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Daycare Center and Family Home Forum>Extra Charge For High Needs Child???
CheekyChick 06:15 AM 06-03-2012
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?
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snbauser 06:22 AM 06-03-2012
In the past I have been told that it is against the Americans with Disabilities Act to charge more for a child with special needs.
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Former Teacher 07:25 AM 06-03-2012
Originally Posted by snbauser:
In the past I have been told that it is against the Americans with Disabilities Act to charge more for a child with special needs.
I have heard this as well.

If my memory serves me right, once at my former center we had a family whose daughter was in a wheelchair. It would have required that we had to redo the WHOLE building to accommodate this family plus add ramps etc.

The director just told the family that we were full. Sad yes I know. But she didn't want to go through the hassle (and the expense!) for a family that may or may not stay.
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CheekyChick 07:30 AM 06-03-2012
Thank you for your input...

I have been googling whether or not it is legal to charge more at an at home daycare, which is completely different than a traditional preschool. We decide what we charge, so I assumed I could charge more for special needs children. Also, the Department of Human Services even pays more for special needs children, but it doesn't specify what is considered "special needs."
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Blackcat31 08:18 AM 06-03-2012
My state actually pays more for children with special needs. So I don't think it is against the ADA...or atleast some cases aren't.

I have received a higher rate reimbursement for children who have diabetes and for children with other issues that require more care then regular kids.

I don't have any idea what the rules are and had no idea I could charge a higher rate until my licensor told me I could and the state subsidy program sent me the paperwork saying how I should go about applying for the higher rate reimbursement.
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Willow 08:37 AM 06-03-2012
It wouldn't matter if it was legal or not, charging a sicker child's parents a higher rate wouldn't sit right with me.

It's not their fault she's sick, and the price their child pays in life enduring her illness is infinitely high enough.


I'm sorry but IMHO you need to suck it up. Some kids need almost no care at all, they are smart and play well, are well behaved, eat well, clean up after themselves...then there are those who need loads of extra supervision because they can't play independently, are into and onto everything, are picky or messy eaters and buck clean up every single time. There are also those with long hair that need tending to throughout the day. Those who wear glasses or hearing aids that need special attention. Those with eczema that need creams put on daily. Those with allergies who need medications administered and reactions monitored etc. etc. etc.

If you start nit picky charging for everything that adds a bit more to your plate you better start doing that for all AND be willing to discount the parents of the easy streeters to boot.




DHS in MN has instituted DOC rates for special needs kids in foster care. Is that what you're talking about? Children that become wards of the state are assessed, given a number and that number corresponds with a reimbursement rate beyond the regular daily rate. Sure, if I've got a drug addicted detoxing newborn who doesn't sleep but two hours a day, needs to eat a specially prepared formula every one to two hours, baths several times a day to keep their bottom clear of the feces that literally burn their skin, doctors appointments several times a week and specialists coming into my home almost daily then that child will have a higher DOC number and I'll be reimbursed for the "extra" care I need to provide.

Not that it's necessary, I certainly didn't need or expect to make more money off the backs of sicker kids as opposed to healthy ones.

I don't know how that would relate to daycare though. Unless perhaps that child's rates are paid via county assistance?


K-12 teachers don't make more for kids in their classes that are more "difficult" to teach or handle. I'm not sure why preschool teachers should be able to.




When you talk about "giving" a wage increase to the next teacher just because she was a bit more work for you....frankly, I'd sue if I was the girl's parents and I was ever presented such a notion.
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Blackcat31 08:50 AM 06-03-2012
Originally Posted by Willow:
It wouldn't matter if it was legal or not, charging a sicker child's parents a higher rate wouldn't sit right with me.

It's not their fault she's sick, and the price their child pays in life enduring her illness is infinitely high enough.
This has nothing to do with this thread really, but please don't say it like that.

My DH is a Type 1 insulin diabetic. He is NOT sick or ill. He does not have an illness that is going to go away some day like having strep throat or an ear infection.

I know that is really not what you meant and I respect the fact that you feel like a higher rate is unfair and such and I also admire the fact that you feel charging more is not morally or ethically right but saying diabetes is an illness or sickness just sits wrong with me.

My DH (and our whole family) have had to deal with biases and mis-information associated with having diabetes so I am aways quick to jump in to correct the wrong wording or wrong ideas about it...so forgive my haste, but I just get upset when people say illness or sickness...kwim?

I know it is just words...but he isn't sick and he isn't ill. He has a disease and one that he can and does live with to the best of his abilities but it isn't going to go away or get better.
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Former Teacher 09:00 AM 06-03-2012
Originally Posted by Willow:
It wouldn't matter if it was legal or not, charging a sicker child's parents a higher rate wouldn't sit right with me.

It's not their fault she's sick, and the price their child pays in life enduring her illness is infinitely high enough.

I'm sorry but IMHO you need to suck it up. Some kids need almost no care at all, they are smart and play well, are well behaved, eat well, clean up after themselves...then there are those who need loads of extra supervision because they can't play independently, are into and onto everything, are picky or messy eaters and buck clean up every single time. There are also those with long hair that need tending to throughout the day. Those who wear glasses or hearing aids that need special attention. Those with eczema that need creams put on daily. Those with allergies who need medications administered and reactions monitored etc. etc. etc.

If you start nit picky charging for everything that adds a bit more to your plate you better start doing that for all AND be willing to discount the parents of the easy streeters to boot.

DHS in MN has instituted DOC rates for special needs kids in foster care. Is that what you're talking about? Children that become wards of the state are assessed, given a number and that number corresponds with a reimbursement rate beyond the regular daily rate. Sure, if I've got a drug addicted detoxing newborn who doesn't sleep but two hours a day, needs to eat a specially prepared formula every one to two hours, baths several times a day to keep their bottom clear of the feces that literally burn their skin, doctors appointments several times a week and specialists coming into my home almost daily then that child will have a higher DOC number and I'll be reimbursed for the "extra" care I need to provide.

Not that it's necessary, I certainly didn't need or expect to make more money off the backs of sicker kids as opposed to healthy ones.

I don't know how that would relate to daycare though. Unless perhaps that child's rates are paid via county assistance?

K-12 teachers don't make more for kids in their classes that are more "difficult" to teach or handle. I'm not sure why preschool teachers should be able to.

When you talk about "giving" a wage increase to the next teacher just because she was a bit more work for you....frankly, I'd sue if I was the girl's parents and I was ever presented such a notion.
Not to hijack this thread by any means, but I am reminded of someone/something. This person will remain anonymous because she no longer posts. However she remains highly respected and well loved here.

If I am remembering and reading her posts right, this is EXACTLY how she does business. She charges the parents for every little thing that requires extra work for her and/or assistant. I don't remember all the little details however it does stick in my mind that she has made the comment, if the parents want special, they have to pay for it.

I do not blame the providers who want to charge extra. Nor do I blame them if they want complete control of the children they take care of. I do however blame the parents that allow such things like this to happen.

Ok off my soap box
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CheekyChick 10:49 AM 06-03-2012
Originally Posted by Willow:
It wouldn't matter if it was legal or not, charging a sicker child's parents a higher rate wouldn't sit right with me.

It's not their fault she's sick, and the price their child pays in life enduring her illness is infinitely high enough.


I'm sorry but IMHO you need to suck it up. Some kids need almost no care at all, they are smart and play well, are well behaved, eat well, clean up after themselves...then there are those who need loads of extra supervision because they can't play independently, are into and onto everything, are picky or messy eaters and buck clean up every single time. There are also those with long hair that need tending to throughout the day. Those who wear glasses or hearing aids that need special attention. Those with eczema that need creams put on daily. Those with allergies who need medications administered and reactions monitored etc. etc. etc.

If you start nit picky charging for everything that adds a bit more to your plate you better start doing that for all AND be willing to discount the parents of the easy streeters to boot.




DHS in MN has instituted DOC rates for special needs kids in foster care. Is that what you're talking about? Children that become wards of the state are assessed, given a number and that number corresponds with a reimbursement rate beyond the regular daily rate. Sure, if I've got a drug addicted detoxing newborn who doesn't sleep but two hours a day, needs to eat a specially prepared formula every one to two hours, baths several times a day to keep their bottom clear of the feces that literally burn their skin, doctors appointments several times a week and specialists coming into my home almost daily then that child will have a higher DOC number and I'll be reimbursed for the "extra" care I need to provide.

Not that it's necessary, I certainly didn't need or expect to make more money off the backs of sicker kids as opposed to healthy ones.

I don't know how that would relate to daycare though. Unless perhaps that child's rates are paid via county assistance?


K-12 teachers don't make more for kids in their classes that are more "difficult" to teach or handle. I'm not sure why preschool teachers should be able to.




When you talk about "giving" a wage increase to the next teacher just because she was a bit more work for you....frankly, I'd sue if I was the girl's parents and I was ever presented such a notion.

You don't know me or the way I run my business. I cater to and pamper each and every one of my families. I ALWAYS go the extra mile. I have watched children for free, I have given huge discounts when parents are going through tough times, I've never charged a late fee, and I will stay open for a parent who is running late with a smile on my face. I give gifts throughout the year to the children, their parents, and even a few grandparents. I hold baby showers for expectant mothers, I feed parents if they happen to be here during meal time, and I buy shoes, coats, and gloves for children that don't have them. Oh, and when this little girl was diagnosed, I spent hours upon hours of my OWN time meeting with her parents on Saturday(s) to learn to care for her.

Do NOT make me out to be a greedy, uncaring person. I am the furthest thing from that. I love this little girl, but she is the work of two children. She is moving to a different class and I feel it's fair to compensate her new teacher for the extra work she has in store - on top of her regular duties. Oh, and this family is doing well. One is a teacher and the other is a pharmacist. I do believe they can afford an extra 25 cents per hour.
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Unregistered 10:48 AM 06-05-2012
Originally Posted by Willow:
It wouldn't matter if it was legal or not, charging a sicker child's parents a higher rate wouldn't sit right with me.

It's not their fault she's sick, and the price their child pays in life enduring her illness is infinitely high enough.


I'm sorry but IMHO you need to suck it up. Some kids need almost no care at all, they are smart and play well, are well behaved, eat well, clean up after themselves...then there are those who need loads of extra supervision because they can't play independently, are into and onto everything, are picky or messy eaters and buck clean up every single time. There are also those with long hair that need tending to throughout the day. Those who wear glasses or hearing aids that need special attention. Those with eczema that need creams put on daily. Those with allergies who need medications administered and reactions monitored etc. etc. etc.

If you start nit picky charging for everything that adds a bit more to your plate you better start doing that for all AND be willing to discount the parents of the easy streeters to boot.




DHS in MN has instituted DOC rates for special needs kids in foster care. Is that what you're talking about? Children that become wards of the state are assessed, given a number and that number corresponds with a reimbursement rate beyond the regular daily rate. Sure, if I've got a drug addicted detoxing newborn who doesn't sleep but two hours a day, needs to eat a specially prepared formula every one to two hours, baths several times a day to keep their bottom clear of the feces that literally burn their skin, doctors appointments several times a week and specialists coming into my home almost daily then that child will have a higher DOC number and I'll be reimbursed for the "extra" care I need to provide.

Not that it's necessary, I certainly didn't need or expect to make more money off the backs of sicker kids as opposed to healthy ones.

I don't know how that would relate to daycare though. Unless perhaps that child's rates are paid via county assistance?


K-12 teachers don't make more for kids in their classes that are more "difficult" to teach or handle. I'm not sure why preschool teachers should be able to.




When you talk about "giving" a wage increase to the next teacher just because she was a bit more work for you....frankly, I'd sue if I was the girl's parents and I was ever presented such a notion.
AMEN I completely agree with you and glad there are daycare providers like you. As a parent of a special needs child I would NOT be happy to find out I had to pay a higher rate because my child was more work.
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Blackcat31 04:59 PM 06-03-2012
Originally Posted by CheekyChick:
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!

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
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sharlan 05:17 PM 06-03-2012
OT - but in CA, we cannot administer insulin. We may monitor blood only.
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Blackcat31 06:09 PM 06-03-2012
Originally Posted by sharlan:
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/...nistration.pdf
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CheekyChick 07:00 PM 06-03-2012
Originally Posted by Blackcat31:
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.
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texascare 05:57 AM 06-04-2012
wow. My son is type 1 Diabetic and I am just floored...........
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Heidi 05:34 PM 06-03-2012
Originally Posted by Blackcat31:
Yah!

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!
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CheekyChick 06:38 PM 06-03-2012
Originally Posted by Blackcat31:
Yah!

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.
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MN Day Mom 09:03 AM 06-04-2012
Originally Posted by CheekyChick:
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.
Here is what I found....http://www.mnchildcare.org/issues/ada.php
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Blackcat31 09:11 AM 06-04-2012
Originally Posted by MN Day Mom:
Here is what I found....http://www.mnchildcare.org/issues/ada.php
Since diabetes can be either Type 1 or Type II, there are certain requirments that each provider must follow in each state and EVERY single state differs in those rules and regulations.

As Sharlan mentioned, California does NOT allow child care providers to administer insulin or glucagon injections where as Minnesota does allow it.

I also think that having diabetes, as ohters have stated, doesn't automatically mean someone is disabled therefore, not always having to follow the rules and guidelines of the ADA.

I know from experience that having Type I diabetes is a whole different ballgame than having Type II. Each requires a completely different type of care. Then if you add having an automated pump, the rules again would be different. So I would automatically assume that different rules/regulations would apply in almost every situation.
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Kelly 09:13 AM 06-04-2012
How much time does it take to deal with this child's diabetes? My son has Type 1 diabetes and I have never found it to take an excessive amount of my time.
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texascare 09:48 AM 06-04-2012
Originally Posted by Kelly:
How much time does it take to deal with this child's diabetes? My son has Type 1 diabetes and I have never found it to take an excessive amount of my time.
It isn't that difficult. Did the OP know this child had Diabetes before accepting them into care? I lost the name of the OP in all the posts....sorry.
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Tags:ada, ada laws, diabetes in child care, diabetes-daycare, idea, insulin, section 504, special needs
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