Section 504 for School Nurses Marie DeSisto RN, MSN Director of Nurses and District 504 Coordinator Waltham Public Schools Waltham, MA

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.

Section 504 Major component of the Rehabilitation Act of 1973 CIVIL RIGHTS legislation for persons with disabilities Administered by the Office of Civil Rights which is part of the US Department of Education

The goal of Section 504: Level the playing field To allow equal access to a free and appropriate education

Eligibility for Section 504 Broad Many different types of disabilities and disabling conditions

Eligibility for Section 504 Eligibility is NOT based on clinical categories, such as mental retardation or learning disabilities.

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

Definition of Disability under Section 504 Physical or mental impairment which substantially limits one or more of such person’s major life functions Record of such an impairment 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

Definition of Major Life Activities Caring for one’s self Performing manual tasks Walking Seeing Hearing Speaking Breathing Learning Working

Major Life Activities Expanded to include: ReadingCommunicating ThinkingStanding ConcentratingLifting EatingBending Bladder functionSleeping Bowel function Other…

Definition of Substantial Limitation Does the impact of the disability on the “major life activity” amount to a substantial limitation. –Unable to perform a major life activity that the average person in the general population can perform

Schools Must: Search for eligible students Provide a “free appropriate public education” for all students Provide the services for students in the least restrictive environment

Schools must establish: Nondiscriminatory evaluation & placement procedures Procedural safeguards to enable parents to participate in the evaluation Afford all children an equal opportunity to participate in nonacademic & extracurricular services and activities.

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 Continued to display behavior problems

Refer a student for a Section 504 evaluation… Diagnosed with a major health problem Expelled or suspended Problems that cannot be explained Parental request for a 504 evaluation Staff member request for an evaluation

Section 504 expansion effective January 2009: Additional categories in Major Life Activities No longer consider “mitigating measures” Consider impairments that are episodic or in remission

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: DESE has been asking for plans for students needing MCAS accommodations

Section 504 Compliance The Office for Civil Rights is primarily concerned with protecting the rights of students and parents We must ALWAYS follow the process

Role of the School Nurse in Section 504: Identification of students who qualify for Section 504

School Nurse continued: May be a member of the Section 504 Evaluation team

School Nurse: Provide nursing care and services to students to ensure that the student can access a free and appropriate education in the least restrictive environment.

School Nurse: Evaluate effectiveness of the Section 504 Plan and the accommodations: –Does the student have access to a free and appropriate education

Section 504 Pitfalls A doctor’s note/order is insufficient data for a 504 Not evaluating Not documenting evaluation/services

Pitfalls… Not having the right staff on the evaluation team Not following the 504 plan Provide the services

Private schools Private schools do not have to follow Section 504 Unless they take Federal funds…such as Title 1, 2A, 2D, 3 and/or 4…

Section 504 Summary: Comprehensive civil rights legislation Incorporates a very broad definition of disability Students not eligible under IDEA may be eligible under Section 504

Section 504 Summary The school nurse serves an important role in Section 504 –Child find –Section 504 team member –Providing nursing care or services –Periodic review of the Plan for effectiveness

Summary The school nurse must be familiar with Section 504 The school nurse must serve as a voice for the students

Summary of Section 504 To eliminate the barriers to a free and appropriate education in the least restrictive environment

Bibliography Betz CL. (2001). Use of 504 plans for children and youth with disabilities: Nursing application. Pediatric Nursing, 27(4), Dang, MT. (2010). The history of legislation & regulations related the children with developmental disabilies: Implications for school nursing practice today. Journal of School Nursing, 26(4), Selekman, J. (2006). School nursing: A comprehensive text. FA Davis, Philadelphia.