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Initial Thoughts
Perspectives & Resources

What are Mr. Logan’s roles and responsibilities, and what types of services should he provide in a school setting?

  • Page 1: Roles of the School Nurse
  • Page 2: Healthcare Services
  • Page 3: Section 504 Plans and Individualized Education Programs

What additional information would be important for Mr. Logan to know as a school nurse?

  • Page 4: Resources
  • Page 5: Advocacy
  • Page 6: Collaboration

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  • Page 7: References & Additional Resources
  • Page 8: Credits
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What are Mr. Logan’s roles and responsibilities, and what types of services should he provide in a school setting?

Page 3: Section 504 Plans and Individualized Education Programs

student at her lockerA student with special healthcare needs usually has either a Section 504 plan or an individualized education program (IEP). These documents are designed to ensure that students receive services appropriate to their individual needs. School nurses participate as part of the school team to develop these plans for students with special healthcare needs. School nurses may want to educate themselves about the laws related to students’ educational needs. The timeline below highlights such legislation. Following the timeline, more information on Section 504 plans and IEPs is provided.

For Your Information

Timeline of federal legislationSchool-based services for students with disabilities are continually improving, in part due to the effect of federal legislation. Click here or on the timeline to the right to learn more about the federal legislation that has had a significant impact on services for students with disabilities.

Federal Legislation Timeline

enlarged timeline of federal legislation

 

Legislation Significance
Rehabilitation Act of 1973 (Section 504) A civil rights act for people with disabilities, it guarantees that they are not discriminated against or excluded from any program or activity receiving federal funds.
Education for All Handicapped Children Act (EAHCA)*, 1975

*Later reauthorized as IDEA

This act ensures that all students with disabilities have a federal right to “a free and appropriate public education.” It also mandates that students with disabilities receive “related services” necessary for them to be educated in the least-restrictive environment.
Individuals with Disabilities Act (IDEA), 1990 This act was formerly entitled the Education for All Handicapped Children Act. It continues to ensure the rights provided in EAHCA, but revisions to the act have added special education categories for traumatic brain injury and autism.
Title II of the Americans with Disabilities Act (ADA), 1990 ADA builds on the Rehabilitation Act of 1973. This legislation guarantees people who have disabilities better access to buildings, public transportation, and communication.
Amendments to IDEA, 1997 Among the changes in IDEA, 1997, are the inclusion of ADHD within the “other health impairments” category, a provision for the participation of students with disabilities in standardized assessments, the inclusion of students with disabilities in the general education classroom, and guidelines about discipline regarding students with disabilities.
Reauthorization of IDEA, 2004 The 2004 reauthorization of IDEA includes several addendums regarding personnel qualifications, assessments, and IEPs. School nursing is included as a related service. This means that school nurses can be listed as related service providers in IEPs and that school districts are eligible for state, federal, and third-party reimbursements for these services.

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Section 504 Plan

A Section 504 plan is a document that outlines the needs of a student who has a physical or mental impairment, so that he or she may participate successfully in the educational environment. This plan specifies the accommodations and modifications necessary for a student to be included in all aspects of his or her school and related activities. Eligibility does not require that the student receive special education services but does require that the student have an impairment that substantially limits a major life activity, such as:

Law: Section 504 of the Rehabilitation Act of 1973
Document: Section 504 Plan
For students who have: a physical or mental impairment that substantially limits a major life activity

  • Breathing
  • Learning
  • Working
  • Executing self-care tasks
  • Walking
  • Seeing
  • Hearing
  • Speaking
  • Performing manual tasks

Depending on school or district policies, a variety of knowledgeable individuals (e.g., a special education teacher, a school nurse) may be responsible for developing a Section 504 plan. With the information gathered from these individuals and other reliable sources (e.g., a parent, a physician, a school nurse), the team will determine whether a student qualifies for a Section 504 plan. There is no standard form, so the actual Section-504–plan format may vary across districts and states. Therefore, it is important for school nurses to be familiar with their districts’ policies.

Individualized Education Program

Law: IDEA 2004
Document: IEP
For students who have: a disability that adversely affects educational performance

An individualized education program (IEP) is a detailed document describing how a school will meet the learning needs of a student with disabilities. This document is created for all students who receive special education services. In order to qualify for special education services, a student must meet the criteria for one or more of the disability categories as defined by the Individuals with Disabilities Education Act (IDEA ’04):

  • Autism
  • Deaf-blindness
  • Hearing impairment
  • Mental retardation*
  • Orthopedic impairment
  • Other health impairments
  • Speech or language impairment

  • Visual impairment
  • Deafness
  • Emotional disturbance
  • Learning disability
  • Multiple disability
  • Traumatic brain injury

*Although IDEA uses the term “mental retardation,” the special education field has shifted away from the term, because of its negative connotations, and toward “intellectual disability” as a more appropriate alternative.

IDEA ’04 ensures that, to the extent possible, students with disabilities are educated with peers who do not have disabilities. In order for students receiving special education services to participate to the greatest possible extent in the typical school environment, they might require support from a related service provider (e.g., a school nurse). As a related service provider, the school nurse should participate in the development of the IEP and oversee any healthcare needs outlined in it.

the nurse's corner

Whether he’s collaborating with team members to develop a Section 504 Plan or an IEP, Mr. Logan’s duties are much the same. He will participate in both by:

  • Appraising a student’s current health status by consulting with the student, the family, and the healthcare providers
  • Acting as a team liaison to the medical community
  • Assisting family members in identifying and utilizing community resources
  • Educating teachers and school personnel about the student’s healthcare needs
  • Collaborating on the development of plans that address the student’s health needs, thus enabling the student to participate in educational activities
  • Developing an Individualized Healthcare Plan (IHP), which is made up of general information about the student’s health needs and of the types of nursing services that will be provided to address these needs on a daily basis (Click here to see Megan’s IHP*)
  • Developing an Emergency Care Plan (ECP), which provides specific instructions on how to handle a specific health emergency (Click here to see Megan’s ECP*)
  • Evaluating the effectiveness of the health-related components of a plan and recommending changes as needed

*Because no standard forms for IHPs or ECPs exist, the IHP/ ECP format may vary across districts and states.

Nursing Services Provided Under Section 504 Plans and IEPs

Section 504 Plan

ryanStudent:
Ryan

Disability:
Asthma

Reason for services:
Asthma limits breathing (a major life function).

Nurse’s role:
Monitor Ryan’s asthma to determine if any changes to his treatment are needed.

Click to view Ryan’s Section 504 plan.

Individual Education Program

sidneyStudent:
Sidney

Disability:

  • Learning disability (LD)
  • Attention deficit hyperactivity disorder (ADHD)

Reason for services:

LD and ADHD affect her educational performance.

Nurse’s role:

  • Administer and monitor Sidney’s medication.
  • Educate the school staff about the side effects of the medication.

Click to view a portion of Sidney’s IEP as it relates to the roles of the school nurse.

Activity

Read both scenarios and answer the question at the end.

Scenario 1/Section 504 Plan Scenario 2/IEP


sarahStudent:

Sarah

Disability:
Severe peanut allergy

Reason for services:
Exposure to peanut products limits breathing (a major life function).


meganStudent:

Megan

Disability:

  • Cerebral palsy (CP)
  • Type 1 diabetes

Reason for services:

  • CP adversely affects her educational performance.
  • CP affects her ability to self-administer insulin to treat her type 1 diabetes.

What types of nursing services might Mr. Logan provide for these students’ medical needs in the school environment? List at least four services for each student.

Nurse’s role
Scenario 1/ Section 504 Plan Scenario 2/ IEP
1. 1.
2. 2.
3. 3.
4. 4.

After answering the question above, click here for feedback.

Your answers should have been similar in both columns. For instance:

Nurse’s role
Scenario 1/ Section 504 Plan Scenario 2/ IEP
1. Assist with EpiPen shot. 1. Assist with insulin injections.
2. Provide training on peanut allergies. 2. Provide training on type 1 diabetes.
3. Develop an IHP to reflect supportive accommodations. 3. Develop an IHP to reflect supportive accommodations.
4. Develop an ECP for emergency situations. 4. Develop an ECP for emergency situations.

Notice how Mr. Logan’s roles in both the Section 504 plan and the IEP are essentially the same.

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