504 Plans for Asthma
If you are a parent of a child with asthma, you know how much work managing it can be. You have to make sure they take their medicines like they are supposed to, watch for signs and symptoms, and help them avoid their triggers.
But what happens when they are at school? How can you feel confident the school staff will manage your child’s asthma properly and know how to handle asthma episodes or attacks?
A 504 plan may be an option. It is a tool that can help you work with your child’s school so you can all be on the same page when it comes to keeping your child healthy.
What Is a 504 Plan?
Simply put, a 504 plan is a contract between you and your child’s school. It addresses how the school will accommodate your child’s asthma.
Its name comes from Section 504 of the Rehabilitation Act of 1973. It’s a law that says schools that get federal funding cannot exclude or discriminate against students who have disabilities.1
A disability under Section 504 is defined by the Americans with Disabilities Amendments Act (ADA) as a “physical or mental impairment which substantially limits one or more major life activities.” A “major life activity” includes walking, seeing, hearing, speaking, breathing, learning, working as well as eating.2 Under Section 504 and the ADA, asthma is often considered a disability, depending on severity.
Does My Child’s School Have to Follow a 504 Plan?
It depends. If a school receives federal funds, they have to follow Section 504. This includes public schools, including preschools,
Does My Child With Asthma Need a 504 Plan?
Not every child with asthma needs a 504 plan.4 When trying to decide, ask yourself these questions:
- Does the school already have effective asthma management policies and procedures in place?
- Does the school have a full-time nurse on site?
- Do they train their staff about asthma management?
- Will my child have easy and quick access to their asthma medicines?
- How likely will my child miss a lot of school days due to their asthma?
- Will my child need accommodations when participating in physical education classes or sports?
- How well is the school responding and cooperating with requests?
Your child’s school may already have an effective plan in place for asthma management. After all, asthma is one of the most common chronic diseases in U.S. children. An individual health care plan (IHCP) may be all that is needed for your child.
But if your child has additional needs that you are concerned about, you may want to consider a 504 plan.
There are three common types of care plans used in many schools:
- Emergency care plan (ECP) – This is a medical plan from your child’s doctor for the school to follow to treat asthma while the student is at school.
- Individual health care plan (IHCP) – This is a type of nursing care plan. For a student with asthma, this would also include an emergency care plan.5An IHCP addresses what the school will do to establish and maintain a safe school environment for the student with asthma.
- 504 plan – This is a legally-binding plan written by the school in collaboration with a student and their family.6 Similar to an IHCP, this plan provides guidelines for changes in the classroom or other school locations to achieve the goal of providing a safe education.
Keep in mind that having asthma does not automatically mean your child qualifies for a 504 plan. Before a 504 plan can be put into place, the school needs to evaluate your child.4 Your child must meet the official definition of having a disability.
You can help your school with this process by having documents from your child’s doctor showing that your child’s asthma seriously limits “major life activity.” Breathing is a “major life activity.”2
How Do I Start the 504 Plan Process?
Start by contacting the school’s principal and the school district’s 504 coordinator. Ask to have your child evaluated for a 504 plan. Once they decide your child is eligible, ask for a meeting to start creating a plan.
The goal of the plan is to ensure your child’s health and manage their asthma while at school. This process can take some time, so you’ll want to start well before school starts. Some parents even start the process in the spring semester for the following school year.
Stay positive when working with the school. The hope is for you and the school staff to work as a team to make sure your child is safe. Communicate often, calmly, and confidently.
How Do I Create a 504 Plan?
Work with the school to create the plan. Look up some sample 504 plans to give you an idea of what yours might include. Your school district may also have forms or formats. You can start with these, making changes to fit your child’s needs. There is no official federal 504 plan document.
Think about what accommodations your child needs. Consider their asthma triggers and what they are likely to be exposed to at school.
The Asthma and Allergy Foundation of America (AAFA) has school planning resources that can help guide you. The Centers for Disease Control and Prevention (CDC) has school resources as well. And your state health department may already have some guidelines you can refer to.
Here are some things your child’s 504 plan might include:
- Your child’s Asthma Action Plan (created with your asthma health care provider)
- Signs and symptoms of an asthma episode or attack
- Your child’s asthma triggers
- What types and methods of cleaning are appropriate to prevent triggering asthma symptoms
- Steps needed to ensure healthy indoor air quality in your child’s classroom
- How your child’s asthma will be managed indoors and outdoors at school
Your child’s 504 plan should also address:
- Who will be responsible for what?
- What training will be required? Who will deliver this training? Who will be trained? Will a trained person always be present during the school day and on field trips?
- What special services, if any, will the school provide to keep your child’s environment safe? Will they give your child medicine? Will they give them space and time to use their medicines (e.g., inhalers with spacers or a nebulizer)? Can changes be made to the classroom environment?
- How will the school handle missed school teaching and work? Will your child be allowed to make up time missed due to asthma?
- What policies need to be in place to help your child avoid their triggers and take their medicine as needed? Will they be given time to use their quick-relief medicine before physical activity?
- If your child has as asthma episode or attack while at school, what is the emergency treatment plan?
It’s best to get the 504 plan in writing. The law does not require it. But it is a best practice. This reduces the chance for mistakes or misunderstandings. A written plan should be available for all staff members who interact with your child. This includes classroom teachers, substitute teachers, other teachers (gym, music, art, etc.), custodians, and lunchroom staff. But the only people who need to sign plan are the 504 coordinator and the parents or guardians.
What If the School Does Not Follow the 504 Plan or Refuses to Accommodate My Child?
All schools that accept federal funding must accommodate your child. Some parents, though, may run into issues, such as:
- The school refuses to create a 504 plan after your child is evaluated and found eligible
- The school creates an unacceptable 504 plan leading to recurrent asthma episodes and/or missed school days
- The school creates an acceptable 504 plan but then doesn’t follow it
If the school says that they “do not do 504 plans for asthma,” remind them of the Section 504 law.
Schools must create due process that includes parental notification and review requirements. If the school creates a 504 plan that does not include any of your requests, you do not have to agree to it. If this happens, write a letter to the school consistent with the procedures laid out. Tell them you do not agree and would like another evaluation meeting. Remind them you have the right to be involved in creating your child’s 504 plan.
Your requests need to be reasonable and should focus on the accommodations that are needed to keep your child healthy.
Stay calm and polite at the meeting. Explain why the plan that the school wrote will not work. Let them know what parts you disagree with. Tell them why your requested changes are important.
If the school still refuses to cooperate, you can file a complaint with the Department of Education’s Office for Civil Rights (OCR).
You may also be able to file a complaint with your state Board of Education. Your state may even have processes in place.
What Happens If My Child Moves to a New School?
If you have a 504 plan in place when you move, the plan goes with your child.
Before you move, contact the new school. Let them know your child has a 504 plan and send them a copy. If they are OK with the plan, they must put it in place as is.3
Sometimes, a school may say the existing 504 plan will not work for their school. If this happens, they must follow your existing plan until a new plan is in place. You’ll need to start the 504 process all over again with the new school.
Can My Child Have a 504 Plan In College?
A college that gets federal funding must abide by Section 504, and all colleges must comply with the Americans with Disabilities Act (ADA). But colleges aren’t required to follow a 504 plan the way elementary and secondary schools are. Colleges are held to a different standard. If you are asking for an accommodation that would be a “fundamental alteration” of their program, or causes them an “undue burden” (usually a financial burden), they can say no.7
Reviewed July 2021 by Naomi Seiler, JD, George Washington University
1. U.S. Department of Justice Civil Rights Division. (n.d.). A Guide to Disability Rights Laws – Rehabilitation Act. Information and Technical Assistance on the Americans with Disabilities Act. https://www.ada.gov/cguide.htm#anchor65610.
2. U.S. Department of Justice Civil Rights Division. (n.d.). Sec. 12102. Definition of Disability. Information and Technical Assistance on the Americans with Disabilities Act. https://www.ada.gov/pubs/adastatute08.htm#12102.
3. U.S. Department of Education, Office for Civil Rights. (2020, January 10). Protecting students with disabilities. Introduction. https://www2.ed.gov/about/offices/list/ocr/504faq.html#introduction.
4. U.S. Department of Education, Office for Civil Rights. (2016, December). Parent and Educator Resource Guide to Section 504 in Public Elementary and Secondary Schools. https://www2.ed.gov/about/offices/list/ocr/docs/504-resource-guide-201612.pdf.
5. National Association of School Nurses. (n.d.). Use of Individualized Healthcare Plans to Support School Health Services. https://www.nasn.org/advocacy/professional-practice-documents/position-statements/ps-ihps.
6. U.S. Department of Education, Office for Civil Rights. (2020, January 10). Protecting students with disabilities. https://www2.ed.gov/about/offices/list/ocr/504faq.html.
7. U.S. Department of Education, Office of Special Education and Rehabilitative Services. (2020, August). A Transition Guide to Postsecondary Education and Employment for Students and Youth with Disabilities. https://sites.ed.gov/idea/files/postsecondary-transition-guide-august-2020.pdf.
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