School Advocacy Guide

Ensuring your child with T1D is safe and supported at school

Understanding 504 Plans
Your child's legal right to accommodations

What is a 504 Plan?

A 504 Plan is a legal document under Section 504 of the Rehabilitation Act that outlines specific accommodations your child needs to manage diabetes safely at school. It ensures equal access to education.

Who Should Have a 504 Plan?

Every child with T1D should have a 504 Plan, even if they're independent with their diabetes care. The plan protects them legally and ensures the school is prepared for emergencies.

Key Components to Include

  • Blood glucose monitoring - when, where, and who assists
  • Insulin administration - timing, location, and support needed
  • Treating hypoglycemia - recognition, treatment, when to call 911
  • Meal and snack times, including flexibility for blood sugar management
  • Physical activity accommodations and monitoring
  • Testing accommodations (extra time, breaks for blood sugar checks)
  • Field trip and extracurricular activity plans
  • Communication plan with parents
  • Staff training requirements

Working with Your Diabetes Care Team

Your endocrinologist or diabetes educator can complete a Diabetes Medical Management Plan (DMMP) that provides medical details for the 504 Plan. This document is essential.

Building Your School Team
Who needs to be trained and involved

School Nurse

The school nurse is typically the primary diabetes care coordinator. Ensure they understand your child's specific needs, devices (pump, CGM), and emergency protocols.

Classroom Teachers

All teachers should be trained to recognize hypoglycemia symptoms, provide fast-acting carbs, and know when to seek help. They should also understand accommodations in the 504 Plan.

Substitute Teachers & Staff

Leave a clear, one-page emergency plan in the classroom and nurse's office that any substitute can follow. Include photos of your child and symptoms to watch for.

PE Teachers & Coaches

Physical activity affects blood sugar significantly. PE teachers and coaches need specific training on pre-exercise blood sugar checks, having snacks available, and recognizing low blood sugar during activity.

School Administrators

The principal and 504 coordinator should understand your child's rights and the school's legal obligations to provide accommodations.

Trained Diabetes Personnel (TDP)

If a nurse isn't always available, identify and train other staff members to serve as backup support for diabetes tasks like checking blood sugar or providing glucagon in emergencies.

Essential Accommodations
Specific supports to request in the 504 Plan

Blood Glucose Monitoring

  • Permission to check blood sugar anywhere at school (classroom, bus, field trips)
  • Access to CGM alarms/data during school hours
  • No penalties for diabetes-related absences or tardiness

Food & Snacks

  • Unrestricted access to water and bathroom
  • Permission to eat snacks as needed for blood sugar management
  • Flexibility in lunch timing
  • Permission to have snacks during tests

Testing & Classwork

  • Extra time for tests if blood sugar is out of range
  • Ability to reschedule tests if very high or low
  • No academic penalties for absences or incomplete work due to diabetes
  • Breaks during testing to check and treat blood sugar

Physical Activity

  • Blood sugar check before, during, and after PE/recess
  • Snacks available during physical activity
  • Permission to sit out if blood sugar is too high or low
  • No grading penalties for diabetes-related PE absences

Communication

  • Immediate parent notification if blood sugar is critically high or low
  • Regular communication about diabetes management at school
  • Parent access to CGM data remotely
Handling Challenges
What to do when schools push back

Know Your Rights

Federal law (Section 504 of the Rehabilitation Act and the Americans with Disabilities Act) requires schools to provide necessary accommodations. Schools cannot refuse based on cost or inconvenience.

Document Everything

Keep records of all meetings, communications, and incidents. Email summaries of verbal conversations. This documentation is crucial if you need to escalate concerns.

Start with Collaboration

Approach the school as a partner first. Most resistance comes from lack of knowledge or fear of liability. Provide education, resources, and reassurance.

Escalate if Necessary

If the school refuses reasonable accommodations, escalate to the district's 504 coordinator, then to the superintendent. You can also file complaints with the Office for Civil Rights (OCR).

Get Support

Contact ADA's Legal Advocacy team (1-800-DIABETES) or JDRF's school advisory services for help navigating difficult situations. Local diabetes support groups can also provide guidance.

Annual Review

Review and update the 504 Plan annually, or sooner if your child's needs change. New school years often bring new staff who need training.