Changes in schedule

Sample 504 Plan Accommodations Cell phone use in emergency Bathroom pass and/or nurse’s office pass Revised seating chart Food/drink in class/self- medication during school Stop-the-clock testing Rescheduling project/exam deadlines Extra set of books Increased time between classes Accommodations for fatigue Excused absences for treatments, appointments, hospitalizations Assistance with make up work, tutoring

What About College? A student with a 504 plan can carry over special accommodations to college Adjustments required to eliminate and/or protect against discrimination. Adjustments include extending length of time for completion of degree requirements or adding time to exams May allow student extra time to complete exams, allow for bathroom breaks, private dorm room or private bathroom

Back to the Case Study… Mother ed teacher with no response She then talked with principal Principal scheduled conference with guidance counselors, teachers Never had another issue with bathroom break What were the gaps here? How could they have been avoided?

Ways to Help Kids with IBD Encourage to keep up with schoolwork while hospitalized as they are able May need home-bound instruction Help school personnel understand child’s needs and be the child’s advocate Assist with 504 accommodations Understand the role physical and emotional stress play in the illness

Take Home Messages Medications, missed school may affect learning Collaborative effort between medical personnel, school services, parents and child Get the process in place ASAP Approach as opportunity to educate and partner with the school

Support and Resources Education National Dissemination Center for Children with Disabilities: U.S. Department of Education: Parent Advocacy Coalition for Educational Rights: Advocacy for Patients with Chronic Illness Inc. 504 Template for Students with IBD:

Support and Resources cont. CCFA: ccfa.org – Look under “search our resources” for: o Taking IBD to School o School accommodations letter o Template Section 504 plan for children with IBD o Crohn’s disease and ulcerative colitis: A guide for teachers and other school personnel o Doing our homework: A parent’s guide to educational equity