Medical Needs at School
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Students with medical needs can be supported at school through a mixture of
supports and plans. Each school district or charter school can help guide parents
and families for the most appropriate level of support. They can look at the
Individualized Education Program (IEP), the Section 504 plan, or even an
Individualized Healthcare Plan (IHP).
The key in establishing the most appropriate support will be in having
open communication with school personnel regarding needs. The IHP, 504 Plan and the
IEP process have a beginning step to determine the individual needs of the student.
In general, the primary care doctor can help their patient by providing a detailed
medical history, including specific health problems, behavioral issues, or learning
issues that may interfere with the child's ability to benefit from their education.
Establishing the Need
Documentation of the specific health problems, behavioral issues, or learning
issues, provided to the parent, are the most helpful. Prescribed recommendations
without more information are the least helpful.
Detailed information addressing the impact of the child’s health condition or
disability on their ability to learn, attend and behave in the classroom, care for
themselves, and their need for special dietary or medical interventions, such as
medications, interventions, equipment, or other aids. The documented details you
provide will help determine your child's eligibility for Special Education, and may
be a key part in the development of his/her education plan, including special
dietary, personal care and medical requirements.
Medications at School
There is a difference among states, and even school districts, but there
are minimum standards for medication administration in school; immunizations;
vision, hearing and spinal curvature screening; and other health and safety
policies. For information about your state, see State Education Contacts and Information.
A student may have a Health Care Plan (IHP) in addition to a Section 504
Plan or IEP at school that can help describe the medical needs and steps of care
associated with this in the school setting. The Health Care Plan is developed by the
school nurse and the student’s doctor, specialist or nurse.
Coordinating Service for Medical Needs
When a student has been sick and is ready to return to the classroom, the
medical team should provide documentation to the parent of the medication plan (side
effects, schedule, etc.), release to return to school, treatment plans and other
important information. A liaison from the medical team can help school personnel
through telephone contacts and training for the specific need. The parent should
ensure that the school has current information listed on the school’s emergency
contact form.
The following is a suggested communication checklist of notable issues for
education personnel to understand:
- Diagnoses and treatment
- Factors affecting attendance:
- frequency of outpatient visits
- frequency/duration of inpatient treatment
- fatigue
- Factors affecting social interaction:
- changes in physical appearance
- changes in motor skills
- medication induced mood changes
- changes in appetite, toileting, etc.
- Factors affecting learning:
- neuropsychological effects of treatments and medications
- changes in fine motor skills; or changes in vision and/or hearing
- limitations on physical activity
- fatigue
- headaches
- nausea
- Factors affecting medical care:
- medication to be administered at school
- medications to be avoided
- exposure to infectious diseases
- availability of school nurse to provide emergency care and troubleshoot
- Who to contact in case of emergency
Special Diets
USDA regulations (7 CFR Part 15b) require substitutions or modifications
in school meals for children whose disabilities restrict their diets. One way to
help in this process is to ask the child’s doctor to provide a signed statement
clearly defining:
- the child's disability;
- an explanation of why the disability restricts the child's diet;
- the major life activity/activities affected by the disability; and
- the food(s) to be omitted from the child's diet, and food or choice of foods that must be substituted.
Food allergies that may result in severe, life-threatening (anaphylactic)
reactions meet the definition for "disability", and must also be accommodated, with
your written statement. Check with the student’s school to determine the procedure
for notifying the school of dietary modifications including food allergies.
For more information and a sample form see: Accommodating Children with Special Dietary Needs in the School Nutrition Programs (
849 KB) from the U.S. Department of Agriculture, Food, and Nutrition
849 KB) from the U.S. Department of Agriculture, Food, and Nutrition
The School Nurse
One role of the school nurse is to bridge the gap between the worlds of
medicine/health care and education. Because of the nurse's license and educational
background, he/she is the only member of the school team to adequately address the
health needs and procedures that must be carried out in the school setting. Through
the IHP, the school nurse can plan for, describe, implement, and ultimately have
responsibility and accountability for the delivery of student nursing care at
school.
The state Nurse Practice Act will provide information about limitations.
School nurses should complete care plans on students who have a medical need, which
may be as simple as a child taking medication for ADHD while at school or more
complicated, like tracheostomy care. School nurses should also be included in the
IEP process.
Depending on the child's specific needs, if there is a Health Care Plan
that does not involve multiple specialties, the school nurse may complete it and
provide instruction to teachers and school staff.
If the student is determined eligible for special education, a
multi-disciplinary approach is needed where an IEP team will include the school
nurse in planning the student's academic/health needs. The school nurse should write
the Individualized Health Care Plan for the student. Check with your state school
nurse association, state education agency, or school district to find the nurse for
the student's school.
With the health needs in mind, nurses cannot be told what duties they can
delegate (or hand over) to another person (including unlicensed personnel). The
nurse has the legal license to determine what may be delegated and to whom it may be
delegated. While the nurse may delegate the duty to another person, the nurse still
retains the responsibility and accountability for it.
Nurses may assess, but not diagnose. Generally, state Nurse Practice Acts
allows the nurse to assess the medical situation and perform or delegate a specific
procedure that will be done in the school. The nurse can give advice on
incorporating the health needs of a student. For more information about your state
Nurse Practice Act, see Find Your Nurse Practice Act.
Resources
Information & Support
For Parents and Patients
Center for Parent Information and Resources
A large resource library related to children with disabilities. Locate organizations and agencies within each state that address
disability-related issues.
Find Your Parent Center
Parent Centers provide education and referrals for families with a child who has a disability, as well as the professionals
who work with them. There are almost 100 Parent Training and Information Centers (PTIs) and Community Parent Resource Centers
(CPRCs) in the US states and Territories; Center for Parent Information & Resources.
Find Your Nurse Practice Act
Links to Nurse Practice Acts of states and territories; National Council of State Boards of Nursing.
U.S. Department of Agriculture
General information from the official website of the U.S. Department of Agriculture.
Accommodating Children with Special Dietary Needs in the School Nutrition Programs ( 849 KB)
Gives a useful guide for nutrition accommodations, including information about modifying school meals for students with disabilities
and other dietary requirements such as food allergies. The site includes a sample Eating and Feeding Evaluation form to be
completed by the child's parent and physician and a sample Information Card for use by school food service staff in preparing
meals for the child. From the U.S. Department of Agriculture Food and Nutrition Service.
Food and Nutrition Service
General information from the U.S. government's official website on food and nutrition services.