Liam will be in Middle School Next year! Please check my Accommodations list below

Parenting a D-Child Child
1

Here’s the list (rather lengthy) of accommodations I’ve provided to the school. We have our 504 meeting this Friday for the 2025-26 school year where Liam will be entering the SIXTH GRADE! So hard to believe time has passed so fast.

Please review and provide feedback.

SPECIFIC ACCOMMODATIONS LIST FOR 504 PLAN for Middle School Year 2025 - 2026

  1. The student may check blood sugar level before an exam. If blood sugar is not in the normal range, the student may show the blood sugar number on the meter and take the test at a later date & time. The student will arrange to take the exam at the earliest convenience.

  2. If the student needs to take breaks to use the water fountain or restroom, check blood glucose, or to treat hypoglycemia or hyperglycemia until back to a normal blood glucose range, during a test or other activity, the student will be given extra time to finish the test or other activity without penalty

  3. The student will work with teachers on deadline extensions and/or shortening assignments if diabetes is affecting attendance

  4. The student shall be given instruction to help make up any classroom instruction missed due to diabetes care, without penalty

  5. The student shall not be penalized for absences required for medical appointments and/or for illness.

  6. The parent/guardian will provide documentation for appointments and exceptional illness from the treating health care professional if otherwise required by school policy. This Plan will constitute appropriate documentation for absences consequent to ongoing diabetes care such as prolonged night treatment of lows and highs, resulting in a lack of sleep for the student.

  7. Information on student’s diabetes (healthcare plan and 504 plan) will be included in all substitute teacher plans.

  8. A staff member trained in diabetes care will accompany the student on all field trips unless a parent/guardian is with the student

  9. Diabetic management may be done in the classroom, or other location of students preference (except in bathroom or at a location where the student may be jostled while performing care, e.g. at a locker in the hallway during passing time.)

  10. The student may carry a cell phone at all times to be able to contact parent/guardian regarding diabetes care and to manage diabetes – the phone is a medical device.

  11. The student may carry all supplies needed for diabetes care (drink, snack, glucose meter, insulin, etc.,) in a pack at all times

  12. If the student misbehaves in any way that could lead to disciplinary measures, the student’s Blood glucose must be checked immediately to verify the student is not currently experiencing hypoglycemia or hyperglycemia (both of which alter mental states and can impact a diabetics behavior.)

  13. The Student may, upon request, check his or her own Blood Glucose level at any time during class

  14. The student will be permitted to carry the following diabetes supplies and equipment with him or her at all times and in all locations: Insulin, snacks (including candy or other fast carb for low corrections), water, injection equipment, glucose monitoring equipment, glucagon kit, CGM and CGM monitoring and sharing equipment including smartwatch, and/or cell phone, insulin pump and control equipment if any, carry-on bag, other supplies as needed to provide services required

  15. Parent/guardian is responsible for providing all diabetes supplies and food to meet the needs of the student.

  16. The student shall have enough time to finish lunch

  17. The student shall be allowed to take part or all of lunch into later classes in order to properly manage blood glucose levels

  18. A snack and fast-acting source of glucose must always be immediately available to the student.

  19. The student will be permitted to eat a snack no matter where the student is

  20. Parent/guardian will provide all snacks needed in addition too or instead of any snacks supplied to all students.

  21. The School district shall provide carbohydrate content information for all meals provided by the school to be consumed by the student

  22. Parent/guardian will provide carbohydrate content information for snacks and meals brought from home

  23. The student shall be permitted to have immediate access to water by keeping a water bottle in the student’s possession and at the student’s desk as well as permitting the student to use the drinking fountain without restriction

  24. The student shall be permitted to use the bathroom without restriction

  25. The student shall be permitted face-to-face, electronic and phone / watch communications about diabetes care with parent/guardian and health care team without restriction

  26. The student shall be provided with privacy for blood glucose monitoring and insulin administration if the student so desires

  27. Whenever the student asks for assistance, or when any staff member believes the student is showing signs of high or low blood glucose levels that necessitate it, the staff member will immediately seek assistance from the school nurse while making sure another person stays with the student at all times

  28. The student with high, low, or SUSPECTED high or low, blood glucose levels should NEVER be sent alone to the nurse’s office or anywhere else. The student should have someone with them that is capable of holding up the student in the event the student loses consciousness and falls

  29. Any staff member who finds the student unconscious will immediately contact the school office. The office will immediately perform the following in the order listed:
    1. Contact the school nurse who will confirm the blood glucose level with a monitor and immediately administer Baqsimi. Baqsimi should be administered if no monitor is available.
    2. Call 911. Office staff will do without waiting for the school nurse to administer Baqsimi.
    3. Contact the student’s parent/guardian and physician at the emergency numbers provided.

  30. The student shall be permitted to participate in all school-sponsored field trips and extracurricular activities (such as sports, clubs, and enrichment programs) without restriction and with all the accommodations and modifications, including necessary supervision by identified school personnel

  31. If the student’s parent/guardian desires to accompany their student as a chaperone on any field trip or extracurricular activity, they will be permitted to do so and they will serve as the sole caregivers for the student and make all necessary decisions for their child during these events (immediate accommodation request).

  32. The student’s parent/guardian will not be required to accompany the student on field trips or any other school activity.

  33. The school nurse will be available on-site at all school-sponsored field trips and extracurricular activities and be prepared to perform the following activities:
    1. The school nurse will provide all usual aspects of diabetes care (including, but not limited to, blood glucose monitoring, responding to hyperglycemia and hypoglycemia, providing snacks and access to water and restrooms, and administering insulin and glucagon where required), ensure that the student’s diabetes supplies travel with the student and ensure parents are notified when supplies are running low.

  34. The school nurse and anyone else privy to the child’s diabetes will keep the student’s diabetes confidential, except to the extent that the student decides to openly communicate about it with others.

  35. The student shall be treated in such a way that does not isolate, singularize or stigmatize; rather, deal with diabetes treatment as the normal day-to-day activity that it is

  36. Every substitute teacher and substitute school nurse will be provided with written instructions regarding the student’s diabetes care and a be provided with a list of all school nurses, office numbers and phone numbers

  37. In the event of emergency evacuations or shelter-in-place situations (whether planned or naturally occurring due to a specific threat), the student’s 504 plan will remain in full force and effect

  38. During an emergency drill or shelter-in-place situation, the teacher or nurse will ensure they keep the student’s diabetes kit with them at all times:
    1. Parent/guardian should be notified immediately in any of the following situations Symptoms of severe low blood sugar such as extreme tiredness, seizure, or loss of consciousness
    2. Symptoms of severe high blood sugar such as the presence of ketones or vomiting,
    3. Any injury
    4. Insulin injection device or pump malfunctions that cannot be remedied
    5. Continuous Glucose Monitor “Sensor” or “Transmitter” come off of the student’s body.

  39. To support effective and safe management of students Type 1 Diabetes, the following technology-related accommodations must be provided by the school:
    1. Continuous Access to Personal Mobile Device: Student shall be permitted to carry and use their personal smartphone / watch or other glucose-monitoring device throughout the school day, including during class time, lunch, recess, and all extracurricular activities. The device must have continuous access to the school’s Wi-Fi network in order to maintain real-time data sharing with diabetes management platforms, such as Dexcom Clarity and Nightscout, so that nursing staff and parents are able to see real-time BG data, at all times.
    2. School Network Access for Nightscout Monitoring: The Nightscout website (For Liam, address is: his URL here) shall be added to the school district’s trusted or whitelisted domains to ensure uninterrupted access. The school nurse and/or other designated personnel must be able to access and monitor students blood glucose levels via Nightscout during school hours.
    3. Bypass of Internet Restrictions for Medical Devices: Any network-level filters, firewalls, or content blockers that may prevent the transmission of CGM data (e.g., from Dexcom Share, Nightscout, or similar services) must be bypassed for medical use. If necessary, the student’s device should be granted a secure exception or medical device profile to avoid connectivity issues.
    4. Uninterrupted Bluetooth and App Functionality: The student shall be permitted to keep Bluetooth and app-based functions active on their device at all times to ensure CGM-related alarms, alerts, and insulin pump data (if applicable) are available and functioning properly. This includes ensuring the phone is not required to be turned off if doing so would interfere with diabetes management apps, and care.
    5. Technical Point of Contact: A designated IT staff member shall be available to coordinate with the family and school nurse to resolve any technical issues related to device connectivity, Nightscout access, or data sharing disruptions as quickly as possible.

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I think it’s awesome that you’re planning ahead!

I don’t know anything about 504s personally. But I have a couple suggestions to maximize its usefulness as a frequently referenced document.

I’d put any emergency hypo/hyper protocols very first. I’d also recommend adding headings, and make sure everything is logically grouped together.

For example, you might use these suggested headings. Put them in whatever order makes most sense, such as by importance or frequency.

  • In Case of Diabetic Emergencies (27-29)
  • Student Rights for Everyday Care (9-10, 13-14, 23-25)
  • Deadlines, Exams, and other Timed Activities (1-4)
  • Excused Absences (5-6)
  • Food (15-22)
  • Extracurriculars and Field Trips (8, 30-33)
  • Confidentiality and Inclusion (12, 26, 34-35)
  • School Emergencies (37-38)
  • Technology (10, 25, 39)
  • Substitute Teachers (7, 36)

Good luck to Liam! I loved getting to choose my classes and extracurriculars in middle and high school. I hope it will be a great new chapter!

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This is great! Ty for the suggestions!

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It is very thorough and complete!

Only one thing to suggest. Perhaps some clarification here for what is considered “normal” range.

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Glad they have these today!!

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Very very thorough and it’s good you seem to have thought of everything and that took a lot of work but…

A little lengthy and kind of runs together. I found myself ignoring the stuff at the end. As mentioned by @RachelMaraii I would put at the beginning the important protocol like quick carbs and basqimi. And then the categories, I love her idea of the categories she listed. Things like field trips that aren’t as common as everyday necessities should have a separate listing. When you separate categories it makes it easier to read what is needed for each. This is what is needed for hypos etc, this is the technology needs etc.

Make it as easy as possible to go to the categories and see what is needed for each. At a scan, glance, someone can zero in on the needs.

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@ClaudnDaye I’ve looked thru your list and it seems very comprehensive, though I agree with @RachelMaraii about the categorization. I think a number of things need definition, like “a staff member trained in diabetes” is a bit vague unless there’s a common definition I’m not aware of. On the devil’s advocate side (and i don’t think any of this applies to Liam), I can see how some students becoming young adults could/would game the system, even while acknowledging needed limits, and take advantage of the accommodations. I’d expect some insertions by the school system to address perceived attempts to do so ( i.e. school’s rights and processes, contact with parent, discussion/warning with/to the child). Sorry if this causes anyone angst, but even the best of kids “push the envelope” about as far as possible at times and our “little angels” can wander off the “right path” (I’ve learned from my 9 year old grandson). It’s like trying to enforce a bed time or play time or dating, most of the time it works, sometimes it doesn’t, and it’s all part of the growing up process.

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The way it typically works is this long list is agreed too / included within his 504 plan. We discuss each and every bullet during our 504 session and “negotiate” until we agree on each. Usually there isn’t much negotiations…I say it and they nod, but they do have some questions about some which I explain rationale. I do agree that adding the categories will help keep things grouped neatly and I’m already working on that.

I appreciate all the great feedback!

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The schools and parents can revisit 504 if there are any issues. Last year, I had two meetings with the staff to clarify some 504 things we had in there. If they had issues with children abusing any of the 504 accommodations, I guarentee it would result in a conference between all the school staff, parents and student and, where applicable, the child would lose those “priveleges / accommodations”. Liam is an angel, though. :blush: He really is. Always doing his best, thinking the best of others, putting others first, he really is an amazing kid (I like to think all my kids are, though) and I’m not worried about him abusing the system. We teach him how he should be in life and it’s based on example he sees in his mom and dad. When a kid has a good role model, they’re less likely to abuse the system and others.

Did I mention Liam got a perfect 600 on his Math SOL this year also? That’s 3 years in a row for him to score perfect 600 on the Math SOL. This year, he was the only one in 5th grade to get any perfect score on any SOL. Yes, I’m a proud papa. :stuck_out_tongue:

I have re-done the accommodations list based on all the feedback received. Let me know what you all think of the re-design?

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1. In Case of Diabetic Emergencies

1.1. Whenever the student asks for assistance, or when any staff member believes the student is showing signs of high or low blood glucose levels that necessitate it, the staff member will immediately seek assistance from the school nurse while ensuring another person stays with the student at all times.

1.2. The student with high, low, or suspected high or low blood glucose levels should never be sent alone to the nurse’s office or anywhere else. The student must be accompanied by someone capable of supporting the student in case of a fall or loss of consciousness.

1.3. Any staff member who finds the student unconscious will immediately contact the school office. The office will:

  • Contact the school nurse to confirm blood glucose level and administer Baqsimi. Baqsimi should be administered if no monitor is available.
  • Call 911 without delay, even before Baqsimi is administered.
  • Contact the student’s parent/guardian and physician using the provided emergency numbers.

2. Student Rights for Everyday Care

2.1. Diabetes management may be done in the classroom or other location of the student’s preference, excluding unsafe or unsanitary locations such as restrooms or hallways during passing time.

2.2. The student may carry a cell phone at all times to contact a parent/guardian and manage diabetes. The phone is considered a medical device.

2.3. The student may check blood glucose at any time during class.

2.4. The student may carry at all times: insulin, snacks (including candy/fast carbs), water, injection equipment, glucose monitor, glucagon, CGM and related devices, insulin pump, and any necessary diabetes supplies.

2.5. The student shall have immediate access to water by keeping a water bottle with them and using the water fountain without restriction.

2.6. The student shall be permitted unrestricted access to the bathroom.

2.7. The student shall be permitted face-to-face, electronic, and phone/watch communications about diabetes care with parent/guardian and healthcare team without restriction.

3. Deadlines, Exams, and Other Timed Activities

3.1. The student may check blood sugar before exams. If levels are not in range (80 – 180), the student may show the reading and reschedule the exam for the earliest convenience.

3.2. The student will be allowed extra time to complete any test or activity if breaks are needed due to diabetes care.

3.3. The student will work with teachers on extensions and/or shortened assignments if diabetes impacts attendance.

3.4. The student shall be provided instruction to make up missed classroom content due to diabetes care without penalty.

4. Excused Absences

4.1. The student shall not be penalized for absences related to medical appointments or diabetes-related illness.

4.2. The parent/guardian will provide documentation when required. This 504 Plan also serves as documentation for absences due to diabetes-related issues like overnight treatment of highs/lows that result in sleep loss.

5. Food

5.1. Parent/guardian is responsible for providing all required diabetes supplies and food.

5.2. The student shall have sufficient time to finish lunch.

5.3. The student may take lunch into later classes to manage blood glucose properly.

5.4. A snack and fast-acting glucose source must be immediately available to the student at all times.

5.5. The student may eat a snack wherever they are, without restriction.

5.6. Parent/guardian will provide snacks in addition to or instead of snacks provided to all students.

5.7. The school district shall provide carbohydrate content for all meals consumed by the student.

5.8. Parent/guardian will provide carb information for snacks or meals brought from home.

6. Extracurriculars and Field Trips

6.1. A staff member trained in diabetes care will accompany the student on all field trips unless a parent/guardian is present.

6.2. The student will be permitted to fully participate in all field trips, sports, clubs, and school-sponsored events with accommodations and support as needed.

6.3. Parent/guardian may attend any field trip or extracurricular event and serve as the sole caregiver during the event.

6.4. Parent/guardian will not be required to attend field trips or events for the student to participate.

6.5. The school nurse will be available on-site at all events and must:

  • Provide all usual diabetes care
  • Ensure diabetes supplies are brought along
  • Notify parents when supplies are running low

7. Confidentiality and Inclusion

7.1. If the student misbehaves in a way that may lead to discipline, blood glucose must be checked first to rule out a diabetes-related cause.

7.2. The student will be provided privacy for blood glucose monitoring and insulin administration upon request.

7.3. School nurse and other privy staff must keep diabetes-related information confidential, unless the student chooses to share.

7.4. The student will be treated in a way that avoids isolation or stigmatization; diabetes care will be normalized as a daily routine.

8. School Emergencies

8.1. The 504 Plan remains in full effect during emergency evacuations or shelter-in-place scenarios.

8.2. During emergency drills or lockdowns, the teacher or nurse will ensure the student’s diabetes kit remains with them at all times. Parents/guardians will be notified immediately in the following cases:

Symptoms of severe low or high blood sugar (e.g., vomiting, extreme fatigue, seizure, unconsciousness)
Injury
Device malfunction (insulin pump or CGM) that cannot be fixed
CGM sensor/transmitter comes off

9. Technology

9.1. The student shall be permitted to carry and use personal smartphone/watch or other CGM devices at all times, including during class, lunch, and extracurriculars.

9.2. The school must whitelist the Nightscout site (e.g., his URL here) for uninterrupted access.

9.3. Medical device data must not be blocked by firewalls or content filters. Devices should receive an exemption from such restrictions.

9.4. Bluetooth and app-based CGM functionality must remain active at all times. Student is not required to turn off phone or apps if doing so impacts diabetes care.

9.5. A designated IT staff member shall be available to work with the family and nurse to resolve any technical issues affecting diabetes device connectivity or access to monitoring tools.

10. Substitute Teachers

10.1. All substitute teacher lesson plans will include the student’s 504 and diabetes healthcare plan.

10.2. All substitute teachers and substitute nurses will be given written diabetes care instructions, and a list of school nurses and their contact numbers.

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Much much better! It makes it a lot easier to understand laid out in categories like this!!!

Some kids are actually angels. But I think every kid at some point pulls things. The smartest kids can figure it out easier when inclined!

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I just read of a middle school T1’s experience now an adult. They had to keep their insulin vial and syringe in the nurse’s office. There he would inject himself in the presence of the nurse.

Because of budget cuts the nurse was reduced to half a day in his school. He needed to have access to his stuff which was locked up. The office refused to unlock the door.

Resourceful kid he was he went to the pay phone dialed 911, and said, “I have T1 diabetes and I need my insulin now. It’s behind a locked door at school, and they won’t unlock it.”

Shortly a fire truck pulls up with the crew carrying their axes. The person who wouldn’t open the door wanted to know what’s going on. We are going to open this door so this young man doesn’t have a medical emergency. She couldn’t find her keys fast enough.

After that he was allowed to have his insulin and syringe with him.

Might sound fanciful, but I have personal experiences with lower level administrators that act as my Dad would say, the little NAZI. A little authority displaces their good sense.

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I am very Nazi when it comes to my child’s care and I accept no less than the best from the staff. We are a team and we all (including Liam) must play their role for it to work. 2 legged stools some remain upright very long.

When they pull me into a meeting, they know they need to know what they are talking about or they will be challenged.

@Liam-M attends these 504 meetings as well because I want him to witness the authority I (and he) must bring to these sessions. We have the law behind us.

Staff only “thinks” they have the authority. They require being rewired. With DMMP, 504 puts the authority in the parents and children’s hands according to The federal laws currently in place… Americans with Disabilities Act (ADA) – Particularly Title II, Section 504 of the Rehabilitation Act of 1973 and the Family Educational Rights and Privacy Act (FERPA)

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I disagree, you are doing the right things for Liam. NAZIs do the wrong things because they can and it gives them a sense of bigness. They are actually very small people.

Keep it up, and we are all proud of Liam who at his young age is taking control of his diabetes, TCOYD🤩

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When I’m in a room with 10 school staff…you better believe they see me as Nazi where my son’s care is concerned. Lol

1 against 10? No problem,

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