504 for osteogenesis imperfecta

[NurseBeans, BSN, RN, EMT-B]

I have a little one who has OI, I have never seen any documentation but mom says that she has it and I'm not going to doubt her. She stated at the beginning of the year that she needs no accommodations and has no restrictions, just that I need to call if she has any particularly bad falls or blows to the body. I did my usual notification of teachers and admin. In writing. And wrote my little EAP, gave that to teachers/admin.

So I got a visit from the principal today that I need to have told her about this kid (I did) and we need to write a 504. My question is, does a child with no restrictions and no accommodations need a 504? And what would that 504 contain?

My feeling was that my IHP and EAP were enough, as the kid is very mild and staff was notified that this child just needs to see the nurse after any kind of incident, even one that seems minor.

I did a little research and can't find any 504 accommodations for OI that apply to this child. Mom does not want her to have restrictions from physical activity either.

[WineRN]

I thought 504 requests had to come from the parents?

I've only done one 504 eval per the parent's request, and the parent refused all of the accommodations we offered.

[Nurse in MT]

No contact sports or rough play. That would apply to gym class and recess time.

[Nurse in MT]

I thought 504 requests had to come from the parents?

I've only done one 504 eval per the parent's request, and the parent refused all of the accommodations we offered.

We're creating a 504 at our insistence now. Parent is finally on board.

[ruby_jane, BSN, RN]

504 requests usually come from parent. Maybe sometimes from the counselor if s/he sees the kid struggling. But you have a parent who has declined the 504, and I assume the parent has declined any IHP you might write as well. So...who triggered the request with the principal? Have you spoken with the counselor? That's just....odd. Do you let the principal know about sickle cell, hemophilia, etc?

[OldDude]

If mom doesn't want a 504 and you have no MD orders for restrictions at school that issue is dead in the water. Continue on status quo and forget about it unless/until something changes.

[grammy1]

No physician diagnosis, no 504. There's not even discussion till I have a letter from the doc. Too many of our parents lie because little snowflake doesn't like PE, etc.

[SassyTachyRN]

No physician diagnosis, no 504. There's not even discussion till I have a letter from the doc. Too many of our parents lie because little snowflake doesn't like PE, etc.

I had a mom who said OI over and over again. I pestered and pestered for a careplan back from her. Finally I caught her in the school and gave her a consent to release information, and told her OI is a very serious diagnosis and it was imperative to have a medical care plan in place at school. THEN she said WELL, it's not OI, "She just breaks bones easy." She had broken an arm and "two leg bones" by first grade. After that, I dropped it. My school does require documented physician dx to write a 504, for what it's worth.

[OldDude]

Eligibility Question #1 of the Section 504 Eligibility Determination form:

1. Does the student have a physical or mental impairment? If so, please identify the impairment(s) in the box below. Notes (1) This is an educational determination only, and not a medical diagnosis for purposes of treatment...

[JenTheSchoolRN, BSN, RN]

I had a mom who said OI over and over again. I pestered and pestered for a careplan back from her. Finally I caught her in the school and gave her a consent to release information, and told her OI is a very serious diagnosis and it was imperative to have a medical care plan in place at school. THEN she said WELL, it's not OI, "She just breaks bones easy." She had broken an arm and "two leg bones" by first grade. After that, I dropped it. My school does require documented physician dx to write a 504, for what it's worth.

So does mine. And that diagnosis needs to have the possibility of impacting learning, like a low blood glucose or needs for frequent restroom breaks during class and testing.

[NurseBeans, BSN, RN, EMT-B]

The kid is quite sharp, no academic struggles. Her OI is very mild, has not had any issues all year (knock on wood). The only modification to anything we did was on bouncy house day she got her own time with two friends who promised to bounce gently. Bouncy house day is a big thing here, the kids come in my office in droves because they bounce too hard and they allow like 20 of them in at once.

I spoke with mom and she said the principal had already called her and she is very confused (I don't blame her) because she does not need or want accommodations, so the 504 is pointless. What the principal seems to want is an emergency action plan, which I did at the beginning of the year when I first spoke to the mom about this kid. The orthopedic doc wants this child to live like any other child and the philosophy of the mom is that she will get fractures, there is nothing to prevent them, she wants her child to live a normal life. My point is that my EAP says to send child to nurse if she is injured in any way, even minor. Does more need to be said? The staff send every little bump and bug bite and hangnail my way, so I don't think an injury in any child would go unnoticed.

At any rate the 504 talk is coming from the special services office, who try to drum up a 504 or IEP on every kid possible. Which is not the same as an IHP or EAP, which are for the nurse to take care of. Which I did. I think special services is just getting all up in my business.

[WineRN]

Bouncy house day is a big thing here, the kids come in my office in droves because they bounce too hard and they allow like 20 of them in at once.

Bouncy house day?!! That is like a school nurse nightmare right there!

I spoke with mom and she said the principal had already called her and she is very confused (I don't blame her) because she does not need or want accommodations, so the 504 is pointless. What the principal seems to want is an emergency action plan, which I did at the beginning of the year when I first spoke to the mom about this kid. The orthopedic doc wants this child to live like any other child and the philosophy of the mom is that she will get fractures, there is nothing to prevent them, she wants her child to live a normal life. My point is that my EAP says to send child to nurse if she is injured in any way, even minor. Does more need to be said? The staff send every little bump and bug bite and hangnail my way, so I don't think an injury in any child would go unnoticed.

At any rate the 504 talk is coming from the special services office, who try to drum up a 504 or IEP on every kid possible. Which is not the same as an IHP or EAP, which are for the nurse to take care of. Which I did. I think special services is just getting all up in my business.

It does sound like the Special Services Office is overstepping. If the guardian and doctor don't want it, they just have to accept that