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Daycare Center and Family Home Forum>WWYD About This Dcg And Increasing Pay?
E Daycare 12:24 PM 02-01-2011
The preemie that I have just turned 1 two weeks ago. Ive had nothing but issues with this family (being very late dropping off and picking up, being early at drop off, no calls, late payments, dcd that has no brains, dcg chews on everything I own etc...) and now I have a new one. The dcg has very bad breathing problems. She is always snotty and I go through a box of tissues every week shes here and shes here just 4 days a week. On her 1 year doc appt her mom pushed real hard for her to get a breathing machine. I find thats great and proactive and I really hope it helps. Her doctor granted the breathing machine. So heres where it affects me. Her mother told me yesterday that the dcg will need this breathing machine every 4 hrs and that shes going to bring it and show me how to use it. That the doctor told her if I use it with her dcg then she can completely write off care. She will pay me upfront and the state will reimburse her. I was a little taken aback. For these reasons:
A) She is already very discounted through me. I needed her business so I knocked off 25$ a week to get her to bring her kid here.
B) She is now down to 4 days a week so that knocks down another 30$ a day as her family needs to "save money". So that puts me at a bind because I filled her thinking that Id at least have a 5 day a weeker. Now Im out $220 a month from these people.
Do I go back and charge her the full time rate I orginally advertised for now that the state will reinburse her and insist she goes back to full time? If so, I dont have anything like this stated in my contract as Ive never had a issue like this before and how do I go about bringing this up? This will take away from the other kids in my care as this needs to be done for 10min at a time. Her mom informed me dcg fights it so its best to do it when shes sleeping. Thats all fine and dandy but what about the other times I need to do it and its not nap time? The girl is with me 10hrs a day. So there will be at least 2 times, maybe 3 thatll Ill need to do this.
Also, because Im just certified in Child development, CPR, AED and First aid, I have not certs in any other "developmentally impaired" field though and I dont know if Im even legally allowed to give this type of treatment. I dont know if it matters on the legal standpoint anyways as it could be just like with giving medication, as long as I have parent consent. When she interviewed me she insisted that the only things the dcg was behind on was feeding (this is a complete separate issue anyways. Ill get into that one later. These people are winners let me tell you) but I kinda figured shed be slow developing in other areas and was ready to help with anything physical or mental that I could with the education I have.
What would you guys do in this predicament? My husband has had it with this family and wants me to start advertising asap to get a full timer in here willing to pay a full rate or at least be here full time. Im kinda on board with him because its been one fail after another with this family and I dont want to be used as a way for them to get something for nothing. She seemed really gung-ho that the state would pay her back so I want to be gung-ho and get my full rate too. Id love to terminate this family overall though and just be done with the headache. If I can but its been hard to get clients. So till then, what would you do?
A) She is already very discounted through me. I needed her business so I knocked off 25$ a week to get her to bring her kid here.
B) She is now down to 4 days a week so that knocks down another 30$ a day as her family needs to "save money". So that puts me at a bind because I filled her thinking that Id at least have a 5 day a weeker. Now Im out $220 a month from these people.
Do I go back and charge her the full time rate I orginally advertised for now that the state will reinburse her and insist she goes back to full time? If so, I dont have anything like this stated in my contract as Ive never had a issue like this before and how do I go about bringing this up? This will take away from the other kids in my care as this needs to be done for 10min at a time. Her mom informed me dcg fights it so its best to do it when shes sleeping. Thats all fine and dandy but what about the other times I need to do it and its not nap time? The girl is with me 10hrs a day. So there will be at least 2 times, maybe 3 thatll Ill need to do this.
Also, because Im just certified in Child development, CPR, AED and First aid, I have not certs in any other "developmentally impaired" field though and I dont know if Im even legally allowed to give this type of treatment. I dont know if it matters on the legal standpoint anyways as it could be just like with giving medication, as long as I have parent consent. When she interviewed me she insisted that the only things the dcg was behind on was feeding (this is a complete separate issue anyways. Ill get into that one later. These people are winners let me tell you) but I kinda figured shed be slow developing in other areas and was ready to help with anything physical or mental that I could with the education I have.
What would you guys do in this predicament? My husband has had it with this family and wants me to start advertising asap to get a full timer in here willing to pay a full rate or at least be here full time. Im kinda on board with him because its been one fail after another with this family and I dont want to be used as a way for them to get something for nothing. She seemed really gung-ho that the state would pay her back so I want to be gung-ho and get my full rate too. Id love to terminate this family overall though and just be done with the headache. If I can but its been hard to get clients. So till then, what would you do?
DCMomOf3 12:36 PM 02-01-2011
Is it a nebulizer? My son needs to use his on and off, it's not hard to do, and takes about 15 minutes a session. You would just need a medication authorization I am pretty sure. I would not say no to a Neb if it were me.
I would tell her that if you choose to take the added responsibility of the treatments you will have to re-write her contract with full time/full week pay. Then tell her you will draw up new contracts for her by tomorrow.
I would tell her that if you choose to take the added responsibility of the treatments you will have to re-write her contract with full time/full week pay. Then tell her you will draw up new contracts for her by tomorrow.
E Daycare 12:41 PM 02-01-2011
Originally Posted by DCMomOf3:
Is it a nebulizer? My son needs to use his on and off, it's not hard to do, and takes about 15 minutes a session. You would just need a medication authorization I am pretty sure. I would not say no to a Neb if it were me.
I would tell her that if you choose to take the added responsibility of the treatments you will have to re-write her contract with full time/full week pay. Then tell her you will draw up new contracts for her by tomorrow.
Im not sure if its a nebulizer or not but Im sure it is. She was vague on that and just wanted to inform me the state would give her money back. I do like the idea about re-writing her contract. The only thing is I JUST did this and require the newly signed forms to be given to me today. Would it look crazy for me to tell her that I need to do this again?Is it a nebulizer? My son needs to use his on and off, it's not hard to do, and takes about 15 minutes a session. You would just need a medication authorization I am pretty sure. I would not say no to a Neb if it were me.
I would tell her that if you choose to take the added responsibility of the treatments you will have to re-write her contract with full time/full week pay. Then tell her you will draw up new contracts for her by tomorrow.
DCMomOf3 12:56 PM 02-01-2011
i wouldn't think it would look crazy if she told you of the change after you gave her the contracts to sign.
lvt77 01:22 PM 02-01-2011
wow I wonder if she only pused for the neb. becuase she knew she could get help with daycare cost? Sounds ratehr fishy.
I have a 7mo DCB that has been put on one. I don't give meds, but mom works just down the street so she comes to do it. He has a lot of reactions with the meds and even had to call 911 once. I cried when all that happened.
I feel in my heart of hearts that the child I take care of needs someone who knows more about his condition, the parents are also a piece of work and dont tell me anything. I feel very stressed when the child is here, because of all the issues we already have had. As well as the liability issues that are imposed on me.
If you feel that you will not be able to give the child the attention the child will need to stay well, then maybe you should let the mom know this. See if she can come give the child the meds. or tell her to find someone who can give the child more time and attention...
I have a 7mo DCB that has been put on one. I don't give meds, but mom works just down the street so she comes to do it. He has a lot of reactions with the meds and even had to call 911 once. I cried when all that happened.
I feel in my heart of hearts that the child I take care of needs someone who knows more about his condition, the parents are also a piece of work and dont tell me anything. I feel very stressed when the child is here, because of all the issues we already have had. As well as the liability issues that are imposed on me.
If you feel that you will not be able to give the child the attention the child will need to stay well, then maybe you should let the mom know this. See if she can come give the child the meds. or tell her to find someone who can give the child more time and attention...
marniewon 01:29 PM 02-01-2011
If it's a nebulizer it's super easy to do. The medicine comes all ready and all you do is dump it in, turn it on and hold it on her face. I wouldn't think you'd need more extensive training or certs to that. But....because it is taking more of your time than originally contracted for, yes, I would write a new contract (even though you just did - you didn't have this info before now) stating your full time full rate. If they don't want to pay it, they can find someone else. Have this start (the full rate) the day you start doing the treatments. If you still want this family gone, you can advertise and term them when you find someone else.
momofboys 03:52 PM 02-01-2011
Originally Posted by E Daycare:
Im not sure if its a nebulizer or not but Im sure it is. She was vague on that and just wanted to inform me the state would give her money back. I do like the idea about re-writing her contract. The only thing is I JUST did this and require the newly signed forms to be given to me today. Would it look crazy for me to tell her that I need to do this again?
Nebs are a piece of cake, particularly if the child can sit on their own. You can even put them in a high chair to do it. She can ask for a mask that goes around his head so you wouldn't even have to hold it for the child. Easy! But I do understand your concerns about the payment. It would be hard for me to know what to do.Im not sure if its a nebulizer or not but Im sure it is. She was vague on that and just wanted to inform me the state would give her money back. I do like the idea about re-writing her contract. The only thing is I JUST did this and require the newly signed forms to be given to me today. Would it look crazy for me to tell her that I need to do this again?
momatheart 04:12 PM 02-01-2011
So in your state if you watch more than one family can you still watch more families if one of the families is recieveing free care from the state? I think there is a law against this in my state... Just saying you may want to check that out. Who knows this may be your out.
momofboys 05:02 PM 02-01-2011
I guess my issue is she was already giving them special deals/discounts & now she has to do additional work, would it now be for less $$$ since the state would pay or will the parent still pay her & get reimbursed? What if she was to do an across-the-board raising of fees? It is no one's business if she raises her fees for everyone. No state can mandate how much you charge. Maybe that is what you could do if you are already on the low end.
nannyde 05:30 PM 02-01-2011
Originally Posted by janarae:
Nebs are a piece of cake, particularly if the child can sit on their own. You can even put them in a high chair to do it. She can ask for a mask that goes around his head so you wouldn't even have to hold it for the child. Easy! But I do understand your concerns about the payment. It would be hard for me to know what to do.
Sure they are easy if nothing goes wrong. It's the day something goes wrong when it's not so easy after all. Nebs are a piece of cake, particularly if the child can sit on their own. You can even put them in a high chair to do it. She can ask for a mask that goes around his head so you wouldn't even have to hold it for the child. Easy! But I do understand your concerns about the payment. It would be hard for me to know what to do.
Medication given by inhalation are VERY serious medications. The provider needs to understand the medication, the importance of properly adminstering them as ordered, the knowledge of when to administer the medication if there is a window of time and an "as needed" decision, AND the very serious side effects of each medication.
I don't feel comfortable doing them in my setting. If a provider feels they are easy peasy and doesn't have a lick of problems with them then the kids who need them need to go to that provider. That's not me
I don't have the luxury of not knowing the seriousness of these medications.
E Daycare 05:43 PM 02-01-2011
Originally Posted by nannyde:
Sure they are easy if nothing goes wrong. It's the day something goes wrong when it's not so easy after all.
Medication given by inhalation are VERY serious medications. The provider needs to understand the medication, the importance of properly adminstering them as ordered, the knowledge of when to administer the medication if there is a window of time and an "as needed" decision, AND the very serious side effects of each medication.
I don't feel comfortable doing them in my setting. If a provider feels they are easy peasy and doesn't have a lick of problems with them then the kids who need them need to go to that provider. That's not me I don't have the luxury of not knowing the seriousness of these medications.
I dont know much about them and have never worked with them at all. The dcm has already informed me dcg does not like them and she has to hold her down to do them and wait for dcg to fall asleep to do a session properly. So Im kinda iffy about it from that standpoint too. I dont want to have to hold down a baby to give meds for a period of time, especially when I have active toddlers running around. If she needs a dose every 4 hrs and shes here 10hrs a day (typical if not more of this child) then I will have to "wrestle" with her at least 2 times a day (well, maybe "wrestle" with her once a day if shes napping for the other dose). Sure they are easy if nothing goes wrong. It's the day something goes wrong when it's not so easy after all.
Medication given by inhalation are VERY serious medications. The provider needs to understand the medication, the importance of properly adminstering them as ordered, the knowledge of when to administer the medication if there is a window of time and an "as needed" decision, AND the very serious side effects of each medication.
I don't feel comfortable doing them in my setting. If a provider feels they are easy peasy and doesn't have a lick of problems with them then the kids who need them need to go to that provider. That's not me
I don't have the luxury of not knowing the seriousness of these medications.I dont know all the details on it really as shes supposed to be on these treatments since last Friday but the mom hasnt brought in the machine to show me so Im also wondering if its really a big concern to her or if its a matter of the state paying her back as well. I know this, I wont write off on anything I dont do.
Homey dont play that.
momofboys 06:00 PM 02-01-2011
Originally Posted by nannyde:
Sure they are easy if nothing goes wrong. It's the day something goes wrong when it's not so easy after all.
Medication given by inhalation are VERY serious medications. The provider needs to understand the medication, the importance of properly adminstering them as ordered, the knowledge of when to administer the medication if there is a window of time and an "as needed" decision, AND the very serious side effects of each medication.
I don't feel comfortable doing them in my setting. If a provider feels they are easy peasy and doesn't have a lick of problems with them then the kids who need them need to go to that provider. That's not me I don't have the luxury of not knowing the seriousness of these medications.
I am fine with doing them for MY child who sometimes requires them . . for a daycare child I probably would not. In my thought if the child requires thAt much attention I really don't get paid enough to be dealing with it. I wouldn't. . . I was just trying to say that they were not difficultSure they are easy if nothing goes wrong. It's the day something goes wrong when it's not so easy after all.
Medication given by inhalation are VERY serious medications. The provider needs to understand the medication, the importance of properly adminstering them as ordered, the knowledge of when to administer the medication if there is a window of time and an "as needed" decision, AND the very serious side effects of each medication.
I don't feel comfortable doing them in my setting. If a provider feels they are easy peasy and doesn't have a lick of problems with them then the kids who need them need to go to that provider. That's not me
I don't have the luxury of not knowing the seriousness of these medications.
nannyde 01:41 PM 02-01-2011
I don't do discounts for four days a week. I do a minimum of three days a week and I charge 25 percent of my weekly fee per day. So if I charged 100 dollars a week it would be 25 dollars a day times four days would equal 100 dollars. If the child was here three days a week it would be 75 dollars.
My policy with nebulizers: We do not give nebulizer or breathing treatments. Please do not ask if we will do this. If your child requires treatments they can not attend the day care until their condition allows them to be in care without the need of the treatments. We also do not allow parents to give breathing treatments in our home. We will accept a child after receiving a treatment. Please let us know if you have given your child a nebulizer treatment before care.
I had a terrible time with the nebulizer treatments a few years ago. It was when they pulled all the kids cold medicine off of the shelves and stopped giving antibiotics for colds. The only thing "left" for the docs to prescribe is nebs so I ended up with a bunch of kids in my house who had them. They also give them 40-50 jets in each prescription so I had parents wanting to use them for colds months after they were originally seen.
They would be ordered every four to six hours and I would have parents coming in at eight in the morning telling me they had one at four a.m. so they needed one right away. They would all say the same thing: I couldn't give it any earlier... so he needs it now. If the kid was here nine hours I could end up doing as many as three a day per KID.
The day my staff assistant and I did TWENTY of them in one day I said ENOUGH. Because I'm a RN I had more liability with assessment and documentation then the average provider does. It was consuming so much of my time that I couldn't do it anymore. I started to charge a "medication administration fee" of twelve dollars per treatment. That stoped it cold. Eventually I morphed into a policy where I just don't do them. I had too many issues with parents not wanting to pay the fee and wanting to come here to do it so I had to put a stop to that.
The funny thing is now that I don't offer them ... I no longer have kids in my day care that "need" them during the day. I had too many issues of parents bringing sick kids in and calling it asthma or reactive airway disease. Once I put a stop to the free they keep their kids home when they have colds.
If you are going to do it CHARGE for it. Make it steep. If the child is special needs then you need to be funded for him as a special needs kid. Medication administration fee AND a daily fee for special care.
My policy with nebulizers: We do not give nebulizer or breathing treatments. Please do not ask if we will do this. If your child requires treatments they can not attend the day care until their condition allows them to be in care without the need of the treatments. We also do not allow parents to give breathing treatments in our home. We will accept a child after receiving a treatment. Please let us know if you have given your child a nebulizer treatment before care.
I had a terrible time with the nebulizer treatments a few years ago. It was when they pulled all the kids cold medicine off of the shelves and stopped giving antibiotics for colds. The only thing "left" for the docs to prescribe is nebs so I ended up with a bunch of kids in my house who had them. They also give them 40-50 jets in each prescription so I had parents wanting to use them for colds months after they were originally seen.
They would be ordered every four to six hours and I would have parents coming in at eight in the morning telling me they had one at four a.m. so they needed one right away. They would all say the same thing: I couldn't give it any earlier... so he needs it now. If the kid was here nine hours I could end up doing as many as three a day per KID.
The day my staff assistant and I did TWENTY of them in one day I said ENOUGH. Because I'm a RN I had more liability with assessment and documentation then the average provider does. It was consuming so much of my time that I couldn't do it anymore. I started to charge a "medication administration fee" of twelve dollars per treatment. That stoped it cold. Eventually I morphed into a policy where I just don't do them. I had too many issues with parents not wanting to pay the fee and wanting to come here to do it so I had to put a stop to that.
The funny thing is now that I don't offer them ... I no longer have kids in my day care that "need" them during the day. I had too many issues of parents bringing sick kids in and calling it asthma or reactive airway disease. Once I put a stop to the free they keep their kids home when they have colds.
If you are going to do it CHARGE for it. Make it steep. If the child is special needs then you need to be funded for him as a special needs kid. Medication administration fee AND a daily fee for special care.
lvt77 01:46 PM 02-01-2011
Please correct me if I am wrong...
I was told that the ADA would consider this discrimination and that you cant charge more for a child that has special needs?? Or is it that you cant tell them you won't allow them to attend? Lol I forget?
I was told that the ADA would consider this discrimination and that you cant charge more for a child that has special needs?? Or is it that you cant tell them you won't allow them to attend? Lol I forget?
Mrs.Ky 02:14 PM 02-01-2011
Originally Posted by lvt77:
Please correct me if I am wrong...
I was told that the ADA would consider this discrimination and that you cant charge more for a child that has special needs?? Or is it that you cant tell them you won't allow them to attend? Lol I forget?
You are very much correct ADA and section 504 is in place to protect children with disabilities such as mental and health. If she was to get rid of the child because the child needed extra treatment for a medical disability she could be in hot water BUT she has every right to use another reason such as parents paying late picking up late,etc. she also can not charge more because the child has a special medical need.Please correct me if I am wrong...
I was told that the ADA would consider this discrimination and that you cant charge more for a child that has special needs?? Or is it that you cant tell them you won't allow them to attend? Lol I forget?
Blackcat31 02:20 PM 02-01-2011
Abigail 02:37 PM 02-01-2011
I would call your licensing and ask what you need to do in order to administer a nebulizer treatment. (I had this as a child because I was born with asthma. Also had to take it during elementary school in the nurse's office too.) If it is considered medication, does your handbook have anything about you NOT giving any forms of medications? Mine does with a parent consent and they must fill out a form. If you don't though, I would ask if you are required to give the treatment when you call.
If you just had everyone turn in a new contract today, I wouldn't want to have them sign another one. Did you raise your rates too? If you are going to term down the road, I would wait a bit as you are advertising and let others know you might have a spot opening soon.
Then, term once you have documentation of one more late pickup or early drop off or late payment. You obviously have records of these from the past, if not, create them.
I wish you the best of luck. You should also ask the mom for the dr's name and number because you "have a few questions to ask him" that you will not share with the mom because.....you will call and mention you are the child's provider and want to know if they really get reimbursed for daycare costs and when or whatever other questions you may have.
Also, if you honestly feel you cannot provide the proper care this child now requires, that is okay to term with that being said and a two week notice. I read it somewhere and it is NOT discrimination. It's honesty and caring and if you're unable to provide the proper care for this child's newly aquired needs then it is best to let them know. You could even try it for a week or two and then decide.
If you just had everyone turn in a new contract today, I wouldn't want to have them sign another one. Did you raise your rates too? If you are going to term down the road, I would wait a bit as you are advertising and let others know you might have a spot opening soon.
Then, term once you have documentation of one more late pickup or early drop off or late payment. You obviously have records of these from the past, if not, create them.I wish you the best of luck. You should also ask the mom for the dr's name and number because you "have a few questions to ask him" that you will not share with the mom because.....you will call and mention you are the child's provider and want to know if they really get reimbursed for daycare costs and when or whatever other questions you may have.
Also, if you honestly feel you cannot provide the proper care this child now requires, that is okay to term with that being said and a two week notice. I read it somewhere and it is NOT discrimination. It's honesty and caring and if you're unable to provide the proper care for this child's newly aquired needs then it is best to let them know. You could even try it for a week or two and then decide.