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Case Management

Case Management

504 Plans

Section 504 Accommodations

Students who present with health conditions impacting their ability to access education may qualify for 504 services. 504 services refer to Section 504 of the Rehabilitation Act of 1973 that is federal legislation prohibiting discrimination against individuals with disabilities in federally funded programs and activities.  “Whereas IDEA covers only students who are eligible for special education, the Rehabilitation Act covers all students and staff with disabilities, including those with chronic conditions,” (Selekman 2013).

“No otherwise qualified individual with a disability in the United States, as defined in section 706(8) of this title, shall solely by reason of her or his handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance or under any program or activity conducted by any Executive agency or by the Unites States Postal service. 29 U.S.C. §794(a) (1973)

Examples of How a School Nurse Plays a Role in 504s

  • The school nurse may identify a student qualifying for a 504 referral based on their chronic health condition.
  • The school nurse can participate on the 504 evaluation team.
  • Health related interventions for students will often be included in student’s IHPs and could help identify accommodations needed in the student’s 504 (Selekman 2013).
  • Assist in monitoring student progress and assist with re-evaluation as appropriate.
  • Advocate for students with chronic health conditions and help communicate their needs to school staff.

*To better understand how students are evaluated for 504s and how these plans are implemented in your district consult your administrator.

Other Resources:


IEPs and the Role of the School Nurse

The Individuals with Disabilities Education Improvement Act (IDEA) is the primary federal legislation that governs how states provide special education services to children with disabilities (Selekman 2013).  Within IDEA there are provisions as to how students are identified and evaluated for special education services (Yonkatis 2017).  Once students are determined to be eligible for special education the school will then develop an Individualized Education Plan (IEP) for that student which outlines annual goals, objectives, and any related services needed for the student.

“Every U.S. student is entitled to a free and appropriate education.  School districts must identify and evaluate any child who they find is unable to engage fully in learning as a participant in the general education curriculum.  The Individuals with Disabilities Education Act of 2004 requires that these students be assessed by qualified individuals in any areas that may be impacting learning…The school nurse, as the health expert, has an important role to play as a member of the special education team in evaluating whether a student has health concerns that are impacting learning and how health barriers to learning might be reduced,” (Yonkaitis 2017).

*For more information on how your district manages IEPs, and evaluates students for special education services consult your local administrator or director of Special Education Services.

Examples of how a School Nurse Plays a Role on the Individualized Education Program Team

  • School Nurse may assist in identifying children who may qualify for special education services, or children who may need other health related services.
  • In collaboration with the child, parents, and healthcare providers; the school nurse can help to assess the child’s functional and physical health status.
  • Assist in developing health related goals for the IEP
  • Develop IHPs and/or ECPs to accompany to the IEP as necessary
  • Provide trainings for teachers and staff regarding the individual health needs of the child.
    (Selekman 2013)

IDEA 2004 Disability Categories:

Autism; Deafness; Deaf-Blindness; Emotional Disturbance; Hearing Impairment; Intellectual Disability; Multiple Disability; Other Health Impaired; Specific Learning Disability; Speech or Language Impairment; Traumatic Brain Injury; Orthopedic Impairment; Visual Impairment; Developmental Delay-special designation for children ages 3-9
(Shannon, 2017)

Medicaid Reimbursement for Nursing Services Provided

When providing direct nursing services, such as tube feedings and medication administration, for students qualifying for special education services; consult your local district to see if services rendered are eligible for Medicaid reimbursement.

*Additional 504/IDEA/IEP resources to share with families can be found on the MT DPHHS School Health Website