Diabetes 504 Plans: A List of Accommodations to Include

One of the top questions that gets asked within the diabetes community and across many diabetes support groups is whether a child with Type 1 Diabetes needs a 504 Plan for school. I typically encourage parents to adopt one as soon as possible to ensure legal protection for their child. Even if you have a good relationship with your child’s school and with their teachers, it is always a good idea to have this extra safety net. It is your right and to your child’s benefit to have a legally binding document that ensures everyone is on the same page. Another frequent question I see asked a lot is what types of accommodations should be included? Below, you will find a checklist of accommodation examples one might consider for their child’s plan. However, before I get too far, you might be wondering what is a 504 Plan?

A 504 Plan describes the types of accommodations that a school will provide to ensure access to a learning environment that supports the success of a qualifying student with a disability.

*Disclaimer: This site is not intended as legal advice. Please consult your attorney for legal consultations related to special education.

Type 1 Diabetes certainly qualifies a student for access to a 504 Plan, which falls under the guidance and purview of Section 504 of the Rehabilitation Act of 1973. This law is overseen and enforced by the Department of Education’s Office of Civil Rights (OCR). Schools can lose federal funding if they do not comply with this law. Any school that receives federal dollars must comply with both the Individuals with Disabilities Education Act (IDEA) and Section 504 laws. A child may still qualify for protection regardless of the need for special education.

The American Diabetes Association (ADA) has a very informative page on their website titled the Safe at School program, which gives parents and caregivers of Type 1 Diabetes a synopsis of their rights to ensure their children are safe at school. An especially helpful tool you will find on this website is a drop down list of the statutes and rules governing diabetes in the schools for each state. You can then further read through the diabetes care plan guides set forth for your particular state.

Each state is different for how diabetes at school is managed. For example, my daughter’s 504 Plan only includes separate accommodations that will affect learning, while the guidelines supplied to the school clinic and to her teachers on how to care for and oversee her diabetes are outlined in her Diabetes Medical Management Plan (DMMP). This plan is typically created and adapted by our diabetes educator team through our endocrinologist’s office. For an idea of the types of guidelines to include in the DMMP, consult your state and district’s manuals. A sample DMMP template is also available here on the ADA website. You can also look through this helpful archive of a website provided by Children with Diabetes. This includes sample 504 plans according to each grade level. Another sample 504 Plan is provided here by the Disability Rights Education and Defense Fund.

For the purposes of this post, the focus will mostly include those accommodations that affect learning, as listed below. Keep in mind, these are just ideas that you can include. There may be additional accommodations that are unique to the needs of your child.

Accommodations Checklist:

No penalties for absences/tardiness due to doctor’s appointments, visits to the office/clinic, or classtime instruction missed to maintain blood glucose control.
Extra time given to finish incomplete or missed assignments and tests due to diabetes management.
Bathroom breaks permitted without restriction.
Office/clinic visits related to diabetes management permitted at any time without restriction.
Permission to carry and consume snacks in the classroom.
Permission to carry and consume glucose tabs, candy or fast-acting carbs in the classroom.
Access to and permission to carry blood glucose testing and insulin supplies.
Permission to carry and consume water in the classroom as well as access to water fountains.
Participation in all field trips and extracurricular activities with access to accommodations/modifications set forth (i.e., sports, clubs, etc).
Permission to test blood glucose at any location in the school, including the classroom, cafeteria, school bus, field trip sites, or any location on the school grounds.
Testing accommodations to allow access to water/snacks/glucose testing and supplies during regular or standardized testing.
Testing accommodations to allow breaks for snacks or to treat low/high blood glucose during regular or standardized testing.
Permission to reschedule regular or standardized testing if blood glucose is higher than 220 or lower than 80.
Permission to carry and use a mobile phone or cgm receiver device for the purpose of monitoring blood glucose.
Permission to cease all physical activity in gym class if blood glucose exceeds 300 (and/or ketones are present) or drops below safe limits (under 85) without penalty or negative effects on the grade.
Extended time in the cafeteria to finish lunch or snacks if not completed during the regular lunch hours.
Advanced notice provided by the teacher of class parties or special food brought into the class.
Permission to wear medical alert jewelry at all times without penalty.
Permission to carry all diabetes supplies (including snacks, drinks, pump/blood glucose testing, glucagon, needles and disposal units) on field trips and extracurricular activities on or off the school grounds.
Assure the child’s privacy in administering insulin or testing blood glucose, if desired.
Keep student’s diabetes and medical condition confidential.

This wraps up the comprehensive list of accommodation ideas for Type 1 Diabetes. Depending on the grade level or particular needs of the child, further accommodations may be warranted. Each plan is not limited to the items on this list. However, this provides you with a helpful framework for how to adopt your own plan for your child.

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