The difference between a 504, an IHP and an IEP, ten accommodations other families have got in writing, a request letter you can send today, and what to do when the school says no.
US only, and it's the thing parents get worn down by
You ask for a 504 plan, the school offers you a health plan instead, and
nobody explains the difference. Here's what those documents actually are,
what to ask for, and what your child's school owes you at lunch. This
section is about US federal law. If you're reading from anywhere else,
the names and the rules where you are will be different.
Civil rights law
504 plan
A 504 plan comes from Section 504 of the Rehabilitation Act of 1973,
which is a federal civil rights law. It covers any school that takes
federal money, so almost every public school in the country. Celiac
disease usually qualifies, because a 2008 amendment to the ADA made
clear that limiting a major bodily function counts as a disability,
and digestion is on that list.
The plan is written by a team that includes you. The school can't
quietly rewrite it or drop it, and if staff don't follow it you have
somewhere to go. That's the whole reason people push for a 504
instead of accepting a health plan.
Legally binding
Yes. Federal civil rights law sits behind it, with written notice, a right to review records, an impartial hearing, and a complaint route outside the district.
What it covers
The school day and everything attached to it: field trips, class parties, after school clubs, sports.
School document
IHP or health plan
An IHP, sometimes called an individual health plan or a health care
plan, is written by the school nurse. It sets out your child's
condition and what staff should do day to day. A good one is genuinely
useful and there's nothing wrong with having one.
What it isn't is a legal agreement. It isn't created by federal
education law, it carries none of the procedural protections a 504
gives you, and there's no impartial hearing you can trigger if the
school stops following it. That's the practical difference, and it's
why the 504 is the one to push for. It doesn't make an IHP worthless.
It's written under state nursing standards, it's usually the most
detailed description of your child's daily care anywhere, and if the
school ignores it for a disabled child that can still be a Section
504 problem.
Legally binding
Not in the way a 504 is. It's a nursing document rather than a civil rights protection, with no federal appeal route when it isn't followed.
Worth having
Yes, alongside a 504 rather than instead of one. Ask for both, and make sure the 504 references the care the IHP describes.
Special education
IEP
An IEP comes from IDEA, a different federal law, and it's legally
binding too. It's built for children who need specially designed
instruction, so the condition has to be affecting how they learn or
get at their schoolwork, not only what they eat.
Celiac disease on its own usually doesn't get you an IEP, and that
isn't the school fobbing you off. If your child has something else
going on as well, ask about it. Otherwise the 504 is the right door
to knock on.
Legally binding
Yes, under IDEA, with its own set of parent protections.
Who it's for
Children who need instruction itself changed, not children who need accommodations around food.
You may not have to pack that lunch
If your child's school takes part in the National School Lunch Program,
it has to make reasonable meal modifications for a child whose
disability restricts their diet, and it can't charge you extra for the
modification. Read that last part carefully: it means the gluten free
meal costs the same as the standard one, not that it's free. You still
pay the normal meal price unless your child separately qualifies for
free or reduced price meals. Obtaining the food is the school's job,
not yours, and "just send lunch from home" is not how they discharge
it. Plenty of families still choose to pack, and that's a perfectly
good decision. Just make it knowing it's a choice rather than a rule.
What that does and doesn't get you
Not a copy of the menu
The school has to make a reasonable modification that's safe for your child. It doesn't have to match the regular menu item for item, and it doesn't have to buy the brand you name.
Only if the school is in the program
Most public schools take part. Many private schools don't. Ask the food service director in writing before you build a plan around it.
Get the medical statement
It needs to come from a state licensed healthcare professional who can write prescriptions where you live, and it should spell out what has to be left out and what can be served instead. Since July 2025 schools also have to accept one signed by a registered dietitian. If the office insists only a doctor will do, they're working from the old wording of the rule.
You may not need one at all
A modified meal that still fits the standard meal pattern is reimbursable with or without a medical statement. Schools stall accommodations over paperwork they don't actually need, and a school can ask for a statement without holding up the meal while it waits.
Ask for two documents at once
When you're at the GI clinic, ask for the diagnosis letter and the meal modification statement in the same visit. They do different jobs and you'll need both.
What to ask for, so you're not starting from a blank page
"I don't know what to ask for" is the most common thing parents say, and
it's a fair thing to say. Here's what other families have actually got
written into a plan. Take the ones that fit your child and leave the rest.
Advance notice of treats
The teacher tells you before food comes into the classroom, not the morning of. Two or three days is usually enough to bake or buy something.
A safe snack stash
A labeled box the teacher keeps in the classroom, restocked by you, so there's something ready when cupcakes turn up out of nowhere.
Non-food rewards
Ask for the class reward system to move off candy and donuts. Most teachers are glad to, and it helps every kid with a restriction, not just yours.
A clean prep surface
A named spot for preparing your child's food, plus a dedicated toaster or toaster bags. Shared toasters are one of the two ways this usually goes wrong.
Tables wiped first
Cafeteria and classroom tables cleaned before your child eats, with a fresh cloth. Crumbs from the previous class are the other way it goes wrong.
Seating that doesn't isolate
Safe seating without a "gluten free table" your child sits at alone. You want them at the same table as their friends, with the surface handled.
Field trip protocol
Written down before the year starts: who tells you, how far ahead, and what happens about food on the day. The same for class parties.
A note for substitutes
A card in the sub folder saying your child has celiac disease, what that means, and who to ask. Substitute days are when plans quietly stop happening.
Bathroom access during testing
Your child can leave during timed tests without losing time or being marked down for it. Gut symptoms don't wait for the bell.
One named adult
A single person responsible for the plan, named in the document, with a backup named too. Without this, everyone assumes someone else has it.
A letter you can send today
Short on purpose. Long letters sit in drafts. Fill in the brackets, attach
the diagnosis letter, and send it to the principal with the school nurse
copied in.
Subject: Request for a Section 504 evaluation, [child's name]
Dear [principal's name],
I'm writing to request a meeting to evaluate my child, [name],
in [grade], for a Section 504 plan.
[Name] was diagnosed with celiac disease on [date]. It's an
autoimmune condition that substantially limits digestion, which
is a major bodily function under Section 504. Even trace amounts
of gluten cause damage, so [he/she/they] needs accommodations at
school to stay safe and to take part in everything the other
children do.
I've attached the diagnosis letter from [doctor's name] at
[clinic].
Could you let me know a few times you're free in the next two
weeks, and tell me who the district's Section 504 coordinator is?
Thank you,
[your name]
[phone] / [email]
Keep a copy of everything you send, with the date on it. If a plan ever
gets disputed, the record of what you asked for and when is the thing
that carries the argument.
When the school says no
Being turned down twice is common and it isn't the end of it. You have the
right to request an evaluation, and a school that refuses has to tell you
why and tell you how to challenge it. Work through these in order.
1. Get the no in writing
Ask them to put the refusal and the reason in an email. A verbal no is easy to give. A written one has to be defensible, and a fair number of refusals don't survive the request.
2. Resend the diagnosis letter formally
Attach it to a dated email to the principal and copy the district 504 coordinator. Say clearly that you're requesting an evaluation under Section 504. You're building a record with dates on it.
3. Ask who the 504 coordinator is
Any district with 15 or more employees has to designate someone to coordinate Section 504 compliance and has to have a grievance procedure. Ask for the name and for a copy of the procedure. That question alone changes the tone of a lot of conversations.
4. Use the district grievance procedure
File it the way the procedure says, in writing, with your dates and documents attached. This is the step schools expect you to skip.
5. File a complaint outside the district
The US Department of Education's Office for Civil Rights takes Section 504 complaints about schools, generally within 180 days of what you're complaining about. It's free and you don't need a lawyer. If the dispute is specifically about school meals, there's a separate USDA route: your state child nutrition agency, USDA's Food and Nutrition Service, or USDA directly on form AD-3027. Filing one doesn't stop you using the 504 process too. The mechanics vary by state, so ask the state agency which door they want first.
This is background on how the process works. It isn't legal advice and it
isn't medical advice. It describes US federal law, and your state and
district layer their own rules on top of it, so check locally before you
rely on any of it. For your child's diagnosis, testing, and diet, talk to
their doctor or a pediatric dietitian. If a dispute stalls, your state's
parent training and information center is a free place to ask what to do
next.