This is a sample of a 504 Plan that a mom of a child with CF drafted up. This is to give you ideas about items to include. Some of the points may not apply to your child or you may think of others that aren't included here.
Just replace the XX's with your child's name and be sure to change the gender, too. Using the "find/ replace" feature on Word works really good for this. Good luck!
Sample 504 PLAN DRAFT
1. Adjust school regulations to allow XX to take her own pancreatic enzymes:
· XX self-administers pancreatic enzymes with all food. OR,
· XX’s teacher administers her pancreatic enzymes in the classroom immediately
prior to all meals. OR,
· The nurse aides come to XX’s classroom to administer her pancreatic enzymes immediately prior to all meals.
· XX’s mother must be informed prior to the end of each day whenever XX receives more pills in addition to the usual snack & lunch time breaks due to planned or unplanned parties, holidays, etc.
2. XX MUST be encouraged to use antibacterial waterless soap after each center, use of classroom materials (books, computer, calendar, etc) and may have a bottle on top of her desk as well. Good hand hygiene should also be encouraged with the entire class.
3. XX MUST wash with soap and water prior to any and all meals and after PE. Rule of thumb: Soap & water should be used after being outside, when you can see dirt and after use of the restroom.
4. All children in the class should bring their own supply box pre-filled with their individual supplies and work needs, as directed by the teacher. There should be limited-use of shared classroom materials, whenever possible.
5. XX’s desk, class water fountain, sink handles and all community tables and chair backs should be cleaned at the end of each day and community tables after use during the day with antibiotic wipes.
6. XX’s classroom should be air-conditioned in order to decrease the spread of germs and prevent dehydration.
7. Children with CF lose five times more salt when they sweat than children without CF. Therefore, XX must drink fluids directly before, during and after exercise (PE, playground, etc). Salt can also be replaced by eating high-salt foods like pretzels or potato chips.
8. XX should be allowed to have a sport bottle of fluids on her desk at all times. Plastic water bottles should be thrown away at the end of each day, even if full.
9. XX should always have the top shelf or cubby at the end of the row nearest the door.
10. XX’s desk should be on the outside of the class and upfront.
11. XX should be moved away from any child who is sitting next to her or at the same table when congested, coughing, runny nose, stomach ache, not feeling well, etc.
12. Unlimited access to snacks, restroom and water.
13. XX may need to attend school with a peripheral interveneous catheter (PICC line) inserted into her arm for antibiotics. It is critical that this line be cared for during the day by school staff to make sure it is not bumped or damaged. Level of appropriate activity should be discussed as well as an emergency plan.
14. XX may need to have support when she must stay at home or be hospitalized due to complications from her illness. She may require that only pertinent work (English/reading & math) be assembled by her teachers in the event of absences. Additionally, if she has to miss school for an extended period of time, homebound services (tutor) may be requested.
15. XX should be encouraged to cough and not hold in a cough. Coughing is the body’s defense system against chronic infection that healthy children ward off automatically. CF is not contagious. A CF child may have an active cough without having a virus.
16. Adjust or waive attendance guidelines.
17. Waive tardy regulations/policy due to time consuming morning therapy.
18. Ensure consistent and regular janitorial cleaning of XX’s classroom, furniture, carpeting and bathrooms. Especially during holiday and school breaks.
19. Access to tissues when needed to blow nose due to chronic sinusitis and/or cough. Again, great for entire class to follow.
20. Second set of text books at home.
21. When teaching class about proper nutrition, be sensitive to XX who has a high-calorie, fat & sodium diet that may appear unhealthy by most nutritional standards.
22. Antibacterial waterless soap should be placed in all central school areas including the office, computer lab, library, MPR, lunch line, etc.
23. Those with CF must never be in the same room, use the same computer/ lab desk (even at different times), lunchtime serving utensils (salad bar) or any materials whatsoever used by someone else with CF. Especially, not to use the same bathrooms. They also must stay a minimum of 3-feet away from each other.
24. XX should not be excluded from any physical activity unless notified by XX’s parents. Exercise is very beneficial for children with CF.
25. Full participation in extra-curricular activities and field trips.
26. XX needs as much time as possible to eat meals at school and snacks should always be accessible in the classroom.
27. XX should always be able to go to the front of the lunch line when purchasing a school lunch.
Please note that this document is just a sample for ideas and is not meant to be legal advice.