school nurses and 504
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What School Nurses Need to Know About 504
Karen HaaseHarding & Shultz
(402) [email protected]
H & S School Law
@KarenHaase
504 Overview
Similarities School districts must evaluate and
determine eligibility Both require
• transportation, • accommodation/modification• related services• manifestation determination LRE requirement
Primary Differences Definition of disability is unique to
each statute No funding under 504 504 encompasses
• Students • Employees • Patrons
When is school required to make a 504 referral?
When district believes that the student has a physical or mental impairment that substantially limits one or more major life activities AND
Student is in need of either regular ed with supplementary services or special ed. and related services
When is school required to make a 504 referral?
When district believes that the student has a physical or mental impairment that substantially limits one or more major life activities AND
Student is in need of either regular ed with supplementary services or special ed. and related services
When district believes that the student has a physical or mental impairment that substantially limits one or more major life activities AND
Student is in need of either regular ed with supplementary services or special ed. and related services
When is school required to make a 504 referral?
When district believes that the student has a physical or mental impairment that substantially limits one or more major life activities AND
Student is in need of either regular ed with supplementary services or special ed. and related services
When is school required to make a 504 referral?
When district believes that the student has a physical or mental impairment that substantially limits one or more major life activities AND
Student is in need of either regular ed with supplementary services or special ed. and related services
When is school required to make a 504 referral?
What constitutes a “substantial limitation?”
504 regs do not define: “The Department does not believe that a definition of this term is possible at this time.”
Phrase is to be defined by local education agency
“substantial limitation?”Congress: a major life activity is substantially limited when “the individual's important life activities are restricted as to the conditions, manner or duration under which they can be performed in comparison to most people.”
Changes to ADA
Sutton v. United Air Lines, Inc., 527 U.S. 471 (1999) The ADA Amendments Act of 2008
increased the number of individuals who qualify for accommodation under both the Americans With Disabilities Act and Section 504 of the Rehabilitation Act of 1973.
Major Changes First, the definition of “major life activity”
has expandedNow include but are not limited to:Caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working.
Major Changes First, the definition of “major life activity”
has expandedNow include but are not limited to:Caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working.
Major Changes Second, interpretation of “substantially
limits” has been changed• Must evaluate impairment that is episodic or in
remission in active state• Must not consider mitigating measures
Episodic Impairments Asthma Chron’s Disease IBS Any other disease that can “come and
go” or has good and bad days
No “Mitigating Measures”
A student may be eligible under Section 504 even if the student’s disability or condition is controlled or mitigated, whether by medication, technology, etc. This means you may be evaluating
a hypothetical student
Mitigating Measures
Mitigating Measures Medication Medical supplies, equipment, appliances Low-vision devices (NOT ordinary
eyeglasses or contacts) Prosthetics Hearing aids/cochlear implants Learned behavioral or adaptive
neurological modifications Reasonable accommodations or other
auxiliary aids or services
Transitory Impairments A “transitory impairment” is defined
as an impairment with an actual or expected duration of six months or less. “Any impairment the duration of
which is less than six months would not constitute a disability.” James A. Garfield (OH) Local School
Dist., 52 IDELR 142 (OCR Feb. 19, 2009).
What if the activity impaired is not learning? The child may still need a 504 plan The focus is on the effect on the student,
not the type of disability “Students may have a disability that in
no way affects their ability to learn, yet they may need extra help of some kind from the system to access learning.”
Health Plan ≠ 504 Plan
504/Health Plans Tyler (Tx) Indep. Sch. Dist., (OCR
2010) • health care plan for diabetic students• Required to evaluate under 504
Dracut (Ma) Pub. Sch., (OCR 2010)• health care plan for peanut allergy• Required to evaluate under 504
504/Health Plans Opelika city (AL) Sch. Dist., (OCR
2010) • health care plan for diabetic
students• Required to evaluate under 504
Jan. 19 Guidance Document
Health Plan Action Steps List of all kids with health plan List of all kids on medication and
what meds are List of all kids identified by parent
as having health condition Train school nurse!
Can We Just Provide Help without creating a plan?
No!! Remember: disability education
law is about PROCESS not RESULTS
Temple (TX) ISD, (OCR 1996)
504 and Private Schools
504 and Private Schools Public schools aren’t obligated to
provide 504 services at private schools • Letter to Vier, 20 IDELR 864 (OCR
1993) 504 applies to private schools
independently• Bristol (CT) Pub. Schs., 55 IDELR 207
(OCR 2010)
Medical diagnosis issues Diagnosis alone not sufficient Must consider – along with info from
other sources May not require parents to provide
medical records If school determined medical
assessment necessary, district must ensure child receives assessment