504 Plan Accommodation Bank: Medical Conditions Accommodation List

Why a Generic Template Is Not Enough

Most free 504 plan templates list a handful of accommodations — "allow water bottle," "permit bathroom breaks," "provide extra time on tests" — and stop there. The problem is not that these accommodations are wrong. It is that they are incomplete.

A child with Type 1 diabetes who wears a CGM and an automated insulin delivery pump needs accommodation language specifically addressing smartphone access for CGM data, protocol for pump site changes during the school day, blood glucose ranges that trigger testing pauses, and emergency glucagon administration by trained non-nursing staff. A generic template covers none of this.

An accommodation bank is different from a template. A template gives you a fixed document to fill in. An accommodation bank gives you a categorised inventory of specific, enforceable accommodation clauses that you select from based on your child's condition, then insert into whatever 504 plan format your district uses.

Classroom Accommodations

These address the daily instructional environment:

For diabetes: Unrestricted access to CGM receiver or dedicated smartphone at all times, including during instruction. Permission to check blood glucose at any time without leaving the room. Permission to consume fast-acting carbohydrates at the desk without requiring teacher approval. Unrestricted water and bathroom access. Exemption from penalties for late work or missed assignments during documented glucose excursions.

For epilepsy: Seating positioned away from fluorescent light flicker and windows with strong sunlight (photosensitive epilepsy). Permission to leave the classroom immediately if the student recognises a seizure aura. Access to a quiet recovery area with trained supervision for post-ictal rest — with no expectation to resume academic work until the student indicates readiness. No academic penalty for instruction missed during a seizure or during post-ictal recovery.

For severe allergies: Allergen-free zone within the classroom (specific arrangements depend on the allergen — airborne vs contact vs ingestion). All classroom celebrations, projects involving food, and science experiments using allergens must be cleared with the student's family in advance. The student must never be isolated or eat alone as an "accommodation" — the adjustment is to the environment, not to the child.

Testing and Assessment Accommodations

Standardised testing requires specific, separately documented accommodations:

• Permission to check blood glucose before, during, and after tests — with the test clock paused during any check or treatment
• If a hypoglycaemic event (below 70 mg/dL) or severe hyperglycaemia (above 250 mg/dL with ketones) occurs during a test, the session stops. The student treats, stabilises within target range for at least 20 minutes, and then resumes or retests without penalty
• For seizure disorders: if a seizure occurs during a test, the student retests on a different day. No partial scoring of interrupted tests
• Extended time accommodations for students whose medication causes processing speed reduction (common with anti-seizure medications like topiramate or valproic acid)
• For SAT, ACT, and AP exams, accommodations must be submitted through the testing organisation's approval process (College Board SSD, ACT TAA) well in advance of the test date — the school 504 plan alone does not automatically apply to external standardised tests

Field Trip and Extracurricular Accommodations

Under Section 504 (34 CFR § 104.37), schools cannot exclude students from nonacademic and extracurricular activities due to a medical condition, and cannot require a parent to attend as a condition of the child's participation:

• A trained staff member (school nurse or Trained Diabetes Personnel / trained seizure responder) must accompany the student on all field trips, including overnight and out-of-state trips
• All emergency medications must travel with the student, not in a locked vehicle or at the base camp
• For diabetes: a portable supply kit containing CGM supplies, blood glucose meter, insulin, glucagon, fast-acting carbohydrates, and ketone test strips must accompany the student
• For allergies: the student's epinephrine auto-injector travels with a trained adult who remains within immediate reach of the student at all times
• Athletic and sports participation requires a pre-activity glucose check for diabetes, a seizure safety plan for epilepsy, and allergen management for any food-related team activities

Transportation Accommodations

Transportation is a related service under Section 504 (34 CFR § 104.33):

• For diabetes: bus drivers must be trained to recognise signs of hypoglycaemia and know the emergency response protocol. The student must have glucose tablets or fast-acting carbohydrates accessible on the bus
• For severe allergies: the bus must be treated as an allergen-aware space (no eating policies where appropriate for airborne allergens), and the bus driver must know the location of the student's epinephrine auto-injector
• For seizure disorders: the bus driver must be trained in seizure first aid, know not to restrain the student, and have a communication protocol for contacting emergency services en route

Emergency Protocol Accommodations

Every medical 504 plan must include an explicit emergency section, not just "call 911":

• Location of all emergency medications (classroom, nurse's office, front office, PE equipment room, bus) — stored unlocked and accessible
• Names of all staff members trained to administer each emergency medication
• The specific sequence of actions, including medication, emergency services, and parent notification, as set out in the student's medical action plan and school emergency procedures
• Post-emergency procedures: who stays with the student, who documents the event, what the return-to-school protocol is

The Medical 504 Plan Toolkit includes a complete, condition-specific accommodation bank worksheet with over 60 customisable clauses organised by school setting — ready to select, adapt, and insert into your district's 504 plan format.