For School Nurses. Marie DeSisto, RN, MSN, NCSN

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1 Section 504 For School Nurses Marie DeSisto, RN, MSN, NCSN 1. Access 2. Accommodations 3. Accountability Key role of the school nurse Scope and standards of school nursing practice: 1. Assessment 2. Diagnosis 3. Outcome identification 4. Planning 5. Implementation ANA (2011). Role of the School Nurse School controversies and legal disputes often pivot on the actions and knowledge of the school nurse. Zirkel (2012) Section 504: No otherwise qualified individual with a disability shall solely by reason of her or his 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. US Department of Education, Office for Civil Rights (2010) Section 504 A major component of the Rehabilitation Act of 1973 CIVIL RIGHTS legislation for persons with disabilities

2 Purpose of Section 504 Allow equal access to a free and appropriate education (FAPE) Level the playing field Eligibility for Section 504 Broad Many different types of disabilities and disabling conditions NOT based on clinical categories Regular Education services Section 504 & Title II ACCESS Section 504 and Title II of the ADA are enforced by the Office of Civil Rights. Prohibit discrimination on the basis of disability. They do not provide any type of funding. 9 Child Find Requirement Districts are required to locate students who may be eligible for protections under Section 504. As with IDEA School Nurse Students with disabilities Students with medical conditions Students with IHP

3 Who is a Qualified Student? Of age during which persons without disabilities are provided such services Of any age during which it is mandatory under state law to provide such services to students with disabilities A student for whom a state is required to provide a free appropriate public education under IDEA Individual Health Plan An IHP does NOT take the place of a Section 504 Plan Numerous cases where OCR has found Districts out of compliance if they rely on an IHP vs. a 504 Plan An IHP does not provide procedural safeguards that the student is entitled Access: When determining eligibility: No longer consider mitigating measures Consider impairments that are episodic or in remission Definition of Disability under Section 504 Has a physical or mental impairment which substantially limits one or more of such person s major life functions Has a record of such an impairment Is regarded as having such an impairment Definition of physical or mental impairment: Physiological disorder or condition Cosmetic disfigurement Anatomical losses affecting one or more of a body system Any mental or psychological disorder, such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities Major Life Activities: Caring for one s self Performing manual tasks Walking Seeing Hearing Speaking Breathing Learning Working

4 Major Life Activities expanded: Reading Communicating Thinking Standing Concentrating Lifting Eating Bending Bladder function Sleeping Bowel function Other Substantial Limitation Unable to perform a major life activity that the average person in the general population can perform Refer a student for a Section 504 evaluation Referred for IDEA but not evaluated or determined not to be eligible Suspected of having a disability Continue to display behavior problems Diagnosed with a major health problem Refer a student for a Section 504 evaluation Expelled or suspended Problems that cannot be explained Parental request for a 504 evaluation Staff member request for an evaluation Evaluation for eligibility Evaluative data from a variety of sources Doctor s order is not sufficient data for a 504 Nurse visits/absences Individual Healthcare Plan (IHP) Temporary Disabilities Covered by Section 504 if they meet the criteria Generally the OCR does NOT require a 504 plan for a temporary disability Exception: MA DESE has been requiring plans for students needing MCAS accommodations

5 Accommodations Accommodations should ensure access to a free and appropriate education in the least restrictive environment May consider the mitigating measures when determining accommodations Accountability Consistent notification of the parents rights under Section 504 and the grievance procedure in plain language. Accountability Proof that the student received the accommodations Documentation of care IHP What Schools Must Do? FAPE: Provide a free appropriate public education for all students Least restrictive environment Schools must establish: Nondiscriminatory evaluation & placement procedures. Procedural safeguards to enable parents to participate in the evaluation. Section 504 Compliance The Office for Civil Rights is concerned with protecting the rights of students and parents ALWAYS follow the process Afford all children an equal opportunity to participate in nonacademic & extracurricular services and activities.

6 Section 504 Pitfalls Not evaluating a student when requested Not evaluating a student in a timely manner Not having the right staff on the evaluation team Pitfalls Not documenting evaluation/services Not following the 504 plan Failing to provide the services agreed upon in the 504 plan Private schools Private schools do not have to follow Section 504 Unless they take Federal funds from the Department of Education and Title II Section 504 Summary: Comprehensive civil rights legislation Core: an anti discrimination law FDE 2012 Incorporates a very broad definition of disability Students not eligible under IDEA may be eligible under Section 504 Summary 504 Qualifying Questions: 1. Does the student have a disability? 2. Is the disability mental or physical? Role of the School Nurse: Access Accommodations 3. Does the disability substantially limit a major life activity? Accountability

7 Resources: Office for Civil Rights 10 regional office. Boston, MA (800) Section 504 Compliance Advisor Newsletter LRP Publications US Department of Education, Office of Civil Rights (2010). Guidelines for educators and administrators for implementing Section 504 of the Rehabilitation Act of 1973 subpart D. References American Nurses Association (2011). School nursing: Scope and standards of practice, 2 nd Edition. Silver Springs, MD: Nursesbooks.org. Florida Department of Education (2012). Individual health care plans and the section 504 white paper. Retrieved from Gibbons, L., Lehr, K., & Selekman, J. (2013). Federal laws protecting children and youth with disabilities in the schools. Selekman, J (ed). School nursing: A comprehensive text. (pp ). Philadelphia: F.A. Davis. References Kim, D., Samples, E. (2013). Comparing individual health care plans and section 504 plans: School districts obligation to determine eligibility for students with health related condition. Urban Lawyer, 45(1), Laubin, M., Schwab, N.C., Doyle, J. (2013). Understanding the legal landscape. Cosante, C. (ed). School nurse administrators: Leadership and management (pp ).Silver Springs, MD:NASN. References: Pfrommer, J. (2013). Serving students with medical needs. Palm Beach Gardens, FL.: LRP Publications. U.S. Department of Education, Office For Civil Rights (ND). Frequently asked questions about Section 504 and the education of children with disabilities. Retrieved from US Department of Education, Office of Civil Rights (2010). Guidelines for educators and administrators for implementing Section 504 of the Rehabilitation Act of 1973 subpart D. Retrieved from nes.pdf

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