Extra Charge For High Needs Child???

[Blackcat31]

You may not refuse care for a child with a disability and you may not charge more for a child with a disability.

so the question is by law is diabetes a disability?

Ask Tom he would know the correct legal answer.

My DH has diabetes (Type 1) and he does NOT qualify for any type of special services and is not recognized as disabled by the ADA.

He takes several insulin shots per day along with the other things a diabetic must do but is in no way considered disabled or eligible to receive any type of payment or reimbursement from social security or any other type of monetary payments.

Same goes for my nephew (age 18) who has been type 1 since he was 6 and for my late BIL who passed away from complications of diabetes at 36 years old. He was on dialysis, had one leg amputated and was partially blind and recieved not one dime of any type of disability during his short life....despite applying several times in the later part of his life but he never qualified as disabled. :confused:

Like Former Teacher said, "It is not simply having diabetes that qualifies a person as being disabled, but how diabetes has impacted their life" http://www.isletsofhope.com/civil-ri...-disabled.html

[Blackcat31]

My sincere apologies.

I knew when I typed the word it wasn't quite right, but could not think of the right way to convey it with what I was trying to say. I considered calling it a disease but actually that seemed to have even more of a negative connotation in my mind than the word illness did. Although it's a tough thing to live with undoubtedly I can imagine there is enough of a stigma surrounding any permanent affliction in a persons life as it is that that makes it even tougher.

Was trying not to add to that and failed, please know that wasn't my intention

Apology acepted. As I said, I know that wasn't your intention. I just wanted to make it clear that diabetes is NOT an illness.

[itlw8]

Then I guess the answer is yes you can charge more.... maybe?

The teacher would still be overwhelmed with more money. Can another staff member come in a test or take over while the main teacher is testing.

In school the child would go to the nurse. so in a center the director?? family childcare would be as anything else just another hat to wear.

[Blackcat31]

Apparently diabetes doesn't necessarily only fall under the ADA rules as much as it follows rules/laws set under IDEA and Section 504 of the Rehabilitation Act of 1973

The law states "This law prohibits all schools and day care centers, except those run by religious organizations, from discriminating against children with disabilities, including diabetes. Protection under is this law is the same as that for Section 504" but doesn't clarify anything about charging higher rates based on accomodation for the higher needs.

It also says "Any educational facility, school or daycare center, which receives federal funding cannot discriminate in the admission, educational process, or treatment of a student who has diabetes".

Privately-run child care centers - like other public accommodations such as private schools, recreation centers, restaurants, hotels, movie theaters, and banks must comply with title III of the Americans with Disabilities Act (ADA).

Child care services provided by State and local government agencies, such as Head Start, summer programs, and extended school day programs, must comply with title II of the ADA. Both titles apply to a child care center's interactions with the children, parents, guardians, and potential customers that it serves.

http://www.childrenwithdiabetes.com/d_0q_600.htm

http://www.childrenwithdiabetes.com/d_0q_100.htm

Here is a wonderful site for child care providers in regards to the law about this subject and other special needs issues: http://www.childcare.gov/xhtml/links/g_3/t_33.html

[Blackcat31]

I have a little girl (almost 2 years) who is diabetic. She requires a LOT more care than the other children in her age group. We have to test her blood throughout the day (even while she's sleeping), give her insulin at times, monitor her eating, and stay in constant contact with her parents throughout the day.

Is it legal to charge a bit more for her care? I've read at traditional preschools that it is not legal to charge more - but I run a daycare which is different.

Anyway, she will be moving to a new class soon and I would like to give a small wage increase to her teacher as she is taking on TONS more work and responsibility.

What are your thoughts?

Yah! happyface

I am pretty sure I found the answer to your question. It is found in the answers to question #13 and #20. (in the link below)

From what I read and understand, you cannot charge this family more.

http://www.ada.gov/childq%26a.htm

[sharlan]

OT - but in CA, we cannot administer insulin. We may monitor blood only.

[Heidi]

Yah! happyface

I am pretty sure I found the answer to your question. It is found in the answers to question #13 and #20. (in the link below)

From what I read and understand, you cannot charge this family more.

http://www.ada.gov/childq%26a.htm

Wow! That is awesome! I just took a "children with differering abilities" course, and we never came accross this link. I think I will send it to the instructor for her next class. Thanks!

[Blackcat31]

OT - but in CA, we cannot administer insulin. We may monitor blood only.

States definitely differ in whether they allow insulin and/or glucagon administration to be delegated to someone other than a medical representative or medically trained person.

Here is a handy little chart that shows whether or not your state allows the child care provider or other delegated person to administer insulin and/or glucagon.

http://www.diabetes.org/assets/pdfs/know-your-rights/for-lawyers/diabetes-care-in-daycare-state-laws-regulations-and-policies-related-to-insulin-and-glucagon-administration.pdf

[CheekyChick]

Yah! happyface

I am pretty sure I found the answer to your question. It is found in the answers to question #13 and #20. (in the link below)

From what I read and understand, you cannot charge this family more.

http://www.ada.gov/childq%26a.htm

You are awesome, Blackcat. Thank you for taking the time to do some research.

The only thing I'm questioning, is that it seems this was written for child care centers - not in-home daycares. I could be wrong though.

[CheekyChick]

Then I guess the answer is yes you can charge more.... maybe?

The teacher would still be overwhelmed with more money. Can another staff member come in a test or take over while the main teacher is testing.

In school the child would go to the nurse. so in a center the director?? family childcare would be as anything else just another hat to wear.

She is not overwhelmed or afraid to care for her, she is overwhelmed by the time and responsibility it would take to care for her AND 9 other children. For example: She has to be tested in the morning, tested before morning snack, tested before she plays outside, tested after she plays outside, tested before lunch, tested during naps, tested before afternoon snack. Oh, and tested it it is too cold outside or if she's acting different in any way.

It is not only the testing, it is watching her like a hawk for signs of going low, agitation, stomach upset, sweating, etc. It is also responding to the parents who call or text throughout the ENTIRE day with questions/concerns. It is also sitting with her at every meal, encouraging her to eat enough because she has to be full enough to last until the next meal/snack which HAS to be spread 3 hours apart, and then calculating the carbs. It is making sure she doesn't eat anything from someone else's plate (not easy for a 23 month old). The list goes on and on...

Those are the reasons it would be fair to my Assistant to get a small wage increase for the additional work. It truly is a HUGE job.

[CheekyChick]

States definitely differ in whether they allow insulin and/or glucagon administration to be delegated to someone other than a medical representative or medically trained person.

Here is a handy little chart that shows whether or not your state allows the child care provider or other delegated person to administer insulin and/or glucagon.

http://www.diabetes.org/assets/pdfs/...nistration.pdf

You should be a detective - GREAT work.

[texascare]

wow. My son is type 1 Diabetic and I am just floored...........

[MarinaVanessa]

The Americans with Disabilities Act doesn't differentiate between a "center" or "FCC". Whenever federal law says "daycare center" they are including centers, FCC, after school programs, etc. "The ADA prohibits family child care providers and child care centers from discriminating against a child, parent, or employee based solely on his/her disability (such as denying admission into a child care program). The ADA requires child care providers to make reasonable accommodations for all children." Here's that sheet from the Public Counsel Law Center, THE AMERICANS WITH DISABILITIES ACT & CHILD CARE PDF

Charging a family more because a child has a condition or disability is opening yourself up for a potential lawsuit unless you have to hire extra staff specifically for that child. Should this family decide to fight you in court it will be your responsibility to show that this child's diabetes doesn't fall under the Americans with Disabilities Act and that could be a tough fight. The Americans with Disabilities Act doesn't list specific conditions "Because each child is unique and has unique needs, no single approach to caring for children with disabilities can be applied to all children, or even to those with the same disability". So in other words, it's based on a case by case basis but courts don't typically side with the person going against this Act.

"The Americans with Disabilities Act (ADA) defines a child with a disability more specifically as one who has a physical or mental impairment that substantially limits the child’s ability to care for herself or himself, perform manual tasks, or engage in any other “major life activity,” such as walking, seeing, hearing, speaking, breathing, or learning, in an age-appropriate manner."

The sheet that I have goes on to say "]The kind of disability a child might have can vary greatly — allergies, moderate retardation, diabetes, cerebral palsy, or even a terminal illness may each be considered a disability under the ADA." When dealing with the ADA it's best to tread the waters very carefully. From Childcarelaw.org Caring for Children with Special Needs: THE AMERICANS WITH DISABILITIES ACT AND CHILD CARE

The only way that you can safely charge more without risk of a lawsuit is if you for example, feel like the staff member that cares for this child will be overwhelmed so you hire an extra assistant for this child and either bill the parents for this extra help or you can raise their rates a bit to cover a portion of the extra assistant and "eat" the other part of the cost.

On a side note, I can just imagine how intimidating this task and responsibility can seem to someone that has never had to deal with it. Are you open to the option of personally training and observing your staff member until she feels comfortable? Or of having your staff member trained by either attending a class or by scheduling an appointment with the child's physician so that she can learn the ins and outs (at the expense of the parents)?

[countrymom]

this has nothing to do about disability, its obvious that this child needs 2 people to care for her. Sometimes you can't be everywhere and monitor this childs diabetes, so this is where a second person is required. Just like people who get a "helper" to help them out during the day, so I would ask for maybe a couple dollars more considering you need a helper. Now maybe when she is about 5 and has it under control and the parents feel comfortable you can drop their rate, but for now, its fine to ask.

[Blackcat31]

The Americans with Disabilities Act doesn't differentiate between a "center" or "FCC". Whenever federal law says "daycare center" they are including centers, FCC, after school programs, etc.

Charging a family more because a child has a condition or disability is opening yourself up for a potential lawsuit unless you have to hire extra staff specifically for that child. Should this family decide to fight you in court it will be your responsibility to show that this child's diabetes doesn't fall under the Americans with Disabilities Act and that could be a tough fight. The Americans with Disabilities Act doesn't list specific conditions "Because each child is unique and has unique needs, no single approach to caring for children with disabilities can be applied to all children, or even to those with the same disability". So in other words, it's based on a case by case basis but courts don't typically side with the person going against this Act.

"The Americans with Disabilities Act (ADA) defines a child with a disability more specifically as one who has a physical or mental impairment that substantially limits the child’s ability to care for herself or himself, perform manual tasks, or engage in any other “major life activity,” such as walking, seeing, hearing, speaking, breathing, or learning, in an age-appropriate manner."

The sheet that I have goes on to say "]The kind of disability a child might have can vary greatly — allergies, moderate retardation, diabetes, cerebral palsy, or even a terminal illness may each be considered a disability under the ADA." When dealing with the ADA it's best to tread the waters very carefully. From Childcarelaw.org Caring for Children with Special Needs: THE AMERICANS WITH DISABILITIES ACT AND CHILD CARE

The only way that you can safely charge more without risk of a lawsuit is if you for example, feel like the staff member that cares for this child will be overwhelmed so you hire an extra assistant for this child and either bill the parents for this extra help or you can raise their rates a bit to cover a portion of the extra assistant and "eat" the other part of the cost.

On a side note, I can just imagine how intimidating this task and responsibility can seem to someone that has never had to deal with it. Are you open to the option of personally training and observing your staff member until she feels comfortable? Or of having your staff member trained by either attending a class or by scheduling an appointment with the child's physician so that she can learn the ins and outs (at the expense of the parents)?

Actually the ADA separate FCC from center care in two groups:

Privately-run child care centers/homes - like other public accommodations such as private schools, recreation centers, restaurants, hotels, movie theaters, and banks must comply with title III of the Americans with Disabilities Act (ADA).

Child care services provided by State and local government agencies, such as Head Start, summer programs, and extended school day programs, must comply with title II of the ADA. Both titles apply to a child care center's interactions with the children, parents, guardians, and potential customers that it serves.

See my post above (post # 19) for links that define each of the areas (Title II and Title III)