Medical needs on bus

For us, if warranted the student has a 1:1 on the bus. But they would also have them for class (can't have a 1:1 for just bus rides and then send them home). 

Bus attendants can be trained but many don't have one. Thus we default to have a copy of the emergency plan in the backpack, and if there is a major medical need the bus driver has to pull over and call parents or 911.

For the amount of responsibility they have they definitely don't get paid enough.

Transportation considerations should be a part of a 504 or health plan in an IEP; If there is reasonable expectation that a student could potentially need nursing services  between home and school, then a nurse should go on the bus.

When I subbed, there was a time where I was contracted to just ride the bus every morning and afternoon with a group of kids with medical needs - Most of them were seizure risk kids with other co-morbidities (ASD, CP, etc.), and there was one who had a trach.

For T1DM, there are a lot of factors, primarily, how independent the kid is, how long the bus ride is, etc. 

There was a time we had a T1DM student who did not have a 1:1 nurse, but his bus ride was over an hour each way. In that scenario, it was written into his 504 that his family would provide transportation, and the district actually reimbursed the family for that, as it was cheaper than hiring a nurse for the bus rides (and easier). Once he was independent (I think by 7th grade), he was able to self manage and the bus driver received cursory education on the condition and what to do in an emergency. Allowing him to eat snacks on the bus was also written into his 504, as typically, kids are not supposed to eat during bus rides.