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Keeping a food-allergic child safe and included in all school activities requires considerable planning. But fortunately, you do not have to go it alone. Thanita Glancey, president of the Loudoun Allergy Network in Virginia, has gained expertise in school allergy accommodations through years of advocacy work. She walks us through the steps that are essential to making sure your child’s school is safe, inclusive, and has the right emergency response procedures in place.
1. Know the local rules
Find out if your school district has a food allergy management policy or guidelines. As well, check your state department of education for allergy policies or law.
See: www.allergicliving.com/stateschools 
2. Get an Allergy Action Plan
Have your allergist complete an Allergy Action Plan (AAP), also referred to as a Food Allergy Action Plan (FAAP) . This is the medical form for the school that will itemize a student’s allergies and medications, how to recognize and treat mild and severe allergic reactions, and state the emergency protocol to follow.
3. Develop the accommodation plans
Think of these as a “how to” manual for caring for your allergic child. Following are the key ones:
• The Individual Health Care Plan (IHCP) – also referred to as a Health Care Plan (HCP), this plan documents the accommodations required to keep the allergic child safe in the school setting. The preparation of the IHCP is a team effort between the parent and the school nurse or an identified staff member or the district health department. Be prepared with your suggested accommodations for the initial discussions. It may also be helpful to take the school’s suggested accommodations to your allergist for discussion. All students with medical conditions should have an IHCP/HCP.
• The 504 Plan – named for Section 504  of the Rehabilitation Act, this document addresses equal access to education for students with disabilities, which public schools must provide. Food-allergic students can fall under this law’s auspices since food allergies qualify as an impairment of “major life activities” (e.g. eating, breathing, caring for oneself). Public school students with disabilities must be allowed to participate in both academic and non-academic activities, including meals, recess and physical education to the “maximum extent appropriate” to their individual needs.
Parents should make a request, in writing, for a 504 Plan for their child to the 504 coordinator for the school. This may be the principal, assistant principal or an employee at the school district level, so first call your school to identify the coordinator. The written request should both describe the impairment (list the food allergies) and state the reason for the request: to avoid the risk of life-threatening anaphylaxis and to provide equal access to education. It is helpful to have the allergist write a letter detailing this information.
I encourage families who have children with food allergies to obtain a 504 Plan, since it assists the staff in understanding how to manage the allergy, while keeping the student included in all activities. It also helps the school avoid finding itself in an anti-discrimination violation.
• The USDA Physician’s Statement for Students with Special Dietary Needs – provides non-discriminatory regulations and regulates the National School Lunch and Breakfast programs. It mandates substitutions to the regular meal for children who are unable to eat school meals because of disabilities. View it here .
4. Schedule meetings
You’ll likely have several meetings in the course of developing a comprehensive plan for your allergic student. The first may be one to develop the plan, and another will be to review it with staff. Some schools will require a separate meeting to determine 504 eligibility before proceeding to the accommodations. To develop the IHCP and 504 plans, request a meeting via e-mail so you have documentation. Send the request to the principal and copy the assistant principal and school nurse.
The 504 Plan committee is composed of individuals with knowledge of the student, typically the parent, the 504 coordinator, the principal or assistant principal, the school or district nurse and the teacher. Meetings for an IHCP and 504 Plan can occur on the same day, but discussions of the details for each should be separate. It may also simply be stated that the 504 Plan includes accommodations stated in the IHCP. The general idea is, if the student’s environment is safe, the student can access education and activities provided by the school to non-disabled peers.
After the student’s plan has been finalized, a meeting with the staff should occur. This allows you to field specific questions about your child’s allergies.
Next: Topics to Discuss: Food Notice, Field Trips, the Bus
5. Negotiate accommodations
It’s worth specifying that accommodations must address every environment that your child will encounter. Before the IHCP or 504 Plan meeting, develop a list of proposed accommodations. If you plan to share the list, be sure to have enough copies for everyone in attendance.
6. Review annually
The plans will need to be reviewed and possibly updated. For example, a new school year in a different grade may present new challenges. The higher grade levels may take part in activities that could be a risk for a food-allergic student.
Topics to Discuss with the School:
• Food-free classrooms: These are the preferred option since keeping the classroom free from food significantly reduces the risk of allergen cross-contamination, food sharing (with young pupils) and inadvertent ingestion.
• Auto-injector locations. Determine in discussions whether your child will self-carry or if the teacher will carry it in the emergency pack from class to class. Another set is likely stored in the nurse’s office.
• Food notice: Request three-to-five school days of notification time prior to food being brought into the classroom. This allows parents adequate time to research foods, call manufacturers (if needed), suggest alternatives and discuss the safe food options with their child.
• Unsafe supplies: In the classroom, the school can also eliminate allergen-containing products, such as soaps, wipes and art supplies). Ideally, you review these before the start of the school year. Your child’s teacher may be able to swap out unsafe products with another class.
• Know your rights: You are not required to supply the entire class with safe products. When your child has a 504 Plan, free and appropriate education must be made at no expense to the parents, unless fees are equally imposed on non-disabled students.
• Field trips: Parents of allergic students must be notified in the early planning stages about the location of the field trip to address any concerns for allergen exposure. For example, a visit to a milk-chocolate plant would not be an inclusive trip for the student with a dairy allergy. (The basis of the 504 Plan is to be sure that students with disabilities have equal access with their peers.) It is essential that the allergic child is in the care of an adult who is trained to avoid, recognize and treat allergic reactions during field trips.
• The school bus: Either the bus driver or an aide on the bus needs to be trained on how to recognize and treat an allergic reaction. A firm “no eating on the bus” policy must be communicated and enforced. Discuss where the auto-injector will be kept. In many cases, the child self-carries and the driver will be notified as to the location of the auto-injector. (Most often in the child’s backpack). Substitute bus drivers and aides will need to have the same training. Discuss where a child will sit on the bus. A younger child should sit near the bus driver or an aide.
• Cafeteria: Since there is no such thing as a truly “allergy-free” table, an “allergy-friendly” table may be set up for your child. The school will need to address the different needs of all of the food-allergic students. For example, a peanut-allergic child may sit at a “peanut-free” table, but his peanut-allergic friend may also have a dairy allergy. School administrators need to minimize the risk of accidental exposures to those with multiple food allergies.
Depending on your child’s age, he/she may sit at the classroom table with a “buffer” of students between those eating the allergens and your child. In some schools, the allergic child sits at the end of the table to reduce the chance of exposure to food allergens, without completely isolating the child.
These steps give you ideas to consider as you work with your child’s school on accommodations. Knowing that your child is well cared for physically and emotionally is well worth the effort.
Thanita Glancey, president of the Loudoun Allergy Network,  has two children with life-threatening allergies.