504 & Epi Self Carry Question

[ajasfolks2]

The KEY thing here for that family, I believe, is to make formal request of the school -- in writing -- to document and prove THEIR accommodation as being "necessary and appropriate" by having their school district's qualified physician state and SIGN STATEMENT that, in his/her professional opinion


"There is no basis in fact for [this child] with [this diagnosis -- AKA, peanut allergy] to have need to self-carry Epi-pen while in school next school year 2012-2013, if this child has not had an anaphylactic reaction IN SCHOOL during the school year 2011-2012.  There is irrefutable evidence that for food allergic individuals past reaction history predicts future reaction history.  [The LAST statement there is patently UNTRUE and they'd have to cite medical evidence of its veracity.  To my knowledge there is NONE]"

(Tweak as you see fit.)

_{(Good luck with that one, school! -- Though one must remember that physician is being paid by school.  One would *hope* that does not sway . . . )}


Typically, a school district contracts with a physician(s) to review IHCPs and/or to consult on those.

Very important that an IHCP (individual health care plan) has been written by the school nurse and attached to the 504 Plan.  Family may need to backtrack here a bit and get their allergist to assist school nurse in developing that plan.  Plan should state, unequivocally, "student with qualifying hidden medical disability of  {XYZ life-threatening allergy} must self-carry epi-pen at all times" with qualifier as to rare exception -- like PE or sports, possibly -- in which case there must be written directive FROM CHILD'S ALLERGIST/DOC that written accommodations be made such that the adult-in-charge-co-located-at-all-times with child have the medication.  There may need to be more detailed explanation from the doctor for each and every scenario to get this through to the school.
Bus = self-carry
Playground = self-carry
Gen Ed Classroom = self-carry
PE = dependent on activity, self-carry -- add more/better details as to specific situation
Cafeteria = self-carry
Hallways = self-carry"

and so on.


Yes, this is leg work. 

The school's medical advising team, likely, has not signed off on that school's added self-carry caveat.

I'd consider trying this.



~ ~ ~
Edited for clarity.

[ajasfolks2]

Also -- I'd have family read at National Association of School Nurses for additional verbiage and understanding.



http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNPositionStatementsFullView/tabid/462/smid/824/ArticleID/32/Default.aspx
 

http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNIssueBriefsFullView/tabid/445/smid/853/ArticleID/81/Default.aspx


and here:


http://www.nasn.org/ToolsResources/FoodAllergyandAnaphylaxis

[ajasfolks2]

One more thought -- does this school have any of it's district 504 personnel ON BOARD and on record as having approved this accommodation as well?

Were any district personnel at the 504 Accommodation Plan meeting and did they SIGN OFF on this accomodation-with-caveat?

Document.  Record.

Decisions based on evidence in fact is what will be necessary to deal with this.

JMHO, and based on personal experience.

[MamaMia]

The KEY thing here for that family, I believe, is to make formal request of the school -- in writing -- to document and prove THEIR accommodation as being "necessary and appropriate" by having their school district's qualified physician state and SIGN STATEMENT that, in his/her professional opinion


"There is no basis in fact for [this child] with [this diagnosis -- AKA, peanut allergy] to have need to self-carry Epi-pen while in school next school year 2012-2013, if this child has not had an anaphylactic reaction IN SCHOOL during the school year 2011-2012.  There is irrefutable evidence that for food allergic individuals past reaction history predicts future reaction history."  Edited to add:[The LAST statement there is patently UNTRUE and they'd have to cite medical evidence of its veracity.  To my knowledge there is NONE]"

(Tweak as you see fit.)

_{(Good luck with that one, school! -- Though one must remember that physician is being paid by school.  One would *hope* that does not sway . . . )}


Typically, a school district contracts with a physician(s) to review IHCPs and/or to consult on those.

Very important that an IHCP (individual health care plan) has been written by the school nurse and attached to the 504 Plan.  Family may need to backtrack here a bit and get their allergist to assist school nurse in developing that plan.  Plan should state, unequivocally, "student with qualifying hidden medical disability of  {XYZ life-threatening allergy} must self-carry epi-pen at all times" with qualifier as to rare exception -- like PE or sports, possibly -- in which case there must be written directive FROM CHILD'S ALLERGIST/DOC that written accommodations be made such that the adult-in-charge-co-located-at-all-times with child have the medication.  There may need to be more detailed explanation from the doctor for each and every scenario to get this through to the school.
Bus = self-carry
Playground = self-carry
Gen Ed Classroom = self-carry
PE = dependent on activity, self-carry -- add more/better details as to specific situation
Cafeteria = self-carry
Hallways = self-carry"

and so on.


Yes, this is leg work. 

The school's medical advising team, likely, has not signed off on that school's added self-carry caveat.

I'd consider trying this.

Hey there. As you know, past history doesn't predict future reactions and severity of reactions.  I know families who's child hasn't had a severe reaction since they were babies due to the proactive efforts the parents provide so I would hate to think that just because they, as parents, who are being so careful, would need that kind of false statement, "...There is irrefutable evidence that for food allergic individuals past reaction history predicts future reaction history.  [cite evidence]"  I know what you're trying to say (that there is no evidence) but I'm afraid that if this school has been jerking them around WITH a lawyer involved, they may actually sign it!  Just thinking about the child. 

To be clear, I don't know the family personally.  I don't even know what district their in.  I just read about their scenario and tried to forward info to help.  Hopefully they found a resolution but last I saw, they may be contacting the OCR.

BTW, the allergist has written the school to say it is med necessary to self carry.  School still resistant for the following year.



~ ~ ~
Edited to correct/address concern.  ~e

[MamaMia]

Also -- I'd have family read at National Association of School Nurses for additional verbiage and understanding.



http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNPositionStatementsFullView/tabid/462/smid/824/ArticleID/32/Default.aspx
 

http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNIssueBriefsFullView/tabid/445/smid/853/ArticleID/81/Default.aspx


and here:


http://www.nasn.org/ToolsResources/FoodAllergyandAnaphylaxis

Thanks for these links!

[ajasfolks2]

Going in to fix my statement concern that you caught -- you knew what I meant, but I didn't state it with adequate qualifier afterwards.

I should not PWE = Post While Exhausted!!

Happy to help with links . . . 
 

[MamaMia]

Going in to fix my statement concern that you caught -- you knew what I meant, but I didn't state it with adequate qualifier afterwards.

I should not PWE = Post While Exhausted!!

Happy to help with links . . . 

haha! Gatcha! Thanks for edit!

[Arkadia]

Off-hand?

No.

There's little that a PARENT, seemingly, can do in these situations other than file a grievance and go through due process.  It's lawyer time when a school starts to pull stunts like defying a physician's order.

Because if the school is following their own "procedure" for 504 elgibility, plans, and accommodations, then OCR will NOT get involved.

Just noting procedural safeguards for IEP/ohi *are* well defined, consistent, uniform, and not open to modification  by school districts, and with more definitive oversight.

That said,  the farthest I ever took a grievance was to mediation. It's an option that while I found it effective, was curiosly, not enforceable.

[MamaMia]

Off-hand?

No.

There's little that a PARENT, seemingly, can do in these situations other than file a grievance and go through due process.  It's lawyer time when a school starts to pull stunts like defying a physician's order.

Because if the school is following their own "procedure" for 504 elgibility, plans, and accommodations, then OCR will NOT get involved.

Just noting procedural safeguards for IEP/ohi *are* well defined, consistent, uniform, and not open to modification  by school districts, and with more definitive oversight.

That said,  the farthest I ever took a grievance was to mediation. It's an option that while I found it effective, was curiosly, not enforceable.

I was under the impression that mediation is not available for 504 plans, only IEP/IDEA

[CMdeux]

Mediation is an option-- but both parties have to agree to it.

It can be a diversion step in either an OCR complaint or in due process proceedings.

But, as Ark notes-- it's non-binding anyway.  Go figure.   

(Which may explain why so few parents opt for mediation.)

[MamaMia]

Mediation is an option-- but both parties have to agree to it.

It can be a diversion step in either an OCR complaint or in due process proceedings.

But, as Ark notes-- it's non-binding anyway.  Go figure.   

(Which may explain why so few parents opt for mediation.)

Hmmm, lots of loop holes to "get out" of educating the disabled.  So not right. 

[ajasfolks2]

Yeah.  They spend more time figuring out how to be ABLE to not accommodate

rather than just removing the barrier to access (in this case the nonsensical "with reax in school" caveat that has NO-basis-in-fact or current best practices for LTFA) . . .

and then accommodating the disabled.


The gyrations are insane.

[Arkadia]

Mediation is an option-- but both parties have to agree to it.

It can be a diversion step in either an OCR complaint or in due process proceedings.

But, as Ark notes-- it's non-binding anyway.  Go figure.   

(Which may explain why so few parents opt for mediation.)

Hmmm, lots of loop holes to "get out" of educating the disabled.  So not right. 

Oh, it's not a loophole at all. I think it's an act of mercy. I think it's wise.

a school can't "get out" of anything with it. It's entirely optional and voluntary. Even if a school wants to go to mediation, a parent can steamroll right to due process.

You can go to due process if agreement can't be met in mediation. (from what I understand) <shrug>

I have good things to say about the mediation process.

Number one being it showed good faith on both sides.

Two being it preserved the relationship between the districtl and my child, as well as that between us and the district.

Three, it was a whole hell of a lot faster, less stigmatized, and operated on the premise that we are not adversaries (which, imho, contributes to more generous, cooperative attitudes on both sides.)

I've yet to read any due process hearing that didn't indicate both sides needed some degree of cooperation, and concession.

Mediation, again, imho, is a much better canvas for such.

The school followed through on four very truly important (due process worthy) points (big deals, all four of them), but did renig on what was probably the most emotional point of contention (Hot Junk Food Day), and which was in direct opposition to their wellness guidelines.

I will add, however, it is being remodelled, and probably in a more realistic fashion than I anticipated. Probably to the preservation of my child's relationship in the community and not being known as "the child of the Mom who stole Hot Junk Food Day".

I almost believe they went back on their word for my own good (and the good of my child).

<shrug>

FWIW. It's a whole lot of time, and a good deal of self analysis that has brought me to this point in my journey.

[twinturbo]

Does the state in which this family live have a self-carry law?  I live in a state that has such a law and while the doctor must sign the form each year, if that form is signed and submitted to school, DD can self-carry.

My first thought as well. That and ask them to 'walk through' their reasons in great detail. Why necessitate a reaction? Why ignore the doctor's orders? Why ignore ADA? Why self-carry one year then suddenly decide against next year?

Really, if the state specifies the right for a student to self-carry (without having to prove said student can self-administer) bob's your uncle.

[ajasfolks2]

Does the state in which this family live have a self-carry law?  I live in a state that has such a law and while the doctor must sign the form each year, if that form is signed and submitted to school, DD can self-carry.

My first thought as well. That and ask them to 'walk through' their reasons in great detail. Why necessitate a reaction? Why ignore the doctor's orders? Why ignore ADA? Why self-carry one year then suddenly decide against next year?

Really, if the state specifies the right for a student to self-carry (without having to prove said student can self-administer) bob's your uncle.

Exactly.  Many questions need to be asked -- either via written correspondence with written answers

OR

at a face-to-face meeting with recording done.

I'd suggest a script of questions to get them on record.

Cannot recall if I've posted this link in this thread:

http://www.dphilpotlaw.com/html/documentation.html


Suggest reading multiple sections of that SPED attorney (Texas) website.