504s and Food Allergies/Asthma


  • Specializes in School Nursing. Has 4 years experience.

Hi all -

I have just taken on a new role where I am assisting in identifying students who qualify for 504s for medical need. We have approximately 40 students with epipens in schools and a couple who take their inhalers regularly for asthma. How do you determine which students with food allergies/asthma need a 504? I have researched and understand that both can be considered a disability and qualify for 504 - I'm just not sure what the line is when they need the 504? Would every student with an Epipen, or just specific students? Any advice on what others do would be greatly appreciated! I want to make sure we are doing what we need to and make sure we are taking the best care of our students, but don't want to do unnecessary paperwork/forms either.

Thanks much!!

Specializes in School nursing.

I do not have a 504 plan for every student with a food allergy (there would be so many 504s...so many...). I have an allergy action plan, which is posted in every classroom. To accommodate the growing numbers of peanut/nut allergies, our school went peanut/nut free. I also have a very basic asthma action plan outlined for staff that is posted.

Unless the student needs further accommodations for severe asthma or food allergy, I stick with the student's IHP. If, for example, a student does have severe asthma with flare-ups in colder months that lead to frequent absences that impact a student's ability to learn, yep, I will help ensure they have a 504 plan.


1,263 Posts

Of all of my allergic/asthmatic/diabetic kiddos, only 1 has a 504. She has very severe allergies and asthma and needed certain accommodations in the lunch room as well as in the classroom to ensure her health and safety. I frequently check in with my diabetic kiddos' parents to be sure their testing/office visits/insulin schedule is not interfering with their academics and that everyone is on the same page as far as testing in the classroom or snacks in class as needed. Everyone gets an individual health plan, but most do not require a 504.

allnurses Guide


1 Article; 4,787 Posts

Specializes in Pediatrics Retired.

The change in terminology of the 504 Eligibility Determination Form would allow anyone with a life threatening allergy or asthma to qualify. I'm not sure what benefit 504 offers these students since nothing changes regarding their care at school whether they are in 504 or not, other than some legal document that can be used against the school for future litigation.

The Determination Form used to take into consideration if the student's condition impacted classroom and/or school attendance...but no more.


420 Posts

All of our students with type 1 diabetes have a 504. This is the only way they can leave and return during state testing without their test being invalidated. Most of them also have stipulations in the medical management plans that they are not to test above or below a certain BG level and that is written into their 504. Severe asthma also gets a 504.


723 Posts

Specializes in School Nursing. Has 10 years experience.

Like PPs said students who need accommodations above and beyond what every student gets every day would possibly get a 504 plan. I only have a handful at each of my schools. For allergies and asthma we have an Emergency Care Plan for each student and emergency medication in the health office. For diabetics they have a 504 plan allowing them to leave whenever they feel they need to test, do not take exams if their BGs is above or below a certain number, extra absences beyond the 7 they are allowed for the whole school year, etc. We have 504s for a couple kids who have severe migraines allowing them to carry a water bottle at all times and extra passes to come to the health office to lay down, they don't take tests if they are symptomatic, etc.