Appendixes

Appendix A

Suggested Roles and Responsibilities 

Specific individual’s roles and responsibilities in the management of students with life-threatening allergies have been determined for:

• Students with Life-Threatening Food Allergies 
• Parent of a Student with Food Allergies 
• School Nurse 
• School Administrators 
• Classroom Teacher/Specialist 
• School Psychologist 
• Food Service Personnel 
• School Bus Company 
• School Medical Advisor 
• Coaches and Other On-site Persons in Charge of Conducting After-school Activities

The following is adapted from Managing Life Threatening Food Allergies in Schools, 2002, Massachusetts Department of Education. 

Students with Life-Threatening Food Allergies

Students with life-threatening food allergies should be encouraged, trained and supported, when appropriate, to participate in and be responsible for the management of their allergic conditions.  
Students should: 

• learn to recognize symptoms of an allergic reaction; 
• promptly inform an adult as soon as accidental exposure occurs or symptoms appear.  Ask a friend to help you if you cannot get to an adult; 
• follow safety measures established by your parent(s)/guardian(s) and school team at all times; 
• not trade or share foods with anyone; 
• not eat any food item that has not come from home or been approved by a parent or guardian; 
• wash hands before and after eating; 
• develop a rapport with the school nurse or another trusted adult in the school to assist with the successful management of the allergy in school; 
• if approved by your parent and authorized by your physician, carry your epinephrine auto-injector all times; and 
• report any instances of teasing or bullying to an adult immediately. 

Parent of a Student with Food Allergies

• Inform the school nurse of your child’s allergies prior to the opening of school (or as soon as possible after a diagnosis). 
• Provide the school nurse with health information from your health care provider. 
• Provide the school nurse with medication orders from the licensed provider. 
• Participate in developing an Individualized Health Care Plan (IHCP) with the school nurse and school team. 
• Provide the school nurse with at least annual updates on your child’s allergy status. 
• Provide the school nurse with written permission to communicate with your health care provider. 
• Provide the school with at least two up-to-date epinephrine auto-injectors. 
• Provide the school nurse with the licensed provider’s statement if student no longer has allergies. 
• Provide the school with a way to reach you (cell phone, beeper, etc.). 
• Provide a list of foods and ingredients to avoid. 
• Consider providing a medical alert bracelet for your child. 
• Be willing to go on your child’s field trips if possible and if requested. 
• Review the list of student responsibilities with your child and be sure he/she understands his role.

It is important that children take on more responsibility for their food aller­gies as they grow older and are developmentally ready. Consider teaching them to: 

• Carry own epinephrine auto-injector. 
• Communicate the seriousness of the allergy. 
• Communicate symptoms as they appear. 
• Read labels. 
• Recognize potentially dangerous situations and make good safety decisions. 
• Administer own epinephrine auto-injector and be able to train others in its use. 

Remember – the ultimate goal is that our children eventually learn to keep themselves safe by making good choices and advocating for themselves. 

School Administrator

• Include in the school district’s emergency response plan a written plan outlining emergency procedures for managing life-threatening allergic reactions. Develop procedures to assist schools at each level (elementary, middle and high) to adapt or modify the plan to meet special needs of individual students. Consider risk reduction for life-threatening allergies. 
• Support faculty, staff and parents in implementing all aspects of the life-threatening allergy management plan. Provide training and education for faculty and staff regarding: 
  • Anaphylaxis and anaphylactic reactions to foods, insect stings, medications, latex 
  • Risk reduction procedures 
  • Emergency procedures 
  • How to administer an epinephrine auto-injector in an emergency 
  • Cafeteria management and food preparation for food service personnel
• Provide emergency communication devices (e.g., two-way radio, intercom, walkie-talkie, cell phone) for all school activities, including transportation, that involve a student with life-threatening allergies. 
• Consider requesting a full-time nurse at your school to meet the needs of students with life-threatening allergies and other students in the school. 
• Have a plan in place when there is no school nurse available including that at least three staff members that are trained in the recognition of early symptoms of anaphylaxis and in medication administration. 
• Inform parent/guardian if any student experiences an allergic reaction. 
• Make sure that plans include notification and training, as indicated, of substitute teachers, nurses or food service personnel. 
• Ensure that the students with life-threatening food allergies are placed in classrooms where teachers are trained to administer an epinephrine auto-injector, if needed. 
• Provide guidance on district-wide issues such as transportation.

School Nurse

• Prior to entry into school (or, for a student who is already in school, immediately after the diagnosis of a life-threatening allergic condition), meet with the student’s parent/guardian to develop a draft of an Individual Health Care Plan (IHCP). 
• Assure that the ECP includes the student’s name, photo, allergen, and symp­toms of allergic reactions, risk reduction procedures, emergency procedures and that it is distributed to all appropriate staff. 
• Arrange and convene a team meeting, if possible before the opening of school to finalize the IHCP.  
• After the team meeting, review the plan with the parent and student. 
• Familiarize teachers with the ECPs and IHCPs of their students by the opening of school, or as soon as the plans are written.  Other staff members who have contact with students with life-threatening allergies should be familiar with their IHCPs and ECPs on a need-to-know basis including principal, school medical advisor, specialists, food service personnel, aides, physical education teacher, art and music teachers, custo­dian, bus driver, local EMS.. 
• Provide information about students with life-threatening allergies and their photos (if consent given) to all staff on a need-to-know basis (including bus drivers, substitute teachers and other new staff members). 
• Conduct education for appropriate staff regarding a student’s life-threatening allergens, symptoms, risk reduction procedures, emergency procedures, and how to administer an epinephrine auto-injector. 
• Implement a periodic anaphylaxis drill similar to a fire drill as part of periodic refresher courses. 
• Track education of all involved parties to ensure that they have been properly trained and updated. 
• Introduce yourself to the student and show him/her how to get to the nurse’s office. 
• Post individualized plans as appropriate and have available all IHCPs and ECPs in an easily accessible place in the nurse’s office.  Post locations of epinephrine auto-injector. 
• Periodically check medications for expiration dates and arrange for them to be current. 
• Arrange periodic follow-up to review effectiveness of the IHCP, at least on an annual basis, or as often as necessary. 
• Make sure that substitute school nurses are fully oriented to students with life-threatening food allergies and their care plans. 
• Communicate with parents on a regular basis.

Classroom Teacher/Specialist

• Participate in the development of the student’s IHCP and ECP (as core team member). 
• Review and follow the ECP and IHCP of any student(s) in your classroom with life-threatening allergies. 
• Keep accessible the student’s ECP and IHCP with photo (if consent is given) in classroom or with the lesson plan. 
• Always act immediately and follow the ECP if a student reports signs of an allergic reaction. 
• Never allow a child you suspect of having an allergic reaction to walk alone to the school nurse. 
• Request that the classroom has a functioning intercom, walkie-talkie or other communication device for communication with the school nurse. 
• Be sure volunteers, student teachers, aides, specialists and substitute teach­ers are informed of the student’s food allergies and necessary safeguards. 
• Leave information in an organized, prominent and accessible format for substitute teachers. 
• Consider coordinating with parent and school nurse a lesson plan about food allergies and anaphylaxis in age appropriate terms for the class. 
• Educate classmates to avoid endangering, isolating, stigmatizing or harass­ing students with food allergies. Be aware of how the student with food allergies is being treated; use this opportunity to teach community caring; and enforce school rules/policies about bullying and threats.  
• Work with the school nurse to educate other parents about the presence and needs of the child with life-threatening allergies in the classroom.  Enlist their help in keeping allergic foods out of the classroom. 
• Inform parents of children with life-threatening food allergies of any school events where food will be served. 
• Participate with the planning for student’s re-entry to school after an anaphylactic reaction. 
  • A. SNACKS/LUNCHTIME 
    • Prohibit students from sharing or trading snacks. 
    • Avoid cross-contamination of foods by wiping down eating surfaces with soap and water before and after eating as applicable. Tables should also be washed with soap and water in the morning if an after-school event has been held in the classroom the day before. 
    • Reinforce hand-washing before and after eating. 
  • B.  CLASSROOM ACTIVITIES 
    • Avoid use of allergenic foods for classroom activities (e.g., arts and crafts, counting, science projects, parties, holidays and celebrations, cooking, pet foods or other projects). 
    • Welcome parental involvement in organizing class parties and special events. 
    • Consider non-food treats for rewards and incentives. 
  • C. FIELD TRIPS 
  • Collaborating with the school nurse and parents, prior to planning a field trip to: 
    • Plan ahead for risk avoidance at the destination and during transportation to and from the destination. 
    • Review plans when selecting field trip destinations; avoid high-risk places.  
    • Ensure the epinephrine auto-injectors and instructions are taken on field trips and remain with the student or in the care of the trained adult during the course of the field trip. 
    • Ensure that functioning two-way radio, walkie-talkie, cell phone or other communication device is taken on field trip and that there are adults present who are trained in the administration of an epinephrine auto-injector. 
    • Ensure that the child with life-threatening food allergies is assigned to staff who are trained in recognizing symptoms of life-threatening allergic reactions, trained to use an epinephrine auto-injector, and trained in emergency procedures. 
    • Consider eating situations on field trips and plan for prevention of exposure to the student’s life-threatening foods. 
    • Consider ways to wash hands before and after eating (e.g., provision of hand wipes, etc.). 
    • Know where the closest medical facilities are located, 911 procedures and whether the ambulance carries epinephrine and EMTs are certified to administer epinephrine. 
    • Invite parents of a student at risk for anaphylaxis to accompany their child on field trips, in addition to the chaperone.  However, the student’s safety or attendance must not be conditioned on the parent’s presence.

School Psychologist

• Participate in the development of the student’s IHCP and ECP (as core team member). 
• Assist with staff training, especially around staff anxiety in caring for students with life-threatening food allergies. 
• Monitor anxiety, stress level, and social development of students with life-threatening food allergies and provide interventions as appropriate. 
• Act as a resource to parents and students regarding anxiety, stress and normal development. 
• Educate classmates to avoid endangering, isolating, stigmatizing or harass­ing students with food allergies. Be aware of how the student with food allergies is being treated; use this opportunity to teach community caring; and enforce school rules/policies about bullying and threats.  

Food Service Personnel

• Participate in the team meeting with appropriate members for entry into school as appropriate. 
• Post the student’s ECP with consent of parent(s). 
• Establish procedures to follow to ensure that students with life-threatening food allergies select only those foods identified and approved by their parent(s). 
• Ensure that all food service staff and their substitutes and cafeteria monitors are trained to recognize the signs and symptoms of an allergic reaction and what to do in the event of a reaction. 
• Maintain contact information for manufacturers of food products (e.g., Consumer Hotline) and make available to parents on request. 
• Provide parents with food labels as requested. 
• Provide advance copies of the menu to parents/guardian and notification if menu is changed. 
• Review and follow sound food handling and food preparation practices to avoid cross-contact with potential food allergens. 
• Establish policies in collaboration with school administration for the cafeteria regarding students with life-threatening food allergies. 
• Create specific areas that will be allergen safe, as needed. 
• Strictly follow cleaning and sanitation protocols to avoid cross-contact. 
• Thoroughly clean all tables, chairs and floors after each meal. 
• Make required food substitutions with documentation signed by licensed physician. In order to make appropriate substitutions or modifications for meals served to students with life-threatening food allergies, the physician’s statement must identify the student’s disability (as defined under USDA guidelines), why the disability restricts their diet, the food or foods to be omitted from the student’s diet and the food or foods to be substituted . 
• Plan ahead to have safe meals for field trips. 
• Avoid the use of latex gloves by food service personnel.  Use non-latex gloves instead. 
• Know how to access epinephrine auto-injector(s) or summon school nurse immediately. 
• Have a functioning intercom, walkie-talkie or other communication device to support emergencies. 
• Take all complaints seriously from any student with a life-threatening allergy. 
• Be prepared to take emergency action and follow student’s ECP. 

School Bus Company

• Provide education for all school bus drivers regarding life-threatening aller­gies (provide own training or contract with school) and what to do if they suspect a student is having a reaction. 
• Provide education for school bus drivers on specific children, when appropriate. 
• Provide functioning emergency communication device (e.g., cell phone, two-way radio, walkie-talkie or similar). 
• Know local Emergency Medical Services procedures. 
• Maintain policy of not allowing foods or beverages to be consumed on school buses. 
• Provide school bus dispatcher with list of students with life-threatening food allergies by bus/van number and instructions for activating the EMS system 
• Plan ahead for informing substitute bus drivers of students with life-threatening food allergies. 

School Medical Advisor

• Provide consultation to and collaborate with school nurse(s) on clinical issues and protocols which may include: 
  • Standing orders for emergency medication including epinephrine; and 
  • Policy recommendations for emergency interventions (for known and unknown reactors) in cases of anaphylaxis.
• Guide the district in the development of procedures for prevention of anaphylaxis and emergency planning to ensure safety without undue interference with a child’s normal development or right of others. 
• Participate in staff training regarding life-threatening food allergies. 
• Attend IHP planning meetings when requested by the school administrator. 
• Assist in the development of educational programs for students to promote wellness. 
• Facilitate community involvement by encouraging development of and participation in school health advisory committee or healthy school policy team. 
• Communicate with other community physicians regarding school district policy, procedures and clinical protocols for managing food allergies. 
• Act as a liaison, if necessary, with the media should controversies or opportunities for education occur.

Coaches and Other On-site Persons in Charge of Conducting After-school Activities

• Participate in team meetings to determine how to implement students Individual Health Care Plan. 
• Conduct sports and after school activities in accordance with all school policies and procedures regarding life threatening allergies. 
• With parent’s consent, keep a copy of the Emergency Care Plan and photo of students (if consent is given) with life-threatening allergies. 
• Make certain that emergency communication device (e.g., walkie-talkie, intercom, cell phone, etc.) is always present. 
• Ensure that at least one but ideally two people during activity who have been trained to administer an epinephrine auto-injector. 
• Maintain a current epinephrine auto-injector in the first aid kit. 
• Know EMS procedures and how to access the EMS system from the site of the after school activity or event. 
• Clearly identify who is responsible for maintaining the first aid kit, if appropriate.

Remind the student to replace his/her medical alert identifica­tion immediately after the activity is completed if for safety reasons it needs to be removed during a specific activity. 

Appendix B

Frequently Asked Questions

1. Does the health care provider have to sign off on each and every accommodation detailed in a child’s IHCP, 504 plan or ECP? 

   The health care provider plays a significant role on the team by providing accurate and current medical information, providing the emergency protocol and signing the appropriate medication administration forms. The health care provider, however, is often unfamiliar with the day to day operations of the school and may not be in the position to recommend or sign-off on each and every accommodation especially since some accommodations are more educational in nature rather than medical.  

2. Does the school team have to include all recommendations from the health care provider? 

   Medical/therapeutic recommendations should be accepted by the school team unless they are outside the acceptable standard of care. Suggestions and recommendations that affect the educational program and school operations from the health care provider should be welcomed and considered carefully; however they need to be decided on by the school team. Open communication between the family, the school staff and health care provider is recommended to develop a plan that meets the individual student’s need and takes into consideration each school’s unique environment. However, consideration should be given to any suggestions and requests the provider has concerning the student.

3. When a classroom is designated as “peanut-free” and a parent complains that his/her child likes peanut butter crackers for snack, how should I respond? 

   All children have the right to learn in an environment that is safe. It is sometimes necessary to designate a classroom as “peanut or other allergen-free” to reduce the risk of accidental exposure for a particular student. Some children will react if they ingest the particular allergen and others will react in varying degrees by touching or inhaling it. Even a young child with an ingestion-only allergy might react if he/she touches the allergen and subsequently puts his fingers in his mouth, nose or eyes. Early elementary classrooms are busy places with many centers such as sand/water tables, puppet theaters, and toy kitchens where the risk of exposure is great. Although the peanut-free designation may be difficult for another child, it does present an opportunity for you to teach all children about understanding and cooperation in meeting the needs of their peers.

4.  Who can administer an epinephrine auto-injector in schools? 

   In the absence of a licensed nurse, only qualified personnel for schools who have been properly trained may administer medications to students as delegated by the school nurse, specifically:

   • medications with a cartridge injector may be administered by qualified personnel for schools only to a student with a medically diagnosed allergic condition, which may require prompt treatment to protect the student against serious harm or death; 
   • coaches and licensed athletic trainers during intramural and interscholastic events may administer medications pursuant to Section 10-212a-8 of Regulations of Connecticut State Agencies; and 
   • paraprofessionals, if approved by the local or regional board of education, may administer medications, including medication administered with a cartridge injector to a specific student with a medically diagnosed allergic condition that may require prompt treatment in order to protect the student against serious harm or death pursuant to Section 10-212a-9 of the Regulations of Connecticut State Agencies (Section 10-212a-2 of the Regulations of Connecticut State Agencies, Administration of medications).

5. Qualified personnel for schools means:

   • a full-time employee who meets the local or regional board of education requirements as a principal, teacher, occupational therapist or physical therapist and has been trained in the administration of medication in accordance with Section 10-212a-3 of the Regulations of Connecticut State Agencies; 
   • a coach and licensed athletic trainer who has been trained in the administration of medication pursuant to Section 10-212a-8 of the Regulations of Connecticut State Agencies; 
   • a paraprofessional who has been trained in the administration of medication pursuant to Section 10-212a- 9 of Regulations of Connecticut State Agencies; or 
   • for school readiness programs and before- and after-school programs, directors or director’s designee, lead teachers and school administrators who have been trained in the administration of medication may administer medications pursuant to Section 10-212a-10 of the Regulations of Connecticut State Agencies (Section 10-212a-1 of the Regulations of Connecticut State Agencies, Definitions). 
6. What paperwork must be in place for a child to have medication in school? 

   No medication may be administered without:
   (1) the written order of an authorized prescriber;
   (2) the written authorization of the student’s parent or guardian or eligible student; and
   (3) the written permission of the parent for the exchange of information between the prescriber and the school nurse necessary to ensure the safe administration of such medication (Section 10-212a-2, Administration of  medication, Regulations of Connecticut State Agencies).

7. Can the school district tell students they cannot carry their epinephrine auto-injector on the bus? 

   No, state law cannot prohibit a student with life-threatening food allergies from carrying their epinephrine auto-injector on school transportation.

8. Can a student be excluded from a school-sponsored activity or field trip if a parent is not available to attend the activity? 

   No. Parents can volunteer to participate in school sponsored activities or field trips and school staff may ask parents to participate. However, if they are not able to attend, the schools should develop appropriate accommodations so that the student can fully participate in the event along with his/her peers.

9. What happens when a child goes on a field trip? 

   It is critical to include collaborative planning for field trips in your child’s IHCP to ensure that he or she will be able to fully participate. The IHCP can include provisions that require the teacher to notify parents and the school nurse in advance of upcoming field trips and for the teacher, parent and school nurse to collaborate in preparing for the trip. Advance notice allows staff and parents time to investigate the destination, to identify safety risks, plan for meals and snacks, and ensure that the same or comparable safety provisions as in school are in place on the field trip. In addition the child’s group should be assigned to an adult who is trained in epinephrine auto-injector administration. The epinephrine auto-injector should remain with that child at all times including during transportation to and from the fieldtrip destination.  Parents may want to volunteer to be a chaperone on trips that are more complicated in terms of safety issues, but should never be required to be a chaperone.  

10. Is it appropriate to discuss accommodations in the student’s IHCP in front of other parents and students? 

    No. Schools should maintain the confidentiality of student information. Parents should be informed of the general food allergy management plan without any reference to a particular child. With permission from the parent of the student with life-threatening food allergies, it may be appropriate in specific situations to share certain aspects of a student’s IHCP, such as the need for allergy-free classrooms, or alternatives to food celebrations in the classroom. However, it is important protect the family and student with life-threatening food allergies from discrimination and harassment due to accommodations that may be made.

11. How should changes to accommodations in the IHCP be made? (i.e., with team decision) 

    The IHCP should be reviewed periodically, and it should be modified or amended when changes in the child’s health status, medical management or development (e.g., self-care competencies) occur, when a student transitions from grade to grade and school to school, when team members identify an improved manner of addressing a safety issue and when accommodations are not working to promote safety.  The team should meet to address any changes to the IHCP, and a new IHCP should be generated to reflect the changes agreed to by the team.  School staff and parents should maintain open lines of communication and any member of the core team should feel comfortable initiating a change.

12. If a child unexpectedly brings in a treat for the class, and it is unclear as to whether or not the treat contains allergens, should the treat be distributed to the class? 

    If the classroom has been designated allergen free and if there is any doubt as to whether or not a treat is free of allergens for a child with severe food allergy, the treat should not be distributed. If the classroom is not designated as allergen-free, the snack may be distributed to the other students; however, a substitute snack that has been provided by the parent should be offered to the student with life-threatening food allergies. No foods should be offered to students with life-threatening food allergies without the approval of the parent. The IHCPs should clearly outline procedures for which foods the child with severe food allergy is allowed to consume and how staff will manage planned and unplanned treats for the class and the student with life-threatening food allergies that are not clearly labeled.  

13. Is it appropriate to use classroom manipulatives (an object which is designed so that a learner can perceive a concept by manipulating it) that involve food allergens? 

    Using classroom manipulatives that contain allergens may prevent a particular child from safely and equally participating in a class activity. As a result, teachers should work with students and parents to ensure that all students can fully participate in the activity. This may require the teacher to utilize manipulatives free from any offending allergens. The extent of the child’s allergy, and his/her age and maturity level should be taken into consideration.    

14. How can a child safely participate in school meal programs (breakfast and lunch)? 

    Collaboration with food service staff is essential to assist the student with life-threatening food allergies to participate in the school meal program. With documentation from the student’s health care provider, meal substitutions can be made to ensure that students are provided with food choices that avoid certain foods. To the extent possible, school food service staff should work with parents to provide them with food labels in order for parents to identify and approve which foods that their child may select for meals in school.  

15. Should all children with life-threatening food allergies be in same classroom? 

    School districts should make their placement decisions primarily on the educational considerations for all students regardless of special health care needs. However life-threatening food allergies may be factored in the decision.

 

Appendix C

Sample Risk Assessment Form

Sample Risk Assessment Form [PDF]

 

Appendix D

Sample Individualized Health Care Plans and Treatment Plans

Sample Individualized Health Care Plans and Treatment Plans [PDF]

 

Appendix E

State Statutes

Connecticut General Statutes (C.G.S.) Section 10-212a. Administration of medications in schools, at athletic events and to children in school readiness programs.

The Regulations of Connecticut State Agencies Section 10-212a-1 through 10-212a-10 Administration of Medications by School Personnel and Administration of Medication During Before- and After-School Programs and School Readiness Programs.

Public Act No. 12-198 (HB 5348) An Act Concerning the Administration of Medicine to Students with Diabetes, the Duties of School Medical Advisors, the Availability of CPR and AED Training Materials for Boards of Education and Physical Exercise During the School Day.  

C.G.S. Section 10-220i.  Transportation of Students carrying cartridge injectors.

C.G.S. Section 10-221o.  Lunch periods. Recess.

C.G.S. Section 10-221p.  Boards to make available for purchase nutritious and low-fat foods.

C.G.S. Section 10-215.  Lunches, breakfasts and other feeding programs for public school children and employees.

C.G.S. Section 10-217a.  Health services for children in private nonprofit schools. Payments from the state, towns in which children reside and private nonprofit schools.

C.G.S. Section 52-557b.  "Good samaritan law". Immunity from liability for emergency medical assistance, first aid or medication by injection. School personnel not required to administer or render. Immunity from liability re automatic external defibrillators.

Appendix F

Steps for Developing Districtwide Policy

The process of policy development is just as important as the final product – the policy. Individuals could work independently to write a policy, but it will be ineffective if it is not supported and implemented district-wide. This requires a team with appropriate representation from the school and community to come to consensus regarding best practices based on local needs.

Step 1: Identify Members of the Food Allergy and GSD Management Team

The district-wide policy development team works to develop, implement, monitor, review, and revise policy to manage life-threatening food allergies and GSD effectively.  The district-wide team should be multi-disciplinary and may include:

• school superintendent or designee; 
• building principal or designee; 
• school nurse supervisor (or coordinator); 
• school nurse; 
• teacher representative; 
• parent representative; 
• student representative; 
• school medical advisor; 
• school food service director or representative; 
• coach; 
• transportation coordinator; 
• supervisor of custodial staff; 
• other school staff (such as, school psychologist or counselor); 
• community health care provider(s) (such as, pediatrician, APRN, dietitian, nutrition or health consultant, local EMS representative; and 
• other community members.

To optimize success, it is also strongly recommended that districts include other members as appropriate, to local needs, such as:

• nonprofit health organizations (such as, Food, Allergy and Anaphylaxis Network and School Food Allergy Program);   
• local hospitals; and 
• public health representatives (such as, local health departments).

 

Step 2: Identify Local Policy Development Process

The district-wide policy team members will need to understand and follow the local school district’s process for policy development and adoption.  The team should be informed about who the decision-makers are, what format should be used, the review and approval process and timeline requirements.  Compliance with all local, state and federal requirements is essential. Districts may have existing health policies that can be expanded to include food allergy and GSD concerns.

 

Step 3: Conduct Local Assessment Process

Before making plans to develop policies, the team should assess the district’s current policies and protocols regarding the care of students with life-threatening allergies and GSD (if they exist), school and student needs, then identify areas that need improvement or development.  The results of school-by-school assessments can be compiled at the district level to prioritize needs. 

 

Step 4: Draft Policy Language

Effective policies should be brief and provide the overarching goals for the district regarding the care of students with life-threatening allergies and GSD.  These policies should include: 

• a commitment to planning and prevention; 
• a collaborative process; 
• a formal process for identifying and developing individualized care plans and action plans for students; 
• provisions for education and training; 
• maintaining a balance between individual, school and community needs; and 
• fostering normal development. 

 

Step 5: Build Awareness and Support

Educating various audiences such as administrators, teachers, food service staff, parents, students and the community, about your policy is essential to success.  Using your local or regional board of education’s Web site, individual schools’ Web site, local media (such as, newspaper articles, brochures and facts sheets) may be avenues to spread awareness.  Managing life-threatening food allergies and GSD will need significant support from students, parents, school staff and the community.

 

Step 6: Adopt and Implement the Policy

Leadership, commitment, communication and support are critical to successful adoption and implementation of district policy.  After the policy is adopted by the local or regional board of education, it must be implemented in order to achieve the intended purpose.

 

Step 7: Maintain, Measure and Evaluate

In order for polices to be successful, school districts must establish a plan for measuring implementation and sustaining local efforts, including evaluation, feedback and documentation based on sound evidence.  Examples of evaluation methods include student, staff and parent surveys; and quantitative data regarding managing life-threatening food allergies and GSD. Schools may also use experts in the field to evaluate the school policy and obtain current information on food allergies and GSD.

 

 

 

Appendix G

References and Resources

American Academy of Allergy, Asthma and Immunology.  Anaphylaxis in Schools and Other Child-Care Settings.

Connecticut State Department of Education. (2011).   

Connecticut State Department of Education.  Circular Letter C-13, Series 2008-09.  Section 504 of the Rehabilitation Act of 1973: Procedural Safeguards Reissue of CIRCULAR LETTER C-9, Series 2000-2001.

Connecticut State Department of Education.  Division of Legal and Governmental Affairs Law: Section 504. 

Connecticut State Department of Education. (2005).  Guidelines for School Nutrition and Physical Activity Policies.  

Connecticut State Department of Education. (2012).  Guidelines for Blood Glucose Self-Monitoring in School.  

Connecticut State Department of Education.  Protecting Students With Disabilities: Frequently Asked Questions About Section 504 and the Education of Children with Disabilities.  

Journal of Allergy and Clinical Immunology, March 2005, Supplement, The Diagnosis and Management of Anaphylaxis: An Updated Practice Parameter. 

Massachusetts Department of Education. (2002).  Managing Life Threatening Food Allergies in Schools.  

The Food Allergy & Anaphylaxis Network.  School Guidelines for Managing Students with Food Allergies. Adapted and printed with permission. 

State Department of Public Health (DPH).  Food Protection Program. 

General References

Bock, S. A., Munoz-Furlong, A., & Sampson, H. A. (001).  Fatalities due to anaphylactic reactions to foods. Journal of Allergy & Clinical Immunology, 107(1):191-3. 

Bureau of Special Education Appeals, Student v. Mystic Valley Regional Charter School.  

Food Allergy News. (October-November 2003).  The Use of Food by Teachers for Classroom Lessons.   

Furlong T.J., DeSimone, J., & Sincherer, S.H. (2001).  Peanut and tree nut allergic reactions in restaurant and other food establishments.  Journal of Allergy & Clinical Immunology, 108(5):867-70

Gern, James E., MD, New Insights in Food Allergy.  

Moses, M., Gilchrest, C.; & Schwab, N. (2005).  Section 504 of the Rehabilitation Act: Determining Eligibility and Implications for School Districts.  The Journal of School Nursing, 21(1):48-58

Munoz-Furlong, A. (2002).  What Principals Should Know About Food Allergies, Principal, 81(5), 22-24. 

National Association of School Nurses (Issue Brief).  School Nurse Role in Education, School Meals Program.  

Perry, T.T., Conover-Walker M.K., Pomes A., Chapman M.D., & Wood, R.A. (2004). 

Distribution of peanut allergen in the environment.  Journal of Allergy & Clinical Immunology, 114(1):127-30.

Sampson, H.A. (2000).  What should we be doing for children with peanut allergy.  Journal of Pediatrics, 137 (6), 741. 

Sampson, H.A. (2004).  Update on food allergy, Journal of Allergy & Clinical Immunology, 113(5), 805-819.

Sheetz, A.H., Goldman, P.G., Millett, K., Franks, J.C., McIntyre, L., Carrol, C.R., Gorak, D., Smith, H., Carrick, C., & Abu, M. (2004).  Guidelines for Managing Life-Threatening Food Allergies in Massachusetts Schools, Journal of Health, 74(5), 155-160 

Sicherer, S.H., Forman, J.A., & Noone, S.A. (2000).  Use Assessment of Self-Administered Epinephrine Among Food-Allergic Children and Pediatricians, Pediatrics, 105(2):359-36275

Simonte, S.J., Ma, S., Mofidi, S., & Sincherer, S.H. (2003).  Relevance of casual contact with peanut butter in child with peanut allergy.  Journal of Allergy & Clinical Immunology, 112(1):180-2 

Simonte, J., Songhui, J.D., Ma, S., Mofidi, S., & Sincherer, S.H. (2003).  Relevance of casual contact with peanut butter in children with peanut allergy.  Journal of Allergy & Clinical Immunology, 112(1):180-2

Sincherer, S.H. & Leung, D. (2004). Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insect stings. Volume 114, Issue 1, pages 118-124. 

Sincherer, S.H. & Malloy, T. (2005). The Complete Peanut Allergy Handbook. New York: The Berkley Publishing Group.

Sincherer, S.H., Furlong, T.J., Desimone, J., & Sampson, H.A. (2001).  The US Peanut and Tree Nut Allergy Registry: Characteristics of reactions in schools and day care.  Journal of Pediatric, 138(4):560-565 

The Civil Rights of Students with Hidden Disabilities under Section 504 of the Rehabilitation Act of 1973. 

The Food Allergy & Anaphylaxis Network.  Managing Food Allergies in the Cafeteria. 

The Food Allergy & Anaphylaxis Network. School Safety.

Web Site Resources

Administration of Epinephrine for Life-Threatening Allergic Reactions in School Settings   

Fact Sheets and Statistics from American Academy of Allergy, Asthma and Immunology(AAAAI)  

Food Allergy and Anaphylaxis Network   

Food Allergy information from Medline Plus

Genetic and Rare Diseases Information Center

Power Point Presentations on food allergies from AAAAI 

Connecticut State Department of Education, nutrition education resources: 

• Healthy Celebrations 
• Healthy Fundraising 
• Food As Reward

Spokane Public Schools, Nutrition Services 

U.S. Department of Food and Drug Administration, Center for Food Safety and Applied Nutrition, information on food labeling  

Other Resources

The Office of Civil Rights (OCR) office for Connecticut is located at:

Boston Office
Office for Civil Rights
US Department of Education, 8th Floor
5 Post Office Square
Boston, MA 02109-3921
Telephone: 617-289-0111
FAX: 617-289-0150; TDD: 877-521-2172
E-mail: OCR.Boston@ed.gov

The OCR National Headquarters is located at:

U.S. Department of Education
Office for Civil Rights
Lyndon Baines Johnson Department of Education Bldg
400 Maryland Avenue, SW
Washington, DC 20202-1100
Telephone: 800-421-3481
FAX: 202-453-6012; TDD: 877-521-2172
E-mail: OCR@ed.gov

Food Allergy Association of Connecticut
http://www.FAACT.org

Food and Latex Allergy Awareness Group  
http://www.flaag.org