Education and Health Plans

An Individual Health Plan (IHP) may be used to help children and teens with special healthcare needs when they return to school after a cancer diagnosis. This type of plan addresses the student’s medical needs while they are in the school setting and focuses on the care needed to promote their health.

The IHP typically does not include non-health related services or accommodations, but it can be included as part of a student’s Individualized Education Plan (IEP) or 504 Plan. It could be helpful to consider having these educational plans in place because the IHP is also not a legal document, so the school does not have to abide by it. However, the 504 Plan and IEP are legal documents.

The Individual Health Plan is important because it:

1. 1. Identifies the medical needs of the student and medical procedures that may be performed at school
2. 2. Outlines the services provided by the school nurse and school staff
3. 3. Provides information regarding how the student’s needs will be met to achieve the student’s health
4. 4. Can include an emergency or safety plan

Schools are required to have individual health care plans for students with special health care needs and policies that allow students to self-monitor and self-administer medication under certain conditions as stated by the South Carolina Department of Education (Sections 59-63-80 and 59-63-90 SC Code of Laws).

Educational plans such as a 504 Plan or an Individualized Education Program (IEP) are available to parents and educators providing support services at school.

An educational plan helps to address the needs of children and teens returning to school after a cancer diagnosis. It identifies the accommodations and assistance a child can receive as they transition back to school and experience side effects and challenges from treatment. This plan also helps to promote a better environment for the student to learn.

A 504 Plan provides educational accommodations to students whose ability to learn is significantly impacted by physical or mental impairments that limit their major life activities. The purpose of this plan is to remove barriers to learning for students and provide equal access to education for all students in school.

Sample 504 Plan Accommodations:

• Increased time on exams
• Breaks during physical education
• Reduced amount of assignments
• Unlimited access to the bathroom
• Procedures for allergies
• Scheduled rest times
• Use of headphones during class instruction

An Individualized Education Program (IEP) is a formal plan that involves access to specifically designed instruction, measurable goals, classroom accommodations, and supportive educational services. These goals are reviewed yearly to measure a student’s progress, and regular progress reports made. Students must be determined eligible to have an IEP.

Sample IEP Accommodations:

• Testing with minimal distractions
• Extended time for testing and assignments
• Smaller class sizes
• Allowing typed or recorded audio responses to classwork
• Allowing access to restrooms throughout the day
• Access to recorded lecture audio or video

Other Supportive Services:

• Speech/language therapy
• Physical therapy
• Occupational therapy
• Specialized transportation
• Mental health counseling
• Academic enrichment classes
• Homebound Instruction

Resources

View a guide to IEP and 504 plans for parents to learn more about how to request and receive the appropriate educational services for a child or teen.

Use the Parent 504 Plan Letter as a template when requesting a meeting to develop and implement a 504 Plan. Send this letter to the teacher and guidance counselor. You may also choose to include administration (principal/assistant principal), instructional coach, nurse, and/or special education coordinator.

Learn about IEP Accommodations including who can receive IEP accommodations, common categories of IEP accommodations, and how these can be useful to a student.

View examples of 504 Plan Accommodations and Modifications for children and teens who can receive support services from their school under their 504 Plan.

Learn about the differences between IEPs and 504 plans used for K-12 students using this table.

Use this list to find common accommodations for IEPs and 504 plans.

There are differences between the IHP, 504 Plan, and IEP. Understanding the applications and restrictions of each plan can help determine which plan(s) will help a child or teen most effectively at school.

Resources

View a comparison chart of school 504 Plans, Individualized Education Plans, and Individual Health Plans to learn more about the difference between these education and health plans.

Use this article to learn how school nurses can aid in assisting students at school with their education and health plans.

Students who are making good grades and are academically successful can still be eligible for a 504 Plan. Even if a student is in a gifted or accelerated class, they may have a 504 Plan if their impairment largely limits one or more of their major life activities. The late effects of treatment can largely limit the major life activity of learning.

Major life activities describe functions that are important in most people’s daily life.

These activities include:

• Self-Care
• Thinking and Reasoning
• Manual Tasks
• Learning
• Walking
• Breathing
• Seeing
• Concentrating
• Hearing
• Interacting
• Speaking
• Working
• Sitting
• Sleeping
• Talking
• Performing Manual Tasks

IDEA, Individuals with Disabilities Education Act, is a federal law that makes free appropriate public education available to eligible children and teens with disabilities, allowing them to have access to special education and related services. Children and teens must be evaluated to determine if they qualify for special education and related services provided under IDEA.

Evaluations can include:

• Medical evaluations
• Psychological evaluations
• Educational evaluations
• Social history evaluations
• Speech language evaluations
• Physical therapy evaulations
• Occupational therapy evaluations
• Assistive technology evaluations
• Classroom observation

There are 13 handicapping conditions under IDEA, and children and teens with childhood cancer who need special education services often qualify under the handicapping condition of “Other Health Impairment.” However, if the child is experiencing other challenges due to treatment, another condition may be used.

Other Health Impairment (OHI) means having limited strength, vitality or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that is due to chronic or acute health problems such as asthma, Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD), diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette’s syndrome and adversely affects a student’s educational performance.

Other Health Impairment Criteria

1. 1. There is evidence that the child has a chronic or acute health problem.
2. 2. There is evidence that the diagnosed chronic or acute health problem results in limited alertness to the educational environment due to limited strength, limited vitality, limited or heightened alertness to the surrounding environment.
3. 3. The adverse effects of the other health impairment on the child’s educational performance require specialized instruction and/or related services.

Where would you find the evidence to meet the disability criteria?

Evidence of a chronic or acute health problem may be found in the following required evaluation components:

• A comprehensive written report from a licensed physician documenting a diagnosis of the chronic or acute health problem
• Documentation that the student’s observable school and/or classroom problem behaviors related to ADHD are occurring at a significantly different rate, intensity, or duration than the substantial majority of typical school peers
• Evidence that the diagnosed chronic or acute health problem results in limited alertness to the educational environment due to limited strength, limited vitality, limited or heightened alertness to the surrounding environment (achievement tests determine if the student is not working on grade level)
• The medical diagnosis may not be used as the sole criterion for determining eligibility
• The Other Health Impairment adversely affects the child’s educational performance requiring specialized instruction and/or related services
• A team discussion on the adverse effects of the cancer/treatment as it relates to school work

Who must be involved in this process?

The multidisciplinary evaluation team must include the members of the IEP team and other qualified professionals, as appropriate.