After way too many hold-ups, our daughter’s school will be convening a group of professionals to oversee the implementation a legal document that will provide protection for her while in school.  Because she is the first in our school district to be diagnosed with Celiac Disease (93% of people suffering from this are undiagnosed), we’ve hit quite a few roadblocks, but at least we’ve got a meeting at which to present our case for 504 implementation. I am sharing this plan in the hopes that other parents in our shoes might find it helpful.

Information on 504 plan from The National Organization for Celiac Awareness:“Section 504 is part of the Rehabilitation Act of 1973, and applies to all institutions receiving federal financial assistance, such as public schools. Under this law, public schools must provide a free appropriate public education and not discriminate against disabled students. This law acknowledges that the disability may not require special education services but a plan is needed to ensure the student receives an appropriate education accommodating the disability within the classroom. This law must accommodate a special diet, including the gluten-free diet which is the only known treatment for Celiac Disease.”

The Department of Education (ED) Office of Civil Rights regulations define a physical or mental impairment as any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological; musculoskeletal; special sense organs; respiratory, including speech organs; cardiovascular; reproductive; digestive; genito-urinary; hemic and lymphatic; skin; and endocrine… The regulations do not spell out every disease and condition that may constitute physical or mental impairments. Section 504(a) of the Rehabilitation Act of 1973, as amended, 34 C.F.R. 104.3(j)(2)(i) and the Americans with Disabilities Amendments Act of 2008 (ADAAA), Title II regulation at 28 C.F.R. § 35.104.

Section 504 Plan for Gillian XXXXXXXXX

School: XXXXXXXX School

School Year: Late 2009/2010

Gillian XXXXX                     XX/XX/X                      X                             Celiac Disease

Student’s name                 Birth Date                 Grade                         Disability

Homeroom Teacher: XXXXXXXXX  Bus Number:X

Objectives/Goals of this plan

Celiac disease is an autoimmune disease that causes damage to the intestinal

lining, interfering with the absorption of nutrients. Untreated, celiac disease

causes multi-system complications such as diarrhea, constipation, gas, bloating,

iron deficiency anemia, decreased bone density, failure to thrive, short stature,

and behavior problems.

The only treatment for celiac disease is a strict gluten free diet for life. Gluten is

found in wheat, rye, barley and contaminated oats. Therefore, all foods with

wheat, rye, barley and oats must be eliminated from the diet. In addition to the

foods being gluten free, it is equally important that these foods are not

contaminated by coming in contact with gluten containing foods during their

preparation or service.

1. Provision of Celiac Disease Care

1.1 All staff members involved in the care and education of Gillian must

receive training in the management of Celiac Disease. This includes teachers,

classroom assistants, substitute teachers, cafeteria workers, office staff, school

nurse, and any other staff that has primary care for her.

1.2 All staff who interacts with Gillian on a regular basis understands Celiac

Disease, can recognize symptoms of gluten ingestion, and work with other school

staff to eliminate the use of gluten containing foods in her meals,

educational tools, arts and crafts projects or incentives.

2. Meals and Snacks

2.1 The only treatment for celiac disease is a strict gluten free diet for life.

Gluten is found in wheat, rye, barley and contaminated oats. Therefore, all foods

with wheat, rye, barley and oats must be eliminated from Gillian’s diet. This includes

the obvious sources such as wheat breads, pastas, buns and rolls but it also

includes items such items as soy sauce, some broths and meat bases, some soups,

gravy thickened with wheat flour and breakfast cereals that contain malt or malt

flavoring. All labels must be carefully reviewed to be sure no gluten containing

grain is used in that food product. Also, items that are made in factories where equipment is shared with glutinous food cannot be served.

2.2 In addition to the food itself being free of gluten, the food cannot come in

contact with or be contaminated by gluten containing foods. This means the gluten-free foods need to be prepared in a separate area, cooked in separate pans, toaster oven or microwave, and served with clean gloves.

2.3 In order to provide a balanced meal containing the 4 groups necessary for

reimbursement, a gluten free bread or bread alternative must be offered at all

school meals. This would include such foods as a gluten-free bread, gluten-free

roll, gluten-free cereal and gluten-free pasta. The meat and meat alternative

must also be free of gluten containing grains such as fillers in hot dogs, poultry

injected with wheat or barley, and a gluten containing grain used as an extender

in other meat products.

2.4 School food service personnel will develop a system for identifying Gillian when moving through the cafeteria line so that a member of the staff can ensure the selected food is safe. To facilitate this, Gillian will identify herself to service staff or use specially code lunch tickets if desired.

2.5 The school will designate a person to be responsible for ensuring that lunch

tables and surrounding areas are thoroughly cleaned before  lunch. It is

recommended that a designated sponge or cleaning cloth be used for the gluten

free area to avoid cross contamination.

2.6 Teachers will give Gillian’s parents a 48 hour notice of any special

events outside the classroom at which food will be prepared that is not from the cafeteria. The school will provide Gillian’s parents with a gluten-free food option for said event. Her parents may choose to provide appropriate food for the event.

2.7 Classroom parties where food will be shared will be gluten free. Gillian’s parents will supply lists of easy-to-find grocery items to homeroom parents and/or teachers.

2.8 Snacks will be available in the classroom, or Gillian’s backpack, or the nurse’s office (whichever is deemed most viable) in the event that she becomes hungry. Because she can only ingest a small amount of food at a time, she needs to eat more often. Gillian has promised to use this privilege conservatively. If it is more convenient and less disruptive for the class, she can quietly eat a small snack at her desk.

3. Bathroom Access

3.1 Accidental exposure to gluten may cause gas, bloating and diarrhea;

therefore, Gillian shall be permitted to use the bathroom without restriction. If she deems it necessary, she will be permitted to use the bathroom in the nurse’s office in case of serious stomach cramping and cold sweats, so that she can be overseen by an adult. Gillian has come to the edge of passing out when symptomatic.

3.2 Benadryl will be available to Gillian should accidental exposure occur, as hives often appear when cross-contamination occurs. This can be dispensed at the nurse’s office at Gillian’s digression.

3.3 Gillian will also need access to hand washing facilities after handling

products that contain gluten such as Play Dough or paper-mâché.

4. Classroom Art Projects

4.1 Rubber gloves will be accessible to Gillian for projects that contain gluten such as Play Dough or paper-mâché. As stated in item 3.3, Gillian will need access to hand washing facilities after handling these products.

4.2 Parents will be informed at least 48 hours in advance of any non-airborne gluten-containing items being used in a project so they can make appropriate substitution if necessary (I.E. gluten-free ginger bread cookies for building a house).

4.3 School projects utilizing glutinous ingredients which can become airborne (I.E. volcanoes) must be substituted with another project or gluten-free ingredients, such as gluten-free flour.

5. Field Trips and Extracurricular Activities

5.1 Parents will be notified of upcoming field trip plans that would involve food or

food-related activities. The school will provide parents with a gluten-free meal

option for any off-campus school-sponsored activity. The parents may choose to

provide appropriate gluten-free alternatives.

6. Communication

6.1 The school staff will keep Gillian’s Celiac Disease confidential, except to

the extent that Gillian decides to openly communicate about it with others.

6.2 The school staff will provide reasonable notice to her parents when

there will be a change in planned activities such as field trips or parties.

6.3 Each substitute teacher and substitute school nurse will be provided with

written instructions regarding Gillian’s Celiac Disease care.

6.4 Prior to the beginning of every school year the new classroom teacher will

receive a copy of the 504 plan and will review it to ensure that the steps

necessary to keep Gillian safe are clear and understandable. Written

documentation of this process will be provided to her parents before Gillian

enters the classroom.

7. Emergency Evacuation and Shelter-in –Place

7.1 In the event of emergency evacuation or shelter-in-place situation the

student’s 504 Plan will remain in full force and effect.

7.2 Gillian’s parents shall provide the school with a 3 day emergency

supply of non-perishable gluten free foods.

8. Parental Notification

8.1 Gillian’s parents shall be notified immediately in the following

situations:

* The student has eaten a food item that contains gluten.

* The student has symptoms of gluten ingestion such as abdominal

pain, cramping, diarrhea, or hives.

9. Emergency Contacts:

XXXXXXX