PSD Guidelines for Students with Severe Food Allergies and Intolerances. Written by the designated PSD Food Allergy Task Force:

Transcription

1 Poudre School District PSD Guidelines for Students with Severe Food Allergies and Intolerances Written by the designated PSD Food Allergy Task Force: Parents Scott and Katie Martin Jim and Cheryl Pietrangelo Catherine Teck (who also runs the Inspiring Children with Food Allergies (I-CAN) support group) Physician Dr. John James PSD Nurses Nancy Weber and Amy Asher Director of Student Services/504 Coordinator Darcie Votipka

2 Contents Overview of Life-Threatening Food Allergies and Food Intolerances...3 Where to Start?...4 Responsibilities of All Key Stakeholders...4 PSD Health Care Action Plans...5 Poudre Schools and Staff...5 Food Services Responsibilities...6 Principal and Site Responsibilities...6 School Nurse s Responsibilities...6 Teacher s Responsibilities...7 Family s Responsibilities...7 Student s Responsibilities...8 Recess, Lunch, Child Care and/or After-School Activity Responsibilities...8 Custodian s Responsibilities...9 PSD Transportation s Responsibilities...9 Field Trip Considerations Resources, Acknowledgements and PSD Downloadable Forms Appendix A Timeline for Preparation Needed to Care for Severely Food-Allergic Students Appendix B Example of Teacher s Letter Home to Parents Appendix C - Colorado Senate Bill passed in May Appendix D Plan Page 2

3 Overview of Life-Threatening Food Allergies and Food Intolerances Severe food allergies can be life threatening. Severe food intolerances (i.e. celiac disease) can be damaging to the body and produce chronic long-term health effects. The risk of accidental exposure to food allergens can be reduced in the school setting if schools partner with students, parents and physicians to minimize risks and provide a safe educational environment for severely allergic and food-intolerant students. A recent study published in the Journal of School Nursing showed that 94 percent of the nation s schools have students with food allergy. Reactions often occur at school, including severe anaphylaxis, which can kill within minutes unless epinephrine (adrenaline) is administered. Deaths from anaphylaxis are usually a result of delayed administration of epinephrine. The foods most likely to cause allergic reactions are: Peanuts, tree nuts, dairy (cow s milk), eggs, soy, wheat, fish, and shellfish. Students affected by celiac disease must typically avoid wheat, rye, barley and oats Poudre School District recognizes the growing number of students enrolling in our schools with potentially lifethreatening food allergies. As public educators we recognize our responsibility to develop appropriate health plans for students with food allergies which detail emergency treatment while proactively addressing conditions to prevent exposure to specific allergens. PSD believes a collaborative partnership between school and family is the best way to achieve this goal while thoughtfully increasing the student s independence to care for him or herself. While the medical and healthrelated needs are unique for each child, the intention of this manual is to establish a set of consistent, systemic practices within the district as a starting point. Principals and school personnel do not need to re-invent the wheel each time a student with serious food allergies enrolls nor do the students and their families need to fear experiencing variable levels of familiarity with regard to food allergens. Poudre School District cannot guarantee that a student will never experience an allergy-related event while at school. Because the PSD is committed to student safety, the district (along with a team of doctors, nurses and parents) has created these guidelines to reduce the risk children with life-threatening allergies/food intolerances will experience an allergy-related event. In some cases, a student s allergies may rise to the level of a disability under Section 504 of the Rehabilitation Act of 1973 ( Section 504 ). In such circumstances, refer to the 504 Plan section in this guide for information. In PSD, we believe there is a school community, made up from staff from various departments, who are involved and have a stake in an allergic child s safety. These departments and staff include, but are not limited to, Food Service, Transportation, Principals, Administrators, Teachers, Counselors, Health Services, Recess Monitors, Substitute Teachers, Janitors, etc. Of course, the family and the student also have a large role in collaborating with the school community and creating a safe environment for all students involved. The purpose of this document is to provide more detailed clarity around the roles and responsibilities of the various key stakeholders within the school community and family. All PSD departments mentioned above have had input and reviewed this document. Page 3

4 Where to Start? The parent of the student with food allergies should notify the principal and the nurse of the school that your child will be attending that your child has allergies/intolerances as soon as possible; prior to the first day of attendance, preferably in the spring preceding the school year. It s important to allow sufficient time to secure physician signatures on all necessary forms, including the Authorization Release to Administer Medicine (PDF form) and/or the Carry and Self-Administer Medicine (PDF form). Some PSD schools have before- and after-school programs managed through a third party. Work with your local school nurse to coordinate breakfast or after-school menu concerns. Work with a team of school contacts - which may include the principal, transportation department, counselor, classroom teacher, and school nurse to determine the appropriate Health Care Action Plan (HCAP) Food Allergy (PDF form) or HCAP Asthma (PDF Form) that accommodates your child s needs throughout the school year. This plan should include your child s daily needs in the classroom, in the cafeteria, in after-care programs, during school-sponsored activities and on the school bus. (Optional) Provide a letter from your health care provider that states your child s diagnosis, any history of allergic reactions (especially whether your child has experienced anaphylaxis and any doctor recommendations) and any medically advisable accommodations Provide written medical documentation, instructions, and properly labeled, current medications as directed by a physician (using the HCAP as a guide) to the school. It is optional to include a photo of your child on the completed form. Provide replacement medications after use or upon expiration. Provide emergency contact information and (optional) a photo of your child on this information. The parent should provide authorization (consent) for PSD staff to consult with the student s healthcare provider regarding prevention and treatment. Responsibilities of All Key Stakeholders Knowledge of the allergens that cause life-threatening symptoms How to recognize symptoms of the student s life threatening allergic reaction Discourage students from sharing or trading snacks with students that have food allergies Reinforce hand-washing before and after eating Monitor closely that bullying or teasing does not occur. Be supportive and inclusive towards students with food allergy Educate the child in the self-management of their food allergy/intolerance including: o Safe and unsafe foods o Strategies for avoiding exposure to unsafe foods o Symptoms of allergic reactions o How and when to tell an adult they may be having an allergy-related problem o How to read food labels (age appropriate) o Teacher awareness of weekly lunch menu o Parents can contact Food Service Director for ingredient listings o No trading food o No accepting foods from anyone unless designated by a parent/guardian. Employees of the district shall be aware of Colorado state law regarding food allergies, and the district s policies. Collaboratively review the health information submitted by parents and physicians to determine whether a Health Care Action Plan (HCAP), Section 504 Plan or both will apply. Page 4

5 Create appropriate plan(s) to be reviewed at least on an annual basis. Distribute HCAP annually (prior to start of school year.) Ensure that pertinent information be shared with faculty and staff that have contact with the student in accordance with federal and state law, but otherwise kept confidential. Inform and educate teachers as far in advance as possible that they will be teaching a severely allergic student or a student with severe food intolerances. Work with the 504/HCAP team as needed to ensure safety of the severely allergic child. Encourage food safety and awareness. A letter home to classroom parents may be necessary to raise awareness and promote a food allergenfree classroom. The student s name will remain confidential (unless parents choose to sign waiver). See Appendix B for an example letter. Take reasonable steps to maintain a playground free of food allergens. Encourage hand washing after lunch. Review supplies to ensure they are non-allergenic. Play-dough, finger paint, art projects, science chemicals, and cleaning solutions can all contain food allergens. With parent consent, provide list of children with severe food allergies/intolerance and their pictures to the food services staff to ensure safe meals are fed to those children who choose to eat a school meal Discuss field trips of the severely allergic/intolerant child to decide appropriate strategies for managing the food allergy(s)/intolerance(s) Determine who is responsible for carrying allergy medications. Ensure access to a phone in case of an emergency Observe and be aware of how other students are reacting to the allergic/intolerant student to prevent teasing/harassment. Enforce district bullying policy if necessary. Ensure that severely allergic/food intolerant students are included in all school activities to the extent that reasonable accommodations can be made to provide for their safety Students should not be excluded from school activities solely based on their food allergy, nor asked to stay home for a day when a school activity involving food is occurring PSD Health Care Action Plans A PSD Health Care Action Plan (HCAP) For Food Allergies (PDF form) should be completed when a student has significant food allergies that require a medical response if exposed to the allergen. There is also an HCAP for Asthma (PDF form). In most cases, the HCAP will address the precautionary needs of the severely allergic/intolerant/asthmatic student, as well as state the proper treatment procedures if the student becomes symptomatic. A HCAP can be sufficient for a student with severe food allergies/intolerances, however, a 504 Plan may be written (in addition to a HCAP) if there are unique accommodations that are not sufficiently covered in the HCAP. Poudre Schools and Staff Be in compliance with Senate Bill Refer to Appendix C for more information on SB Review the health information submitted by parents and physicians to determine whether Food Allergy HCAP or a Section 504 Plan or both will apply. Distribute HCAP annually (prior to start of school year) to all teachers and staff of the severely allergic/food intolerant child. Ensure that pertinent information is shared with faculty and staff that have contact with the student in accordance with federal and state law, but otherwise kept confidential. Inform and educate teachers as far in advance as possible that they will be teaching a severely foodallergic/intolerant student. Page 5

6 Routinely train appropriate staff to know how to identify signs of an allergic reaction and how to administer epinephrine. Members of staff include teachers, substitutes, paraprofessionals, custodians, playground monitors, bus drivers, cafeteria staff and extra-curricular staff. Ensure that severely allergic/food intolerant students are included in all school activities to the extent that reasonable accommodations can be made to provide for their safety. Food Services Responsibilities Allergen-free tables can be established in any PSD school cafeteria. Special sanitation buckets and cleaning cloths are used for washing those specific tables. Upon request, parents may work with the local school principal and food services coordinator to modify the school menu as appropriate per the student s needs. Other students may continue to bring the threatening food allergen (for example, peanut butter) in their lunches but may not sit at cafeteria tables designated peanut-free. Clearly designate and communicate the allergen-free table(s) to all students and school workers on an ongoing basis (such as a peanut-free or milk-free table). Maintain fresh 4.5 disinfecting solution and PH7 all-purpose soap as effective cleaning solutions. This solution is generally found to be effective for removing peanut allergen from surfaces. Communicate with parents and students about specific menu ingredients. Know and follow protocol for safe food preparation, handling and service to avoid cross-contamination. PSD Food Service can be contacted to provide additional information at Parents are welcome to visit kitchens to check for allergens, nutrition labels or food preparation process. School menus are posted online monthly and can be accessed through this PSD food services link. Principal and Site Responsibilities The school principal is encouraged to form/utilize a 504/HCAP team representing a cross-section of child safety key stakeholders. The school principal shall be supportive of faculty, staff and parents in the development and implementation of a Health Care Action Plan (HCAP). The school principal shall ensure the training and education for faculty and staff in all matters regarding Senate Bill The school principal shall ensure the provision and/or implementation of emergency communication devices (walky-talky, cell phones, etc.) for all school activities. School Nurse s Responsibilities Develop and write an individualized Health Care Action Plan in collaboration with the student s parent/guardian and primary care provider. This plan will be amended as needed and reviewed at least annually. The health plan will be shared with appropriate staff, as determined by the parent/guardian, school nurse and school administrator. Conduct staff trainings, individual or group, regarding food allergy management in the school/classroom, including, but not limited to, symptom recognition and emergency medication administration. Train and delegate medication administration in compliance with the Colorado Nurse Practice Act and Poudre School District medication administration policy and regulations. Page 6

7 Oversee proper storage, availability of medications and documentation of medication administration in accordance with state regulations and Poudre School District policy. Provide ongoing supervision of staff members trained and/or delegated to administer medication. Participate in the development of a 504 plan, when indicated by the school team. Teacher s Responsibilities Review the Health Care Action Plan (HCAP) for any student(s) in your classroom with life threatening food allergies Participate in emergency response and medication training which shall include: o Recognizing the signs and symptoms of an allergic reaction such as hives, nausea, trouble breathing, dizziness, swelling hands, face, tongue, etc. o Epinephrine auto-injector and emergency medication administration and training o Adopt rules to prevent accidental exposures to allergens (allergen-free classroom) When appropriate, and with permission of student and parent, conduct a lesson for the child s classroom(s) about severe allergies/food intolerances Keep HCAP with (optional) photo and emergency contact information in a well-organized and accessible format/location for substitutes When logging a personal absence, record with the substitute-finder system a message that a student with life-threatening food allergies is a student in your class. Substitutes may or may not be trained to administer emergency epinephrine and emergency medications; substitutes will be informed on who to contact to assist in an emergency. Suitable arrangements must be made to ensure the health and safety of a student with severe food allergies when there is a substitute. Collaborate with the parent/guardian/family of the student with life-threatening allergies to develop a relationship that is mutually supportive and beneficial Enlist the help of custodians/classroom parents/guardians in keeping a safe environment in the classroom (this may include certain soaps and lotions) Encourage and adopt a planned, proactive schedule of classroom celebrations and/or non-allergic food rewards When organizing class parties and special events, consider non-food treats When a student exhibits symptoms or an allergic reaction, ensure there is always an escort with allergic/intolerant child Avoid use of allergenic foods for classroom activities Act as field trip coordinator: o Collaborate with the school nurse and parents, prior to planning a field trip o Plan proactively for risk-avoidance before, during and after the field trip o Ensure emergency medications (and instructions) are taken on field trip and remain with student at all times Family s Responsibilities Notify the school (principal and school nurse) of the child s allergies/intolerance as soon as possible prior to the first day of attendance, preferably in the spring preceding the school year. **Allow sufficient time to secure physician signatures on all necessary forms, including the medication administration form Work with the school team - which may include the principal, counselor, classroom teacher, school nurse, and others to determine the appropriate health care action plan that accommodates the child s Page 7

8 needs throughout the school including in the classroom, in the cafeteria, in after-care programs, during school-sponsored activities and on the school bus Provide a letter from a health care provider that states your child s diagnosis, any history of allergic reactions, especially whether your child has experienced anaphylaxis (and any doctor recommendations) and any medically advisable accommodations. Give school personnel consent to talk to healthcare provider(s). Provide written medical documentation, instructions, and properly labeled, current medications as directed by a physician using the appropriate health care plan (Health Care Action Plan) as a guide to the school. Include a photo of the child on the written form. Provide replacement medications after use or upon expiration. Pick up medication at the end of every school year. If your child is a bus rider, notify the PSD Transportation Department of your child s food allergy/intolerance as soon as possible prior to the first day of riding the bus Provide a list of foods/ingredients to avoid Provide emergency contact information Provide safe meals for lunchtime Provide safe snacks if the family determines the likelihood of accidental exposure is too great when other parents provide birthday treats, party treats, etc Strongly consider participating in the classroom as a volunteer and/or room parent to organize parties where food may be present. Be willing to go on your child's field trips, if possible and if requested If you observe a student not following these guidelines at school or on a field trip, request a school staff member to intervene Student s Responsibilities When appropriate, attend the Health Care Action Plan (HCAP) and/or 504 Plan meetings so that selfadvocacy and food allergy/intolerance knowledge will continue to increase with age Agree to not trade food with anyone Agree to not eat anything with unknown ingredients or anything with a known allergen Agree to be proactive in the care and management of their food allergy/intolerance and reactions based on their developmental level. This may include educating their classmates about their allergy/intolerance or mentoring other severely allergic students about their allergy/intolerance Notify an adult immediately if you eat something believed to contain a food allergen Notify an adult immediately if you believe you are experiencing an allergic reaction Agree to carry their epinephrine at all times and fully comply with the terms and conditions of self-carry medication authorization PSD cannot guarantee that products with nuts or other food allergens will never be present at school or at school sponsored events. Likewise, PSD cannot monitor products sold at athletic events or special student sales, products brought for potlucks or celebrations, or served on off-campus trips. Therefore, students with severe food allergies/intolerances must carefully monitor their food (and likely provide own food) in these situations Recess, Lunch, Child Care and/or After-School Activity Responsibilities Participate in team meetings to determine how to implement the HCAP should the student with life threatening food allergies choose to participate in childcare or after school events. Be vigilant in monitoring whereabouts of food allergy students on the playground. Page 8

9 Assign a lunch supervisor to monitor safe table use Maintain a copy of the HCAP and photo of student(s) with life threatening allergies with parent/guardian permission 1-2 persons should be present who have been trained in the administration of emergency medications Maintain easy access to the prescribed emergency medications Post all EMS or 911 procedures After school or before school activities sponsored by the school and/or hosted by school programs should follow school practices/procedures All after hours, school sponsored events that serve food such at PTO evening events must identify a clearly defined area where food will be served and/or consumed. The student with life-threatening allergies and his/her family must be notified well in advance to accommodate scheduling and selfdirected activities. As a function of sponsoring and promoting such events, the school should communicate to all parents/guardians attending the event the importance of avoiding food and ingredients which could cause the student to experience an anaphylactic response. Custodian s Responsibilities Check soap ingredients to make sure does not contain allergens such as, milk (or a milk derivative), nut oils (like almond oil), shea butter (which is derived from a nut), etc. o Information is available upon request from a PSD Facilities supervisor Attend all necessary training according to the student s HCAP Follow safe food handling practices to avoid cross-contamination with potential food allergens. Follow cleaning and sanitation protocol to avoid cross-contamination Thoroughly clean all tables, chairs and floors after each meal with soap and water Maintain fresh 4.5 disinfecting solution and PH7 all-purpose soap as effective cleaning solutions. This solution is generally found to be effective for removing peanut allergen from surfaces Health Care Action Plans may require more frequent cleaning of tabletops, chairs, desks, which should be specified in the plan and specific to the student s sensitivity (e.g. before assemblies, emergency response to littering or spills) Provide hand wipes for classroom with affected student and if necessary for lunchroom protocol. These dispensers are mounted on the exterior of the rooms. Liquid soap, bar soap and commercial wipes are considered effective when removing peanut allergens from hands Provide hand wipes to the Transportation Department for wiping down the bus seat/ handrails. Provide hand wipes to teachers to wipe down student seating prior to an assembly or off-site performance Provide hand wipes for field trips taken by the classrooms with affected students if running water will not be readily available PSD Transportation s Responsibilities With parent consent, inform bus driver of food allergic/intolerant child Supply driver a folder on bus with picture, name and food allergy/intolerance information for that student Ensure that bus driver of food allergic child has annual training on recognizing symptoms of an allergic reaction and on administration of epinephrine Ensure all buses have communication devices such as cell phone and 2-way radio communication in case of an emergency Page 9

10 Discourage children from eating on the bus and drivers from distributing food to children on bus. Bus drivers should not hand out food treats even on special occasions With parent/guardian permission, bus drivers should be provided with a copy of the HCAP. This document should be kept in a safe place and shared with drivers who may substitute for primary driver and/or shared with team leaders. Provide annual training for all school bus drivers on managing life-threatening allergies Students with life-threatening food allergies should sit in the seat designated by the bus driver when transporting to/from school and on field trips Students with life-threatening food allergies should be introduced to the bus driver Transportation should follow students HCAP wipe down guidelines in preparation for all bus runs, including field trips, although such practice will not guarantee that accidental contamination from previous trips and ridership won t occur. Student and/or responsible adult should carry emergency medications at all times if instructed in medication orders. In the absence of accompanying parents/guardian/family members or school nurse, a trained staff member must be assigned the task of watching out for the student s welfare and for handling any emergency while on a field trip The trained staff member carrying the emergency medications for young students should be introduced to the bus driver and to the student Field trips need to be chosen carefully; no student should be excluded from a field trip due to risk of allergen exposure Field Trip Considerations Parent(s) are strongly encouraged to contact the field trip site to ask any questions pertinent to the child s medical needs. Parents are strongly encouraged to come on the field trip to assist. The child s medicine bag is prepared by the health tech or the school nurse. Medicine bag must follow the child everywhere on the trip. Trained staff should have a cell phone on them in case of an emergency. A responsible adult should be designated as the specific child s safety advocate on the trip. Resources, Acknowledgements and PSD Downloadable Forms It is important to acknowledge the states, schools, websites, and people who have written thorough and helpful guidelines for our PSD committee to use as guides and framework. Some additional resources and PSD downloadable forms follow: Poudre School District Forms (PDF): HCAP (Health Care Action Plan) Form Food Allergy HCAP (Health Care Action Plan) Form Asthma Authorization and Release to Administer Medicine Form Authorization and Release to Administer Medicine Form Español Carry & Self-Administer Medicine Asthma/Allergy Form Carry & Self-Administer Medicine Asthma/Allergy Form Español Page 10

11 Massachusetts Department of Education Food Allergy American College of Allergy, Asthma, and Immunology Food Allergy & Anaphylaxis (FAAN) Network Celiac site: Page 11

12 Appendix A Timeline for Preparation Needed to Care for Severely Food- Allergic Students Refer to for a general guideline for a timeline of appropriate actions to take and the relevant timetable. Page 12

13 Appendix B Example of Teacher s Letter Home to Parents Date: Dear Parent/Guardian, Occasionally a health concern arises in the school setting that requires enlisting the support of Parent/Guardians and classmates to help make the classroom a safe and healthy place for all. This letter is to inform you that a student in your child s classroom has a severe allergy to peanuts. Strict avoidance of all peanut products is the only way to prevent a lifethreatening allergic reaction. Even touching a small amount of a product or accidental ingestion containing peanuts could result in a life-threatening situation. We are asking your assistance in providing the student with a safe learning environment. If exposed to peanuts the student may develop a life-threatening allergic reaction that requires emergency medical treatment. To reduce the risk of exposure, no peanuts will be allowed in your child s classroom this year. Please do not send any products containing peanuts for your child to eat during snack in the classroom. Please read ingredient labels carefully. Any exposure to peanuts through contact or ingestion can cause a severe reaction. If your child has eaten peanuts or other tree nuts prior to coming to school, please be sure your child s hands have been thoroughly washed prior to entering the school. Since lunch is eaten in the cafeteria/lunchroom, your child may bring peanut butter, peanut or nut products for lunch. In the cafeteria, there will be a table designated where no peanuts nuts are allowed. Any classmate with a lunch from the cafeteria lunch program may sit at this table along with students with severe allergies. If your child sits at this table with a peanut or tree nut product, s/he will be asked to move to another table. This plan will help to maintain safety in the classroom while allowing classmates without allergies to enjoy peanut products in a controlled environment. Following lunch, the children will wash their hands prior to going to recess or returning to class. The tables will be cleaned after each lunch. Please remind your child not to share any food, eating utensils, or food containers with a student that has severe food allergies. We appreciate your support of these procedures. We believe all families understand a parent/guardian s concern/worry about safety and will join us in ensuring that our environment is conducive to this goal. Please complete and return this form so that we are certain that every family has received this information. I have read and understand the procedures to not allow (nuts) in the classroom. I agree to do my part in keeping nuts out of the classroom. Child s Name: Parent/Guardian Signature: Date: If you have any questions regarding ingredient lists or other questions, please contact any one of us. Signature of Teacher: Signature of Principal: Signature of School Nurse: Page 13

14 Appendix C - Colorado Senate Bill passed in May 2009 Bill Summary (Note: This summary applies to this bill as introduced and does not necessarily reflect any amendments that may be subsequently adopted.) Requires the state board of education (state board) to promulgate rules establishing a policy for the management of food allergies and anaphylaxis among students enrolled in schools of school districts and institute charter schools (statewide policy). Requires the state board to consult with the department of public health and environment (department) in adopting the statewide policy. Specifies mandatory provisions for the statewide policy. Requires each school district to adopt a policy for the management of food allergies and anaphylaxis among children in schools of the school district. Requires each school district policy to include provisions that satisfy the requirements of the statewide policy. Requires each school district to ensure that each school of the school district makes available self-injectable epinephrine for the purpose of providing emergency medical treatment in the event that a student or other person suffers anaphylaxis as a result of an allergic reaction to food. Requires the state charter school institute to adopt a policy for the management of food allergies and anaphylaxis among children in institute charter schools. Requires the institute charter school policy to include provisions that satisfy the requirements of the statewide policy. Requires the state charter school institute to ensure that each institute charter school makes available self-injectable epinephrine for the purpose of providing emergency medical treatment in the event that a student or other person suffers anaphylaxis as a result of an allergic reaction to food. Requires the department to consult with the state board concerning the adoption of the statewide policy. Requires the department to develop, maintain, and make available to school districts and institute charter schools a standard form to be used by school districts to gather information from physicians and parents and guardians of students concerning students' risk of food allergies and anaphylaxis and the treatment thereof. Page 14

15 Appendix D Plan Section 504 is the part of the Rehabilitation Act of 1973 that guarantees specific rights in federallyfunded programs and activities to people who qualify as disabled. Section 504 states: No otherwise qualified handicapped individual in the United States...shall, solely by reason of his handicap 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... A person is disabled under the definition of Section 504 if he or she has a mental or physical impairment which substantially limits one or more of such person s major life activities; has a prior record of a diagnosed impairment; or is regarded as having a diagnosable impairment. Major life activities include functions such as caring for one s self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. When a condition does not substantially limit a major life activity, the individual does not qualify under Section 504. Accommodations under Section 504 are determined by a team of professionals and include the parent(s)/guardian of the child. The eligibility process for Section 504 determination is similar to that of the IDEA (including formal and/or informal evaluations as necessary). Although it is not required, there should be some interventions attempted before a referral is made. The referral can come from staff, parent(s), or others who know the child well. Page 15