Section 504 for
School Nurses
Marie DeSisto RN, MSN
Director of Nurses and District 504 Coordinator
Waltham Public Schools
Waltham, MA
Section 504:
• No otherwise qualified individual with
a disability …shall solely by reason of
her or his disability, be excluded
from the participation in, be denied
the benefits of, or be subjected to
discrimination under any program or
activity receiving Federal financial
assistance.
Section 504
• Major component of the Rehabilitation Act of
1973
• CIVIL RIGHTS legislation for persons with
disabilities
• Administered by the Office of Civil Rights which
is part of the US Department of Education
The goal of Section 504:
• Level the playing field
• To allow equal access to a free and
appropriate education
Eligibility for Section
504
• Broad
• Many different types of disabilities
and disabling conditions
Eligibility for Section
504
• Eligibility is NOT based on clinical
categories, such as mental
retardation or learning disabilities.
Who is a Qualified
Student?
• Of age during which persons without disabilities
are provided such services
• Of any age during which it is mandatory under
state law to provide such services to students
with disabilities
• A student for whom a state is required to provide
a free appropriate public education under IDEA
Definition of Disability
under Section 504
• Physical or mental impairment which
substantially limits one or more of such
person’s major life functions
• Record of such an impairment
• Regarded as having such an impairment
Definition of physical or
mental impairment:
– Physiological disorder or condition
– Cosmetic disfigurement
– Anatomical losses affecting one or more of a
body system
– Any mental or psychological disorder, such as
mental retardation, organic brain syndrome,
emotional or mental illness, and specific
learning disabilities
Definition of Major Life
Activities
• Caring for one’s
self
• Performing manual
tasks
• Walking
• Seeing
• Hearing
• Speaking
• Breathing
• Learning
• Working
Major Life Activities
Expanded to include:
• Reading
Communicating
• Thinking
Standing
• Concentrating
Lifting
• Eating
Bending
• Bladder function
Sleeping
• Bowel function
• Other…
Definition of
Substantial Limitation
• Does the impact of the disability on the
“major life activity” amount to a
substantial limitation.
– Unable to perform a major life activity that
the average person in the general population
can perform
Schools Must:
• Search for eligible students
• Provide a “free appropriate public
education” for all students
• Provide the services for students in
the least restrictive environment
Schools must establish:
• Nondiscriminatory evaluation &
placement procedures
• Procedural safeguards to enable
parents to participate in the evaluation
• Afford all children an equal
opportunity to participate in
nonacademic & extracurricular
services and activities.
Refer a student for a
Section 504 Evaluation…
• Referred for IDEA but not evaluated or
determined not to be eligible
• Suspected of having a disability
• Continued to display behavior problems
Refer a student for a
Section 504 evaluation…
• Diagnosed with a major health problem
• Expelled or suspended
• Problems that cannot be explained
• Parental request for a 504 evaluation
• Staff member request for an evaluation
Section 504 expansion
effective January 2009:
• Additional categories in Major Life
Activities
• No longer consider “mitigating
measures”
• Consider impairments that are
episodic or in remission
Temporary Disabilities
• Covered by Section 504 if they meet
the criteria
• Generally the OCR does NOT require
a 504 plan for a temporary disability
• Exception: DESE has been asking for
plans for students needing MCAS
accommodations
Section 504 Compliance
• The Office for Civil Rights is
primarily concerned with protecting
the rights of students and parents
• We must ALWAYS follow the
process
Role of the School
Nurse in Section 504:
• Identification of students who
qualify for Section 504
School Nurse continued:
• May be a member of the Section 504
Evaluation team
School Nurse:
• Provide nursing care and services to
students to ensure that the student
can access a free and appropriate
education in the least restrictive
environment.
School Nurse:
• Evaluate effectiveness of the
Section 504 Plan and the
accommodations:
– Does the student have access to a free
and appropriate education
Section 504 Pitfalls
• A doctor’s note/order is insufficient
data for a 504
• Not evaluating
• Not documenting evaluation/services
Pitfalls…
• Not having the right staff on the
evaluation team
• Not following the 504 plan
• Provide the services
Private schools
• Private schools do not have to follow
Section 504
• Unless they take Federal funds…such
as Title 1, 2A, 2D, 3 and/or 4…
Section 504 Summary:
• Comprehensive civil rights legislation
• Incorporates a very broad definition
of disability
• Students not eligible under IDEA
may be eligible under Section 504
Section 504 Summary
• The school nurse serves an important
role in Section 504
–
–
–
–
Child find
Section 504 team member
Providing nursing care or services
Periodic review of the Plan for
effectiveness
Summary
• The school nurse must be familiar
with Section 504
• The school nurse must serve as a
voice for the students
Summary of Section 504
• To eliminate the barriers to a free and
appropriate education in the least
restrictive environment
Bibliography
•
Betz CL. (2001). Use of 504 plans for children and youth with disabilities: Nursing application.
Pediatric Nursing, 27(4), 347-352.
•
Dang, MT. (2010). The history of legislation & regulations related the children with developmental
disabilies: Implications for school nursing practice today. Journal of School Nursing, 26(4), 252259.
Selekman, J. (2006). School nursing: A comprehensive text. FA Davis, Philadelphia.
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