Photo of Children headed into school

The first day of school brings out the jitters in everyone – even parents. If your child has food allergies, your anxieties may be multiplied. You want to ensure your child is safe within the school environment.

One of the most important things a parent can do to prepare to send their child off to school safely is to make sure that the proper school healthcare plans are in place to manage your child’s food allergies while at school.

There are four types of healthcare plans that schools use to take care of students. It’s important to learn about each of these plans – and what the purpose is for each. A child with food allergies may need one or more of these healthcare plans. By learning about each of these plans, you will be better informed. You will be in a position to work effectively with the school to advocate for your child’s needs and make sure the plans are in place when school starts.

The four types of school plans a student may need are:

Individualized Healthcare Plan (IHP or IHCP)

Most schools offer an Individualized Healthcare Plan developed by the school nurse in collaboration with the parents and physician. The IHP is designed to help children with food allergies or asthma with complex needs stay safe at school. It details a child’s asthma or food allergy diagnosis, prevention strategies, medication needs and what to do in case of an emergency.

An individualized healthcare plan:

  • is a document written in nursing language for nurses to utilize. It must be written by a registered nurse and directs nursing care.
  • should be filed as “part of the student’s permanent health record.”
  • Is based on professional nursing practice.
  • is reviewed at least annually – and will change during the school year based upon the student’s needs.

Emergency Action or Care Plan (ECP)

An emergency care plan is a document written in lay language to guide non-medical staff to respond in an emergency. Every student with an order for epinephrine should have an ECP.

It contains instructions from the child’s doctor on how to handle a severe allergic reaction or anaphylaxis while at school.

An emergency care plan:

  • is written by the school nurse.
  • should be distributed to all staff that has supervisory responsibility for a student at risk for anaphylaxis.
  • requires school nurse to train staff to administer plan – reinforce at least every 6 months.
  • outlines the steps to take in an when anaphylaxis occurs –
  • should be reviewed and renewed at least annually.

Section 504 Plan

A 504 Plan is a written management plan governed by Section 504 of the federal Rehabilitation Act of 1973. It outlines accommodations that elementary, secondary and post-secondary schools must make for children with disabilities. Food allergies are included as a disability because anaphylaxis, a life-threatening allergic reaction, substantially impacts major life activities such as eating and breathing.

Once a parent formally requests a 504 Plan evaluation, the school nurse, principal, 504 Plan coordinator and others evaluate the student’s health needs. Medical records are reviewed, and a decision is made if the student is eligible. If the answer is yes, a 504 Plan is developed and all school staff members, including school nutrition and transportation employees, are expected to implement it. The  plan should be reviewed annually. It can be altered as the child’s needs change.

While every child does not need a 504 Plan, all families have the right to request one. The age of the student or severity of symptoms makes no difference. If you think your child’s food allergy limits their ability to participate fully in school activities and requires special accommodations, a 504 Plan may be the answer.

A 504 plan is:

  • a legally binding plan written in educational language to ensure accommodations at school for a student with a chronic health condition – includes allergies and risk for anaphylaxis.
  • should be filed in student’s educational record.
  • written by healthcare team – initiated and overseen by the school district’s 504 Coordinator.
  • formalizes accommodations needed to make it through the school day.

Individualized Education Plan (IEP)

Another school plan is an Individualized Education Plan (IEP), part of the protections of the Individuals with Disabilities Education Act (IDEA). It is only applied to children with food allergies when they also have an educational disability.


  • is a written statement of the special education program designed to meet a child’s individual needs.
  • is usually only used for food allergies when other disabilities exist.
  • may be included for a student who has a plan written for a learning disability and also has a food allergy.
  • would be listed under the heading “Other Health Impaired.”

How do I know what school plan is best for my child?

Deciding what best meets your child’s needs will take some homework on your part. Schedule a meeting with the school nurse, administrative staff and your child’s teachers to ask about the school’s food allergy policies and how your child’s needs can be best met.

Also ask: How aware is the staff of the signs of anaphylaxis? Are treats offered at classroom birthday parties or school dances? Does the school have stock epinephrine available? Where are epinephrine auto-injectors stored? Talk with other parents of food-allergic children, too, on how well the school manages food allergies.

If a parent feels the school has strong food allergy policies and management in place, and that their child’s school works well with parents and children to voluntarily accommodate their child, the parent may decide that a 504 Plan is not necessary. In that case, a decision can be made to see if an IHP and ECP will help manage the child’s food allergies. Sometimes one school will provide appropriate accommodations without a formal document, but a plan may be put in place when a child changes schools to maintain the high level of care.

The one caution about not having a 504 plan in place is that IHPs and ECPS do not afford the same legal protection as 504 Plans.

Regardless of the plans, it is essential that they are customized and focus on each  student’s specific needs.

Learn more about accommodation plans for food allergies at the Food Allergy & Anaphylaxis Connection Team (FAACT) website: